New Heart Disease Research
I had intended to devote this issue to the benefits of exercise for arthritis.
However, some important heart disease research papers were published during the past several weeks and I thought it would be timely to focus on them instead:
• On October 1, 2013, the British Medical Journal (BMJ)published an analysis of research comparing the effectiveness of exercise vs. drug therapy for heart disease, diabetes, and stroke. One of the authors of this paper is John Ioannidis, MD, a well-respected epidemiology researcher from Stanford University. Regarding coronary heart disease, these authors concluded that:
"....exercise and drug therapy are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease....."
• Subsequently, the Journal of the American Medical Association (JAMA) summarized this study in their November 20, 2013 issue. The title of the article, written by Mike Mitka, is: "Exercise May Match Medication in Reducing Mortality Associated with Cardiovascular Disease, Diabetes."
BMJ and JAMA are two of the most prestigious medical journals in the world, so, when something is published here, it is significant.
Then, on November 12, 2013, the journal Circulation published several papers that summarize the most current opinion on how best to treat heart disease. Circulation is also a highly-respected medical journal. These new reports reflect the opinions of experts from the American College of Cardiology (ACC) and the American Heart Association (AHA).
However, in contrast to the analysis by Naci and Ioannidis in the BMJ, the ACC and AHA concluded:
"...currently, there isn't yet enough evidence to recommend for or against cardiovascular fitness as being a useful risk indicator for coronary heart disease."
I was stunned when I read that. (And so was an "exercise-epidemiology" expert I talked to about this!) How can the ACC and the AHA take such a neutral stance on the role of exercise in coronary heart disease?!!
In my opinion, there is plenty of evidence to support the view that aerobic exercise is not only effective for CAD, it is probably the one single best strategy you can employ. I recently published my own review: "Exercise and Coronary Artery Disease." While researching this topic, I read nearly 300 papers. Here are several that really stood out:
• Diet & Exercise Reverses CAD - The dramatic case of Nathan Pritikin: Mr. Pritikin completely reversed his own coronary artery disease without any drug therapy. Instead, he chose to run regularly and consume a low-fat, low-cholesterol diet. When he died, his coronary arteries were examined at autopsy. They showed absolutely no atherosclerotic plaques and no compromise of their inside diameter. His coronary arteries were like those from a newborn infant. This report was published in 1985! (Hubbard JD, et al. 1985).
• Lifestyle Modification Works Better Than Drug Therapy: Dean Ornish, MD, et al. showed that a comprehensive lifestyle-modification program (eg., aerobic exercise, low-fat diet, smoking cessation, and stress reduction) can achieve much better results than drug therapy in patients with CAD (Ornish D, et al. 1998).
• Aerobic Fitness Level is a Powerful Determinant of CAD Risk: In November 2012, an evaluation of nearly 40,000 men studied at the Cooper Clinic in Dallas was published. Researchers evaluated fitness level and LDL-cholesterol levels for their ability to predict risk of future coronary events. They found that a man with an LDL-cholesterol level > 190 mg/dL, but who is highly aerobically fit, actually had a lower risk than a man with an LDL level of < 100 mg/dL and who is unfit (Farrell SW, et al. 2012). To my knowledge, this is the first study to compare these 2 risk factors like this. It suggests that aerobic fitness is a more important risk factor than your cholesterol level is.
Getting back to these new reports that were just published, how can leading experts reach such divergent conclusions? Actually, digging deeper into the BMJ paper, Naci & Ioannidis admit that there isn't as much "hard evidence" supporting the benefits (and, thus, the place) of exercise in the management of diseases such as CAD as there is for drug therapy. Note that this DOESN'T mean that exercise is less effective. It simply means that less research has been done on exercise therapy than has been done on drug therapy.
What does all this mean for you? Here's the bottom line:
Everyone -- whether you have heart disease or not -- should perform some type of aerobic exercise regularly. Even if all you do is walk around your neighborhood, that will give you some very substantial health benefits. There is absolutely no controversy about that! And, if you can add in a bit more, such as a little jogging, or play tennis, or some weight lifting, then, even better.
As always, if you need some help with your exercise plan, AthleteInMe.com® offers expert advice on exercise, provided from a health-enhancement perspective. (see Health Coaching).
So, let us know if we can help you...