“Physicians, get out your prescription pads and prescribe this book to every one of your heart patients. This encouraging, common sense and easy-to-read book deserves to be in the hands of all freshly-diagnosed heart patients and those who love them.”
That’s the little blurb I wrote for Oregon cardiologist Dr. James Beckerman’s new book, Heart To Start.* As explained in last week’s book excerpt published here, Dr. B believes that heart disease is essentially a sitting disease. To rally against that, he embraces a profound belief that “exercise is medicine” – and this is especially important for all of us heart patients. In fact, he believes that physical exercise is the least prescribed yet most effective heart treatment. Far too many of us, however, get little or no regular physical activity – particularly while recuperating from a cardiac event – and instead insist on doing something that just might be dangerous to our health: we sit.
But Dr. Beckerman believes that what we most need to do is to move more. We were “born to walk”, he reminds us. And even if we weren’t born to walk, we sure weren’t born to be sitting around all day.
This week, once again with his kind permission, let’s take a look at another excerpt from Dr. B’s book – this time specifically at his thoughts on the role muscles play in our heart health, and especially how knowing when to move those muscles may play an even more important role. We know that up to 80% of all cardiovascular disease is preventable based on lifestyle choices like everyday physical activity, so whether you are a heart patient or simply don’t ever want to become one, consider this message from Heart To Start:
“Even when our muscles are not called upon to run, jump, or just help us stand up, they continue to play a constant role in our health. They are more than just engines that make us move. Muscles also lay down new tracks that impact what direction our health will take. And the path we will follow is guided by inflammation.
“As you may know, heart disease is the end game of an inflammatory process that results in cholesterol plaque forming in the walls of our coronary arteries. The more plaque you have, the more likely you are to develop symptoms on exertion – like chest pain or shortness of breath as the plaque obstructs the flow of blood and oxygen to hungry heart muscle.
“And with more inflammation, you are also more likely to experience a heart attack when the plaque ruptures and a blood clot forms that can completely obstruct blood flow. This is not a random process. It requires microscopic damage to blood vessel walls to create the perfect storm.
“Inflammation is that perfect storm.
“And the more you have, the more likely you are to develop coronary artery disease, and the more likely you are to have a heart attack.
“Here is where your muscles play a role, regardless of how you are using them.
“Active muscles turn on genes that produce anti-inflammatory proteins and anti-oxidants, which protect your blood vessels from damage. Healthier blood vessels are less likely to develop blockages that can result in chest pains or heart attacks.
“Active muscles also produce proteins that help us to process the sugars and fats that can cause blood vessels to run amok. That is why more active people experience better control of diabetes and elevated cholesterol.
“Active muscles lead to a happier metabolism, and in turn, happier blood vessels.
“But it is not realistic to be moving, or even standing, all the time. That’s why I’m going to let you in on a little secret.
“There are three times of the day when you can get the biggest bang for your standing buck by getting on your feet and moving around. Scientists have proven that the twenty minutes after your three daily meals – breakfast, lunch, and dinner – are truly the ‘golden hour‘.
“Here stands your opportunity to make, or break down, the process of putting down cholesterol plaque. Doctors call the period just after eating the postprandial state. Studies indicate that a postprandial state marked by elevated blood levels of sugar and fats is a predictor of future heart attacks. Higher levels of sugar and fats put stress on your blood vessels, trigger inflammation and dysfunction of the blood vessel walls, and even increase your risk of developing blood clots.
“This does not just apply to people living with diabetes. Even if you have never had a problem with blood sugar, small spikes after meals can still increase your risk of heart disease over time.
“But the good news is that we can break this cycle by moving our bodies right after we eat, or even between meals throughout the day. Interrupting prolonged periods of sitting with low to moderate intensity walking lowers blood sugar and triglyceride levels after meals. It only requires about ten minutes to get your juices flowing in the right direction and your muscles producing the proteins that help to curb the postprandial inflammation that puts you at risk.
“All this research into the effects of sedentary lifestyles on our health begs the question – how did we get so sedentary in the first place?
“There is a lot of armchair quarterbacking going on to try to explain it. We blame:
- our cars and long commutes
- the expansion of cities
- the dawn of suburbs
- even what we do for a living
“A fascinating study using data from the United States Bureau of Labor Statistics (bean counters who count the bean counters) looked at jobs requiring at least moderate intensity physical activity over the past 50 years. Researchers found that in the early 1960’s, about half of jobs involved some serious physical activity, whereas less than 20 percent do today.
“We also can’t forget about the impact of television, personal computers, tablets, and especially smart phones. Screen time of any type increases the amount of time we spend sitting. I personally did a lot of field research in this area (i.e., television) as a teenager, and I can assure you that the correlation is real.
“For many people, limiting television or other screen time to fewer hours per day is a concrete way to ultimately spend more time on their feet. The impact on life expectancy is significant. Compared to people who do not watch television, individuals who spend six hours a day in front of the television will ultimately have 4.8 fewer years to do it. Not to mention the impact of watching all those commercials – let’s not even go there. To put this into proper perspective, consider the assertion that smoking one cigarette cuts eleven minutes off your life. That’s scary for sure. Especially when you consider that smoking a cigarette has the same health impact of watching a half hour of television.
10 Ways to Get Up and Stay Up
- Stand while speaking on the phone.
- Take a ten-minute walk after dinner every evening.
- Set a reminder every hour to get on your feet.
- Get off the couch during TV commercials.
- Encourage walking meetings at your workplace.
- Wear comfortable shoes.
- Use a pedometer, tracker, or app to set a daily walking goal.
- Invest in a standing desk.
- Meet in person rather than by phone or email.
- And stop looking for a good parking space!
“Take a minute – or 10! – to stand up for your health. Even as you fill your exercise prescription, please do not ignore how you approach your everyday behaviors. Working out a half hour a day and then sitting the rest is like eating a steady diet of bacon cheeseburgers and washing them down with some cholesterol lowering medication.
“Don’t shoot yourself in the feet. Stand on them instead.”
© 2015 Dr. James Beckerman
* Excerpt published here with permission, from Heart to Start: The Eight-Week Exercise Prescription To Live Longer, Beat Heart Disease, and Run Your Best Race, by Oregon cardiologist Dr. James Beckerman – heart doc, jock, team cardiologist of the Portland Timbers major league soccer team – and a self-described “cardiactivist” at Providence Heart and Vascular Institute.
Head shot of Dr. Beckerman via KATU News; group shot via Dr. B himself.
Q: February is Heart Month! How have you included walking into your daily routine so far?
- Six Ways NOT to motivate patients to change
- Heart disease is a sitting disease – another excerpt from Dr. Beckerman’s book, Heart To Start
- Get off that couch and “walk the heart walk”
- Women’s heart health advice: “Walk often, walk far!”
- Why your heart needs work – not rest! – after a heart attack
- Physical exercise vs. the ‘plumber’s pipe’ theory of heart disease treatment
- The Sitting-Rising Test: what’s your score?
- Squishing, burning and implanting your heart troubles away
- Too miserable outdoors to walk today? Take a heart-smart mall walk!
- Let’s make our day harder – not easier!
- Failure to refer: why are doctors ignoring cardiac rehab?
- Why aren’t women heart attack survivors showing up for cardiac rehab?
- Chest pain while running uphill
- We know we should do ____, but instead we do ____