Healthy for Life

Exercise, exercise, exercise

Exercise, even walking briskly for 30 minutes most days of the week, may be the single best health prescription in America.  Do you want to lower your risk of a heart attack by 30%?  I thought so.  Then take a brisk 30 minute walk today--even three 10-minute walks will do to start.   

What is enough exercise and what does 'brisk walking" and mean?   

Obesity is the new tobacco

As surely as the 70-year rise and fall of cigarette smoking correlated with the rise and fall of heart disease and lung cancer, the recent obesity epidemic will correlate with a rise in type-2 diabetes and vascular (heart and peripheral vessel) disease.   

A BMI of 35 increases your annual risk of dying the same as smoking a pack of cigarettes per day. 

My real focus is the truly obese, those with a BMI over 35, because I believe that is where the real additional mortality approximates the real additional mortality of smoking. 

I'll fill in these charts later and then overlap them (when I have a spare couple of hours):

A graph showing the rise in tobacco 1900 to 2000.

A graph showing the causes of death 1900 to 2000.

A power point showing the rise in obesity 1980 to 2006.  Click on this and then click forward through the other slides.  You will be impressed.  Mind you, this is all based on phone surveys asking for height and weight--just how many people do think are going to over state their weight?   

A slide showing the time line between obesity and type-2 diabetes and then on vascular disease.   

Eat your omega-3s

We all know the line: eating fish twice a week is healthful because they contain and we need omega-3 fats.   But what fish, what about mercury, what about fish capsules and what about flax seed? 

Once upon a time, dietary villain was fat so America moved in mass to a low-fat, high carb diet.  The only problem is that the calories stayed the same.  (Oh, by the way, the real villain was and still is saturated fat--mono-saturated fats are very healthy.)  Everyone thought they could eat more food because the fats were gone--they forgot that the calories stayed the same.   

Once again, the media--and much of the public--has a new dietary villain: trans fats.  And, once again everyone is missing the point.  Yes, trans fats are bad and yes they increase heart attacks.  But total calories are still a bigger villain than just trans fats.  Removing trans fats from a food does nothing to the total calorie count.   Read this USA today article for more. 

Corporate Wellness Programs Are Worthwhile

Corporate wellness programs are clearly profitable.  Ron Goetzel, director of the Cornell Institute for Health and Productivity Studies, says that a company realizes $3 in savings for every $1 it invests in preventive-care and wellness programs. 

Does Fit Overcome Fat?

The evidence showing the health benefits of exercise continues to mount. A recent article looked at the relationship between weight and fitness level to mortality in a group of 116,000 women studied for 24 years—probably the largest study group possible.

The research has several interesting lessons, some are confirmation of what we already know, and others are new.

First, the article clearly emphasizes the importance of fitness to good health; fit people live longer and have less disease. Note the amount of exercise required to be fit was relatively modest and within the reach of everyone: a person met the study definition of being physically fit if they got 3 _ hours of physical activity per week and any activity that burns the same energy as walking 3 to 4 miles an hour met their definition of physical activity. In other words, taking a brisk 30 minute walk or 3 ten-minute walks every day was enough to be physically fit.

The women who got less than one hour of exercise per week had a 50% increase in their risk of premature death. Their risk of heart disease was three times higher and their risk of cancer was 30% higher than seen in those who exercised.

Being fit reduced, but did not cancel, the health dangers of being overweight or obese in this group of 116,000 women. This is shown in the chart below:

The study defined:
Lean as a BMI of less than 25
Obese as a BMI of 30 or higher
Inactive as less than one hour of exercise per week
Active as doing 3 hours of physical activity per week.

The conclusion is quite clear: A brisk 30 minute walk a day will reduce your risk of heart disease and cancer and prolong your active life. You may do any exercise that you like that burns about the same amount of energy as walking.

Source: Hu FB, et al, Adiposity as Compared with Physical Activity in Predicting Mortality among Women, New England Journal of Medicine, December 23, 2004.

Your Family's Health is Your Health Too

Do you want to know your genetic risk for early heart disease or a living to 100?

No need to wait for science to develop fancy genetic tests; you can find the answers today: Ask your parents about the health or diseases that run in your family. You are looking for clues to your own health or risk of premature disease. Both a predilection for good health and premature disease can be inherited.

Scientists have identified a very beneficial genetic mutation in a small Italian town. This genetic mutation produces an exceptionally powerful HDL cholesterol that prevents heart disease. Scientists tested the entire town and found 40 people with the same genetic mutation and HDL type—all relatives of Giovanni Pomaroli and Rosa Giovaneli who married in 1780—and all without heart disease.

Very few people have Giovanni and Rosa for great-great-great grandparents. Some people are unlucky enough to have a family of uncles, aunts, and their own father with a heart attack before age 50. These people are at a very high risk of doing the same—unless you heed their warning and take active steps to prevent your own heart disease. A family history of premature heart disease doubles your own risk of the same.

And a family history of some cancers substantially increases your risk of the same disease. These include breast, ovarian, colon cancer, and multiple early cancers, particularly if the cancer was first diagnosed before age 50.

Family history is an under-used diagnostic tool. The government has a new website so you can gather the information on family history in the privacy of your own home and then share the data with your personal physician.

I strongly recommend you download the web based family history tool. This tool is very helpful in gathering the important information in the scientific family tree format. The important information about what to do with your family history tree is found at another CDC website.

I will be addressing these important questions in my newsletter over the next few months so keep reading. Remember, a longevity benefit of a good family history can be ruined by lousy health habits and a family history of early disease can be reversed by good preventive, health promotion care.

Walking, Powerful Medicine for Everyone

Exercise may be the single best most powerful medicine.

There is no disease or medical condition not made better with exercise. Exercise can substantially reduce the risk of heart disease, diabetes, cancer, high blood pressure. Even if you are ill, exercise can be a powerful part of your recovery treatment.

You know everyone should get 30 minutes of exercise four or more days per week. But national statistics indicate that only 20% of the American public gets that much exercise. A full 30% of Americans get no exercise or do any physical activity. Another 50% get some exercise but not enough to give them any real health benefit.

Walking briskly counts as exercise.  Studies have consistently shown that walking a two miles a day, or 30 minutes a day, or 3 hours per week reduces heart disease by more than 30%.

Seventy percent of people indicate walking is their most common exercise. Unfortunately, few people get enough. How can you get more walking time in your already busy life?

There are three ways to increase the amount and benefit of the walking you do.

1. Walk faster everywhere you go. Even the 2 blocks from the car into the grocery store adds up if you go fast enough. And "fast enough" means walking like you are late for an appointment. Strolling does not count as exercise.
   
2. Add 2 or 3 ten minute brisk walks during your day. Walk briskly for 10 minutes and then eat a 20 minute lunch. At the beginning or end of the work day, walk the very long way to your car. Another 10 minutes.
   
3. In the evening, go for a brisk 30 minute walk. The average American adult watches 4 hours of television per day. You do not need to watch Seinfeld for the 4th time. Turn off the television, go out the front door, turn right, walk for 15 minutes, turn around and walk home.

At the end of the day you just walked for an hour. And that is more than enough to give you personal and substantial health benefits.

The Fountain of Youth is a glass of water a mile away.