Participants: Don Morgan
Series Code: WM
Program Code: WM000387
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00:01 The following program presents principles
00:03 designed to promote good health and is not intended 00:05 to take the place of personalized 00:06 professional care. The opinions and ideas 00:09 expressed are those of the speaker. 00:11 Viewers are encouraged to draw their own 00:13 conclusions about the information presented. 00:36 Our hearts pump 42 million gallons of blood 00:40 during the course of a normal life time. 00:43 Unfortunately for many engaging in unhealthy 00:48 lifestyle habits can prematurely cut short 00:51 the work of this magnificent pumping machine. 00:55 Hello and welcome to Wonderfully Made. 00:58 My name is Don Morgan and I'm a professor 01:01 in the department Health and Human Performance 01:03 at Middle Tennessee State University. 01:07 This is the ninth in a series of health programs 01:10 aimed at underscoring the foundational 01:13 role of physical activity in achieving 01:16 and maintaining good health. 01:18 In today's program, we're going to be 01:21 discussing the relationship between sedentary 01:24 living and heart diseases and we'll examine 01:27 how a regular program of physical activity 01:30 can help strengthen your heart 01:32 and reduce heart disease risk. 01:36 Heart disease also known as cardiovascular 01:40 disease is the leading killer of people 01:43 in United States and other developed countries 01:46 around the world. 01:48 Latest estimates from the 01:50 America heart association indicate 01:52 that heart disease was the underlying 01:55 or contributing cause of over one million 01:58 four hundred thousand deaths in 2003. 02:03 One in three adult men and women have some 02:07 form of cardiovascular disease 02:09 and 64% of US adults have one or more 02:14 cardiac risk factors, from a financial 02:18 perspective the combined direct and indirect costs 02:22 of heart disease in 2006 are estimated 02:27 to be a staggering $403 billion. 02:33 As shown in the following graphic, 02:35 heart disease isn't just a single health disorder, 02:38 but rather it's a general name for over 02:42 20 different heart and blood vessel diseases. 02:46 Before discussing the processes which 02:48 contribute to heart disease, 02:50 it's important to define the terms 02:53 arteriosclerosis and atherosclerosis. 02:58 Arteriosclerosis are hardening of the arteries 03:02 is a condition in which blood vessels thicken 03:06 and lose their elasticity. 03:09 Atherosclerosis is a pathological form 03:12 of arteriosclerosis, where the inner layers 03:16 of the blood vessels walls become thick 03:18 and irregular, because of the deposits of fat, 03:22 cholesterol and other substances. 03:26 As this atherosclerotic plaque grows over time 03:31 blood flow can gradually decrease diminishing 03:34 the oxygen supply to the heart. 03:38 The atherosclerotic plaque can also become 03:41 calcified and develop cracks or ulcers 03:45 leading to blood clots that can obstruct blood 03:48 vessels in the heart. 03:51 When certain areas of the heart are deprived 03:53 of adequate blood flow and oxygen, 03:56 an uncomfortable pressure, fullness, 03:59 squeezing or pain in the center of the chest 04:03 called angina pectoris can result 04:07 a heart attack or myocardial infarction 04:11 occurs when part of the heart dies 04:14 or is permanently damaged due to a lack 04:17 of blood supply and oxygen. 04:22 While the clinical manifestations of 04:24 cardiovascular disease usually appear later 04:27 in adulthood. Mounting evidence suggests 04:30 that their genesis occurs in early in life. 04:34 Autopsies of youth, who died in accidents 04:37 have conformed the presence of fatty streaks 04:40 in the arteries of children as young as 04:42 3 years of age. In another autopsy study 04:47 involving over 1000 males and 360 females, 04:51 who died between the ages of 15 and 34, 04:55 individual differences in the severity of 04:58 atherosclerosis were linked to factors 05:01 such as blood fat levels and lifestyle habits. 05:05 The incidence of atherosclerosis in 05:08 10-15 year olds, while only 7% rises 05:13 to 14% at 15-20 years of age 05:17 a relative increase of 100%. 