Category Archives: exercise

More benefit to physical activity~ Prevents Heart Failure

BW ARA labcoat

Physicians talk about patients with heart failure (HF) when describing someone with shortness of breath, inability to exert physically without having shortness of breath, or also experiencing fluid retention (leg swelling, increased waist size).

 

Non-physicians (my husband for example) hear about ‘heart failure’ and imagine death, or heart stopping like in sudden cardiac death. The terms could be better, but for now are used as above for physicians and for HeartHealth Doctors followers: Heart Failure refers to symptoms of shortness of breath (dyspnea) or fluid retention either due to reduced (r) heart pumping function (also termed Ejection Fraction or EF) (HFrEF) or preserved (p) EF but ineffective heart pumping function (HFpEF).

 

Heart failure is one of the most common reasons for hospitalization and is more common as people get older.   In the US more than 6 million adults have HF.

 

HeartHealth Doctors blog has information regarding the benefits of exercise and heart healthy lifestyle as powerful ways to prevent symptoms from heart issues.

 

For the first time, the Women’s Health Initiative program (WHI) has reported benefit of physical activity specifically walking, for post menopausal women to prevent HF.

Physical Activity and Incidence of Heart Failure in Postmenopausal Women (J Am Coll Cardiol HF 2018;6:983–95) reports findings from WHI that support regular physical activity – reported as recreational physical activity by participants – as a powerful means of reducing Heart Failure risk (both HFrEF and HFpEF).

The findings again support exercise (physical activity) as medicine – without potential side effects, and with a good dose response (more activity time, less chance to develop Heart Failure).

The study looked prospectively at the women, and the following list are possible ways physical activity impacts risks for developing heart failure. As HeartHealth Doctors have outlined, physical activity improves risk factors for heart disease, and as pointed out in the Clinical Research Study, for Heart Failure-

 

Exercise or physical activity helps prevent or manage:

Obesity

Blood pressure

Glucose / blood sugar regulation

Inflammation and Oxidative stress

Left ventricular compliance (heart pumping/relaxing function)

Arterial function

Aerobic capacity

Skeletal muscle function

Coronary Heart Disease

Diabetes

Atrial fibrillation

 

The researchers removed participants who were unable to walk 1 block prior to enrollment.

They included post menopausal women age ~50-79 years at start of the study and followed the group for 15 years with surveys.

The study highlights new benefit to heart healthy habits of exercise and physical activity; still the best way to multi task for your heart health.

How much physical activity is enough?

The study suggests volume of activity is a good focus rather than intensity – just walk for example work toward the authors’ goal of ‘brisk walking (3.3 mph on level ground) with the target of achieving 30 min/day on 5 or more days of the week.’

Benefit was shown with regular walking pretty much in line with current guidelines of 150 minutes per week; which can be 10 minutes twice a day or 30 minutes 5 days per week ~ now a big study shows one more of so many reasons to be physically active.

 

Physical Activity and Incidence of Heart Failure in Postmenopausal Women (JACC: Heart Failure December 2018)

J Am Coll Cardiol HF 2018;6:983–95

Exercise can make your body feel younger. . . and (maybe) actually make it younger?

IMG_8348rt5x7bwAs we prepare for Thanksgiving (and in my case, the Thanksgiving Day Turkey Trot!) there is some good news on exercise and aging.  We know that lifelong regular exercise can reverse many of the effects of aging – at least in “elite” or professional lifelong athletes. But what about “regular people” who commit to a lifestyle of regular activity? Can their bodies become “younger” too?

A recent study (link to full study here) tried to answer this question – by studying the Running Turkeybodies (specifically, muscle tissue) of older individuals who had remained active though regular leisurely activities. The main findings, according to this article in the New York Times summarizing the study:

“The muscles of the older exercisers resembled those of the young people, with as many capillaries and enzymes as theirs, and far more than in the muscles of the sedentary elderly.

The active elderly group did have lower aerobic capacities than the young people, but their capacities were about 40 percent higher than those of their inactive peers.

In fact, when the researchers compared the active older people’s aerobic capacities to those of established data about “normal” capacities at different ages, they calculated that the aged, active group had the cardiovascular health of people 30 years younger than themselves.”

What does this mean?

  1. Committing to an active lifestyle can slow, or even eliminate” many of the changes in our muscles that we consider “normal aging”
  2. Even though our overall exercise capacity does diminish over age, these changes are slowed significantly in those who remain active, compared to less active older individuals.
  3. In the words of one of the researchers, “exercise could help us to build a reserve of good health now that might enable us to slow or evade physical frailty later”

So this is more evidence for all of us to stay active – here is our overview of physical activity and its benefits on heart health, and here are more articles on exercise:

Exercise News: Delay Dementia, and Never Too Late to Start!

Is Running Risky? Lets check the science. . . .

Can 1 Minute of Exercise Possibly be Useful?

What is the “right dose” of exercise for a long and healthy life?

 

 

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.