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What is a respiratory infection? Can you test too early for COVID? How much exercise do adults need per day? Can exercise lower your blood pressure?
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, covers current trends of COVID, RSV, and flu and preventing illness this holiday season. She also discusses the obesity epidemic in the U.S. and why adding five minutes of exercise to your daily routine can help lower blood pressure, plus the mental and physical benefits of practicing gratitude. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer in Chicago. Welcome back, Andrea.
Garcia: Thanks, Todd. Appreciate the opportunity to be here.
Unger: Well, this is going to be our last update before Thanksgiving, so if you're looking for something to go along with that turkey and mashed potatoes, you'll have an AMA Update to take a look at over the long weekend. Kicking us off, Andrea, we often see a spike in respiratory illnesses following the holiday, so why don't we just get kind of the lay of the land on where things stand as we enter Thanksgiving weekend. How are things looking?
Garcia: Well, right now, cases of the three respiratory illnesses that we are typically looking at this time of year, COVID, RSV and flu are relatively low. And if you recall, we did have that summer COVID surge, however, that began receding in September.
Since then, cases, hospitalizations and deaths have generally been trending downward. If we took a look at the latest wastewater surveillance data from the CDC, it does indicate that the levels of COVID, flu and RSV are either low or minimal as of the first week of November. And if we look at data from the same week last year, the rates of COVID and RSV were both already on the rise and then flu began to increase towards the end of November last year.
However, we're still obviously at the beginning of the season. It's still likely that, as you said, we'll get a new wave of illness when those holiday gatherings and colder weather hit. There was a recent Axios article that quoted Michael Osterholm, who we've talked about as a noted public health expert, as saying from a respiratory virus standpoint, this is probably the lowest we've been in terms of risk in the community for any serious illness since the beginning of the pandemic. However, he went on to state that a quiet start does not mean a quiet ending.
Unger: Well, we'll take a quiet start as something to be thankful for as we all head into the holidays here. Andrea, so COVID, RSV and the flu are relatively stable right now. Are there other respiratory viruses that we need to keep an eye on?
Garcia: Well, the short answer to that is yes. Rhinoviruses and enteroviruses, those typical cold viruses have been around since August. And as we've discussed here before, pertussis, also known as whooping cough, has returned to those pre-pandemic levels with more than 10,000 cases typically reported each year.
I think the other one that we're hearing about that we need to keep an eye on right now is walking pneumonia, which is hitting kids and adults at levels that we haven't seen in years. And last month, the CDC said cases of walking pneumonia started rising in late spring. They've remained high and children's hospitals are getting hit particularly hard.
According to that same Axios article, some hospitals are reporting as much as a 10-fold increase from last year, and they're expecting more to come. Walking pneumonia is a mild form of pneumonia, so kids will often feel well enough to go to school. However, as CDC warns that it can cause serious complications in people with asthma and weakened immune systems. So it's certainly something that we need to keep an eye on as we head into those holiday gatherings.
Unger: Andrea, those are pretty astounding numbers. Is there any preventative measure that we can take?
Garcia: Well, Todd, as always, the best thing you can do is stay home if you're sick, so you're not spreading those illnesses to others. It's a good idea to test for respiratory illnesses before you're going to those family gatherings. This is especially important, if you will be around immunocompromised individuals who may be in attendance.
And as a reminder, this year we do have those new at home combination tests for both COVID and then influenza A and B. There was a recent NPR article that noted that these tests are likely to be a game changer. So far, FDA has authorized nine over-the-counter combination tests. One of those recently received FDA marketing authorization. The other combination tests are available under an emergency use authorization.
As we've discussed before here, all but one of those tests are antigen tests. So they work like the do-it-yourself COVID test. Many of us have become accustomed to with a nasal swab sample. The other is a molecular test that uses a different technology. If you are testing because you have symptoms and you test negative, it is always a good idea to test again two days later. This will not only help protect others by helping to limit transmission, but can also help people get treatment early, which we know can be critical when we're dealing with these viruses.
Unger: Absolutely. Well, thank you for that update. Andrea, you also think of the holidays as a time where, I don't know, we might overdo it, but a new study suggests that we have a problem that extends far beyond the holidays and the problem is complex. Tell us a little bit more about that.
Garcia: Well, it certainly is complex. And there was a large study that was published a couple of weeks ago in The Lancet, and it was reported on by The New York Times and it said that nearly three quarters of U.S. adults are overweight or obese. This is a startling number, and as The Times article pointed out, could have wide reaching implications for the nation's health and medical costs as we face a growing burden of weight related diseases such as diabetes, high blood pressure, heart disease and even cancer.
