Heart Disease...
A Ticking Time Bomb.
Are You Ready to Explode?

Heart Disease is as serious as a heart attack.  The whole complement of cardio diseases is collectively the number one cause of health related deaths in the U.S.  

What is scary about the whole thing, is that too often there are no warning signs.  The first sign of heart trouble for many is sudden death, a myocardial infarction or heart attack as we call it.

The human heart

With cardiovascular disease there may be plenty of warning signs if we know what to look for and are smart enough to keep check on our vital signs.  Blood Pressure and cholesterol don't sky rocket to fatal levels overnight. 

Usually it's a slow build up as a result of years of sedentary living, too many fries and cheeseburgers and too much stress.

Let's get into the "heart" of the matter  and see what we can do about it before it’s too late.

Putting it in perspective, as far back as 2003, heart diseases accounted for 685,089 U.S. deaths a year, fully 28% of all deaths; definitely number one on the parade of death. 

Two years later in 2005, heart disease was still number one with 652,091 deaths according to the CDC and its still number one in 2013.

The Hearts Work is Never Done...
Until it Goes on Strike

A fairly lengthy overview of the workings of the heart and blood vessels was given in the pages on the Cardiovascular System and how it works hand-in-hand with the Respiratory System.

We don't want be repetitive so here we will just recap and say that the heart is an electrical pump that moves blood through a vast system of blood vessels to provide oxygen and nutrients to the entire body on the outbound trip and removes waste products during the return trip.

Heart and cardiogram

The system holds about one and half gallons of blood, pushes it through 50,000 miles of blood vessels and moves it at the rate of 80 gallons per hour.  Ever picked up a 5-gallon can of gas?  Pretty heavy, right?  Now pick up 16 of those 5-gallon cans.  That's how much blood our hearts move every hour.  If that doesn't impress you, nothing will.

It sounds simple but so much can go wrong if we don't keep it tuned up and working right.


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What is Heart Disease
and Where Does it come From?

Heart disease is largely a self-inflicted condition that arises from bad lifestyle choices.  Should we say that if it is self-inflicted, maybe it shouldn't be covered by insurance? 

Just think, since heart disease is our number one killer and if it is truly self-inflicted and if health insurance didn't have to cover it, how much would insurance rates fall? 

Relax, it will never happen in this world, health insurance is here to stay; well that is until Obamacare declares your policy illegal and makes you buy an unaffordable healthcare government designed policy.  Ah, but that's a digression.

Heart Disease, or the expanded definition of cardiovascular disease, has many faces.  Blood vessels can become scarred or nicked causing a plaque buildup. 

This is normal and a cholesterol patch is supposed to repair the vessel damage.  But if an inflammatory reaction occurs, the plaque can grow to a clot and reduce or stop blood flow.  

If blood flow to the heart is reduced enough, it can cause sections of the heart to die, something we call a heart attack.  Heart valves can go bad and leak or quit working altogether.  Something can upset the electrical signals that initiate and regulate the heart beat. 

Recall that blood pressure is two numbers, like 120/80, where the 120 is called the systolic pressure or the contracting force that pushes the blood out.  The lower number is the diastolic pressure or relaxing force that allows blood to enter the heart.  Two problems can develop that affect either the systolic or diastolic function.

Systolic dysfunction (or systolic heart failure) occurs when the heart muscle doesn't contract with enough force, so there is less oxygen-rich blood that is pumped throughout the body.

Diastolic dysfunction (or diastolic heart failure) occurs when the heart contracts normally, but the ventricle – the main pumping chamber -- does not relax properly, reducing the amount of blood that can enter the heart.

Let's expand on the self-inflicted idea by looking at the main causes of heart disease related to lifestyle.  But first it's important to realize that not all heart disease is self-inflicted or under our control. 

For example, viral infections anywhere in the body can dump a lot of inflammation into the blood stream and if that inflammation attacks the heart muscle, we can develop a lot of the problems already mentioned. 

That's why a routine high sensitivity C-Reactive Protein test is an important diagnostic tool in that it will reveal inflammation in the blood and points to an infection somewhere in the body. 

Nutrition

Unhealthy eating habits and stress combine to absolutely destroy our pipes, blood vessels, that is.  Ever seen how scale can build up in a water pipe and eventually clog it completely? 

That's a great analogy to what happens in our blood vessels.

