Thursday, September 18, 2014

Stay Tuned!

Just a quick note to let you know that I am in transition ~ enthusiastically beginning a post doc fellowship where I will learn to robustly study the effects of US public health laws.

I will return to semi-regular blogging as soon as possible, but this weekend I leave for Philly and once there will need a little acclimation time.

Please continue to promote your health by staying active and eating nutritiously within your caloric limits.

Saturday, September 6, 2014

Should smokers exercise?

   Smoking is an independent cause of heart disease.  One possible link between smoking and heart disease is that smokers’ arteries tend to be stiffer than the arteries of non-smokers, even when controlling for other factors that might lead to this condition, e.g., having a family hx of heart disease.  Physical activity is also independently related to heart disease - being active reduces the risk and sitting around increases it - to be clear - sitting around for extended periods of time (independent of how active you are otherwise) is associated with the risk of heart disease.
   New research from a small study of young men1 suggests that smokers who engage in regular physical activity have less stiffness of large arteries than smokers who do not engage in regular physical activity.  However, the stiffness in active smokers was worse than that of active non-smokers, and clearly the best option is not to smoke.
   When I read the study conclusion, I wondered how they measured smoking?  For instance, did they say, ‘in the last month have you had at least one cigarette’ and then put all the yes's in the smoking group and the no's in the nonsmoking group?  If that were the case, I would discount the validity of the conclusion because a person who is physically active and otherwise healthy, might by chance, have had one cigarette in the last month, whereas a physically inactive smoker might have smoked 2 packs a day. That was not the case; the researchers categorized smokers as those who had at least 8 to 10 cigarettes every day during the past two years.  
   Unfortunately, there were other limitations of the study which give me pause, though they do not diminish my faith in the benefits of exercise.  In this small study, the inactive smokers were different in other ways that could lead to heart disease, i.e., they were older, had higher % body fat and smoked more cigarettes per day than the active smokers.  In addition, the average age of the participants in the study was 22 and artery stiffness and other markers of heart disease usually occur later - even those associated with smoking.
   Still: Physical Activity is the sine qua non of health and experts recommend it for EVERYONE.  Smoking is the sine qua non of disease and experts recommend it for NO ONE.  I pride myself in being pro exercise and anti-smoking; but I am not anti-smoker and so I got my dander up when I read the following facebook post of one of my acquaintances.  

Just saw the most bizarre thing ever. Two older ladies walking through (x) Park at a decent pace (clearly here for exercise) then one of them lights up a cigarette and they keep on walking. Why bother exercising?!? At least she can enjoy her death stick in some pretty scenery I guess
   First,  I one hundred percent agree that the park should be tobacco free and I would be furious and loud mouthed about someone smoking near me as I walked, ran or cycled, but that is not what this facebooker was venting.
   The person who started the post, and most of the people who commented on it, wanted to know why the smoker was bothering to exercise - the people speaking on the thread were clearly anti-smoker - if we followed their line of reasoning that a smoker shouldn’t bother to exercise (because they were killing themselves with the cigarettes), then smokers should also stop wearing seat belts or looking both ways when crossing the street.  Ridiculous, judgmental, nonfactual discourse.
   For goodness sakes - EVERYONE should exercise and not all smokers die from smoking related diseases…. maybe because they are otherwise healthy or genetically protected – still, it is not smart to smoke, but it is even less smart to do all the other reckless things on top of it.

Now, put those cigarettes down and go take a walk.