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High intensity exercise programs

There has been increasing evidence for high intensity training in terms of changing and improving your metabolism in terms of insulin resistance. This may have benefits in terms of improving you metabolic profile over the long term.
How does it work?
20 secs of maximal effort in between normal steady paced exercise for three interval that's it.... three times a week.
This may be of benefit but has to be taken in context. Weight reduction is aided by exercise. The mental and physical benefits of exercise are well documented.

Statins

Statins are a class of medicine that lower cholesterol. Drugs such as simvastatin, rosuvastatin or atorvastatin may be familiar to some. Cholesterol is a key component in causing furring up of the arteries that can lead to heart pains and even heart attacks.
There has been some recent news about who should need a statin, indeed should more of the population take them? What about the side effects?
The answer is to look at the individual patient and assess their individual risk profile. Then decide together if a statin is necessary.

Smoking

Smoking is one of the single biggest risk factors for heart disease and stroke. The numbers of smokers is reducing thankfully. This does mean that the remainder of smokers are the more 'hardcore' smokers who are less likely to quite. The fact remains that qutting at any point in your life is of benefit.
There are a number aids to stopping, counselling, patches, gum and even electronic cigarettes. There has been some controversy about the use of these are the amount of nicotine may be unregulated.

unsaturated or saturated fats

There has been a recent trial looking at the presumed benefit of polyunsaturated fat versus saturated fats (like butter). The trial suggests that there is no benefit from polyunsaturated fats like olive oil. Don't panic. I think the basic message is still the same. Portion discipline and regular exercise still apply. Moderation is the key. Simply follow the same old advice such as fruit and veg regularly, If you do decide to go back to butter as opposed to margarine with polyunsaturated fat, just remember moderation is the key.

Diet and cardiovascular health

Supplements and heart health.
Health supplements are promoted to help cardiovascular health. There has been a recent large analysis looking at the benefit of health supplements and cardiovascular health. The results seem to suggest that there is no benefit from these over the counter health supplements. Multivitamins do not seems to prevent cardiovascular events such as heart attacks. (USPSTF Annals of internal medicine Feb 2014).
Having a healthy diet and taking regular exercise are the key to reducing your risk of heart disease.

Four rules for exercise

1. Gradually build up the intensity to avoid injury.
2. Vary what you do to avoid boredom-- walking, sitting up, bowls it does not matter.
3. Like a medicine take exercise regularly.
4. Start now and make it part of your daily routine.
 
 
Forming a habit of exercising is a lifelong gift. If I could prescribe it I would. Make exercise your medicine before you need to start taking medicine.

Diabetes and extra virgin olive oil

A recent trial in the Annals of Internal Medicine looked at the role of a Mediterranean diet in reducing the onset of type 2 diabetes. It seems to suggest that eating this type of diet which is especially high in extra virgin olive oil  (50ml/day) in some way prevents the onset of diabetes. The benefit was a 30% risk reduction in developing diabetes compared to controls who were on a low fat diet. The diet was relatively low in dairy products and low in carbohydrate content.
Although the mechanism of how the Mediterranean diet reduces the onset of diabetes is not completely understood it may be related to the relatively low carbohydrate content and the prevention of insulin resistance.

high blood pressure

High blood pressure is a major risk factor for heart disease and strokes. As we age blood pressure can become more likely. The major problem with blood pressure is that we can have it without feeling any ill effects andtherefore be undiagnosed for years. So it is really important to get is checked if you think you could be at risk-- a simple check by your family doctor or practice nurse or even at the local pharmacy is a start.
Blood pressure readings above 140/90 mmHg indicate some degree of high blood pressure.

Diabetes and heart disease

The number of people with diabetes is growing. The likelihood of developing in particular type II diabetes goes up if you have relatives with the condition. It is also associated with having a higher body mass index (BMI) (greater than 27). If you have a family history, it is better to keep your BMI low as you get older. The lower the better, some have argued that between 23 and 25 is better.
The reason that diabetes affects the heart is that it makes the blood vessels, the coronary arteries more likely to develop atheroma (fatty deposits blocking up the arteries).

Risk factors for heart attacks

There are traditionally five main risk factors for artherosclerosis (furring up of the blood vessels that can lead to angina and heart attacks)
 
1. high blood pressure
2. smoking
3. high cholesterol
4. a family history of heart disease below the age of 60
5. a previous heart attack
 
addressing the ones you can modify is important
1. checking and if necessary reducing your cholesterol (usually less than 4.8mmol/l)
2. checking and if necessary reducing your blood pressure (usually to less than 135/85mmHg)