We will get to stress below but nutrition first.  Trans fats, saturated fats, refined sugar, high fructose corn syrup, processed foods and too little fresh fruits and vegetables and too much chicken fried steak, cream gravy and mashed potatoes all contribute mightily to heart disease. 

A lengthy discussion is presented below on nutrition and heart disease. 

Food for thought:  a little red wine does wonders as a supplement to good nutrition and stress alleviation; it's the resveratrol and more on that below.

wine.com

Exercise

Next is that we have largely evolved into a sedentary life form.  We sit at our desks at work and school, we sit on the couch or easy chair and watch TV all night or play video games and exercise consists of getting up to go to fridge or make a pit stop.

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If our recreation is sedentary, we are headed for trouble.   A constant diet of bingo, bridge, watching sports instead of playing sports, vicarious thrills from TV and movies can all take the place of getting out and experiencing life.

Golf carts have made golf a sedentary sport and walking is a foreign concept.  At the supermarket, you really have to be careful not to get run over by someone tooling around on a little scooter.  Unless you just had a double hip or knee replacement, get off the scooter, get a cart and push it around the store. 

The heart is a muscle and needs to be worked.  If we don't work our muscles they get weak and no longer serve us as they are meant to.  The same is true of the heart. 

If we have a weakened heart from lack of regular exercise and at some point we need to really exert ourselves, such as shoveling snow for an hour or two, better have someone standing by to call 911 for the ambulance when we keel over with the heart attack.

Weight

We are a fat people.  Being obese or overweight is getting to be the norm instead of the exception and much of it is directly the fault of the food industry, the pharmaceutical industry and the medical profession.  The food industry and the medical profession are still pushing the idea that eating fat makes us fat so low fat is the way to go. 

Low fat dieting makes people fat if they happen to fall into two of the five genetic types.  Removing fat from the diet also contributes to ill health.  The problem is that most low-fat and no-fat food sold in the stores is highly processed and very high glycemic.

There is a strong correlation between increased waist size and heart failure in both men and women.  In men, both higher waist circumference and high body mass index are strong predictors of heart disease.  Numerous clinical studies associate obesity with heart failure based on two adult studies in Sweden.

The Metabolic Syndrome

There is something known as the Metabolic Syndrome that relates certain body characteristics with heart disease, diabetes and stroke.  It's not just one thing; it describes a group of risk factors linked to overweight and obesity that increases our chances for heart disease and other health problems.

The metabolic syndrome in living color

The five conditions listed below are metabolic risk factors for heart disease. A person can develop any one of these risk factors by itself, but they tend to occur together. Metabolic syndrome is diagnosed when a person has at least three of the following heart disease risk factors. 

A large waistline, known as abdominal obesity, is a dead giveaway.  Excess fat in the abdominal area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.

An elevated triglyceride level in the blood is the second risk factor for heart disease. Triglycerides are a type of fat found in the blood and are a major source of energy and the most common type of fat in the body. 

In normal amounts, triglycerides are important to good health. When triglyceride levels are high, it is not clear whether these high levels directly increase the risk for heart disease. But high triglycerides are often part of a group of conditions called metabolic syndrome, mentioned above.

The flip side of the triglyceride factor is a lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol).  HDL is considered “good” cholesterol because it lowers your chances of heart disease. Low levels of HDL increase our chances of heart disease.

High Blood Pressure

Higher than normal fasting blood sugar is the last of the factors.  Mildly high blood sugar can be an early warning  sign of diabetes.  The chances of exhibiting the metabolic syndrome is closely linked to being overweight or obese and to a lack of physical activity.

Another cause is insulin resistance which is a condition in which the body can’t use its insulin properly. Insulin is a hormone the body uses to help change blood sugar into energy. Insulin resistance can lead to high blood sugar levels and is closely linked to heart disease.

Stress

Stress management which is nothing more than learning how to handle those situations outside our control that tend to drive us crazy, make us mad or make us want to strike back at someone or something.

Very stressful situations such as loss of a spouse, loss of a job or getting back-ended by someone texting on their smartphone are outside our control. 

If it happens to us, our challenge is to handle it wisely and not go off the deep end.

Why?  Because stress damages our vascular system with strong chemicals called corticosteroid hormones. 

They cause scarring of the vessels that results in plaque buildup and narrowing of the lumen (the inside of the vessel).  The end result is cholesterol buildup, high blood pressure and damage to the heart muscle.

Sleep

Sleep is restorative to the entire body and an absolute must for maintaining good heart and cognitive health. 

