cholesterol Archives

January 17, 2019 By Trishala Chopra 1 Comment

Effect of different medications on exercise!

statins (1) (2)

Either you or somebody you know might be on some kind of long term medications! I am not talking about somebody who takes an aspirin or a paracetamol or some antipyretic. When I say long term medications-I am talking about cholesterol, blood pressure and blood sugar lowering drugs. When a patient usually gets on any of these drugs there are high chances that they are on them forever!

Each one of these medications has a tremendous impact on the body which comes as a blow if you an exercise person!

Every medication has a different set of action, here are some points for you to keep in mind!

(1) Cholesterol medications

statins

Most commonly used cholesterol medication is statin.
The generic names of these drugs mostly available are Rosuvastatin, Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Simvastatin, Pitavastatin.

(To check which statin is your medication- check behind the tablet. Salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

Statins deplete CoEnzyme Q10 in the body which is very important for muscles to make energy. This will affect your strength training routine. Post strength training recovery will be slow.
It might also lead to rhabdomyolysis which means muscle death is definitely not good!

So, what can be done?

The first thing which you should always try is getting off statins as soon as possible with some changes in your diet and exercise routine. You can ask your coach to help you with this! (Let your doctor change your medicines and coach can guide the path to that!)
While you are on a statin, you should always try a gradual progress. Do not rush into any kind of exercise routine. Give your body enough time to get adapted.
Take longer recovery time. Instead of having a 1-day gap between your strength training schedules you can take 2 days gap which will give your muscles more time to recover! You can do light workouts on the day when you don’t plan to do strength training.

(2) Beta blockers

beta blocker

This is a group of medications used for lowering down the high blood pressure.
Most commonly used beta blockers are atenolol, bisoprolol, propranolol, metroporolol.

(To check which beta blocker is your medication- check behind the tablet. Salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

People who are on beta blockers see that their heart rate is always less no matter what form of exercise they do. Maintaining a proper heart rate during different activities is very important for having a good cardiac health.
People taking beta blockers witness that their heart rate after a sprint and after a moderate jogging is exactly the same. In fact, this shouldn’t be the case. It has to be more while sprinting than jogging.

So, what can be done?

Instead of checking your heart rate for your exercise progress, start checking your exertion timing.
If you start panting very soon, note that time. Work on your stamina and then go ahead. Beta blockers will always keep your heart rate low.

(3) ACE inhibitors

pharmacology-of-ace-inhibitors

These are another set of medications which are used in the treatment of lowering your high blood pressure!
Most commonly used ACE inhibitors are fosinopril, lisinopril, quinapril.

(To check which ACE inhibitor is your medication- check behind the tablet. The salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

There are 2 types of people- One who has high blood pressure and is not taking any medication and another one who has high blood pressure and is on either beta blocker or ace inhibitor. If the person without the medication exercises, his blood pressure will come down automatically post exercise. This is called as post exercise hypotension.
This even happens with someone who is a blood pressure medication, but then it can go really very low! That’s the reason people feel dizzy, shaky, nauseous, blurred vision post exercise. Sometimes the person can faint as well.

So, what can be done?

For obvious reasons, you cannot skip the medications and neither can you skip your workout but you can definitely manage it.
For people on BP medications, you should cool down a bit longer than an average person. Instead of a 5-minute cooldown, do a 10-minute cooldown.
Your heart beat tracker can help you in this!
For example, if your heart rate is 140 beats per minute- Post workout it can drop to 110 which is ok. After another minute it might go further low to 90. Hold on. Breathe it. Stretch yourself. Your targeted heart beat should be only 10% more than your RHR (Resting heart rate) which is around 60-70 beats per minute.

(4) Blood sugar lowering medications

lower blood sugar

There are different blood sugar lowering medications which affect the body in different ways.
Either they increase the insulin function, or removes excess sugar out through urine or decreases the amount of carbohydrate absorption in the body
For a non-diabetic person, while exercising there are different hormonal fluctuation which happens. Adrenaline is released followed by a surge in the cortisol levels and these hormones rise the blood sugar levels. To bring this down, pancreas secretes another hormone called as insulin which brings the elevated sugars down. So, the fluctuation is not seen whereas this is not the case in people with diabetes.
Some medications can cause hypoglycemia (Blood sugars below 70) in diabetics.

