CARDIOVASCULAR

Posted Jan 18, 2012

To keep your car running for as long as possible you have to treat it properly: service at regular intervals, use quality fuels and keep it clean.

So why would you treat your body, itself the ultimate machine, any less carefully?

Alas, too many of us do. A recent University of Miami study found that heart disease risk factors, such as high cholesterol levels and artery inflammation, can start as early as age 3.

In the United States, 19 percent of children 2 to 18 are obese and 30 percent are overweight, according to the U.S. Centers for Disease Control and Prevention.

“By the fourth grade, 13 percent of American children already have abnormally elevated cholesterol, with a total cholesterol of 200 or higher,” said Dr. Steven E. Lipshultz, one of the study’s authors and the chairman of the pediatrics department at the University of Miami Miller School of Medicine. The numbers are disproportionately higher among Hispanic and African-American children who tended to have higher inflammation levels and lower levels of HDL, the “good” cholesterol.

“There are three really important pieces that go into exercising across the ages from childhood to the 90s: the need to do aerobics, strengthening and stretching exercises,” said Dr. Neva Kirk-Sanchez, an associate professor in the department of physical therapy at the University of Miami.

Here, then, is a lifetime guide to good health.

Birth-9

Good nutrition begins at birth.

— Breast feed your newborn.

“In long-term studies, breast feeding truly does benefit children, including lowering cholesterol levels and having lower weight and a lower prevalence of Type 2 diabetes.”

The official recommendation is to breast feed baby for the first year, with breast milk the exclusive source of nourishment for the first six months.

— Limit fat to 30 percent of a child’s total calories after age 2. After age 2, switch from whole milk to non-fat milk and have your toddler drink lots of water.

— Limit fruit juices, even 100-percent fruit juices, to no more than four ounces per day for ages 2-21.

–Trans fats should be avoided and TV time should be limited to one to two hours “of quality programming” per day, he said. “Avoid ever putting a TV in a child’s bedroom.”

— Lower sodium intake. “It’s never too early to limit sodium in a child’s diet,” Lipshultz said. “Elevated blood pressure is a major contributor to heart disease.”

— Begin blood pressure checks at age 3.

— Tests to screen for cholesterol should begin by age 9 to 11 and again at 17 for all children.

Children and adolescents should have at least one hour or more of physical exercise every day, according to the Centers for Disease Control and Prevention. Aerobic activity such as running, brisk walking and playing sports should make up the majority of the exercise.

Children 10 and under don’t need formal muscle strengthening programs, such as weight lifting, as the development of muscles begins at puberty, but muscle strengthening should be done via fun activities, such as playing on the jungle gym, swimming or gymnastics.

10-19

— Exercise, exercise, exercise — at least an hour daily, and include bone strengthening activities such as jumping rope and running games like tag or sports.

“Ninety percent of bone mass is acquired by girls by 19 and boys by 20, so childhood and early adolescence is the most important time for building bone health,” Lipshultz said. “Physical activity patterns established in childhood are carried forward in adulthood. Exercising and unlimited playtime will incorporate lifelong habits that will help the child live longer.”

— Start weight training at around age 14 or the onset of puberty, said Garrett Ratleff, personal training manager for South Beach’s Crunch. “Supervised weight training will have an effect on their body, especially if they are playing sports,” he said.

— Monitor diets. This is a time when children begin making some of their own food choices and salts, fats and sugars are tasty temptations that can lead to trouble.

“Encourage whole foods high in dietary fiber — brown rice, oatmeal, popcorn and encourage fresh fruit and vegetables at every meal,” Lipshultz said. “If you are concerned that your child is overweight, don’t wait until the next checkup to discuss ways to improve a child’s weight and diet and activity levels.”

–Don’t begin smoking and avoid smoke, period. Exposure contributes to heart and lung disease.

20-29

— The Cars had it right: Shake it up. “This is a time you should be exploring and trying different types of workouts,” Ratleff said. “At 20, your body is resilient, you don’t have to worry about injuring yourself as much.”

