Welcome to Dr. Warrick's podcast channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. Hi, my name is Dr Warrick Bishop and welcome to my podcast and videocast station. Today I'd like to talk about lifestyle, including tobacco and alcohol. But let's start with exercise. Everyone knows that exercise is good for you. We know that. Everyone knows that. And we know that exercise comes in two main types. That's aerobic exercise and resistance exercise. Now, if you're not sure exactly what that means, aerobic exercise is, well, walking along a beach where your arms and your legs are freely swinging and you're undertaking some exercise and often your heart rate will go up with that. Resistance exercise is where your arms and legs are not moving, where, if you like, holding or bracing or lifting a weight. Sort of a weight lifting type movement rather than a gentle activity or movement such as walking. So there's two types of exercise, aerobic and resistance. In spite of us all knowing that exercise is good for us, it turns out that about 50% of the adult population in the western world still don't get as much exercise. as they probably should and fall short of current national and international recommendations. Well, for those interested, what are those recommendations? Well, those recommendations relate to the sort of exercise you do to some degree. We generally recommend as the medical fraternity that individuals should be undertaking about, well, about 150 minutes per week of moderate intensity exercise. And that would be a walk, if you like. A 15-minute walk to and from your car to get to work would be 30 minutes a day times five days, Monday to Friday. There's your 150 minutes. Alternatively, we recognise that higher intensity exercise has a greater benefit. And so guidelines suggest about 75 minutes. of high intensity exercise and that might be running something like three 25 minute runs in a week or two runs a bit over 35 minutes. Remembering that the benefit is cumulative so do it as often as possible with some frequency and regularity. Why is exercise so good? We know it helps with weight control and particularly with weight loss if someone starts to exercise and most importantly the weight that we tend to lose is that weight around the middle of the tummy, that so-called hazardous waste, the waste circumference comes in and we know that is closely linked with a reduced risk of heart attack into the future. We know blood pressure will come down as you exercise and that's a good thing. We know you improve your insulin resistance. Now insulin resistance means that your body deals with sugars and carbohydrates more effectively, but it also means you change the cholesterol balances within your bloodstream and you will raise your good cholesterol and lower your bad cholesterol. So whatever you do, exercise is good. There's a little bit of work on this and I'm just going to step on. to a slightly different area where I was able to attend a meeting a number of years ago where they talked about the mechanism that exercise can improve these functions within the body and the presentation was talking about the development of G shock proteins that's G for George shock proteins and these proteins are a response to the uh physical effort the stress and the strain that the muscles go under through exercise and the knock-on effect is that these g-shock proteins then have some of these metabolic effects on increasing metabolism and metabolic rate on improving insulin resistance and so forth with their knock-on effect well here's a really interesting thing it turns out that these g-shock proteins can also be activated through temperature and so it's possible you can get some exercise benefit equivalent from having a 30 minute hot tub or even a 30 minute sauna. Sounds a rather luxurious way to get your 150 minutes in per week but there is a bit of data supporting it so maybe combine your exercise with a nice hot tub or a bit of time in the sauna. afterwards. Whatever you do, do try and put exercise into your daily routine and particularly try and think where you can increase your incidental exercise. Park the car a little bit further away, take the stairs instead of the lift. Do things around your daily activities that just increase your activity. My general recommendation to patients is to find something you enjoy. My experience over the years is you just can't tell people to go and do cycling, do walking, go running, go swimming. Because if you don't enjoy the activity, you're never going to do it in a sustained and ongoing way. So please find something you enjoy. If it's wading through a pool with your friends, that's great. fantastic if it is walking along a beach do it if you do like running and your knees and hips are good all power to you go and do it if you like cycling please wear bright colored clothes and don't be hit by a car or use the cycle tracks but whatever you do get out there get active because not only does exercise, help with your weight, help with your blood pressure, help with your cholesterol. There's also some really nice data to show us that it is good for mood and its effect on your mood is as good as a mild antidepressant agent. So stay happy, stay healthy and stay exercising. I'm going to touch on tobacco next and I'm afraid as you already know there is no good news about tobacco. It is quite possibly the leading preventable cause of mortality and morbidity in the western world so we can really really do something about it and mitigating future risk by smoking cessation is a powerful, powerful objective. Not only does it affect your heart, it affects your lungs in terms of breathing effectiveness, but risk of cancer in the lungs, mouth cancers, esophageal cancers, peripheral vascular disease, skin. Really, if you've taken up smoking, do whatever you can to put it behind you. But the news is not just bad for you. The news is bad for passive smokers as well. So if you are around loved ones who are not smoking, consider them. The impact of cigarette smoking, passive or secondhand cigarette smoke, is significant. It's not as bad as being the smoker yourself, but it's right up there. And significant exposures to secondhand smoke can have the same consequence as being a smoker yourself. So please be considerate of others. And if you are someone who's in a... passive or secondary secondhand smoking situation, please have the conversation you need to with the people around you to look after your own health. It turns out that you only need a couple of cigarettes a day to keep your risks elevated of things like heart attack, stroke, cancer. So cutting down is great and it may slow progress to our lung disease. but it doesn't completely reduce your risk. You have to stop altogether. It turns out that e-cigarettes are probably best avoided. We don't have long-term data on those at this stage, but the preliminary stuff looks like the body really treats those chemicals in the same way as they would a standard cigarette. Probably, if you really must have a puff from time to time, perhaps limit it to cigars, at weddings and births and don't inhale. Pass them around and enjoy the day and enjoy your health and do your very best to put the cigarettes and the smoking behind you. The last thing I wanted to touch on was alcohol. Now up until relatively recently we've used the term a glass of red might be good for you or a glass of red is good for your health with that thought that the coloured agents in there within the glass of red the antioxidants together with the little bit of blood pressure lowering together with a little bit of HDL raising. could well be a positive for your health. Well it turns out that the most recent national, international guidelines looking at alcohol have not been able to demonstrate clearly any benefit from regular consumption of alcohol. And so our guidelines from major organisations and institutions in that space have moved away from suggesting that a glass of wine is good for you. and now have a neutral position on that and follow that up with a recommendation that probably something in the order of 10 drinks per week is about the maximum recommended. No more than four in one sitting and that would be equating to somewhere like two drinks per day for five days out of the week with two days free of alcohol. but you can mix that up any way you like and there is a general feeling that a day off from alcohol per week is not a bad idea. My own feeling though is that alcohol does have a role that's beyond just health and certainly keeping within those guidelines and recommendations is sensible but my own feeling to a degree is that alcohol has a role in social interaction. It is something that's become part of our cultural fabric. My personal feeling is it helps me digest a meal so I like half a glass of wine or even a glass of wine through the course of an evening particularly while I'm having a meal. Myself I happen to enjoy collecting wine and I enjoy the opportunity to go to wineries, purchase a wine that I find interesting at the time, take it home, lay it down in the cellar and a number of years later share that with a friend or family member and have a story that goes with the wine. So personally I enjoy wine with a passion. I understand it has a socialising component to it and I enjoy it with a meal. But of course the sensible thing is in moderation, ten drinks per week, maximum of four in one session and please enjoy it, enjoy it in moderation and maybe do your exercise beforehand so you get the benefit of some exercise as well. I hope you found that little spiel on lifestyle, exercise, tobacco and alcohol informative. I hope it's given you some guidelines, some food for thought. If you have any queries or questions, drop us a note. For now, however, I'm going to wish you the very best. Take care. Bye for now and please don't die from a heart attack. Goodbye. You have been listening to another podcast from Dr. Warrick. Visit his website at drWarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.