So, what can be done?

Well, in this case, nothing much can be done apart from monitoring.
Check your blood sugar levels before exercising, middle of the exercise and after the workout gets over.
Keep half glass of fruit juice or 1 glass of milk always with you and if the sugar drops please consume either of this.
Do strength training, reduce your carbohydrates, add enough proteins to your routine and ask your doctor to reduce your medications!

Questions for me? Please drop in the comments below!

January 18, 2018 By GOQii Editor Leave a Comment

“Good health is easily accomplished by just learning to live healthy and fit”

2 years back

Renu_Scan1

As of Nov 2017

Like every other corporate professional, her excuse for not keeping fit and healthy was her busy schedule and family. She would go for a walk as and when she felt she had the time. It was clearly not a priority for her. Being a foodie she had no concept of portion controls. She ate to her heart’s content. The end result of all this Renu Rajani, 50, was 25 kgs on the heavier side along with low metabolism and thyroid. Her condition scared her to no end and she decided to take matters into her hand to rectify her habits and become healthy. One year of disciplined lifestyle change that included exercise, eating right and sleeping well has helped her shed over 12 kgs and she is still counting. Today, she walks 15-20 k steps on an average daily, apart from 45 minutes of Yoga every day. How has she been able to transform herself? Let’s hear Renu’s story in her own words

Until mid-2016, I used to pride myself with my busy schedule, international travels and when it came to my weight gains, justified it for lack of time, about being busy with growing children and time needed at home beyond my job. Also, being a foodie, I enjoyed the richness of food, at home as well as outside. I never believed in the concept of portions control. All my New Year resolutions were short-lived. Also, amount of catching up on work late in the evening made it just impossible to wake up the next morning for a fitness routine.

My idea of fitness was just about an easy walk if I found the time. During the last 10 years, I was introduced to Fitbit and walkathons by my organizations, but I could not discipline myself. I had stopped swimming due to lack of time and I had stopped using bicycle some 15 years back. Over the last 10 years, my sedentary and unhealthy lifestyle had got me to acquire thyroid and I had to go on routine thyroid dosage. Doctors gave varied advice, some who took a view that since I had thyroid and started on medication, it should reduce my weight with some exercise. Some were of the view that given low metabolism with thyroid, it was difficult to reduce weight. I was then 25 kgs overweight.

It was difficult for me to take that 25 kgs and move around. I felt lethargy. Later in mid-2016, I started feeling stiffness in my knees, found it difficult to climb down stairs and felt swelling in my lower legs towards the evening. I found it difficult to drive back home from work. Initially, I thought it was temporary, but soon, it became a routine habit for me to come home and put my legs in the warm water to relax. My family and friends said I was ageing and that I should stop driving and have a driver. Not that I could not afford a driver, but I felt it would just make me more immobile and I would lose my freedom by restricting my activities.

I visited the doctor again and was suggested a full health examination. The examination revealed that apart from thyroid, I had borderline cholesterol, BP and Sugar. While I was thankful to god that I did not actually get into these health issues so deep, it was certainly a warning sign for me to rectify my lifestyle and in the process improve my health. I decided to accelerate my fitness journey as that was the only way to be healthy.

Soon my quest to my fitness journey started. I began with a regular walk every morning. In the process, I came across a group that performed Yoga and Pranayama in my neighbourhood. Doing Yoga at 6 am in morning meant I wake up at 5 am and walk/carry out my warm-ups. I took this seriously and had shed some 6 kgs with regular walk and yoga in about 4 months. I started to change my lifestyle influenced by my Yoga group. I started drinking water in the morning before warm-up, started carrying food from home to office, started to ensure, I slept on time to wake up for my fitness pursuits.

In the midst of my fitness journey, one day I came across GOQii in my office. It was being offered as a trial to all VPs in my organisation. I got one as well. Unlike other times where I have been introduced to a program and, I chose to not be active, this time around I took it very seriously. I thoroughly understood what GOQii does. I had an introductory call from my coach to set up goals for myself. I liked the discipline and methodical approach of GOQii. Some of my peers who were introduced to the same program used to joke about coach chasing them up for an appointment. But, having gone through a disease scare, I felt this was important and being pushed by a coach was needed. In fact, it’s the discipline and the routine set by my coach that helped me shed another 6 kgs within 6 months.

