NEW YEAR RESOLUTIONS FOR YOUR HEART

NEW YEAR RESOLUTIONS FOR YOUR HEART:

As the old cliché goes; time flies by, and a new year is upon us already. At the start of the year, most of us indulge in another cliché, which is making up New Year resolutions. Most of these have do with eating healthier and starting an exercise program. Usually, somewhere between a Sangeet and a wedding reception in late January, these resolutions are relegated to the dustbin, much like that old stationary cycle you bought five years ago in a fit of enthusiasm, and is now used as a clothes hanger !

However, man is an eternal optimist and we never give up. So, here is a set of 8 resolutions you can follow (or try to follow) for 2012. I have kept them deliberately simple, and eminently achievable. Have a fantastic year and let me know how many of these you plan to follow.


RESOLUTION NO 1: I WILL KNOW MY NUMBERS.

The first step towards better heart-health is to know where you stand currently. For that it is very important for you to know your health numbers. For heart disease prevention, the most important numbers to know, and their normal values are:

Blood Pressure: Normal blood pressure should be less than 120 / 80 mmHg.

Blood cholesterol: Your cholesterol profile should be done after a 12 hour fast and the values should be:

Total cholesterol Less than 200 mg/dl

Triglycerides Less than 150 mg/dl

LDL cholesterol Less than 100 mg/dl

HDL cholesterol More than 40 mg/dl.


Blood sugar: Uncontrolled blood sugar leads to diabetes, which is a very important risk factor for heart disease. Your normal fasting blood sugar should be between 70 –100 mg/dl.


RESOLUTION NO. 2: I WILL NOT SMOKE

A smoker’s risk of having a heart attack is more than twice that of a nonsmoker. Smoking speeds up the development of plaque in the arteries. It also reduces the level of the good cholesterol (known as HDL), and increases the stickiness of blood cells causing blood clots inside the arteries. If you smoke currently, strongly consider quitting- its not cool anymore!


RESOLUTION NO 3: I WILL TAKE 10,000 STEPS DAILY

Exercise helps protect against heart disease and several forms of cancer. But besides regular exercise every extra step you take during the day builds up your ‘health balance’, and helps prevent disease. Try and factor in at least 30 minutes of moderate physical activity (such as walking) in your daily life.



RESOLUTION NO 4: I WONT LET THE WEIGHING SCALE RULE ME!

Its important to maintain a healthy weight, according to your height, but its more important to eat a healthful diet and exercise regularly. Studies have shown that exercise programs and healthy eating lead to improved health parameters, even in the absence of weight loss. However, these studies should not be seen to be a license to be overweight, but to serve as encouragement to those making a change in their lifestyle, which might not necessarily be reflected on the weighing scale.

RESOLUTION NO. 5: I WILL NOT CRASH DIET
If your BMI is more than 25 kg/m2, it is important for you to lose weight, but it needs to be done through a combination of a sensible diet and exercise. Crash dieting and starvation may help you to lose weight quickly but that weight will come back on very rapidly, besides this being dangerous for health. You should adjust your exercise and caloric intake, such that you lose about 1-3 kg per month, not more. Under no circumstances should you reduce your caloric intake to less than 1000 calories per day.

RESOLUTION NO. 6: I WILL EAT HEALTHY
This is an important follow-up to resolution number five. Contrary to popular opinion it is not difficult to eat healthy. It is a misconception that healthy eating means giving up ‘all the good things’ and eating an oil-free diet. You should include oil in your diet, but make sure its in limited quantity- about half a kg per person per month. Fruits and vegetables should form the major part of your diet. If you are non-vegetarian you need to reduce your intake of red meat (once in 2-3 weeks), but chicken and fish are fine to consume on a regular basis.

RESOLUTION NO. 7: I WILL TAKE MY PILL….

