Spring Asparagus Tart Recipe, Spotlight on Whole wheat flours and Rolling Pins, Music for Stress Relief, and Are You at Risk of Burnout?

Spring is officially here, and that means one thing to food lovers: fresh asparagus. There’s nothing quite like a plate of steamed spears dressed with the freshest olive oil and perfectly aged balsamic vinegar…unless it’s my puff pastry tart! So elegant and yet so easy, it makes a wonderful brunch centerpiece or first course for dinner gatherings. The two studies I’m sharing are especially helpful when considered together: how to recognize the signs of burnout and how to use music to help with stress, often at the core of burnout.

Spring Asparagus Tart

• Spring Asparagus Tart

  This gorgeous dish comes together with only a few ingredients and very little active prep. It’s the perfect example of using olive oil as Mother Nature’s “sauce”—a drizzle right before serving turns EVOO into the star of this dish. Read the fine print on frozen puff pastry labels—many brands are loaded with artificial ingredients and no butter! I like the Bronx, New York-based Dufour Pastry Kitchen brand—the company is run by women and the results are delicious (they also make a vegan version). Any dough trimmings can be twisted into spirals, brushed with egg, sprinkled with grated cheese, and baked on a separate sheet of parchment for about 20 minutes.

  Ingredients

  • 4-ounce package of frozen puff pastry
  • White whole wheat flour
  • 8 ounces Gruyère cheese, grated
  • 12 ounces asparagus, rinsed and trimmed to the same length
  • 1 tablespoon extra virgin olive oil, plus more for drizzling
  • 1 small egg
  • Optional garnishes: thin strips of prosciutto, Parmigiano-Reggiano shavings, balsamic vinegar

  Directions

  Step 1

  Defrost the puff pastry according to package directions. Preheat your oven to 400°F. Place a piece of parchment paper about 24 inches in length on your countertop and sprinkle on a small amount of the flour, then flour your rolling pin. Unfold the thawed dough on the paper, gently roll out the creases, and then roll it to about 10 by 16 inches. Use a paring knife to trim any uneven edges and then to score a rectangular border just 1 inch in from the edges on all four sides—it will look like a picture frame (be sure not to cut all the way through the dough). Lightly prick the dough within the border in an even pattern with a fork. Slide the parchment paper with the dough onto a rimmed sheet pan, cutting off or folding under any excess paper. 

  Step 2

  Evenly sprinkle the grated cheese across the dough within the border. On a plate, toss the asparagus with a tablespoon of olive oil, then arrange the spears in one row over the Gruyère. In a small bowl, whisk the egg, and use a pastry brush to brush it on the dough border. 

  Step 3

  Bake the tart for about 30 to 35 minutes, until the border is golden brown and the cheese is bubbly. Let cool for 10 minutes before topping with prosciutto and/or cheese, if using. Serve warm or at room temperature with a drizzle of olive oil and, if desired, a splash of balsamic. 

  Yields 8 servings

Healthy Ingredient Spotlight

Whole Wheat Flours

Many people love the fiber in whole wheat breads and pastas and may even reach for whole wheat flour to dredge proteins, from chicken cutlets to scallops, before sautéing. Yet they often find it hard to use whole wheat flour when baking. That’s because traditional whole wheat flour is milled from hard red wheat, and it creates denser baked goods. 

There are two other kinds of whole wheat flour that better lend themselves to baking, especially for baking sweets. One is whole wheat white flour, and the other is whole wheat pastry flour. Both are milled from white wheat, which has a milder flavor than red wheat, yet still contain the wheat germ, bran, and endosperm of whole grains. So you’ll still get fiber along with some protein, vitamins, and minerals. Which of these to use comes down to what you’re cooking. If you’re a fan of pastry flour for baked goods, try whole wheat pastry flour first; its superfine texture will give tender results. If you’re looking to thicken sauces, make gravy, or coat foods before cooking, reach for white whole wheat flour. I keep both in my pantry. 

