Don’t overdo it when launch­ing a new work­out rou­tine

The Record (Troy, NY) - - YOUR DAILY BREAK - Eve Glazier + El­iz­a­beth Ko Eve Glazier, M.D., MBA, is an in­ternist and as­sis­tant pro­fes­sor of medicine at UCLA Health. El­iz­a­beth Ko, M.D., is an in­ternist and pri­mary care physi­cian at UCLA Health.

DEAR DOC­TOR » I’m a mid­dle-aged guy, and I thought my health was fine. But I just got di­ag­nosed with pre- di­a­betes, so I’ve started hit­ting the gym pretty hard — car­dio five days a week, strength-train­ing three days a week. Now I read that all this ac­tiv­ity can raise my risk of a heart at­tack. What gives?

DEARREADER » It’s been sev­eral decades since the “feel the burn” ex­hor­ta­tions of scores of fit­ness pro­grams first started to seep into the Amer­i­can con­scious­ness. If a mod­er­ate amount of phys­i­cal ac­tiv­ity was good, the think­ing went, then more — a lot more — just had to be bet­ter. But when a group of re­searchers re­cently looked at data from 25 years’ worth of ex­er­cise pat­terns in about 3,000 men and women en­rolled in a long-term study about heart health, they un­cov­ered sur­pris­ing trends.

In­di­vid­u­als who logged 7.5 hours or more of stren­u­ous ex­er­cise per week were 27 per­cent more likely to de­velop a buildup of calcium and plaque in the ar­ter­ies of their hearts by the time they reached mid­dle age than were the more mod­er­ate ex­er­cis­ers. When the data was bro­ken out by gen­der, the re­sults were even more star­tling. White men had an 85 per­cent higher risk than did their less ac­tive peers of de­vel­op­ing ar­te­rial cal­ci­fi­ca­tion in their later years. This in turn trans­lated to a rate of heart disease that was dou­ble that of the more mod­er­ate ex­er­cis­ers. And to add one more un­ex­pected twist, these pat­terns didn’t ap­ply to the black men in the study.

The higher lev­els of coro­nary artery cal­ci­fi­ca­tion, of­ten short­ened to CAC, sug­gested that the more in­tense ap­proach to ex­er­cise re­sulted in dam­ag­ing stress to the ar­ter­ies. More ex­treme ex­er­cise, both in ef­fort and du­ra­tion, has been shown to in­voke an in­flam­ma­tory re­sponse in the body. With ev­ery­thing we’re now learn­ing about po­ten­tial dan­gers of chronic in­flam­ma­tion, we look for­ward to fu­ture stud­ies, which may shed light on this con­nec­tion.

When it comes to your own ex­er­cise rou­tine, we land on the side of mod­er­a­tion. We think that by be­com­ing ac­tive, you’ve made a good start at ad­dress­ing the con­di­tions that put you on the road to pre- di­a­betes. (And be­fore we get to specifics, we’re go­ing to put in a plug for you to please take a clear- eyed look at your diet as well.)

Cur­rent guide­lines rec­om­mend 150 min­utes per week — that’s 2.5 hours — of mod­er­ate phys­i­cal ac­tiv­ity. In the most gen­eral sense, that’s any sus­tained ac­tiv­ity per­formed at a pace where hold­ing a con­ver­sa­tion is pos­si­ble but not easy. If you pre­fer a more rig­or­ous work­out, such as run­ning, then the in­ten­sity goes up but the time spent drops to 75 min­utes per week. That’s a work­out where yes, you can say a phrase or two, but a con­ver­sa­tion is out of the ques­tion. In ad­di­tion, weight­bear­ing ex­er­cises that tar­get all of the ma­jor mus­cle groups — that’s the legs, hips, back, ab­domen, chest, shoul­ders and arms — should be done twice a week.

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