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Fitness: Has high-intensity interval training been oversold?

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High-intensity interval training (HIIT) took the No. 1 spot on the American College of Sports Medicine’s annual Worldwide Survey of Fitness Trends for the first time in 2014 and has stayed in the top 10 ever since. It’s the darling of the fitness world, and there seems to be little that HIIT can’t do.

Characterized by short bursts of high-intensity exercise (anywhere from one to four minutes) followed by short periods of rest, HIIT’s popularity largely lies in its capacity to offer big results in little time. Health and fitness benefits have proved to be similar to or better than those from moderate-intensity workouts that take twice as long.
It’s not just the gym crowd that’s been crowing about HIIT. The research community has been bringing the young, old, fit, unfit and everyone in between into the lab to see whether HIIT’s magic is universal. By and large, it is. Most of the populations studied have benefited from meaningful gains in health and fitness. But what’s still up for debate is whether exercisers find high-energy workouts more enjoyable than moderate-intensity, steady-state exercise.
Panteleimon Ekkekakis, professor and chair in the department of kinesiology at Michigan State University, has spent most of his career studying how different intensities of exercise make people feel. He’s been following the HIIT trend since news of its benefits started circulating among exercise physiologists back in the early 2000s.

“HIIT started to gain traction at an astonishing rate and became this major global phenomenon,” said Ekkekakis, who claims there are roughly 700 published studies a year on HIIT.

In the early days, HIIT was considered more appropriate for athletes and the very fit, but it wasn’t long before fitness experts were suggesting it might prove valuable for the average Joe and Jill. Exercise psychologists like Ekkekakis were doubtful.

“It’s never going to work, because we all know that high-intensity exercise is unpleasant,” he said.

To gain the much-ballyhooed benefits of HIIT workouts, you need to train at 85 to 95 per cent of your maximum effort (peak heart rate), which isn’t for everyone. The no-pain, no-gain philosophy of exercise has always been embraced by the few, not the masses. Despite this, researchers started publishing data suggesting HIIT is not only well tolerated by average exercisers, they actually find it more enjoyable than less intense workouts.

The combination of enjoyment with the promise of significant results in less time is the holy grail in terms of exercise adherence. Lack of time has been cited as one of the main reasons so few people exercise on a regular basis.

Still, Ekkekakis wasn’t buying it.

“It’s a lot more complicated than that,” he said of why the exercise dropout rate is so high. “Most people have discretionary time — they just choose not to allocate that discretionary time to exercise, presumably because they find other things that make them feel better or give them more satisfaction.”

Citing a preponderance of evidence proving that intensity drives people away, Ekkekakis decided to take a closer look at HIIT’s track record for long-term adherence. The results were published in a recent edition of Psychology of Sport and Exercise. Along with colleague Stuart Biddle from the University of Southern Queensland, Australia, Ekkekakis identified eight quality studies comparing HIIT to moderate-intensity exercise, all of which included followups of at least 12 months. What they found is unlikely to make HIIT fans happy.

“While non-adherence and dropout represent great challenges for any form of exercise, especially in unsupervised settings, these problems were shown to be exacerbated with HIIT,” Ekkekakis and Biddle stated in the study. “Compared to moderate-intensity exercise, more individuals assigned to HIIT did not adhere to their prescription when unsupervised, most likely because they could not.”

Not all the study subjects gave up exercise altogether — some just weren’t as motivated to sustain the same intensity on their own as when they were under the watchful eye of an instructor. They took the workouts down a notch or two into a more comfortable, moderate-intensity range. That’s not a bad thing — it’s just that when combined with the short duration of most prescribed HIIT workouts, health and fitness benefits are likely to be less significant than advertised.

So, where did the idea that exercisers preferred HIIT over less intense workouts come from if all eight studies proved that the majority of people eventually gave up on HIIT altogether?

It turns out gauging exercise enjoyment is harder than you might think. People are in no condition to answer questions about how they feel while in the middle of a tough workout. Any inquiries need to wait until after the workout is over. With all the hard work done and most people feeling accomplished with their efforts, their feelings are much different than when they were in full sweat mode.

“After exercise, almost everyone feels good,” Ekkekakis agreed. “But they might feel good because the darn thing is done.”

Does that mean HIIT has been oversold as a solution to sedentary habits? Probably. But that doesn’t make it a bad option. It’s just not for everyone, which puts it on par with most other workouts. The gauge of an effective workout isn’t how successful it is in a lab, but whether you want to do it all over again on your own.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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