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Feb 19, 2018 WRITTEN BY KANNY GREWAL, MD
How Exercise Can Help More Than Your Jean Size

We know exercise and increased physical activity can improve, and sometimes even eliminate, many chronic medical conditions and diseases. And science supports the link between activity level and heart disease.

Most of us know we should be more active, but our modern lifestyle can be a challenge to our activity goals. I prefer the term “activity” over “exercise,” because exercise usually means something we have to perform intentionally, while activity is a part of daily life. The challenge is to increase our daily activity to a level that minimizes the risk of long-term disease. For those with conditions like heart disease, diabetes, high blood pressure, and obesity – increased activity can become a therapy, which is critical to the management of these conditions. Remember, before you start any new activity program, you’ll want to talk with your doctor.

Think of your body as having three essential “systems” that are affected by exercise:

  1. Heart and lungs – their purpose is to get oxygen into your lungs and blood, and pump the blood to the muscles are needed.
  2. Muscles – they do the work of moving your body.
  3. Bones, joints, and ligaments – provide the support to allow your body to move.

Any exercise or activity affects all three of the systems but some more than others. For example, your muscles have their way of using blood glucose/sugar.  So people with high blood sugar or diabetes benefit from exercise because their muscles can make immediate use of blood sugar – lessening the amount of sugar in their system.

To maintain consistent health and exercise without injury, you need to improve the strength and abilities of each of the three systems.

Almost all exercise-related injuries happen when you have some imbalance between the three systems. For example, a long-distance runner who pushes their exercise too hard can pull a hamstring or develop plantar fasciitis, because they’re overworking those particular systems. Likewise, a bodybuilder can develop impressive muscles, but if they don’t add in cardiovascular exercise, they’ll eventually neglect the aerobic system.

How much activity do we need for good health?

First of all, you should always talk to your doctor before starting a new exercise program or plan.  National guidelines recommend about 150 minutes of sustained activity per week. That activity can include walking, biking, jogging, or anything else that gets your heart rate up and uses the large muscle groups in your body.

However, the specific amount of activity or exercise needed to improve your health depends on your current baseline activity level.  For someone who is entirely sedentary, even 15 or 20 minutes of walking per day can have a positive impact.

There are some other points to consider regarding exercise:

  1. Just Move – There is no one type of exercise or activity that is better than another.  What’s the best exercise? The kind you’ll do. What’s important is that you are moving, using your muscles, and increasing your aerobic activity.  Aerobic activity refers to the amount of air you breathe and blood your heart pumps. You know it’s working when your breathing becomes heavy and your heart rate increases. For some people, walking at a steady pace can do the trick, while others may benefit more from vigorous exercise.
  2. It All Adds Up – Feel free to break up your activity into small portions.  A few 10-minute walks are just as good as one long walk.
  3. Keep Challenging Yourself – As your fitness level advances, you should increase either the duration or the intensity,  for steady improvement.
  4. It All Counts – It is important to remember that all activity counts.  What may be more important than a set exercise routine is to increase your total daily activity. A simple pedometer or fitness tracker can be a great way to promote more regular activity.
  5. Change It Up – Interval training is an excellent way to increase the intensity of your exercise, and the benefits as well. It also adds variety.  Interval training refers to short bouts of more intense exercise. For example, jogging for 5 minutes and then walking one or 2 minutes. Check out this HIIT (high-intensity interval training) workout from our friends at Grant Medical Center Fitness Center.
  6. Build Strength and Flexibility – For overall health (and to balance your 3 exercise “systems”), it can be beneficial to add weight based routines into your exercise mix. Workouts that incorporate flexibility will also improve specific “systems.”

How do I know my level of activity? You measure it.

The quality of exercise depends on two things: time and intensity.   We can all measure how long we’re exercising, but determining intensity is a bit more challenging.

Measuring your heart/pulse rate will let you know how hard you’re working, or you can take a look at your exertion. Your heart rate, or pulse rate, is the number of times your heart beats per minute. You can learn to measure this yourself or use a device like a heart rate monitor or fitness tracker.

A typical resting heart rate is 60-80 beats per minute. The lower your resting heart rate, the more efficient your heart and circulation. Heart rate always increases with exercise, but measuring it allows us to see if we’re in a range that will maximize benefit to our body.

A more accurate way to know your heart rate is to have a supervised treadmill test which will show your maximum heart rate and calculation of your target range. If your doctor has recommended (or has done) a treadmill stress test, ask them to tell you your maximum heart rate achieved and your target range.  Remember that heart rate can be affected by medications, hydration, illness, and medical conditions.

A second method, which is more convenient than measuring your heart rate, is a concept called “perceived exertion.” You just rate your current effort on a range from one (complete rest) to 10 (absolute maximum exertion).  For routine exercise, you should try for an effort of 6-8, which typically means your breathing is relatively heavy and it is hard to speak a complete sentence without taking a breath.

But I’m So Busy!

I know exercise can be challenging to squeeze into our busy lives. Here are some ways to blend it into our schedules:

  • Choose stairs
  • Park far from the store
  • Consider biking
  • Dance to music
  • Use a fitness tracker to be aware of your step count

Can too much exercise be harmful? There is some evidence that “extreme” levels of exercise can have negative consequences on your body or even longevity. And there is a slight risk that exercise can bring about a sudden cardiac event. But the multitude of benefits of a regular activity far outweigh the risks, especially if you build up the intensity and duration of exercise gradually. This is another reason to consult with your healthcare provider before starting a new exercise program. And always notify your doctor immediately if you notice chest pain or tightness,  unusual breathlessness, or dizziness or faintness with exercise.

No matter what activity you choose, find an accountability buddy.  If you tell someone you want to exercise or move more, chances are better you’ll do it. So get moving!

This article was originally published on The Heart Health Doctors, a blog written by OhioHealth cardiologists, Kanny Grewal, MD, and Anne Albers, MD.

Kanny Grewal, MDAbout Dr. Kanny Grewal

Dr. Kanny Grewal has been with OhioHealth Heart & Vascular Physicians since 1997 and is currently the system chief of cardiac imaging for OhioHealth. He practices at OhioHealth Riverside Methodist Hospital, specializing in cardiac imaging, including echocardiography, nuclear imaging and cardiac CT imaging. His clinical interest includes heart disease prevention and heart valve disease, but he enjoys providing consultations on all aspects of cardiology. He is co-founder of an online blog on heart prevention, www.hearthealthdocs.com. He is currently on the board of directors of the Columbus Medical Association. Dr. Grewal is an avid runner and also enjoys cycling and golf.

 

 

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