The role of exercise in prevention of Coronary Artery Disease, Stroke and Other Disorders


 The role of exercise in prevention of Coronary
Artery Disease, Stroke and Other Disorders

Lt. Gen. Prof. Emeritus Mahmud Ahmad Akhtar HI (M)
Former Surgeon General Pak Army and DGMS-IS

Physical activity in any form is very important strategy. It costs nothing-aerobic exercise at least 30 mins a day on most of the weekdays aided by muscle flexibility (stretching before and after exercise regime) and muscle strengthening exercises are very effective and preventive measures. Running is more effective than brisk walking in reducing weight, while brisk walking is more effective in preventing heart attacks and strokes. Exercises done before breakfast are more helpful in reducing and maintaining an ideal weight. A schedule that allows physical activity for a few minutes every working hour of the day is far more practical and highly beneficial. The combination of morning and hourly exercises is ideal. Exercises both aerobic and muscle strengthening improve memories both verbal and spatial and prevent dementia. Exercises particularly weight bearing like running and jogging are very effective in preventing osteoporosis.

Lt. Gen. (R) Mahmud Ahmad Akhtar

These exercises done by girls from 11 to 14 years age group and by boys from 14 to 17 years age group are most effective as most of the bone is laid down during these periods after that loss of bone content begins. Exercise done during pregnancy even for 30 minutes duration on alternate days reduce the incidence of pre-eclampsia, improve mother’s sleep, well being, weight control, healthy foetal development and better parturition. After delivery mother’s sleep and health are better and the prevalence of post-partum depression is lessened. Baby sleeps well, feeds well, develops better and is less prone to metabolic diseases. Therefore like good nutrition, exercise before conception and during pregnancy is beneficial for later life.

Sitting more than an hour inhibits the enzymes responsible for fat breakdown and thus increases the weight. One should sit less and move more. There are examples of many dignitaries like Mr. Churchill who have been working while standing and giving dictations while pacing in the room. Recent studies in the UK and European countries have shown that those people who travel to their working place by walking or cycling, compared to those travelling by their vehicles, have significantly lower incidence of DM, hypertension, heart attacks, strokes and renal failure. Even those who walk to the bus stands or metro stations have lesser prevalence of such problems. Take stairs, avoid lifts, take every opportunity for walking and physical work etc.

Exercise also lowers heart rate. It has been noted that individuals with over 90 beats per minute have higher prevalence of atherosclerotic diseases and exercise helps them by lowering the heart rate. Activity in any form even feet tapping, finger wringing and house hold chores are beneficial. However some studies have shown that many urbanite women are not benefited as they get help of servants and their activities are not enough while their food intake is high. It is worth while in history taking to have details of activities and food intake in form of a few days record. Although exercise may be done from ½ to one hour in a day the rest of the waking hours of the day are most important. If rest of the day’s time is spent in inactively in bed and chair- it is highly detrimental. Any form of activity during the period is highly beneficial and matters. The paradigm is “keep on moving no stand still”.

The disabled who cannot walk can indulge in activity moving their upper limbs also lower limbs, abdomen and neck while sitting or lying down. Blood glucose drops during activity and all parameters are improved with activity. Yoga is only a muscle strengthening exercise and not an aerobic one. Sports, athletics and other activities should be promoted right from early are in all the institutions. Facilities like gyms, even at work places, parks, play grounds etc. should be provided all over the country to give optimum and accessible setting for undertaking physical activities that can prevent metabolic disorders, atherosclerotic arterial diseases, infections and malignancies etc. and produce physically and mentally fit individuals to excel in sports, athletics, workforce, soldiering and leadership etc. It is aptly said that the battle of Waterloo was won by the British in the play grounds of prestigious schools like Eaton and Harrow. Activity and exercises form and schedule should be based on the age, physical form and medical condition of the individual. One should have a thorough medical checkup and advice from a physician. Exercise regulates the circadian rhythm and sleep timing, duration and quality. Exercise should be a part of life like food and sleep. For very elderly and disabled people simple activities/ exercise like stretching, carrying on simple movements of the limbs/ trunk for few minutes every hour is a good preventive strategy.

It has also been found that regular exercise brings structural changes in the genes for the better. Strolling after lunch improves mental state for the routine work. Lunch improves mental state for the routine work. For diabetics 15 minutes exercise of moderate intensity, half an hour after meals is very beneficial in lowering blood glucose levels.

Recent Norwegian study has shown that those people who remain active in doing exercises may have fitness of biological age less than two decades of chronological age. At the age of 70 years one may have physical fitness of 50 year old person.