Exercise, behavioral changes key to heart health [Sponsored content]
Do you have 21.5 minutes a day to show your heart some love?
Regular moderate exercise and a few other lifestyle changes can set you on the road to a healthier heart, a cardiologist and an exercise physiologist at CarolinaEast Medical Center say.
Mike Dunlap, manager of cardio-pulmonary rehabilitation at the hospital, said a 2004 study found that 90 percent of coronary artery disease can be predicted. The study identified nine factors that lead to the disease.
The risk factors are cholesterol, smoking, diabetes, high blood pressure, obesity, stress, lack of daily consumption of fruits and vegetables, lack of daily exercise, and alcohol consumption, Dunlap said.
“What we try to teach the patients is to take a look at those nine things and try to figure out how well you’re doing in each one,” he said. “If you’re not doing well in one or more, how do you address that?”
Dunlap said exercise can have a positive effect on many of the risk factors for heart disease, including smoking.
“If you start an exercise program, usually one of the things you’re going to quit – smoking or exercise,” he said. “They tend not to go together very well.”
Exercise always helps with stress, providing a relief valve so people can blow off steam, Dunlap said. Sometimes stress can be triggered by simply watching the news on TV, he said.
“One of the best ways to maybe manage it is to go for a walk, go for a run, go for a bike ride,” Dunlap said. “Your body’s kind of letting some of those stress hormones get used.”
To meet the heart-healthy goal of 21.5 minutes of exercise a day, the recommendations are much the same – walking, bike riding, swimming, and exercise machines such as elliptical and rowing machines, he said.
In the real world, though, exercising seven days a week can be tough. Dunlap said he shoots for seven and probably gets in four or five days. So, he just ups the time to about 30 to 40 minutes a day.
The goal is to exercise without getting short of breath, he said, also known as aerobic exercise. One way to make sure you’re getting the proper level of exercise and not overdoing it is to see if you can talk at the same time as exercising.
“If you’re getting to the point where you can’t talk because you’re breathing so hard, I call it puffing like a freight train, you’re no longer working out aerobically,” Dunlap said. “It has converted over to anaerobic, which is kind of uncomfortable.”
While some athletes push to the anaerobic level while training for competition, he said there’s no health benefit to it for most people. Instead, benefits are found in aerobic or moderate exercise.
Unfortunately, only 15 percent to 20 percent of people get the minimum amount of exercise, Dunlap said.
We’re challenged to meet those exercise goals by spending more and more time sitting in front of computer and TV screens or on our phones, and with the restrictions of COVID-19, he said.
“Sitting is the new smoking,” Dunlap said. “Don’t do it. It’s deadly.”
Dr. Alex Kirby, a cardiologist at the hospital, said aerobic exercise conditions the heart muscle, developing more tone and flexibility.
“If you’re loading up rocks or doing yard work, your heart is conditioned to be able to do not only that amount of work, but the stamina,” Kirby said. “And then if you drink a lot of fluids to balance your hydration needs during that activity, your heart is flexible to handle the fluids so you don’t get into a volume-overloaded state like heart failure.”
He said lifestyle can change 60 percent to 80 percent of modifiable cardiac risk factors.
“One of the biggest ones is eating a heart-healthy diet, which may be low-sugar fruits -- like kiwi, avocado, cantaloupe, honeydew, peaches, blackberries, raspberries and strawberries,” Kirby said. Such a diet also would include vegetables and low-fat meats like chicken and turkey, and low-fat dairy products. Red meat would be avoided.
Websites such as MyPlate.gov can help with calculating your calorie allowance per day.
Smoking is a big risk factor in eastern North Carolina. To get help with stopping smoking, Kirby suggested calling 1-800-QUITNOW.
“We work on that real heavily,” he said.
The benefits of quitting smoking are experienced quickly, even for long-term smokers, Kirby said.
“It’s a matter of weeks, not months that your heart will start getting better oxygenation,” he said. “What happens is your blood vessels don’t constrict as much so they provide a fuller oxygenation and nutrients to the heart. That can actually remodel the heart somewhere in the four to eight weeks time frame from stopping smoking.”
Consumption of alcohol should be minimized, Kirby said. Guidelines for moderate consumption are two to three drinks per day for males and one to two drinks per day for women.
“If you get beyond kind of a moderate level, you typically make the muscle weak,” he said. “It’s more of a depressant of the muscle activity if you’re consistently getting more than two drinks in a 24-hour time period.”
Another factor is maintaining a healthy body mass index, typically between 18 and 25, through diet and exercise, Kirby said. The index is calculated using height and weight, and can vary depending on body type.
Since the onset of COVID-19 last year, doctors have noticed people putting on 5 to 10 pounds above their usual weight, he said.
Blood pressure is another body measurement people can track to ensure heart health, Kirby said. All is needed is a simple in-home blood pressure cuff. One way to help control blood pressure is to limit salt intake, he said.
“Really only about 1 teaspoon per day is all that’s needed,” Kirby said. “We get it a lot in our food.”
One food to watch out for is processed soups, especially those that are tomato based, because they are high in salt, he said.
Medication compliance also is important for those with high blood pressure, Kirby said.
“We’re trying to work on all the behavioral changes that might get you to a point where you don’t need medications and your parameters are safe just by making those adjustments,” he said.
Behavioral modifications are key to reducing the risk of heart disease, Kirby said.
“I find that patients who do that really have great outcome,” he said, “even if they require additional medications to do it, it still complements that. There’s no taking that away.”