4 Tuesday March 15 2022 | the times
health
Dr Mark Porter
That ‘ruddy-faced buffoon’ you’ve
insulted may in fact have rosacea
How to get
stronger: lift
weights for 3
seconds a day
New research has found that doing a
single three-second exercise daily can
lead to strength gains — but does it
just work for beginners, asks Peta Bee
L
ess is more is a phrase
most of us like to hear
when it comes to
exercise, so many will
be pleased by the news
that US researchers have
found that the 10,000
steps a day target we
are often told to aim for is too high.
Apparently walking 6,000 steps a day
is enough to reduce the risk of early
death in the over-60s, and anything
over 8,000 is a waste of shoe leather.
It’s a similar situation in the gym. In
recent years, cardio workouts have
been crunched to a minimum with
HIIT (high-intensity interval training)
workouts lasting a matter of minutes.
Now strength training is under the
spotlight, with a new study suggesting
that just three seconds of daily
weight-training could make a big
difference to your muscle strength if
you have neglected resistance exercise
until now, something that the NHS
recommends you shouldn’t do.
For their study, exercise scientists
reporting in the Scandinavian Journal
of Medicine & Science in Sports asked
a small group (39) of healthy but
sedentary men and women to
perform the astonishingly brief
arm-strengthening exercise with
weights every day for a month. To
ensure uniformity of movement
among participants, the team from
Niigata University of Health and
Welfare in Japan and Edith Cowan
University in Australia used a
lab-based training machine called
an isokinetic dynamometer that
recorded precise measurements of
force and range of motion as they
performed a simulated three-second
biceps curl with “maximum force” —
as heavy as they could manage —
on five days a week.
There were subtle variations in how
they lifted, says Professor Ken Nosaka,
director of exercise and sports science
at ECU and one of the researchers.
“One group performed an ‘eccentric’
lift, which meant lowering the weight
down from the shoulder so that the
elbow joint was forcibly extended
and the muscle lengthened. A second
‘concentric’ group slowly lifted the
weight upwards, meaning the muscles
shortened, as in a biceps curl, and the‘isometric’ group held the weight in
place at the mid-point.”
They continued with this single
three-second daily contraction on
Mondays to Fridays for four weeks,
completing 20 sessions in all, with a
total muscle contraction time of 60
seconds in the month-long trial. They
did no other exercise during this time
and a control group did nothing, not
even the minuscule arm workouts.
Considering the minimal time and
fitness investment, when Nosaka and
his colleagues came to re-evaluate the
effects of the three second workouts
the results were impressive. All the
participants had some strength gains
in their biceps with improvements of
6-7 per cent among the concentric and
isometric exercisers, yet it was the
eccentric lifters who made the biggest
leap, ending the short trial with arm
muscles 11.5 per cent stronger than
when they started. “People think you
have to spend vast amounts of time
exercising to improve their muscle
strength, but that’s not the case,”
Nosaka says. “Our study results
suggest that a very small amount of
exercise stimulus — even 60 seconds
in four weeks — can increase muscle
strength and that every muscle
contraction counts.”
The improvements were seen in
people who were starting from a
strength-training base of zero, so
gradually increasing intensity and
duration would be necessary to
maintain and improve further. But it’s a
starting point that will come as a relief
to those who have skirted resistance
training in the past. Government
physical activity guidelines suggest that
adults should do “strengthening
activities that work all the major
muscle groups — legs, hips, back,
abdomen, chest, shoulders and arms —
on at least two days a week”.
That doesn’t necessarily mean
swinging a kettlebell at the gym —
lifting your own bodyweight with
push-ups and squats, even doing
repeated chair-sit-to-stand moves,
would count. Yet statistics from Sport
England’s Active Lives survey reveal
that 34 per cent of men and 38 per
cent of women fail to meet this target.
From age 75 onwards, when muscle
strength is of prime importance in theand pustules) than redness, which may
require laser therapy if marked.
It is important not to underestimate
the psychological impact of rosacea.
Just as some teenagers can be upset by
a few spots while others seem unfazed
by severe acne, so it is with rosacea in
older adults who can develop anxiety,
depression and low self-esteem as a
result of even relatively mild disease.
Rosacea can also spread to the eyes,
causing complications such as
blepharitis and conjunctivitis, and
there is a rare form — rosacea
fulminans — that causes a severe
outbreak of acne-type spots and
cysts over much of the face.
However, it’s changes to the
nose — the classic swollen
“strawberry” appearance
known as rhinophyma — that
many dread because it is hard
to treat, with the most
severe cases resisting
all but using lasers
and/or surgery.
