Health Prescription for a Healthy Heart: Cardiovascular Wellness with Dr. Todd Duhamel

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Health Prescription for a Healthy Heart: Cardiovascular Wellness with Dr. Todd Duhamel


For millions of years humans adapted to be moving and what's happened over the last 100 years is really we've gained so much mechanical advantage in industry and with machines that we've really engineered our environment where we get less physical activity now than we historically have it's time for another edition of.

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Head to atfw doca to enter on today's episode we welcome Dr Todd Dell who's a professor in the faculty of Kinesiology and Recreation management at the University of Manitoba and principal investigator at The Institute of cardiovascular Sciences at the General Hospital in Winnipeg now we know that insufficient physical activity is the.

Single largest risk factor contributing to development of chronic diseases in the world today sedentary time is not the opposite of exercise it's actually its own risk factor now being heart health month today we're going to explore his research that highlights that avoiding exercise might not be about discipline but rather how physical.

Activity is viewed he provid science-backed insights into understanding people's motivations as a way to help them find more suitable and enjoyable exercise that's easier to integrate into daily life and sustain in the long term before we get to the snack sized episode be sure to hit like And subscribe we have new episodes weekly.

Featuring industry thought leaders and influencers I'm your host Chrissy van and this is atfw I am so pleased to have you because it is heart month and I know here at all things Fitness and Wellness we speak so often into how our fitness and our overall health is really influenced by movement and we do have this physical.

Inactivity crisis within Canada and unfortunately the numbers and percentages that we see of the populace that aren't getting physically active really hasn't changed or pivoted that much in a very long time so I think a lot of us are trying to crack the code on how do we get more people to embrace movement in their lives and I know that.

This is an area that you are an expert in but before we get to it speak to me a little bit more about our cardiovascular health and how exercise is actually something that can really help us enhance that yeah well there's a number of ways that exercise is good um physical activity is even better because we do it because we it's interesting to.

Us more than anything else we can accumulate physical activity just by going out and hanging out with friends so the heart pumps harder blood gets flowing that's good for your vasculature because the as the blood rubs the uh vascular walls you get more nitric oxide that leads to vasil dilation lots of good things there muscles release extra.

Kinds which are kind of hormones and different things signaling molecules that are released during exercise those go signal far away places make your brain work better your liver work better and other tissues like that and there has to be recognition that um you know for millions of years humans adapted to be moving and what's happened over the.

Last 100 years is really we've gained so much mechanical advantage in industry and machines that we've really engineered our environment where we get less physical activity now than we historically have you bring up such a good point I actually had a guest on recently who was working with a movement specialist and she kept asking him you.

Know what's the ideal amount how much should I be going and he's like you're telling me Ideal World and if it's Ideal World we actually wouldn't be setting aside time to exercise at all it would have been foundations built in our everyday lives because of how we had to live and now convenience lifestyle I'm sure sure many of us in 2024 are very.

Glad we quite literally have the world at our fingertips but it is coming at this cost so talk to me a little bit because I know human behavior is such a specialty of yours explain some of the misconceptions we have in regards to incorporating movement into our daily lives because the code doesn't need to be as hard to crack as it seems like.

We're making it yeah I always get worried that when we talk about these Fitness crazes and things we we worry about people that are consider themselves be athletes and athletes are easy right like they make themselves go out and exercise they're willing to go do crazy type Olympic Training and different things and so we don't have to.

Worry about Olympic athletes much we don't have to worry about Weekend Warriors much because those people are making good choices the people that I I really worry about are the ones that hated fiz Ed so think back to grade school and high school how many people would sit on the sidelines there right very few initially in grade school but.

As you got to high school people started haed fette for whatever reason um some people just never really enjoyed doing the volleyball or the different sports that were there and we created um kind of a fizzed program that was really sport based and not really lifestyle based so people that you see active as they age are people that walk in their.

Neighborhood people that go out and do gardening people that um find ways to have an active lifestyle rather than go exercise because those people that are choosing to go to the gym to work out that's awesome that's better for you than just walking but um it's the people that are in healthc care are the ones that were likely to probably have hated.

Fette in the old days if they think back in their lifestyle um everybody knows exercise is good the hard part is is how do you get up and do it you highlight something that speaks to me so greatly because I was the kid that was really terrible at Sports and I had a lot of gumption so I would I warmed a lot of benches because I would try out for.

Everything and then just get sidelined because I was terrible and because of that I was vied was one of the first classes I actually dropped in high school so you saying that I actually you gave me that aha moment in my own brain and eventually as an adult I kind of circled into fitness and gym spaces because I realized that was me against.

