Every minute about four Indians between the age group of 30 to 40 suffer fatal heart attack. In the recent past many young celebrities of same age group lost their life due to heart attack and most of them exercise very regularly to maintain their physique. What could be the reasons behind…

1. Ethnicity: South Asians four times higher risk of heart diseases and south Asians are prone to high blood pressure, high cholesterol and diabetes.

2. Lifestyle: This mainly includes bad eating habits, especially salty, sugary and fatty food which leads to high cholesterol, high blood pressure, ending up putting undue pressure on the heart. Lack of sleep and physical activity can trigger obesity, stress and diabetes which risks heart disease.

3. Diabetes. India is the diabetes capital of the world. Prevalence of diabetes among young population has increased 10 times and diabetics are three times more vulnerable to heart diseases. Increase in blood sugar in diabetes increases the chances of blood clot and inflammation in the blood vessel walls which leads to heart attack.

4. Tobacco: Tobacco consumption in the form of cigarettes and bidis is a dominant cause of heart attack in young people. High levels of carbon monoxide in cigarettes cuts down the oxygen that blood carries. And when the heart doesn’t get enough oxygen it ends up malfunctioning. Tobacco also affects the blood vessels by causing plaques and fat build up which constricts the arteries, thereby affecting the passage for blood.

5. Alcohol: Alcohol causes the arteries to stiffen faster than they usually do from ageing. Lesser flexible arteries bear more blood pressure which can lead to heart attack. The habit of drinking with smoking worsens the condition.

Answer these six questions to assess your heart:
1. Is your waist size above 39 inches (Male) or 35 inches (Female)?

2. Are you Diabetic?

3. Is your cholesterol level high?

4. Do you suffer from high blood pressure?

5. Do you smoke?

6. Has anyone in your family (Blood relation) had or has heart problem?

If you have answered yes to any of three options above “You are at cardiac risk”. In medical terms it’s called as METABOLIC SYNDROME.

Metabolic syndrome is no different from any coronary heart disease as recommended by the American Heart Association (AHA). More specifically it is referred to a cluster of all CHD risk factors. AHA makes no discrimination in their treatment with Metabolic syndrome and CHD. The risk factors associated with this syndrome act synergically to increase cardiovascular disease morbidity and mortality.

Metabolic syndrome is preventable and reversible through diet and exercise as they have direct as well as indirect impact on reducing all the risk factors of cardiac problems. There are two major objectives for management of this syndrome:

1. Reduce underlying causes of the disorder (obesity and physical inactivity.

2. Treat the associated risk factors.

Exercise and Diet recommendation:
1. Grains: Eat a variety of whole grains (like whole wheat bread, whole grain pasta and brown rice). Limit refined grains (like white rice and white bread)

2. Vegetables: The more veggies and the greater the variety the better. Potatoes and French fries don’t count.

3. Protein: Choose fish, poultry,beans and nuts, limit red meat and cheese, avoid bacon, cold cuts and processed meats.

4. Fruits: Eat plenty of fruits of all colours.

5. Dairy: Move to low fat or fat free milk or yoghurt.

6. Water: About 3-4 litres per day approximately.

Use healthy oil like olive and canola for cooking, on salad and at the table. Limit butter and trans-fat.

Activity pyramid
Is there any exercise dangerous for my heart?
This question arises basically because most of the fit celebrities inspite of their extreme level fitness regime get heart attacks. Is exercise also a reason to get heart attack? The answer is yes if exercise is not done properly.

When exercise becomes a reason for heart attack:

1. Getting started with exercise without proper screening.

2. Overexercise and crash diet.

3. Pushing too much in the name of transformation.

4. Empty stomach work with the goal of burning more calories.

5. Usage of steroids along with exercise to get better and faster results.

6. Following a generalised exercise programme which is not custom designed for you.

7. Following some fancy workout routine which doesn’t match your fitness level and lifestyle.

8. Smoking especially before or after exercise.

Exercise is actually a stress to the body and especially to the heart. Physical activity in order to stay healthy should be widespread throughout the day apart from sleep hours. But sometimes in the name of exercise, we try to do all exercises in a power packed 1-2 hour in a gym or outdoor. How we follow a diet which is widespread even our physical activity should also be spread throughout the day. Apart from the time spent for sleeping and eating the remaining time has to be analysed on how physically active it is spent. The activities performed during this time is called as Activities of Daily Living (ADL).
The rest of the time spent apart from sleeping and eating is very crucial to stay healthy. Please check how long you sit during this time. The continuous sitting time period has to be broken down with 3-5 mins walking breaks. This change will make a huge difference. Increased activities of daily living along with a structured 1-2 hours of exercise will give better results without putting stress on our body.