With appropriate lifestyle modification, you should be able to control most of your risk factors. But at some point, you may need to take medications. If you need medicine, do not stay avoid it because of the over-hyped and unjustified fear of side-effects or ‘being on medicine for life’. You should discuss the risk to benefit ratio of any medicine with your doctor and make the decision
RESOLUTION NO. 9: I WILL GET A HEALTH CHECK

We all feel that it will ‘never happen to me’, but heart disease is an equal opportunity killer. Unfortunately most of the risk factors for heart disease are silent- they give you no warning of their presence. You should get your blood pressure, blood sugar, cholesterol and weight checked on a regular basis. Ideally these tests should start at the age of 15, and then repeated periodically. After all, the disease process begins in adolescence. If you have crossed 40, its also a good idea undergo a stress test.

RESOLUTION NO. 8: I WILL ENJOY THE NEW YEAR
For good health, it is extremely important not to get ‘stressed out’ over small matters. Stress has several negative effects on our body, and should be kept under control. While, some stress is important it is vital to not allow it to completely take over our lives. So, as you start the year and try and implement all your resolutions make sure you make some time for relaxation and fun.

HOW TO RUN A HALF MARATHON IN UNDER 1 HOUR 45 MIN

ENDURANCE TRAINING IS ALL ABOUT SETTING GOALS:


At this point in time, the value of exercise for health and well-being has been proven beyond a shadow of doubt. Besides, all the great health benefits, the most important benefit is that it 'makes you feel good'. However, even the most avid exercisers often get jaded at some point in time and a feeling of boredom or 'sameness' sets in.
In my personal experience, the best way to avoid this is to set up a medium term goal, create a plan to achieve it, and then stick to it diligently. You will be surprised, by your own capability. Here is my account of setting a goal, and the journey to achieve it.

SETTING THE GOAL:

I have been a regular runner, since the past 15 years, but have been dogged with injuries over the past 5 years, which have prevented me from running the distances I want to run. I ran the 2009 Mumbai half marathon, in 2 hrs 6 min (though, this was without adequate preparation), and then again in 2010, this time in 1 hr 54 min, with reasonable preparation. My injury resurfaced its ugly head mid-way through training for the 2011 run, and I did not participate. So, post-marathon in mid-Jan, I was wallowing in self-pity, and decided that the only way to escape it was to set up some goals, which were difficult to achieve. I set 2 targets, and in typical mid-life crisis style, decided to achieve them before I turned 40, which if you must ask, was in November 2011. The first was to cycle non-stop from Mumbai to Pune, and the second was to run a sub 1hr 45 min half marathon. I am happy to tell you, that the cycle ride was achieved on April 4, and here is an account of the same, for those of who you want to be further bored......

http://www.cyclists.in/profiles/blogs/mumbai-to-pune-for-charity

For a few months I was content with that achievement, when it suddenly hit me, that there was one more target to hit. I finally 'woke up' in mid-August, and realized that I was way behind where I ought to be if I needed to do a sub 1:45 before November. At that point in time, I was running 6-8 k on the treadmill, at a speed of 10.7-11 k/h. I consider a speed of 11 km/hr (5 min 30 sec per km) to be my 'comfort z0ne' running pace, which I can sustain for a length of time. Therefore an average speed of 12.1 k/h, for the half marathon, seemed almost to be a fool-hardy dream. I distinctly remember a conversation I had at the Qi gym, one sunday in August, with Cyrus Mehta, a friend of mine who had run 1:40 in the 2010 Delhi half marathon. He convinced me that the weather in Delhi is fantastic in November and the flat course, helps to knock off more than 5 min of one's Mumbai marathon time. Considering I had done a 1:54 in Mumbai, that meant, I could easily run 1:49 in Delhi, and would need to just shave off 4 min more, to achieve my goal. Somewhere, deep down I knew that this was overly simplistic, but that day I decided that my goal would be achieved in the Airtel Delhi half marathon on November 27, and I made Cyrus promise that he would be my pacesetter. To make matters interesting, I promptly went and contracted the flu, which put me off exercise for the next 10 days, and when I finally got around to my first long run (anything over 10 k, by my definition) outdoors, it was on Sep 17- a 12 k on Marine Drive at an average speed of 11.1 k/h. Here is the garmin link for the same.