Keep in mind that if you replace all the refined flour in a standard recipe with one of these whole wheat flours, you will not get the same exact results, especially with yeasted doughs. Start by replacing just 25 percent of the refined flour in a cookie or pie dough, for instance, and see how you like the taste—with this amount, you may not notice any difference. Keep experimenting, swapping more until you reach about 50 percent. Of course, for any recipe developed specifically for whole wheat flour, white whole wheat, or whole wheat pastry flour will give you a more tender result.

Quick Kitchen Nugget

Rolling Pins

If your tool drawer has an old-fashioned rolling pin with handles and a 10-inch working section, you may have found that it’s limited in its usefulness. It has to be picked up and moved often, leaving ridges in your dough and making it hard to get a uniform thickness. Also, this kind of rolling pin is often too short for you to be able to fold your dough over the pin to transfer it to your baking pan. If you’re ready to upgrade, consider these styles:

Dowel rolling pin. This is a long rolling pin with a consistent diameter from end to end and no handles. It should be long, at least 18 inches, and have a certain weight to it, at least 1-1/2 pounds. Many people like wood, though there are nylon models available that offer easier cleanup.

French rolling pin. Usually considered a secondary rolling pin, this one has tapered ends (it should also be long). If you bake a lot of pies, tapered ends make it easier to roll out dough in circular shapes. 

For Your Best Health

Music for Stress Relief

Even avowed music lovers will be pleasantly surprised by the results of a University of Michigan National Poll on Healthy Aging, done at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, the University of Michigan’s academic medical center. 

Virtually all (98 percent!) of the 2,657 adult participants, ages 50 to 80, said that they benefit in at least one health-related way from engaging with music, whether it’s singing in a choir, playing an instrument at home, or just whistling along while listening to a recording. Seventy-five percent said music helps them relieve stress or relax, 65 percent said it helps their mental health or mood, and 60 percent said they get energized or motivated by music. In addition, 41 percent said music is very important to them, with another 48 percent saying it’s somewhat important.

“Music has the power to bring joy and meaning to life. It is woven into the very fabric of existence for all of humankind,” said Joel Howell, MD, PhD, professor of internal medicine at the U-M Medical School, who worked with the poll team. “We know that music is associated with positive effects on measures from blood pressure to depression.”

People engage with music in a variety of ways: 85 percent of participants listen to it at least a few times a week, 80 percent have watched musical performances on television or the internet at least a few times in the past year, and 41 percent attended live musical performances at least a few times in the past year. Nearly half sing at least a few times a week, some in a choir or other organized group, while others play an instrument on their own or with others. Music also helps people keep in touch with one another throughout their lifetime. 

“While music doesn’t come up often in older adults’ visits with their usual care providers, perhaps it should,” said associate professor of internal medicine at U-M and poll director Jeffrey Kullgren, MD, MPH. “The power of music to connect us, improve mood and energy, or even ease pain (like 7 percent of respondents said it does for them) means it could be a powerful tool.” 

With the rising concern about the health effects of loneliness and social isolation among Americans in general and among older adults in particular, the power of music to connect people and support healthy aging should not be underestimated, Dr. Howell said. 

“Music is a universal language that has powerful potential to improve well-being,” added Sarah Lenz Lock, senior vice president of Policy and Brain Health at AARP and executive director of the Global Council on Brain Health. “AARP’s own research shows that music can play an important role in healthy aging by improving our moods, fostering social connections, and, potentially, enriching our brain health.”

Fitness Flash

Burnout: Are You at Risk?

Do you find that you often feel slammed at work? An upcoming deadline or having to temporarily cover for a sick co-worker may leave you feeling overwhelmed for a time. But when you feel that way more often than not, you could be experiencing burnout, the body’s response to unrelenting stress. 

Burnout can drain you emotionally and physically, putting you at risk for cardiovascular disease, pain, sleeping problems, and depression. Burnout usually refers to a work-related syndrome, but there is evidence that work-life balance also plays a role. Stress and burnout don’t necessarily stop when you go home at the end of the day, as these effects often extend into other areas of life and vice versa.

