Weekly Health Update: stress

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Sunday, December 19, 2010

Job and Workplace Stress

Weekly Health Update:

Job and Workplace Stress

"A critical weekly review of important new research findings for health-conscious readers..."

By, Robert A. Wascher, MD, FACS

Updated: 12/19/2010

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

JOB AND WORKPLACE STRESS

The global economy remains in the doldrums, unemployment remains at historically high levels around much of the world, and many people are feeling stressed in both their professional and personal lives. In today’s highly competitive job market, many employees are feeling increasingly vulnerable. There is also the perception among many workers that the poor job market has given employers the upper hand when it comes to the workplace environment. Employees are working longer hours (and often without traditional overtime pay, and the other economic incentives of the pre-recession era), taking more work home with them, and in general, are feeling a great deal more stress and insecurity than they experienced before the economy took a nose-dive in 2008.

Increased levels of chronic stress have been linked to a variety of health problems, including cardiovascular disease, depression, obesity, increased drug use (including tobacco, alcohol, and illicit drugs), domestic abuse, interpersonal conflicts (at home and at work), and some cancers. With no end in sight to this second-worst economic downturn in modern history, the odds remain relatively high that many employees will continue to face increased demands in the workplace, increased difficulty in finding a reasonable work-home life balance, and will continue to feel vulnerable and anxious about the stability of their jobs. Many employers recognize that treating their employees fairly, and helping them to feel secure and appreciated in their jobs, is a “win-win” for everyone. Employees who are treated fairly, and who come to work each day knowing that their workplace environment is both supportive and free of unnecessary strife, are more efficient and more productive, and tend to take fewer days of sick leave. On the other hand, employees who feel that they are not being treated fairly, or that they are being taken advantage of, or that their jobs are at risk for reasons other than their performance, are less productive, more prone to interpersonal conflicts, and take more days of sick leave than employees who enjoy a healthy workplace climate. While some employers may see the current economic downturn as an opportunity to take advantage of their employees, and to exploit and mistreat their employees at a time when many workers already feel insecure and vulnerable, most employers understand that when their employees look forward to coming to work in a healthy, supportive, and fair workplace climate, both employer and employees are more likely to thrive.

Two newly published public health studies, which appear in the current issue of the Journal of Occupational & Environmental Medicine, offer both employees and employers important insights into creating a healthier, more productive, and more collegial work environment.

The first study was a long-term longitudinal, prospective occupational health study of 326 men and 338 women who originally enrolled in this research study in 1980 (while between the ages of 9 and 18 years). These children and adolescents were then followed for an impressive 27 years, until 2007. This study found that the now adult workers who had engaged in frequent leisure-time exercise, and effort-intensive sports, during childhood and adolescence were significantly less likely to complain of chronic workplace stress after they reached adulthood (i.e., when compared to employees who had rarely engaged in exercise or sports during their youth). Interestingly, after being tested for cardiovascular fitness during adulthood, this study found that a high level of physical fitness in adulthood only partially explained the apparent benefit of increased physical activity during late childhood and adolescence on perceived workplace stress. In addition to engaging in regular exercise and sports, having a “Type A” personality also appeared to be predictive of less workplace-associated stress. (People with “Type A” personality traits are highly goal-oriented, performance-oriented, “take charge” people, as opposed to people with so-called “Type B” traits. “Type B” people tend to feel more comfortable in delegating tasks, are less confrontational than Type A” folks, and also do not feel the sense of task-oriented urgency that their “Type A” peers constantly experience.)

While we probably cannot change our basic personality type, we can all increase our levels of physical activity, starting in childhood and continuing through adulthood, as a means of coping with the increased levels of chronic stress that many of us are feeling these days. (Importantly, there are many clinical research studies that have demonstrated a strong correlation between regular exercise and a decrease in the incidence of stress-related physical and mental illnesses.)

The findings of the second occupational health study should serve as a wake-up call to those employers that take advantage of hard economic times to exploit their workers, as well as those employers that permit an unhealthy or unfair work environment to persist. In this study, 2,763 randomly selected employees from the general population were interviewed and evaluated with respect to their workplace environment and their satisfaction with their jobs. A second group of 3,044 employees who appeared on their companies’ sick lists for more than 14 days, over a 2 month period, were similarly evaluated.

Among the women employees, a perceived unhealthy or unfair workplace environment was associated with an 80 percent increase in the likelihood that these female employees would end up on chronic sick lists. The impact of a toxic workplace environment on the male employees was even more profound, as men who complained of an unhealthy or unfair workplace climate were 174 percent more likely to chronically call in sick when compared to the men who were generally satisfied with their workplace environment and their jobs. (Interestingly, increased workload alone, in the absence of an unhealthy workplace environment, increased the risk of absenteeism among women, but not among men.)

