I’ve been arguing against the universal use of statin drugs for several years now, but I’ve felt like the kid at the parade who kept saying the emperor was naked even as all the “grown-ups” continued to admire the emperor’s sartorial elegance.

Among the arguments I and many of my esteemed colleagues have made include these (pay particular attention to number 4):

1. Cholesterol doesn’t cause heart disease
2. Half the people with normal cholesterol have heart attacks and half of those with no heart disease have high cholesterol
3. Any possible benefit you may get from statin drugs is because they are mildly anti-inflammatory, not because they lower cholesterol, and
4. There has never been a single piece of convincing evidence that lowering cholesterol in women prevents a single death.

Well, it’s probably too early to be jumping with glee, but there are signs—small ones, admittedly, but signs nonetheless—that these ideas are beginning to creep over into the mainstream media.

The latest good news is an article in Time magazine by Catherine Elton which says, among other things: “…there is little evidence that (statins) prevent heart disease in women” and goes on to ask the question, “If statins do not help prolong women’s lives, why are so many women taking them?”

Good question.

One answer is that most doctors in America have about 7 minutes to spend with a patient and practice medicine by formula. “High cholesterol? Prescribe a statin.” Next patient, please.

I suspect that most docs don’t even know that the old division between “good” and “bad” cholesterol is woefully out-of-date. We now know that there are at least 5 different types of LDL (so called “bad” cholesterol”). LDL that looks like big puffy cotton balls is harmless. LDL that looks like little hard BB-pellets is atherogenic. Nonetheless most docs simply look at “LDL” as if it is all the same—which it’s not.

Another reason so many women are put on statins is what Time magazine called “The prescription Gender Gap.” Gender-based medicine takes into account the differences between en and women in the diagnosis and treatment of disease, but, as Elton points out, it has been slow to catch on, especially in the pharmaceutical industry. “Before the 1990s, women were largely excluded from clinical drug trials—an attempt to protect pregnant women from harm and avoid the potentially confounding effects of women’s hormone fluctuations” she writes. “Since then, as studies have actively recruited women, gender-based research has begun to reveal crucial information about how the development of diseases—such as heart disease, lung cancer and autoimmune disorders—may affect women in markedly different ways from men.”

Alarms get raised about saturated fat raising cholesterol but these alarms are misguided. Saturated fat often does raise cholesterol—but it raises HDL (“good”) cholesterol, and tends to increase the big fluffy cotton ball type of LDL and decrease the little BB-pellet type. So theoretically your overall cholesterol could go up but you could actually be a lot less likely to have a heart attack. I’d much rather have a high LDL (where most of the LDL was “big fluffy cotton ball type”) than a lower LDL (where most of the LDL was the atherogenic “BB-pellets type”).

In my interview on the website Big Think, link http://bigthink.com/jonnybowden I was asked to suggest some strategies for the prevention of heart disease. My first suggestion—one which I admitted was bound to infuriate a lot of conventional docs—was to stop worrying about cholesterol.

By focusing exclusively on this one misunderstood molecule—one which you absolutely need for health, by the way—we have collectively missed paying attention to the far more important risk factors for disease: smoking, high triglycerides, inflammation, and being overweight and sedentary.

Of course the fact that the two main medicines for bringing down cholesterol—Zocor and Lipitor—bring in over 30 billion dollars a year for their manufacturers might have something to do with our obsession with cholesterol numbers.

After all, as the great American writer Upton Sinclair once said: “It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”

The post Should You Take A Statin Drug? appeared first on Total Health Magazine.

Lose Weight, Get Healthy, And Live Longer

Now it turns out that the advice we were given was very far from the whole picture. “Moderate exercise can really produce enormous gains for health,” says Harvey Simon, MD, associate professor of medicine at Harvard Medical School. Dr. Simon should know. He was one of the strongest advocates for the “more is better” philosophy that’s predominated in the fitness industry for the last twenty years. “I used to say that golf was the perfect way to ruin a four mile walk,” Dr. Simon says ruefully, “because it was only exercise at a moderate level, it didn’t bring your heart rate up and your walk is constantly interrupted. Then a study was published in the American Journal of Medicine that found men who simply added golf playing to their normal daily routine lost weight, lowered their girth and improved their cholesterol levels. That got me thinking.”

Dr. Simon began researching the literature and found that indeed moderate exercise had profound benefits. Then why had the experts touted heart-pounding heavy exercise for so long? “The problem had to do with what we call “end-points,” Dr. Simon said. “When you want to find out if something is working, you have to choose some specific end point to measure. So if, for example, you’re investigating a new teaching technique for reading, you want to measure whether kids actually read better. That’s the ‘end-point.’ The old studies on exercise were looking at the ‘end point’ of aerobic capacity—how much oxygen your lungs could hold and how efficiently your body used it, he explained. To improve that specific measure of fitness—called VO2 Max, indeed, harder aerobic exercise is needed. But when you look at the ‘endpoint’ of good health, a very different story emerges.