05:22 Many young people also display a number 05:24 of risk factors for heart disease such as elevated 05:27 cholesterol levels and obesity, 05:31 taken together these findings provide support 05:35 for the notion that adopting and maintaining 05:38 a healthy lifestyle early in life may yield 05:42 significant long term health dividends 05:45 for the older adult. This next graphic displays 05:50 a list of major risk factors for 05:52 coronary artery disease used by the 05:56 American college of sports medicine to classify 05:59 a person's heart disease risk prior to starting 06:02 an exercise program. The first risk factor 06:06 on the list is family history, 06:09 if you have a family history of heart attack 06:12 or sudden death before the age of 55, 06:16 an father or other male first degree relative 06:19 like a brother or before the age of 65 06:23 in a mother or female first degree relative 06:26 like a sister. The risk of premature 06:30 coronary heart disease is 2-5 times higher 06:34 than persons with no family history 06:36 of heart disease. The second risk factor 06:41 is being a current cigarette smoker 06:43 or having quit cigarette smoking within 06:45 the past six months. The third risk factor 06:50 for heart disease is hypertension or 06:53 high blood pressure. Criteria for hypertension 06:58 include taking blood pressure medicine, 07:01 having a systolic blood pressure 07:03 which is the top number in blood pressure 07:05 reading greater than or equal to 140 mmHg 07:11 or obtaining a diastolic blood pressure 07:14 or the lower number in a blood pressure 07:16 reading greater than or equal to 90 mmHg 07:23 The fourth positive risk factor for heart disease 07:26 is dyslipidemia or abnormal blood fat levels. 07:31 The defining criteria for dyslipidemia include 07:35 LDL cholesterol levels greater than 07:37 130 milligrams per deciliter. 07:40 HDL cholesterol levels less than 07:43 40 milligrams per deciliter or 07:46 total cholesterol levels greater than 07:48 200 milligrams per deciliter. 07:51 If total cholesterol is all that's available 07:54 from blood work analysis. 07:58 The fifth risk factor is impaired fasting glucose 08:02 or having fasting glucose levels that are greater 08:05 than or equal to 100 milligrams per deciliter. 08:10 The next risk factor is obesity, 08:14 while there are many ways to quantify obesity 08:17 the criteria used here by the American college 08:20 of sports medicine are having a body mass index 08:24 of greater than 30 kg/m2 or 08:28 having waist growth greater than 40 inches 08:31 in men or 35 inches in women. 08:36 The last positive risk factor for heart disease 08:39 and the one that we're highlighting today 08:43 is a sedentary lifestyle, 08:46 based on the 1996, Surgeon General's Report 08:49 on Physical Activity and Health. 08:51 It's recommended that a minimum of 30 minutes 08:54 of moderate physical activity be accumulated 08:58 on most days of the week. 09:02 According to the American Heart Association 09:04 the chance of having a heart attack increases 09:07 proportionately with the number of heart disease 09:10 risk factors that a person has often heart disease 09:16 can be present in a person who has several 09:18 risk factors, whose values are only slightly 09:21 abnormal, clearly some risk factors like 09:27 family history, age and being male 09:30 cannot be altered. However, the remaining 09:35 risk factors can be influenced by making 09:37 positive lifestyle choices. For example, 09:42 quitting cigarette smoking can decrease 09:44 heart disease risk by 50-70% in 09:48 a five-year period and becoming physical active 09:52 can lower heart disease risk by 45%. 09:57 Of all the heart disease risk factors that 09:59 I've mentioned physical inactivity is the most 10:03 prevalent among adults in United States. 10:09 Well it may seeming intuitive that sedentary 10:12 living increases the risk of heart disease. 10:15 It's only been in the last fifty years that 10:18 solid evidence has emerged to confirm 10:21 this relationship. In one of the first large scale 10:25 studies in this area published in 1953. 10:29 Investigators evaluated heart disease risk 10:32 among bus drivers and conductors in London, 10:36 England and found that the bus drivers 10:39 were at higher risk for coronary heart disease 10:42 compared to the conductors, 10:44 who are moving throughout the 10:45 double-decker buses collecting tickets. 10:49 Nearly two decades later a study involving 10:53 San Francisco longshoreman revealed 10:55 that those whose jobs included little 10:58 or no physical labor, exhibited 60% 11:02 greater risk of death from coronary heart disease, 11:05 then longshoremen who were involved 11:07 in physical demanding work. 11:12 This investigation was followed a few years 11:14 later by a series of studies documenting 11:17 the health status and physical activity habits 11:20 of Harvard college alumni. 