Dr. Christopher Quirk

BA Oxon, MA, MBBS Hons, MRCP, FRACP, DDU

Exercise PDF Print E-mail
Thursday, 26 November 2009 07:20

The fact that exercise is beneficial for the heart is not only my view. There is substantial evidence to support the value of regular exercise to help prevent just about all aspects of ill health. Not withstanding the benefits on the heart and physical aspect of our body, it is often forgotten that despite mental illness remaining one of the commonest conditions in modern society with arguably the biggest impact on our general wellbeing, and the fact that regular exercise is the best treatment for stress, anxiety, depression, we still find it easier to prescribe drugs like Prozac or Zoloft. 

From the heart point of view, exercise remains the number 1, 2 and 3 best ways of reducing cardiac risk. Despite this, I still find it the single most difficult thing to persuade my patients to undertake!!??—

I can almost guarantee that if you were to give me your body for 6 to 12 months I could reduce your risk of heart disease, improve your wellbeing and improve your mental wellness, and likely reduce the need for you to take prescribed medications. 

Is it safe to start exercising?

Whilst exercise remains the best way of reducing risk for many medical conditions, it is very important to be properly assessed prior to starting an exercise programme.

YOU MUST SEEK MEDICAL CLEARENCE PRIOR TO UNDERATAKING AN EXERCISE PROGRAME.

This will involve seeing your doctor who will decide if any testing is recommended. This may include general examination, checking blood pressure, and blood analysis. Of course, this should be part of our regular ‘service’ anyway. I would also strongly recommend review by a Cardiologist for a treadmill exercise test. This will help rule out heart disease that is not otherwise apparent on examination, the presence or absence of any blockages of the coronary arteries, the blood pressures response to exercise, the heart rate response to exercise and gauge you’re level of fitness. It is well established and accepted in medical literature that the level of cardiac fitness remains one of the best predictor of Cardiac risk. Not only will this help assess the risk of exercise, but also help guide a future exercise programme. 

Why does Exercise benefit the heart?

Regular exercise has multiple benefits on the heart and body. Ignoring the benefit on the Cardiovascular system, regular exercise is good for our general wellbeing, stress levels, ability to deal with stress, sleep patterns and on the whole will make you feel better. Somewhat paradoxically, it will also improve lethargy and tiredness. From the more objective aspect, multiple studies have demonstrated improvements in cholesterol levels, higher HDL (good cholesterol) levels, lower blood pressures, improvement in blood sugar levels and improved insulin sensitivity. There is also improvement in function of the blood vessels and reduced viscosity of blood, all of which reduce likelihood of heart diseases and strokes. Of course, forget the objective benefits above, the simple improvement in fitness and the way you will feel remains the most noticeable benefit of regular exercise and this in itself means it’s worth giving it a go. 

What type of exercise should I be doing?

This will vary enormously depending on multiple factors –What you are trying to achieve with an exercise programme, your age, any limitations from other medical conditions, your ability to perform different types of exercise and of course personal preference and what is readily available. One of the most important aspects of taking up exercise is to be doing something you enjoy and to vary it- No matter how much will power you have, if undertaking an exercise programme is not fun or becomes a chore you will not continue with it! I cannot generalise as the type of exercise I would recommend will vary between a patient of 80yrs old and one of 40yrs. It will also vary between patients I treat who already have heart disease, those that are otherwise well, patients who primarily need weight loss versus those that need improved cardiac and aerobic conditioning. The type of exercise I recommend is clearly different in different subgroups of patients. However, a regular walk, including walking up and down hills in order to get the heart rate up and cause mild breathless is a good starting point. 

How often should I exercise?

Tradionally, exercise guidelines have suggested 20 minutes 3 times per week. There is no doubt that this is better than none at all, which is the usual frequency. However, in my opinion this frequency is not adequate. Most of the benefits  discussed that result from exercise are dependent on daily exercise and indeed some, for example, the effects on blood pressure, benefit even more with twice daily exercise. Of course, exercise prescription does have to be tailored to a realistic achievable goal for any individual. I recommend daily exercise between 40 mins to 1 hour per day should be the minimum duration. Varying the type of exercise is also important and if possible being able to do some exercise at home will likely improve compliance. It’s amazing how quickly ½ hour on the treadmill or static bike goes in front of your favourite TV show! 

Who should exercise?

There is no doubt that as we get older we do less exercise, and yet it is as we get older that regular exertion becomes even more important, whether you are 80 or 90yrs old. ‘Use it or loose it!’ Of course, as mentioned, the type of exercise needs to be tailored to your age and ability, but as we get older a simple daily walk, particularly up some hills or stairs, to get you a little breathless is all that is needed. 

How do I start my exercise regime?

It is important to be assessed prior to starting unaccustomed exertion, so you should see you’re doctor and if required ask for a referral for appropriate assessment, such as an exercise test. Following this I would recommend a review for an Exercise Prescription which would be individualised to your needs, and subsequently followed up and monitored.

 

Last Updated on Friday, 27 November 2009 20:48
 
 
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