In summary, these are tough times for many, many people. Most employers treat their employees in a fair and ethical manner, knowing that happy and secure employees are more efficient, more productive, more reliable, easier to get along with, and less likely to take excessive sick leave. Unfortunately, there are also employers who, sensing the insecurity of their employees during difficult economic times, exploit their employees through excessive and unfair workloads, and through their permissiveness in allowing unhealthy or unfair workplace environments to persist. For employees who must navigate these uncertain times, regular and frequent exercise can be a very important coping mechanism, and can pay important dividends in both one’s personal and professional lives (including a reduction in the risk of stress-related physical and mental ailments). For the minority of employers who take advantage of their anxious employees, or who turn a blind eye towards unhealthy or unfair workplace environments, such employers not only betray their responsibilities to their employees (and their responsibilities to society, in general), but their unethical treatment of their employees may also be detrimental to the overall success of these organizations, as disaffected employees often respond to such treatment with passive-aggressive work-avoidance behaviors, increased absenteeism, and in some cases, with litigation.

In time, we will emerge from this terrible global recession. When that happens, companies that have treated their employees fairly, and according to high ethical standards, during the worst of times will have an inherent advantage over those companies that took the low road. High levels of productivity, excellent employee morale and loyalty, and low levels of absenteeism and workforce turnover, will improve the competitiveness, stability, and productivity of the companies that treated their employees well during tough economic times (while the companies that did not treat their employees well are more likely to face increased employee turnover as the economy improves, as their disenfranchised employees seek better opportunities within an improving employment marketplace).

For a complete discussion of the role of stress on cancer risk, and important evidence-based approaches to cancer prevention (including exercise), order your copy of my new book, A Cancer Prevention Guide for the Human Race,now! For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, in both paperback and e-book formats, and begin living an evidence-based cancer prevention lifestyle today!

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On Thanksgiving Day, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com Top 100 Bestseller’s List for Kindle e-books!

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

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Robert A. Wascher, MD, FACS

Dr. Wascher's Archives:

12-19-2010: Job and Workplace Stress

12-12-2010: Metformin, Diabetes and Death

12-5-2010: Vitamin D and Depression

11-28-2010: Mammograms Save Lives in Women with Family History of Breast Cancer

11-14-2020: Low Dose Aspirin Reduces Colorectal Cancer Risk

11-7-2010: Coffee, Tea, Caffeine and Brain Cancer Risk

10-28-2010: Diet and Lifestyle Habits that Decrease Colorectal Cancer Risk

10-21-2010: The Silent Epidemic of Surgeon Burnout and Depression

10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk

10-7-2010: Hormone Replacement Therapy (HRT) and Breast Cancer Risk

10-3-2010: Mammograms Between 40 and 49 Years of Age

9-26-2010: Vitamin D, Cardiovascular Disease, Cancer, and Death

9-19-2010: Fruits and Vegetables Improve Memory

9-12-2010: Low-Carb Diet and Risk of Death

9-5-2010: Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death

8-29-2010: New Treatment for Irritable Bowel Syndrome (IBS)

8-22-2010: Lactoferrin Reduces Abdominal (Visceral) Obesity

8-15-2010: Blueberries, Obesity, Diabetes and Metabolic Syndrome

8-8-2010: High LDL Cholesterol in Young Adults and Heart Disease Risk in Middle Age

8-1-2010: Physician Error

7-25-2010: Obesity and Cancer Risk

7-18-2010: Vitamin D Reduces Risk of Cognitive Decline & Dementia

7-11-2010: All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk

7-4-2010: Irritable Bowel Syndrome: Cause Discovered?

6-27-2010: Soy, Curcumin & Prostate Cancer Risk

6-20-2010: Green Tea Epicatechin Reduces Heart Damage & CHF

6-13-2010: Diacylglycerol (Diglyceride) Oil Reduces Obesity

6-6-2010: Important New Advance in the Breast Cancer Treatment: Intraoperative Radiation Therapy

5-30-2010: Medical Research Studies & “Spin”

5-23-2010: Soy & Curcumin Reduce Prostate-Specific Antigen (PSA)

5-16-2010: Coffee & the Risk of Death from Heart Disease & Cancer

5-9-2010: Soy Foods & Stomach Cancer Risk

5-2-2010: Chemotherapy for Breast Cancer & Memory Loss

4-25-2010: Smoking, Teenagers & Tobacco Company Advertising

4-18-2010: Coffee Improves HDL Cholesterol Levels

4-11-2010: Cruciferous Vegetables, Soy & Breast Cancer Risk

4-4-2010: Avodart (Dutasteride) & Prostate Cancer Prevention

3-28-2010: Aspirin & Breast Cancer Survival

3-21-2010: Obesity, Alcohol & Liver Disease

3-14-2010: Nuts, Diet & Obesity

3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides

2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer

2-21-2010: Testosterone Supplements in Frail Elderly Men

2-14-2010: Pancreatic Cancer Risk, Sodas & Juice

2-7-2010: Vitamin D, Cardiovascular Disease & Death

1-31-2010: Concord Grape Juice Improves Memory

1-24-2010: Mozart, Music, Babies & Health

1-17-2010: Breast Cancer, Physical Therapy & Lymphedema

1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery

1-3-2010: Ginkgo Biloba, Memory & Cognitive Health

12-20-2009: CT Scans & Cancer Risk

12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk

12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009: Exercise & Prostate Cancer Risk

11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009: Breast Cancer Treatment & Chronic Pain

1-8-2009: Vitamin D & Breast Cancer Risk

11-1-2009: Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009: Surgery, NSQIP, Complications & Death

9-27-2009 Stress, Heart Disease, Exercise & Death

9-20-2009: Vitamin D & Colorectal Cancer Survival

9-13-2009: H1N1 Swine Flu Update

9-7-2009: Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009: Breast Cancer Recurrence, Death & Vitamin D

8-2-2009: Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009: Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009: Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009: Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008: Smoking & Quality of Life

10-19-2008: Agent Orange & Prostate Cancer

10-12-2008: Pomegranate Juice & Prostate Cancer

10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity

3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?

