Regular exercise has long been tied to heart health, but a growing body of research is illuminating the ways in which physical activity battles the major contributors to heart disease: It’s not just that exercise strengthens the heart muscle, increases your lung capacity and controls weight (all good stuff); regular workouts also positively affect many underlying body functions that contribute to heart health. In addition, research is showing that inactivity is more than a missed opportunity to be healthier — it’s actually detrimental to your heart health. Here, a look at the ways getting up off the couch will keep your cardiovascular system healthy — and how to get and stay moving once you do.
Beat Belly Fat
While being extremely overweight in any body configuration stresses your heart, research shows that visceral fat — the stuff that sits in your middle and surrounds your intestines — is far more dangerous to your health than the fat that lies under skin (think saddle bags and jiggly arms), called subcutaneous fat. Visceral fat doesn’t just sit there and jiggle; multiple studies have shown that it acts as an organ, producing proteins that contribute to inflammation and insulin resistance, both of which increase your likelihood of heart disease as well as of diabetes and cancer.
Exercise is directly tied to the buildup — and burn-off — of this fat: A research project from Duke University known as STRRIDE has dramatically shown the effects of exercise versus inactivity on a number of heart disease risk factors. Among the findings: Those who remained inactive over a period of six months gained visceral fat. Regular workouts prevented that belly-fat buildup.
In addition to combating visceral fat by burning calories and reducing your weight (when paired with the right diet, of course), regular physical activity actually changes where your fat is stored. Through exercise, “people will redistribute fat from their core to their peripheral layer,” says Gordon Blackburn, MD, director of the Cardiac Rehabilitation Program at the Cleveland Clinic. In other words, it’ll go from being dangerous to being just, well, annoying.
Take That, Bad Cholesterol
Another STRRIDE finding was that the physically inactive ended up with higher LDL (“bad”) cholesterol levels and lower HDL (“good”) cholesterol levels. Moderate exercise (for instance, brisk walking), though, benefited participants’ cholesterol levels, lowering LDL and raising HDL. Why does raising HDL matter? “Every 1 percent increase in HDL” “carries a 2 percent decrease in the risk of heart attack,” Dr. Blackburn says. Given that HDL can be difficult to raise by dietary measures, pairing exercise with an LDL-lowering eating plan (such as the Mediterranean diet) is a heart-healthy double play.
Energize Your Endothelium
Regular physical activity also directly affects the health and functioning of your arteries, Dr. Blackburn says. First, it can help improve the endothelium, a single layer of cells that line your entire cardiovascular system. The endothelium is like an organ, and when we exercise regularly, he says, “the cells of this lining become more dynamic and act to protect the artery walls from damage.” Exercise also increases production of nitric oxide. This chemical makes the arteries more elastic. Finally, exercise lowers blood pressure and increases insulin sensitivity. All of this reduces your risk of angina, heart attack, stroke and diabetes.
What’s Your Capacity?
So now you’re ready to get going — but how hard, and how often? The latter question is easy — engage in some form of exertion daily for at least 30 minutes. How hard, though, largely depends on the current state of your fitness. The goal is to work at 60 to 75 percent of your functional capacity, which is a measure of how hard your heart and lungs can maximally perform. For some, a brisk walk will get them there; on the other hand, Dr. Blackburn notes, “if you were to take someone like Lance Armstrong and have him just walk every day, his functional capacity would actually decrease.” Why? Because that wouldn’t get him close to 60 to 75 percent of his functional capacity. Of course, there’s a wide range between someone who would feel pumped after a brisk walk and a seven-time Tour de France winner.
If you don’t have heart disease or diabetes already, you can take two routes to figuring out if you’re achieving that target range. (If you do have one of these conditions, you should work with a health care professional to determine the correct level of exertion for you.) The first method is the talk test — exercising at a level that allows you to speak without gasping for air. “We’re talking just a sentence,” Dr. Blackburn says, “not a whole conversation.” The second, more exact approach is to work with your heart rate.
Start by determining your peak heart rate, which is 220 minus your age. Then measure your resting heart rate — what it is when you’re just sitting in a chair — either by using a heart rate monitor or by taking your pulse using a watch with a second hand or a digital timer. To take your resting pulse with a watch, place the tips of your index, second and third fingers on the palm side of the opposite wrist, below the base of the thumb. Press lightly with your fingers until you feel your pulse beating. Using the watch’s second hand or digital timer, count the beats for 10 seconds. Multiply this number by six to get your heart rate per minute.
Subtract your resting heart rate from your peak heart rate to get the “delta value.” Multiply that number by 0.6 and by 0.75; add each of those results to your resting heart rate to get your target range.
Here’s an example: if you’re 45 years old, your peak rate would be 175. If your resting pulse is 85 beats per minute, your “delta” value is 90. Sixty to 75 percent of that is 54 to 67.5, so your target range for exercise is 139 to 152.5 beats per minute. While you’re exercising, watch your heart rate monitor (or the one on the exercise machine at the gym) or take your pulse to determine if you’ve reached and are staying in your target range.
Do What You Love
Dr. Blackburn’s description of the perfect exercise: “Something you enjoy, something you can fit in on a daily basis and something you can continue doing.” Walk briskly, run, bike, use a program like Wii Fit — as the saying goes, “it’s all good.”
Once you find what you love, aim to gradually increase the duration and intensity of your activity. As you get fitter, your functional capacity increases, so you really can do more. If you love your daily walk, add distance and build up speed. If you love bicycling, add another few miles or tackle that big hill. It all adds up, and getting going today will keep your heart going in the long run.