Aug 26, 2015


Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: The Scope Health Sciences Radio. Are you well? I hope so. We are broadcasting from Be Well Utah at Rice-Eccles Stadium, and it's always a pleasure when Dr. John Ryan stops by and we always notice a boost in ratings in Ireland, your home country. Your mom must tune in.

John: Yeah, I think my mother listens over and over.

Interviewer: Yeah, I like that. You ran the 5K. How did that work out for you today?

John: Went well. We had a really big crowd, over 2,000 people registered for it so a big turnout and went very well. Everyone started the race and everyone finished the race. All in all, a good result.

Interviewer: Yeah. I've got a question for you before we start talking about heart stuff. I've been training to try to run a 5K and about mile number two of consistent running, I get a really bad stitch. What can I do to get around that? I can't seem to get past that.

John: I think these energy bars are very useful to take about half an hour beforehand and it takes about half an hour for it to kick in. At least when I'm doing my training, I eat one of those about half an hour beforehand, one of these gels and then have another one at mile one, another one at mile two, and [inaudible 00:01:09]

Interviewer: Really, that surprises me that I eat something. What's causing that stitch, usually?

John: Usually, it's a change in your metabolism, where you've entered into lactic acidosis. So you've entered into an anaerobic metabolism, whereas normally right now, we're using aerobic metabolism, lots of glucose and so it changes over. That's normally what it is.

Interviewer: Okay. I'm pushing myself a little hard because I'm in that anaerobic

John: Exactly, you've reached the anaerobic threshold early and then you can immobilize different parts of your glycogen storage and then you do better, then it might go away. I think to prevent it, it's useful to have some sort of glucose load beforehand. At least that's what I do.

Interviewer: Huh. Interesting. All right. Let's talk about heart health. And what I like to approach this from is, first of all, what's the bare minimum you can do and how can you maybe take a step above that and then a step above that and are there benefits? I've heard the bare minimum is you need to get 30 minutes of exercise a day where you get the heart rate up. How high do you need to get the heart rate?

John: Yeah, that's the American Heart Association recommendations, which we agree with. Getting 30 minutes of exercise every day, getting the heart rate up to maybe 120, 130, really depends on your age, depends on what medications you're on, as well.

Interviewer: Because the older you get, the lower it's going to need to be.

John: Exactly, you won't get into a heart rate. You and I would get into 130s, 140s, 150s and that's not the case with folks who are older. I think if you get into 120, 130 and you're doing that for half an hour every day, I think you're really decreasing your risk of having a cardiovascular event, namely heart disease, stroke, et cetera. You can really make a positive change in your life by embracing this and making it part of your daily routine. It doesn't actually need to be 30 minutes all in a row. You can split it up into different intervals and just get it into your schedule, your daily schedule.

Interviewer: And I think the message I really want to get across is we all have, most of us, anyway, have such a sedentary lifestyle and maybe earlier in our lives we considered ourselves fit and we'd get around and move and we still have that image of ourselves in our brain. And it just really dawned on me recently that I hardly get up and move at all. It is crucial for your heart health. What kind of difference is it going to make, life longevity or life quality or what?

John: Yeah. So it decreases your risk of having a heart attack so your length of life is longer and also your quality of life is better. Actually, exercise has more than just cardiovascular benefits it also decreases your risk of having hip fractures, decreases your risk of having depression and in some circumstances, at least, these folks who exercise have decreased risk of some cancers. There's this great benefit that can really prolong your life and give you a better quality of life.

Interviewer: And you can get that out of a half-hour a day.

John: Half an hour every day of something that gets your heart rate up and folks ask, "Well, what's the best form of exercise? What should I do?" What I tell them, at least, is it's the exercise that you like doing.

Interviewer: Sure, yeah.

John: Because that's the one that you're going to do on a daily basis. So if you like running like the folks who came out for the 5K this morning, then that's what's good for you. There are other folks who say that yoga is what's good for them. It's funny, right, because I've gone to yoga classes and, frankly, I found it very boring. This isn't an anti-yoga statement.

Interviewer: Better be careful there, they're doing yoga right across the way from us here.

John: But then you meet folks who do yoga who are like, "You run? That's incredibly boring." Whatever it is you like to do.

Interviewer: Okay. Let's go to the next level: 30 minutes a day is the base. If I do more than that, do I get more benefit?

John: It's unclear. Probably, there does seem to be a peak threshold, there are some folks who get concerned about extreme athletes, namely, triathlon runners, 100K runners, folks who do that, that there may be some scar to the heart contributing to atrial fibrillation and irregular heartbeat and also, obviously, damage to your knees, et cetera. There probably is some sort of threshold but in reality, Scott, most of us aren't going to reach that threshold and incorporating that 30 minutes will be sufficient. But if we could get everyone to that 30 minutes, I think we would be very happy.

Interviewer: And you might be out of a job.

John: Yeah, yeah, it's funny, it's like a dentist with fluoride, right? They advocate for fluoride in the water, but that obviously decreases dental disease. I would be more than happy to be less busy because people were more active.

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