Features November 2019 Issue

Should You Do Strength Training?

The answer is yes, in addition to aerobic exercise!

In almost every publication about heart disease, you'll find an article on the benefits of aerobic exercise. Some patients interpret this as meaning they should focus on exercises that increase their heart rate, and strength training is unnecessary or possibly harmful. But experts say that's not the case.

"There's no reason why a heart patient without contradictions to strength training shouldn't do both," says Erik Van Iterson, PhD, Director of Cardiac Rehabilitation at Cleveland Clinic. "Strength training improves musculoskeletal health, which helps slow the loss of bone and muscle associated with aging. Aerobic exercise strengthens the lungs, heart and body-wide circulation. You will benefit from a global approach to cardiovascular health and fitness by doing both."

Building Up Your Heart

Aerobic exercise is any activity that makes your heart beat faster for an extended period of time. The duration depends on your medical history and experience with exercise. Popular forms include walking, bicycling, running and dancing.

People who have lived largely sedentary lives may be overwhelmed by the prospect of doing aerobic exercise. Dr. Van Iterson advises them not to overthink it. "It all comes down to getting up and moving around on a regular basis," he says. "If you have heart disease, what do you want to do better? Usually, it's walk. Therefore, walk more."

Getting Stronger

5 strengthtraining

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Strength training does not help the heart directly, but it is a wonderful complement to aerobic exercise.

Strength training-sometimes called resistance training-is designed to put healthy stress on the bones and make the muscles stronger. Lifting weights or using Nautilus equipment are the most popular forms of strength training.

However, the exercises must be done properly to derive benefit, and it's important to be physically prepared to do them. "If you cannot perform the activities of daily living independently, you are not ready to do unsupervised strength training," says Dr. Van Iterson.

Before you attempt any type of exercise, you should be evaluated to determine whether you can exercise safely. It's particularly important if you've never exercised before, or if you've had a heart attack or a cardiac procedure.

"I always recommend these patients start by visiting a cardiac rehab program, where an exercise professional will assess your risk factors and test your exercise capacity," he says.

If you can't find a cardiac rehab program in your area, Dr. Van Iterson suggests you contact your local fitness center and ask to speak with an exercise professional.

"Explain that you had a heart attack, bypass surgery or stenting, and tell them what your doctor has advised you to do. Then ask if there is someone on their staff who is qualified to help you."

Ready, Set, Go!

Once you are given the go-ahead, they will start you on basic exercises and teach you how to perform them correctly. As your strength and endurance improve, they will make changes to your exercise program and add new exercises.

"Cardiac rehab professionals take your medical history into consideration, watch you closely while you are exercising and teach you what signs and symptoms might indicate you are pushing yourself too fast and too hard," he says. "By doing the right exercises and taking it slowly, you will safely improve the strength of your heart and body over time."

How to Avoid Side Effects

Pharmaceutical companies are required to reveal all reported side effects in ads for their products. Vitamins and herbal supplements are exempt from this requirement, because the U.S. Food & Drug Administration considers them foods. Because consumers never hear or read a long list of potential side effects, they may assume there aren't any. But that's not the case.

"Taking too much of some dietary supplements can be harmful," says Cleveland Clinic geriatrician Ronan Factora, MD. "Also, some can interact with prescription drugs or change how the body metabolizes the medications."

For example:

- Excess vitamin A may increase risk of osteoporosis.

- Excess vitamin B6 may cause neurological problems, such as lack of balance or peripheral neuropathy.

- Garlic, ginger, ginkgo and ginseng can increase bleeding risk in patients taking blood thinners.

- Echinacea, kava, cinnamon and melaleuca may cause statins and other medications to become less effective or produce more side effects.

To avoid these problems:

- Discuss the products you take or would like to take with your doctor, and talk about what you hope the supplement will do. "Supplements marketed for vague reasons, such as ‘support' or ‘wellness,' are unlikely to do what you expect," says Dr. Factora.

- Bring the actual bottles of vitamins, supplements and herbal products you take to your next appointment. This will allow your doctor to read what the supplements contain. "It's easy for patients to take more of one substance than they realize," he says.

- If your doctor recommends against taking a product, or warns about the dosage, pay attention. "You should know as much about the dietary supplements you take as you do about your prescription medications and treat them the same way," says Dr. Factora.

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