This is the time to consider that 5K, half marathon or full marathon. Three to six days a week of moderate to intensive aerobic activity for 20 to 60 minutes should be a goal, along with two to five days of strength training.

— Work all the major muscle groups, the legs, hips, back, abdomen, chest, shoulders and arms. If you can’t afford a gym, or class, then run, swim, bike, dance, or walk briskly around the neighborhood. Push-ups, crunches, squats and other strength activities can be done around the house or in the office. Find a wall and push against it or do dips from the back of your chair.

If you can do more than 300 minutes a week of moderate intensity activity or 150 minutes of vigorous activity you should see improvements in health.

— If you have a disability, consult with a doctor or physical therapist to see what kind of activities are suitable for you. You can also visit the National Center on Physical Activity and Disability at www.ncpad.org.

30-39

Careers and raising children often get in the way of an exercise program but there are ways around the obstacle.

— “Be more efficient in your workouts in the gym, or wherever you do it,” Ratleff recommends. Interval training — sets with multiple reps and tempo — works all the muscle groups and gets the heart rate up in an hour’s time.

— Consider classes, like a boot camp, dance, step, Pilates, kickboxing or any other creative group workout. A Masters swimming group is another fun option.

“The social support in these groups is very helpful,” Kirk-Sanchez said.

— Women should absolutely begin a weight-lifting program, or some other form of strength resistance training, in this decade if they haven’t done so during their 20s to ward off bone density loss, which starts about this time.

“Osteoporosis is a risk so if you want to delay that, start weight training,” Ratleff said.

— If you haven’t begun regular dental visits, which generally suggests twice-yearly cleanings and exams, begin now. The American Dental Association has identified an association between maternal periodontal disease and preterm delivery, preeclampsia and low birth weight infants. Later, periodontal disease can lead to cardiovascular disease.

40-49

— Stretching becomes more important as flexibility lessens. Devote more time to warming up and the post-workout stretch, Kirk-Sanchez suggests. “Don’t just walk out the door and sprint down the street. You need to adapt to the aging body and warm up,” she said.

Avoid injuries. “When you are 40 and injured you can be out for a month; in your 20s, you’re usually out for a week,” Ratleff said. Consider a certified trainer in the gym.

— Workout videos are another option for those who need some guidance but like to work out in the home. Jane Fonda, who launched the home video workout revolution in the ’80s with her tapes, is back with a new series of Prime Time DVDs that offer toning, sculpting and stretching routines designed for adults. The Dancing With the Stars pros also have DVD workouts, including one that promises Ballroom Buns & Abs.

— For women, it’s the pre-menopause period. Estrogen levels start to drop and fat storage around the abdomen goes up. Strength training and cardio remain important. For men, lean muscle mass is good for posture and a boost in the metabolism.

50-59

— If beginning an exercise program, “Start slowly and listen to the body if anything painful needs to be addressed,” Kirk-Sanchez said. Maintain at least 30 minutes of moderate activity daily and strengthening two to three days per week.

Tissues tend to get less flexible with age. Chronic problems like arthritis and obesity are often felt at this time but it is not too late to begin a program. “People very easily take the medications their doctor prescribes but are much less eager to do exercise.

“For all the chronic conditions exercise is known to prevent, you have to consider the exercise prescription just as important as taking your pills,” she said.

— Break it up. While 30 minutes of sustained moderate to vigorous activity is best in the younger years, at this stage you can break up the activities into 10-minute blocks. A brisk 10-minute walk, three times a day, five days a week, will help you hit the required 150 minutes of moderate intensity exercise.

60-69

— The retirement years (for some) lead to more time for exercise. Circuit training, swimming, cardio walking are good options, along with resistance training. Resistance bands are as viable as weights if you don’t have access to a gym.

Stretching, longer warm-ups and safety is paramount.

