The team here at NAM will be taking part in a couple of fundraising events this summer involving exercise. At the less demanding end of the scale, a number of us (twelve so far) will be joining the annual Crusaid Walk for Life on 7 June: see www.walkforlife.co.uk and search for NAM. This ten-kilometre stroll is Europe’s largest sponsored walk to support people affected by HIV and raises thousands of pounds every year for HIV charities. We would love you to join our team and get sponsored, have fun and help us raise vital funds for NAM. Of course if you can’t make the day, we still need your support! Please sponsor us using the enclosed form or at www.walkforlife.co.uk.
Passing us in the fast lane, some of the fitter members of the team will be participating in the London Triathlon on 1 and 2 August. Watch this space for more information.
Exercise, it’s been said, is so good for the body and mind that if it were a pill, pharmaceutical companies would be fighting to patent it. That may seem obvious: of course being fit should mean you get fewer illnesses. But what are the specific benefits for people with HIV?
In the post-HAART era there has been little research on the effects of exercise on HIV infection itself. The best data we have are from 1991, when a study1 found that an aerobic exercise programme produced a significant CD4 count increase of about 50 cells/mm3.
Even very moderate exercise boosts the immune system compared with doing nothing. Researchers2 measured immune function in 15 women when they had taken a 30-minute walk and when they had spent the 30 minutes sitting and found increases in many different parts of the immune system after exercise.
However, there is also evidence that too much intense exercise can reduce immunity. More than 90 minutes of high-intensity exercise can make athletes susceptible to illness for up to 72 hours. This is important information for those who compete in longer events such as marathons. The reason appears to be that very high-intensity exercise increases the stress hormone cortisol, which suppresses the immune response.
More recently, studies of exercise have concentrated on improvements in fat distribution, body shape and cardiovascular health measures like cholesterol. Exercise regimens have tended to produce consistent, but relatively small, decreases in fat accumulation inside the abdomen, significant decreases in total cholesterol, reductions in insulin resistance (the precursor of diabetes)3 and lowering of blood pressure4 and triglycerides, other heart disease indicators.5
Studies of resistance6 and aerobic exercise7 have found significant increases in cardiovascular fitness and mood. Exercise may also have more psychological benefits than previously thought. Even 30 minutes of exercise has been shown to improve the mood of depressed patients8 and just six 20-minute sessions of aerobic exercise significantly reduced the tendency of study participants to get anxious when exposed to stress.9
Aerobic exercise means exercise that gets your heart beating faster such as running, cycling, swimming, even dancing. A good level to aim for is 20 minutes three to four times a week.
Resistance exercise builds muscle (you don’t have to use weights: sit-ups and press-ups are resistance exercises). Aim for about 40 minutes, one to three times a week. Exercise all muscle groups and do an aerobic warm-up first.
For more information, look up ‘exercise’ on www.namlife.org.
Finally, don’t start any regime without consulting your doctor and, especially with weight training, get instruction in how to do it safely. Londoners could start at the YMCA Positive Health scheme – see www.ymcaclub.co.uk or phone 020 7343 1700. They can also tell you about schemes elsewhere in the UK.
The highs and lows of an HIV-positive marathon runner
Jim Pickett is Director of Advocacy for the AIDS Foundation of Chicago (AFC), and has experienced the highs and lows of exercise. The AFC offer volunteers free marathon-running training in return for the sponsorship they raise.
“I was a big fella 8 years ago and decided I had to get fitter. I quit cigarettes and started running but frankly looked on marathon runners with a mix of pity and scorn: why would anyone put themselves through that?
“However, the training deal came up and I decided to go for it. I found I loved it – it’s really hard but I’ve found strength and ability in myself I never knew I had. It’s as much a mental exercise as physical. I did three marathons in Chicago and one in Florence.”
The last one was not such a good experience, however. “We did it in 90-degree heat and they hadn’t provided enough water. It was called off when I was at the 16-mile mark because people were collapsing.
“Since then I worry I’ve become a bit of a potato and want to start again, possibly do a half marathon.
“My recommendation if you want to do any kind of exercise is: be kind to yourself. If you run, do it somewhere nice. If you like music, take your iPod.
“Make it do-able. If it’s a two-mile walk then do that. Start doing little runs during the walk, that sort of thing. Anyone can do it, especially if you do it with friends for support.”
1. LaPerriere A et al. Exercise training in an AIDS risk group. Int J Sports Med 12, Suppl 1: S53-7, 1991.
2. Nieman DC et al. Immune Response to a 30-Minute Walk. Med Sci Sports Exerc 37:57-62, 2005.
3. Robinson FP et al. A pilot study of the effects of endurance and resistance exercise on HIV antiretroviral-associated metabolic abnormalities. Third IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro. Abstract TuPe22B09, 2005.
4. Driscoll SD et al. Effects of exercise training and metformin on body composition and cardiovascular indices in HIV-infected patients. AIDS 18:465-473, 2004.
5. Gavrila A et al. Exercise and vitamin E intake are independently associated with metabolic abnormalities in Human Immunodeficiency Virus-positive subjects: a cross-sectional study. Clin Infect Dis 36:1593-1601, 2003.
6. O’Brien K Progressive resistive exercise interventions for adults living with HIV/AIDS. Cochrane review abstracts 2007.
7. Nixon S et al. Aerobic exercise interventions for adults living with HIV/AIDS. Cochrane Database of Systematic Reviews, issue 1, 2009.
8. Bartholomew JB et al. The effects of acute exercise on mood and well-being in patients with major depressive disorder. Med Sci Sports Exerc 37:2032-2037, 2005.
9. Roman-Fulks JJ et al. Effects of aerobic exercise on anxiety sensitivity. Behav Res Ther 42:125-136, 2004.