“We have found that approximately 13 percent of Norwegian employees are at high risk of burnout,” says Leon De Beer, PhD, associate professor of work and organizational psychology at the Norwegian University of Science and Technology (NTNU) department of psychology. He and colleagues from the Healthy Workplaces research group have contributed to a new study on burnout,“The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct‐relevant multidimensionality,”published in the Scandinavian Journal of Psychology. 

According to the researchers, if you’re facing demands and stress at work that seem to be intractable and you have frequently experienced the following symptoms in recent weeks, it might be a sign that you are on the verge of burning out:

• You feel mentally exhausted at work.
• You struggle to feel enthusiastic about your job.
• You have trouble concentrating when working.
• You sometimes overreact at work without meaning to.

For their study, the scientists developed a first-of-its-kind measurement tool to identify the early warning signs of burnout, aptly named Burnout Assessment Tool, or BAT, and it’s now being tested in more than 30 countries. 

BAT measures four main groups of risk factors: exhaustion, mental distancing, cognitive impairment, and emotional impairment. For some people, burnout can be stopped in its tracks and solutions found to improve their situation. For others, however, burnout can last for years if the problem isn’t addressed. The tool can help identify who requires the most urgent follow-up so that the risk of burnout can be reduced.

“For entertainment and educational purposes, interested parties can use our online tool to test if they are at risk of burnout,” said Marit Christensen, PhD, professor at NTNU’s department of psychology. “Please note that the tool only gives an indication of risk and does not provide any type of formal diagnosis or medical advice. If you are concerned about your levels of work-related stress, we encourage you to visit a healthcare provider to discuss the matter.” You can find the tool at https://burnoutassessmenttool.be/start_eng/.

It’s important to identify the early signs of burnout in order to mitigate the harmful effects, said the researchers. The warning signs are often present before things have gone too far, as long as we manage to identify them. “Not addressing the risk of employee burnout in time can have long-term consequences,” said Dr. De Beer. 

“We can deal with burnout through individual treatment, but it is of little use if people return to a workplace where the demands are too high and there are few resources,” added Dr. Christensen. “It is then highly likely that the employee will become ill again. Therefore, it is important to create good working conditions and structures that safeguard the health of employees.” 

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Pan-Sautéed Cod Recipe, Spotlight on Pan, No-Waste Lemon Rinds, Breakfast for Your Brain and Exercise Can’t Undo the Heart Risks of Sugary Beverages

Do you shy away from making fish at home? It doesn’t have to be tricky. What’s more, fish is not only tasty, but also fast to prepare. Cod is a meaty yet mild fish, and when you buy the tenderloin, or central portion, it all cooks evenly—no worries about the thin end drying out while waiting for the thicker portion to be done. This week’s studies are both food-related, but in different ways. You’ve often heard it said that breakfast is the most important meal of the day and a new study serves up some proof, while another offers more evidence of the downside of sugary drinks.

Pan-Sautéed Cod

• Pan-Sauteéd Cod

  This simple prep creates a delicious sauce for the fish, and it cooks in a single pan. If you can’t find wild-caught cod, you can substitute another white-fleshed fish, fresh or frozen, preferably sustainably caught. There are now wonderful online fishmongers that ship expertly frozen fish to your door.

  Ingredients

  • 1-1/2 pounds cod, loin cut
  • Coarse sea salt and freshly ground black pepper
  • 3 tablespoons extra virgin olive oil, plus more for drizzling
  • 4 garlic cloves, finely minced
  • 2 cups cherry tomatoes, halved lengthwise
  • 1/2 cup white wine 
  • 2 tablespoons unsalted butter
  • 1/2 lemon
  • 1/2 teaspoon dried oregano

  Directions

  Step 1

  Use paper towels to thoroughly pat the fish dry; season both sides with salt and pepper. Heat a large cast-iron skillet or deep frying pan over medium-high heat. Once hot, add the olive oil and then the fish, skinned side up. Arrange the garlic and cherry tomatoes around the fish and cook for 8 minutes (overall cooking time will be longer than for a thin fillet). Use a wide spatula to flip the fish, then add the wine. After 3 minutes, cover the pan, lower the heat to medium, and continue cooking until cooked through, about another 5 minutes.

