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How You Sit and Rise Predicts Longevity

How You Sit and Rise Predicts Longevity

Medscape2 days ago

You might want to sit down for this — then stand up as smoothly as you can.
The ease with which a person can sit on the floor and rise to their feet, using as little support as possible, may help predict how long they will live.
Adults who aced the so-called sitting-rising test were far less likely to die of natural or cardiovascular causes over about 12 years of follow-up than those who scored the lowest, according to a study published online on June 18 in the European Journal of Preventive Cardiology .
The study added to the body of evidence showing that various measures of physical function beyond aerobic fitness, including flexibility, the ability to stand on one leg, and grip strength, can predict longevity.
The sitting-rising test measures several key components of non-aerobic fitness at once, including muscle strength or power, flexibility, balance, and body composition, without the use of any equipment, according to the researchers.
The study by Claudio Gil S. Araújo, MD, PhD, dean of research and education at Clinimex, an exercise medicine clinic in Rio de Janeiro, Brazil, and colleagues expands on a 2012 study that found scores on the test were associated with all-cause mortality.
10 Points Possible
To get a perfect score on the sitting-rising test, you must complete the tasks without using your hands, forearms, knees, or the side of your legs for support, and you must remain steady.
If you start to lose your balance or, say, need to kneel or put a hand down to support yourself, you start to lose points from a perfect 10 (5 points possible for sitting and 5 for standing).
If you cannot complete the tasks without external help such as a table, wall, or another person, you score a 0. (This video illustrates the test and scoring.)
The investigators analyzed data of 4282 individuals (age, 46-75 years; 68% men) who completed the sitting-rising test as part of a voluntary fitness evaluation between 1998 and 2023. None had physical or clinical limitations that restricted their participation in the fitness tests.
During a median follow-up of 12 years, 665 participants died of natural causes (15.5%). Among those who scored a 10 on the sitting-rising test, 3.7% died. Of those who scored an 8 on the test, 11.1% died. Among participants with the lowest scores (0-4) on the sitting-rising test, 42.1% died.
In an analysis that adjusted for age, sex, BMI, and clinical variables, the researchers found people who scored the lowest were 3.8 times more likely to die of natural causes and six times more likely to die of cardiovascular causes than those with the highest score.
Key questions remain, the authors acknowledged: What 'exercise prescription' would best improve or maintain sitting-rising test scores? Would improving the scores prolong survival? And how do predictions based on this non-aerobic fitness measure compare with those based on aerobic fitness tests?
More Than Swimming
Clinicians and researchers are increasingly recognizing the role that non-aerobic fitness plays in health, said Daniel Forman, MD, with the University of Pittsburgh and the Veterans Affairs Pittsburgh Healthcare System, both in Pittsburgh. A recent statement on the core components of cardiac rehabilitation programs, which Forman co-authored, highlights the importance of strength training and physical activity, in addition to aerobic exercise, which had historically been the focus.
'It's not enough to think that 'I have to go swimming several times a week,'' Forman said. 'We are talking now about adding in strength training at least twice a week. And it is just as essential if not more so to prevent decline.'
Rising from a seated position is a dynamic exercise that incorporates strength and balance, and difficulty performing this action can reveal impairment, Forman said.
While many clinics in the US would not necessarily be set up to conduct the sitting-rising test, it is inexpensive and yields important information, Forman said. The underlying principle may be more important than the exact technique used to test and score physical abilities, he said.