http://connect.garmin.com/activity/117155258

To be honest, I was quite happy with that run, though it seemed a lifetime away from my intended goal in exactly two months. I set a schedule for myself, which included 3 runs a week (due to my injury, I am not able to run on consecutive days). The first run was on a mon or tues evening, which was a tempo run of 6 k, the second run was interval training on a treadmill, starting with intervals of 400 m and 800 m (totally six in all), and the third was the long run, which I did with Cyrus and Shabbir Eran, on Sat morning. Every Saturday, we increased the long run distance by 2 km, and on Oct 8, I did an 18 k run, at an average of 10.9 k/h. Post-run, I was not sure whether to be happy or dejected. On the one hand, 10.9 k/h (5 min 31 sec/km), seemed a far cry from running 12.1 k/h, but at the same time, I had given it my best effort, as was evident from my heart rate data. My average heart rate for the run was a staggering 177 beats/min - 98% of my age predicted max of 180 beats/min, which is insane. Quite frankly, I would not advise anyone to run beyond 90% for a consistent length of time, and here I was doing it for 1 hour and 39 min ! At best, that showed that I really had given it all, and at worst it showed that I was being pretty silly. However, this did drive home the point of the capability of the human body. In my opinion, most runners training in large groups in Mumbai are grossly underperforming, in spite of putting in a ton of effort, and I believe the missing piece is BELIEF. If you dont think its possible to run faster, you never will ! Here is the garmin account of that run, with the heart rate data.

http://connect.garmin.com/activity/119794815

On Oct 15, I did my first practice half marathon, which is 21.1 km- dont forget that 0.1 km, at the end. It can make all the difference to your calculations, when trying to run a precise time. I did that in 1h 50 min at an average speed of 11.5 k/h, and wasnt feeling 'dead' at the end of it. Thats the first time, that I truly believed that a sub 1:45 time was possible.

By this time, I had shifted my tempo runs outdoors and increased the distance to 8 km- however, I was just about managing to hit 12 k/h, (and was totally pooped by the end of the run) and I had to continue at that pace for 13 more km! The interval training had increased to two sets of 400 m/800m/1600 m, with a rest of 400 m between each interval. I was running these on the treadmill at a speed of 16,15, and 14 k/hour , and the rest period was at 10 k/h. On Nov 5, and 12, I ran two more practice half marathons and finished in 1:48 and 1:47. To an extent, I felt I now had it under control, since almost everyone I spoke to seemed to suggest that it would be possible to shave off at least 2 min in Delhi. One week before the final run, I ran a 16 k at a speed of 12.1 k/h and felt elated, since this is the first time I had completed a long run, at that speed.

D-DAY : November 27, 2011

On the morning of race day, November 27, everything was perfect. I remember having a conversation with my friend Amit Sheth, at the start line. We were praising the perfect weather conditions and the organisation (and the fact that we were amongst the lucky few starting with the elite runners, though we were far from 'elite'), and then came to the conclusion that if we did not achieve our individual goals, we had no one to blame but ourselves. As the starting gun went off, I thought, 'this is it'- this is what the last two months have boiled down to, and as runners often do I started a conversation in my head, which was more reflective. I was very pleased with the journey I had undertaken, and was proud of the fact, that in the last 8 weeks I had not missed a single scheduled run. One part of my brain was saying that today's timing did not matter, as I had given my best, and as has been famously said by Baron De Coubertin, the father of the modern Olympics, "the most important thing is not winning, but taking part." The other part was telling me that thats the excuse of losers, as echoed by the American sporting culture and the words of the legendary American football coach Vince Lombardi, " winning isnt everything; its the ONLY thing."