Me and for myself personally became a space to really exercise my mental muscles as much as my physical but that disconnect in Fitness they lost me there because it was entirely sports-based and as somebody that as much as I tried it wasn't a talent I was like well guess physical activity is not for me which we clearly know is not the answer so I know.

That you worked on the encourage project so first of all explain what that was yeah encourage is a great acronym that we came up for because what we wanted to do was encourage people to be more active uh and we made connections with two different some primary care clinics in Winnipeg so we partnered with the regional health authority we have here.

And we actually put a kinesiologist into these two clinics and their job was three things one is to be able to help the Physicians and nurse practitioners to be able to better prescribe exercise to their own clients so they are a resource for that the second thing that they did was actually counsel patients on how to become more physically active.

So the kinesiologists would meet with their own clients at the primary care clinics uh and then prescribe exercise and then the third thing and this was actually probably the biggest learning uh primary care clinics aren't necessarily well integrated into their neighborhoods so if you think about it you go see your doctor you go in the.

Doctor's office and then you leave and there's no connection to Community well if you can go to your doctor's office and actually be given information on where's the closest yoga place or where's the closest place to go on a walking trail and you see lots of health promotion activities listed there and then your your physician or your nurse.

That you're seeing if they tell you more about exercise how many different times can people give you information before it starts sinking in that you know what actually being active is easier than I thought and my healthcare provider telling me it's a good thing so you're getting an exercise prescription from a doctor you're getting it from a.

Kinesiologist and you're seeing that there's opportunities around um what would you do if your if your um physician told you by the way did you know there's a pool about a kilometer from here just around the corner um would you think about going more that was kind of the ideas of of what encourage was doing how do we.

How do we more holistically integrate physical activity counseling into Healthcare so what were your findings when that was being integrated in regards because I mean we know for so long we're habitual creatures it's very easy to fall back into our patterns of how we're living our lives so was this influence and reminders from somebody.

That I think most of us respect our health care providers opinions it's who we go to in our time of need so was this effective yeah so we had several hundred referrals to the program even for things that we didn't expect um Physicians were referring people with pain to us uh people with chronic diseases women that were pregnant the Physicians wanted them.

To become more active so they would refer them to their program uh and on average people are adding at least 1500 steps to their daily activities um normally we we can talk about how to prescribe exercise in a variety of ways one of the easiest is to do step counts Harden Stroke Foundation of Canada recommends people to do about.

10,000 steps a day the reality is is most people that are 45 and older might accumulate about 3,000 steps so if you add 1500 steps to that that's actually an increase of 50% so they're moving more they're not necessarily meeting the guideline that heard Strokes recommending they might not be meeting Canada's 24-hour movement guidelines.

Which is about a a 2 and a half hours of moderate vigorous physical activity Plus getting enough sleep plus reducing their sedentary time but you know what anything any movement is better than what you did yesterday and if you can do more tomorrow that's success so when you think about these people that are in healthcare when you walk in and you see.

People that are sick for various reasons again they're the people that didn't necessarily love doing sports so how do we get them doing more so I think a lot about my grandmother she gardened until she was 85 she would go out and she would just putter in the garden now you may not think about that as exercise for people but what does high-intensity.

Interval training look like to somebody that's 85 years old right it's different than what it looks like for an Olympic athlete who we would normally give high-intensity interval training to but when she had to walk down and carry her her um gardening supplies with her and she had to work for a little while tilling the ground with her hands and.

Shovel and stuff that was hard work for my grandma and I actually think that that kept her alive a long time it was good for her mentally it was good for her to do physically down there so that exercise prescription looks different than maybe what you give an athlete and why I want us to contextualize doing more than you did.

Yesterday is success or physical activity um it's a message that anybody can have so when you uh I'm aware of a program at aut Heart Institute and they do high intensity interval training with um older adults that have had heart disease and that inter that prescription they give is dancing Just Dance for a minute until you um get tired then catch.

Your breath if you look at a different disease State like peripher arity disease We Tell those people walk as fast as you can until your legs hurt and you get this pain called claudication pain it's kind of like angina but when you have peripher disease in your legs you feel the pain in your legs so walk as fast as you can until you feel that.

Pain sit down take a break and then get up and do it again right so that prescription looks different than it does for an Olympic Athlete but it's intensity based it's it's um duration based and it's Progressive in that as you get the people doing this over a few weeks they actually will walk longer before they feel that pain they'll walk.

Faster before they feel the pain it's really good so in our research in Winnipeg we um use walking speed as a predictor of cardiac surgery outcomes So the faster you can walk five meters actually predicts how many days you'll be in hospital after heart surgery um so that's really interesting so how do you how like theoretically how could you get.

