Moderate exercise and High intensity interval Training! Pros and cons!

In a tragic turn of events, Kannada actor Puneeth Rajkumar died at age 46. He suffered from a massive cardiac arrest shortly after work out. Punith Rajkumar’s sudden death has highlighted the perils many in their 30s and 40s are facing today, which is the increasing risk of heart ailments and cardiac arrests.

None of the clubs or the clinics have the basic infrastructure including a defibrillator and monitors! A defibrillator would definitely have saved Punith Rajkumar’s life for sure!

A similar connection to extreme workout conditions was that of actor Sidharth Shukla’s death, when it was stated that he had previously worked out for 2 hours before passing away in his sleep.

In a tragic incident, a 29-year-old Italian footballer died on the field while playing a memorial match for his late brother. In February, celebrity trainer Bob Harper — a famously fit CrossFitter — suffered a “widowmaker” heart attack and went into cardiac arrest at his gym.

Hello friends

I am Dr Prabhudev

Former director of sri Jayadeva institute of Cardiology Bangalor

And Former VC of Bangalore University and

Former Chairman of Karnataka state Health commission

I am going to talk on exercise and Work outs — Moderate exercise and High intensity interval Training! Pros and cons!

Is Moderation better than intensity?

Overweight and obesity are emerging health problems in India. India is gaining weight. India has seen a rapid rise in overweight incidence in the last decade and a half. India is one of the capitals of diabetes and cardiovascular diseases. A large percentage of people in India are inactive with fewer than 10% engaging in recreational physical activity.

There is a huge population at risk for developing diabetes and other non-communicable diseases. This underscores the urgent need to improve overall physical activity levels. This could go a long way in curtailing the twin epidemics of diabetes and obesity in India.

Normal BMI: 18.0–22.9 kg/m²

Being Overweight and obese are not the same!

An adult who has a BMI between 25 and 29.9 is overweight

An adult who has a BMI of 30 or higher is obese.

Globally, more than 1.9 billion adults are overweight and 650 million are obese. Approximately 2.8 million deaths are reported as a result of being overweight or obese.

In India, more than 135 million individuals were affected by obesity. Obesity in India has reached epidemic proportions. Morbid obesity affecting 9 % of the country’s population. Do you know that our country is poor but still the third most obese country in the world! That’s insane!

Common health consequences of overweight and obesity?

Cardiovascular diseases, diabetes; musculoskeletal disorders, some cancers including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon

Obesity is preventable.

Engage in regular physical activity

Do you exercise regularly?

You know exercise is good for you, but do you know how good? Regular physical activity is one of the most important things you can do for your health. The good news is that moderate-intensity aerobic activity, such as simple brisk walking, is generally safe for most people.

Bottom line — Get at least 150 minutes of moderate aerobic activity in a week or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. Do strength training exercises for all major muscle groups at least two times a week. This Increases Your Chances of Living Longer.

Science shows that physical activity can reduce your risk of dying early from leading causes of death, like heart disease and some cancers. People who are physically active for about 150 minutes a week have a 33% lower risk of all-cause mortality than those who are physically inactive.

You don’t have to do high amounts of activity or vigorous-intensity activity to reduce your risk of premature death. Benefits start to accumulate with any amount of moderate- or vigorous-intensity physical activity.

9 or 90, abundant evidence shows exercise can enhance your health and well-being.

Aerobic exercise is the centrepiece of any fitness program. The disease-fighting benefits of exercise revolves around cardiovascular activity, which includes walking, jogging, swimming, and cycling. Brisk walking should quicken your breathing. This level of activity is safe for almost everyone and provides the desired health benefits.

High Intensity Interval Training is popular in America. The entertainment industry has adopted it without questioning it! Chiselled body with six packs and handsome looks take you a long way in the cinema industry. It pushes you to the forefront and makes up for lack of talent. Celebrities post their vigorous work out videos on the social media platforms. It gives a huge female fan following. It gives a Macho image. It makes you highly desirable.

