Exercise May Reduce Cardiovascular Disease Risk Twice as Much for Women Compared to Men

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Exercise offers significant advantages for all, yet women might reap even greater rewards, suggests recent research.

Numerous research indicates that physical activity lowers the risk of early mortality, but findings from a study released on Monday in the Journal of the American College of Cardiology reveal that women require less exercise than men to achieve comparable benefits, according to Dr. Susan Cheng, lead researcher and director of the Institute for Research on Healthy Aging at the Smidt Heart Institute at Cedars-Sinai.

“In other words, women tend to benefit more from the same amount of exercise effort as compared to men,” explained Cheng, who also holds a professorship in cardiology at Cedars-Sinai.

Cheng highlighted that the majority of adults fail to meet the advised exercise quotas. The Physical Activity Guidelines for Americans recommend 150 minutes of moderate-intensity physical activity and two days of muscle-strengthening activities weekly.

The study analyzed responses from over 400,000 U.S. adults aged 27 to 61, who reported their exercise habits in a survey conducted by the National Center for Health Statistics every few years from 1997 to 2019. Using the National Death Index records for the two years following the survey period, researchers tracked mortality rates from all causes, with a particular focus on cardiovascular diseases.

During the survey period, nearly 40,000 participants passed away, with 11,670 of those deaths attributed to cardiovascular issues, according to the study.

During the study period, women engaging in at least 150 minutes of exercise weekly had a 24% lower risk of mortality from any cause compared to those who exercised less. For men, exercising a minimum of 150 minutes weekly was associated with a 15% reduction in mortality risk compared to those not meeting this exercise benchmark, according to the findings.

Additionally, women exercising regularly were 36% less likely to experience a heart attack, stroke, or another cardiovascular event, in contrast to a 14% reduction in risk for men who exercised.

While men required up to 300 minutes of moderate to vigorous physical activity weekly to achieve the most significant decrease in death risk, women attained the same level of benefit with just 140 minutes of exercise weekly. Moreover, as women increased their physical activity up to 300 minutes weekly, their risk continued to decline, the study indicated.

The study in question was observational, indicating that while there’s a clear link between exercise and a reduced risk of death, it cannot definitively prove causation. Nonetheless, the research did encompass a range of physical activities, including both aerobic and muscle-strengthening exercises at various intensities, noted Cheng.

Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, affirmed the study’s reliability and its contribution to the growing evidence of the differential impacts of exercise on men and women. He emphasized the critical role of regular physical activity in promoting health and well-being.

Freeman, who was not involved in the study, pointed out that physical activity is an underutilized treatment option that too few physicians emphasize. He likened the benefits of exercise to a hypothetical medication that could prevent heart disease, heart attacks, cancer, and cognitive decline while also enhancing mood, suggesting that if such a medicine were available in pill form, it would be highly sought after. Yet, this “medicine” is available through the effort of exercise.

Addressing the question of why exercise yields different benefits for men and women, Cheng suggested that it might be related to the lower frequency and intensity of exercise typically observed among women, implying they may achieve more significant benefits from the exercise they do engage in. She also highlighted the influence of social and societal norms that have historically promoted physical activity more among males than females from an early age, a trend that persists despite some shifts in how sports and physical activities are organized for children and adults.

Freeman highlighted the role of physiological differences in the disparate health outcomes observed between men and women following exercise regimes. Research has consistently shown that women often experience quicker and more substantial improvements in muscular strength from exercise compared to men.

“This indicates that women’s bodies are not merely smaller versions of men’s but possess distinct physiological traits. These differences are underscored by muscle studies and the findings of this research,” Freeman explained. He stressed the importance of customizing treatments, therapeutics, and health discussions to the specific characteristics of individuals, taking into account gender, body size, ethnicity, and other factors.

Freeman pointed out the growing significance of personalized medicine, which tailors healthcare to individual characteristics, including gender. This approach is becoming increasingly important and relevant in medical practice.

However, Freeman also acknowledged the challenges in pinpointing the precise reasons behind the observed differences in exercise benefits between men and women. “It’s difficult to fully unravel the specific mechanisms at play, but the outcomes speak for themselves. If it’s evident that women gain more from exercise, we should accept this reality. The underlying reasons may well be the subject of future research,” he added, underscoring the complexity and ongoing nature of understanding gender differences in health and fitness.

“Eat plants, exercise, stress less, love more, and sleep,” encapsulates a holistic approach to well-being, highlighting the simplicity yet significance of each element in maintaining health. Cheng underscores the paradox that, despite exercise being freely available, it demands effort, which can be a barrier for some.

However, she offers encouraging insight that any level of physical activity is beneficial, challenging the misconception that exercise must be extensive and regular to be effective. “The beauty lies in the flexibility of exercise; even minimal amounts can yield substantial health benefits,” Cheng elaborates. This perspective shifts the narrative from an all-or-nothing approach to one that embraces any form of exercise, emphasizing its value regardless of the quantity. Cheng’s comments invite a more inclusive view of physical activity, encouraging individuals to find and engage in whatever form of exercise suits their lifestyle and capabilities.

For those either beginning their fitness journey or seeking to enhance their current regimen, Freeman advises aiming for at least 30 minutes per day of vigorous, breathless activity, of course, after obtaining approval from a healthcare provider.

To ensure the longevity of this habit, CNN fitness contributor Melanie Radzicki McManus recommends selecting an enjoyable activity, incorporating it into your daily routine, and gradually increasing intensity and duration.

Moreover, Freeman emphasizes the broader scope of health optimization, which goes beyond exercise. He routinely discusses with everyone the foundational aspects of lifestyle medicine, which include plant-based eating, increased physical activity, reduced stress, fostering loving relationships, and ensuring adequate sleep. These pillars are integral to improving overall health and well-being, underscoring the multifaceted approach required for a healthy lifestyle.

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Jose Rossello, MD, PhD, MHCM
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