By the time this great mental debate was over, I was happy to note that 5 k had gone by, and I was clipping along nicely at 12.2 k/hr, and was feeling pretty good. The only downer was that I had lost both my running companions. A pacesetter is also known as a 'rabbit' in running parlance, and Cyrus took that literally, and ran off like a hare, and the only time I caught glimpses of him, was in portions of the course where he was on the other side of the road (he completed the run in a fantastic time of 1 hour 39 min). Along the way, I met up with a Mumbai runner, Varun Joshi, whose goal was to do a sub 1:45 as well, so we stuck together. The distance flew by pretty comfortably and at the 14 k mark we were cruising at an average speed of 12.3 k/h. It took all my self control to push back the greed and temptation of turning it up a notch, and potentially running much faster or 'blowing up' too early. Luckily I remained sensible and was thrilled to finish in 1:43:50. Here is the garmin account of the run:

http://connect.garmin.com/activity/131446981


The purpose of writing this account is not self-glorification, but to highlight the fact that 'stretch' targets are extremely achiveable, but the key is to hit the milestones along the way. All too often we are caught up in our own excuses, which always seem 'genuine' to us, but at the end of the day, besides illness and injury, there is really no valid excuse, least of all the most commonly used one, "i have no time".



So, whats your goal going to be for the next 6 months? Please share it on this site- mine is to do a 250 km non-stop bike ride.

4 WEEK-ENDS TO GO FOR THE 2012 MUMBAI MARATHON !

WHERE SHOULD YOUR TRAINING BE TODAY?

Full Marathon:

If you have registered for the full marathon, at this point in your training, you should be getting ready for your BIG long run, on this weekend- December 25 (unless you did it last week-end). This run should be anywhere between 30-35 km, though the ideal distance is 32 Km (20 miles), especially for those attempting it for the first time. Make sure you are adequately hydrated during the run, and you consume some carbohydrates during the run to replenish your glycogen stores of energy.
A sample training plan for the next two weeks could be as follows. This is just a suggestion, and you are free to follow the plan that best suits you- but make sure you DO have a plan. Below is a sample schedule for the next 2 weeks.

M T W T F S SUN

R 5 12 X R 6 32

R 5 12 X R 6 22

Distance in Kilometers, R-Rest, X=Cross Train eg. Cycling, swimming. Cross-training can be replaced by a day of rest or stretching/strengthening.

THE TAPER STARTS:

The last 3 weeks, leading up to the marathon is the ‘taper period’ where mileage is greatly reduced. Many runners like to train up to race day and feel insecure about cutting back on the mileage, but that leads to a drop in peak performance on race day.
Research shows that levels of muscle glycogen, enzymes, antioxidants, and hormones--all depleted by high mileage--return to optimal ranges during a taper. The muscle damage that occurs during sustained training is also repaired. Also, performance is actually improved in athletes who taper versus those who don’t. All the hard work has now been done, and this is the time to conserve your energy and recover from any injury, such that your best performance is on race day !

Half Marathon:

A sample training plan for the next two weeks could be as follows. This is just a suggestion, and you are free to follow the plan that best suits you. Please note that this is a plan for those running the half marathon for the FIRST TIME. If you have run it several times before, it might be a good idea to throw in some speed work for the next couple of weeks, to try and improve your race time. Include a tempo run or interval training in one of your mid-week runs. A tempo run is a 30-40 minute run, during which you run at a faster pace than normal, and push yourself out of your normal ‘comfort zone’ of running. In interval training, you run intervals of 400 or 800 meters at close to all-out pace, and in between each interval you either walk or jog slowly for 400 m to recover. Start with 3-4 intervals.Below is a sample schedule for the next 2 weeks.


M T W T F S S
R 7 5 X R 5 16

R 7 5 X R 5 18

Distance in Kilometers, R-Rest, X - Cross Training, eg cycling, swimming


Dream Run:

Those participating in the Dream Run, should have already started their training by now, especially if it’s their first attempt. It’s always nice to ‘run’ the distance, rather than walk it, unless there is an injury or any other condition, in which running is not recommended. Below is a sample schedule for the next couple of weeks. There is a lot of variation in the ability of those participating in the dream run, since some are accomplished runners looking to better their time, while others just want to walk and complete the distance. During training, you need to adjust your run / walk breaks based on your ability.