Sleep deprivation is a major contributor to hypertension and metabolic changes that lead to weight gain.
 
People who are sleep-deprived have elevated levels of those stress hormones in their blood that indicate a heightened state of inflammation in the body, which have been shown to be major risk factors for heart disease and stroke; as well as cancer and diabetes.

Other studies have found that sleep influences the functioning of the lining inside blood vessels, which could explain why people are most prone to heart attacks and strokes during early morning hours.  Men need between seven and eight hours of good quality sleep while women can get by with a bit less, six to seven hours.

Bad Habits

Do you or have you ever smoked cigarettes, dipped snuff or chewed the nasty stuff?  Yes? Report immediately to your neighborhood behavior adjustment center for electric shock therapy or a frontal lobotomy. 

Don't smoke!  Besides cancer, it will kill your heart and destroy your blood vessels.  Enough said.

Preventing Heart Disease

Want to avoid heart disease?  Here's the best way to put it.  Look at the list of lifestyle items discussed above that contribute to heart disease and DON'T DO THEM!

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Don't, Don't, Don't

Don't eat the trans and saturated fats, highly processed foods or high glycemic foods.  Don't sit on your butt all day.  Don't try to get by on 4 to 6 hours of sleep a night.  Don't smoke.  Don't stress out and obsess over things outside your control. 

Smile and laugh more.  Don't let your weight get outside what is normal and healthy for your height, sex and build.
What could be simpler?

OK, that's a lot of "don'ts" and generalities are easy to spout so let's get more positive and more specific.  We're going to concentrate on nutrition and exercise in the rest of this section since the other factors of sleep and stress management were adequately covered previously.

Food First

First and foremost for good heart health is the food we eat.  It's hard to pick up one of the popular magazines and not find some article on eating for good heart health.  Most people could probably recite the rules by "heart" (no pun intended) but let's do it anyway.

The idea is to eat foods that don't tend to clog our vessels with fats; that is, the low density cholesterol (LDL).  Right off the bat, that means more fruit and vegetables; eaten raw is best. 

One of the basic rules of healthy eating  is to eat foods high in fiber in their natural state if possible.  High fiber foods take longer to digest and don't trigger an insulin spike that we will talk about soon. 

Leafy greens such as spinach, endive and romaine lower the risk of heart disease and have an added benefit of helping protect against some types of cancers.  We have said many times throughout this site that if we are eating for good heart health, we are automatically eating for good brain health and will forestall cognitive declines.

Soy Bean pods,Superfood

Legumes, including dried beans, peas and lentils, should be eaten four times a week.  A Tulane University study has shown that this can lower the risk of heart disease by 22% in that they lower the LDL cholesterol and don't cause 
insulin spikes. 

If you just can't live without red meat, then keep the portions small; no larger than the palm of your hand and trim off the fat.  It's best to substitute fish or chicken for the red meat whenever you can.

The DASH Diet

All of this is incorporated very nicely in something called the DASH diet. DASH is an acronym that stands for "Dietary Approaches for Stopping Hypertension".  The DASH diet combined with a reduced intake of sodium and vitamin D has been shown to reduce systolic blood pressure by 11.4 mm of mercury and diastolic pressure by 5.5 mm of mercury in as little as 8 weeks.

The DASH diet can be summed up in seven bullet points:

  • High consumption of fruit and vegetables (8-10 servings/day)
  • Whole grain intake of 6 - 8 servings/day
  • 2-3 servings/day of low fat or no fat milk and milk products
  • 6 or less servings/day of lean meat, poultry and fish
  • 4-5 servings/week of nuts, seeds and legumes
  • 2-3 servings/day of oils and the right fats
  • 5 or less servings/week of sweets and added sugar
  • By the way, a serving is defined as one-half cup.

    For a very comprehensive coverage of the DASH diet from the NIH, read Your Guide to Lowering Your Blood Pressure with DASH.

    Vitamin D3

    We can't leave nutrition without mentioning vitamin D, vitamin D3 to be exact.  Vitamin D3 is another one of those miracle nutrients for combating heart disease.  It's benefits include improved vascular, bone and immune system health as well as better brain function and mental health.

    D3 comes from sunlight, fish oil and tiny amounts from milk.  If you're drinking milk for vitamin D, forget it.  We need 5000 IU per day to promote the wellness benefits mentioned above but since no one spends enough time in the sun anymore and fish oil only gives up about 400 IU, supplementation is necessary.