People to get out a hospital suor get them to walk better right and that starts out by having people with really low Fitness levels doing more today tomorrow the next day and that progressively builds up so it's really about how do you get people to get activity into their daily living more than um getting them out to a certain.

Gym to a certain program to a certain routine if you can get people moving more now that's the benefit that everybody can can really gain from I really like that example because we talk about that a lot that low fit or no fit to low fit segment and how that is an absolute win if you find something that is access.

And that they Embrace and ultimately you hope that they enjoy with this prescription model did the research explore it all in regards to adherence for more longer term outcomes like if this mindset shift is obviously happening for people that are taking part so how did that work from the adherent side because we know people.

Have a lot of you know ex intrinsic motivation at the beginning there may be excited that they're starting something new but that's a very fleeting feeling yeah so one of the things we would uh we would recommend is try to find some friends to do it with having friendships and people to go out with give you a support group and that leads to better.

Adherence we have seasonal effects in Winnipeg right it's wonderful to be spring summer and fall Winnipeg Sunny is can be I I compete against anybody in can for our weather in the summer you know I used to be a weather anchor so I'll give you that most years though when it gets cold in January February typically could be minus 40 so we see.

Activity levels plummet but there's still ways to be active a lot of people go Mall walking or different places so the motivation um changes through the year but the exercise prescription should change during the year what you want to do might change during the year there's actually evidence showing that knitting um has health benefits or just.

Standing and doing nothing else but standing can actually improve your glucose control so if you're a low-fit person you can get a lot of benefits from um doing small activities and then as time as you get more fit then you should be doing more purposeful activities you should be going more intense longer and maybe you go for from.

Being a non-ex exerciser to somebody that actually likes being doing exercise maybe your identity changes a bit so from an adherence perspective everybody falls off the wagon sometime it's about what do you do to get up so if you don't like exercising per se which is a purposeful intentional thing do a stealth intervention find a way to trick.

Yourself into it so we actually um created an App it was called the encourage app it was a workplace based thing and it was it was simple reminders would come up every 30 minutes on your phone go fill the uh printer with 500 pieces of paper right and it's a ridiculous thing to do but you walk over you get up from your desk you walk to.

The machine the printer you put in one Reef of paper you walk back to your desk and it's like a brief exercise snack I know when you contacted me you mentioned exercise snacks these are wonderful things so we've actually looked at um population level data through um different data sets we can get and we actually looked at can a brief 30 second.

Boow actually reduce Frailty in people and we've shown this idea that um if you just sit there and be sanitary for a while and you do a 30 second bout of intense exercise and then go back and sit down um there's actually health benefits to that and the idea kind of came from a joke where when I was talking to one of my students I'm like.

Hey when I watch football on Sundays and this is relevant to the Super Bowl this weekend I sit there I watch the play a commercial comes on and I run to my fridge I run back to my chair and I sit down and I eat whatever nachos I brought home right brought over but I said is there health benefits to me running to my fridge and running back.

It only lasts for 30 seconds so we basically research that question and we're showing that that 30 second Interruption to the sedentary time I'm getting sitting in my chair actually has health benefits so like that's the place to start if if that little bit of exercise can help somebody um imagine what doing more of that can do so this.

Is where the high-intensity um models that are out there that people do um one minute on one minute off kind of things um and density seems to be the biggest driver of Fitness changes or strength changes and can affect everybody and we use these models with people with heart disease as well as Olympic athletes one of the more poignant things that you.

Shared in this that stood out to me is when you were speaking to the reduction in days in hospital from implementing some of these activities and you know nobody ever considers that unless they're actually faced with an illness I think that we just have this mindset that it will never be me it's always someone else until it is you and then.

All of a sudden you go shoot I really should be taking charge and being an active participant in what my health looks like but through your research were there any other discoveries that made you go like wow I didn't realize that even just this little bit of effort could have such a big impact on my overall health so the good news is it's.

Never too late to start being more active than you were yesterday so even if you've perhaps um been unfortunate and had a heart attack you could actually start exercising within 3 days after after heart attack safely and every single time that you do a high-intensity exercise boat after heart attack Cuts your risk of a future heart.

Attack in half that's data shared by American College of sports medicine so that statistics always stuck with me because it means that even in this when you're at your sickest you can get up and just walk from your bed to the nursing station and back that's a good thing so we actually talk about exercise differently after surgery a lot of times.

We talk about early Mobility how do we get people home sooner and when of the things that seems to work is getting them up out of bed going to the washroom you know sometimes you're lucky enough where there's a bathroom maybe 10 feet away from your bed and the nurse is always encourag you get up and go to the bathroom right we don't realize that.

