Saturday, 1st June 2024

Bits and pieces

I may seem to believe that exercise is the answer to all the world’s medical problems and then some. This is nearly true but even so I am often surprised by finding research that identifies new benefits from physical activity.

Here a few of those which I have recently encountered:

Inflammatory Bowel Disease (IFD)

This group of chronic diseases are associated with inflammation of the bowel. Symptoms usually include persistent diarrhoea, often bloody, and abdominal pain. The commoner forms include Crohn’s Disease (CD) and Ulcerative Colitis (UC).

A recently published systematic review and meta-analysis of previous studies involved 1,963 CD patients, 3,488 UC patients and 867,380 subjects without IFD – ie big numbers. Those with high levels of physical activity had between 22% and 38% lower risk of developing CD and 13% lower risk of developing UC.

Not startling results but it does seem that those at high risk of developing CD may be protected a bit by upping their exercise levels. The main risk factors for CD include cigarette smoking and having a close relative with the disease.

Type 1 Diabetes (T1DM)

The value of exercise in the prevention and treatment of Type 2 Diabetes (T2DM) is very well known, firmly established – and I have written heaps about it.

T1DM is very different. It begins much earlier in life, affecting children and young adults who have lost the ability to produce insulin  and need insulin injections for their continued survival. A few months after insulin therapy has started, most patients experience a partial remission phase which usually lasts no more that a few months. During this period, there is a recovery of insulin production and a reduction in need for treatment. A study of T1DM patients looked at the association between levels of physical fitness and the presence and duration of partial remission. The findings were that the higher the level of physical fitness as assessed by VO2max (the best measure of physical fitness) the better the chance of partial clinical remission and the longer the duration of the remission.

There is no long term benefit from this change, but the finding does add to the sum of knowledge of this condition and may eventually lead to effective prevention.

Down Syndrome

This is a relatively common genetic abnormality caused by one extra chromosome, chromosome 21. It occurs in about one per 800 of the population. The characteristics include some typical facial features (flattening of the cheeks with almond shaped eyes), shorter than average height, poor muscle tone and delays in learning to speak and intellectual impairment. Congenital heart disease and poor hearing are also common features.

Compared to the general population, adults with Down Syndrome are less physically active, with reduced levels of physical fitness and muscular weakness. They are prone to becoming overweight or obese. In the longer term they are also prone to premature frailty and early death.

A recently published study looked at the effects of physical training for this group. It identified a number of benefits such as improved aerobic fitness, strength, balance, body composition, flexibility and functional capacity. The authors of concluded that physical training should be encouraged for all adults with Down Syndrome with a view to improving functionality and quality of life.

Autism spectrum disorder

Over the past two decades there has been a huge increase in young adults being diagnosed as being “on the spectrum”. What might be the benefits of physical training for this growing group? A recent review concluded that  their physical performance was particularly improved by aerobic and resistance training, as well as programmes focussed on movement skill and sport-specific exercise. There is no evidence yet to suggest that exercise improves core autism symptoms but the gains in quality of life must be desirable.


Another recent study examined the association between physical activity and sleep patterns. 4,339 adults aged 39-67 years reported on their physical activity and sleep habits. 37% were persistently inactive and just 25% persistently active. Compared with the inactive, the active participants had 60% the chance of having difficulty in “dropping off”, 71% the chance of sleeping for less than 6 hours and 53% the chance of sleeping for excessive time of more than 9 hours compared with the inactive. Problem insomnia was 22% less likely in the more active.

This is not rocket science. Most of us would recognise that we sleep better when we are physical tired – but is it good to have this confirmed for usual activity levels.


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