  Step 2

  Take off the cover, add the butter, squeeze the lemon over the fish and tomatoes, and sprinkle with the oregano. Once the butter melts, spoon the sauce over the fish, then transfer to a serving platter for an elegant presentation or slice into individual sections and plate. (If you’d like a thicker sauce, remove the fillet and turn up the heat, cooking the sauce until it reduces.)

  Step 3

  Serve with the tomatoes, pan sauce, and a drizzle of olive oil.

  Yields 4 servings

Healthy Ingredient Spotlight

Cozy up to Cod

A mild fish, cod is a great choice if you want to expand beyond salmon and tuna. It doesn’t have the amount of omega-3 fatty acids found in those fatty fish, but it does have about a gram or so per serving. A great source of protein, plus important nutrients like vitamin B12 and selenium. it’s also low in mercury, a concern when it comes to fish like swordfish and king mackerel.

Because cod will take on the flavors of your recipe’s other ingredients, it lends itself to many cuisines. The center cut or loin, sometimes called the tenderloin, cooks evenly since it’s of a uniform thickness, plus it typically comes boneless and skinless. For the most nutrients and environmentally friendly cod (as well as any type of fish), look for fish that’s fresh or flash-frozen wild caught or certified as sustainably sourced.

Quick Kitchen Nugget

No-Waste Lemon Rinds

If you’re like me, you’re always looking for ways besides composting to use up lemon rinds. Here are some ideas:

Make candied lemon peels. These are a delicious treat and a festive garnish for many desserts. You can easily adapt my candied orange peel technique to lemons (and any other citrus rinds).

Mix up a household cleaner. Fill a spray bottle halfway with distilled vinegar and add the rinds of a lemon or two. Wait a week and then top off the bottle with water. 

Refresh your cutting boards. This is a great use of lemon halves that still have some juice left. Sprinkle your board with salt and then use the cut side of a lemon to make a paste with the salt. After 5 minutes, use the edge of a wide metal spatula or bench scraper to scrape off the paste. Give the board a quick water rinse and pat dry.

Add a citrusy aroma to your home. Bring a large pot of water to a boil, add lemon rinds, and simmer for 10 minutes or longer.  

For Your Best Health

Breakfast for Your Brain

Despite the age-old cliché that breakfast is the most important meal of the day, there hasn’t been a lot of definitive research to support why this might be. Now a Danish study has found that a very specific type of breakfast, one that’s rich in protein, may leave you feeling more satisfied and improve your concentration for the day ahead. 

The study followed 30 obese women, ages 18 to 30, for three days, during which time the women ate either a protein-rich breakfast, a carbohydrate-rich breakfast, or no breakfast at all. The women’s sense of satiety, hormone levels, and energy intake were measured at lunchtime, along with their total daily calorie intake. They also completed a cognitive concentration test during the study.

“We found that a protein-rich breakfast with skyr and oats increased satiety and concentration in the participants,” said Mette Hansen, PhD, associate professor in the department of public health at Aarhus University in Denmark and one of the authors of the study. Several of the subjects even had a hard time finishing the entire protein-rich breakfast!

“It’s intriguing that there can be such a big difference in the satiety effect of two different meals with the same calorie content. Had the women in the project been allowed to choose the size of the meal themselves, it’s likely that they’d have consumed more food and thereby more calories on the day they were served bread and jam than on the day they were given skyr and oats,” Dr. Hansen said. 

Although the study provides important insights, it also has its limitations because only overweight young women participated, and it was based on relatively short-term observations, leaving open the question of how long-term dietary changes can affect health and weight. The researchers are already in the midst of a study looking at the differences between a high-protein breakfast and a low-protein breakfast on body composition and other measures such as microbiota and cholesterol levels.

The study, “A dairy-based protein-rich breakfast enhances satiety and cognitive concentration before lunch in young females with overweight to obesity: A randomized controlled cross-over study,” was published in the Journal of Dairy Science.

