NYC’s Public-Health Policies Linked to Lower Cardiovascular Disease!

A decade of health policies and health-promotion messages in New York City aimed at preventing cardiovascular disease have pushed heart-disease rates downward faster than they have elsewhere in the US, according to the city’s health commissioner. “Making healthy choices easy ought to be our goal at the population level,” Dr Thomas Farley said during the opening ceremonies of the Canadian Cardiovascular Congress 2013.

Since 2002, when Mayor Michael Bloomberg took office and began implementing policies to battle smoking and obesity, the life expectancy of New Yorkers has risen by 36 months vs an average increase of 21.6 months in the rest of the country, Farley noted. Half of this increase was from decreased heart disease—probably the result of the ban on smoking in public places.

 

Encouraging Smoking Cessation

The city used a multipronged strategy to get its citizens to stop smoking. In 2002, it banned smoking in public places. Currently, it has the highest taxes on cigarettes in the country. When focus groups revealed that smokers were afraid of suffering but not of dying, they implemented a hard-hitting ad campaign that shows a patient with lung cancer “suffering every minute.”

The prevalence of smoking dropped from 21% in 2002 to 15.5% in 2012, “which represents about 300 000 fewer smokers . . . and saves an estimated 1500 lives a year,” Farley said.

Focusing on Diet, Calories, and Physical Fitness

Close to 60% of adults in New York City are overweight or obese—”a problem of normal people in an abnormal environment,” according to Farley.

To turn this around, the public-health department focused on increasing consumption of fruits and vegetables and making people aware of calories, sugary drinks, trans fat, and sodium.

The city established standards for food and beverage vending machines that deliver millions of meals and snacks to New York City government employees. It is also working with retailers to increase the prominence of healthy foods and set up a system of street vendors who sell only fruits and vegetables, in targeted neighborhoods.

In 2006, the New York Board of Health voted to restrict artificial transfat in 24000 restaurants, one of the first major cities to take this step. That initiative appears to have paid off. Then, in 2008, the city implemented a policy requiring that fast-food restaurants post the calorie content of foods. This resulted in a small but meaningful effect: 15% of consumers read the calorie content, and these individuals then eat 100 fewer calories.

The city has also led a successful campaign to lower the sodium content in food. Last year, 21 companies met voluntary sodium-reduction targets for such products as Heinz ketchup (15% lower) and Kraft singles American cheese (18% lower).

Public Policies to Prevent CVD

Speaking with heartwire after Farley’s presentation, CCC scientific program committee chair Dr Andrew Krahn (University of British Columbia, Vancouver) noted that the public-policy approaches undertaken in New York will be key to combating CVD.

 

via http://www.medscape.com/viewarticle/812802

Fit physicians more likely to encourage patients to be active!

Its so common to be advised by a Physician to exercise for good health. But have you ever asked a Physician if he exercises?

Healthcare providers who were physically fit themselves—were more likely to encourage their patients to make regular physical activity a part of a healthy lifestyle, researchers report.

Their findings, based on a literature review of 24 observational and four interventional studies, were presented at EPI|NPAM 2013, the Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

Lead author Isabel Garcia de Quevedo (CDC, Atlanta, GA) found that  “being more active [yourself, as a healthcare provider] . . . gives you the tools to give better counseling.”

The researchers identified 28 studies of how physical-activity habits of healthcare providers were related to counseling patients about physical activity. The fitness habits of the studied healthcare providers—physicians, nurses, pharmacists, others, and nursing and medical students—significantly influenced the likelihood that they would take time to counsel patients about fitness.

Physicians who exercised were more likely to counsel about exercise. They were more confident and efficient about this counselling about this health habit than their sedentary counterparts.

Physicians can be positive role models. McCrindle, who does triathlons among other activities, noted that patients “are more likely to view healthy lifestyle advice in a positive manner if the physicians themselves look like they are following their own advice.”

When counseling patients, healthcare providers should share their personal fitness stories, which can help motivate patients and make the physician seem more human. “Patients will react to a personal story . . . rather than [simply being told] “you should do this, and this is how you should do it,” McCrindle noted.

Be active thyself  before advising thy patients!

via Fit physicians more likely to encourage patients to be active | theheart.org.

From Walking to Running!

Its necessary you read my earlier post: “Start Walking: How do I do it?”

In this post we will discuss about How to graduate from walking for 30 min to running for 30 minutes.

The American Heart Association recommends at least 30-45 minutes of exercise of moderate intensity. The goal is to increase your heart rate to at least 80% of your maximum heart rate (MHR). The MHR is calculated from the formula 220-age.

Exercises which will increase your heart rate are ones which are carried at moderate intensity. These include jogging, running, cycling, swimming and so forth.

After reading the article on  “Start Walking: How do I do it?”, I am taking for granted that you will be in a position to carry out brisk walking for 30 minutes at a stretch.