American Heart Association says more than 350,000 people suffer out-of-hospital cardiac arrests each year throughout the United States. I don’t have the relevant figures for India. And many of these events happen while people are working out.

Make sure your fitness club or the clinic has a Defibrillator

Making sure your fitness club or a clinic which is attended by many work out addicts — has a defibrillator can mean the difference between life and death. People who suffered cardiac arrest in traditional exercise facilities with a defibrillator had a 56% survival rate. Every minute’s delay in instituting resuscitation elevates the mortality by 10 %.

Work out — Is Moderation better than intensity?

Moderate exercise

‘Walk Tall’

The line is very clear- Put your Best foot forward!

Remember Walk is your own natural gymnasium!

Is Laughter the best medicine? Yes!

But Walk is better than the best!

Being fit and active ranks alongside not smoking as the most powerful choice we can make to stay healthy.

Age is not an excuse.9 or 90 does not matter! It is never too late.

Walking 10,000 Steps a Day Keeps the Doctor 10,000 steps away! Even Walking for 30 to 60 minutes each day is one of the best things you can do for your body, mind, and spirit. Daily Walk can add 3 to 7 Years to Your Life — says the European Society of Cardiology.

Regular daily walking has been found to trigger an anti-aging process and help repair old DNA. Walking is a super food. It’s the defining movement of humans.

Go Slim Without Gym

Human walking is accomplished with a strategy called the double pendulum. During forward motion, the leg that leaves the ground swings forward from the hip. This sweep is the first pendulum. Then the leg strikes the ground with the heel and rolls through to the toe in a motion described as an inverted pendulum. The motion of the two legs is coordinated so that one foot or the other is always in contact with the ground.

How to walk?

Walk this way- The Art and Science of Fitness Walking

1.”Heel to Toe”

2. Step forward landing squarely on the heel of your foot.

3. Roll forward onto the ball of the foot.

4. Raise the heel and push off with your big toe.

5. Relax shoulders and keep them back and down

6. Bend arms 90 degrees at the elbow and swing in time with the opposite leg. This balances the body

7. Don’t tilt your head to one side, hold it straight

8. Keep your breaths regular and deep and in time with your footfalls.

Research has shown that walking at least 30 minutes a day can help you:

9. Reduce your risk of coronary heart disease and stroke

10. Improve your blood pressure, blood sugar levels and blood lipid profile

11. Maintain your body weight and lower the risk of obesity

12. Enhance your mental well-being

13. Reduce your risk of osteoporosis

14. Reduce your risk of breast and colon cancer

15. Reduce your risk of diabetes

Men Should Walk Two Miles per Day for Sexual Health to Reduce Risks of Impotence and Erectile Dysfunction. Nitric oxide (NO) increases blood flow. Physical activity has been shown to increase the vascular nitric oxide by increasing insulin sensitivity and endothelial Nitric Oxide production.

The early morning walk!

An early morning walk is one of the best exercises for a healthy life. The fresh oxygen that we often miss in concrete jungles may be easily obtained in the early hours of a morning. The freshness and mist is exhilarating!

The morning walk is more than an apple a day that keeps a doctor away. It modifies your nervous system, lessens your anger and hostility, steadies your skelleto-muscular system and prevents falls and injuries there off. It connects you with people, prevents Seasonal affective disorders, prevents depression and is antidote for winter blues. It sparks creativity.

Regular morning walks reduce resistance to insulin and makes it more functional and there by reduces obesity and belly fat. It is a low impact effective way of remodelling Body composition.

We may not avoid becoming old, but we may delay the time we get old. Regular walk makes you look ten years younger than you are! We may look young at 70 and may live into our nineties. It is an antidepressant, it improves cognitive function, and it may even retard the onset of dementia.

Benefits of Early morning walk

1. good for your heart:

One prominent benefit of early morning walk is that it can help reduce high blood pressure and high cholesterol, both of which contribute to heart disease. Three hours of brisk walking each week just 30 minutes per day can lower a woman’s risk of heart disease by 30% to 40%.