— Balance exercises should be added to the program. Stand on one leg, practice walking on a line or navigate through an obstacle course. Tai-Chi and yoga classes are great options for balance exercises.

“All of the sensory systems tend to decline a little in the older population, but maintaining good muscles and a healthy nervous system is much easier in those who exercise regularly,” Kirk-Sanchez said.

70-79

— Don’t forget the trunk. The core muscle group in the abdomen area helps the body maintain balance and accomplish tasks, like rising from the bed or a chair. “When older people have trouble getting out of bed that’s generally because abdominal and hip strength has declined — it’s the Use it or Lose It philosophy,” Kirk-Sanchez said.

Modified sit-ups, while seated in a chair, or crunches could help tone the tummy and help with balance.

— Forget cultural fallacies. “In Hispanic women, especially, they feel as they get older they shouldn’t exercise, but the opposite is true. They must exercise to fend off chronic diseases that come up, such as osteoporosis and diabetes,” Kirk-Sanchez said.

80 and older

— The same lessons apply. Exercise. Ratleff recalled an instructor who once counseled, “You’re never too old to do a squat.”

“You see seniors who are hunched over, posture will go quickly if you lose muscle mass and bone density,” he said.

— Consider two days of low-impact exercise, like walking or Tai-Chi. A half hour of circuit training. Trunk rotations to keep the body limber to ward off injuries from falls, which can be life-threatening.

— Many hospitals and centers offer free exercise programs, such as Baptist Health’s mall walkers program at Dadeland Mall which incorporates activities like stretching and toning exercises to music with group walking.

“Even in the 90s people can make big improvements in their ability to get up and walk around,” Kirk-Sanchez said. “Exercise has an effect on cognition, normal aging memory. It’s not only the blood flow, but the biochemistry in the brain. There are changes in the brain in response to exercise across the life span.”

©2012 The Miami Herald

Visit The Miami Herald at www.miamiherald.com

To keep your car running for as long as possible you have to treat it properly: service at regular intervals, use quality fuels and keep it clean.

So why would you treat your body, itself the ultimate machine, any less carefully?

Alas, too many of us do. A recent University of Miami study found that heart disease risk factors, such as high cholesterol levels and artery inflammation, can start as early as age 3.

In the United States, 19 percent of children 2 to 18 are obese and 30 percent are overweight, according to the U.S. Centers for Disease Control and Prevention.

"By the fourth grade, 13 percent of American children already have abnormally elevated cholesterol, with a total cholesterol of 200 or higher," said Dr. Steven E. Lipshultz, one of the study's authors and the chairman of the pediatrics department at the University of Miami Miller School of Medicine. The numbers are disproportionately higher among Hispanic and African-American children who tended to have higher inflammation levels and lower levels of HDL, the "good" cholesterol.

"There are three really important pieces that go into exercising across the ages from childhood to the 90s: the need to do aerobics, strengthening and stretching exercises," said Dr. Neva Kirk-Sanchez, an associate professor in the department of physical therapy at the University of Miami.

Here, then, is a lifetime guide to good health.

Birth-9

Good nutrition begins at birth.

-- Breast feed your newborn.

"In long-term studies, breast feeding truly does benefit children, including lowering cholesterol levels and having lower weight and a lower prevalence of Type 2 diabetes."

The official recommendation is to breast feed baby for the first year, with breast milk the exclusive source of nourishment for the first six months.

-- Limit fat to 30 percent of a child's total calories after age 2. After age 2, switch from whole milk to non-fat milk and have your toddler drink lots of water.

-- Limit fruit juices, even 100-percent fruit juices, to no more than four ounces per day for ages 2-21.

--Trans fats should be avoided and TV time should be limited to one to two hours "of quality programming" per day, he said. "Avoid ever putting a TV in a child's bedroom."

-- Lower sodium intake. "It's never too early to limit sodium in a child's diet," Lipshultz said. "Elevated blood pressure is a major contributor to heart disease."

-- Begin blood pressure checks at age 3.

