Lifestyle Changes
Inactivity is one of the four major risk factors for coronary artery disease, on par with smoking, unhealthy cholesterol, and high blood pressure. In fact, studies suggest that people who change their diet in order to control cholesterol are successful in actually lowering their risk for heart disease only when they also follow a regular aerobic exercise program.
The following are some observations on the effects of exercise on coronary artery disease:
- People who maintain an active lifestyle have a 45% lower risk of developing heart disease than do sedentary people. Even moderate exercise reduces the risk of heart attack.
- People who lose weight and exercise regularly have significantly better chance of maintaining that weight loss compared to those who do not exercise.
- Some studies suggest that for the greatest heart protection, it is not the duration of the exercise that counts but the total daily amount of energy expended. Therefore, the best way to exercise may be in multiple short bouts of intense exercise.
- Burning at least 250 calories a day (the equivalent of about 45 minutes of brisk walking or 25 minutes of jogging) seems to confer the greatest protection against coronary artery disease, particularly by raising HDL (the so-called good cholesterol) levels. (It may take up to a year of sustained exercise for HDL levels to show significant improvement, but in terms of raising HDL levels, more is better.)
- Aerobic exercise also appears to open up the blood vessels and, in combination with a healthy diet, may improve blood-clotting factors.
- Resistance (weight) training offers a complementary benefit by reducing LDL (the so-called bad cholesterol) levels.
- Exercises that train and strengthen the chest muscles may prove to be very important for patients with angina.
[For complete information, see Well-Connected Report #29 Exercise.]
Stress Reduction
Stress is always highly associated with negative effects on the heart and other parts of the body. A number of techniques are available to help people relax and reduce tension. [See Well-Connected Report #31 Stress.]
Key Components of a Lifestyle Change Program
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Lifestyle
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Reduce rate of eating.
Keep food records.
Eliminate environmental triggers to eating.
Identify high-risk situations for overeating.
Uncouple eating from other activities.
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Exercise
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Confront psychological barriers to exercise.
Understand mechanisms linking exercise to weight control.
Establish reasonable exercise goals.
Develop a plan for regular activity.
Integrate increased activity into daily lifestyle.
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Attitudes
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Develop reasonable weight-loss goals.
Avoid "all or none" thinking.
Focus attention away from the scale and toward behavior.
Uncouple weight from self-esteem.
Recover from lapses with constructive action (relapse prevention).
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Relationships
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Understand the key role of social support to health.
Identify supportive others.
Match personal style to support-seeking activities.
Be specific in making support requests.
Be assertive but reinforcing in drawing help from others.
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Nutrition
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Resist the lure of popular fad diets.
Develop pro-health rather than restriction mentality about eating.
Eat with moderation in mind.
Maximize fiber.
Develop a tailored plan.
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From Brownell KD. The LEARN Program for Weight Control. 7th ed. Dallas, Tex: American Health Publishing Company; 1998.
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