One hour of regular, moderate exercise equivalent to brisk walking, done five days a week, may cut a man’s risk of stroke by half.

2. Strengthens Bones and Joints:

Several studies have proven that just half an hour walk, four times a week, can help prevent osteoporosis.

It is easier on your joints than higher-impact activities like Tread mill or running or aerobics. It reduces the risk of falls and fractures.

Taking a walk is one of the best favours you can do for your back. It strengthens the muscles, increases circulation, and speeds up the release of feel good hormones.

3. Weight control with the help of Morning Walk:

It may seem like a leisurely activity, but with the right intensity, it can elevate your heart rate and burn serious calories so you can reach and maintain a healthy weight. Intake of fresh oxygen increases the fat burning process and hence increases the chances of weight control. It may add a dash of glow over the cheeks.

Older people who walk six miles or more per week are more likely to avoid brain shrinkage and preserve memory as the years pass. Since dementia affects one in 14 people over 65 and one in six over 80, I reckon that’s a pretty great idea.

4. General Benefits:

The oxygen that you get early in the morning also gives you great amount of energy. It opens up some of the “chakras” or channels of energy. By constantly moving your joints, you increase your blood circulation in and around the joints. A long list of mental health benefits have been attributed to exercise.

5. Walk to control Metabolic Syndrome

The metabolic syndrome is a constellation of disease. These include high blood pressure, Diabetes, high cholesterol, high levels of triglycerides, and reduces insulin resistance.

Now let us learn more about High intensity interval Training! This is what many celebrities do!

It’s a HIIT. Celebrities can teach us a lot when it comes to being sculpted, chiselled, and curvy and most importantly improving our overall health and wellbeing. New York Fitness Routine is said to deliver red carpet results.

Celebrities Britney Spears, Scarlett Johansson, and Jennifer Lopez Punith rajkumar, Siddrth Shukla are all fans of one type of training that is taking the health and wellness world by storm — HIIT.

As you can tell from the name, high-intensity interval training (HIIT) is challenging. It takes your cardio workout to another level, as you push your pace out of your comfort zone.

The HIIT program — You’ll work up a sweat fast, working at a very intense level and then backing off for a slower recovery period, followed by another round of high intensity. That strategy can save you time: You don’t have to work out as long as you would if you were keeping a moderate pace.

Results — You’ll lose weight, build muscle, and boost your metabolism. Plus there’s a post-workout bonus: Your body will burn calories for about 2 hours after you exercise.

HIIT workouts promise better results in less time, but they can take a toll on your body. The fitness industry has a bad habit of glamorizing things that aren’t actually good for you. HIIT is very taxing on the body, hence the ‘intensity’ is the name. For all of its benefits, HIIT can sometimes cause more harm than good.

Metabolic results — Cortisol levels spike, Glycogen stores deplete, Sleep becomes elusive, Metabolism is disrupted and joints pay a heavy price!

Celebrities want all in no time! A Macho image for males, a curvy body for females and a much bigger fan following for celebrities.

Negative aspects of HIIT

With research — preliminary right now, extreme exercise could be a risk factor which can damage or disrupt the heart’s functioning. However, it’s difficult to ascertain to what degree. Some research has found evidence that high intensity exercise can acutely increase the risk for sudden cardiac arrest or sudden cardiac death in individuals with underlying cardiac disease and in those with a genetic susceptibility for heart disease.

There’s been a shocking rise in the number of cardiac arrests being observed amongst those in their 30s and 40s, or even their 20s. A cardiac arrest is not a heart attack in the conventional sense! A cardiac arrest is an electrical malfunction that disrupts your heart’s rhythm so that it stops pumping blood to heart and brain and around your body. It starts with multiple ectopic beats that translate to ventricular tachycardia and may degenerate into ventricular fibrillation!

A cardiac arrest can happen anytime, anywhere. It carries a considerably high mortality. The lack of visible symptoms and detectable signs makes it dangerous.

