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Physiology of Heart Disease and Exercise

Melody Giles • February 26, 2021
Cardiovascular Disease is defined as atherosclerotic arteries of the heart, brain, and peripheral vasculature. Under this umbrella term, there are multiple other conditions, which are specific to the region of concern. For example, atherosclerosis of the coronary artery is termed coronary artery disease (CAD), and atherosclerosis of the arteries throughout the body (most commonly in the legs) is called peripheral artery disease (PAD). In instances where a blood clot or plaque cuts off circulation/blood flow to the surrounding areas, it results in a stroke (brain) or a heart attack (heart). Cardiovascular disease significantly increases your risk for these events.

Now, I’ve mentioned this term “atherosclerosis” many times already, but do you know what this is? Atherosclerosis is a term used to describe a significant buildup of plaque in arteries throughout the body, which is made up of fats, cholesterol, and other substances. When the body becomes stressed, one of its common stress responses is to over-produce molecules called free radicals. These free radicals run rampant in the bloodstream, which can oxidize these fats and cholesterols. Oxidation of these substances makes them more “sticky,” which causes them to stick to the sides of the arteries, creating plaque buildup. [This is why eating antioxidant foods is important to maintain health!] Over time, as plaque builds, the area through which blood can flow through becomes smaller and smaller. As mentioned previously, if a piece of plaque breaks off, the artery ruptures, or a blood clot forms that can’t pass through the narrowed artery, this results in a heart attack or stroke, depending on the location of the event. Atherosclerotic arteries can also be the culprit for many conditions, again, depending on the location of the plaque buildup. Plaque in the heart’s arteries can lead to symptoms like angina (chest pain or pressure). In the brain, it can lead to a transient ischemic attack (TIA), which will display as leg or arm weakness, difficulty speaking or slurring of words, and facial drooping, etc. If left untreated, the TIA will progress into a stroke. In the arteries of your legs and/or arms, plaque buildup will lead to PAD, which, for example, can characterize as leg pain when walking (medically termed claudication). Lastly, if the arteries leading to the kidneys become atherosclerotic, you will develop high blood pressure (Fun fact! Yes! Your kidneys are responsible for regulating changes in blood pressure.). 

The risk factors for cardiovascular disease are; 

  • Age
  • Family history of heart attacks
  • Smoking
  • Physical inactivity (less than 30 minutes of moderate activity 3 days/week for 3 months consistently)
  • Obesity (high BMI and/or high waist circumference)
  • Hypertension (high blood pressure over 140/90)
  • Dyslipidemia (high LDL cholesterol, low HDL cholesterol, high total cholesterol)
  • Diabetes (high blood sugar)


All of these risk factors are related to your likelihood for having atherosclerosis or hardening of the arteries. The good news for you is that participating in regular physical activity has a positive effect on five out of these seven risk factors! 


Physical inactivity

This point is pretty self-explanatory. To be considered physically active, one must engage in more than 30 minutes of moderate activity, 3 days per week, for at least 3 months. Moderate physical activity means that it has gotten a bit harder to breathe, but you may still be able to carry on a conversation. Examples include riding your bike or going on a brisk walk. The key to kicking this risk factor is consistency. To attain health benefits from physical activity, it’s recommended that adults participate in at least 150 minutes of exercise, accumulated throughout the week in bouts of 10 minutes or longer. 

Obesity

Physical inactivity and poor diets are key contributors to obesity. Obesity is defined as a body mass index (BMI) of over 30kg/m^2 and/or a waist circumference of over 88cm in women and 102 cm in men. A consistent exercise regime and healthy eating plan will likely result in weight loss, thus reducing BMI and waist circumference.


Hypertension

Blood pressure is a product of cardiac output (the amount of blood the heart ejects per beat) and total peripheral resistance (the resistance to blood flow throughout the arteries of the body). People with plaque buildup in their arteries have narrowed blood vessels, which creates more resistance when blood tries to flow through them. As such, atherosclerosis is one culprit for increased total peripheral resistance and thus, high blood pressure. Total peripheral resistance can also be increased by hardening of the arteries, caused by arterial damage. This means that the arteries are not as elastic and are less pliable to blood flow, but we want them to be. Exercise reduces blood pressure by the mechanism of causing temporary artery dilation (widening) by releasing molecules called vasodilators. When you consistently stick to your exercise regime, this vasodilation becomes more permanent. If we reduce total peripheral resistance by increasing dilation, we have now taken one route towards naturally reducing blood pressure! 