That's an early Mobility um intervention that they're doing where they want to know if we can walk that far because if you can walk that far well then maybe you can walk three times as far to the nursing station and if you're able to work to the N to the nursing station um that shows that you're able to go home right and then these are good things.

Right so there's other date out there showing that just being able to do stairs keeps keeps older adults in their homes longer um simple things like being able to open a heavy door is predictive of your quality of life and different things so even at your sickest if you can walk better and just add some activity you'll you'll be healthier and.

Then if you can really keep that going which is the hard part people sometimes change and they can't continue doing it what it might mean is is that stop doing the same thing you're getting bored of it go find something different that can do that's fun so one of the things that we we've done with some of our um different initiatives is think about.

People that you like to have fun with what do you do when you're hanging out with that person right rarely is it watching TV and not talking right rarely is it just watching your iPhone Alone by yourself it's usually with someone so if you think about that really good feeling you get with your friend or with your aunt or uncle or maybe your grandparent.

You're always doing something so go do something that's the first thing do something that's better than sitting it's funny even on my way into my studio today I was having a conversation with my mom who's in her late 60s and she was quite a sedentary person funny enough also worked in healthcare previously 12-hour shifts night shifts no time in.

Her world in her view for physical activity and it wasn't until these later years it started with pickle ball and now it's pickle ball aquafit but the thing that stood out to me in the conversation because I said to her I'm so proud PR of you you've made this move but the biggest thing is actually the social elements that have come out of it.

As well because she's like now I have a walk scheduled with an that I met at taiichi and this that and the other and her entire world that she lives in has completely changed around her because she has now this community and because of that Community it's encouraged her to try more try more and that's for somebody that really was like I can't I.

Don't know how and was very married to that mind set so it is really possible at any point in life to mix things up but you know for ourselves here at atfw we speak to a lot of Fitness professionals right up to the Sea sues kind of thing and and everyone's asked themselves the same question for many years of how do we get people to hold on.

How do we keep them moving so you've shared a lot of great tips here but if you were in their role and really working to get people to like adhere and fall in love with Fitness those people that are like my mom that was like nah not for me what would be your like biggest overarching message for them to put into practice Yeah I would tell.

Everybody go live life it's the most important thing you can do right because if you're living life and you're and you're making um life enjoyable for yourself you're going to be doing things you're going to be moving it's going to be in the background now if you like going and and doing particular Fitness classes that's awesome do it if you like.

Lifting weights go do it if you don't like doing those things though there's other ways to do that without even realize you're lifting weight weights if um we need to get people to go out and exercise per se which is purposeful that's great but they have to want to do it if they don't want to then they're not going to show up consistently so.

Find the want find The Who that makes them want to do those things and I think that it'll be a lot easier for people to be able to stay motivated or at least to adapt and do something different when it's time to change because they're getting bored with something I really appreciate because I know so many people talk about the why but the who that's a.

Really good takeway way because that really can be all the difference when they can visualize and know who they're doing it for who they want to be there for who they want to play with participate with so and Longevity luckily is such a bigger part of the conversation especially from the Fitness industry perspective The Narrative shift.

Has been very refreshing because I do think unfortunately the way advertising was particularly when I grew up it hasn't been helpful nor effective nobody wants to hear every year about the shred like that's not the goal I so appreciate your time and your Insight is there anything else that you'd like to share with us today on the topic yeah a lot of.

Our work with heart disease is actually focused on Frailty and aging um and aging we all know somebody that's 100 years old and can run a marathon or do something that's fantastic and it's so wonderful but what they've done is they they've been able to move enough to counteract Frailty and this idea of Frailty that I want to share with you as.

We leave here is it's two components one is physical frailty the strength that they have the endurance that they have but it's also Frailty has a social component to it if people are alone they tend to become sedentary they tend to do less activity and it's the loneliness that's a big part so that when earlier when we talked about the hoop I think.

That's really important of why people actually get out and live life and do things so think about that how do you not become frail you get out you live life you do things with people that motivate you to do things or that you have fun doing things with and if you do that I think people will then do the higher intensity the programs the.

Exercise that we really promote right but it has to start with the physical activity and wanting to do it well thank you so much I really appreciate your time I always love having a fellow Canadian on as well so I hope that you have a wonderful rest of your day and I appreciate you sharing your expertise with us today yeah go live life perfect.

That's the like Mantra of the day thank you you've just listened to the all things Fitness and Wellness podcast hosted by Chrissy van this episode was brought to you by Fitness World your Fitness your way be sure to hit like And subscribe we have new podcast episodes weekly featuring industry insiders and influencers together we're on a mission.

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