March 6, 2024 – It turns out there may be something to the “weekend warrior” mentality after all. 

A recent study suggested that concentrating all your exercise into just 1 or 2 days could work as well for fat loss as spreading it throughout the week. 

The research builds on growing evidence that the weekend warrior exercise pattern can aid your health. A 2023 study of nearly 90,000 people found that weekend warriors were less likely to have a heart attack, stroke, or heart failure than inactive people. Another study of nearly 351,000 adults found no difference in risk of early death between weekend warriors and those who exercised three or more times a week. 

The new study was the first to examine the weekend warrior pattern and body fat, which was measured using dual-energy X-ray absorptiometry (DXA scan). 

“In [our] fast-paced society, we are interested in exploring alternatives to stay fit for individuals who cannot meet the recommended frequency,” said study author Lihua Zhang, MD, PhD, a health care scientist at Fuwai Hospital’s National Center for Cardiovascular Diseases in Beijing.

In general, public health guidelines advise at least 300 minutes of moderate to vigorous exercise a week for weight loss. Even then, results may not be dramatic: A 2022 analysis of 25 trials concluded that at least 3 months of regular aerobic exercise resulted in “modest” waist size reductions of a little more than 1 inch in adults who were overweight or obese. 

The weekend warriors in the recent study did indeed work out harder and longer than those exercising throughout the week. In fact, they worked out for 147.6 minutes, on average, per session – well over 2 hours at a time. 

That part is key. In this and other studies, weekend warriors are, by definition, meeting or exceeding recommended exercise levels. They just happen to do it over fewer days.

“We don’t know that it’s the weekend pattern per se that is responsible for the findings rather than simply comparing 150 minutes accumulated in two versus three or more bouts of exercise with the same weekly total,” said Peter Hall, PhD, a professor of public health at the University of Waterloo, Ontario. 

The weekend warriors “may have been healthier than the traditional exercise group and the control group to start,” said Kimberley Dawson, PhD, a professor of sport and exercise psychology at Wilfrid Laurier University in Waterloo, Ontario. “Therefore, they didn’t need as much activity to make a difference.”

Still, the study authors suggest there could be more to it than that, saying that long weekend workouts may affect the body differently than more traditional exercise patterns. Previous studies have shown that short-term exercise may increase blood levels of stress hormones called catecholamines and boost blood flow through fat tissue, which could help the body burn more fat. 

But not everyone agrees. “It’s not the movement that will improve our health but rather the sedentariness that will decrease it,” Dawson said. “Sitting for five days and moving for two does not adequately decrease the lack of movement to gain physiological effects of movement.” 

At the same time, exercising less often might increase the risk of injury, Zhang warned. A 2014 study found that out of 351 adults who had a severe injury, 55% got hurt on the weekend, while 45% were injured between Monday and Friday. The authors suggested lack of experience and low fitness could be to blame, or it could be that more people take part in riskier sports on days they don’t have work. 

“I would rather see individuals move as much as they can during the week and enjoy longer durations of exercise on weekends when their schedules permit it,” Dawson said. “From a behavior modification perspective, this approach will lead to sustained activity change.”

And regardless of when you choose to exercise, it may be wise to measure your expectations about weight. People tend to become discouraged when their true weight loss falls short of their hopes. Instead, focus on improving your quality of life and the health benefits – you’ll get those and a more capable body even if the scale doesn’t budge.

March 5, 2024 — There’s a widespread – and long-held — belief that swallowing a low-dose aspirin pill every day can help protect you from heart attacks and strokes. 

Almost 30 million Americans take aspirin to prevent a first cardiovascular event (“primary prevention”), and nearly 40% of those over 50, around 49 million people, are taking aspirin either for primary prevention or for secondary prevention after they’ve had a stroke or a heart attack.

However, experts have begun to question aspirin’s effectiveness, prompting health care professionals to reevaluate the role of aspirin in primary prevention. 

In 2019,  the American College of Cardiology/American Heart Association primary prevention guideline, the most recent one available, said aspirin “should be used infrequently” in the routine primary prevention of a type of cardiovascular disease because of lack of net benefit.” 

This recommendation was made after weighing the benefit of aspirin use in primary prevention against the risk of bleeding in the brain and the digestive tract. The results of three major clinical trials published in 2018 had a major influence on the guideline, said cardiologist John W. McEvoy, MBBCh, one of the guideline’s co-authors and a professor of preventive cardiology at the National University of Ireland in Galway.