Fitness Flash

Exercise Can’t Undo the Heart Risks of Sugary Beverages 

Despite all the benefits of physical activity, it can’t neutralize the risks of cardiovascular disease (the world’s leading cause of death) associated with drinking sugar-sweetened beverages, according to the new study “Sugar-sweetened or artificially-sweetened beverage consumption, physical activity, and risk of cardiovascular disease in adults: A prospective cohort study,” published in The American Journal of Clinical Nutrition.

Sugar-sweetened beverages are the largest source of added sugars in the North American diet. “The marketing strategies for these drinks often show active people drinking these beverages. It suggests that sugary drink consumption has no negative effects on health if you’re physically active. Our research aimed to assess this hypothesis,” said study co-author Jean-Philippe Drouin-Chartier, PhD, professor at the Université Laval in Canada.

For the study, scientists looked at two groups of participants, totaling around 100,000 adults, who were followed for about 30 years. The data show that those who consumed sugar-sweetened beverages more than twice a week had a higher risk of cardiovascular disease, regardless of their physical activity levels.

The study found that even the recommended 150 minutes of weekly physical activity said to protect against cardiovascular disease is not enough to counter the adverse effects of sugar-sweetened beverages. “Physical activity reduces the risk of cardiovascular disease associated with sugar-sweetened beverages by half, but it does not fully eliminate it,” Dr. Drouin-Chartier said.

The frequency of consumption considered in the study—twice a week—is relatively low, but still significantly associated with cardiovascular disease risk. With daily consumption, the risk of cardiovascular disease is even higher. For this reason, Dr. Drouin-Chartier underlined the importance of targeting the omnipresence of sugar-sweetened beverages in the food environment, a category that includes soft and carbonated drinks (with or without caffeine), lemonade, and fruit cocktails. The study did not specifically consider energy drinks, but they also tend to be sugar-sweetened. 

For artificially-sweetened drinks, often presented as an alternative solution to sugar-sweetened beverages, consumption was not associated with a higher risk of cardiovascular disease. While replacing sugar-sweetened beverages with diet drinks is better in some respects because it reduces the amount of sugar, Dr. Drouin-Chartier reiterated that the best drink option remains water.

“Our findings provide further support for public health recommendations and policies to limit people’s intake of sugar-sweetened beverages, as well as to encourage people to meet and maintain adequate physical activity levels,” added lead author Lorena Pacheco, a research scientist in the department of nutrition at the Harvard T.H. Chan School of Public Health.

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Rich Chocolate Rolled Cookies Recipe, Spotlight on Cocoa Powder, A Surprising and Unhealthy Consequence of Stress, Spouses may Do Better Exercising Separately

If you’ve cooked from my e-book My All-Time Favorite Chocolate and Olive Oil Recipes, you know that extra virgin olive oil and cocoa add wonderful flavor to sweet as well as savory foods. But if you’ve never paired chocolate and EVOO, my chocolate cookie recipe is a wonderful introduction. This edition of the newsletter features two studies on topics many of us grapple with—stress and the quest to exercise more. Both have eye-opening suggestions for better health.

Rich Chocolate Rolled Cookies

• Rich Chocolate Rolled Cookies

  Looking to satisfy a sweet tooth? This recipe for chocolate cookies uses olive oil in place of some of the traditional butter, resulting in a cookie that practically melts in your mouth. If you’re a true chocoholic, press a few chocolate chips into the dough or dip one end of each cookie in melted dark chocolate for an added treat.

  Ingredients

  • 3 cups all-purpose flour 
  • 1-1/2 cups unsweetened natural cocoa, plus more for rolling out the dough
  • 2-1/2 teaspoons baking powder 
  • 1 teaspoon instant espresso powder
  • 1/4 teaspoon salt 
  • 12 ounces unsalted butter 
  • 2-1/2 cups sugar 
  • 4 tablespoons extra virgin olive oil 
  • 2 large eggs 
  • 1 teaspoon vanilla paste or extract

  Directions

  Step 1

  In a large bowl, sift together the flour, cocoa, baking powder, espresso, and salt. In the bowl of a stand mixer with the paddle attachment or with a hand beater, cream the butter for 5 minutes, then slowly add the sugar and then the olive oil. Add eggs and vanilla and beat until combined. On low speed, beat in the flour-cocoa mixture in 4 batches. When fully incorporated, transfer the dough to a large piece of parchment paper, flatten it out into a rectangle with your hands, fold up the sides of the paper, and chill for 30 minutes for easier rolling. 

