More exercise, less high blood pressure

People who continue to exercise throughout their lifetimes are far less likely to develop high blood pressure and the more they exercise, the less likely they are to develop high blood pressure (Journal of Hypertension, June 2008). In various studies, up to 91 percent of the North American population suffers from high blood pressure which puts them at markedly increased risk for strokes, heart attacks, kidney damage and arteriosclerosis. Virtually all scientists agree that this frightening incidence of high blood pressure is caused by lifestyle, and the major lifestyle factors are lack of exercise, obesity, and eating too many calories, refined carbohydrates and saturated fats.

For some people, but not all, increased intake of salt also contributes to high blood pressure. However, if you exercise, you need to take in extra salt since salt is the only mineral that you lose in large amounts through sweating. Low salt levels can cause muscle damage, fatigue and depression. Salt deficiency can also raise high blood pressure because it causes your kidneys to produce large amounts of renin and your adrenal glands to make more aldosterone. These hormones constrict arteries to raise blood pressure.

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Measure Abdominal Fat, Not Just Weight

Researchers at the University of Michigan report that not all people who are fat are at high risk for heart attacks (Archives of Internal Medicine, August, 2008). They showed that 51 percent of overweight adults (36 million Americans) have normal blood pressure, cholesterol and blood sugar, while 25 percent of normal- weight Americans (16 million) have high levels of at least two of these tests. The media picked up this study with headlines such as "Better to Be Fat and Fit Than Skinny and Unfit" (New York Times, August 19, 2008).

However, the entire study is flawed. The authors measured overweight, not abdominal obesity. If you just compare weight to height to define obesity, more than 50 percent of professional football players would be obese, and they are not. I am sure that the study would show the far more harmful effects if the authors had measured abdominal obesity rather than just weight. Storing fat primarily in your belly can predict premature death. It means that a person's insulin levels are very high and high insulin levels mean that your body is not responding to insulin so you are at increased risk for a heart attack, stroke, kidney damage, arteriosclerosis and all the other harmful side effects of diabetes.

Other studies do show that it is better to be fat and fit than out-of-shape at any weight. Steven N. Blair of the University of South Carolina showed that adults over 60 who had higher levels of fitness lived longer than unfit adults, independent of how fat they were (JAMA, December 5, 2007). He showed that fat people who were able to run on a treadmill longer than unfit, fat people had better blood tests and fewer heart attacks and deaths.

How should these studies affect you? If you are overweight, you increase your risk for heart attacks, strokes, cancers and premature death. If you store large amounts of fat primarily in your belly, you are at such great risk for premature death that you should check with your doctor and probably get a thallium stress test to see if your coronary arteries are already blocked. If they are not blocked, start a supervised exercise program and diet to lose weight and become fit. If your coronary arteries are already blocked, you will need immediate counseling about future treatment.
Vacation photos

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Saturated fat risks cancelled by exercise

The Masai of Kenya and Tanzania eat the same type of high animal-fat diet as North Americans, but they have a very low incidence of heart attacks. In spite of the large amount of saturated fats in their diets, they have lower body weights, waist measurements, blood pressures and cholesterol levels (British Journal of Sports Medicine, July 2008). This is explained by the fact that the average Masai burns 4,000 kilocalories a day, which is roughly equal to walking 12 miles every day (this number includes the amount you burn for normal daily activities such as breathing and sleeping).

Saturated fat is the dominant fat in meat, chicken and whole milk dairy products. It raises cholesterol only when a person takes in more calories than he burns. A high-meat diet does not cause heart attacks in people who get a lot of exercise. Saturated fats are broken down by your body into two-carbon units. If you are getting too many calories, your liver converts these two-carbon units into cholesterol. If you are not getting enough calories, your body burns these units for energy.

When you take in more calories than your body needs, you store the excess as fat. Full fat cells release cytokines into your bloodstream, and they turn on your immunity. Your immunity is good because it protects you from infection, but if it stays overactive, it starts to destroy your body including your heart and blood vessels. The bottom line: if you eat much saturated fat, be sure to get plenty of exercise.
New photo of us

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Dieting Without Exercise Does Not Work

A new study from Israel shows us once again that dieting without exercise does not work. The participants took off only six to 10 pounds in two years. No matter what diet they were on, most regained some of the weight they lost in the early months by the end of the study (New England Journal of Medicine, July 17, 2008). It didn't make any difference whether the overweight person was on a low-fat or low-carbohydrate diet, or the healthful Mediterranean-type diet that stresses fruits, vegetables, whole grains beans, seeds, nuts and seafood. However, their small weight loss did result in improved cholesterol and blood pressure readings.