11:24 Data from these reports indicated that the alumni, 11:27 who are more physical active demonstrated 11:30 a lower risk for coronary heart disease than 11:33 their less active counterparts, 11:36 even when other risk factors for heart disease 11:39 were controlled statistically. 11:42 Interestingly in a related study, 11:45 these authors noted that former varsity athletes 11:49 who became sedentary after leaving college 11:52 displayed a high risk for coronary heart disease, 11:57 conversely, previously sedentary students 12:00 who became more physical active after 12:03 leaving college experienced the same 12:05 low risk for heart disease that are found 12:09 in alumni who had maintained a moderately 12:11 vigorous program of exercise all along. 12:16 These findings demonstrate that 12:18 to secure health benefits physical activity 12:22 must be current. It can't be stirred up 12:25 and drawn upon at a later time. 12:30 Did you know that an active lifestyle 12:32 can actually lower your chance of dying 12:34 from cardiovascular disease? 12:37 In a study conducted at Cooper Institute 12:40 for Aerobics Research. Maximal treadmill testing 12:43 was used to measure the aerobic fitness levels 12:46 of 10,000 men and 3,000 women. 12:51 Data obtained from these tests were used 12:53 to classify participants as being in poor, 12:56 average or good physical fitness. 13:00 For both men and women those classified 13:03 as having poor fitness displayed the highest 13:06 age-adjusted mortality from cardiovascular 13:09 disease, were as those in the good fitness 13:12 category exhibited the lowest age-adjusted 13:16 death rates. The most striking result from 13:20 this study however was when the greatest 13:22 reduction in cardiovascular mortality occurred 13:25 between individuals who are least fit 13:29 and those who displayed just average levels 13:32 of physical fitness. This findings suggests 13:36 that even slight improvements in fitness 13:39 can yield significant health benefits. 13:43 According to the lead author of this study 13:46 as little as two miles of brisk walking performed 13:50 on a daily or near daily basis would be 13:53 sufficient to attain an average level of fitness. 13:58 In a latest study from this research team 14:01 low aerobic fitness was identified as a strong 14:04 and independent predictor of heart 14:06 disease mortality, comparable to that 14:09 observed for other risk factors such as smoking, 14:13 elevated blood cholesterol and 14:16 high blood pressure. Overall the risk for heart 14:21 disease among persons who are sedentary 14:24 is two times as high as compared to those 14:27 who lead relatively active lives. 14:31 To me the take home message from all of 14:34 these studies, is that you don't need to be 14:37 well-trained athlete or highly fit person 14:41 to be heart healthy. Just engaging in moderate 14:45 levels of physical activity on a regular 14:47 basis can substantially lower your risk of having 14:51 and dying from heart disease. 14:56 This is the message that conveys much hope 14:58 and encouragement, especially for those of you 15:01 that may have experienced challenges 15:04 in starting and sticking with a program 15:07 of daily physical activity and exercise. 15:12 All of us need to look for daily opportunities 15:15 to be active, like parking your car farther away 15:19 from the entrance to the mall or walking 15:21 into the bank to transact business instead of using 15:24 drive-through window. Instead of taking 15:27 the escalator, why not use the stairs 15:30 at the airport. Is it really that hard 15:34 to get off the sofa to change the TV channels? 15:38 Not really. The bottom line here is that all 15:43 of us need to look for ways to accumulate 15:46 small trunks of physical activity throughout 15:48 the day, because in doing so we can begin 15:52 to reap the health benefits that come from 15:55 living a physically active life. 16:00 Why is that active few people have a less risk 16:02 for heart disease. Well a major reason is that 16:07 a physically active lifestyle helps to keep 16:10 other risk factors for heart disease under 16:12 better control. The prevalence of smoking 16:15 among active individuals for example, 16:18 is much lower than that scene in the 16:20 overall population. For people who wish to quit 16:24 smoking regular doses of physical activity 16:27 can improve fitness, aid in expending calories 16:31 to offset the weight gain that can accompany 16:33 smoking sensation, and help to cope with 16:36 negative mood states and stress. 