Explaining its advice for older people, the the task force said the aspirin-related risk of gastrointestinal or brain bleeding, and stroke increases with age.

Not many studies have been done on the risk-benefit question of aspirin use in older adults. But a secondary analysis of data from one of the 2018 studies that were crucial in the American College of Cardiology/American Heart Association guideline indicates that the risk of brain bleeding is significant in people over 70, while there is no benefit of aspirin for primary prevention of stroke in this population.

All of the 19,114 participants in the study, conducted in Australia and the U.S., were healthy people with a median age of 74. Half of them got aspirin, and the other half got a placebo. 

Aspirin didn’t produce a statistically significant reduction in the rate of ischemic stroke (the most common kind). But there was a significant increase in bleeding in the brain among those taking aspirin compared to those getting the placebo. 

However, she advises people to control their risk factors before starting to take aspirin, she added. She recommends that they reduce their blood pressure and cholesterol, exercise regularly, and improve their diet, among other things. 

If they have no risk factors for cardiovascular disease, she won’t put them on aspirin. If they’re over 70, have significant risk factors, and have been taking aspirin for some time with no problems, she recommends that they continue taking it. But she keeps a close eye on these patients, making sure they’re not at risk for falls, for example.

McEvoy, likewise, tries to get patients’ risk factors under control before discussing aspirin with them. If their risk of CVD is low, he’ll tell them they don’t need aspirin. With people over 70, he highlights the risks of aspirin to a greater extent.

Discontinuing Aspirin May Pose Risks

Should older people who have been on aspirin for years continue taking it for primary prevention? That’s a surprisingly difficult question to answer. 

“I say, ‘There’s mixed evidence. As you get older, the risk of bleeding will become higher, but we also know that aspirin can reduce nonfatal cardiovascular disease,’” he said.

Some patients feel strongly about their risk of heart disease or stroke to the point they worry about that over the bleeding risk. “In those patients, I don’t necessarily stop aspirin,” McEvoy said. “But I do weigh the risk factors, and if they have other risk factors, I tell them that aspirin may not be necessary.”

March 5, 2024 — Thunderstorm asthma can strike with little warning, leaving people with the symptoms of an asthma attack during or after the dark clouds pass. 

If you’re unfamiliar, the risk for a thunderstorm asthma attack grows when heavy storms arrive on a day with very high pollen or spores. The storm uplifts these particles, adds water, and causes them to explode into smaller grains. The electrical activity in a storm can do the same. Next, strong winds sweep these particles down and across the ground. People in the path of the storm can experience shortness of breath, coughing, and wheezing.

If thunderstorms are predicted to become more frequent and more severe with climate change, will the same hold true for thunderstorm asthma?   

“Yes, if only because the amount of pollen appears to be increasing in many areas due to climate change,” said Frank S. Virant, MD, chief of the Allergy Division at Seattle Children’s Hospital.

Most cases of thunderstorm asthma occur in the spring and early summer, but that also could change. Pollen seasons “have been getting longer and more intense,” said Shaan M. Waqar, MD, an allergist at ENT and Allergy Associates in Plainview, NY. 

Continue controller therapies — such as longer-acting inhalers and allergy medications — and use a rescue inhaler or nebulizer for prompt treatment of symptoms, recommended Donald J. Dvorin, MD, of The Allergy and Asthma Doctors in Mount Laurel, NJ. Ideally, people seeking shelter indoors during storms should be “accompanied by friends or family who can help them transport quickly to a hospital if needed.”

This event spurred a “thunderstorm asthma epidemic of unprecedented magnitude, tempo, and geographical range and severity,” Beggs and colleagues wrote in their June 2018 report in The Lancet Planetary Health. 

Large-scale events like this can affect entire communities and quickly overwhelm local health care resources. Within 30 hours of the Melbourne storms, 3,365 people more than usual came to local emergency departments with respiratory issues — and 476 with asthma were admitted to the hospital. Ten people died: five in the hospital and five who could not be resuscitated or died while waiting for emergency services.

More research is needed “so as to best prepare for this unpredictable, significant public health threat,” Kevat wrote.

People whose asthma is triggered by pollen or mold spores are particularly at risk for thunderstorm asthma, Waqar said. If you’re unsure, an allergist can help diagnose and treat your allergic risks.

More severe thunderstorms are just one asthma trigger associated with climate change. Last summer, Canadian wildfires sent smoke across the northern U.S. and triggered widespread asthma exacerbations. See the WebMD slideshow to learn more about how rain, humidity, and seasonal weather changes can also present asthma challenges.