2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality

12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer

Dr. Wascher's Home Page

Sunday, September 27, 2009

Stress, Heart Disease, Exercise & Death

Health Report:

Stress, Heart Disease, Exercise & Death

"A critical weekly review of important new research findings for health-conscious readers..."

By, Robert A. Wascher, MD, FACS

Updated: 09/27/2009

STRESS, HEART DISEASE, EXERCISE & DEATH

Multiple prior clinical research studies have identified a link between high levels of stress and the risk of death in patients with coronary artery disease (CAD).

Aerobic exercise training is a standard component of rehabilitation programs for patients with CAD. A properly supervised exercise training program for patients with CAD, including patients who have suffered a heart attack, has been shown to reduce the risk of CAD-related death. At the same time, it is also well known that regular aerobic exercise can also help patients to better cope with high levels of personal stress, and also improves the symptoms of depression and other mental health disorders, as well.

An intriguing clinical research study, newly published in the American Journal of Medicine, evaluated the impact of exercise training on the risk of death in patients with CAD. The two “experimental” groups of patients included 53 patients with CAD who reported high levels of stress in their lives, and 369 patients with CAD who reported low stress levels in their personal lives. These two groups of patients participated in a cardiac rehabilitation program that included formal aerobic exercise training. A “control” group of 27 patients with CAD was also included in this research study, and these control patients also reported high levels of stress in their lives. However, unlike the experimental group patients, this control group of patients did not undergo cardiac rehabilitation, or any other form of supervised exercise training. The subsequent findings of this clinical research study were rather dramatic.

Overall, the risk of death among the patients with CAD who reported high levels of stress was a whopping 4 times greater than the mortality rate of the patients with low levels of stress in their lives (22 percent vs. 5 percent, respectively).

As has been shown in previous clinical studies, regular aerobic exercise appears to decrease self-reported stress levels. In this study, the percentage of patients reporting severe levels of stress declined from 10 percent, at the beginning of the study, to 4 percent, by the end of the study, among patients who underwent formal exercise training.

Perhaps the most interesting finding from this study was that patients who increased their total exercise capacity by at least 10 percent also lowered their risk of death by a rather amazing 60 percent when compared to patients who achieved a less than 10 percent improvement in exercise capacity. Moreover, among the patients who reported high levels of stress in their lives, the risk of dying during the course of this clinical study was dramatically reduced in the group of patients who were able to increase their prior exercise capacity by at least 10 percent. In fact, while 19 percent of the “highly stressed” patients who achieved little or no improvement in their exercise capacity died during the course of this study, none of the “stressed” CAD patients who managed to increase their exercise capacity by at least 10 percent died. On the other hand, CAD patients reporting low levels of personal stress did not appear to experience any significant improvement in mortality risk whether they achieved a high level of exercise capacity improvement or a low level of exercise capacity improvement.

The results of this study suggest that (as has previously been shown) a high level of personal stress is independently associated with an increased risk of dying from preexisting CAD. A second finding of this study, which has also been confirmed by other studies, is that self-perceived levels of stress can be significantly reduced with regular aerobic exercise. The most interesting and novel finding of this study, however, is that exercising at a level that increases one’s exercise capacity by at least 10 percent appears to be a potentially powerful way of reducing the increased mortality risk that is associated with chronically elevated levels of personal stress in patients with CAD.

One potential limitation of this clinical study is that it is not entirely clear how well the patients in each group were matched in terms of the severity of their CAD (as well as other chronic illnesses, including mental health and personality disorders). For example, at least some of the experimental group patients who were unable to improve their exercise capacity by at least 10 percent may have been unable to do so due to the presence of serious illnesses (including more severe heart disease) that limited their ability to exercise. In such cases, the increased risk of mortality observed in this study may have been directly caused by the presence of more serious illnesses in these patients, when compared to the patients who were able to more dramatically improve their exercise capacity. However, as most of the findings of this clinical research study are consistent with larger and better controlled previous studies, it is very likely that there is some validity in its more novel conclusions (and, most notably, that vigorous and regular aerobic exercise may directly reduce stress-related physiological factors that increase the risk of dying from CAD).

Prior to embarking on a new or more vigorous exercise program, I advise that you first be evaluated by your personal physician, especially if you have CAD or other serious illnesses. (For an in-depth overview of the benefits of exercise on cancer prevention, look for the publication of my new book, “A Cancer Prevention Guide for the Human Race,” in the spring of 2010.)

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California