Tips from a Cardiologist

[RAE]

Short article in the local paper with some advice from a cardiologist on heart health:

https://www.freep.com/story/news/20...lth-beaumont-cardiovascular-clinic/550861002/

A few key points:

- exercise is good, to a point, but don't overdo it;
- he does not recommend HIIT for those over 40;
- slow walking speed is a harbinger of death for those over middle age.

 

[JoeWras]

Excellent! I agree about the HIIT. I'm done with it. I primarily swim and bike. No more sprinting of any significance.

The walking thing is interesting and I think there is something to it. Under 2 mph seems like you ought to be sticking to the couch. I shoot for around 4 mph.

As for "more is better..." Why? Where did this come from? Is it all this extreme stuff? Is it the American attitude?

When I was doing "more running," I tore my joints up and my muscles ached. Why shouldn't it be doing damage to your softer tissues (heart, etc.)? I know, I know, I'm a computer geek practicing physiology.

Jim Fixx had issues, for sure. Some he ignored. Ultimately, he overdid it. And sadly, the various Raleigh marathons over the last few years have had a few cardiac deaths. Guess what? In the last mile or two. I think this guy has it right.

 

[marko]

Excellent! I agree about the HIIT. I'm done with it. I primarily swim and bike. No more sprinting of any significance.

The walking thing is interesting and I think there is something to it. Under 2 mph seems like you ought to be sticking to the couch. I shoot for around 4 mph.

As for "more is better..." Why? Where did this come from? Is it all this extreme stuff? Is it the American attitude?

When I was doing "more running," I tore my joints up and my muscles ached. Why shouldn't it be doing damage to your softer tissues (heart, etc.)? I know, I know, I'm a computer geek practicing physiology.

Jim Fixx had issues, for sure. Some he ignored. Ultimately, he overdid it. And sadly, the various Raleigh marathons over the last few years have had a few cardiac deaths. Guess what? In the last mile or two. I think this guy has it right.

My brother was an elite athlete. At age 62 he was doing ironmans, marathons, ran 200 miles a month and swam 25 laps every morning. One of the fittest people I've ever seen for that age. It was all he did; go to work, come home, work out.

Out of nowhere he suffered a massive stroke (while watching TV). He's doing better but two years later still can't talk or use his right arm. No one knows how this happened.

 

[Chuckanut]

Agree. Overdoing is bad for joints.

 

[athena53]

I quit running years ago- will do it only when there's no gym and I really need a workout. I do have a 5K coming up in the local corporate athletic event (I compete as a retiree of a previous employer) but that's small stuff and I don't push myself too hard.

To add to the horror stories: my Uncle, a marathon runner in (apparently) glorious shape, died of a heart attack in his boss' office one Monday morning. He was 42. A local physician co-authored a study a few years ago in which he sadly concluded that multiple marathons weren't good for the body- he was a marathon runner himself. He said you should do one, then cross it off your bucket list.

 

[RunningBum]

And sadly, the various Raleigh marathons over the last few years have had a few cardiac deaths. Guess what? In the last mile or two. I think this guy has it right.

I googled this because I was unaware of this stat. For good reason. I see 2 from a 2014 race, and that was a half-marathon. Not "a few" in "various Raleigh marathons" unless you can show me where I missed them. I see that another person died in the first mile of the 5-mile Krispy Kreme challenge, in which you have to eat 12 donuts over the course of the race. Not a marathon at all.

I also make the distinction of the half-marathon, because people often think they happen in marathons, so the ultra marathons I do must be even worse since they are longer. My observation, without looking at the numbers, is that a lot more people die in half-marathons.

One reason for that is probably pure statistics, that I think a lot more people run halfs than fulls. But another is that most runners tend to train seriously for a full, but not all will for a half. And a full marathon is generally run at a pace at which you can hold a conversation, which means your HR doesn't get too high. A half marathon, run competitively, is a lot more intense, and for a significant amount of time (compared to a 5 or 10K).

 

[braumeister]

A local physician co-authored a study a few years ago in which he sadly concluded that multiple marathons weren't good for the body- he was a marathon runner himself. He said you should do one, then cross it off your bucket list.

It's funny how attitudes change. I started running a LONG time ago, and back then (before Jim Fixx's death) the common feeling (as published in Runner's World magazine more than once) was that doing just one marathon immunized you for life against a heart attack. More was better.

We just didn't know a lot back then, and I'm not sure we've learned all that much since.

 

[JoeWras]

I googled this because I was unaware of this stat. For good reason. I see 2 from a 2014 race, and that was a half-marathon. Not "a few" in "various Raleigh marathons" unless you can show me where I missed them. I see that another person died in the first mile of the 5-mile Krispy Kreme challenge, in which you have to eat 12 donuts over the course of the race. Not a marathon at all.