Although, I started slow. My initial goals were very basic – drink 3-litre water daily, walk 5000 steps a day, have minimum 6 hours of sleep, have smaller portions of meals more frequently (I started to have 5 smaller meals, rather than 3 big meals). I tried some simple changes – walk/cycle rather than using the car for short distances, climbing steps rather than taking the elevator, perform regular stretches to increase my activity levels. I started recording my Yoga sessions to be able to continue with Yoga during my official travels outside of Bengaluru. Food for me during international travels remained a challenge. Each time I travelled overseas, I came back with 1 Kg added in 2 weeks trip.

GOQii coaches are well trained and I have been lucky to always get a good coach. I have been a unique case of having had 7 coaches in a span of a year. 3 coaches went on long leave and each time I felt very sad about losing a good coach. On the positive note though, having the wisdom of more coaches is valuable as well. While I found one of them too easy on me and hence wanted a more pushy coach, there were two of them who pushed me beyond my stamina. Although one of my goals was weight reduction, my first priority was to get fit. I realized despite my trying, body did not cooperate. I chose to ask for a coach who would have coached age group of 40-50 women. I then found the right coach as per my needs and goals set. I am happy with my current coach Pooja Rao now.

I feel very good about myself now. My coach has slowly made me realize that I could have the right nutrition I need and could have a balanced meal with low carbohydrates. She regularly looks at my logs, suggests me any changes to food if required, has advised me on sleep, water, exercises, nutrition, etc. I feel motivated to continue trying various activities.

Over the last year, I have reduced a total of 12 kgs. Apart from my step count, Yoga/meditation and balanced food, I have been an active cyclist. I had discontinued music many years back and got back to practising music now. A month back, I also joined Salsa to add a fun activity that can also contribute to fitness. I feel lighter and feel encouraged to try more activities. I have built my stamina over the last year. I walk 15-20k steps a day, apart from 45-60 minutes of Yoga every day.

3 months back I felt encouraged enough to start with high-intensity workouts. While my knees cooperated, I realised I needed 2 hours daytime sleep to cope with 30-45 minutes of high-intensity workout. I decided to take the advice of the GOQii doctor, who asked me to check on Vitamins B12, D3 levels as I felt fatigued.

Thanks to two consultations with GOQii doctor Viral Thakkar, which I found very helpful, I realized that I needed to first address my vitamin deficiency levels to be ready for more intensive workouts.

I am encouraged to see friends who have participated in marathons, given I am able to do 10-12 km fast walk, I am now feeling motivated to someday run a marathon. Given, I am an older age group and not an athlete in my early years, I am hoping will be able to make a beginning someday soon.

The best part of GOQii is that it not only gets you fit but also socially responsible. The karma points that we earn to be active can be donated to various causes listed on GOQii’s karma platform. To date, I have donated approximately 10000 Karma points (~1000 points earned every month based on my activity).

Health is wealth. In the busy lives that we lead, health keeps becoming a distant dream and ailments keep getting added. GOQii is leveraging simple tips combined with human connect from its coaches to help people be healthy. Good health is important and it is easily accomplished by making fitness a part of daily routine and learning to live healthily.

What does coach Pooja Rao think of her player Renu Rajani

Renu is a very focused and a determined player. Despite not having coached her from day one of she getting on to the platform, the one factor I realized about her is that she is extremely hardworking and puts in a lot of efforts to achieve her goals.

The main challenge with Renu is that she has a lot of travelling in her schedule it may be domestic or international due to which being on track with her exercise and food is always a challenge, never the less she tries to make it up once she is back by setting new targets for herself.

The best thing about Renu is, she understands the portion control of her meal very well which is a challenge with all new players and once that is understood then controlling food becomes easy.

When it comes to exercise, she is open to trying out new things like cycling, yoga, HIIT, salsa-dancing and now new challenge is to participate in a Marathon.

Having a history of thyroid losing weight is always a bigger challenge and despite her lifestyle, she has still managed to drop 10 kg by working twice as hard as a normal individual.

At 50, she epitomizes the adage- “It’s never too late to begin “ completely.

September 29, 2017 By Anusha Subramanian 2 Comments

The Heart Truth: ‘Let heart disease be a new beginning’

Widely recognized as a pioneer of Cardiac rehabilitation in India, Dr Aashish Contractor is a valuable information resource for the layperson to understand the various dimensions of coronary complications, their prevention and resolution. He just does not believe in leading a sedentary lifestyle. He is a marathoner and was the medical director at Standard Chartered Mumbai Marathon from 2004-14. In his book ‘The Heart Truth’, Dr Contractor has summed up his 18 years of medical experience to provide inputs and tips on how to take care of the heart. This is not a doctor prescribing from the pulpit but a heart expert sharing his knowledge as a friend would. The intention of the book is to spell things out with clarity. Anusha Subramanian met up with Dr Contractor to know all about ‘The Heart Truth’. Here are excerpts from the Interview.

What prompted you to write this book?

Heart Disease is the leading cause of death among men and women worldwide and even in India. I have found that even among people who have suffered a heart disease, the lack of knowledge about the disease is astounding. With the amount of information we have today, I would expect people to be more aware but they aren’t. Funnily enough, there is lots of alternative information floating around and what’s app just amplifies it. Which is why I called the book- ‘The Heart Truth’ and decided let’s stick to facts and put it out. Secondly, I wanted to share a lot of real-life examples in order to show that after suffering a heart disease life does not end in fact in my opinion it begins. One starts a new chapter in life. My philosophy is one should get better than before and not just get back to where they were before. Through these real-life examples, many of whom have gone on to run marathons or climb mountains. One of them even had a turnaround just 200-300 meters from Mt Everest Summit only because of bad weather. Through the book, the idea was to showcase these real-life examples and inspire people to turn their lives and let heart disease be a new beginning.

What has led India to face this heart disease epidemic? We are already called the world Capital of Diabetes and we are not far from being called the World Capital of Heart Disease. Any particular reason why India’s are more prone to heart disease?

You are absolutely right, the trend of heart disease in India is rapidly on the increase. The statistics show that from 1990-2000 there has been a rapid upward curve for the disease and we are getting close to being called the world capital of heart disease and there are multifactorial reasons for this. According to me earlier many were dying of infectious diseases. I guess, the life expectancy during the early 50s and 60s was also less. Most were not living long enough to suffer from heart disease. As we are getting better and taking care of infectious diseases we are living longer. And with better diagnostic, we are understanding what the health issues are. Earlier, probably people were suffering heart diseases but one did not know or diagnosed and just died. Hence, we did not label it as dying of heart disease. There is a gross underestimation of the no. of heart disease deaths in the past. Now we are getting better in measuring this. Secondly, as we have got economically better off, our lifestyle has also changed. There is more processed food in our diet now than it was before, one is indulging in far less physical activity on a daily basis or there is no activity at all. Indian’s are genetically more prone to developing insulin resistance, metabolic syndrome, and higher triglycerides and more prone to developing belly fat and all of these conditions are a boiling pot which makes Indians more susceptible to heart disease.

When you say Indians are more susceptible to insulin resistance, higher triglycerides and other areas of diseases.. is it because of our diet?

One aspect could be a diet but, we should not isolate genes. Genetics or family risk for heart disease is a potent risk factor. How much would they affect, it is difficult to say. Some people’s genes are so ‘bad’ they may get it no matter what but there is a difference. If they take all the care, they may get an attack at 60, that too, a mild one than getting a fatal attack at 45. So it is not that if your genes are bad, you are doomed, there are a lot of other things that you can do. We are genetically prone and Indians are affected a decade earlier than our western counterparts.

What according to you is the best way to detect Cardiac Ailment? As a layperson, if I do not want to go to a doctor but yet know if have a cardiac ailment?

There is no best way to detect. Once you become an adult you should keep a track of your BMI, height, weight, waist circumference on a regular basis. Once a year you should get a medical checkup done to know your basic lipid, cholesterol, BP and blood sugar levels. If the values are normal then it’s very good and you should get your tests done regularly once a year and if they are not then you must take the necessary action and make sure you go for follow-ups. If you feel any sort of discomfort, heaviness, breathlessness, chest pain, pain in the arms, in the right, in the left, back, jaw, exhaustion related kind of pain could be related to heart disease, exhaustion in your daily activity which you were doing easily at one point in time could be a symptom. These are warning signs and in most cases, these symptoms do occur before the full-blown attack it’s just that people ignore these symptoms.