  Step 2

  Preheat your oven to 350°F. Working in two batches and using a small amount of cocoa to coat the rolling pin, roll out the dough into a larger rectangle about 1/4 inch thick. While you can use cookie cutters, it’s easier and more elegant to cut the dough into long, thin rectangles, about 4 inches long by 1-1/2 inches wide. Transfer to cookie sheets, spacing them about 1 inch apart—they will spread. Bake until set and slightly puffed, about 10 minutes, rotating the cookie sheets halfway through. Don’t overbake—they’ll firm up as they cool. Cool the cookies on racks and then place them in a cookie tin.

  Yields about 50 cookies

Healthy Ingredient Spotlight

All Hail (Tuscan) Kale

If you’re not a huge kale fan, it could be that you’ve never tasted Tuscan kale. Also known as lacinato kale, black kale (cavolo nero), and even dinosaur kale, deeply colored Tuscan kale is not as bitter as curly kale, the more common option. So you get all the benefits of dark leafy greens that you don’t have to massage to make tender. 

Quick Kitchen Nugget

Soaking Beans

It’s hard to beat the convenience of canned beans, but there are many more varieties to choose from when you use dried beans. Even the same variety that’s available canned will be more flavorful when made from scratch. One pound of dried beans will yield about 7 cups when soaked and cooked.

There’s very little active time needed—place your beans in a bowl that can hold at least three times their volume, cover them with cold water, and come back 4 hours later (or overnight). 

You can shorten the soaking time with a quick hack: Rinse the beans and place them in a large pot. Add enough cold water to cover them by 2-3 inches and bring the water to a boil. Cook for 5 minutes, then take the pot off the heat and let it sit for an hour. 

For Ribollita, the beans must be fully cooked before adding to the soup because of its limited cooking time. To do this, rinse your soaked beans, return them to your pot, cover them again with cold water, and bring them to a boil. Simmer for about 2 hours or until the beans are tender but not overly soft and they’re ready to add.

For Your Best Health

A Surprising Benefit of Flaxseed

A new animal study demonstrated how the gut microbiome could be a factor in breast health. In the study, flaxseed components called lignans were shown to influence the relationship between gut microorganisms and the expression of mammary gland microRNAs or miRNAs (short, noncoding RNAs that regulate gene expression). A subset of these miRNAs regulates the genes involved in breast cancer, including genes that control cell proliferation and migration. 

“The gastrointestinal microbiota plays an important role in modifying many components of our diet to impact human health,” said Jennifer Auchtung, PhD, assistant professor in the Food Science and Technology Department at the University of Nebraska Lincoln and the editor who coordinated the review of the paper. “In this study, we found correlations between diets enriched in flaxseed, cecal microbiota composition, and miRNA profiles in the mammary gland that regulate many pathways, including those involved in cancer development. This preliminary study supports further research into the role that the microbiota plays in dietary approaches to reduce risk factors associated with disease.”

For this study, the researchers studied the effects of flaxseed lignans on the microbiota of young female mice. Lignans, fiber-associated compounds found in many foods and particularly plentiful in flaxseed, are associated with reduced breast cancer mortality in postmenopausal women. The researchers found that lignan components generate specific miRNA responses in the mammary gland. 

To determine whether the relationship between the microbiota and mammary gland miRNAs could be manipulated to reduce the risk of breast cancer, the researchers fed flaxseed lignan components to female mice to see whether gut cecal microbiota profiles are related to miRNA expression in the mammary gland. The cecum, the first part of the colon, located in the right lower abdomen near the appendix, is believed to have a role in production of short-chain fatty acids and has been proposed to serve as a reservoir of anaerobic bacteria.

