How Much Exercise For Boosting Heart Health?

Exercise is one of the key methods for lowering cholesterol – and blood pressure, my new concern — without medications. So to reduce my blood pressure and to continue to keep my cholesterol in check without any meds, I’ve been wondering just how much, how hard, and how often I need to exercise.

In researching, I found this nifty chart from the American Heart Association. It’s a little busy, but the key is the bottom-most graphic, which is for lowering cholesterol and blood pressure (how handy that they are together goal-wise!)

Apparently, to lower cholesterol and blood pressure, one needs to exercise for an average of 40 minutes at a ‘moderate-to-vigorous-intensity aerobic activity’ 3-4 days each week.

AHA Exercise Guidelines

Which sounds like kind of a lot, people.

I mean, I can jog for 20 minutes before my knees hurt – but certainly not 40 minutes (I was awed when my 21 year old son ran the Chicago marathon in 3 hours and 49 minutes. I still can’t believe he did that / that anyone can run for that long!).  So, um, 40 minutes of ‘moderate-to-vigorous’ exercise 3-4 times a week sounds like a LOT to me.

So obviously, the key question is – what is ‘moderate-to-vigorous-intensity’ aerobic activity?

To me, moderate-vigorous seems like it’d be exercise that gets my heart rate to hit at about 70-85% of my Max Heart Rate (for me, that’s 140-154 or so). If you want to know more about setting a personal heart rate goal, read How To Set A Simple Heart Rate Goal. But is that moderate or is that vigorous?

Luckily, the American Heart Association had a post that answered that exact question: Moderate to Vigorous – What is your level of intensity?  The AHA defines moderate and vigorous exercise as follows (link to the article for more detailed, pretty interesting info):

Examples of Moderate Intensity:

  • Walking briskly (3 miles per hour or faster, but not race-walking)
  • Water aerobics
  • Bicycling slower than 10 miles per hour
  • Tennis (doubles)
  • Ballroom dancing
  • General gardening

Examples of Vigorous Intensity:

  • Race walking, jogging, or running
  • Swimming laps
  • Tennis (singles)
  • Aerobic dancing
  • Bicycling 10 miles per hour or faster
  • Jumping rope
  • Heavy gardening (continuous digging or hoeing)
  • Hiking uphill or with a heavy backpack

Whew. I can walk quickly for 40 minutes to count as heart-healthy exercise. Yay – that’s one I can actually do!  But walking is kind of boring to me – and 40 minutes still feels like a lot of time.

So I need another option. One that’s vigorous but doesn’t eat into my day. Which is why I’m intrigued by High-Intensity Interval Training. In fact, this explanation of HIIT from Karen Reed of Positive Health Wellness was music to my ears, “Thanks to the non-stop, high-intensity pace of the workout, you can fit in both aerobic (cardio) and anaerobic (resistance training) exercise in just 15 to 25 minutes.” For more details, read her article, “All The Benefits of High Intensity Interval Training Workouts.”

I’d rather ramp up my exercise plan than go on blood pressure or cholesterol meds, so I’m looking at trying out High-Intensity Interval Training and/or scheduling more – or longer – aerobic exercise into my week. How about you?

 

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Non-Sweetened Metamucil with Grapefruit and Orange Juice

With my cholesterol, triglycerides and blood pressure higher last month, I needed to try to salvage things before my doctor(s) advise statins and/or blood pressure medication. Step one: a lo-co lifestyle exercise and diet review (and correction):

  • Exercise. I’d let my exercise habit lapse in the past six months, so have recently re-started exercising daily. Of course today I pulled my hamstring. Sigh. But I am determined to at least walk daily, because ‘Study Proves Exercise Staves Off Bad Cholesterol.’
  • Diet – General. While I don’t eat a lot of red meat, I do eat a lot of carbs (pasta and bread) and sugar (M&Ms and wine). So I’m cutting down on pasta, pizza and sticking with 1 glass of rose per night. And M&Ms, well…not sure how they got back into my diet but it ends now.
  • Diet – Supplements. As with exercise, I had stopped my daily dose of Metamucil. Which is lame, because Metamucil both lowers cholesterol and helps with diverticulosis, which I also have. So I tossed my very expired Metamucil and bought a new, huge jar of Orange Smooth Metamucil, with sugar.

Metamucil_SugarThen I got to thinking about that Metamucil. I chose Orange Smooth Metamucil (with sugar) because I both despise aspartame and believe it to be unhealthy. As all the sugar-free Metamucil products have aspartame, that left me with the Metamucil with sugar. But with sugar-sensitive high triglycerides and a desire for a nightly glass of wine, it seemed sugared Metamucil might not be a great choice.

