During American Heart Month, diet and exercise are emphasized as factors that contribute to heart health. This is because, as individuals, we have significant control over each. In order to achieve a heart healthy lifestyle, we can (and should!) pay attention to what we eat and how we move.

Last week, nutrition for a healthy heart was on the menu. This week we are pleased to introduce York Hospital’s Anne Marie Prewitt, MS, clinical exercise physiologist, for a moving conversation regarding the importance of physical activity for heart health. To begin, Anne Marie makes a distinction between physical activity that we engage in during daily life, and exercise that is planned and structured. While the benefits of physical activity are cumulative and can have a positive impact on health, the addition of regular, planned exercise is better.

Wanting to know more, we asked Anne Marie (AMP) several questions, beginning with: Why is physical activity and exercise an important part of being heart healthy?
AMP: Physical activity, especially in the form of aerobic (cardiovascular) exercise, is good for both the body and the brain. Exercise is proven to lower blood pressure and blood lipid (cholesterol and other fats) levels. It can also reduce blood glucose (sugar) levels, aiding in managing or even preventing diabetes. Exercise is  wonderful for reducing stress, improving sleep, and making us feel good about ourselves.

Before asking more questions, we want to be sure our readers understand the definition of “aerobic.” The Cleveland Clinic notes that aerobic means “with oxygen,” meaning that breathing controls the amount of oxygen our bodies receive. The American Heart Association (AHA) says that moderate aerobic (or “cardio”) activity benefits our hearts by improving cardiorespiratory fitness. Moderate activity causes us to breathe harder and increases our heart rate. This increase in oxygen and blood flow throughout the body improves the function and performance of the heart, lungs, and circulatory system.

Our next question for Anne Marie:  Is there one type of aerobic exercise that you would recommend over others for someone who is generally healthy and focused on healthy aging, but perhaps could be in better shape?
AMP:  First, it’s important that a person check in with their primary care provider before starting any kind of exercise. Once a person is cleared to begin, one of the most accessible and cheapest exercises is walking. Simply put on a pair of sneakers, walk out the door, and keep going! There are not a lot of barriers to prevent people from walking. No special equipment is needed, it can be done almost anywhere, there’s not a lot to learn. It is low impact and easier on the body than running. Begin at an easy pace and, as you become more comfortable, vary your terrain and increase your pace so your body has to adjust to different surfaces and different speeds, which will provide a better workout. If you walk on a treadmill inside, you can vary intensity by adjusting incline and speed. In addition to improving heart health, walking is a weight-bearing exercise that strengthens bones and may help prevent osteoporosis.

How long and at what intensity does someone have to exercise for it to benefit the heart?
AMP: The AHA recommends 150 minutes a week of easy to medium intensity (still able to talk somewhat) exercise for ages 18-65. Activity can easily be tracked with an app on many different devices, such as a fit bit, smart watch or smart phone. A common goal is 10,000 steps daily, equal to about five miles. High Intensity Interval Training (HIIT) can yield great benefits for heart health by alternating periods of high intensity and low intensity or recovery. However, HIIT is not recommended at the beginning of an exercise plan because it is more demanding physically and takes more effort mentally. Consistency is a better goal! Start with an easier activity level that you can maintain on an ongoing basis. That will contribute to overall health.

Are other types of exercise besides cardio, such as strength training or yoga, beneficial to heart health?
AMP:  The heart is a muscle, so cardio exercise IS actually strength training for the heart. But overall strength training is also beneficial for cardiovascular health, as are yoga, stretching and meditation, which contribute to lower stress levels and improved sleep. More sleep and less stress can reduce arterial inflammation that is a factor in cardiovascular disease. Systemic inflammation, the body’s response to stress or chronic disease, can have a negative impact on overall health. Choosing better nutrition and increasing physical activity can lessen inflammation and help reduce negative outcomes.

What is the best time to exercise?
AMP:  The American Council of Exercise suggests late afternoon because our muscles and joints are warmed up, but the bottom line is that whatever time enables you to be consistent is the best time for you. Many people favor first thing in the morning because it provides a feeling of accomplishment and energy that helps propel them through the day. The recommended 150 minutes is often achieved by exercising for five 30-minute sessions throughout the week. However, two 15-minute sessions or three 10-minute sessions that yield increased heart rates can be as effective as longer sessions. Be creative—try out different times and different exercises until you find what works for you!

You mentioned sleep earlier. Why is sleep important for our daily activities and our heart health?
Sleep is as important to our bodies as eating. Getting enough sleep not only allows us to refuel our energy, but it also allows our cells to repair damage that has occurred so that we are in top form physically and mentally. A fatigued person will be less capable of physical activity or exercise that is considered beneficial. Loss of sleep is lost sleep. It cannot be recovered, so getting adequate sleep is important. Many people achieve better sleep by following a sleep ritual when bedtime approaches, such as unplugging from electronic devices, sitting quietly with a cup of tea, anything that helps prepare the mind and body for sleep.

Do you have any additional advice or guidance?
:  Exercise does not have to be complicated. It is not all or nothing. If you only have 15 minutes, don’t think 15 minutes is not enough time to make a difference. Fifteen minutes, even 10 minutes, WILL make a difference, especially if it happens consistently. Each small goal reached is a success, and each new day is a new opportunity. And, for our patients recovering from a cardiac event, participation in a structured cardiac rehab program—including education on nutrition and exercises that are individually tailored to the patient’s abilities and needs—leads to far fewer repeat cardiac events.

When it comes to heart health, exercise IS medicine. It can be the best medicine.

Thank you, Anne Marie, for your time and for letting us know that small moves can add up to big results when it comes to improving heart health.

 If you haven’t seen it yet, please read the February 3 news post that helped kick off the hospital’s American Heart Month reporting. The February 11 news post focused on nutrition and heart health. Next week we will close out the month with the expertise of York Hospital cardiologists Dr. Krista Michelin and Dr. Jonathan Bridges. For additional information, please contact Community Relations at (207) 351-2385 or [email protected].