“I reviewed 22 studies, involving 320,000 people, that evaluated the impact of moderate exercise on cardiovascular disease and longevity,” Dr. Simon said. “The results were eye-opening. Moderate exercise was credited with 18.84 percent reductions in the risk of heart disease and 18.50 percent reductions in overall mortality. If you look at breast cancer, colon cancer, depression, heart attacks, stroke, sudden cardio death, diabetes, obesity, hypertension, even dementia, exercise is extremely beneficial,” said Dr. Simon, “and it doesn’t take aerobic exercise as traditionally defined to achieve those benefits.”

Dr. Simon, in his, The No Sweat Exercise Plan has come up with a term called “Cardiometabolic Exercise” to describe the kind of moderate exercise he’s talking about. “My theory is that all physical activities anywhere on the spectrum can benefit the heart and can benefit metabolism—things like blood sugar and body fat,” he said. In his book, Dr. Simon assigns points to various activities so that people can set a goal for how many points they need a week to achieve measurable health benefits. He calls these CME points (for Cardiometabolic Exercise). Dr. Simon recommends that you achieve 150 CME points per day or 1000 CME points per week to attain significant health benefits, but you can work up to that over the course of nine weeks starting with as little as 25 CME points per day. (See table on previous page of CME points for selected activities).

Walking is the core exercise in Dr. Simon’s “No-Sweat Exercise Program” and it gets a table all it’s own in the book. The number of CME points you get for walking depends on both your weight and on your speed, but typically a 160 pound individual would chalk up about 125 CME points for every 30 minutes of walking. “I’m not at all opposed to harder exercise,” Dr. Simon said, “and if people want to earn their 1000 weekly CME points by doing hard aerobics or weight training or sports, that’s just fine. The point of this is not that those exercises aren’t valuable, but that much more moderate exercise confers great benefits as well.”

Those benefits include 21.34 percent reduction in the risk of stroke, 15.50 percent reduction for dementia, 40 percent for fractures, 30 percent for breast cancer and 30.40 percent for colon cancer. “Many of these benefits were obtained with as little as 55 flights of steps a week, an hour of gardening, or two to four hours of light leisure time activity.” said Dr. Simon. “The little things really do add up.”

In one study, after just three weeks of inactivity, healthy twenty-year-old men developed many physiological characteristics of men twice their age. After just eight weeks of exercise there was an improvement in virtually every physiological and metabolic measure, including cholesterol, heart rate stiffness, digestion, muscle mass and metabolic rate. “Exercise is just the best anti-aging medicine we have,” Dr. Simon said.

From Bottom Line’s interview with Harvey B. Simon, MD, associate professor of medicine at Harvard Medical School and the founding editor of Harvard Men’s Health Watch. Dr. Simon is the award-winning author of five previous books on health and fitness, and received the London Prize for Excellence in Teaching from Harvard and MIT. His book is The No Sweat Exercise Plan (McGraw-Hill, 2006).

The post The No Sweat Exercise Plan appeared first on Total Health Magazine.

Time is the great equalizer. The poorest person on the planet and the richest have exactly the same amount of it, 24 hours per day. No more, no less. So let’s forget about finding extra time. (Where are you going to find it, under a rock?) Instead, let’s talk about developing a budget. Let’s talk about creating our life the way we want it to be.

As a writer, I’m always fascinated with what the writing process is like for other writers. Writing is right up there with exercise in the procrastination sweepstakes. There are thousands of failed writers all over the place who are sure that the only reason they’re not successful is that they “couldn’t find time,” or didn’t have the right computer, or the right quiet room, or because they had too many other responsibilities. But successful writers-like successful exercisers-don’t have any more minutes in the day than unsuccessful writers. My favorite writing story is the one about the lawyer who wrote a novel in the wee hours of the morning before proceeding to go to work, where he put in a 60-hour week while supporting a family with three small children. It took him three years to complete the novel. The novel was A Time to Kill and the lawyer was John Grisham.

Oh, and did I mention the almost destitute young housewife with a young child and a burning desire to write no matter what? She’d sit in coffee shops and write by longhand while the baby would nap. Did it for a long time, by the way, with little support from the university. Her name is J.K. Rowling. Maybe you know her. She wrote the Harry Potter books.

So let’s dispel this notion of “I can’t find the time.” Of course you can’t. Neither can I. The problem is not one of time, it’s one of habit development. It’s about taking something that you’re not used to doing-exercise-and turning it into something that you’re not used to doing without. Work on the plan for habit acquisition and believe me, time will take care of itself.

So how do you build a habit?

Suppose you’re playing catch with a little kid. A real little kid, one who can barely get her hands around the ball and is just learning to throw. What do you do? Do you throw the ball as hard and as fast as you can? Of course you don’t because it would be impossible for her to catch it and she would get completely frustrated and give up. Sometime watch a father teaching his kid to hit a baseball. How does he pitch those first balls? Easy and gently. Underhand.

Now why do you do it like that?