Metamucil_OriginalSmoothSo I dug a bit more and found ONE Metamucil product with neither sugar nor aspartame. Called Metamucil Original Smooth, it was just what I was looking for. Oh, except for the taste. While I did not despise the ‘wheat-y’ taste as much as others on the internet seem to, it was certainly not a flavor I wanted to wake up to every morning.

So I started thinking about how Going Lo-Co reader Eileen makes a cholesterol-loweirng grapefruit juice / Metamucil smoothie: info here.) Smoothies are too much work for me, so I looked around on the web and found many who said they mixed the Original Smooth with juice. Which is what my Mom does too – she mixes Metamucil with diluted orange juice. But OJ is just a lot of sugar with no cholesterol-lowering benefit so that did not appeal. Then it hit me: what if I combined grapefruit and orange juice?**

This morning, I stirred up an inaugural glass of Going Lo-Co Metamucil Elixir. To make it, I combined 1 teaspoon of Metamucil Original Smooth with 4 ounces of grapefruit juice, splashed in some (about 1 oz) orange juice to cut the tartness of the grapefruit juice, then topped it off with about 2 oz of water.  After a vigorous stir, I guzzled it.

I am pleased to say that I really liked it. Well, as much as one likes these things.

The taste is decent AND unlike sugared Metamucil, my version delivers potassium AND the blood pressure, cholesterol, and triglyceride lowering properties of grapefruit juice (see Grapefruit Pros and Cons for more info.)

Then I estimated the nutritional value for my Going Lo-Co Metamucil Elixir. My concoction does have more calories and sugar than sugared Metamucil, but I’m willing to accept those extra 30 calories and 4 grams of sugar for the better taste AND potassium AND the cholesterol-lowering benefits of grapefruit juice. Here’s how they compare:

Metamucil Grapefruit OJ
If you don’t take ANY medications, give my Going Lo-Co Metamucil mix a whirl. If you do take medication – any medication – read message below: and do NOT try this unless you’ve consulted with your doctor.

** VERY IMPORTANT:  do NOT try this ‘recipe’ — in fact, do NOT drink any grapefruit juice — if you are on statins or other medications. Specifically, do NOT eat grapefruit or drink grapefruit juice if you take Lipitor or any other statin medication to lower cholesterol without speaking first to your doctor.  Same grapefruit warning exists if you take other types of medications that can also interact with grapefruit juice, including drugs for blood pressure, heart rhythm, depression, anxiety, HIV, immunosuppression, allergies, impotence, and seizures.  It is dangerous to start eating grapefruit (or drinking grapefruit juice) if you take any of these medications – unless you speak to your doctor first.

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Walking Counts as Exercise… REALLY!

On NPR this morning, I heard Renee Montagne utter this intriguing line, “About half of all Americans say they exercise regularly.” I literally laughed out loud as exercise is a big topic of conversation this week in my house, with my parents visiting from Florida. My dad had a second heart surgery last year and my mom has high cholesterol, and they really would benefit from regular exercise. I know this. They know this.  And yet…they are not among the apparently half of Americans exercising regularly.

Maybe peer pressure (as opposed to kid pressure) would help? So I listened keenly. In fact, after noting that half of Americans say they exercise regularly, Ms. Montagne continued with proof that it’s true:

“That’s the finding of a recent poll NPR conducted with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. The most popular exercises are cardio/aerobic using treadmills, elliptical machines, and stationery bikes. But leading the pack: going for a walk!”

I looked up the poll: Sports And Health In America. Published in June 2015, this study interviewed 2,506 adults age 18 and older who were interviewed on the phone, in English and Spanish, between January 29 – March 8, 2015. While this study is 50+ pages of intriguing facts, one thing I did not see is a breakout of exercise among those age 70 and older, which I could have used as fodder for an exercise discussion with my parents. Sigh.

But no matter, as there was a key nugget I could use with my folks! Right after Ms. Montagne’s segment was a ‘Health News’ story entitled, “Take A Hike To Do Your Heart And Spirit Good.” In this piece, Patti Neighmond discussed a topic near and dear to my heart (apologies for bad pun): is walking REALLY exercise?

Frankly, I’m of two minds about walking. For my parents, I have tried to convince them that walking is vital — that to lower cholesterol and blood pressure and have a healthier heart, they need to walk, daily. I’ve posited that the lower energy my father feels one year post successful heart surgery is partially due to the fact that he’s not exercising enough. Even he admits his cardiologist has said the same thing. I’ve gifted both parents workout clothes and iPods (and conducted remote IT sessions to load music). I’ve asked. I’ve cajoled. To little effect. That said, big kudos to you, Dad, for you for getting on the treadmill at my house this morning; color me very impressed!

And yet, when I was injured this winter and could not play tennis for several months, I didn’t walk. Instead, I was a slug (a very sad slug) and did nothing. The result was unsurprising: I gained weight and my cardio conditioning lapsed. All because as much as I preached to my folks that walking is exercise, in the end I guess I didn’t believe it.