    When buying a vitamin D supplement, be sure it is "cholecalciferol".  There are some sneaky products on the market with names containing "D3" but are in fact D2.  There is also a great website that will give you everything you ever wanted to know about vitamin D.

    Go to www.vitamindcouncil.org.

    Inflammation

    Inflammation is a real destroyer of our blood vessels so we need to eat foods that tend to reduce inflammation. 

    This means foods that are high in omega 3 fatty acids which means cold-water fish (salmon, tuna, sardines), nuts (especially walnuts), flaxseeds, olive oil (extra virgin, cold pressed), beans (soy beans, kidney beans, navy beans), and a good omega-3 supplement.

    Omega-3 is anti-inflammatory, it keep platelets from clotting abnormally, it discourages plaque formation and promotes normal thickness of blood vessel walls.

    Fish, heart food and brain food

    Here's the deal...what we want to do is to keep our omega-3 and omega-6 in a one-to-one balance.  The problem is that we get way more omega-6 than we need in most of our foods; most people have about a 20-to-1 ratio of omega-6 to omega-3 and that results in a host of inflammatory disease conditions.

    Tuna, eat mo' fish

    We could get most of the omega-3 from eating a lot more large cold-water fish but we would probably end up with a load of mercury in our system and end up with heavy metal poisoning.  That's not fun. 

    Supplementing with a high quality, pharmaceutical grade omega-3 produced by molecular distillation (to remove the mercury and other heavy metals) is highly recommended.

    Stress

    Stress is another promoter of inflammation and that will destroy our cardiovascular system.  Stress causes a release of cortisol from the adrenal glands which prepares us for that fight or flight situation.  Once the stressful situation passes, the cortisol is cleared from our body and we go back to a state of rest and relaxation. 

    Today, too many of us are under chronic stress and have a constant load of cortisol in our blood which tends to cause scarring of our vessels.
     
    Cholesterol comes along to repair the scarring, much like a plaster patch, but with ongoing scarring and patching, cholesterol can build up to the point of dangerously reducing blood flow. 

    Ultimately, the plaque buildup will rupture and chunks of it break off and immediately block the vessel or be carried by the blood stream to narrower vessels which they will block. 

    If that narrow vessel happens to be in the brain, we get an ischemic stroke, or if we're lucky, a passing transient ischemic attack (TIA). 

    That should be sufficient to set off alarm bells, telling us that we need to make some adjustments in our lifestyle choices.

    Nitric Oxide (NO)

    The real miracle cure for cardiovascular disease is a gas the our body makes but it is very transient and we don't make enough of it.  That miracle gas is nitric oxide.

    The Cardiovascular Cure: How to Strengthen Your Self Defense Against Heart Attack and Stroke

    The book, The Cardiovascular Cure by Dr. John Cooke is highly recommended reading.  Dr. Cooke says, "There is a magic within all of us.  It comes in the shape of a molecule known as nitric oxide.  A substance so powerful, that it can actually protect you from heart attack and stroke."

    Vascular disease is an inflammatory disease and the progression of the disease is the same throughout the whole body.  It's effects are to damage and clog our blood vessels.

    Nitric Oxide to the rescue.  Nitric Oxide tells the blood vessels to relax and open up.  In a healthy vessel, the endothelium (inner lining of the blood vessel) is like teflon...smooth and slick and nothing sticks to it.  With the onset of vascular disease, the endothelium more resembles velcro...everything sticks to it.

    Long term, nitric oxide will transform the "velcro" to "teflon".  It is restorative in that it strengthens the "cap" over the plaque, making rupture less likely; dissolves plaque and makes the vessels more supple and flexible.  It's the fountain of youth for blood vessels.

    Click on the link above to go to Amazon.com and get more information on this book and ordering instructions.

    While we are still on Nitric Oxide, there are two more good books shown below that would be great additions to a cardiovascular care library.

    Both of them are available at Amazon just by clicking the respective links or book covers.

    Nitric Oxide, Second Edition: Biology and Pathobiology



    NO More Heart Disease: How Nitric Oxide Can Prevent--Even Reverse--Heart Disease and Strokes



    Enter L-arginine

    L-arginine is an amino acid that the body uses to produce nitric oxide.  We get some from food and our body makes some from another amino acid, citrulline.  There is a problem in that we don't get enough from food and our body doesn't make enough so supplementation is mandatory.</p>

    Published clinical studies show that nitric oxide from L-arginine in the endothelium may:

  • lower blood pressure
  • lower cholesterol and triglycerides
  • reduce blood clots and strokes
  • improve heart failure and wound healing
  • improve sexual function
  • improve kidney function
  • improve diabetes
  • improve memory and cognitive function
  • So when supplementing with L-arginine, shoot for 5000 mg per day, liquid formulations are absorbed best and it should be taken with other nutrients for optimal results.  