M T W T F S SUN

R 2 4 X R 5 45 min run/walk

R 2 4 X R 5 45 min run/walk


Distance in Kilometers, R-Rest, X Train- Cross Training, eg cycling, swimming

HYDRATION:

Adequate hydration is extremely important for optimal sports performance. High temperatures and humidity increase, the risk of dehydration, especially when exercising outdoors.

What is dehydration?
Dehydration is the lack of adequate body fluids for the body to carry on normal functions at an optimal level. This lack could be due to fluid loss, inadequate intake, or a combination of both. Fluid losses up to 5% are considered mild; up to 10% are considered moderate; and up to 15% are considered severe. Severe dehydration can result in cardiovascular collapse and death if not treated quickly.



Prevention.

The environmental conditions that lead to dehydration and heat illness are out of your control, but there are many things that you can do to help prevent getting sick.

1) Adequate nutrition before an event.
Consume a nutritionally balanced diet and drink adequate fluids during the 24-h period before an event, especially during the period that includes the meal prior to exercise, to promote proper hydration before exercise or competition.

2) 200-500 ml fluid before exercise
It is recommended that you drink about 200-500 ml of fluid about 2 h before exercise to promote adequate hydration and allow time for excretion of excess ingested water.

3) Fluids during exercise
During exercise, athletes should start drinking early and at regular intervals in an attempt to consume fluids at a rate sufficient to replace all the water lost through sweating (i.e., body weight loss). A good rule of thumb is to consume about 150-250 ml of fluid for every 15 minutes of exercise. In the recent past there have been many reported cases of hyponatremia (low salt in the blood) due to over-hydration. Therefore, it is better to tailor fluid replacement according to your sweat rate.

CALCULATE YOUR SWEAT RATE:

To find out how much fluid you lose, the best method is to weigh yourself before and after a run, lasting an hour (weigh yourself at home, with no clothes on). The amount of weight lost, in grams, is the amount of fluid you lose in an hour of running, and that is the amount you need to replenish. For example, if you lost 900 grams of weight, that’s equivalent to 900 ml of fluid (assuming you did not ingest anything during the run). Once you know your hourly sweat rate, you can divide that amount by four and consume that much fluid, every 15 minutes. It is recommended that ingested fluids be cooler than ambient temperature.
4) Add sugar and salt for long exercise
Addition of proper amounts of carbohydrates (sugars) and/or electrolytes (salt) to a fluid replacement solution is recommended for exercise events of duration greater than 1 hour. During exercise lasting less than 1 hour, there is little evidence of physiological or physical performance differences between consuming a carbohydrate-electrolyte drink and plain water.

Choice of fluid

For exercise lasting less than 1 hour, water alone is adequate. During intense exercise lasting longer than 1 h, it is recommended that carbohydrates be ingested at a rate of 30-60 grams per hour to maintain oxidation of carbohydrates and delay fatigue. This rate of carbohydrate intake can be achieved without compromising fluid delivery by drinking 600-1200 ml per hour of solutions containing 4%-8% carbohydrates.
Inclusion of sodium (a pinch of common salt) in the rehydration solution ingested during exercise lasting longer than 1 hour is recommended since it may be advantageous in enhancing palatability, promoting fluid retention, and possibly preventing hyponatremia (low salt) in certain individuals who drink excessive quantities of fluid.
On race day, for the half and full marathon, there will be energy drinks available which contain the precise amount of carbohydrate and electrolyte replacement needed.
Run safe and strong !

Dr. Aashish Contractor
Medical Director, Standard Chartered Mumbai Marathon.
Head of Dept: Preventive Cardiology and Rehabilitation
Asian Heart Institute, Mumbai

Welcome Note

I have finally made my foray into the world of blogging, rather late in the day, I must add. As the title suggests, I intend to blog on health subjects, with an emphasis on cardiac health and exercise. I will be putting up my own articles, as well as links to the latest research around the world on the subject. Oftentimes, the research can be confusing, or worse still, have a bias towards promoting a commercial product.
Through the blog, I hope to distill this information and leave the reader with a simple 'take-home' message.
Happy reading, and please do send me your feedback.
Dr. Aashish Contractor.