Living life to the fullest


living-life-to-the-fullest
Chan, an avid mountaineer and myelofibrosis patient, with a photo of himself (in red jacket) and fellow climbers at the summit of Mount Kinabalu. Photo: UU BAN/The Star >>

Despite having a rare blood disorder, Tan Sri Chan Choong Tak not only continued his active lifestyle , but also took up mountain-climbing.

FORMER Dewan Negara president Tan Sri Chan Choong Tak’s motto in life is to live it to the fullest.

Not surprising then that among his many accomplishments are two Malaysian Book of Records titles as the oldest Malaysian to reach the top of Mount Kilimanjaro’s Uhuru Peak (on Aug 31, 2003, at the age of 70) and the oldest Malaysian to reach the top of Mount Kinabalu’s King George Peak (on Aug 29, 2004, at the age of 71).

Uhuru Peak is the highest point on Mount Kilimanjaro, which is the tallest freestanding mountain in the world (from sea level) and the tallest mountain in Africa, while King George Peak is located on the more challenging and lessclimbed Eastern Plateau of Mount Kinabalu, Sabah.

What makes these two records more significant – aside from the impressive fact that Chan only took up mountain-climbing in his sixties – is that he was suffering from a rare bone marrow disorder at the same time.

His condition, primary myelofibrosis, is one of a group of diseases called myeloproliferative neoplasms, which are caused by abnormal production of blood cells in the bone marrow.

In the case of myelofibrosis, the problem lies in the abnormally-increased production of megakaryocytes, which are the cells that directly give rise to platelets. This results in an initial increased number of platelets in the body.

Cytokines – protein growth factors that are produced by megakaryocytes – are also correspondingly increased.

And as these cytokines are what stimulate the bone marrow’s fibroblasts to produce collagen, this results in an excessive amount of collagen being made.

The collagen deposits in the bone marrow as webs of fibre – similar to scar tissue on the skin – resulting in the disease’s characteristic fibrosis of the bone marrow.

With the collagen taking up so much space in the bone marrow, regular blood cell production is disrupted.

Red blood cells (RBCs) are usually decreased in number and abnormally formed, resulting in anaemia, while white blood cells (WBCs) are abnormal and immature, resulting in increased infection rates.

With production of blood cells in the bone marrow disrupted, the spleen, which is the body’s secondary supplier of blood cells, steps up to meet the body’s needs.

This extra work usually causes the spleen to enlarge (splenomegaly), resulting in pain or a feeling of fullness below the left rib.

Occurring commonly in those above 50 years of age, myelofibrosis is caused by a spontaneous genetic mutation (i.e. not inherited) in the affected person’s blood stem cells. This is what causes the uncontrolled production of megakaryocytes.

The cause of the mutation itself in primary myelofibrosis is, as yet, unknown.

Accidental discovery

As the symptoms of myelofibrosis, like fatigue, shortness of breath, pallor, frequent infections and easy bruising, are quite vague, diagnosis can be quite difficult.

In Chan’s case, he did not notice any signs or symptoms of myelofibrosis prior to his diagnosis.

In fact, it was a combination of a road accident and his wife, Puan Sri Cecelia Chia’s sharp eyes that alerted them to the possibility of a problem.

He shares: “My son gave me a racing bike for my 60th birthday – that was 21 years ago. So, I used to cycle around. Then, I met with a road accident.”

Chan was cycling along the narrow, winding roads of his hillside residential area in Seremban, Negeri Sembilan, when he suddenly met an oncoming car.

With no space to avoid the car, he braked hard and was thrown to the ground in a head-first fall.

“My helmet broke and I thought I would be paralysed. My friend, who is a doctor, straightaway rang up the hospital and they sent the ambulance,” he says.

Fortunately, Chan suffered no major injuries from the accident.

However, his cardiologist son insisted that he be checked more thoroughly for brain injuries, which resulted in him seeing a neurologist.

While his brain turned out to be fine, his wife noticed that his platelet count from the blood test were quite high – between 600,000 to 700,000 platelets per cubic millimetre, when the upper limit for normal is 400,000.

His son then sent him to consultant haematologist Dr Ng Soo Chin, who prescribed hydroxyurea to bring down his platelet count.

That seemed to work quite well for Chan, and it was, in fact, shortly after this that he began mountain-climbing with a group of fellow MBA (Masters of Business Administration) alumni from Tenaga Nasional Bhd.

Chan was then a director of the company, and had gone to Ohio University, United States, to study his MBA along with other Tenaga Nasional executives.

“So, as I climbed, I continued to take hydroxyurea and everything was normal.

“But Soo Chin said, hydroxyurea will eventually bring down your red corpuscles (another term for RBCs), and recommended anagrelide,” he says. Anagrelide is a platelet-reducing agent.

Accelerating disease

Chan continued happily with the two medications, until the year 2011, 18 years after his initial diagnosis.

