Monthly Archives: March 2014

Rehab Riot

About 3 months ago I attended a heart attack rehab meeting. there was about 40 people there and two speakers. I interjected with questions like

1. How can one find a UK test for LDL particle size (They had no idea that LDL had particle sizes)
2. Why is the T break we have just had in the canteen 70% full of heart unfriendly food
3. What do you think of the new Swedish guidelines (they had no idea what I was talking about)

These questions started to wrangle the audience a little, there was a feeling of shut up and listen to the experts. One woman who was with her husband shouted up to point 2, ‘You dont have to buy it, its your free choice as an individual’. The fact that the hospital endorse poor dietary choices by stocking them seemed lost on her.

However things went really off the rails and the audience turned on me big time when the inevitable food pyramid diagram went up. It was the usual out of date bollocks with lots of Carb’s advocated. There was pictures of potatoes and corn flakes amongst the heavily promoted carb’s. I put my hand up once again and stated that the diagram was wrong to which the roof went off the room as the audience hooted laughed and hollowed. One guy shouting ‘are you a doctor then ?’ to which I perhaps churlishly replied ‘No but then again thst means I am not tied or influenced by drug or food companies’, that really caused a furorer. I finished by saying ‘Look that diagram will have to be completely rewritten particularly with simple carb’s being relegated to the top (eat less) section, unlike Sweden, it may take another 5 years but it will happen’.

There was a feeling amongst many members of the audience that heart disease was hereditary and not really due to the diet we have been cajoled on to by food companies. This argument does not really stand up when there is plenty of evidence showing when heart healthy Japanese populations migrate to heart disastrous USA they develop heart disease as readily as your average coke guzzling, overweight American. Their magical genes offer little protection. Of course this has not stopped my local Cardio heading a gene based study attempting to drill down and perhaps find gene profiles that suggest high risk of heart disease. Call me cynical but this smacks of drug companies funding a project that if baring fruit will enable them to promote a gene heart busting drug at a much earlier age than they prescribe a statin. There is a whole lot of money to be made out of prescribing such a drug to 18 year old’s  as opposed to waiting for cholesterol levels to rise in mid age.

Exercise Good or Bad ?

It is always more striking when you come across research results that endorse your own gut instincts, not that you should seek out such data as this can lead to a biased view of things. Before my heart attack I had, despite being a long term runner, football, tennis and general sports player, a gut feeling that excessive exercise was not particularly protective. I based this on what I thought was a premise too shaky to be a solid foundation for truth.  My feeling was that perhaps the heart was just like any other muscle. Exercise it too vigorously, especially as you get older, and maybe you run the risk of straining it. I know my calves are not what they used to be and can occasionally pull on a run. On the other hand sit around doing no exercise and the heart like any other muscle loses strength and performance. A simple analogy is that of a car. Thrash it and it will quickly give up on you. Leave it unused and it will equally pack in on you. Although I hate the word moderation except in the phrase’ moderation kills’, I have to admit that when it comes to exercise I wondered whether moderation was the key.

I was very interested therefore to discover some research that appeared to back up my feelings. A group of people had been tracked for a number of years after first being categorized into one of five categories. Category 1 was the complete couch potato. Number 2 was the type who did a small amount of walking, maybe half an hour a day but not much else. Category 3 were people who whilst not being regular exercise types did have a regular informal workout such as cycling to work or conducting say an hour’s walking per day. Group 4 were regular sports types, maybe two or more sessions per week. The final category 5 was for people who are very serious sports enthusiasts. Marathon runners, triathlon competitors and the like. When these five groups of people were rechecked after 10 years the worst performers in terms of medical incidents was category 1, the couch potatoes (no surprise there). The second worst however was the serious sports people in category 5. Coming out tops was category 3 followed by category 2.

It seems that light but regular exercise is all one needs to keep the engine ticking over and the no pain no gain merchants may be doing more harm than good. My exercise schedule now consists of Yoga twice a week. Walking at least an hour each day and light jogging twice a week. I have just bought a bike so some cycling will find its way in there as well but those eyeballs out running sessions I used to do are certainly a thing of the past.

There is an article here about some research finding similar to those above but with regard to runners http://www.webmd.com/fitness-exercise/news/20140401/too-much-running-tied-to-shorter-lifespan-studies-find

There is also an excellent talk here https://www.youtube.com/watch?v=Y6U728AZnV0