By Dr Günther Neumayr and Dr Peter Lechleitner
We all like holidays, but do they improve our health? We lack knowledge about the potential health effects of holidays. In fact, we know nothing about whether and to what extent the duration and activities of a vacation exert a positive impact on our health. Recently, we published the results of the East Tyrolean Health Tourism Study in the Journal of Sports Medicine and Physical Fitness (“Effects of a one-week vacation with various activity programs on cardiovascular parameters”, J Sports Med Phys Fitness, 2018 Mar 1. doi: 10.23736/S0022-4707.18.08221-X. [Epub ahead of print]). The East Tyrolean Health Tourism Study was the first to investigate, among healthy vacationers, the cardiovascular effects of a brief vacation with various activities. The main elements of the study are summarized and discussed here: 52 healthy vacationers spent one week in East Tyrol and participated in two types of activities (golf vs. Nordic walking or e-biking [nw&eb]). In the former group 30 subjects played golf for 33.5 hours per week, and in the nw&eb group 22 did Nordic walking or e-biking for 14.2 hours per week. Cardiovascular parameters such as performance capacity, blood pressure, heart rate profiles, and cardiac diastolic function were measured by a cardiopulmonary exercise test, Holter ECG, and echocardiography performed one day before and after the stay. We observed a significant decrease of 1.0 kg in body weight in the nw&eb group, but not in the golf group. In both groups we noted a reduction in blood pressure and heart rate, which was marked and significant only in the golf group. We registered no significant changes in performance capacity, but did note an improvement of cardiac diastolic function in both groups. The Table below provides a summary of the results.
Table. Cardiovascular parameters in the golf group and the Nordic walking plus e-biking group (nw&eb group) one day before and after vacation
Golf-Group NW&E-Group
pre-vacation |
post-vacation |
pre-vacation |
post-vacation |
|
HRmean |
81 (73; 93) |
77 (75; 84) ** |
81 (76; 87) |
76 (70; 86) |
HR100W |
123 (108; 136) |
112 (104; 137) * |
116 (105; 132) |
112 (98;133) |
HRmax |
156 (142; 165) |
155 (142; 165) |
155 (143; 164) |
155 (137; 169) |
SBPrest |
130 (117; 135) |
119 (111;128)* |
125 (114; 136) |
122 (111; 142) |
DBPrest |
80 (73; 84) |
75 (69; 77) * |
84 (78; 87) |
81 (74; 84) |
SBP100W |
162 (148; 184) |
153 (131;180) * |
143 (136; 182) |
150 (130; 170) |
Wmax |
150 (124; 199) |
151 (128; 184) |
175 (125;216) |
172 (132; 229) * |
VO2max/kg/min |
26 (23; 35) |
26 (21;34) |
28 (25; 35) |
28 (21; 35) |
LV-Tei |
0.61 (0.50; 0.69) |
0.51 (0.44; 0.64) |
0.51 (0.44; 0.64) |
0.45 (0.35; 0.56) *** |
E/e´ ratio |
8.0 (6.4; 9.5) |
7.8 (6.4; 8.5) |
7.8 (6.9; 10.1) |
7.4 (6.7; 8.3) * |
NT-proBNP |
74 (32; 101) |
62 (43; 88) |
44 (31; 80) |
46 (26; 99) |
Within the group: vs pre-vacation *=p<0.01; vs pre-vacation **=p<0.005; vs. prevacation ***=p<0.001; Results are expressed as median with interquartile range
NW&E = Nordic Walking and E-Bike, HR = heart rate, SBP = systolic blood pressure, DBP = diastolic blood pressure, W = Watt; VO2 max = maximal oxygen consumption, LV-Tei = left ventricular Tei index, NT-proBNP = NT-pro brain natiuretic peptide
Vacation is a form of macrorecovery and is likely to be a more powerful recovery opportunity than regular free evenings or weekends because of two underlying mechanisms. The first passive mechanism is that a vacation denotes a direct release from job demands; the second is the active mechanism of spending time on valued non-work activities of one’s own choice, such as hobbies, family, or sports. In sports, active recovery with low intensities, at a work rate <30% of VO2max, accelerates the regeneration process by faster lactate degradation compared to passive recovery in sedentary persons. Therefore, we assumed that a vacation with an activity program might result in earlier and more complete recovery than that achieved by a simple holiday. Playing golf, Nordic walking, and e-biking are activities of low to moderate exercise intensity, feasible even for untrained persons. The observed cardiovascular benefits in our subjects included a marked reduction in systolic and diastolic blood pressure, reduction of heart rate, and the improvement of cardiac diastolic function. Blood pressure was reduced to a much greater extent in the golf group because golf involves extensive isometric handgrip training. The mean reduction in blood pressure in the golf group was 11.0/5.0 mmHg, which is similar to the results of a recent meta-analysis by Cornelissen (13.5/6.1 mmHg; Hypertens 2011;58:950-958). Therefore, it would be quite appropriate to assert that playing golf is a very effective antihypertensive treatment and even better than walking or biking.
In conclusion, the data of the East Tyrolean Health Tourism Study prove that a mere one-week vacation with an activity program induces several improvements in cardiovascular parameters, and may be recommended as an excellent recovery program for cardiovascular regeneration. Active holidays seem to be more regenerating than lazy ones.
Competing interests
None declared
Prof Günther Neumayr Consultant for Internal Medicine Cardiology and Sports Medicine; Medical Office, Lienz, Austria; Former Head of the Departments of Internal Medicine in the Hospitals of Kitzbühel and Innichen; Current President of the Austrian Society of Sports Medicine and Prevention. Contact: neumayr.g@aon.at