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CNN: Pressing question: Can we count the calcium from milk in coffee? Nitzkorski: Yes! In the book, Jocelyn and I share that we both nail our calcium targets by drinking a lot of milk with a little bit of coffee. It's true that consuming more than 300 milligrams per day of caffeine lowers your body's calcium absorption — but that's a high bar when you consider an 8-ounce cup of coffee contains around 100 milligrams and a double shot of espresso contains about 140 milligrams. Wittstein: Milk, whether it's from cows or a plant-based type that's been supplemented, is a good source of vitamin D, too. We know that consuming 2,000 IU of vitamin D a day can benefit bone health and may help decrease joint pain. When it comes to coffee, people are often glad to learn that it is rich in anti-inflammatory antioxidants. It contains the polyphenol quercetin, which may help alleviate pain and has anti-inflammatory properties. I like to add cinnamon to my coffee for added anti-inflammatory effect and glucose control. You can also add whey protein — which provides amino acids that your body uses to build muscle — and/or collagen supplements, which can improve both bone density and joint pain, depending on the type. CNN: What's the connection between inflammation and joint health? Wittstein: Inflammation can break down cartilage and contribute to joint pain. Chronic inflammation accelerates joint deterioration. Anti-inflammatory nutrition taken in through diet and supplements like omega-3 fatty acids and curcumin, for example, can help ease symptoms like pain and swelling. CNN: What does an anti-inflammatory diet look like? Nitzkorski: What I love about recommending anti-inflammatory foods is that they provide so many other benefits, too, such as decreasing heart attack risk, increasing longevity, improving digestion and giving you more energy. An anti-inflammatory diet is rich in lean proteins, which could be animal-based — such as non- or low-fat dairy, eggs, fish, chicken or turkey — or plant-based like beans, lentils and soy as well as pea proteins, which are found in a lot of protein powders. An anti-inflammatory diet also includes healthy fats, such as olive oil and foods containing omega-3 fatty acids like fish as well as walnuts and flax, chia and basil seeds. Alliums — including garlic, onion, leeks and shallots — are flavorful plants that have multiple anti-inflammatory properties. And there's a whole spectrum of spices including turmeric, cayenne, black pepper and ginger. Wittstein: Also important is dietary fiber from fruits, vegetables, beans and whole grains that provides short-chain fatty acids, higher levels of which are associated with lower levels of inflammation. Fruits and vegetables also contain myriad anti-inflammatory phytochemicals — naturally occurring compounds that provide an array of health benefits. Avoiding or limiting inflammatory ingredients like processed meats, red meat, fried foods, saturated fats and processed carbohydrates is also important. CNN: What types of exercise promote bone and joint health? Wittstein: It's critical to incorporate resistance training and impact exercises. The goal is to work into your 150 minutes of weekly activity a combination of the following: three days of weight-bearing aerobic exercise, two days of resistance training, and two days of balance work and light-impact exercises. That might sound like a lot, but these don't have to be long, intense sessions, and several of these types of conditioning can be combined. Standing on one leg and doing an overhead press counts as resistance training as well as balance work, for example. There are multiple things we want you to do to stimulate your bones and your muscles in different ways, but some of these activities can count as two. Nitzkorski: You can also integrate little exercises into your daily life. Just as we lose muscle and bone mass with age, we also lose our ability to balance. Practice intentionally throwing yourself off balance a little bit so your body must work to find its equilibrium again. Stand on one foot while brushing your teeth. Instead of sitting while watching TV, stand on one leg. Pretend a paintbrush is strapped to your toe and try to write your name or the alphabet. Write A through M on your right leg, and then switch and do N through Z on your left. To work on muscular endurance, do little arm circles. These start out super easy, but if you do them for two or three minutes it becomes exhausting. CNN: What do you mean by light-impact exercises? Wittstein: These include small jumps, jumping jacks or jumping rope. Studies show that doing 10 to 50 jumps three times a week is enough to stimulate your bone density. I encourage people to weave them into their day. By doing a little bit of hopping while you're waiting for the bus, you're getting your heart rate up and getting in some light-impact conditioning. CNN: Do you recommend jumping if it causes knee pain? Nitzkorski: No, people should listen to their joint pain! If jumping hurts your knees, focus on other kinds of conditioning like shallow squats, for example. You can also spread out your jumps over the course of the day or a week so you are not doing too many in a row. Or you can modify jumping exercises by using the back of a chair, or something else, for balance. Wittstein: Or try modifications like pool jumping, which adds resistance and partly reduces impact. Water-based exercises are not as effective as land-based jumping exercises, but they are definitely beneficial for bone mineral density. Although the gains from some of these exercise-based interventions may seem small, they actually translate to big risk reductions. We know from studies of pharmaceutical interventions that a 2% increase in lumbar-spine-bone density reduces spine fracture risk by 28%. A 4% improvement in hip-bone density decreases hip fracture risk by 32%. So even small improvements matter significantly. CNN: Is it ever too late to start boosting your bone and joint health? Nitzkorski: Absolutely not. While it's ideal to start early, you can always benefit from improving your diet and exercise routine. Start small — even 10 minutes of activity is better than nothing. Over time, small dietary changes can become a habit that sticks. The goal is consistency and gradual improvement so you can enjoy the life you live for that much longer. Editor's note: Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts. Jessica DuLong is a Brooklyn, New York-based journalist, book collaborator, writing coach and the author of 'Saved at the Seawall: Stories From the September 11 Boat Lift' and 'My River Chronicles: Rediscovering the Work That Built America.'

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