Dyslipidemia

Low-density lipoprotein cholesterol (LDL-C) is considered to be the “bad” cholesterol, whereas high-density lipoprotein cholesterol (HDL-C) is labelled as the “good” one. Imagine you’re stuck on the 403 in rush hour, LDL-C and HDL-C are the cars, and each fat molecule in your blood are drivers and passengers. Let’s say there are 1,000 people on the road. When all the cars on the highway are low-density lipoproteins, there is one person per vehicle, which means 1,000 cars on the road, which means quite the traffic jam. BUT, if all the cars on the road are high-density lipoproteins (mini-vans?), that means that there can be a lot of people in one car. Since minivans can sit about 7 people per vehicle, that means that if there were 1,000 people on the road, that there would only be 143 cars on the road… easy sailing! When we transfer this into terms relating to cardiovascular disease, having high counts of LDL-C and low counts of HDL-C creates fatty traffic jams in our bloodstream (bad!), however, low LDL-C and higher HDL-C is extremely favourable. Although it isn’t well-researched, it has been hypothesized that when you exercise, enzymes are released that focus on removing LDL-C from the bloodstream and re-directing them to the liver. From there, the LDL-C is processed into bile and excreted through the digestive tract. Re-adjusting your ratio of LDL-C to HDL-C can also be emphasized through proper nutrition intake. See next week’s blog for more details. 


Diabetes

Over time, chronically high blood sugar levels, which is a characteristic of Diabetes, causes damage to the walls of blood vessels and nerves that control your heart. When blood vessels are damaged, it can lead to other conditions mentioned previously such as atherosclerosis, vessel hardening, and hypertension due to increased total peripheral resistance. Exercise has long been known as an important factor in managing Diabetes and blood sugar levels. Our main source of energy in our muscles are forms of sugar. When you exercise, you deplete your glucose (sugar) stores for energy, forcing your muscles to absorb residual glucose that floats around in your blood when you are finished with your routine. As such, blood sugar can progressively lower for up to 24 hours after your workout. This, if kept consistent, can stabilize blood sugar levels and increase your body’s sensitivity to insulin, which makes you better able to deal with meals higher in sugar.

In addition to improving these specific components of cardiovascular disease, regular exercise also decreases the “stickiness” of platelets, thus reducing the risk of blood clot formation and associated heart attacks or strokes. Exercise will also gradually increase and increase the intensity at which you are able to tolerate exercise without feeling symptoms of chest pain, leg pain, and breathlessness, etc. Most importantly, physical activity has been demonstrated to reduce the risk of cardiovascular-related mortality by 20-25%.

In conclusion, it is evident that maintaining a consistent exercise routine will do wonders for your heart health. Yes, resistance training to get toned arms and legs is nice, but don’t forget to do things for the most important muscle in your body - your heart!!