The British
Association of
Dermatologists
has produced
fact sheets on
rosacea and
rhinophyma,
which can be
found at bad.org.uk.
The rosacea one
contains links to other
sites, including DermNet
NZ (dermnetnz.org/
topics/rosacea).
Like most conditions,
the earlier rosacea is
diagnosed the greater
the chances of minimising
its impact. And not
commenting on someone’s
complexion when arguing
with them helps too.confused with dermatitis). Drinking
may make rosacea more obvious but
having the condition doesn’t mean
that the person is a heavy drinker.
Rosacea is not curable (see below)
but it can normally be controlled by
a range of treatments that reflect the
differing theories about what triggers
the condition. Self-help includes
avoiding the sun or using high-factor
sunscreens and switching to a
non-soap cleanser.
Topical treatments include antibiotic
gels, the anti-inflammatory azelaic
acid and the antiparasitic drug
ivermectin to combat Demodex mite
infestation. Oral antibiotics (eg
tetracyclines) are another option.
All take at least two months to work
properly and tend to be better at
treating inflammatory spots (papulesY
ou need a thick skin to
thrive on a social
medium such as
Twitter, and it helps if
it’s flawless too, as the
MP Edward Leigh
knows only too well.
I may not share his
views on Brexit or Ukrainian refugees
but that doesn’t mean it is acceptable
to harangue him with comments
about his complexion.
“Peak gammon” and “ruddy-faced
buffoon” are two of the milder barbs
I have seen. Ironic, given that he is
chairman of the All-Party
Parliamentary Group on Skin, which
campaigns for better awareness of the
impact on mental wellbeing of
dermatological conditions such as
rosacea, which he has.
Rosacea, or acne rosacea as it used
to be known, is a chronic
inflammatory skin condition that
affects the nose, cheeks, chin and
forehead. Symptoms include redness,
flushing, prominent blood vessels
(telangiectasia), spots and thickening
of the skin, particularly of the nose.
And it is common.
According to the National Institute
for Health and Care Excellence (Nice),
as many as one in 20 people in the
UK has some degree of rosacea, most
of them women in their thirties, forties
or fifties. Men may be less likely to get
it, but if they do it tends to be more
severe and disfiguring.
There is no single cause and the
underlying mechanism is not fully
understood. It is essentially an
abnormal immune response associated
with a range of predisposing factors
including smoking, genetics (it can run
in families), overexposure to the sun,
and infestation with Demodex mites
(these thrive near oil-producing glands
on our skin but are more common/
numerous in people with rosacea).
Once it develops symptoms are
typically exacerbated by stress, anger,
exercise, spicy foods, alcohol and
extremes of temperature (hot and
cold). The flushing and redness can
also be made worse by some types
of prescription medication, including
the popular blood-pressure treatment
amlodipine and steroid creams
(often prescribed in error if rosacea is
Q A
After telling my GP
that my memory was
starting to let me
down I had some
tests that revealed
a folate deficiency.
She has suggested
correcting this as
the first step, as it
can cause memory
problems. Is this just
wishful thinking?No. Low levels of
folate (vitamin B9)
can affect brain
function, as can B12
deficiency, and we
always test for both
when assessing
people concerned
about failing
memory. However,
this doesn’t mean
your deficiency is
definitely the cause
of your concerns,
but it makes sense to
try supplements to
see if they help.
Other clues to low
folate levels include
unexplained fatigue,
weakness, mouth
ulcers and a pale
complexion. And
deficiency is more
common in people
who drink too much
alcohol, have liver,
kidney or heart
disease, or struggle
to absorb nutrients
properly because of
bowel problems such
as coeliac disease.
Good natural
sources include
asparagus, broccoli,
brown rice and peas,
but you will need
pills to replenish
your stores, and
the standard
regimen is 5mg
of folic acid
daily for four
months. Never
take folic acid
supplements
without
checking B12
levels, since
they can mask
B12 deficiency
that can lead
to irreversible
nerve
damage.Rosacea tends
to be more severe
and disfiguring
when men get it
Face facts
6 Most people who develop rosacea
can be managed in general practice,
but more severe/persistent cases
benefit from referral to a
dermatologist
6 Of those people seen by specialists
about one in five will go into
complete remission (no/minor
symptoms), although this can take
years of treatment to achieve
6 Three out of five will have a partial
remission, with the remaining fifth
not improving or getting
progressively worse
For the latest guidance from Nice on
managing rosacea, visit nice.org.uk