One flaxseed oil lignan requires microbial processing to release bioactive metabolites, small-molecule chemicals produced during metabolism that influence physiology and disease—in this case, having antitumor effects. The researchers found that the microbiota and mammary gland miRNA are related and that flaxseed lignans modify the relationship to be non-cancer-causing.

“If these findings are confirmed, the microbiota becomes a new target to prevent breast cancer through dietary intervention,” said Elena M. Comelli, PhD, associate professor in the Department of Nutritional Sciences and the Temerty Faculty of Medicine, University of Toronto, the corresponding author on the paper. The study was published in Microbiology Spectrum, a journal of the American Society for Microbiology.

Fitness Flash

Alternating Cardio with Resistance Exercise is Heart-Healthy

A robust body of evidence shows aerobic exercise can reduce heart disease risks, especially for people who are overweight or obese. But few studies have compared results with resistance exercise, also known as strength or weight training, or with workout regimens that are half aerobic and half resistance. Researchers at Iowa State University led one of the longest and largest supervised exercise trials to help fill this gap.

Their results, published in European Heart Journal, indicate that splitting the recommended amount of physical activity between aerobic and resistance exercise reduces cardiovascular disease risks as much as aerobic-only regimens. However, resistance exercise on its own for the same amount of time did not provide the same heart health benefits.

“If you’re bored with aerobic exercise and want variety or you have joint pain that makes running long distances difficult, our study shows you can replace half of your aerobic workout with strength training to get the same cardiovascular benefits. The combined workout also offers some other unique health benefits, like improving your muscles,” said Duck-chul Lee, PhD, lead author and professor of kinesiology at Iowa State. That’s a huge plus because we tend to lose muscle mass, and consequently mobility and independence, as we age. 

“One of the most common reasons why people don’t exercise is because they have limited time. The combined exercise with both cardio and strength training we’re suggesting is not more time-consuming,” Dr. Lee underscored. Performing a certain number of sets and repetitions with weight machines, free weights, elastic bands, or your own body weight through push-ups or lunges, all count as resistance exercise.

How the study was done: 406 participants between 35 and 70 years of age enrolled in the one-year randomized controlled exercise trial. All met the threshold for being overweight or obese with body mass indexes between 25 and 40 kg/m2 and had elevated blood pressure. The researchers randomly assigned participants to one of four groups: no exercise, aerobic only, resistance only, or aerobic plus resistance. Those who were in one of the three exercise groups worked out under supervision for one hour three times a week for one year.

Every participant in the exercise groups received a tailored workout routine based on their individual fitness levels, health conditions, and progression. Those assigned to resistance training were given a certain number of sets, repetitions, and weights for weight-lifting machines. With aerobic exercises, participants wore a heart rate monitor and inserted a unique exercise program key into a treadmill or stationary bike. Sensing the participant’s heart rate, the machine automatically adjusted the speed and grade to match the prescribed intensity.

All participants wore pedometers to measure daily steps and met every three months with registered dietitians at Iowa State for “Dietary Approaches to Stop Hypertension” education, which is promoted by the National Institutes of Health. On three random days per month, participants were asked to record what they had consumed in the last 24 hours with an online dietary assessment tool developed by the US National Cancer Institute.

At the start of the yearlong clinical trial, six months in, and at the end, the researchers measured each participant’s systolic blood pressure, low-density lipoprotein cholesterol, fasting glucose, and body fat percentage, all well-established cardiovascular disease risk factors. “Many previous studies only looked at one of these four factors, but it’s really multiple factors combined that increase cardiovascular disease risk,” explained Dr. Lee. The researchers used a composite score to fairly quantify changes across all four factors since each uses a different unit of measurement. A lower composite score indicated less risk of developing cardiovascular disease.

At the end of the yearlong trial, the percentage of body fat in all three exercise groups had decreased significantly compared to the no-exercise control group. The authors found that “every -1% body fat reduction is associated with -3%, -4%, and -8% lower risks of developing [cardiovascular disease] risk factors of hypertension, hypercholesterolemia, and metabolic syndrome.” Taking all four cardiovascular disease risk factors into account, the aerobic and combined exercise groups had lower composite scores than the control group, with results consistent across gender and age.

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