    Antioxidants

    Antioxidant foods can protect our cardiovascular system from the effects of stress and free radical damage and there are several specific nutrients that will go a long way in helping control the effects of stress. 

    These include Folate, vitamins B6 and B12, Coenzyme Q10, Alpha Lipoic acid, L-Carnitine, reservatrol and the high quality omega-3 essential fatty acid that we covered in the above paragraph.

    Folate

    Folate is a B vitamin found in legumes, green leafy vegetables, orange juice, tomato juice, eggs, bananas, strawberries, corn, beets and many others.  It's not hard to find good sources of folate (folic acid).  In fact all the B vitamins can be found in the foods mentioned with the addition of whole grains.

    Coenzyme Q10

    Coenzyme Q10 (CoQ10) is an antioxidant with anti-inflammatory properties and is absolutely critical to avoiding heart disease.

    Every cell in our body requires CoQ10 in that it is vital to mitochondrial function and the production of adenosine triphosphate (ATP), the fuel that runs the body.

    CoQ10 is also known as ubiquinone, a name that signifies its widespread occurrence throughout the body.  Vegetable sources include spinach, broccoli, peanuts, wheat germ and whole grains in that order.  Non-vegetable sources include fresh sardines and mackerel, the heart, liver and meat of beef, lamb and pork along with eggs, also in descending order.

    Relative to heart disease, it is important to know that statin drugs used to lower cholesterol, cause a decrease in serum levels of coenzyme Q10. These drugs inhibit the production of coenzyme Q10 by the liver and will cause serious complications unless one supplements coenzyme Q10 back into the diet.

    A prescription for lipid-lowering statin drugs should always be accompanied with a recommendation to take coenzyme Q10, because if a person is deficient in coenzyme Q10, heart failure is more likely. Yes, it's that important.  In addition, beta-blockers (drugs which slow the heart rate and lower blood pressure) can inhibit coenzyme Q10-dependent enzyme reactions.

    Even more important for congestive heart failure is that the heart may cease to function as coenzyme Q10 levels fall by 75%.  In congestive heart failure, the heart can't pump efficiently, which slows the flow of blood to the lungs and the rest of the body.

    The heart can temporarily maintain the blood in several ways. It can enlarge to pump extra blood; it can beat faster; or the ventricular walls can become thicker, which can strengthen the pumping ability.</p> 

    All things considered, it's just better if we can keep it pumping efficiently like it's supposed to.

    Alpha-lipoic Acid

    Alpha-lipoic Acid is an antioxidant that is made by the body and is found in every cell, where it helps turn glucose into energy.  It is both fat-soluble and water-soluble meaning it can work throughout the body.

    In addition, antioxidants are depleted as they attack free radicals, but evidence suggests alpha-lipoic acid may help to regenerate these other antioxidants and make them active again.  The good news is that a healthy body makes enough alpha-lipoic acid to meet our needs but for the record, it is found in red meat, organ meats (such as liver), and yeast (particularly Brewer's yeast).

    L-Carnitine

    L-Carnitine is a naturally occurring amino acid that helps the body turn fat into energy. Normally the body's liver and kidneys produce sufficient quantities and store it in the skeletal muscles, heart, brain, and sperm.

    Relative to heart disease, several clinical trials indicate that L-carnitine and propionyl-L-carnitine can help reduce symptoms of chest pain caused by reduced oxygen-rich blood to the heart (angina) and improve the ability of those with angina to exercise without chest pain.

    Some small studies suggest that people who take L-carnitine supplements soon after a heart attack may be less likely to suffer a subsequent heart attack, die of heart disease, experience chest pain and abnormal heart rhythms, or develop heart failure. However, other studies have found no benefit.

    Dietary sources of L-carnitine include red meat, lamb, dairy products, fish, poultry, wheat, asparagus, avocados, and peanut butter.

    Red wine, a major source of resveratrol

    Resveratrol

    Resveratrol is an antioxidant and anti-inflammatory flavonoid found in red wine, purple grape juice and the skin of red grapes.  It has numerous benefits in warding off heart disease such as decreasing the stickiness of blood  platelets, helping blood vessels remain open and lowering LDL cholesterol; all of which help combat atherosclerosis.

