CARDIOLOGY, PRIMARY CARE AND NUTRITION

Blogpost: American Heart Association Says Just Move!

New physical activity guidelines were released by the American Heart Association (AHA) at the annual meeting.  They added to the current guidelines.  However, approximately 80% of Americans are currently not meeting the previous guidelines.  What!  Of course physicians are quick to point the finger and pull out presciption pads to write for BP and cholesterol medicatons because patients won’t exercise and eat well.  But wait, if 80% of Americans not exercising adequately, that includes a substantial proportion of physicians.  Perhaps they too are writing their own presciptions.

I know what makes physcians tick because I have been one and hung out with them for many years.  If they are passionate about a treatment or procedure, they will be telling their patients all the details and the reasons they should take the pill or have the procedure.  The patient will get calls, reminders, pamphlets  and threats as to why they should be compliant and take the pill or do the test.  If we had an 80% failure rate of BP or cholesterol medication presciptions, there  would be regulations to revoke privileges and penalize reimmbursements.  I am sure that the box on the medical record is checked that says exercise and and healthy diet was suggested on most office visits but rarely the words are spoken, and if they are it is a mere sentence.  Eat right and exercise.   We can’t escort the patient to the gym right? But where is the passion when it comes to educating patients on one of the most effective treatments for our top killers.

Exercise can decrease ALL CAUSE MORTALITY.  That includes bladder, uterine, esophageal, colon, kidney, lung and stomach cancers as well as cardiovascular disease.  It can decrease dementia development, depression, anxiety, sleeping disorders and post partum depression.  It can decrease hip fractures, falls, and hospitalizations.  Collective studies have shown a 26% decrease in mortality in cardiac rehabilitation patients.  That is better than any pill or procedure!  Yet, the passion is not there for 80% of Americans including physicians.

There is even a study in JAMA from 1990 that shows INCREASED THIGH MUSCLE MASS in 90 year olds after JUST 8 WEEKS of strength training! The participants also had improved walking speeds.  The oldest patient in the study was 96! That translates into independent living and less falls which means a better quality of life into the 90s.  Now that I have shared this information, the number of people in  my age group in the marathon at 90 will probably go up.  See you at the starting line girls.

All you have to do is start.  Because even bouts of 10 minutes of exercise or walking the stairs can improve you diabetes, your cancer risk,  and your cardiovascular risk.  The guidelines call for 75 to 150 minutes of vigorous activity or 150-300 minutes of moderate intensity each week.  They have also added the recommendation of 2 strength training sessions weekly.  Squat you must! Preschoolers need three hours a day and 6 and up kids need an hour of vigorous exercise.  Walk your kids to the bus stop please.  This is a benefit for everyone even me.  I hate running by all the cars lined up on the streets with the exhaust coming out  as they wait on the school bus.  Good habits start at a young age not to mention that good endurance runners need to start early.  The Kenyan kids run to school, run home for lunch, back to school, and then home to work on the farm.  Then they smoke us in the marathon when they grow up.  Walk your kids to the bus stop at least.

When I first read the guidelines, I was hoping for increased recommended times for exercise.  These guidelines reflect what is needed to reduce mortality and morbidity from lifestyle diseases.  However, there is much more to be achieved.  Vigorous physical activity can improve your whole day.  It is a stress reliever. I have solved many problems and have come up with many ideas while out on a run.  There are fabulous running and biking communities out there just waiting for more people to join.  Just start simply. Lay out your clothes the night before and in the morning go out for 10 minutes every day.  Commit to the 10 minutes.  Commit to 10 minutes of strength training two nights a week even if it body weight squats and push ups during commercials on TV.  Walk around the soccer field instead of sitting in a chair looking at your phone in the bleachers.  Jump in the masters lane during your child’s swim practice.  Better yet coach  a team.

How do we get physicians involved?  Perhaps we should have physical fitness tests for physicians to make sure they understand the importance of physical exercise.  Give a few hours of CME credit for those competing in an athletic event.  Maybe there could be a higher reimbursement for pediatricians that have a playground in their office building.  Is your physician in good physical condition?  Maybe you could ask them why the TV doctors alway appear to be in good physical condition.  The answer might be that physicians do work a lot of hours.  Rounds started in training before day break and ended in the dark.  But we are out of training now, and we need to set examples for our patients as well as educate them.  The guidelines are easy to achieve.  An hour a day of moderate activity and 2 hours of weight training a week.  That is less time than most people spend on social media.

We as physicians need to lead the way in lifestyle disease prevention.  Exercise and plant based nutrition together is the answer to the majority of these diseases.  Move your body throughout the day.  Take the stairs.  Park in the furthest spot from the store.  Walk your children to the bus stop.  Do squats, push ups, and other weight training  at least twice a week.  Get your heart rate and breathing rate up by biking, swimming, running or racket sports.  You will be setting a good example for your children that will protect their health for years to come.  Who knows, you might even save your doctor’s life.

 

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