By then, he was seeing consultant haematologist Datuk Dr Chang Kian Meng at Hospital Ampang, Selangor, as Dr Ng had advised him to continue his follow-ups at a public hospital as his medications are quite expensive.

Chan shares that Dr Chang started him on epoetin alfa and pegylated interferon that year as his blood cell levels were fluctuating.

While interferon decreases the production of blood cells in general, epoetin alfa stimulates the production of RBCs to counteract the effects of anaemia.

However, his haemoglobin levels dropped even further, and he started requiring blood transfusions about once every two months.

The transfusions made a big difference as he reports feeling “very energetic” after receiving the first one. (Fatigue is a common symptom of anaemia.)

The following year, it was the WBCs turn to go “completely haywire”, when a blood test revealed that they had dramatically increased to about 56 from the regular range of about 4 to 10.

He also started experiencing profuse night sweats and cramps, along with the occasional itchiness that had started in his seventies – all of which are among the symptoms of myelofibrosis.

“Then, both Dr Chang and Soo Chin agreed that I had entered into myelofibrosis in acceleration,” he says.

The only cure for myelofibrosis is a bone marrow transplant, but aside from the difficulty of finding a suitable donor and the riskiness of the procedure, Chan’s age rendered him unsuitable for such a treatment.

Fortunately for him, a new drug had recently been approved by both the European Commission and the United States Food and Drug Administration for use in myelofibrosis at that time.


A new drug

The drug, ruxolitinib, inhibits certain enzymes in the JAK pathway, which regulates blood cell production. Half of primary myelofibrosis cases are caused by mutations in the JAK genes, which results in the dysfunctional production of blood cells in the bone marrow.

However, the drug was not available in Malaysia then. (It was only launched in the Malaysian market in 2013.)

This is where his political connections as a Gerakan life member and former secretary-general came in useful.

Then Minister in the Prime Minister’s Department and Gerakan president Tan Sri Dr Koh Tsu Koon offered to help pass on the letter Chan had written to the Health Ministry requesting approval to use the drug on compassionate grounds, to the Health secretary-general.

Four days later, Chan received the approval he needed, and received his first dose of ruxolitinib in October 2012.

Since then, after some adjustments in dosage, Chan’s blood cells are back in the normal range and his last transfusion was in December 2013.

He is currently doing well enough for his doctor to lower his dosage of ruxolitinib, while still taking epoetin alfa and interferon.

Life goes on as normal for this active 81-year-old, who still climbs hills, reads newspapers of various languages and blogs daily, works out in the gym and does regular morning calisthenics.

Of his condition, Chan shares that he never felt the need to know about the disease, being only interested in his blood test results.

“I didn’t know what myelofibrosis was all about until I was asked to do this interview. That was the first time I went into Google to see what was myelofibrosis,” he says with a laugh.

“But I knew it was a dangerous disease, but I wasn’t bothered. I continued to carry on with my normal life.”

He adds: “I’m not bothered with what happens because I have full trust in my doctors.

By Tan shiow China The Star/ANN

Related:

101 Ways To Live Your Life To The Fullest personalexcellence.co/blog/101-ways-to-live-your-life-to-the-fullest/  – If your answer to any of the above is a no, maybe or not sure, that means you’re not living your life to the fullest.

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Keeping a pledge to fitness resolutions for a new year new beginning 2014


New Year 2014 FitTwo heads are always better than one, so grab a friend to exercise with. The support and motivation will go a long way towards achieving results. – AFP
A new year signals a new beginning, but are fitness resolutions necessary when most people can’t sustain them?

RESOLUTIONS are never easy to keep, especially fitness ones.

Every year-end, I hear these mantras from at least a dozen people: lose weight, get toned, enrol in yoga, run faster, muscle up, eat less…

It’s like a pledging ritual, but without proper planning and implementation. Only one, at most two, will doggedly stick to the resolve. Hats off to them.

Most people gear up to hit the gym come Jan 1, follow through for the first couple of months, hit a roadblock (most likely from laziness, muscle soreness or injuries), and eventually, slide off the commitment ladder. This is also the period when gyms, as well as wellness and slimming centres, offer huge promotions to entice new clients.

Don’t be fooled or gullible enough to fall into this trap unless you know you have the perseverance to succeed.

Resolutions seem possible at the start of the year, but become impossible as the days and months whiz past. Or, you’ve set unrealistic expectations. Habits and behaviours require time to change, so don’t be too tough on yourself.

One of my Pilates students has told me countless times that his intention is to lose his belly fat. He’ll point to a macho guy at the gym and say, “I want to look like that.”

Not wanting to engage in a lengthy discussion about body types, every year, I’ll advise him on a workout regime he can adhere to. He’ll pump iron, run on the treadmill, and attend classes diligently the first few weeks.