-- Tests to screen for cholesterol should begin by age 9 to 11 and again at 17 for all children.

Children and adolescents should have at least one hour or more of physical exercise every day, according to the Centers for Disease Control and Prevention. Aerobic activity such as running, brisk walking and playing sports should make up the majority of the exercise.

Children 10 and under don't need formal muscle strengthening programs, such as weight lifting, as the development of muscles begins at puberty, but muscle strengthening should be done via fun activities, such as playing on the jungle gym, swimming or gymnastics.

10-19

-- Exercise, exercise, exercise -- at least an hour daily, and include bone strengthening activities such as jumping rope and running games like tag or sports.

"Ninety percent of bone mass is acquired by girls by 19 and boys by 20, so childhood and early adolescence is the most important time for building bone health," Lipshultz said. "Physical activity patterns established in childhood are carried forward in adulthood. Exercising and unlimited playtime will incorporate lifelong habits that will help the child live longer."

-- Start weight training at around age 14 or the onset of puberty, said Garrett Ratleff, personal training manager for South Beach's Crunch. "Supervised weight training will have an effect on their body, especially if they are playing sports," he said.

-- Monitor diets. This is a time when children begin making some of their own food choices and salts, fats and sugars are tasty temptations that can lead to trouble.

"Encourage whole foods high in dietary fiber -- brown rice, oatmeal, popcorn and encourage fresh fruit and vegetables at every meal," Lipshultz said. "If you are concerned that your child is overweight, don't wait until the next checkup to discuss ways to improve a child's weight and diet and activity levels."

--Don't begin smoking and avoid smoke, period. Exposure contributes to heart and lung disease.

20-29

-- The Cars had it right: Shake it up. "This is a time you should be exploring and trying different types of workouts," Ratleff said. "At 20, your body is resilient, you don't have to worry about injuring yourself as much."

This is the time to consider that 5K, half marathon or full marathon. Three to six days a week of moderate to intensive aerobic activity for 20 to 60 minutes should be a goal, along with two to five days of strength training.

-- Work all the major muscle groups, the legs, hips, back, abdomen, chest, shoulders and arms. If you can't afford a gym, or class, then run, swim, bike, dance, or walk briskly around the neighborhood. Push-ups, crunches, squats and other strength activities can be done around the house or in the office. Find a wall and push against it or do dips from the back of your chair.

If you can do more than 300 minutes a week of moderate intensity activity or 150 minutes of vigorous activity you should see improvements in health.

-- If you have a disability, consult with a doctor or physical therapist to see what kind of activities are suitable for you. You can also visit the National Center on Physical Activity and Disability at www.ncpad.org.

30-39

Careers and raising children often get in the way of an exercise program but there are ways around the obstacle.

-- "Be more efficient in your workouts in the gym, or wherever you do it," Ratleff recommends. Interval training -- sets with multiple reps and tempo -- works all the muscle groups and gets the heart rate up in an hour's time.

-- Consider classes, like a boot camp, dance, step, Pilates, kickboxing or any other creative group workout. A Masters swimming group is another fun option.

"The social support in these groups is very helpful,'' Kirk-Sanchez said.

-- Women should absolutely begin a weight-lifting program, or some other form of strength resistance training, in this decade if they haven't done so during their 20s to ward off bone density loss, which starts about this time.

"Osteoporosis is a risk so if you want to delay that, start weight training," Ratleff said.

-- If you haven't begun regular dental visits, which generally suggests twice-yearly cleanings and exams, begin now. The American Dental Association has identified an association between maternal periodontal disease and preterm delivery, preeclampsia and low birth weight infants. Later, periodontal disease can lead to cardiovascular disease.

40-49

-- Stretching becomes more important as flexibility lessens. Devote more time to warming up and the post-workout stretch, Kirk-Sanchez suggests. "Don't just walk out the door and sprint down the street. You need to adapt to the aging body and warm up," she said.

