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Forget 10,000 Steps A Day — This Is The Number You Should Focus On Instead
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How many steps have you taken today?
Most of us have been confronted by that question at some point in our lives, and many of us use our step count as a metric to gauge how active we are. For years we've been told that getting at least 10,000 steps is crucial to maintaining our health, but how did that number get chosen and is it really accurate?
That's what we — Raj Punjabi and Noah Michelson, hosts of HuffPost's "Am I Doing It Wrong?" podcast — discussed with Heather Milton, an exercise physiologist at NYU Langone Health in New York, when she stopped by our studio to give us tips and tricks for exercising better.
Listen to the full episode by pressing play:
"We always hear about 10,000 steps, and I actually read that that number is based on this pedometer that was designed in Japan [in the 1960′s]," Michelson said. "The [Japanese character] for 10,000 looks like a person walking, so... It just sort of became known for that."
Even though that specific figure wasn't based on medical or scientific research, it has remained the benchmark for our daily step goal for decades.
"There has been more recent literature that looked at [10,000 steps] per day, and how that's related to 30 minutes of moderate intensity activity per day," Milton told us. "The idea is if you're getting the right intensity of that [10,000-step] walk, then you're getting the CDC and ACSM recommended amount of aerobic exercise per day, because it equates to about 30 minutes of moderate intensity activity."
However, not all steps are created equal.
"When you're counting steps, does that mean like I got up and walked to get water and came back? That's probably not moderate intensity," she said.
That's why Milton emphasized that in order for us to get the most out of our walks, our pace should be brisk enough to keep us from being able to easily chat while we're doing it, which she referred to as "the talk test."
"If you and I were trying to have a conversation, would you only be able to answer 'yes' or 'no' to my questions? Or could we be chatting like this?" she asked. "There's a threshold dose or intensity dose that then lends towards increasing your health, and if we're looking at heart rate ranges, [that's] about 60... 64 to 76 technically... Percent of your max heart rate. That zone is your moderate intensity zone."
Aside from intensity, different step counts can provide different results based on other factors, like age. A 2019 study involving 16,741 women who ranged in age from 62 to 101 found that "4,400 steps a day was associated with a 41% reduction in mortality compared with walking 2,700 steps a day, [and walking] around 7,500 steps was associated with a 65% reduction." Another study showed progressively decreasing risk of mortality for people under 60 when they logged 8,000 to 10,000 steps a day.
Because there's so much to consider when attempting to use step count to determine our fitness, Milton suggested we stop concentrating so specifically on our steps and instead focus on a different number: 30.
Not only is 30 the number of minutes of moderate activity we want to aim for each day, it's also the maximum number of minutes we should allow ourselves to remain seated or sedentary at any given time during the day.
"Sedentary time is a whole other risk factor for health," she noted.
Inactivity can contribute to countless medical issues, including obesity, high blood pressure, certain cancers and mental health issues, so the less sedentary we are, the better our health and well-being may be.
"The sweet spot for breaking up sedentary time [is moving] every 30 minutes," Milton said. "If you're walking, your steps are contributing to that [and that's] helping your health from a different domain."
That's why she likes using steps as a "simple tool — an objective measure of if [my client] got some activity or didn't that day."
"So, for the general population, if you have a Fitbit or another device that's counting your steps, you can see how low they are," she said. "Then you can set goals for increasing it over time."
If we see a meager end-of-the-day count, that could indicate we were sitting or sedentary for much of the day.
"10,000 [steps] may not be what you want to set [your goal to]," Milton said. "It may just be to increase it by 200 [steps]. Then you can increase slowly over time, so you're getting more active time. It may not be structured exercise, but it is physical activity. And that can help with your metabolism and your overall health."
The Mayo Clinic notes that we can also break up sitting time by finding ways to walk while we work, like taking a walk with colleagues instead of sitting during a meeting, using a standing desk (or working while standing at a counter) for parts of the day, or standing for a bit while we do an activity we'd normally do sitting, like talking on the phone or watching TV.
During our conversation with Milton we also learned why we might be warming up all wrong (and how to do it better), the truth about spot training, and much more. So listen to the full episode above or wherever you get your podcasts.
