Melanie Cole (Host):  If you want a healthy heart, you know that you have to exercise but how do you get started and how much does it really work for you? My guest today is Rhonda Becker. She is a Bryan LifePointe Exercise Specialist. Welcome to the show, Rhonda. Tell us a little bit about heart disease and exercise and what’s the relation there?

Rhonda Becker (Guest):   Everyone needs to exercise to have a healthy heart. Each year, more than 600,000 people die from heart disease in the United States. Heart disease continues to be the leading cause of death for both men and women in the United States and worldwide. Coronary heart disease occurs when cholesterol filled plaque builds up over time in the coronary arteries that supply blood to the heart. Over time, this plaque buildup can cause narrowing of the arteries which may lead to chest pain or a heart attack. Plaque can start accumulating in the arteries as early as childhood and adolescence. How you live now affects your cardiovascular risk later in life. If you already have heart disease, though, don’t despair. You can always avoid another heart event.

Melanie:  How does someone know they are even at risk for heart disease?

Rhonda:  There are many risk factors for heart disease you could change and control including smoking, high blood pressure, high cholesterol, being overweight or obese, having diabetes or just being sedentary. A major step to reducing your risk factors for heart disease is to increase both your daily activity and exercise.

Melanie: We hear from organizations like the American Heart Association and the American College of Sports Medicine that we should get 150 minutes of exercise a week. What is the difference between not being sedentary--getting daily physical activity--and true exercise?

Rhonda:  Physical activity is anything that makes the body move and burn calories, such as climbing stairs or doing your housework. Any increase in physical activity can benefit your health because it decreases the amount of time that you are sedentary. However, the most effective exercise for improving heart health is aerobic exercise also sometimes called cardiovascular exercise. Aerobic exercise uses large muscle groups such as the arms and legs in a rhythmic continuous nature such as walking or bicycling. Aerobic exercise improves the ability of the lungs and heart to deliver oxygen to working muscles by making the heart and lungs work harder than at rest. As a result, the heart becomes stronger and more efficient leading to increased endurance.  

Melanie:  Where does strength training fit into this? Is there any correlation between strength training and heart disease?

Rhonda:  There is some correlation to strength training and general health. However, we have found that the greatest thing to prescribe for people who are really worried about heart disease is to do the aerobic activities, to not be sedentary, and to just mix that strength training into their daily activity.

Melanie:  How does someone begin? If there is someone who has recently been diagnosed with heart disease or someone who just has never been an exerciser, what is your best advice for getting started on a program?

Rhonda:  The first phase is to just get into it, to talk to someone who understands exercise. The first thing that I could tell someone is to make sure that they are doing proper aerobic exercise. The first phase to that would be to warm-up. This phase allows you to transition from rest to activity. Just as you allow your car to warm-up when it is cold outside and prevent damage to the engine, a warm-up is going to lessen stress placed on your heart and your muscles and help prevent injury. The warm-up helps to slowly increase breathing, heart rate, body temperature. Warm ups can include exercise activity at a very low intensity, such as walking or just pedaling your bicycle slowly. Your warm-ups should last about five minutes. The second phase is the conditioning phase. For best results, remember these four points in your condition phase. One is frequency. How often do you need to exercise? You should exercise most days of the week. Two is intensity. How hard do you need to exercise? Exercise intensity can be measured in several ways. One method is to use the target heart rate range.  A general recommendation for a healthy person is 60-85 percent of age predicted maximum. What is your age predicted maximum? You can figure that by taking 220 minus your age. So, a 30-year-old person would have a heart rate maximum of 190 and an exercise range of 124 to 161. Many medications, such as beta blockers, may affect your heart rate maximum so you should consult your doctor or a certified fitness professional for an appropriate range. Another method is to use the Borg scale which is a subjective way to rate your perceived exertion or how hard you feel you’re working. During moderate exercise, you should have a perceived exertion of fairly light to somewhat hard and during vigorous exercise somewhat hard to hard. The talk test can be used to monitor how hard you are working as well. You should only be able to speak a full sentence when you are exercising. If you can only gasp a few words, than you are exercising too hard. If you can carry on a marathon conversation or sing along with the radio, you’re exercising too lightly. Duration:  how long do you need to exercise? To get the most benefit, you should exercise aerobically 30-45 minutes most days of the week. If you can’t exercise 30 minutes at once, don’t worry. You can still gain some benefit exercising two to three sessions of 10 to 15 minutes. Just do what you can and increase the minutes gradually until you reach your goal. Type of activity is also important. There are many types of aerobic activity. Remember, it must contain large muscle groups and be continuous. Walking for 30 minutes without stopping is aerobic. Shopping is not aerobic. There is just too much stopping and starting. However, remember that’s still better than sitting on the couch. You can also vary your activity by participating in more than one activity. For example, a combination of walking, swimming and cycling strengthens several muscle groups and will prevent you from becoming bored. The last phase is cool down. This phase allows your body to recover from the conditioning phase. The goal is for the heart and blood pressure to return to its near resting value. Cool down does not mean sit down. You wouldn’t want to take your nicely warmed up car and slam your brakes on at the stop light. No, you need to slow down first. In fact, you should never stand still, sit, or lie down immediately after exercise. This may cause you to feel dizzy, light-headed or have some palpitations. During cool down, you should slowly decrease the intensity of your activity, such as walking or pedaling slower. Like the warm-up, phase it should last about five minutes.

Melanie:  I think it’s so important that you pointed out that it doesn’t have to be 30-40 minutes all in one go. You can split it into 10 minute increments. What if somebody wants to work out at home? They are not at a gym. If you were to recommend one piece of equipment that they could have that would get them this exercise to help their heart what would it be?  

Rhonda:  For most people, having a pair of exercise shoes would probably be the best thing for them. You can walk around your house. You can march in place. You can go for a walk outside. You don’t have to go to a gym to do these activities. Anything that you feel comfortable doing – anything that you like to do--is the best thing for you.

Melanie:  In regards to heart disease, when you do exercise, what happens if you have existing heart disease? What symptoms would you like them to kind of keep aware of, red flags while they are exercising, that might signal something is wrong?  

Rhonda:   Sure. It is always important to note that you should not feel any chest discomfort, any lightheadedness, dizziness, or nausea during exercise. If you do have any of those symptoms, that should always be reported to your physician.

Melanie:  Are they something that would be emergent? Do you stop exercise? What do you advise people to do if they get pains?  

Rhonda:   Absolutely. Stop exercise, sit down, and follow the doctor’s instructions. If you have nitro, what are they supposed to do? If it’s chest pain that is not going away, they do need to seek some emergency care.

Melanie:  Rhonda, tell us about Bryan Life Point and what people can expect when they are there.  

Rhonda:  Bryan Life Point is a one-stop shop. We have both cardiac and pulmonary rehabilitation to help people get better after heart events or lung problems. We also have a general fitness facility to help anyone from the age of 14 up to 114 achieve their fitness and health goals. We have diabetes education. We have physical therapy. Anything that anyone needs to become healthy, they can get done at Bryan Life Point.

Melanie: In just the last few minutes, give your best advice about exercising and heart disease and why you think it’s so important for people to do that.

Rhonda:  Exercise is just such an important part of life in general. Heart disease starts at such a young age. The more we can do now, the better off we will be in the future. Use a buddy system. Ask a family member or friend to help you and become healthy together.    

Melanie:  That’s great information. Thank you so much, Rhonda.  You’re listening to Bryan Health Radio and for more information you can go to BryanHealth.com. That’s BryanHealth.com. This is Melanie Cole. Thanks so much for listening.