16:40 Hypertension is another coronary risk factor 16:43 that affects 65 million Americans or nearly 16:47 one out of every three United States adults. 16:51 Another 59 million adults have a condition 16:54 called pre-hypertension, which is defined as having 16:59 a systolic pressure between 120 and 139 mmHg or 17:06 a diastolic pressure between 80 and 89 mmHg. 17:11 Worldwide it's estimated that approximately 17:14 one billion people have high blood pressure. 17:20 Hypertension is associated with a number of 17:22 negative health consequences; 17:24 these include an increase in the work load 17:27 on the heart, an increase in the size of the heart, 17:31 which can lead to heart failure, and a narrowing 17:35 of blood vessels in the kidneys. 17:39 Hypertension can also thickened and stiffened 17:42 blood vessels throughout the body and impair 17:46 cognitive function later in life. 17:51 For individuals with normal resting blood 17:53 pressure, aerobic exercise training can reduce 17:57 mean blood pressure readings by 3-4 mmHg. 18:03 For those with hypertension regular 18:06 aerobic training can exert even 18:08 more of an effect. Average diastolic 18:12 and systolic blood pressures can be lowered 18:14 by 6 and 7 mmHg respectively 18:19 in persons with hypertension, 18:22 this reduction is independent of changes 18:24 in diet or body weight, both of which can cause 18:28 even more of drop in blood pressure. 18:32 While the magnitude of these changes may appear 18:35 to be small every one millimeter drop 18:39 in diastolic blood pressure results in 18:42 2-3% decrease in heart disease risk, 18:48 again this emphasizes the point that small 18:51 changes in physical activity status can 18:55 translate into meaningful improvements 18:58 in health outcomes. 19:01 The potential impact can participating 19:03 in a consistent program of physical activity 19:06 and exercise is even more apparent 19:09 when one considers individual with 19:11 high blood pressure are about 30% less fit 19:15 compared to persons with normal blood pressure. 19:19 A majority of study show that anti-hypertensive 19:22 effective exercise takes place during the first 19:25 few weeks of increased physical activity. 19:29 Although, further reductions in blood 19:31 pressure can occur, if training is maintained 19:34 for more than three months, 19:37 based on activity guidelines established 19:40 by the American college of sports medicine. 19:43 Improvements in resting blood pressure 19:45 can be achieved by engaging in regular 19:48 moderate intensity of aerobic exercise like 19:51 brisk walking performed for at least 30 minutes. 19:57 Interestingly the training component that appears 20:00 to be most essential in treating resting 20:02 hypertension is frequency. 20:06 In other words consistency and 20:09 physical activity is absolutely vital, 20:15 the role of physical activity in moderating 20:17 high blood fat levels, another heart disease 20:20 risk factors depends on the type blood fat 20:23 type being considered. High-density lipoprotein 20:27 cholesterol or (HDLC) takes up cholesterol 20:31 from the blood in body cells, thus promoting 20:34 the excretion of cholesterol from the body. 20:37 Consequently, a high level of HDLC is actually 20:42 desirable and functions as a negative risk 20:45 factor for heart disease. 20:49 Heart disease risk can be lowered by 2-3% 20:52 with just a 1% rise in HDLC values. 20:57 On the other hand elevated levels of 21:00 low density lipoprotein cholesterol or 21:03 LDLC contribute to the development 21:07 of atherosclerosis. Findings from a number 21:11 of studies have revealed that endurance 21:14 training increases HDLC but has little 21:17 or no effect on LDLC or total cholesterol. 21:22 However, if weight loss occurs as part of 21:26 an exercise training or activity program, 21:29 levels of total cholesterol and LDLC 21:32 can also decrease. Moreover, losing weight 21:37 can produce a rise in HDLC, but only if the 21:41 weight loss is sustained. So if weight loss occurs 21:47 following an exercise program changes in blood 21:50 fat levels will reflect the combined effects 21:54 of physical activity and weight loss along 21:57 with any alterations and dietary habits, 22:00 which may have occurred. How much physical activity 22:05 is required to produce favorable changes 22:07 in blood fat profiles? In line with the surgeon 22:11 general report, 30 minutes of aerobic 22:14 exercise performed at least 3-5 days a week 22:18 at a moderate intensity can raise HDLC levels 22:22 to health producing values. 