Turns out, I should have.

Back to Patti Neighmond, who wondered: “Is Walking Really Exercise?” (emphasis is mine). She even asked it the same way I would, with some degree of snark:

“But are they kidding themselves to think a moderate walk is really helping them much, exercise-wise? Should we all be power-walking or jogging if we want to count that activity as good for us?”

Ms. Neighmond went on to answer:

“Dr. Tim Church, who studies the effects of physical activity at Louisiana State University’s Pennington Biomedical Research Center, is reassuring on that score.”

He says, “Too many people think you have to exercise really, really hard to get a benefit, and nothing could be further from the truth. You’re actually getting probably 95 percent or more of the benefits when you’re walking as compared to jogging.”

The entire NPR segment is about five minutes long. I found it pretty interesting; you can listen to it here.


Ms. Neighmond wraps up with this recommendation: “Federal Health Officials suggest 150 minutes a week of moderate physical activity. That’s about 30 minutes, five days a week. If you’re walking, it would be a moderate pace – so you can still carry on a conversation.”

The obvious next question: what’s a moderate pace? The answer is not straightforward as it depends on your overall fitness level. According to the Center for Disease Control’s very interesting Measuring Physical Activity Intensity page, a moderate pace is a ‘brisk walk’ of 3 miles per hour or faster. That translates to a pace of 20 minutes per mile.

That felt slow to me so I kept researching. Turns out, this pace would not qualify as a brisk walk for me, personally, since my cardiovascular fitness is pretty high (despite my high cholesterol). According to an article I found on about.com, How Fast Is Brisk Walking, “fitter people still will not be in a moderately intense exercise zone at that pace. A pace of 15 minutes per mile, or four miles per hour, is more likely to put fitter people into a moderately intense exercise zone.” So for many, a 20 minutes per mile walk will qualify as brisk, while others will want to shoot for 15 minutes per mile.

As I’m inspired by goals, I’m energized by attempting to hit 15 minutes per mile. Others might prefer to forget about targeting a pace and instead count (brisk) steps. I know many people using a FitBit to hit a daily step goal (have you read David Sedaris’ hilarious FitBit story, Stepping Out? And relatedly, I had no idea my iPhone 5 was counting my steps for the past year; check out the ‘health’ app to see if yours is too!)  For still others, tracking to a particular pace or counting steps would be (gasp!) the opposite of fun. For these folks getting out frequently for a brisk walk with a friend is what will motivate.

So find what inspires you…and just get out there and briskly walk!

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New Year’s Exercise Resolutions and Heart Health

If you’re like most Americans, getting more exercise is on your list of New Year’s resolutions.

And for good reason: exercise is one of the key methods for lowering cholesterol – and blood pressure, my new concern — without medications.  Oh, and that dropping weight side-benefit (ha ha) is kind of fantastic, too.

So to reduce my blood pressure and to continue to keep my cholesterol in check without any meds, I’ve been wondering just how much, how hard, and how often I need to exercise.

In researching, I found this nifty chart from the American Heart Association.  It’s a little busy, but the key is the bottom-most graphic, which is for lowering cholesterol and blood pressure (how handy that they are together goal-wise!)

Apparently, to lower cholesterol and blood pressure, one needs to exercise for an average of 40 minutes at a ‘moderate-to-vigorous-intensity aerobic activity’ 3-4 days each week.

AHA Exercise Guidelines

Which sounds like kind of a lot, people.

I mean, I like exercise and exercise more frequently than most people I know, and that sounds like a lot to me.

So obviously, the next question is – what is ‘moderate-to-vigorous-intensity’ aerobic activity?

Luckily, the American Heart Association had a post that answered that exact question: Moderate to Vigorous – What is your level of intensity?  The AHA defines moderate and vigorous exercise as follows (link to the article for more detailed, pretty interesting info):

Examples of Moderate Intensity:

  • Walking briskly (3 miles per hour or faster, but not race-walking)
  • Water aerobics
  • Bicycling slower than 10 miles per hour
  • Tennis (doubles)
  • Ballroom dancing
  • General gardening

Examples of Vigorous Intensity:

  • Race walking, jogging, or running
  • Swimming laps
  • Tennis (singles)
  • Aerobic dancing
  • Bicycling 10 miles per hour or faster
  • Jumping rope
  • Heavy gardening (continuous digging or hoeing)
  • Hiking uphill or with a heavy backpack

I found this useful, but prefer a more specific goal: for me, moderate-vigorous means my heart rate hits at about 70-85% of my Max Heart Rate (for me, that’s 140-154 or so).  If you want to know more about setting a personal heart rate goal, read How To Set A Simple Heart Rate Goal.

