The Doctor Weighs In

"Most heart attacks in women are preventable," is the headline of an article posted on NBC.com.  The article describes a study, published in the Archives of Internal Medicine, that was done by the researchers at the Karoinska Institute in Sweden.  Dr. Agneta Akesson and colleagues looked at the diet and lifestyle patterns of almost 25,000 postmenopausal women.  At the time of enrollment none of the women had heart disease, diabetes or cancer.

The researchers asked the women to fill out "food frequency" questionnaires to identify how often they ate 96 different foods.  The researchers analyzed the data and found four major dietary patterns:

• Healthy - vegetables, fruits, and legumes
• Western/Swedish - red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes, and fish
• Alcohol - wine, beer and some snacks
• Sweets - sweet baked goods, candy, chocolate, jam, and ice cream

Other information collected included family history of heart disease, education level, physical activity, and body measurements.

The women were followed for an average of 6 years.  During that time, 308 women had heart attacks.  The investigators found that two of the dietary patterns (healthy and alcohol) were associated with a decreased risk of heart attack.  Women who drank less than a quarter ounce of alcohol daily (that is just a splash in the bottom of your glass) and ate lots of veggies, fruit, whole grains, legumes, and fish had a 57% lower risk of having a first heart attack.  That is a whopping big difference.

If women added three other healthy lifestyle habits into the mix (not smoking, being physically active, and avoiding too much weight gain), they had a 92% lower risk of heart attack.  In other words, most heart attacks in women are preventable by making healthy lifestyle choices.

Now, it is one thing to say, eat healthy, drink in moderation, exercise and maintain a healthy weight.  It is quite another thing to actually do all of those things over the course of an entire lifetime.  On the other hand, if you look at the amount of money the US (and, indeed, the entire world) spends to treat cardiovascular disease, I believe you would find there is enough there to buy each and every person a personal cook and a personal trainer (I believe this is the secret to Oprah's weight loss and maintenance).

I say this tongue in cheek, but it does make the point that we aren't spending our "health" care dollars on the right things.  We spend generously to fix disease, but we are very stingy when it comes to funding health.   It is time to get this right.  There aren't enough dollars in any treasury to treat all of the heart disease we are going to see as a result of the global epidemic of obesity and physical inactivity.  This must be  a top priority of policy makers and health reformers.  Studies, like the Karolinska study, should be used to promote changes in public policy - such as healthy school foods, ensuring that all neighborhoods have access to fresh fruits and vegetables and that they have safe places where kids and adults can move their bodies (without worrying about getting shot in the process).

Every politician, health reformer, and policy wonk ought to know about this study and others that prove that healthy lifestyles mean fewer heart (expensive) attacks - not just in women, but in men as well.  The bottom line is most heart attacks are preventable!

There is a great story in the SF Chronicle about a woman named Barbara Hillary. The headline in the print version of the Chronicle proclaims “Black woman reaches goal – North Pole.” But to me the real story here is that Hillary is a 75 year old lung cancer survivor who hired a personal trainer and learned to ski so that she could go to the North Pole.

When I was a kid I thought being 65 meant getting a Barcalounger and watching the soaps. Now, grammas and grampas are engaging in adventures previously thought to be the purview of the young and crazy.

Hillary, the article says, grew up in Harlem. She was a nurse and a community activist. After retirement, she battled lung cancer. By age 72, she was dog sledding in Quebec and photographing polar bears in Manitoba.

When she learned that no black woman had yet reached the North Pole, she set her sights on that goal. She contacted a travel company, Eagles Cry Adventures, Inc. They get people to the North Pole in all sorts of way, including being dropped off by helicopter.

But that would be too easy for Barbara Hillary. She wanted to ski in. But she didn’t know how. “Skiing wasn’t a popular sport in Harlem,” she points out. So she signed up for cross-country skiing lessons and hired a personal trainer who helped her get fit for the trip.

Hillary faced another challenge in getting to the North Pole. The trip cost $21,000. Not one to let anything get in the way of her dream, she solicited donors and scraped together the money.