Then poof!, he disappears, citing work, travel, weather and family issues. By year-end, he’ll reappear, pinch his spare tyre and exclaim, “Look at this!”

I’ll look and smile knowingly. This scenario has continued for the past five years. Buddy, I can’t help you if you don’t help yourself.

So this year, why not do something different before embarking on your fitness goals?

First, sit on the couch and get your cravings out of the way. Yeah, that’s right. Allow yourself to binge to your heart’s desire to usher in the New Year. Put your feet up, snack on your favourite food – junk included, and sip your preferred drink, while watching the telly.

It’ll feel good for a while, but pretty soon, you’ll be sick of the over-indulgence and yearn for a more meaningful activity.

When you have mental clarity, focus on a fitness programme that is attainable. Ditch the impossible resolutions (e.g. losing 20 kilos in six months), but take your health and self-improvement goals one baby step at a time.

Unlike food, the endorphins released during exercise leave you feeling high for a longer time. Not only does it boost your mood, it also helps you get in shape.

Have you heard of anyone feeling depressed after a round of exercise? Fatigued, yes, but they’re rarely down in the dumps.

Physical activity doesn’t have to be complicated, so here are some tips for a healthy start:

Always warm up before starting a physical activity

Warming up is essential to prepare the body for energetic activity and reduce the risk of injury. The purpose is to ease both the mind and body from a state of rest into a state of strenuous activity.

A warm-up routine should consist of a 10-minute cardio workout, such as skipping or brisk walking, and five to 10 minutes of gentle loosening exercises, which produces a light sweat (for example, rotation of the ankle, wrists, shoulders and hips).

Increasing the core and muscle temperatures helps to make muscles loose and supple. Besides increasing the heart rate and boosting blood flow, warm-ups supply oxygen to the muscles and prepare the body for action.

Walk, walk and walk

If you have limited finances or lack time to join the gym, go brisk walking, weather permitting. Avoid taking lifts, but walk up the stairs, walk to the shops, walk around the park or walk to your colleague’s cubicle instead of phoning or sending her/him an Intranet message.

Walking has multiple benefits, including helping against heart disease, high blood pressure and type 2 diabetes.

Work out with a friend

Two heads are always better than one, so grab a friend to exercise with. The support and motivation will go a long way towards achieving results. And with the crime rate these days, it’s better to have a companion, especially if you’re doing an outdoor workout.

Commit to early morning exercise

Everyone needs an extra minute of sleep, but if you can rise early and squeeze in at least 30 minutes for exercise, you’ll be more likely to keep to your regime.

Plus, once you get the exercise bit out of the way, you’ll also have plenty of energy left for the rest of the day.

Combine cardio and strength training

Instead of allocating separate days for cardio and strength training, combine both. Do a two-minute cardio routine and add two strength moves (e.g. crunches and push-ups). Repeat the cardio and add two more strength moves (e.g. squats and tricep dips).

Not only does it help with muscle retention, but it also promotes a faster metabolic rate and enhances lipolysis, speeding up the rate of fat loss.

Cool down and stretch

Cooling down is equally as important as warming up, though many people fail to realise this and jump into the next activity immediately.

Cooling down restores the body to a pre-exercise state in a controlled manner, helps the body repair itself, and can lessen muscle soreness the following day. Gentle walking for five to 10 minutes is good to recover the heart’s resting rate. After that, perform some static stretches by holding the stretch for at least 20 seconds.

Eat healthy

Try to eat healthy (cut out the fried stuff) and load up on fruits and veggies, but don’t skip your favourite desserts, no matter how sinful they are. Instead, have a mini serving to satiate your taste buds.

Research reveals that skipping dessert can backfire and leave you wanting more. In a 2010 study published in the journal Obesity, dieters who were restricted from eating a small dessert were more likely to be left “wanting” than those who had a bite of sweets. Eliminating your favourite foods can be a recipe for disaster and may create an obsession.

Personally, I can’t keep to resolutions. As I get older (translation: injuries that take longer to heal), I occasionally cut myself some slack and allow my body a break to recharge for a week. But, that doesn’t mean I do nothing. I still stretch in bed, do breathing exercises, or take long strolls and get to know the neighbourhood dogs.

After all, you’re not participating in a sprint to get fit. Rather, we’re all runners in this slow, steady marathon for better health. There are no winners or losers, just healthier, trimmer individuals and less medical expenses.

On that note, here’s wishing readers a happy new and fit year ahead!

Contributed yy Revathi Murugappan

The writer is a certified fitness trainer who tries to battle gravity and continues to dance, but longs for some bulk and flesh in the right places. She hopes to do one final dance in 2014 before gracefully bowing out from stage to make way for the next generation.