30:3 formula
30:3 formula: Apart from sleeping and eating, the remaining time whereever and whatever you are doing, try and add a walk of three minutes every 30 minutes of your day and again get back to your work after that. This is strictly for every 30 minutes even if you are sitting in a movie theatre. There a simple calculation apart from 8 hours of sleep time left is 16 hours. So, this 16 hours will have 32 breaks that means 32 times of 3 mins walk.

Myths and facts
1. Myth#1: Heart attack patients should avoid exercise after their heart attack.
Exercise should be done under medical supervision which is known as cardiac rehabilitation and later a modified workout can be prepared and monitored by a fitness expert.

2. Myth#2: Heart attack runs in my family, so there’s nothing I can do to prevent having one.

Heart attacks depends on both modifiable (Smoking, High blood pressure, sedentary lifestyle etc;) and Non-modifiable factors (Family history, age, gender etc;). Modifiable factors can be managed by diet, Physical activity and following your physician’s advice.

3. Myth#3: No chest pain means it’s not a heart attack.

While it’s true that heart attacks often cause pain in the chest, it is not necessary. The classic symptoms include a heavy feeling in the chest that may be painful. The heaviness and pain may spread to the left side arm, neck or jaw. But a diabetic patient with neuropathy may not experience pain during heart attack.

4. Myth#4: Stroke is another name for heart attack.

Heart attacks are caused by decreased blood flow to the heart muscle. Strokes are caused by decreased blood flow to the brain. Stroke leads to weakness on one side of the body, difficulty in speaking, confusion and unconsciousness whereas heart attacks are commonly caused by chest pain and shortness of breath.

5. Myth#5: A young healthy person with good cholesterol levels will not have a heart attack.

A person with healthy cholesterol levels is less likely to experience heart attack, but no one is immune. Many factors contribute to heart attack risk including genetic, lack of physical activity, sleep and at time the reason is unknown. Even young people can have a heart attack.

6. Myth#6: Once you have a heart attack the damage is done.

The sooner you get to the hospital for treatment, the more likely physician can save your heart muscle. Heart muscle cells can repair themselves if treatment is started right away to restore blood flow and limit damage. Followed by this, regular exercise and a proper diet can prevent further damage.

7. Myth#7: Lifting weights can cause heart attack.

Lifting weights beyond your limits and any other exercise beyond your limits are dangerous for your heart. But lifting weight as per your capacity is not harmful rather it will help to strengthen your muscles. And before starting any kind of exercise screening of your body is important so that you get to know about risk factors in your body.

8. Myth#8: Is heart attack and cardiac arrest same:

Many of us get confused between heart attack and cardiac arrest and sometimes people assume both are same.
Heart attack: When a blood clot blocks the blood flow to the heart. Without blood, cardiac muscle dies. Symptoms includes tightness or pain in the chest, neck, back or arms as well as fatigue, lightheadedness, abnormal heart beat and anxiety.
Cardiac arrest: The heart abruptly stops beating leads to loss of heart function, breathing and consciousness. During cardiac arrest the person collapses suddenly with no pulse, no breathing and loss of consciousness.

Do’s and Don’ts
Undergo an extensive medical evaluation before starting an exercise program. Medical clearance is advised before participating in any physical activity.

Warm up before exercise and cool down after exercise.

Exercise larger muscle groups before small muscles.

Raise weights with slow, controlled movement with proper biomechanical form.

Exhale during exertion phase of the lift and inhale when lowering it.

Stop exercises if warning signs and symptoms occur, especially dizziness, unusual shortness of breath and chest pain.

Increase in complex carbohydrate consumption.

Sustained, tight gripping, which may evoke an excessive BP.
Get involved in positions where head is below the heart level which will again increase the BP.
Consumption of saturated fat.
Alcohol consumption.
Increased salt intake.
Holding breath while performing exercise.

Performing too vigorous exercises.

By Dr. Arunkumar Arunachalam
Physiotherapist (Cardio)
Health fitness specialist
Fitness head: Slam Fitness and lifestyle studio.