She arrived in the base camp, via Norway, and, together with her fellow travelers, pitched a tent (I don’t think my grandmother was ever in a tent, let alone pitched one). On April 23, Hillary set off on skis with two trained guides. She reached her goal:

“Standing at the top of the world, she could have cared less. The enormous expanse of ice and sky left Hillary, for once in her long life, speechless.”

Way to go, Barbara Hillary. Way to go! I can’t wait to read about your next adventure.

This is from the Wall Street Journal and is too perfect to change a word.  Thanks, Kevin Helliker.  This is a real motivator.

Benefits of a Canine Running Mate

By KEVIN HELLIKER  (April 17, 2007)

Hearing the shriek of a fierce wind outside, I tried sleeping late the other morning. But my 80-pound Labrador came beside the bed and bumped her cold nose against my ankle. In her view, an April snowstorm is no excuse for canceling our predawn run. So moments later we were jogging down the dark shoreline, assaulted by pellets of ice, watching the sky brighten over Lake Michigan. It was exhilarating.

After decades of jogging with friends, colleagues and loved ones, I've come to see that the ideal running mate is a dog. She is not competitive. Your fastest speed is nothing next to hers, so you will never run too fast for her. But neither will she whine about, let alone ridicule, your slowness. The only time she will complain is when you don't run at all, and that type of push is what personal trainers charge money for.

COMMENT:Runner David Hill, with two clients, Angie & Wombat.

There is growing appreciation of the value of having a workout companion, reflected in the popularity of Web sites such as exercisefriends.com, which matches partners in athletics. Running doesn't require a partner. But "The Loneliness of the Long Distance Runner" is more than just a great book: Over the course of hours on the running path, solitude starts to feel like isolation.

Unlike humans, of course, dogs can't talk. But any runner who has had a long-winded partner knows that silence isn't the worst quality. And unlike humans, dogs don't show up late, cancel or argue about which course to take.

A canine jogging companion can confer health benefits beyond the lift to your workout regimen. A body of scientific evidence shows that pet ownership can protect health. A pet can decrease blood pressure, reduce cholesterol and improve mood, among other benefits, says the Web site of the federal Centers for Disease Control and Prevention.

Yet these benefits accrue only if owner and pet manage to make it work. The most popular pet in America, dogs are also the most problematic, in large part because a growing number of them live in houses or tightly confined yards. Of the nearly 45 million American homes with dogs, a large percentage represent the second or third owners for those canines, pet advocates say. Owners often get frustrated by out-of-control chewing, barking, biting, whining or accidents on the rug.

Demand for help is so great that an entire industry -- replete with antidepressants, canine psychologists and shock collars -- is developing around canine control. But often the answer is as simple as exercise. In fact, canine expert Cesar Millan, star of the television show "Dog Whisperer," ranks exercise first -- ahead of discipline and affection -- as the key to a well-behaved dog. There are even treadmills for dogs to get them exercise.

A border collie mix named Flynn exhausted the patience of the first two families that adopted him from -- then returned him to -- a Chicago shelter. Then a marathoner whose running partner had moved away visited the shelter seeking a four-legged replacement. The marathoner, David Hill, found that several fast-paced miles a day relieved Flynn's anxiety and hyperactivity. "The running totally calms him down," says Mr. Hill, who now is a professional dog-runner, giving others' pets a workout.

The sheer pleasure that dogs take in running can remind performance-obsessed humans what's really important. After an ankle injury sidelined a competitive Boston runner named Jill Hourihan, depleting her conditioning, she was reluctant to start training again. Enter Alex, her run-happy dog. "He'd stand at the door with the leash in his mouth, and that would get me going," she says.

Security is another benefit. A head-in-the-clouds runner, I can count on my dog to see, hear and smell every creature nearby, including an array of Chicago wildlife from squirrels to the occasional coyote.

Dogs, especially large breeds, can run farther than humans. But like humans, they must build distance gradually. Small dogs can run farther and faster than most owners might think. But dogs of any size shouldn't be run seriously, especially on pavement, until they are nearly full-grown, some veterinarians say. English bulldogs may be one breed not built for running.

Cold is rarely a problem, but heat stroke can kill dogs, so run at dawn, dusk or night during summer. When a normally energetic dog seems sluggish, don't push him. He may be sick or overheated.