Avoid injuries. "When you are 40 and injured you can be out for a month; in your 20s, you're usually out for a week," Ratleff said. Consider a certified trainer in the gym.

-- Workout videos are another option for those who need some guidance but like to work out in the home. Jane Fonda, who launched the home video workout revolution in the '80s with her tapes, is back with a new series of Prime Time DVDs that offer toning, sculpting and stretching routines designed for adults. The Dancing With the Stars pros also have DVD workouts, including one that promises Ballroom Buns & Abs.

-- For women, it's the pre-menopause period. Estrogen levels start to drop and fat storage around the abdomen goes up. Strength training and cardio remain important. For men, lean muscle mass is good for posture and a boost in the metabolism.

50-59

-- If beginning an exercise program, "Start slowly and listen to the body if anything painful needs to be addressed," Kirk-Sanchez said. Maintain at least 30 minutes of moderate activity daily and strengthening two to three days per week.

Tissues tend to get less flexible with age. Chronic problems like arthritis and obesity are often felt at this time but it is not too late to begin a program. "People very easily take the medications their doctor prescribes but are much less eager to do exercise.

"For all the chronic conditions exercise is known to prevent, you have to consider the exercise prescription just as important as taking your pills," she said.

-- Break it up. While 30 minutes of sustained moderate to vigorous activity is best in the younger years, at this stage you can break up the activities into 10-minute blocks. A brisk 10-minute walk, three times a day, five days a week, will help you hit the required 150 minutes of moderate intensity exercise.

60-69

-- The retirement years (for some) lead to more time for exercise. Circuit training, swimming, cardio walking are good options, along with resistance training. Resistance bands are as viable as weights if you don't have access to a gym.

Stretching, longer warm-ups and safety is paramount.

-- Balance exercises should be added to the program. Stand on one leg, practice walking on a line or navigate through an obstacle course. Tai-Chi and yoga classes are great options for balance exercises.

"All of the sensory systems tend to decline a little in the older population, but maintaining good muscles and a healthy nervous system is much easier in those who exercise regularly," Kirk-Sanchez said.

70-79

-- Don't forget the trunk. The core muscle group in the abdomen area helps the body maintain balance and accomplish tasks, like rising from the bed or a chair. "When older people have trouble getting out of bed that's generally because abdominal and hip strength has declined -- it's the Use it or Lose It philosophy," Kirk-Sanchez said.

Modified sit-ups, while seated in a chair, or crunches could help tone the tummy and help with balance.

-- Forget cultural fallacies. "In Hispanic women, especially, they feel as they get older they shouldn't exercise, but the opposite is true. They must exercise to fend off chronic diseases that come up, such as osteoporosis and diabetes," Kirk-Sanchez said.

80 and older

-- The same lessons apply. Exercise. Ratleff recalled an instructor who once counseled, "You're never too old to do a squat."

"You see seniors who are hunched over, posture will go quickly if you lose muscle mass and bone density," he said.

-- Consider two days of low-impact exercise, like walking or Tai-Chi. A half hour of circuit training. Trunk rotations to keep the body limber to ward off injuries from falls, which can be life-threatening.

-- Many hospitals and centers offer free exercise programs, such as Baptist Health's mall walkers program at Dadeland Mall which incorporates activities like stretching and toning exercises to music with group walking.

"Even in the 90s people can make big improvements in their ability to get up and walk around," Kirk-Sanchez said. "Exercise has an effect on cognition, normal aging memory. It's not only the blood flow, but the biochemistry in the brain. There are changes in the brain in response to exercise across the life span."

©2012 The Miami Herald

Visit The Miami Herald at www.miamiherald.com

Tags: Arthritis, Body, Building, Cardiovascular, Chest, Children, Cholesterol, Clean, Cleaning, Diabetes, Food, Gain, Hair, Heart, High cholesterol, Injuries, Liver, Memory, Menopause, Nervous system, Osteoporosis, Pain, smoking, Strength, Weight, Weight lifting, Women

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