Precautions!

To run you need to do brisk walking without feeling breathless. This is necessary as going to running directly when one cannot walk could be dangerous. Running is to be avoided if you are extremely obese. Please don’t overtrain and injure yourself. During any stage of the exercise, if you feel any pain in your joints (especially the knees), its advisable to stop running. Seek medical advice if the pain persists.

Here are some general guidelines to graduate to Running:

1. Always start with some stretching exercises to relax your leg muscles.

2. Start walking at a comfortable pace for at least 10-15 minutes.

3. Now to proceed to running continuously for 30 minutes. This can be gradual and you need not rush into it. I would recommend the following to achieve this:

Lets break the 30 minutes into 5 minute intervals:

Weeks 1 and 2:  Run for 1 minute, Walk for 4 minutes, Repeat this for 30 minutes.

Weeks 3 and 4: Run for 2 minutes, Walk for 3 minutes, Repeat this for 30 minutes.

Weeks 5 and 6: Run for 3 minutes, Walk for 2 minutes, Repeat this for 30 minutes.

Weeks 7 and 8. Run for 4 minutes, Walk for 1 minute, Repeat this for 30 minutes.

Weeks 9 and 10: Run for 5 minutes, with no walk intervals, (one can still continue to have 30-60 seconds walking breaks if one wishes). That’s continuous running for 30 minutes! Congratulations! Sounds Easy!

Please remember: The 2 week options are not compulsory. One can continue with a particular week plan as long as you are comfortable (say for 4 weeks). You need to be comfortable and not have any injuries during the run. If you have any pain, stop running. Rest for few days till the pain goes away and continue only walking during that time.

So in just 10 weeks you will be able to go from  Walking to Running for 30 minutes a day!

4. The pace of running is entirely up to you. Do not sprint and invite injuries. Let it be very slow at the start. Maintain a pace wherein you are in a position to carry a conversation with a friend/ running partner comfortably without being out of breath. Slow running is better and can be continued through out life rather than fast running which may invite injuries and cause you to give it up.

5. Do a cool-down walk of 15 minutes following the run.

6. The important thing is to enjoy it! During any stage, if you feel tired or breathless, please go back to walking. Its also safer to consult your doctor if you have never exercised before.

Sounds Easy! I hope it helps! Running not only improves physical health but also give immense mental satisfaction and a sense of accomplishment. So Savour every moment of the run and the healthy lifestyle! Good Luck!

Start Walking: How do I do it?

The American Heart Association recommends at least 30-45 minutes of exercise of moderate intensity. The goal is to increase your heart rate to at least 80% of your maximum heart rate (MHR). The MHR is calculated from the formula 220-age.

So, how do you start regular walking if you have never walked before?

Exercises like running can be very bad for the joints if one is overweight and also not trained well. Swimming is one of the best exercises for the overweight, however not everyone has access to swimming pools.

So the easiest one to carry one and perform is WALKING!

Walking can be performed at any time or place and even when you are travelling!

But what do you do if you have never exercised before?

Take it easy! You can do it! Read ahead!

Here are some general guidelines:

1. Start walking at a leisurely pace for at least 10-15 minutes in a day.

In case you feel tired or breathless, slow down.  Its recommended to start any exercise gradually so that you minimize injuries. Do not overtrain.

If you have never walked before, walk for a minute and then take a break for 4 minutes. Repeat this for 30 minutes.

2. One may experience muscle cramps or joint pain in the initial few days if one has never exercised before. Do not get disheartened! Take it easy if you experience some! Apply some local ointment or take hot fomentation (with a hot water bag/ or a hot shower). Do some stretching exercise to relax your muscles. The aches and pains usually disappear in one or two weeks time.

3. Continue Walk and Rest repeats till you can do it for at least 30 minutes.

4. Now to proceed to walking continuously for 30 minutes. This can be gradual and you need not rush into it. I would recommend the following to achieve this:

Lets break the 30 minutes into 5 minute intervals:

Week 1:  Walk for 1 minute, Rest for 4 minutes, Repeat this for 30 minutes.

Week 2: Walk for 2 minutes, Rest for 3 minutes, Repeat this for 30 minutes.

Week 3: Walk for 3 minutes, Rest for 2 minutes, Repeat this for 30 minutes.

Week 4. Walk for 4 minutes, Rest for 1 minute, Repeat this for 30 minutes.

Week 5: Walk for 5 minutes, with no rest intervals, That’s continuous walking for 30 minutes! Congratulations! Sounds Easy!

So in just 5 weeks you will be able to go from No Walking to Walking for 30 minutes a day!

5. The important thing is to continue it for life and not give it up after few days.

Sounds Easy! I hope Everyone of us carries on Walking! Walking for Life!