Because you want the child to develop her skill. Because the one thing you don’t want is for her to feel defeated. Because you don’t want her to be frustrated. Because skill building has to start slowly, a little at a time. When she gets good at catching the ball with an easy throw, when he gets good at hitting the ball with an easy pitch, then you make it marginally harder. You keep the challenge level just slightly above the skill level, so that the skill can grow organically, step by step and the learner is always reinforced positively with a feeling of accomplishment.

And why, at the risk of repeating the obvious, do we do it this way?

Well, if I can be blunt, because no one likes to do what they suck at. If you keep having an unsuccessful experience with something, you just stop doing it. It’s not fun to fail. And that’s what most people have done with their exercise programs. They cut off a big chunk right at the beginning they can’t chew it and they spit it out. And they stop.

And blame it on not having enough time.

You are going to teach yourself something new, a new skill, a new habit, just as surely as you would teach a child to catch and throw a ball. If you start with some ridiculous goal like “I must do one hour of jogging every day,” it will be like throwing a fastball to the kid who never played catch before. You’re going to be frustrated, you’re going to think you stink at this game and you’re going to give up. That you can take to the bank. So you have to do something different. You have got to stack the deck in your own favor.

You have to set the game up so you win.

See, the subconscious mind is very simplistic. It’s very digital. It knows two states: on or off. Win or lose. Success or failure. If you set yourself an initial goal like “30 minutes on the treadmill” and you only do 20 minutes, whether you are aware of it or not, your subconscious mind logs that as a failure. You aimed for 30 and didn’t make it. Somewhere in your subconscious is a little voice sticking out its symbolic tongue and yelling “loser!” But if you set a goal of five minutes and you do five minutes, guess what? Your mind logs that as a win. Which it is. Does it matter that it’s “only” five minutes? Not on your life. What matters is that you had a positive experience.

In the first months of exercise, all we’re trying to do is to log those positives. We’re in a habit-building mode, not in “how much exercise did I do?” mode. It is not important how much you do-what is important is that you do something. Consistently. That’s how we build a habit successfully. That’s why the intro level “Shape Up” program begins with only 10 minutes of walking three times a week. What you’re really trying to do here is condition your subconscious. You want to trick it into thinking that exercise is always a “win” situation for you. Maybe for you, right now, that means just doing five minutes a day. No problem. Your conscious mind may be saying, “Five minutes can’t possibly make a difference,” but it’s dead wrong. What makes a difference-and believe me, this is the most important difference of all-is that you keep your word to yourself. You said you would do five minutes . . . and you did five minutes. You said you’re going to walk half a block . . . and you walked half a block. It may not seem like much but on a subconscious level you were learning the most valuable lesson in habit development; you’re learning to believe your own words.

I once trained a woman named Marnie, an absolutely lovely and charming occupational therapist who weighed around 250 pounds. She had never exercised successfully, hated the concept, didn’t see how she could possibly fit it into her extraordinarily busy life, but had reluctantly come to the gym on doctor’s orders. She had tried working out several times in the past and had been given long routines of weights and aerobics that she found both difficult and dull and had abandoned within a matter of days. She had very little hope that this would be different but had promised her doctor that she would give it one more shot.

The first training session we did nothing but talk. I didn’t even let her change into her gym clothes.

At the end of our meeting, I gave her her first assignment: Show up for the next session. Which she did. Early, actually.

The second time we talked some more. What was her job like? Where did she want to be in a few years? What was her health life? How, if at all, did she feel her weight held her back? How did she feel about her body? You know, stuff like that.

The third time I showed her how the treadmill worked. She actually got on it and we walked together on adjoining treadmills.

For three minutes. Yes, you heard me right. Three minutes. And that was her assignment for the next two visits. Three minutes on the treadmill. No more, no less.

She had now logged in five successful trips to the gym. I upped her assignment to four minutes.

See where I’m going with this? The biggest mistake people make when it comes to incorporating exercise into their lives is concentrating on the amount they do and how quickly it will produce results. It’s the wrong focus. Until it becomes something you can’t imagine living without, the focus should be simply on doing something consistently. Do you realize that if you started with as little as one minute a day and over the next two months added no more than 30 seconds each day, you’d be up to a half hour of daily exercise in 60 days? You can always up the ante once you develop the habit. The trick is developing the habit.

In case you’re wondering what happened with Marnie, she became one of the strongest athletes I ever trained. When she finally left me to move out West, she was regularly lifting weights, running in Central Park, going mountain biking on weekends and looking forward to learning how to ski.

You can do it, too. Or any version of it that suits your life.

If exercise is new to you, treat this part of the program as a remedial course in the power of your word. Trust me that it does not matter how little you do right now. What matters is that you promise to do it and then you keep that promise. Keep the bar low for now-in fact, I insist on it. You can always raise it. You will raise it.

When you say so.

But first you have to learn to negotiate this skill at the beginner’s level, just like the little child learning to throw a ball. You have to believe in your own word again.

And if that little voice in your head tells you that a few minutes a day can’t possible make any difference, well then, please tell her she’s more than welcome to her opinion, but to please stop chattering for a few minutes while you go work out.

The post Making Time For Exercise appeared first on Total Health Magazine.