If you really want to lose weight for good, you have to exercise. Appetite is controlled in a part of your brain called hypothalamus. If you try to lose weight just by eating less food, your hypothalamus makes you miserable when you see tasty food and know that you shouldn't eat it. If you exercise, you will eat more, but you will not increase your intake of food to equal the extra calories that you burn when you exercise. After you have been exercising for a few months, your muscles will be stronger, you will feel and sleep better and you can actually start to enjoy your new activity. Then you are set for a life-long pattern of burning up the calories you take in.

Unfortunately, the majority of older people who start exercise programs drop out in the first six weeks. People are more likely to stay in an exercise program if they have company and find a sport that is fun for them. The best success comes when a husband and wife exercise together. You can also increase you chances of sticking to an exercise program by having a personal trainer, going to regular exercise classes, or joining an exercise group that is also a social club, such as Road Runners, a bicycle club or a square dancing society.

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Lifestyles Determine Who Lives Longest

According to a new National Geographic book, The Blue Zones, people live longer in the Barbagia region of Sardinia, Italy; Okinawa, Japan; Loma Linda, California (a community of Seventh-Day Adventists); and the Nicoya Peninsula in Costa Rica. The lessons drawn from these cultures are the same as those I've preached to you for the last thirty years: eat more vegetables, exercise, minimize stress, don't be overweight, and avoid smoking. Your odds also increase if you are married, live in a rural area and are a woman.

In this 1960's, people in the Georgian Republic in Russia, Abkhazians in Pakistan and the Vilcabambas in Ecuador were reported to live long lives, but it turned out that they were among the world's greatest liars, rather than the world's oldest people. The centenarians cited in The Blue Zone have documented birth certificates.

A new study from the British Journal of Sports Medicine (March 2008) found that people who exercise regularly live 12 years longer than non-exercisers, no matter where they live.

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Progress report on our training program

Several of you have asked about our training progress since I retired from my radio show and full-time medical practice. Diana and I are a 66-year-old woman and a 73-year-old man who want to ride a tandem bicycle faster than any one else in our age group. We know that training for sports requires stressing and recovering. On one day, we take a hard workout in which we ride as fast as we can, feel sore the next morning, and then go slow for as many days as it takes for the soreness to leave our muscles.

Since we often go to rallies on weekends, we usually ride very fast on Saturday and Sunday. I feel so sore on Monday that I take the day off, and then go slowly for the next four days because it takes that long for my muscles to recover. So we are doing two hard days, followed by a day off, then four recovery days and repeat the cycle. I must tell you that training depends on how you feel, so our schedules vary from week to week, depending on how sore or tired we are. There are days when we plan to ride hard, but have to take an extra easy day or even a day off, or we can expect to become injured.

It took many years for us to get up to schedule we do now. Diana had never exercised hard until she was in her late forties, so she has built up gradually over the last 17 years. She has never had a wear-and-tear injury from riding too much, but she has had three serious injuries from crashes. On the other hand, I have spent my lifetime trying to exercise hard all the time and have paid with repeated, persistent wear-and-tear injuries. Until recently, I just refused to take days off.

Last Saturday we raced 62 miles over a hilly course almost as fast as we could, holding back a little because we knew that we had to ride fast the next day also. On Sunday we raced 45 miles. On Monday, my legs were so sore that I took the day off. On Tuesday, my legs were still sore so we rode 20 slow miles. On Wednesday, my legs were still tired so we rode 43 miles, mostly easy with slight pickups when other riders came along. On Thursday, we rode 38 miles and on Friday, 46 miles. That amounts to 253 miles for the week with one day off. We are doing so many miles now that I try to stay off my feet when I'm not riding, because I know that walking and standing delay muscle recovery from hard exercise. We have several wonderful cycling trips planned this summer and will post some pictures soon.

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Football players more likely to become diabetic

People who have huge muscles usually have high levels of insulin because insulin causes muscles to grow. Exercise makes muscles so sensitive to insulin that it prevents blood sugar levels from rising too high. However, when these people stop exercising, their muscles are not as sensitive to insulin and blood sugar levels rise, this causes insulin levels to go even higher, so they eat more and gain weight.

A study from Mt. Sinai Medical Center shows that National Football League linemen are more than twice as likely as other Americans to develop diabetes in later life. More than 60 percent of NFL linemen become diabetic, compared to only 30 percent for the average American (The American Journal of Cardiology, May 2008).

People who have large muscles when they are young need to continue to exercise for the rest of their lives. If they reduce the amount of exercise or stop exercising for any reason, they must do everything in their power to protect themselves from gaining weight. Before insulin can do its job of driving insulin into cells, it must first attach to special insulin receptors on the surface of cells. Extra fat in the body prevents these receptors from responding to insulin, so blood sugar levels rise even higher. To compensate for this, insulin levels rise higher also, which sets the person up for diabetes and premature death.

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