It is said that the earliest signs of a cardiac arrest begin to show up with general symptoms which are ignored at least two weeks before the actual event and thus, over time, tend to build up and may lead to a silent death.

Younger people, particularly those in their 20s, 30s and 40s ‘ignore’ the symptoms. Those who have a genetic and pre-established disposition to heart problems do badly. While not preventable, since a lot of the ‘signs and symptoms’ of heart disease come up in the weeks preceding, and mimic common symptoms of digestive problems, fatigue, or muscle strain, it can be very difficult to rule out a cardiac arrest, and get help in time.

Late diagnosis and absence of emergency help is often the cause of increasing cardiac deaths globally.

High-intensity interval training (HIIT) has earned a spot as one of 2019’s top fitness trends, according to the American College of Sports Medicine’s annual survey. Although HIIT workouts are typically less than 30 minutes, if you did a 30 minute HIIT workout, effectively, you’d burn up to 3 times the amount of calories as you would with a weightlifting or steady-state cardio workout.

15/35, 20/40, 30/30,40/20- is the Active Vs Rest period of HIIT

The goal is to get up to 90–95% of your max heart rate each set, then when resting, not let it drop below 65%. This workout places big demands on your heart. It is muscle-building and fat-burning. It is intense. It is short. You will be breathless after the short intense work out! All you need is 7 minutes. The word is intensity! You must work out at your max capacity! It is good for losing weight. It is excellent for your body shape. But complications are significant!

The Prevalence Of Tabata

Named after Japanese researcher Izumi Tabata, who has conducted extensive research on interval training. Tabata consists of performing an activity all-out for 20 seconds, resting for 10 seconds, and then repeating the on-off sequence for four minutes total.

True interval training isn’t a rushed jog — it’s balls out. The central nervous system (CNS) is primarily affected by this high-intensity work and takes a minimum of 48 hours to recover. Training intervals once per week can improve body composition along with conditioning levels. If you’re looking to really up your conditioning, twice a week is a nice, sweet spot.

Is it good for the body?

There are tons of great reasons that HIIT has become the most popular workout in America. It’s been shown to slow down aging at the cellular level. It burns tons of calories and boosts your metabolism. It’s also super-efficient. Research has shown you can make faster cardiovascular progress with shorter, more intense workouts than you can with longer, less intense ones. Plus, you can do it from the comfort of your own home with little to no equipment required.

For better and sometimes worse, this exercise stresses your heart. “Exercise increases the need for the heart and the cardiorespiratory system to deliver oxygen to your working muscles. This Exercise can cause the heart to work harder than it should, ultimately leading to a cardiac event — like a heart attack, arrhythmias and cardiac arrests.

Excessive aerobic activity can decrease testosterone levels, increase cortisol production, weaken the immune system, handicap strength gains. It just means you need to be smart about your cardio workout.

Over exercise creates an anaerobic metabolism or a relative Hypoxic state of metabolism which often can give rise to fatal results! Anything extreme is harmful. Often It can be deadly. In women it can lead to loss of menstrual flow. It can lead to Osteoporosis. In men it can induce sexual dysfunction and loss of libido! It can hurt the joint system with arthritis. It can affect your heart! After an intense work out our immunity is on a low ebb for nearly 72 hrs.It can render you a sitting duck for infections.

What is an intense exercise?

Heart rate is measured as beats per minute. Maximal heart rate can be worked out by the following equation: Maximum HR = 220 — age. Resting Heart rate is 60 to 90 beats per minute!

Normal work out: One should aim to achieve 60 to 70 % Maximum heart rate! You can work out to include all major group of muscles twice a week

Vigorous work out is achieving 7o to 80%

Intense work out is to achieve 80 to 95% of maximal heart rate. It is dangerous if you do it regularly and for a long time! It can lead to an increase in the incidence of cardiac events! Pseudo culture tells us to push your limits.Working vigorously for more than an hour every day induces an Athlete’s heart! It gets bigger, thicker and remodels itself to meet the extra work load! It is vulnerable to cardiac events. There is a limit to human endurance- this much and no further! HIIT is not for all. Addiction for vigorous exercise more than twice a week is harmful!

