Category Archives: exercise

Can 1 Minute of Exercise Possibly be Useful?

IMG_8348rt5x7bwYou may have noticed (or perhaps soon will) this article from the NY Times earlier today with an enticing headline: Only a single minute of high intensity exercise  can replace 45 minutes of moderate exercise. This seems like good news for those of us who are always pressed for time to find time for exercise. But we need to delve into the details of this study before drawing broad conclusions about the optimal duration of exercise.

The study in question showed that an exercise routine using high intensity exercise for one minute of total duration (in a routine that took 10 minutes total including warmup and rest periods) had similar benefits to a longer routine of moderate exercise in this study group of 25 subjects. It suggests that incorporating intervals of high intensity exercise can shorten the amount of time needed to obtain long-lasting health benefits.

I do think this is an enticing concept and it is a very good reminder that adding interval trainingrunning shoes can be quite beneficial to our health and our fitness goals. But we need to remember why we advocate for physical activity for wellness and disease prevention. Exercise should not be a “bitter medicine” taken as quickly as possible, but should be considered a desired component of our day-to-day lifestyle. Therefore I think that moderate exercise, such as brisk or sustained walking, as well as light jogging, can have much broader benefits, such as improving our mental state, helping concentration and sleep, and of course improving our long-term health and disease prevention.

This article is certainly a useful reminder that adding intervals to exercise, for those of us who are physically able, can help us reach our fitness goals quicker and more successfully.  However, these type of programs can also increase the risk of injury or worsen underlying medical conditions.  Therefore, high intensity exercise regimens should only be undertaken with the guidance of a fitness professional, and for those with chronic heart or other medical conditions, with the approval of our personal physician or health care provider.

Here is the link to full article.

Another Reason to “Stand Up” to Heart Disease!

IMG_8348rt5x7bwIn case you need another excuse to get off the couch (and think about a treadmill desk). . . it appears “too much sitting” may in itself contribute to the progression of heart plaque. . .

Too Much Sitting May Up Risk of Coronary Artery Calcification

Marlene Busko

SAN DIEGO, CA — Each added hour spent sitting was associated with a 14% increase in coronary artery calcium (CAC) score, independent of traditional risk factors, including physical activity, in a study of middle-aged subjects without cardiovascular disease[1].

“Our study contributes to the growing body of evidence whereby health consequences of ‘sitting too much’ appear to be distinct from those of ‘too little exercise,’ and [it] suggests that increased subclinical atherosclerosis may be one of the mechanisms through which sedentary behavior increases CV risk,” Dr Jacquelyn Kulinski (Medical College of Wisconsin, Milwaukee) told heartwire from Medscape.

The researchers examined data from 2031 participants in theDallas Heart Study who were aged 20 to 76, with a mean age of 50. Just over half (62%) were women, and about 50% were black.

Participants had a CT scan to measure CAC; a CAC score above 10 was deemed positive and a score below 10 was deemed negative. In addition, the participants wore a watch accelerometer for at least 4 days to measure body movements, which were classed as sedentary, light activity (nonexercise), or moderate to vigorous physical activity.

On average, participants were sedentary for 5.1 hours a day, but this ranged from 1.1 to 11.6 hours a day. Older people, those with a higher body-mass index (BMI), and those with diabetes or hypertension were more likely to spend more time sitting.

After adjustment for BMI, systolic blood pressure, total cholesterol, HDL cholesterol, statin use, type 2 diabetes, smoking, household income, education, marital status, employment, and moderate to vigorous physical activity, each hour of sedentary time was associated with a 10% higher odds of having CAC (adjusted odds ratio 1.10, 95% CI, 1.01–1.21; P=0.035).

Moderate to vigorous physical activity was modestly associated with CAC in models adjusted only for age, gender, and ethnicity, but the association disappeared after adjustment for traditional cardiovascular risk factors, including smoking, diabetes, BMI, cholesterol, and blood pressure, Kulinski added. Even though study participants exercised only an average of 6 minutes a day, other studies in marathon runners have also reported that exercise was not associated with CAC, she noted.

LINK TO FULL ARTICLE:

Too Much’ Sitting May Worsen Coronary Calcification, Regardless of Exercise
Heartwire from Medscape, 2015-03-11

Heart Health News. . . You Can Use

IMG_8348rt5x7bwHere are some quick links to useful items in the news recently that reflect new findings on prevention and heart health:

Could drinking alcohol actually affect the way you exercise? Some new research described here suggests that could be the case – and in a positive way. 

The upshot? Because exercise and alcohol intake affect similar “pleasure” centers in our brain, you may actually be tempted to drink more in days you exercise – but people who drink moderate amounts of exercise also tend to exercise more regularly. . . and seem to be healthier. (see our earlier article about wine and heart health).

Is coffee good or bad for you? A new study described here looked at coffee intake and risk of death from various causes.

The upshot? Keep bringing on the java (and consider buying Starbucks stock!)

Can you be “too old” to exercise. . or get its benefits? Not according to new research. 

The upshot? Even in those over age 75, regular walking can reduce your risk of heart attack and stroke. So keep moving!

This article describes research into the link between weekend sleep and weekday sleep.

The upshot? Sleeping in late on weekends may feel good, but may have negative health consequences.

Remember. . only your doctor can give you specific health care advice. . so always check with your health provider if these articles (and the advice they contain) apply to you and your health situation. 

 

VIDEO: Which Exercise is Best for Preventing Heart Disease?

IMG_8348rt5x7bwRecently, I was asked by the online video blog, VIDOYEN, about the best exercise for heart prevention. Here is my 3 minute answer:

Cardiologist and Heart Health Advocate Kanny S. Grewal, MD answers Which Exercise is Best for Preventing Heart Disease? (3 minutes) – VIDOYEN.

 

Is “Too Much” Exercise Harmful? Some New Information. . .

IMG_8348rt5x7bwWe have known for some time that physically active individuals have a longer life span and are overall healthier than those who are sedentary.  This certainly extends to heart disease, where exercise clearly has a beneficial effect for both prevention and therapy. But more recent research into “extreme” levels of exercise, especially endurance running, is raising questions about whether it is possible to exercise too much. This is becoming a controversial and heavily debated topic in the world of sports medicine.

Recently, a new study was released which adds important information to this debate. This was a veryrunning shoes detailed study in Europe of individuals over many years to try to link the degree of jogging with overall mortality and cardiovascular health.  Called the Copenhagen Heart Study, this particular analysis identified over 1000 active joggers and followed them for over 12 years. Not surprisingly, those who exercise either mild or moderate amounts were healthier and lived longer than their sedentary counterparts. What was most interesting however, is that those who ran the most vigorously (defined as 4 or more sessions weekly, or high intensity sessions) actually did not have improved survival compared to the sedentary non-runners.  This suggests that perhaps more extreme levels of running may actually be harmful. In fact, other studies have suggested a similar connection, such as a higher risk of irregular heart rhythms in those who participate in extreme sports.  The study did have some limitations as it did not address other types of exercise, the participants were not randomized,  and the limited number of participants prevented detailed analysis and comparisons.

So, for overall wellness and heart health, what level of exercise should we recommend? Here are some guidelines:

1. Remember, always check with your physician or other health provider to determine whether physical activity is appropriate for your specific medical condition.

2. This study adds to the evidence that light and moderate exercise is clearly beneficial.  The current recommendation by the American Heart Association is 150 minutes a week of moderate exercise. That could include brisk walking, light or moderate jogging, or many other types of aerobic activity. However, as we previously reported, even very short sessions of exercise can be beneficial.

3. High-intensity exercise, defined as 4 or more sessions a week, or frequent sessions of very high intensity activity (for example, running > 7 MPH) , may not be optimal for long-term health and survival. There is still minimal evidence that this level of exercise is actually harmful, but the benefit may not be as high as for those that stick to moderate exercise.

4. For those who elect to perform higher intensity exercise, it may be reasonable to cycle the periods of high activity with “down time”or cross-training with other less-intense types of exercise. There is still really no evidence that any particular type of aerobic exercise is best, so an active lifestyle that focuses on a mix of activities may be optimal.

Other than perhaps diet, an active lifestyle is still the single most effective way to prolong our lives and prevent disease. We hope you will join the HeartHealth Docs in participating in the upcoming Capital City Half Marathon and the New Albany Walking Classic.

Here is a reference to the study mentioned and this article.

Here is our overview of exercise, and an additional article on the benefits of exercise.

Exercise can make you feel younger. . . and function younger!

IMG_8348rt5x7bwMost of us are well aware of the benefits of regular exercise (certainly, regular readers of this blog should be!)  While there is plenty of evidence of the the benefits of exercise for our heart and circulatory health, an interesting new study has taken this concept a bit further – it showed that older adults who are regular exercisers were not only healthier, but essentially “younger” – in other words, their bodies had the physiologic and mental attributes of someone who was younger. And, this not only included their athletic endurance, but things like mental acuity and reflexes. This study was in an unusual group of elderly folks who were fairly vigorous cyclists, but there is a good chance these findings would apply to all active elderly adults.

So while some aspects of normal “aging” may be inevitable, studies such as this show that staying Runningactive may not only make our bodies and minds feel younger, but possibly function younger! Here is a link to a nice summary of the study in the New York Times:

For some of our tips about starting and maintaining an exercise program see our previous article. And always remember, you should always check with your doctor to make sure that an exercise program is safe and beneficial for your specific health conditions.

Asian Americans Face Greater Risk for Stroke and Hypertension

Asian Americans are at higher risk for stroke and hypertension compared to whites, according to a study examining U.S. death records from 2003–2010.

IMG_8348rt5x7bwAlthough heart disease is the No. 1 killer of all Americans, certain races and ethnic groups face higher cardiovascular risk than others. Asian Americans are the fastest growing racial/ethnic group in the United States, yet little is known about heart risks in distinct subgroups of the Asian American population.

Published in the Journal of the American College of Cardiology, a recent study analyzed death records for the six largest Asian-American subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean and Vietnamese. Together, these subgroups make up 84% of the Asians in the United States.

After comparing U.S. death rates from 2003–2010, researchers found that stroke and high blood pressure was more common among every Asian American subgroup compared to non-Hispanic whites. Compared to whites, Asian Indians and Filipino men also had greater mortality from coronary artery disease—a condition that occurs when the heart’s arteries narrow, often due to the plaque build-up on the arterial walls. (text taken from http://www.cardiosmart.com)

Until further studies clarify the specific reasons for elevated risk in Asian Americans, the goals for prevention in this population are similar to all adults, with a few areas of emphasis:

1. Blood Pressure Control – monitoring blood pressure – .and prompt treatment of elevated readings – it is important for all adults, but in Asian American’s we may need to emphasize more thorough monitoring, and consider intervention ( either lifestyle changes or medications) at an earlier age or with lower blood pressure targets. Here is more information.

2. Manage Your Cholesterol – in recent years we have certainly learned more about specific changes of cholesterol in the Asian population. For example, here is an article I co-authored which looked at specific cholesterol findings in Indian Americans.  Even though the spectrum of specific cholesterol abnormalities vary among the various agents are groups, the lifestyle advice to minimize the impact is universal: Reduce intake of saturated fats, processed grains, and minimize wheat based carbohydrates. Here is more information.

3. Stop smoking and minimize tobacco exposure. Hopefully the impact here is self-explanatory. Here is additional information.

4. Monitor Blood Sugar – Type 2 (or “adult onset”) diabetes is far more common in certain Asian populations (such as Indians), especially those that have moved to Western countries that eat highly processed diets. In many Asians, diabetes can develop even in the absence of the usual weight gain (e.g. abdominal fat) typical in other populations. Ask your physician about screening recommendations for those at risk of diabetes.

4. Stay Active! Regular readers of our blog should be well versed in the many benefits of the ultimate medical therapy: Regular exercise. Here is an overview of the benefits of exercise, and here is even more information.

For now, the screening recommendations for prevention of heart disease and stroke in Asian Americans are no different from the population at large. However, there is some evidence that certain screening tools may benefit certain populations. These include advanced blood testing and imaging to screen for early coronary plaque. If you are concerned about your risk, you should ask your physician whether additional screening may be useful. or even consider calculating your very own “Heart Age”.  In the meantime, clinical studies are providing more and more information about cardiovascular risk in this growing segment of Americans.