Whoops! You are right, the other was the Krispy Kreme challenge! I mis-remembered.

I think most anyone, cardiologist or not, can agree that's a bad idea.

 

[Mr._Graybeard]

While on the j*b, there was a stretch of time where half a dozen colleagues, all men, died at a relatively young age. Of that group, four were fitness enthusiasts, and three of those died of cardiac arrest during or shortly after working out.

 

[athena53]

I see that another person died in the first mile of the 5-mile Krispy Kreme challenge, in which you have to eat 12 donuts over the course of the race. Not a marathon at all.

Just as I thought- Krispy Kremes will kill you.

Seriously- I believe RunningBum has a point: runners in the longer races (marathons and ultras) have planned, disciplined training, sometimes with coaches. The shorter runs attract more weekend athletes who overdo it.

 

[JoeWras]

It's funny how attitudes change. I started running a LONG time ago, and back then (before Jim Fixx's death) the common feeling (as published in Runner's World magazine more than once) was that doing just one marathon immunized you for life against a heart attack. More was better.

We just didn't know a lot back then, and I'm not sure we've learned all that much since.

Yeah, and although I may have remembered some of our local race data wrong, I did read quite a bit about Jim Fixx and his situation because it freaked me out. I think I generally have it correct (see source below*).

Fixx had a decades long history of habits that caused damage. It wasn't going to all be undone. And ultimately it wasn't so much the running that did it, but the attitude. As you said, there was an idea that you were "immunized," and Fixx went down that path, despite clear warning signs which he attributed to asthma. If anything, the running he had done gave him good corollary circulation when allowed him to survive some "minor" events the weeks before his big one.

So, a few take aways:
- exercise is good, real good
- too much (which is A LOT) should be avoided
- don't ignore warning signs (pain, shortness of breath). Exercise does not give you immunity.

* Source:

“Friends and family reported that Fixx had complained of “chest pains while running” (Schanberg, 1984, p. 23) and tightness in his chest (Cooper, 1985; Wallis, 1984).Yet he refused to have an exercise stress test, despite the urging of his former wife, Alice Cashman Fixx, and the invitation of Kenneth Cooper (Cooper, 1985; “Deadly Refusal,” 1984).”
https://onceuponaparadigm.wordpress...y-killed-fitness-god-jim-fixx-i-just-learned/

 

[eytonxav]

At this point in my life, the only thing I do that comes close to HIIT is playing softball, running bases and running down fly balls in the outfield. I will say that during the season, it does seem to help my HDL levels stay above 40, and off season they seem to drop to around 38.

 

[FIREmenow]

We have recently started doing 12-15 mi per week walking at ~4 mph average ---- since about December of last year. On other days, I do stairs, core, and weights when I can --- but not often enough

Had my regular checkup last week - total cholesterol was 175 with 72 of that HDL!

 

[ncbill]

I googled this because I was unaware of this stat. For good reason. I see 2 from a 2014 race, and that was a half-marathon. Not "a few" in "various Raleigh marathons" unless you can show me where I missed them. I see that another person died in the first mile of the 5-mile Krispy Kreme challenge, in which you have to eat 12 donuts over the course of the race. Not a marathon at all.

I also make the distinction of the half-marathon, because people often think they happen in marathons, so the ultra marathons I do must be even worse since they are longer. My observation, without looking at the numbers, is that a lot more people die in half-marathons.

One reason for that is probably pure statistics, that I think a lot more people run halfs than fulls. But another is that most runners tend to train seriously for a full, but not all will for a half. And a full marathon is generally run at a pace at which you can hold a conversation, which means your HR doesn't get too high. A half marathon, run competitively, is a lot more intense, and for a significant amount of time (compared to a 5 or 10K).

Around a year ago watched a very fit-looking guy who couldn't have been out of his 30s collapse at the finish line of a...well, my kid was there for a half-triathlon.

Unconscious, unresponsive, full-court press while he was being taken away on a stretcher to the ambulance.

 

[6miths]

I think the author is a PhD in Physiology and not a Cardiologist. And I'm pretty sure that being in reasonable shape and exercising moderately beats being sedentary and/or overweight. I don't recall any reasonable person ever espousing exercise as giving you 'immunity' from death though I think there may be some evidence that it improves immune system functioning.

 

[haha]

Life regresses to the mean. And this is a damn dirty shame.

Ha

 

[audreyh1]

- slow walking speed is a harbinger of death for those over middle age.

Well of course, but that doesn’t necessarily indicate you can do anything about it. My Dad is late 80s and has walked slower and slower since turning 80. He’s really slow now.

 

[athena53]

Well of course, but that doesn’t necessarily indicate you can do anything about it. My Dad is late 80s and has walked slower and slower since turning 80. He’s really slow now.