Make sure to subscribe to "Am I Doing It Wrong?" so you don't miss a single episode, including our investigations of the ins and outs of tipping, how to apologize or vanquish your credit card debt, how to find love online or overcome anxiety, tips for online shopping, taking care of your teeth and pooping like a pro, secrets to booking and staying in a hotel, how to deal with an angry person, cooking tips from celebrity chef Jet Tila, shocking laundry secrets, the tips and tricks for cleaner dishes and more.
Need some help with something you've been doing wrong? Email us at AmIDoingItWrong@HuffPost.Com, and we might investigate the topic in an upcoming episode.
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Heart Attack Symptoms Can Last Minutes Or Hours—Here Are The Warning Signs To Know
Heart attacks, no matter how big or small, should be taken seriously. They are defined as acute events, meaning they can happen suddenly, and are often caused by a lack of blood flow and oxygen to your heart, per the American Heart Association (AHA). But exactly how long does a heart attack last?Heart attack duration and symptoms can vary greatly depending on the person, and no two heart attacks are the same. This is especially true depending on how quickly you get treatment.
Here, two cardiologists explain the average length of heart attacks, the warning signs to look for, and how to protect your heart in recovery.
How long does a heart attack last?Because heart attacks are considered acute events, their duration is typically short. "They don't last long, usually happening suddenly and severely," says Ernst Von Schwarz, MD, a cardiologist and author of The Secrets of Immortality.
"A heart attack is a life-threatening condition, and individuals can succumb to it immediately. In some cases, however, there could be repeated small heart attacks because the [affected] blood vessel is not yet completely blocked," he adds.
A heart attack does not last for days, but it's possible for symptoms of a heart attack to linger, which can signal a looming threat of another attack. That's why immediate care is so crucial.
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"Typically patients seek medical attention within minutes to hours," says Blair Suter, MD, a cardiologist at The Ohio State University Wexner Medical Center. But if symptoms are subtle, they may not seek care for a few days, he adds, which can be particularly dangerous and more difficult to treat.
Duration of heart attack symptomsTiming is everything when dealing with a heart attack. Before a full-on attack strikes, you may have symptoms for a few minutes or several hours that serve as warning signs, says Dr. Suter.
Symptoms typically include the following, per Dr. Suter:
These symptoms usually resolve if the heart attack itself is treated immediately, says Dr. Suter. But if it's left untreated or there's a delay in care, there's a higher chance of permanent heart damage, and even death. In fact, up to 50 percent of heart attack deaths happen in the first three to four hours after symptoms start, per Cedars Sinai.
Heart attacks symptoms can also vary between men and women, according to the AHA. While chest pain is a hallmark symptom for most people, women are more likely to also have subtle symptoms like shortness of breath, nausea/vomiting, back pain, or jaw pain. "These atypical symptoms in women contribute to the frequent under-recognition or misdiagnosis of acute heart attacks, leading to delays in treatment and worse outcomes in women compared to men," says Dr. Von Schwarz.
Women are also often underrepresented in research for heart disease, leading to significant gender disparities when it comes to how heart disease and heart attacks affect different genders, per the AHA.
There's also evidence that heart disease in young adults is on the rise. In a March 2023 study in JAMA, researchers found increased rates of high blood pressure, diabetes, and obesity in young adults (ages 20 to 44 years old)—all of which are risk factors for heart disease and heart attacks.
Keep in mind: This information is not meant to scare you, but rather to make you aware of the risks that contribute to heart attack. If you're unsure about your own heart health and risks, reach out to your doctor.
Warning signs of heart attackThere are several warning signs to look out for that could signal a heart attack, including the following, per Dr. Von Schwarz:
"These symptoms can be signs of a gradual blockage of the arteries, which may occur for weeks, if not months or years, before an acute heart attack occurs," adds Dr. Von Schwarz. "Having any one of these symptoms may require a cardiac evaluation."
While these are the most common signs of a heart attack, not everyone feels the same things, per Cedars Sinai. Some people may feel pain in the middle of their chest that spreads to their back, jaw, or arms, though 1 out of every 3 people who have heart attacks don't get chest pain at all, per Cedars Sinai. You may even feel pain or discomfort in your stomach area, which can be mistaken for indigestion.
When to go to the ERTime is of the essence when it comes to heart attacks, so it's important to catch signs early and call 911 without hesitation. The most obvious sign it's time to go to the ER? If you have new or worsening symptoms of chest pain and shortness of breath, says Dr. Suter.
