ten lifestyle tips to help avoid seeing a doctor about heart disease or cancer

reposted from: Bandolier


This sheet is a quick summary of ten lifestyle tips to help avoid seeing a doctor about heart disease or cancer, based on good quality information. For more details, see the healthy living pages off the Bandolier home page at www.ebandolier.com. This is also available as a downloadable PDF.

1. Eat whole grain foods (bread, or rice, or pasta) on four occasions a week. This will reduce the chance of having almost any cancer by 40%. Given that cancer gets about 1 in 3 of us in a lifetime, that's big advice.
2. Don't smoke. If you do smoke, stop. Nicotine patches, gum or inhaler won't help much, and acupuncture won't help at all. Try to reduce your smoking, as there is a profound dose-response (the more you smoke, the more likely you are to have cancer, or heart or respiratory disease). So cut down to below five cigarettes a day and leave long portions of the day without a cigarette.
3. Eat at least five portions of vegetables and fruit a day, and especially tomatoes (including ketchup), red grapes and the like, as well as salad all year. This protects against a whole variety of different nasty things:
   • It reduces the risk of stroke dramatically
   • It reduces the risk of diabetes considerably
   • It will reduce the risk of heart disease and cancer.
4. Use Benecol instead of butter or margarine. It really does reduce cholesterol, and reducing cholesterol will reduce the risk of heart attack and stroke even in those whose cholesterol is not particularly high. Benecol UK Home.
   
5. Drink alcohol regularly. The type of alcohol probably doesn't matter too much, but the equivalent of a couple of glasses of wine a day or a couple of beers is a good thing. The odd day without alcohol won't hurt either. Think of it as medicine.
6. Eat fish. Eating fish once a week won't stop you having a heart attack in itself, but it reduces the likelihood of you dying from it by half.
7. Take a multivitamin tablet every day, but be sure that it is one with at least 200 micrograms of folate. The evidence is that this can substantially reduce chances of heart disease in some individuals, and it has been shown to reduce colon cancer by over 85%. It may also reduce the likelihood of developing dementia. Folate is essential in any woman contemplating pregnancy because it will reduce the chance of some birth defects.
8. If you are pregnant or have high blood pressure, coffee is best minimised. For the rest of us drinking four cups of coffee a day is likely to reduce our chances of getting colon cancer and Parkinson's disease.
9. Get breathless more often. You don't have to go to a gym or be an Olympic marathon runner. Simply walking a mile a day, or taking reasonable exercise three times a week (enough to make you sweat or glow) will substantially reduce the risk of heart disease. If you walk, don't dawdle. Make it a brisk pace. One of the benefits of regular exercise is that it strengthens bones and keeps them strong. Breaking a hip when elderly is a very serious thing.
10. Check your height and weight on a chart to see if you are overweight for your height. Your body mass index is the weight in kilograms divided by the height in metres squared: for preference it should be below 25. If you are overweight, lose it. This has many benefits. There is no good evidence on simple ways to lose weight that work. Crash diets don't work. Take it one step at a time, do the things that are possible now, and combine some calorie limitation with increased exercise. The good news is that in a few years time we may have some appetite suppressants to make it easier.

Reference:

1. MJ Stampfer et al. Primary prevention of coronary heart disease in women through diet and lifestyle. New England Journal of Medicine 2000 343: 16-22.

Women should walk - evidence for exercise benefits

reposted from: Bandolier - full article posted below, unedited. "The bottom line is that women who walk briskly or exercise vigorously for three hours a week or more can reduce their risk of heart disease."

Women should walk

Study Outcomes Results Comment

Bandolier is keen on evidence on healthy living. One of the excellent sources of evidence is the US nurses' health study, started in 1976, when about 122,000 female nurses in the 30 to 55 age group were enrolled. Questionnaires were filled in then, and other information was collected in 1980, '82, '86, '88 and 1992. This information showed the relationship between folate and multivitamin use and reduced colon cancer incidence ( Bandolier 60 ).

A new analysis [1] sought to pin down the relationship between coronary heart disease and exercise in women. In Japanese men, a study showed that regular walking decreased mortality ( Bandolier 50 ).

Study

Detailed information on physical activity was first collected in 1986 and updated in 1988 and 1992. This included various forms of vigorous and non-vigorous exercise, plus a walking history that included their walking pace: easy or casual (less than 2 mph), average (2.0 to 2.9 mph) or brisk (more than 3 mph) [note that 1 mph = 1.6 kph]. A weekly metabolic-equivalent (MET) was calculated for the various forms of activity. Total MET hours per week was then calculated.

Activity	MET per hour
Vigorous	more than 6
Nonvigorous	less than 6
Walking	2.5 to 4.5, depending on pace
a MET is the caloric need per Kg per hour of activity divided by the caloric need per Kg at rest

Outcomes The primary endpoint was coronary events defined as nonfatal myocardial infarction or death due to coronary disease occurring after 1986 and before mid-1994. There were 645 coronary events. The physical activity assessed in 1986 was used as the baseline. Results Information was grouped into quintiles of MET hours per week, with about 14,000 to 15,000 women in each quintile. The distribution of physical activity between the quintiles is shown in Figure 1. The mean of 15 MET hours per week in quintile 4, for instance, implies that a woman would walk briskly for about four hours per week. Women in the high MET quintiles were less likely to smoke, were leaner and had lower prevalences of diabetes, hypertension and hypercholesterolaemia than those in the lowest quintiles. Figure 1: MET hours per week for each quintile

When adjustment was made for these factors there remained a significant association between higher levels of total physical activity and reduced risk of a coronary event (Figure 2). There was a 34% reduced risk for the highest total activity quintile. Figure 2: Relative risk of coronary event for each quintile Significant reduction in quintiles 4 and 5