Exercise can affect your DNA


DNA_ExcerciseExercise doesn’t only improve your appearance, it can alter your genes, cutting your risks of obesity and diabetes, a new Swedish study finds.Healthy_Body_Healthy_Mind

While inherited DNA cannot be altered, the way that genes express themselves can through exercise, diet, and lifestyle, researchers from Lund University Diabetes Center explained, noting that a workout can positively affect the way cells interact with fat stored in the body.

Lead author Charlotte Ling, associate professor, and her team looked at the DNA of 23 slightly overweight but healthy men aged around 35. The men previously didn’t exercise but attended indoor cycling and aerobics classes for six months. “They were supposed to attend three sessions a week, but they went an average 1.8 times,” says associate researcher Tina Rönn.

Using technology that analyses 480,000 positions throughout the genome, they could see that epigenetic changes had taken place in 7,000 genes (an individual has 20,000 to 25,000 genes). A closer look revealed genes linked to diabetes and obesity, also connected to storing fat, had also been altered.

“We found changes in those genes too, which suggests that altered DNA methylation as a result of physical activity could be one of the mechanisms of how these genes affect the risk of disease,” said Rönn.

“This has never before been studied in fat cells. We now have a map of the DNA methylome in fat,” Lind added.

The findings, announced this week, appear online in the journal PLOS Genetics.

A separate study published this March in the journal Cell Metabolism shows that when people exercise for as little as 20 minutes, it can alter their DNA almost immediately. – AFP Relaxnews

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Malaysia needs re-engineering sports, not computer games, junk foods….


Re-engineering sports in schools

KHAIRY Jamaluddin, our Youth and Sports Minister, wants to transform our country into a sporting nation – he has a daunting task to achieve with many challenges along the path of success.

Golf_schoolFirst and foremost, how much time is allocated to physical education in schools? With more children reportedly facing obesity, we wouldn’t even get to the starting block.

Also, our children are too engrossed with computer games and our fields are being hijacked for commercial development, making our children lazier. Let’s not forget too the unhealthy fast food eating culture.

Physical education classes are irregular in schools and disorganised. PE teachers lack the knowledge in sports science or health science.

Most teachers lack the capability to assess a potential athlete as they cannot even explain the percentage of fast and slow twitch muscle fibres and other aspects related to athletic performance such as physiology, physical ability, technical proficiency and psychological predisposition to performance.

Based on feedback, students are just given a ball to kick around without being given much guidance on ball skills. In many cases, students just laze around the field without proper attire.

The main focus of schools, teachers and parents seems to be for students to score the maximum number of “A’s” in the exams, with sports ranking low in priority among the stakeholders.

ATCO PSA World Series Squash FinalsThe million-dollar question now is how are we going to create a sports culture in schools and sell the idea to parents that sports offers great career progression?

Parents have seen that sports does not pay in the long run, except in a few cases like Datuk Nicol David (squash), Datuk Lee Chong Wei (badminton) and Pandelela Rinong (diving) who are positive role models.

There must be a firm commitment from the Government to prioritise school sports, facilities and space for competitive sports and play.

Khairy, our No.1 sports fan must work closely with the relevant stakeholders to promote a strong sports culture among our youths.

C. SATHASIVAM SITHERAVELLU Seremban

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Exercise for the brain


The therapeutic properties of exercise is well supported by a substantial amount of research.

Recent studies reported that an increase in the time dedicated to physical health-based activities is not associated with a decline in academic performance.Recent studies reported that an increase in the time dedicated to physical health-based activities is not associated with a decline in academic performance.

THE benefits of exercise are well publicised. Exercise is associated with a reduction in physical illnesses such as cardiovascular disease, colon and breast cancer, obesity and mental illness (including depression and anxiety disorders) across the adult lifespan.

The National Health and Morbidity Survey 2011 revealed that about 64.3% of Malaysians were physically active. The level of physical activity gradually decreased with increasing age, and this was particularly apparent in senior citizens.

Despite evidence of the importance of exercise, the prevalence of overweight and obese Malaysians was 29.4% and 15.1% respectively based on the World Health Organization (1998) classification.

Although some are aware of the benefits of exercise, there are many who are unaware that exercise has considerable benefits for the brain. This is put aptly by John Ratey, author of A User’s Guide to the Brain.

“Exercise is really for the brain, not the body. It affects mood, vitality, alertness and feelings of well-being.”

There is increasing evidence that exercise can improve learning and memory, delay age-related cognitive decline, reduce risk of neurodegeneration and alleviate depression.

Exercise and brain function

Exercise improves brain function in different ways. It enhances learning and plasticity, is neuroprotective, and is therapeutic and protective against depression

Exercise enhances learning and plasticity, which is the capacity of the brain and nervous system to continuously alter neural pathways and synapses in response to experience or injury.

Although some are aware of the benefits of exercise, there are many who are unaware that exercise has considerable benefits for the brain.

Although some are aware of the benefits of exercise, there are many who are unaware that exercise has considerable benefits for the brain.