It's also important to get care ASAP if you have any of the following risk factors for heart attack:
And when it comes to treatment, every minute counts. A doctor may prescribe heart medications to start the recovery process, including the following, according to the Mayo Clinic:
The short answer? "Yes and no," says Dr. Von Schwarz. You can reduce your risk of heart attack by addressing certain risk factors, which include:
But factors like genetics and family history are often out of your control. As long as you're leading a healthy lifestyle—eating a balanced diet, getting exercise, staying hydrated, sleeping well, and treating any health concerns—you can at least slightly reduce your risk.
How can I rule out a heart attack at home?"If you're worried about a heart attack, you should seek medical care and not try to rule it out on your own," says Dr. Suter. "This is a very serious medical condition that can have major consequences if not treated or if treatment is delayed."
That said, Dr. Suter does suggest being well-informed about symptoms of heart attack, and knowing the differences between heart attacks and panic attacks, heart palpitations, and even indigestion—which can present with similar symptoms. While anxiety typically resolves after taking deep breaths and implementing relaxation techniques, and indigestion resolves after taking an antacid, heart attack symptoms will just continue to get worse as time goes on.
Bottom line: If you're unsure of what's going on, call 911. It's better to be safe!
When should I go to the ER for chest pain?Chest pain can be caused from a number of different things. If your chest pain is new, severe, and lasts for several minutes, it's best to go to the ER, according to the Mayo Clinic. While there, a medical professional can check you out and determine the underlying cause. Even if you're not having a heart attack, you won't regret getting some peace of mind, or possible treatment for other health issues.
—reviewed by Jennifer Logan, MD, MPH
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20 Years Later, A Rochester Partnership Continues To Look At Health Disparities Among Immigrants
ROCHESTER — Last month, a group of Somali and Latino community members came together to display their photography in a group exhibition. The photographers aimed to show others what they care about most when it comes to health and well-being.
The photo exhibit was one of many research projects facilitated by the Rochester Healthy Community Partnership, a collaborative group that is now in its 20th year of engaging local immigrants in public health research.
"The broad problem statement that we've been working on ... Is that, as a broad generalization, immigrants or refugees arrive to Rochester, arrive to Minnesota, arrive to the United States healthier than the general population in terms of cardiovascular risk," said Dr. Mark Weiland, an internal medicine physician and chair of Mayo Clinic's Division of Community Internal Medicine, Geriatrics and Palliative Care. "But then, the longer they live here, the more they exceed that risk in conjunction with the social and structural determinants of health."
This year, RHCP won the Association of Clinical and Translational Science's award for addressing health equity through partnership and innovation. For the partnership, doing health equity research involves giving those people who are studied an equitable say what should be studied and how to bring change to their communities.
How the partnership came together
In the early 2000s, Jenny Weis, now the administrator for the Center for Clinical and Translational Science at Mayo Clinic, was pursuing her master's degree in nursing and needed to do some volunteer work for credit.
"I was driving to the (Twin Cities) twice a week," Weis said. "I could do my practicum on Saturdays there, but locally made more sense, and they said, 'The only place we have is Hawthorne,' which I knew nothing about."
Weis started volunteering at Hawthorne Adult Education Center and, as the only nursing student there, she responded to myriad health concerns from the Hawthorne students, many of whom were immigrants.
"They would come grab me because somebody passed out, or somebody had a child with asthma," Weis said. "(I) didn't know anything about community-based participatory research but felt there should be a way that we could improve the health of this group through research."
Contributed / Mayo Clinic
The first area of focus was tuberculosis, or TB, a bacterial infection of the lungs. Julie Nigon, the former administrator of Hawthorne, said Weis approached her because she noticed that some of the Hawthorne students had TB.
"We had more than one case at that point, a couple of cases, of ... Active TB," Nigon said. "And so Jenny flat out said, 'Your students are sick and I'm worried about them,' and she stepped in. I said, 'What do we do?' and that's when she said, 'I know who I'm going to call,' and it was sort of like calling Ghostbusters."
Weis' call was to Dr. Irene Sia, an infectious disease physician in Mayo Clinic's Division of Public Health, Infectious Diseases and Occupational Medicine. Sia said she remembers that she was rounding on patients in the intensive care unit when she got the page from Weis that set off this partnership.