In women who took no vigorous exercise, brisk walking had a similar effect on reducing the risk of a coronary event (Figure 3). Using women who walked at a casual or easy pace as a baseline, women who walked briskly reduced their risk by 36%. Compared with sedentary women, women who walked briskly for 1 to 3 hours a week had a risk reduced by 30% (95% CI 5 to 49%) after allowing for other factors. Figure 3: Relative risk of coronary event by walking pace for women who did not take vigorous exercise

Comment This is another study linking increased physical activity to better health. Importantly this study is one of the biggest to examine the effects of exercise in women. The bottom line is that women who walk briskly or exercise vigorously for three hours a week or more can reduce their risk of heart disease. ImpAct 3 examined a visionary scheme for prescribing walking exercise. Bandolier 50 had reports of walking reducing coronary and all cause mortality in retired Japanese men in Hawaii, and of exercise reducing death rates in a Finnish twin study. The benefits of moderate exercise have been known for some time, and the evidence continues to accumulate. The size of the effects continues to impress, and just shows that evidence-based healthy living is something upon which we should concentrate more. Reference: JE Manson et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. New England Journal of Medicine 1999 341: 650-8.

Can 15 minutes exercise a day give an extra 3 hours a day to your life?

source: Hacker's Diet, Exercise 

Where is the evidence that doing 15 minutes exercise a day will increase life span by an extra 3 hours a day? Via NHS Direct gave a link to Bandolier. 

Bandolier say "This site is for those of us who want to know that getting breathless is a good thing, but need assurance or reassurance that it has powerful benefits for our health now and in the future."

What, Me Exercise?

Those who do not find time for exercise now will have to find time for illness.

—The Earl of Derby, 1873

Don't kid yourself into thinking that exercise, by itself, will make you lose weight. Consider the following activities, and the number of calories an average person burns per hour in each.

Activity	Calories/hour
Walking	300
Bicycling	300
Aerobics	400
Swimming	400
Tennis	500
Basketball	500
Jogging	700

Compare those numbers, remembering that they're for a full hour spent nonstop in the exercise, with the calories in the following food items:

Tasty Treat	Calories
Peanut butter sandwich	275
Pizza (3 slices)	500
Big Mac	560

Clearly, even an hour a day of exercise doesn't account for much food. And what's the likelihood you'll find the time to spend a full hour, every day, month after month, year after year, doing those exercises?
So, don't exercise to try to burn off calories and lose weight. Unless you're a professional athlete or obsessed with sports, you're not likely to spend enough time exercising strenuously enough to make much of a difference. Exercise will help you lose weight in more subtle ways. Regular exercise increases your rate of metabolism: the number of calories you burn all the time. Plus, for many people, exercise actually reduces appetite.
But these are side effects: hardly reasons to start exercising. The real reasons to exercise are that you'll live longer and feel better. Let's consider the case for exercise from those standpoints.

Living longer

I was never much of a one for sports. Every time I played baseball, I got hit in the mouth with a ball or bat. Whenever I played football, I ended up with a mouthful of mud. Imagine my delight when I discovered that the physical education requirement at my college could be satisfied by playing ping pong or on the rifle range.
After reaching that glorious stage in life when other people couldn't make me do things I'd rather not, the case against exercising seemed straightforward and overwhelmingly persuasive.

1. Exercising consumed time.
2. Exercising was not programming.
3. Therefore, by exercising, less time was available for programming.

I'm a hacker—I like to program! Substitute your own favourite activity for programming and you'll see what I mean. In addition, exercise carried all the unpleasant connotations of high school calisthenics, or the equivalent indignity of more modern, yet equally regimented, forms of workouts.
But is there a flaw in this argument after all? Indeed there is. The premises are correct, but the conclusion doesn't account for the fact that regular exercise will, in all likelihood, allow you to live longer. Let's look at the numbers.
This “Life Extension Worksheet” is provided as an Excel worksheet. You may want to load LIFEXT.XLS and plug in your own numbers to compare with mine. Directions for calculating increased lifespan by hand are given in the Pencil and Paper chapter.

So, if you're 40 years old, and you exercise 15 minutes a day from now until you turn 65, you'll have spent a total of about a quarter of a year exercising in those 25 years.
But, if by exercising you manage to live 3 years longer, you're ahead by a total of two and three quarters years by age 65—1000 days. Your increased life span works out to an additional 172 minutes per day from age 40 through 65. Even after spending 15 minutes exercising, the life extension you can expect from getting into shape gives you what amounts to two and half more hours per day to do whatever you enjoy most! Even if you live only one additional year through physical fitness, you'll still end up with 270 more days by exercising.
Of course, we're talking percentages here; you could be run over by a truck tomorrow. But hey, if you're in shape you may dodge that truck!

Feeling better

Exercising not only gives you more time to live, it makes the time you live more enjoyable. You'll feel better, think straighter, sleep more soundly, and have more capacity and endurance for everything you wish to do. How much? It varies from person to person; the only way to experience the benefits is to start an exercise program and see for yourself.
Fortunately, the payoff becomes apparent pretty early-on, particularly in a program like this one where you can always compare your current level of fitness with the much lower levels you strove to master only a few weeks before.
If you don't buy the “feeling better” argument, consider this. Virtually all medical evidence shows that if you don't exercise, you're more likely to suffer a heart attack or, if you're going to have one anyway, to have it earlier in life. Even if you're resolute in believing you won't feel one whit better from exercising, you'll certainly concede that you'll feel a whole lot worse after collapsing to the floor with a coronary. I've no direct experience with this particular unpleasantness from life's menu of surprises, but folks I've talked to who have are unanimous that it's best avoided. Those who dropped dead right away were unavailable for comment.