The effects of exercise have been demonstrated in ageing human populations in which sustained exercise has augmented learning and memory, improved executive functions, impeded age-related and disease-related mental decline, and protected against age-related atrophy in parts of the brain areas that are vital for higher cognitive processes.

Physical activity has a positive effect on cognition, which includes every mental process that may be described as an experience of knowing (including perceiving, recognising, conceiving, and reasoning).

There is a significant relationship between physical activity and improved cognition in normal adults as well as those with early signs of Alzheimer’s disease (AD), in which there is mild impairment of memory or cognition.

There is a dose-response relationship between exercise and health-related quality of life, with moderate exercise associated with the best outcomes.

The literature on the effects of exercise on cognition during children’s development is less substantial. However, a meta-analysis by Sibley & Etnier reported a positive correlation between physical activity and cognitive performance in children aged between four and 18 years in eight categories, i.e. perceptual skills, intelligence quotient, achievement, verbal tests, mathematic tests, memory, developmental level/academic readiness and others.

A beneficial relationship was found for all categories, with the exception of memory, which was unrelated to physical activity behaviour, and for all age groups, although it was stronger for children in the ages of four to seven and 11 to 13 years, compared with the ages of eight to 10 and 14 to 18 years.

Recent studies have reported that an increase in the time dedicated to physical health-based activities is not associated with a decline in academic performance.

The literature on the impact of exercise on cognition in young adults is limited, probably because cognition peaks during young adulthood and there is little room for exercise-related improvement at this stage of the lifespan.

Although there is considerable evidence that exercise can facilitate learning in humans and other animals, there are gaps in knowledge regarding the types of learning that are improved with exercise.

Therapeutic exercise programmes after a stroke accelerates functional rehabilitation. Therapeutic exercise programmes after a stroke accelerates functional rehabilitation.

Exercise protects the brain (neuroprotective). It reduces the impact of brain injury and delays the onset and decline in several neurodegenerative diseases. For example, therapeutic exercise programmes after a stroke accelerates functional rehabilitation.

Furthermore, physical activity delays the onset and reduces the risk for AD, Huntington’s disease and Parkinson’s disease, and can even slow functional decline after neurodegeneration has begun.

There is evidence that exercise is therapeutic and protective in depression, which is associated with a decline in cognition.

Depression is considered to be a health burden that is greater than that of ischaemic heart disease, cerebrovascular disease or tuberculosis.

Clinical trials have reported the efficacy of aerobic or resistance training exercise in the treatment of depression in young and older patients, with benefits similar to that of antidepressant medicines. More exercise leads to greater improvements.

Trials have also reported improvement in depressive symptoms in AD compared to those non-exercising individuals whose depressive symptoms worsened.

Bipolar disorders do not appear to respond as well to exercise, but those with anxiety respond even faster.

There is a convergence of the concept that brain health and cognition are influenced by the interplay of various central and peripheral factors. Brain function is believed to be impaired by peripheral risk factors that lead to cognitive decline, including hypertension, hyperglycemia, insulin insensitivity and dyslipidemia, features that are commonly known as the “metabolic syndrome”.

Of these factors, hypertension and glucose intolerance play crucial roles. Exercise not only reduces all these peripheral risk factors but also improves cardiovascular health, lipid–cholesterol balance, energy metabolism, glucose use, insulin sensitivity and inflammation.

As such, exercise improves brain health and function by directly enhancing brain health and cognitive function, and indirectly, by reducing the peripheral risk factors for cognitive decline.

It is believed that exercise initiates an interactive cascade of growth factor signals which lead to the stimulation of plasticity, improvement of cognitive function, reduction of the mechanisms that drive depression, stimulation of neurogenesis and improvement of cerebrovascular perfusion.

Although much is known about the effects of exercise and physical activity on brain and cognition, there are many important questions that are unanswered.

They include questions like the design of exercise interventions which optimise the effects on cognition and brain health; when it is best to begin; what are the best varieties, intensities, frequencies and duration of exercise; is it ever too late to start an exercise programme; and can exercise be used to reduce the effects of neurodegenerative diseases.

Knowing the how

Exercise affects many sites in the nervous system and stimulates the secretion of chemicals like serotonin and dopamine, which make humans feel calm, happy, and euphoric. You do not have to wait for these feelings to occur – you can initiate them by exercising.

There is no shortage of advice on the various physical exercises that enhances cardiovascular health. Prior to embarking on exercise, a consultation with the doctor would be helpful, especially for senior citizens. This will help in choosing the appropriate exercise for one’s individual situation.

In general, what is good for the heart is also good for the brain.

The usual recommended minimum is half an hour of moderate exercise thrice a week. This can be walking, jogging, swimming, playing games, dancing etc.

The public is often reminded about a healthy lifestyle, which is focused on physical health. However, it is also important to exercise mentally and keep the brain healthy.

There are publications and activities available that can help you make a start and continue to improve cognition, memory, creativity and other brain functions.