22:27 During previous programs in this series, 22:30 I have discussed how regular physical activity 22:32 can help to moderate the pernicious effects 22:35 of obesity and diabetes, two other risk factors 22:39 for heart disease. And adult who are overweight 22:42 or obese, regular physical activity 22:46 and aerobic exercise improves cardio 22:48 respiratory endurance. In addition, weight loss 22:53 leads to a healthy lipid profile. 22:56 It has been estimated that every pound 22:59 lost results in a one milligram per deciliter 23:02 reduction in total cholesterol. 23:07 A daily program of physical activity 23:09 and exercise also enhances long term 23:12 diabetic control by improving insulin 23:15 sensitivity and reversing insulin resistance, 23:20 even before changes in body composition 23:22 can be detected. For a person with diabetes 23:27 the importance of performing physical 23:29 activity on a routine basis is critical. 23:32 Since the residual effects of a single 23:34 exercise about on insulin sensitivity 23:38 and glucose control lasts for only 1 to 2 days. 23:44 In addition, daily physical activity 23:47 promotes weight loss which can spur 23:50 improvements in insulin sensitivity. 23:53 Large muscular aerobic activities like walking, 23:57 cycling and swimming can enhance 23:59 insulin sensitivity and aid in the overall 24:03 management of blood glucose levels. 24:08 Along with controlling other major risk factors 24:11 there are other reasons which helped 24:13 to explain why daily physical activity 24:15 and exercise are linked to a lower 24:17 heart disease risk. Coronary blood vessels 24:21 and endurance trained persons are more 24:22 expandable and wider than those of 24:25 unfit individuals, if atherosclerotic plaques 24:29 is present, in large blood vessels reduce 24:32 the chance of completely blocking blood supply 24:35 to a specifically area of a heart. 24:38 In addition there is some evidence that exercise 24:41 may diminish the potential for clot formation. 24:46 Taking together these adaptations would reduce 24:49 the likelihood of a heart attack. 24:53 Another possibility is that regular physical 24:56 activity and exercise may lower the hearts 24:59 vulnerability to normal heart rhythm. 25:03 Now still an unsettle question. 25:05 It's also been suggested that a trained 25:07 and fit heart may develop more blood vessels, 25:11 thus promoting better oxygen delivery. 25:16 Before we end today, I want to spend a minute 25:19 or two talking about role that physical 25:22 activity comply in preventing strokes. 25:25 Stroke is a cardiovascular disease that is caused 25:28 by arteriosclerosis or they build up the plaque 25:32 in the blood vessels of the brain. 25:34 Stroke is third leading cause of death in the 25:37 United States. Furthermore of those 25:40 who survive a stroke 15-30% suffer 25:44 a long term disabilities. 25:49 A variety of risk factors exists for stroke. 25:53 Well, documented factors that are 25:55 amenable to change include Hypertension, 25:59 diabetes, heart disease, and dyslipidemia. 26:04 Obesity and physical inactivity have also been 26:08 identified as potential modifiable risk 26:10 factors for stroke. As we know the negative 26:16 impact of these risk factors can be mitigated 26:19 by adapting and maintaining a more 26:22 active lifestyle. For example, 26:26 in one study of over 7700 middle aged men 26:30 those who are moderately active 26:32 displayed a 40% reduction in stroke risk 26:36 compare to inactive subjects. 26:40 Similarly data collected on 72,000 nurses 26:45 revealed that the brisk walking was associated 26:49 with a lower risk of stroke. 26:54 Today we've talked about the beneficial 26:57 effects of physical activity and exercise 27:00 in preventing and treating diseases 27:03 of the heart. Whether you're a child, a young 27:07 adult or a senior citizen following a moderate 27:13 program of physical activity on a daily basis 27:17 can strengthen your heart reduces your risk 27:21 for heart disease and extend your life. 27:26 In addition to being a magnificent pumping 27:28 machine our heart serve as the seat our emotions, 27:33 our thoughts and our intentions. 27:36 In the Bible Proverbs 27:19 states that 27:41 as a faces reflected in water, 27:43 so the heart reflects the person. 27:48 It's my prayer today that each of you will 27:52 allow Jesus to work on your heart. 27:56 So that your spiritual fitness can increase 27:59 in tandem with your physical health. 28:04 Until next time then, keep moving 28:06 step by step towards better health and fitness. |
Revised 2014-12-17