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Are you struggling to stay consistent with your fitness and nutritional goals? Being consistent is crucial to making long term lifestyle changes, but it is one of the biggest challenges we all face. Here are 5 strategies to help you find consistency: 1. BE REALISTIC Change takes time . There is no fast way to make lifestyle changes, so it’s imperative to make goals that make sense for you. The more attainable and realistic the goal, the more likely the goal can be accomplished. When goals and milestones are accomplished, it gives you a sense of reward and enhances your self-efficacy (i.e., the belief that you can accomplish your goals). On the other hand, if the goal we have set in place for ourselves is too difficult, it may lead to demotivation and lower self-esteem. If you want sustainable and lasting results, being realistic is the first step. 2. HAVE CLEAR GOALS Not having clear goals is like driving to a new destination without a map. Goals are important in leading us in the right direction. Goals provide you with the motivation to push yourself to work towards chane. Implementing S.M.A.R.T goals is a good place to start. S - Specific M - Measurable A - Attainable R - Relevant T - Time-Bound When setting goals, make sure to include both short term and long term goals . Short term goals help with commitment and determination by allowing you to celebrate small wins more frequently that contribute to the bigger goal in place. Long term goals give you something to focus on and strive for in the bigger picture and help focus on where you want to be in relation to where you are now. For example, you decide that you want to “Lose 5 lbs in 6 weeks.” This goal is specific, measurable, attainable, relevant, and time-bound. However, this creates the need to make smaller goals to help you get there. Just doing what you are now, unchanged, will likely not get you to your goal. For instance, you might state that you will “Lose 5lb in 6 weeks” by incorporating 1-2 servings of vegetables into every meal, by limiting take-out meals to once per week, exercising for 45 minutes 3 times per week, and going for a 30-minute walk with your dog every day. If you achieve these smaller rules/goals, you’ll be well on your way to reaching the big one. 3. CREATE A ROUTINE AND HAVE A PLAN Fail to plan and plan to fail! Having a game plan for the week ahead will help adhere to your goals, as there is less opportunity for impulsive behaviours. This may mean planning out your workouts for the week, meal prepping, and making a grocery list of healthy and balanced foods. In regards to exercise, scheduling in your workouts, and knowing what you're doing when and where, will take the stress off not knowing what to do and "winging" a sub-par workout. In turn, you will be more likely to follow through until your goal is reached. Building on these habits will make it easier to stay consistent with your goals. Stay organized! In addition, it is always a good idea to have a plan ready in case you fall into relapse. The biggest fallback for people creating healthy habits is that once you miss a workout, you eat dessert when you know you shouldn’t have, or if life just gets in the way… You say “oh well” and keep venturing down the wrong path rather than steering yourself back onto the right one. Having a plan in place in case this happens is crucial for helping with motivation post-relapse. 4. ENJOY WHAT YOU'RE DOING It is much easier to be consistent with exercise and nutrition when you enjoy what you're doing and eating. Exercise will be less of an obligation and you will be more excited to get moving. If you’re feeling stuck doing something you don't enjoy, try something new! Whether it be a new exercise class (HIIT, Spin, Yoga, Pilates etc.), getting outside, or joining a club/team. Bottom line is, you cannot be consistent if you dislike what you're doing. In regards to nutrition, implementing foods you don't enjoy will be doing yourself a disservice. Incorporating a variety of foods and flavours you love that also align with your goals is important in having a healthy attitude about food and staying consistent with your nutritional habits. 5. TRACK YOUR PROGRESS Seeing progress in yourself fuels motivation . There are several ways to track your progress: Monitor body measurements How your clothes fit Scale weight or body fat % Lifting heavier weight or doing more reps Check blood pressure Progress pictures How fast you catch your breath after you lose it Activities of daily living get easier to complete Energy levels improve Sleep gets better Tracking progress is essential to staying consistent. People get addicted to seeing results, which creates more and more motivation. When results aren’t achieved, it creates a sense of self-doubt, which reduces motivation because why would you continue if you aren’t getting any better? Even though you definitely should continue because exercise has so many benefits for you beyond the physical changes (bone, heart, emotional, cognitive health, etc.), it is still encouraging to see results and know you’re doing well. Need help with staying consistent? We have a team of friendly and well-educated personal trainers and health practitioners here at The Firm. Our mission is to educate and motivate you into living your healthiest and happiest life - even if it is just to get you started on your fitness journey. We are here to help you.
By Kerri Sherk September 15, 2021
Dear valued members, The COVID-19 situation is continuing to develop in light of the Delta-variant. As such, the Government of Ontario has implemented COVID Vaccination Passports , which will affect the usage of facilities used for sports and fitness activities and personal training, including gyms. The Government of Ontario's website news release states that "Requiring proof of vaccination in these settings reduces risk and is an important step to encourage every last eligible Ontarian to get their shot, which is critical to protecting the province’s hospital capacity, while also supporting businesses with the tools they need to keep customers safe, stay open and minimize disruptions." We are striving to protect our members and our staff in these uncertain times, which means that starting on September 22nd, 2021, be prepared to show proof of full vaccination to be able to enter the gym. Starting at 12:01 am on the 22nd, those individuals who have not provided proof of vaccination will not be given access. Given the controversial nature of this mandate to some people, we want to remind everyone that this mandate is the same as the mask mandate - it was created by the government . Our staff, management included, can't and won't make exceptions to this policy, and we ask that members show the same patience, kindness, and respect that we have received thus far. In order to prevent a bottleneck on September 22, we will be allowing members to bring in their vaccination records during desk hours starting on Monday, September 13th. We will be requiring members to provide us with a photocopy or electronic copy of their vaccination receipts, which we will keep on file. When dropping the proof of full vaccination off at the front desk, we will also be taking your profile picture for our system. Non-Vaccinated Members If you are unable to show proof of full vaccination (2 doses + 14 days) by September 22, 2021, your fob will be rendered inactive. For those that have short-term memberships with an expiration date, your membership will expire. If required, we will give members a maximum of one-month extension on their expiration date if you need extra time to get fully vaccinated. For those that have a perpetual membership , you have the option to hold your membership at $5/month until you're able to provide full proof of vaccination. * Please email us if you require these accommodations with your request because these will not be done automatically. For members with a medical exemption to the vaccine mandate, we will require a copy of a written exemption letter from a Medical Doctor stating that you are exempt from receiving the COVID-19 Vaccine. We do not allow religious exemptions; letters from spiritual healers, chiropractors, nutritionists/dietitians; or self-claiming exemptions, etc. Reminders Let's keep the Aldershot community safe by following COVID-19 Protocols when not at home. Wear a mask when indoors in public Don't leave the house if you are experiencing COVID-19 symptoms Social distance when possible Sanitize your hands consistently, with soap and warm water Get vaccinated as soon as you can! When at The Fitness Firm... Keep your mask on at all times when on the main floor (yes, even when staff aren't here!) Maintain distance when possible Put all your equipment, weights, and plates back on the racks when you are finished with them Sanitize everything you touch after you use it Under no circumstances are you allowed to let individuals/friends into the facility who do not have a gym membership In the event of any falsified documents being discovered, the individual falsifying documents will be banned from The Fitness Firm until the COVID-19 pandemic is declared over (or longer). This is a criminal act under the Government of Canada's Criminal Code . Thank you Please note that these policies from the government are constantly evolving. This is all the information we have available currently, and these may change between now and the 22nd. Fitness is an essential component of peoples' lives, and it's moments like these where our purpose and values regarding the health of our members and staff matter a lot to our community and the individuals we serve. Thank you for your patience and respect for our decisions as we navigate this new government-required policy. Best, Fitness Firm Staff
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