Anyone at any age can do so, even senior citizens. It is moot to remember the adage: if you don’t use it, you lose it.

Malaysia Festival of the Mind 2013

The ninth Malaysia Festival of the Mind will be held from June 15-16, 2013, at Universiti Tunku Abdul Rahman (UTAR) Perak Campus in Kampar, and June 22-23 at Tunku Abdul Rahman University College (TARC) Main Campus in Setapak, Kuala Lumpur.

It is open to the public from 9.30am – 4.30pm. Talks, workshops, exhibitions and competitions will be held to create awareness about the human mind and its unlimited potential; as well as ways of tapping into and developing one’s brainpower to the fullest.

For further information, visit www.utar.edu.my/mmlm or email mmlm@utar.edu.my or call (03) 7625 0328 (Justin/Sin Yee) or (05) 468 8888 (Wei See/Jamaliah).

By Dr MILTON LUM

> Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Measuring your Heart Rate for fitness


Why do you need to know your heart rate? What heart rate zone will give you the absolute BEST results for fat burning from your cardio?

I was recently inspired to write this article on heart rates in relation to fitness due to the numerous questions I have received lately about it, and the importance of knowing what it is, and why. Even though the heart rate is a huge element to achieving an optimal workout, and its been around forever, many individuals do not know what theirs is, or how to measure it, or even to care about it. So I am going to clarify this simple yet important component to fitness.

Resting, Exercise and Maximum
Heart Rates
 
There are three HR to consider when training to get fit, or as it relates to cardiovascular fitness, as well as your Target Zone.

The first is the Resting HR. This is your HR when you are not engaging in any physical activity that elevates it, or when you are in a resting state such as sleep. As you become more fit, this number will decrease because your heart and lungs have become stronger. The heart is then able to pump more blood, which is called stroke volume, throughout the body with less effort. The lungs are able to pull in more oxygen, which is called maximum oxygen uptake, with less effort, which means more blood and oxygen to the working muscles makes up the endurance portion of being fit. Having enough oxygen going into the blood keeps the lactic acid out-thus you can sustain a prolonged aerobic workout.

A normal Resting HR can vary as low as 40 BPM to as high as 100 BPM. 70 BPM is usually the average for a man, and 75 BPM is average for a woman. The Resting HR should be used as an index to improve your cardiovascular fitness level, with a focus on decreasing it. The best time to measure your Resting HR is when you first arise from sleep in the morning. The palpation (beats) of the Radial Pulse is accurately measured in your wrist in line with the base of your thumb. Place the tips of your index and middle fingers over the Radial Artery and apply a light pressure to it. DO NOT USE YOUR THUMB. It has a pulse of it’s own. You may count the beats for one full minute to get the HR, or for 30 seconds and multiply by 2 for the number of BPM.

The Second is the Exercise HR. This is the rate at which your body is in motion from a sustained exercise, and the rate increases. Of course you measure it during exercise. The goal here is to stay within your Target HR Range or Zone, which is normally between 75% to 85% of your Maximum HR which is the third. Maximum HR is the rate at which your heart beats at 100% Max. during a sustained aerobic activity. You never want to work at 100% of your Max. HR unless a professional has you on a specific program designed for that, and your fitness level can sustain it. 100% of Max. will cause you to cross over into an Anaerobic Threshold. These numbers can vary depending on your age and fitness level.

The Exercise Pulse is most accurately palpated at the larger Carotid Artery on the side of the neck. It is usually located beside the larynx. Place your index and middle fingers alongside the base of your ear lobe and slide it down to the side of your throat and apply a light pressure. DO NOT apply a heavy pressure to the Carotid Artery when measuring your Exercise HR. These arteries contain Baroreceptors that sense increases in pressure and will respond by slowing down your HR. You will feel this pulse easily during a workout, so heavy pressure is not needed to locate it. The Exercise HR should be taken for 10 seconds, always counting the first beat as “0,” then multiply by 6. This number is your Exercise HR. Which brings me to the point of all of this information.


For Determining Your Max Heart Rate 

To determine your Maximum HR, use the calculators below. The simple formula: Take 220 and minus your age which is accurate to approximately +15 BPM. You then take that number and multiply it by .75 – .85, which will give you your percentages of 75% — 85% of your Max. HR. This is the Target Range or Zone that you want to stay in when doing any type of cardiovascular (aerobic) activity. When in this range your body is getting an optimum workout with maximum benefit, and it stays in a Fat Burning mode.
There are two different ways to calculate your maximum heart rate and your target heart rates. The method I just explained is the simple method.
Simple Target Heart Rate Calculator
Using the 220 – Age formula.