Same here- my Dad is 87 but still walks. Mom was diagnosed with breast cancer at 85 and still kept walking until she deteriorated to the point that she couldn't. She once said you should do everything you can to keep your balance.

I shudder when I see old (and not-so-old) people on scooters in the grocery store. Most of them are terribly overweight and I don't know which comes first- the obesity that makes it too painful to walk or the infirmities that make it too painful to walk followed by obesity because you've quit moving. I just know I'm going to do everything I can to avoid that.

 

[mcbraemer]

Yes, the "Scooter" craze is interesting to me too. We see the battery powered crowd everywhere, including big box stores, theme parks and public outings (art fairs, concerts, etc.). Most are not very elderly folks, most are indeed overweight. I don't know if the majority of these folks actually need the mobility assistance, or are simply too lazy to get up and walk. If they do need it, it is a blessing for them. If not, it seems to be a downward spiral scooter in terms of their health.

Of course, there seems also to be a similar situation with handicapped parking stickers in my opinion, as well. Drive right to the front of the mall parking lot using the sticker/mirror hanger, then waddle or scooter out to the food court in your favorite mall.

I imagine many of these people could do themselves a favor by practicing some regular walking (at 3 mph ) on a fairly regular basis.

Which comes first, the scooter or the bad legs?

 

[RunningBum]

Scooters were all over at the Disney parks. I wonder what the conversation was when they first ordered them.

"How many do you think we'll need, a dozen?"

"Make it two dozen, just to be safe."

Off by a factor of 100, at least.

On the other hand, if people come to FL in the heat and haven't been exercising at all, walking all over those parks is asking for trouble.

 

[Midpack]

I was a regular runner for a few years around age 30, but I quit running a long time ago assuming it would lead to joint pain eventually. But I still walk almost every day.

I was surprised at the walking pace in the article, IME 2 mph is REALLY slow. That sounds like a very casual stroll.

We now realize that even somebody's walking speed is a good index of their overall health," Franklin said. "Several studies have now shown that if middle age and older adults in their day-to-day activities walk at less than 2 miles an hour, we say that's a harbinger of the approaching grim reaper, the personification of death. Those people are headed toward generally a poor prognosis.

"Whereas numerous studies now show that middle age and older adults who walk briskly — 3 miles an hour or faster — generally have very good health profiles. So I tell our patients, invariably, you can disguise your exercise by picking up your pace, simply walking on day-to-day basis at 3 miles an hour or faster."

 

[razztazz]

I was surprised at the walking pace in the article, IME 2 mph is REALLY slow.

Just goes to show you that all this talk about exercise this and exercise that is way the H overblown. And the indicators used are of little value. Two mph+ not that fast, so yeah, anyone who struggles with 2 mph is clearly having a problem and it is not lack of exercise. the dopey-assed doc in the article makes the same mistake all these articles make. In crease your walking speed and it will increase your health. That is not the phenom being witnessed. The reality with exercise is anything above a true couch potato is enough. "workout" sessions and "exercise regimens" just make you feel better. Maybe. But it's not a requirement. Fitness is not health and health is not fitness

About 15 yrs ago it was reported that a study noticed that people in their 90s who had greater grip strength were healthier and happier. So, the exhortation was to increase your grip strength for a longer healthier life! You cannot take these people seriously

 

[MRG]

I think the author is a PhD in Physiology and not a Cardiologist. And I'm pretty sure that being in reasonable shape and exercising moderately beats being sedentary and/or overweight. I don't recall any reasonable person ever espousing exercise as giving you 'immunity' from death though I think there may be some evidence that it improves immune system functioning.

+1

I really don't understand his qualifications.

 

[CountryGal]

I have been walking every night for the past 8 years. Will turn 60 this year. 3 mph is the fastest I have ever gone and need to keep it to about 2.5. I had too many sprained ankles in my youth and old injuries pop up when I go faster. In January I slipped down the stairs and twisted my knee good. I am just now back to walking every day and 2.2 mph is my fastest.

 

[Sojourner]

Yes, the "Scooter" craze is interesting to me too. We see the battery powered crowd everywhere, including big box stores, theme parks and public outings (art fairs, concerts, etc.). Most are not very elderly folks, most are indeed overweight. I don't know if the majority of these folks actually need the mobility assistance, or are simply too lazy to get up and walk. If they do need it, it is a blessing for them. If not, it seems to be a downward spiral scooter in terms of their health.

...

I imagine many of these people could do themselves a favor by practicing some regular walking (at 3 mph ) on a fairly regular basis.

Which comes first, the scooter or the bad legs?

Just based on my observations, I think the "bad legs" come first, albeit actually just weak legs that have trouble supporting and propelling the very overweight bodies they're attached to. Then the scooters come into the picture, and from there it is an inevitable downward spiral — less walking, more obesity, more need for scooters, less walking, etc. etc.