    Recent studies have also shown that resveratrol can help limit the effects of cardiac fibrosis which is the hardening of the heart tissue that can occur when a person has high blood pressure or heart failure.

    Wine grapes on the vine

    For a whole host of reasons, it is important to keep our food choices confined to the low end of the glycemic index with only occasional forays into the moderate glycemic foods.  Besides bestowing heart benefits, the obvious reason to stick to a low glycemic diet is to avoid the ravages of diabetes. 

    The objective here is to protect our pancreas by not triggering insulin spikes and overworking our pancreas and liver.  Insulin spikes occur when we overload our system with carbohydrates having high sugar content, especially the refined foods loaded with high fructose corn syrup and the like. 

    Repeated demands on the pancreas for more insulin result in more sugar getting stored as fat instead of burned as energy and this leads to being overweight or obese which causes heart disease.

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    Low glycemic foods fall between 0 and 54 on the Glycemic Index and moderate is between 55 and 70.

    Avoid any food that is over 70.  In general high glycemic foods are white and refined; white potatoes, white bread, white rice and many highly refined, sugar-coated breakfast cereals. 

    The higher the index number, the greater the rise in blood sugar from that particular food and the rapid rise in blood sugar in what triggers the insulin spike to deal with the sudden influx of blood sugar.

    Wrapping up with some
    Thoughts on Exercise

    Many studies validate that Exercise improves heart function and staves off heart disease.

    Its benefits include lowering blood pressure and blood cholesterol, and boosting energy. 

    No doubt, being overweight forces the heart to work harder and about 1 in 4 U.S. adults are sedentary.  Almost by definition, sedentary means overweight.

    Jogger and friend

    The National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health recommend at least 30 minutes of moderate physical activity every day of the week.  

    It's not necessary to run a marathon or buy an expensive gym club membership to do it.  If it is more convenient, the 30 minutes can be broken up into 10-minute intervals throughout the day.

    Vigorous exercise like running or aerobics brings more health benefits than lighter intensity activities, but walking is a great form of exercise.

    Brisk walking can get your heart rate up and give you a solid workout. Walking at a comfortable pace can work well for many people, too. The best exercise is one you will actually do and do every day instead of just procrastinating about it.  Good intentions don't mean much to your heart.

    It's really simple.  Try parking farther away from the door when you go to the grocery store or mall.  At the office, try the stairs instead of the elevator. 

    Lots of women form walking groups; you can see them in most neighborhoods any morning of the week.  Men don't seem to get too excited about group walking however but OK, racquetball or tennis works well too, and you can't beat swimming for getting the heart pumping.

    Champion Athleticwear

    It's a good idea to know your maximum heart rate and know how to measure it while exercising.  Heart rate gets to the heart of the intensity of a workout.  Knowing your heart rate will insure that you are training aerobically.

    Training below your target zone may not be intense enough to burn sufficient calories, while training above your zone will force your body to burn calories inefficiently; anaerobically meaning without oxygen.

    What is your target zone?  First step is to calculate your maximum heart rate, which is the fastest that your heart can beat.  To find your maximum heart rate just subtract your age from 220. 

    If you are 40 years old, your maximum  heart rate is 220 - 40 = 180.  Next ask yourself if you are a beginner and need to work at a low fitness level, or want to work at an average or high fitness level.</p>

    Ranges for the three fitness levels are:

  • low fitness level = 50%-60% of max heart rate
  • medium fitness level = 60%-70% of max heart rate
  • high fitness level = 75%-85% of max heart rate
  • The last step is to multiply your maximum heart rate by the percentage of the desired intensity range.  That 40 year old who want to work at a medium fitness level should maintain their heart rate between 108 and 126 beats per minute.

    A quick way to determine your heart rate while exercising is to find a good strong pulse in your neck and count the number of beats in six seconds and multiply by 10.  If you count 12 beats in six seconds and multiply by 10, you are working at an intensity of 120 beats per minute.

    The last question is how long should you keep the pace going?  For good health and targeting weight loss, the minimum is 20 minutes and shoot for a maximum of 45 minutes to an hour.   Common sense rules...if you have an existing heart condition, go easy on the exercise or, better still, don't do it at all without getting guidance from your doctor.

    The bottom line is that you and no one else are responsible for the health of your heart.  Heart disease is a lifestyle choice.  Choose wisely.


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