HEART RATE CALCULATOR
Enter Your Age
Results
Max Heart Rate
75-85% Max Heart Rate
THR 15 sec count

 

The Karvonnen formula is more advanced since it also takes into account your resting heart rate. This is your heart rate at complete rest. To determine this, take your pulse for 60 seconds just before you get out of bed… or take it for 30 seconds and multiply by 2.
Advanced Target Heart Rate Calculator
Using the Karvonen Formula.

  • For your age, use a whole year. (Between 0 and 100)
  • Put your Resting Heart Rate in the next box. (Between 30 and 100)
  • In the % box, use a number between 50 and 85. Do not include the %.
  • Click on the Calculate button, and it will calculate your target heart rate or that percentage.
Your Age in Years
Resting Heart Rate
% of Maximum Effort
Your Target Heart Rate
%

When you start to work over these percentages, not unless you are in great shape and can push yourself into a higher range, then you have gone into an Anaerobic Threshold. Which means that you are pushing yourself way too hard, and no healthy benefits are being obtained. You are defeating your purpose. If you push yourself into an Anaerobic Threshold your body can no longer meet its demand for oxygen. You will start to feel exhausted, your HR increases above the Max. (which is 100%), you will stop the fat burning process, and you will start to hyperventilate due to the excessive amounts of lactic acid in your body. In other words, you are not pulling in enough clean oxygen through the lungs to clean it out of the blood. Your heart can no longer pump enough blood to your working muscles to sustain your activity, and you are overloading yourself. You prevent this from happening by staying in your Target HR Range. As you become more fit, you can push yourself into a higher range without going over into the Anaerobic Threshold. The purpose of this article is to give you insight to perceive that, and always know where you are in your range or zone when working out.

AN FYI Remember that Aerobic means “with oxygen,” and Anaerobic means “without oxygen.” Aerobic exercise is training at a certain level of intensity for a sustained period of time, usually 20 minutes to 1 hour as on a stair-climber, treadmill, or in an aerobics class. You need oxygen rich blood to maintain this.

Anaerobic exercise is training at a level of intensity that does not require a sustained period of time, usually 30 seconds to 1 minute. Such as weight training, strength circuit, circuit and interval training sessions when sets/reps are involved. Because the time period is shorter and faster in cases of intervals and circuits, you use all of the oxygen rich blood more quickly to complete your sets/reps before lactic acid causes you to stop the exercise. That’s what “The Burn” means. Then you take a break so the blood can be cleaned of lactic acid and you catch your breath before your next set.

One more element to consider is the Rating of Perceived Exertion Scale. This scale provides a standard means for evaluating your perception of your exercise intensity. You can use this scale on a 1 – 10 basis with 1 being “very very easy,” and 10 being “very very hard.” If you’re like me, I don’t like to stop during my aerobic exercise sessions to measure my HR, so I use this scale to measure where I am in my Target Range. I know how I feel at 75% — 95% of my Maximum HR, so I can either increase or decrease my intensity before I cross over into an Anaerobic Threshold, and maintain my work out and Fat Burning process. If you are going to use this scale, make sure that you too know how you feel at 75% — 85% of your Max. HR so that your perception is accurate on this scale.

Working out in the Target Zone helps me get lean!
(Editor’s Note: This pic gets MY heart going.)

Knowing this simple information will help you greatly in evaluating your progress when training to get fit, or when training to compete. You can develop your training sessions and know what you need to change or add in your program by being in tune to your Heart Rate. Always be aware that you are in THE ZONE!

Train for Success!!!

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Rightways for Heart Health

Rightways for Heart Health


Work to stretch and strengthen your body for 30 minutes, and you will pump up your heart

Heart_running_healthy_man_woman
Run For Heart Health!
Heart_health_Women

Unless you live on another planet or under a rock, you probably know by now how important exercise is to overall fitness and heart health.

It is a message that is hard to escape these days. There is plenty of research to suggest that exercise can reduce the risk of heart disease, stroke and some cancers.

It can also help lower high blood pressure and lift your mood. And it has been shown to improve self-esteem and help with weight loss.

Yet despite the many studies backing the role exercise plays in heart health, a lot of adults aren’t listening. Two-thirds of them are considered overweight and one-third fall into the obese category with a body mass index over 30.

For many, getting fit and healthy might seem like an unachievable goal, but experts say you don’t have to spend hours in the gym to see the benefits of exercise.

A minimum of 30 minutes of cardio exercise can do the trick.

“It doesn’t matter what type, as long as you do it,” said Dr. Daniel Clearfield, Cowtown Medical director and a sports medicine and primary-care physician.

“Ideally, you should do it five days a week but even two is beneficial.”

Casual exercising is not going to do the trick, said Dr. Benjamin Levine, director of the Institute of Exercise and Environmental Medicine at UT Southwestern Medical Center and Texas Health Resources.

It has to be something that you are committed to doing on a regular basis.

“Exercise should be part of hygiene, just like brushing your teeth,” said Levine, who is also a professor of medicine and cardiology at UT Southwestern Medical Center.