"It was very intuitive among the three of us that there is a pathway, there is a guideline on how you treat (TB) or how you screen, but why is it not effective?" Sia said. "So it was just intuitive that we need to find out what the barriers are and why is it that it's not working?"
The group secured project funding from the National Institute of Allergy and Infectious Diseases, and Nigon said they started learning how to do community-based participatory research by diving in and doing it. They began with focus groups, asking Hawthorne students what their experiences were with TB and what they wanted to know.
"We came to the conclusion that institutions were telling immigrants and refugees what they should do, but they weren't asking them about what their fears were, why they weren't being tested, why they were hiding the fact that they maybe had symptoms of tuberculosis," Nigon said.
With the affected community, RHCP helped establish screening opportunities at Hawthorne and changed the TB screening policy for at-risk groups.
Community-based participatory research
Contributed / Mayo Clinic
The way research is collected through the RHCP's projects differs from most biomedical research, Weiland said. The goal of community-based participatory research is to address a complex problem by having the affected community provide input on how to solve the problem.
"CBPR is an approach to research where community members, commuinty-based organizations, academics partner in an equitable way through every phase of the research process," Weiland said. "The promise of CBPR is that participatory work together gets at that complexity in a way that leverages the strengths of community partners."
When the partnership first came together, CBPR was not a well-known research approach, Weiland said.
"When we started and when Juila and Irene adopted the CBPR approach for that project (on TB) ... That was a pretty innovative way of working," Weiland said. "Now, it's become so well-validated as an approach that it is expected of work that includes community."
The people who are studied in CBPR projects aren't subjects, but rather are research participants. These participants get involved through RHCP partner organizations that represent Southeast Minnesota's immigrant communities.
"It depends on who's interested in the topic and who has the bandwidth to participate," said Abby Lohr, a senior associate consultant Mayo Clinic's Division of Epidemiology.
One of the RHCP's longterm partners is the Alliance of Chicanos, Hispanics and Latin Americans. Miriam Goodson, the alliance's director, said her organization teamed up with the RHCP during its second initiative, which was called Healthy Immigrant Families.
"We knew that more people were getting diabetes and high blood pressure at an earlier age," Goodson said. "So, together, using the community-based participatory research approach, we decided on the first research project, (which) was about becoming physically active and losing weight."
One recent RHCP initiative centered around diabetes. Dr. Jane Njeru, an internal medicine physician at Mayo Clinic, said researchers first looked at what people in immigrant communities knew and didn't know about diabetes through a survey.
Then, some of the survey respondents were invited to take part in focus groups to talk about their experiences living with diabetes and what strategies worked for them in managing their conditions. Those participants came up with a digital storytelling intervention to inspire others in self-managing their diabetes.
"The group, together, came up with using stories, authentic, real stories from people," Njeru said, "talking about, 'This is me, my diabetes. This is what I do to cope, and these are the barriers. These are the strategies that I use.'"
Njeru said RHCP just did a large study to see if hearing those stories from community members translates into better health outcomes for patients. Lohr said she is also looking at that data to see "who did better and why."
"If we can figure out who did better and why, then we can tailor that for the future, and then it makes the intervention more effective," Lohr said.
CBPR initiatives are designed to include these longterm interventions and follow-ups, things that require trust between the project partners and the research participants, Nigon said — the researchers don't just pop in, ask questions, fix a problem and never come back.
"Without that trust, communities are not going to share their concerns. Without that trust, academics cannot share their work with the community," Nigon said. "Trust is huge, and that trust has been built. It was built early, and they have maintained it."
The future of health equity research
Maya Giron / Post Bulletin file photo
What RHCP will focus its future efforts on is currently under discussion.
"We're in the midst of strategic planning right now, so we don't know exactly what that'll look like," Weiland said.
"I think we're definitely looking at how we can broaden our scope to work with other CBPR partnerships, both in Minnesota and nationally," added Lohr.
A typical guiding idea for projects, Weiland said, is getting future medical advances not only into the hands of clinical providers such as doctors, but also translating that knowledge for communities to use it, too. This means addressing social and structural barriers that make it harder for people to access health care and medical treatment.
"Those gaps (in access) widen as new technologies emerge, new cures and new screenings," Weiland said. "It just leaves pockets of people behind in really predictable ways. So I think the CBPR approach — or community-engaged approach, more broadly — couldn't be more important as technologies accelerate."
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