Walking – yes, really – tops the list.
Doctors want you to get up. They want you to move. Americans are too sedentary, they say – and fitness is one of the greatest predictors of heart health in middle-aged adults.
But are some exercises better than others to keep our hearts healthy? Doctors say yes. And one is recommended more than all the rest: brisk walking.
"Walking is remarkably beneficial," says Dr. Walter C. Willett, professor of medicine at Harvard Medical School and professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health. "A half-hour a day can make quite a bit of difference. In terms of return for your investment of time, it really is a big bargain."
A casual walk won't do it, though; you need to be huffing and puffing a bit. Doctors like other exercises that get our hearts pumping, as well, such as jogging, biking, dancing and swimming. But experts point to walking, in particular, because most healthy people can do it and stick to it, and research shows great benefits. A National Runners' and Walkers' Health Study comparing runners and walkers found that runners who ran an hour a day reduced their risk of heart disease by 4.5 percent, while walkers who used the same amount of calories reduced their risk of heart disease by 9 percent.
Willett says vigorous exercise brings other benefits, including increased athletic ability and fitness. "There is some additional benefit of higher intensity activity, but most of the benefit can be obtained by brisk walking," he says. The American Heart Association recommends exercising at least 30 minutes a day, five days a week. The sweet spot for exercise is hitting your target heart rate, which refers to how fast your heart should be pumping based on your age and resting heart rate.
The rule of thumb is to increase heart rate to between 50 and 85 percent of your maximum heart rate. Moderate exercise such as light bicycling or brisk walking gets your heart pumping between 50 and 70 percent of your maximum. During high-intensity exercise such as playing singles tennis, jogging or snow shoveling, your heart pumps between 70 and 85 percent of its maximum. Here's a calculator to help you figure yours out. "You should be challenging yourself a bit," Willett says.
Brisk walking, running and other cardio activities are aerobic exercises, which means they increase the body's demand for oxygen, causing faster breathing and heart rate. It's an activity you can generally do while speaking some words, but singing a song would be nearly impossible. When done correctly, it improves the efficiency of the body's cardiovascular system as it absorbs and transports oxygen.
Studies show that the greatest gains in survival outcomes are when someone goes from being sedentary to becoming moderately active, according to a study published in the American Heart Association Journals. "Researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20 to 25 percent," the study says.
Weight Control and Fitness
Exercise helps maintain healthy arteries and an ideal weight. People who want to lose weight will likely need to kick up their workout to about an hour a day, says Jonathan Rifkin, an exercise physiologist at Wake Forest Baptist Medical Center's cardiac rehabilitation center.
For those just starting to get fit, Rifkin recommends walking or another moderate-intensity activity. "If you are able to have a baseline level of fitness, you can have drastic changes in body composition and overall fitness level with not a lot of time required to do that," he says.
Perks of walking, Rifkin adds, include that it can be either social or solitary, and when done outdoors, reduces anxiety and depression.
But he says that for fitness levels to improve further, people need to push themselves. That's where interval training comes in, meaning short bursts of high intensity.
For a brisk walker who is healthy and exercising five days a week, Rifkin adds, try jogging a few minutes during one of those walks a week. Once that becomes comfortable, continue to challenge yourself in small increments so you don't get injured. "If you're able to improve your fitness level, you're going to be a lot better off," Rifkin says.
Strength training is a critical but often overlooked component of cardiovascular health. Exercising with weights or body resistance – such as sit-ups and push-ups – is recommended by the American Heart Association twice a week, and Willett says strength training for 5 to 10 minutes several times a week is important.
It makes us stronger and actually helps prevent diabetes, which is a risk factor for cardiovascular disease, Willett says. He explains that when we exercise our muscles, it reduces their insulin resistance, which is a fundamental problem that leads to prediabetes. He adds that weight training increases metabolism and vascular health.
Any Exercise Is Good Exercise
Even if you're not able to exercise the recommended amount each week, any exercise helps. A study in the Journal of American Medical Association analyzed the effects of different kinds of exercise on healthy men and found that running for at least an hour per week showed a 42 percent reduced risk for a heart attack.
Vigorous exercise is good, but only after a vigorous warm-up, says Dr. William A. Zoghbi, chair of the department of cardiology at Houston Methodist DeBakey Heart and Vascular Center, and professor of medicine at Weill Cornell Medical College and the Institute of Academic Medicine.
Zoghbi encourages his patients to do yoga, stretching and strength training, as well as cardio. "I think about total body, not just the heart," he says. "Do some aerobic exercise. Toning is important, flexibility is important for core body and joints. If the heart is doing well and joints are not, I don't think we're doing well."
Zoghbi recommends everyone know their weight, blood pressure, cholesterol and blood sugar numbers. "It's important to keep the engine running healthy," he says. "We need to look under the hood sometimes."
However, if you have a heart condition, always check with your doctor before starting a routine. You can discuss the best exercises for you and what your target heart rate should be during activity.
For people who do not set aside time to exercise, there are small steps that can incorporate movement into daily life, such as going for two 10-minute walks during the day, taking the stairs instead of the elevator or parking at the back of a parking lot and walking up to the door.
All exercise is important, experts say, and the hardest step is the first one out the door.
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