The study documents a quick and steady rise in obesity rates nationwide. That was like since 1990 when just over half of adults were overweight or obese. I think equally concerning, it shows that people are becoming overweight or obese at younger ages than they were in the past.
The study's authors documented increases across all ages but were especially alarmed by that steep rise among children with more than one in three of whom are now overweight or obese. They forecasted that without aggressive intervention, the number of overweight and obese people will continue to go up, reaching nearly 260 million people by 2050.
Unger: Andrea, those numbers are, they're frightening. I read that article when it came out, and it's just so surprising, especially since you mentioned, this is a trend that really accelerated from the 90s, which doesn't seem that long ago for me. But until now, it's just not that much time. How did we get there?
Garcia: Well, some have suggested that our current policies simply don't do enough to address this crisis. But there are really a lot of potential drivers. And The Times article specifically cites the wide availability of ultra processed foods, the challenge to accessing fresh fruits and vegetables, and then that increase in sedentary online activity.
The article also called for more research into understanding the potential effect of environmental factors, so exposure to microplastics that may be disrupting our microbiomes. There are also societal factors to consider food insecurity, access to transportation, income, employment, level of education. Those factors can all influence health and the complexity and volume of factors at play, I think, is part of what makes this such a challenging issue to address.
It's been referred to as simply a calorie issue where the fix was to eat less and exercise more. However, it is more complex than that. We have to take into account genetic, physiological and environmental factors as well. It's really going to take a multi-tiered approach to address it, including not only those individual interventions, but also those population level and systemic changes.
Unger: Well, that is certainly something we'll continue to watch. Andrea, in better news, there is another new study out that suggests that just five more minutes of exercise can help you lower your blood pressure. What can you tell us about that?
Garcia: Well, this was reported on by Healthline, and it was a study published earlier this month in the journal Circulation. And that headline may lead people to think that they just need five minutes of exercise per day to get that benefit. But what it is actually saying is we need five more minutes of exercise a day. And that is clearly an important distinction.
What this study revealed is that by adding just a few minutes of vigorous, everyday physical activity onto our daily exercise routine can help control blood pressure. The researchers found that an extra five minutes of stair climbing or cycling, or running was linked to slight reductions in systolic and diastolic blood pressure, while clinically meaningful improvements were seen at an additional 10 and 20 minutes of daily exercise.
Those less strenuous forms of movement, such as standing or walking, had more minimal effects. But overall, making small additions can be helpful, such as short five-minute brisk walks while at work, taking the stairs instead of the elevator or parking farther from the store and walking.
Unger: I'm comforted to know that you didn't suggest that I need to run for five minutes. That may as well be an hour for me. Andrea, how much exercise should we be getting in a week in order to add five minutes on top?
Garcia: Well, the physical activity guidelines for Americans recommends that adults get at least 150 minutes of moderate intensity exercise each week, or 75 minutes of vigorous exercise or an equivalent combination of moderate and vigorous exercise. One of the researchers on this study said that for heart health, he recommends closer to 30 minutes of moderate intensity aerobic activity daily, most days of the week.
Unger: Well, that's good to know. To close out this week, there are also some health benefits that are linked to another practice that requires a little less physical activity. What can you tell us about that?
Garcia: Well, this is not new research, but I think is particularly relevant right now as we head into the holiday. And that is according to UCLA Health, the simple practice of gratitude. So regularly focusing on the positive parts of our lives is a powerful health habit.
Research has shown that practicing gratitude just 15 minutes a day, five days a week for at least six weeks can enhance mental wellness and possibly promote a lasting change in perspective. Gratitude and its mental health benefits can also positively affect your physical health. There was a review of 70 studies that included responses from more than 26,000 people, and it found an association between higher levels of gratitude and lower levels of depression.
Gratitude has also been recognized as a coping tool for anxiety by combating negative thinking patterns and keeping thoughts focused on the present. And it can also help relieve stress by calming your nervous system and promoting better sleep. Interestingly, several studies even show that a grateful mindset positively affects biomarkers associated with the risk for heart disease. So these are good things to keep in mind right now and something that we really can do anywhere.
Unger: Well, that sounds like a great place to wrap things up today. As always, thank you for being here, Andrea. We are certainly grateful for you. And we wish all of you out there a safe and Happy Thanksgiving. And we'll see you back with a brand-new AMA Update on Monday.
If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. You can find all our videos and podcasts at ama-assn.org/podcasts. Thanks so much for joining us. Have a wonderful holiday.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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