Running and swimming are excellent. But cycling, walking on a treadmill or working out on an elliptical can also be beneficial.

Even yoga or tai chi can make a difference if the workout is strenuous enough to elevate your heart rate.

Any combination of endurance exercises that get the large muscle groups moving is going to get results.

Whatever exercise you chose, you should be moving enough to produce a sweat. Runners should be moving at a clip that is fast enough to make talking possible but not easy. A Zumba class can get you the same results, if you are moving fast enough.

“Anything that gets your heart rate up, makes you sweat a little and makes you short of breath,” Levine said.

To improve your overall health and keep your ticker pumping effectively, add strength and stretching exercises to a cardio routine one or two days a week. Yoga is great for stretching, and you can build strength with or without the use of weights.

Commit to exercising regularly and your body will respond.

The heart is a muscle, so you want to strengthen it, but you also want to tone the arteries around the heart, just like you would tone your arms, Clearfield said.

“When you work your biceps, you’ll find it easier to lift things,” he said. “It’s the same thing with your heart.”
With regular exercise, the heart starts pumping more efficiently and your stamina improves. That can pay off in big ways.

If someone is sedentary and one day has to run hard to catch a bus, he may end up having a heart attack, Levine says, as an example. “But for someone who is fit, that’s barely a blip,” he said.

Although the younger you start exercising, the better, you are never too old to get into shape. Someone who is really committed to fitness when they are young could have a heart that is as youthful as a 30-year-old later in life.

If you start at 70, you won’t be able to protect against arteriosclerosis but you can protect your heart against sudden death and see the health benefits of regular exercise, such as lower blood pressure, Levine said.

It takes about six weeks to start seeing an improvement in physical fitness, but the payoff continues over a lifetime, Clearfield said.

“Exercise is great at combating obesity and keeping the heart healthy,” he said. “In the long run that can mean more years of life.”

Expert tips on starting a healthy, heart-wise excercise rountine

We asked three fitness pros from the Amon G. Carter Downtown YMCA to demonstrate three ways to kick off a healthy routine that includes cardio, strength and stretching.

Stretching

Yoga is one of the best ways to stretch the body, but a lot of people steer clear of this type of exercise because they are afraid it is just too hard to get into those pretzellike poses.

But you don’t have to be limber like a rubber band to benefit from yoga. Poses can be modified, and most teachers are more than willing to do what it takes to make yoga accessible.

Yoga is all about focusing on your mat and not worrying about how flexible your neighbor is. The best way to enjoy the many heart-healthy benefits of yoga, including stress reduction and lower blood pressure, is to just do it.

“Yoga is how you get flexible,” said Lisa Rodriguez, a trainer and instructor at the Downtown YMCA. “You don’t have to start off flexible to do it.”

Two to try at least twice a week:

1. Downward-facing dog – (Watch your dog stretch for hints on how to do this)

What it does: Strengthens shoulders and back. Stretches hamstrings and calves.

What to remember: Breathe through your nose. Keep your core muscles tight, your spine long and your shoulders down.

Kneel on all fours with your hands providing support and your fingers spread like starfish. Lift your hips so your tailbone is pointed toward the ceiling. Your body should be in an upside-down V shape. Shoulders should be down. Your hands and feet should be your foundation. If your hamstrings are less flexible, you can bend your knees to lift your hips up and back. Listen to your body and only stretch as far as you are comfortable.

2. Side gate

What it does: Increases strength, balance and flexibility. Opens hips.

What to remember: Maintain your alignment so you don’t injure your rotator cuff.

From all fours, turn toward one side, bend one leg and use it for support. Raise the other leg, pushing the heel forward and keeping it flexed. Raise your arm to the ceiling, keeping your hand and shoulder aligned, fingers spread. Hold the position for a few seconds.

Strength

3. Lunge

What it does: Strengthens glutes, thighs and calves

What to remember: Keep your knee behind your toes when bending.

Standing tall, step forward with one leg, bending at the knee. Drop the other leg toward the floor, then slowly return to starting position. Repeat on the other side, working up to 12 reps. If this too easy, try holding light weights in each hand.

4. Pushup

What it does: Strengthens chest, triceps and shoulders.

What to remember: Keep core muscles tight

Start on all fours with your spine in a neutral position and hands spread wide apart. Drop toward the floor, keeping your spine straight. Repeat.

Cardio

5. Running

What it does: Improves endurance, stamina and heart health

What to remember: Start off slowly and gradually build up. You need to walk fast or run about 30 minutes five times a week for heart health.

For fitness, you need to move fast enough to sweat for 30 minutes.

For interval training, alternate between 1 to 2 minutes of running at 85 percent of your maximum heart rate and 2 to 3 minutes at 65 percent of your maximum heart rate. Repeat for up to 30 minutes.

By Jan Jarvis jjarvis@star-telegram.com
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