Whereas those who did intense work out were seen to have a 20% incidence of irregular heartbeats and these can degenerate into fatal arrhythmias like massive cardiac arrests.

Since intense interval training should be done sparingly and for short duration, walking should never really leave your conditioning portfolio. After all, interval training for over 30 minutes at more than 75 percent intensity can be detrimental to your gains.

HIIT exercising, or high intensity interval training as it’s more formally known, has taken the fitness world by storm the last few years. It’s a proven effective way of getting fit, fast. Quite literally; the sessions are quick but tough. Because of the nature of HIIT, and the intense pressure it can put your body under. More than twice a week is pushing your selves a bit too far!

Aerobic and anaerobic exercise

If the sport becomes more intense, the oxygen requirements are higher than what your body can bring in, and that’s when you pass to the anaerobic phase. In anaerobic exercise, you have to stop the activity to recover; otherwise, you’ll become exhausted and the muscle will stop. The Anaerobic exercises tend to enlarge the myocardium. The heart muscle increases in size with sustained activity. Too much exercise can be harmful, and may cause cardiac hypertrophy or sudden cardiac death in those with certain genetic characteristics.

Changes in the Blood:

More red blood cells: athletes have more red blood cells circulating because these cells carry oxygen and the body needs more oxygen. This has an indirect effect on efficiency, as the gas is easier to transport and requires fewer heartbeats to do so. Athletes who regularly exercise have more nitric oxide circulating, which lowers blood pressure since this substance is a vasodilator.

Venous Return:

Venous return is greatly increased during exercise for the following reason: Milking or Massaging Action of Skeletal Muscles: It is claimed that limb veins undergo reflex vasoconstriction during exercise thus facilitating rapid venous return to the heart. Respiratory movements exert a sucking effect over the right heart and great veins so that greater venous return may occur.

Blood Pressure:

Blood pressure is raised with the onset of exercise. There may be an anticipatory blood pressure due to nerve impulses originating from the cerebral cortex to the medullary cardiac and vasoconstrictor centres. Other factors that may participate in the rise of blood pressure during exercise are due to activation of sympathetic — adrenal systems causing shifting of blood from the splanchnic beds to the other parts of the body.

As the work load of the heart is increased tremendously during exercise, the coronary flow is increased accordingly to its own nourishment, otherwise hypoxia may prevail. So in moderate exercise, coronary flow is increased according to the O2 requirement of the cardiac muscle.

But in severe high intensity exercise, the coronary flow may be increased no doubt, but the cardiac muscle due to tremendous increase of heart rate, will fail to maintain its O2 according to its need and the subject may feel angina pain. Results in relative Hypoxia. The Blood flow in the abdominal organ, kidneys and in the skin is greatly decreased due to compensatory vasoconstriction.

Majority of indicators tend to increase with the intensity of physical activity. The amount of oxygen consumed increases with the intensity of exercise, which causes the heart to contract more often and leads to increased breathing. Blood is pumped faster through blood vessels, so the body needs a higher concentration of oxygen molecules for active cellular absorption.

There is a significant redistribution of cardiac output. Evidence from observational studies suggests that the sweet spot is reached at just 35 minutes of intense exercise per day or two hours of moderately intense exercise after which exercise confers no additional health benefit.

After an hour of intense exercise, you are actively harming your health. There are plenty of examples of people who were thought to be supremely healthy up to the point they dropped dead of heart disease. So more is not always better when it comes to intense exercise. Some exercise is good, a lot of exercise is bad.

It’s about balancing everything. “Doing exercise, having a good diet and also giving your body time off the exercise to recover, recuperate and return to previous levels of activity.”

So, Ladies and gentlemen, I advise moderation in your workouts. Let us not be obsessed with workout addictions.

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission