Tuesday, May 20, 2014


We ask all our patients to exercise regularly, telling them that is it good for their health, generally, including cardiac health, bone health, musculo-skeletal health and mental health. Conversely, it is obvious that no exercise is bad BUT, does too much exercise harm you? That is the question.
Two new studies published last week at the May 14th issue of "The Heart", tries to answer this question.
The first study is interesting. Dr Ute Mons of the German Cancer Research Center, Heidelberg ( don't ask me how he got involved ), studied 1,038 CAD patients from the KAROLA study population. They were each ask about their exercise habits through a self questionaire. They found that over a 10 year priod, those who exercise intensely ( here defined as exercising 5-6 times weekly ) then to have a greater decline in exercise rates after 10 years, while those who exercise moderately ( defined as 2-4 times weekly ) could sustain their exercise regimes better. But what was more interesting was that over 10 years, those who exercise did not exercise had the highest MACE and mortality rates. Followed by those who exercise strenously. Those who exercise moderately ( 2-4 x weekly ) had the reference MACE and mortality rate, showing us that there maybe a reverse J-curve relationship between exercise and the Heart.

The second study was done by the Sweddish investigators from the Karolinska institute. They studied 44,410 AFib free male Swedes over 12 years. They were part of the Sweddish National In-patint Register. This study started in 1997, and followed up over 12 years. The age range from 45-79 with a mean age of 60 upon completion ). The subjects were asked to fill up their exercise habits at age 15yrs, 30 yrs and 50yrs. They were then grouped into the strenous exercise group ( 5hrs a week ), of leisure exercise, walking, and cycling. At the end of 12 years, they found that those who did 5hours of strenous exercise beginning when they were 30 years, had the highest incidence of A Fib. almost like those who were doing almost no exercise activity. Those who did only leisure walking exercise of about 1 hr a week had the lowest incidence of new onset A Fib. Those who did strenous activity beginning when they were younger, also then to stop exercising when they are old.

These two papers seemed to suggest that we must exercise in moderation and not to over exercise. Looks like walking about 1 hr a week sustained till old age, will help to reduce incidence of new onset A Fib and that 2-4 times of leisure exercise a week is better than 5-6 times a week and of course, no exercise is bad.
As always, everything in moderation.

1 comment:

Winston Yap said...

Ah, doc, we have always been told that we needed at least half an hour of brisk walking daily to maintain our fitness.
And it seems that this edict applies to all, including the elderly.
I think that following this exercise plan would be good for everybody.