Are Bypass and Angioplasty the only cure or are there alternative therapies?

Talking about heart disease or blockages, depending on where and what type of blockages these are. The kind of risk profile and symptoms the patient has, the medical management the patient has undergone, whether it is a bypass surgery or angioplasty? Bypass and Angioplasty are not the only cure. All the above questions have to be built on good lifestyle management. Whether you do A B or C you still need to maintain a good lifestyle. In addition to all of this, you may be fine just taking medicines or you might need a surgery or an angioplasty. Considering avoiding bypass and telling will manage through good lifestyle is not an alternative therapy. It’s a misnomer. True alternative therapies are external counterpulsation (ECP). ECP is meant for a specific subset of patients who have had stable angina after best medical management and stable angina still remains then ECP might work on them. This is generally done over 35 sittings, for an hour each. The goal of the therapy is to create collateral circulation by opening up small channels of blood. ECP is a good therapy for some patients with angina and for patients with heart failure. However, it’s not appropriate for every person with heart disease.

Can we reverse heart disease without surgery?

The term reversal of heart disease needs to be understood properly. We think that there is an artery with 90% block and you do something and it reduces to 60% but, it doesn’t work that way. The block doesn’t shrink to 60%, the only thing that is reduced is the chance of an event. So it is a physiological reversal but it is not an anatomical reversal. When you take care of all these factors, a reversal is possible. That is what we also do in our cardiac rehab program. He has ‘a method’, we have ‘a method’ but the principles are the same

There is a huge confusion on the fact that fit people are succumbing to a heart attack. Case in point is Dr Rakesh Sinha who was fit and a marathoner and he suddenly one day had a heart attack and died. And on the other hand, you have people who are completely unfit and doing all sorts of vices and yet survive longer a with no ailments

This is a concept of Risk Factors. Different factors go into your risk to develop heart disease. My classic example is driving a car; there are many factors that are in consideration when making a car accident-free. You cannot just say that my breaks were running fine and still I had an accident. That is exactly like saying I am fit and I still got a heart attack. It is good that one is fit but it is just one factor, being fit doesn’t give you immunity against other factors.

Two things that women need to know about Heart Disease.

One of the main thing that women need to know is that heart disease is one of the main cause of deaths among women, not breast cancer. Secondly, awareness is important as women often do not get diagnosed and this is a fact world over which is they get less care than men. The symptoms such as breathlessness in women are never considered to be a risk towards heart disease and hence not be considered for diagnosis. Sadly, women’s health is the most neglected.

Dr Contractor how do you keep yourself fit

I run, cycle and gym at least four to 5 days a week. It’s a mix and match of all the activities during the week.

How do you keep yourself away from getting stress?

Stress is part of normal life. I do believe that exercising regularly is a great stress buster for me. I would like to think that I take on a fairly positive attitude and this helps. It’s about how you deal with it. Some people really react to it negatively while some people deal with it calmly.

What are the three main things that people should keep in mind?

1^st thing- you do not have to run a marathon or climb a mountain to be healthy. That you should do for achievements and not for health. First thing is to build a good baseline. Basic routine for few months then after that you can go for your huge goal of running a marathon or other extreme activities.

2^nd Make a good plan and 3^rd stick to that plan and gradually build on it. Believe me, there is nothing that you cannot do. Everybody can do everything.

Your Parting comments

Overall take care of yourself. Nobody needs to do anything dramatic. Consistency gets people results. As supposed to doing a dramatic program… push hard for 3-6 months and then after that, the motivation fades away. Remember, always stick to your plan. 42-43 weeks out of 52 weeks in a year helps.

Follow the ABCD principle-A- active, B- Blood pressure, C-Cholesterol and D-Good balanced diet, take care of Diabetes and do not smoke and get adequate sleep daily.

It’s not the end of the road. After suffering a heart ailment you can still come back and live a good life.