Since the only thing I do for exercise that lasts more than 30 minutes is walking or spin class, all this means I need to be a bit more, um, diligent about working out. Sure, I play tennis 2-3 times per week, power walk on nice days (3 miles at about 4 mph) and take spin classes – but I’m pretty clear that I’m not hitting the 40 minutes part of the 3-4 days per week goal.

One option to boost exercise without it taking too much time is High-Intensity Interval Training. This explanation of HIIT from Karen Reed of Positive Health Wellness was music to my ears, “Thanks to the non-stop, high-intensity pace of the workout, you can fit in both aerobic (cardio) and anaerobic (resistance training) exercise in just 15 to 25 minutes.” For more details, read her article, “All The Benefits of High Intensity Interval Training Workouts.”

I’d rather ramp up my exercise plan than go on blood pressure or cholesterol meds, so I’m looking at trying out High-Intensity Interval Training and/or scheduling more – or longer – aerobic exercise into my week. How about you?

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What’s Your Recovery Heart Rate?

Charts and tables explaining how to calculate a target heart rate for exercise abound. In fact there’s so much information it can be downright confusing (hence my blog post, How To Set A SIMPLE Heart Rate Goal.)

But there’s very little information about another interesting heart rate goal: Recovery Heart Rate.

Which is unfortunate because it’s a pretty useful measure.  Lots of people have trouble starting and staying with an exercise program, and Recovery Heart Rate actually shows your progress – which could be very motivating.  In their online article, What You Should Know About Your Heart Rate or Pulse, NEMAhealth.org explains, “One way to determine if you are reaping the benefits from exercise is to calculate your Recovery Heart Rate, a measure of how quickly you return to your resting heart rate after a workout.”

And it’s easy to do.  The article goes on to explain that to calculate recovery heart rate, follow these steps: 

1. Take your pulse ten seconds immediately after you have finished exercising. Write down the number.

2. One minute later, take your pulse again and write it down.

3. Subtract the number for the second pulse check from the number for the first pulse check. This number is your Recovery Heart Rate. The greater the number, the better shape you are in!

Simple, right?

Yes.  Except for the fact that in some articles, the directions are to take your pulse/note heart rate on your heart rate monitor 1 minute post exercising, while other articles say 2 minutes.

Sigh.

I don’t love that ambiguity.  But I can deal with it because there’s a bigger problem, IMHO.  For me, the larger issue is that I… um… want a goal.  I want to know how much my heart rate SHOULD go down (after 1 minute….and/or 2 minutes) to indicate that I am: a) pretty fit, and  b) getting fitter with increased exercise.

I don’t feel like that’s a lot to ask.  And yet, it is.  Because nowhere could I find a target.

What I did find is a study the American Heart Association published in 2001 that showed that if your recovery heart rate is <=18 beats lower than it was when exercising, that is indicative of poor heart health (and, um, predictive of higher death rate. Not kidding.)

Then I read Heart Rate Recovery Can Be Improved with Exercise from The Cleveland Clinic, which said after 2 minutes, heart rate must go down at least 12 beats per minute to be in good heart health.

Um – those don’t jive.

The conclusion: if you have cardiac issues, your cardiologist will know what to do about this 18 beats after 1 minute vs 12 beats after 2 minutes conundrum.  If your Recovery Heart Rate after 1 or 2 minutes is in the 12-18 beat range, you should probably check in with a cardiologist.

Which brings me to the other end of the spectrum.  The question I’m wondering about is this: if you are already exercising to keep your cholesterol in check, how can you use Heart Rate Recovery to gauge progress?

On a site called EnduranceCorner, Dr. Larry Cresswell states that a drop in heart rate of 15-20 beats per minute is ‘normal’  (and less than 12 would be ‘unfavorable.’)  And WebMD’s Researchers Find Heart Rate Worth a Thousand Words also posits that a ‘normal’ heart rate recovery is a decrease in beats of 15-25 beats after one minute.

Absent any other way to set a goal, I’ve decided to set my own personal goal of a drop of at least 25  beats, 1 minute after stopping after exercising at my maximum heart rate level.  It’s really easy to do this in a spin class – I try to ramp my heart rate up to my (personal) max of 154-ish during a song… then after that song ends, I note the time and heart rate on my heart rate monitor, then sit and pedal slowly (and gulp water) and watch my heart rate after 30 seconds and 1 minute.

The thirty seconds part I just made up.  It just keeps me occupied.  Interestingly, my heart rate remains kind of near the max even after 30 seconds.  But this week – after several weeks of intense spin training for my upcoming European bike trip (!) – I noticed that  my resting heart rate after 1 minute was consistently 30 beats less than maximum.  And that’s a pretty big improvement vs the typical 20-25 it had been when I was spinning just once a week.

Now that’s the kind of progress I need to keep spinning twice or three times a week.

That, and the fact that in just a few weeks, I’ll be spending 5 days in a row riding up the rolling hills of Croatia!

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