Eric Heiden, M.D.
Tribune Media Services
October 5, 2010
Even people with risk factors need exercise. In fact, people with risk factors stand to see the greatest gains from regular exercise, including a potential reduction in the very risk factors they once viewed as an impediment to it.
According to exercise performance physician Max Testa, M.D., there are many exercise options appropriate for people with certain risk factors. First, he advises that you check with your doctor to ensure that it's safe for you to begin exercise. If during exercise you ever experience shortness of breath, chest pressure or pain, light-headedness, or if you're a woman and experience shortness of breath or the sensation of fatigue, you should stop immediately and seek medical attention.
In cases of Type 1 diabetes, Testa recommends aerobic activity, which burns sugar and increases peripheral sensitivity to insulin. If you experience light-headedness (or any symptoms of low blood sugar) as you begin to exercise, increase your food intake before and during exercise. Continue to take your medication, but discuss potential adjustments with your doctor as you increase your level of fitness.
For high blood pressure, Testa recommends that you improve your endurance with mild- to moderate-intensity exercise sustained for a long time. Choose an activity that utilizes a number of muscles in a rhythmic pattern: walking, cycling on the flats, cross-country skiing, in-line skating or swimming. Certain exercise programs have been shown to reduce high blood pressure. We included a very good one in "Faster, Better, Stronger: The Fitness Bible." However, do not discontinue your medication. Instead, talk to your doctor about possibly reducing it after you have established your exercise program.
With lung limitations, or chronic obstructive pulmonary disease (COPD), check with your doctor. Start with low-intensity aerobic activity to slowly develop your oxygen-carrying system. You can also use weights to gain strength, particularly in your core and respiratory muscles.
Those with a high body mass index (BMI) or hypertension are best served lifting light weights in sets with high repetitions. This burns the highest percentage of fat, especially subabdominal fat. Select aerobic activities that are easy on the knees and back, such as moderate cycling, swimming, rowing and so on. Avoid jogging, running and walking downhill.
If you have only one risk factor and it's cardiovascular in nature, you should perform aerobic activity at mild to moderate intensity and increase the volume very, very slowly. You are among the people who can benefit most from exercise. If you have a combination of the above risk factors, you need to talk to your doctor or schedule a consultation with Dr. Testa at Intermountain Healthcare.
If you have had a heart attack, stroke or heart failure, ask your doctor to design your exercise program based on your clinical condition. In general, Testa advises that you warm up longer to fully prepare your cardiovascular system. Start with mild activity (such as walking on flat surfaces) to give your cardiovascular system time to develop. Activity that is concentrated in your upper extremities is a little more dangerous for you than milder activity that involves more of your total muscle mass, so in the beginning, exclude activity that works your upper body, such as shoveling, lifting heavy weights or doing chin-ups.
( Eric Heiden, M.D., a five-time Olympic gold medalist speed skater, is now an orthopedic surgeon in Utah. He co-authored "Faster, Better, Stronger: Your Fitness Bible" (HarperCollins) with exercise performance physician Max Testa, M.D., and DeAnne Musolf. Visit www.fasterbetterstronger.com.)
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