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As mentioned in my prior column, The Role of Exercise in Your Future: Getting Started, aerobic type exercise will be emphasized, i.e. wind-building or endurance rather than weights, nautilus, or muscle building. This does not mean these are not a good thing to do but if time is an issue, and one is looking for the most overall cardiovascular and biochemical bonuses, aerobic type in my view wins out. It has been estimated that only 22% of adults in the U.S. participate in any type of regular exercise of sufficient magnitude to have long term health benefits; one quarter are completely sedentary. Likewise, the beginner is more likely to stay with a given program when he or she starts with a moderately vigorous program rather than one that is initially too intense. Physicians, family, and friends all have to encourage the beginner; otherwise it has been shown that up to 50% of individuals will drop out of a fitness program by 6 months.
At this time I assume you have a medical clearance from your physician, know what goals you are aiming for and have the necessary shoes and the all-important lifestyle habit anyone can do to reach and subsequently maintain a healthy body. The insurance companies and employers will love you, your family will be proud of you, and excited by your new adventure. The bank deposit might also reflect a healthier balance due to a decrease in medical bills.
Cardiovascular Benefits from Aerobic type exercise
Platelets have a vital role in the clotting process by becoming stuck to one another and thereby aiding scab formation should one sustain, for example, a laceration in the skin. They are formed in the bone marrow and circulate in the blood stream. The normal platelet count in the blood stream may range between 130,000-400,000 mmol./L. The individual with coronary artery disease demonstrate one or more narrowed segments in the coronary vessels due to deposits of cholesterol and other cellular elements which are called plaques. Should a plaque rupture or crack, the platelets again do what is natural by becoming stuck to each other. But now reaction is not favorable to the host as this may lead to a thrombosis or plug in the affected coronary artery which could lead to a heart attack.
Physicians frequently consider an aspirin a day (if they see no other contrindication) in an effort to make platelets less sticky and less likely to result in Thrombosis or the arteries. Likewise, there is some data that suggesting aerobic excercise may have a cardiac protective effect by decreasing platelet stickiness.
It has been suggested that 1/2 hour of aerobic exercise (so as to be pleasantly out of breath) will increase the good cholesterol (HDL) which acts as a scavenger, and decrease the total cholesterol for up to 2 days. This is good because there has been substantial data relating excess total cholesterol and subsequent coronary disease. (The exceptions to the rule however can occur.). The other potentially "bad cholesterol" (LDL), in most cases falls as the total cholesterol falls.
It has been my observation that individuals seriously engaged in a regular exercise program "building up their wind" soon realize that smoking cigarettes is counterproductive by causing progressive shortness of breath. Also those who stop smoking, in my experience, have much less a problem with subsequent weight gain if they become involved in an aerobic exercise program during that withdrawal period.
Over the years I have witnessed patients try every known diet. Often the diet works initially but a great number will regain their lost weight by 2 years with the exception of those who concomitantly embark on a daily exercise program. Hence, my policy has been to stress the exercise daily and to "just be reasonable" in their calorie intake. Daily exercise takes a great deal of discipline, and in the beginning I will often say that it is OK to say, "I hate this!" But after a while, the sense of well being takes hold in most cases and the struggle goes from being onerous to being thoroughly enjoyed. How many times have I heard this remark: "I didn't feel like exercising today but I'm glad I did as I feel much better".- endorphins to the rescue!
Not only does weight reduction help in lowering cholesterol, create a better self image, they create more energy, and help arthritic joints, but there is the added advantage of a lowered blood pressure in many instances. The reverse is also true: a twenty-five pound weight gain often will bring about or aggravate all the above conditions.
We all see cases where weight reduction and supervised exercise have had a beneficial effect upon the management of maturity onset diabetes.
A "beta-blocker" has been effectively used in many cases of what I have called an "irritable heart", i.e., a heart that is intrinsically healthy by proper evaluation, but has spells of fast rates or excess skipping. The beta-blocker says, "Goodbye excess adrenaline; I'm here first." It can be thought as having placed a "No Vacancy" sign on the heart and excess adrenaline is excreted into the urine. The autonomic nervous system can therefore cause mischief when under severe stress, with excess caffeine intake, use of some antihistamines, red wine (may contain tyramine which is a cousin of adrenaline), lack of sleep, lack of regular exercise, some cough mixtures, and nose sprays containing adrenaline type compounds, and the cola drinks-even diet cola, unless the cola is caffeine-free. By avoiding the above stimulants, with physician guidance in an exercise program which will cut down stress, people often sleep better and enjoy a sense of well being. All the above help to alleviate the irritable heart. By changing certain lifestyle patters, there is a certain pride patients have by avoiding medicines and "working with nature." The caveat is that it's best to work with one's physician as there are individuals that still may require medications despite adhering to an excellent lifestyle.
If a spouse or friend wants to join you for your daily aerobic brisk walk, be aware not to count on the partner always being ready at the same time and walking at the same speed as one might like. I've often said, "Your program requires the best time of day for you, your choice of place, and your training speed." Try not to eliminate the walk should the partner not be available on a given day. There is another reason to carry out your daily walk. One needs time to be quiet in today's busy world. Even if the partner is available, it still may be best for the friend to walk around the block in the opposite direction and wave, each walking at one's training speed; both experiencing a good work out and enjoying a quiet visit with nature. With completing of the workout, a more leisurely stroll devoted to visiting would then seem appropriate. The sense of well being and relief from stress experienced at the conclusion of a brisk walk has in its own right a beneficial effect towards not only curbing the progression of coronary disease but also enhancing overall good health. Stress is a major factor in heart disease.
Time to start "trucking". Best wishes and congratulations!
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