This guest post was written by Dr. Bob Murray.
Four years ago, Ed had his third back surgery to relieve pain in his low back caused by spinal stenosis (narrowing of the spine.) His prescreening physical showed an abnormality in his EKG and his doctors suggested follow-up testing. Both an exercise stress test and a nuclear stress test done at rest confirmed the possibility that Ed’s coronary arteries might be blocked and an angiogram was scheduled. The angiogram verified the doctors’ suspicion: 70-95% blockage of his four main coronary arteries.
Ed’s doctors wanted to keep a close eye on him in case emergency surgery was needed so he remained in the hospital over the weekend until a surgical slot opened up. Open-heart surgery and a quadruple bypass was required to restore normal blood flow to Ed’s heart. After a few days of recovery in the hospital, he returned home to begin the cardiac rehabilitation process so familiar to millions of men and women who have undergone the same procedure.
Ed’s heart surgery was unfortunate but far from unusual for a man in his late 50s. One unusual part about Ed’s experience was that he couldn’t recall having any of the common symptoms related to coronary artery disease such as chest or arm pain, shortness of breath, unusual sweating, or fatigue. Although Ed has a desk job, he keeps himself fit by lifting weights for 45 minutes four mornings before work and then walking 3 to 4 miles after work at a fast clip while carrying a 10-lb shot-put to stress his upper body, a routine he has kept up for decades. In addition, he spends weekends on construction projects at home and around the neighborhood.
The other unusual part of Ed’s story is that he is very lean and muscular, certainly not a poster boy for heart disease. When he graduated from high school, Ed weighed 165 pounds and has maintained that exact weight for the past 40-plus years. Never one to eat much, Ed now follows a stringent low-fat diet of less than 2,000 calories each day consisting of a Clif Bar, string cheese, whole-grain bread, yogurt, fruit, skinless chicken breast or other lean meat, potatoes, and another vegetable. He only goes out to lunch if business requires it; otherwise, Ed eats only what he brings to work, along with drinking diluted coffee all day long for hydration. He may treat himself to a few cookies on some evenings and a couple beers over the weekend. Ed has conditioned himself to what many would consider to be a spartan diet but he rarely gets hungry, has above-average muscle mass and strength, and has maintained a steady body weight for many decades. There’s no disputing that this approach has worked for Ed.
Ed’s long-term goals include being able to continue his exercise and construction projects for as long as possible. He knows he needs to stay physically active to keep his heart and back healthy and recognizes that walking and biking are critical in that regard, but has learned that those activities have to be supplemented with regular strength training. Ed might also consider increasing the protein content of his diet. As we age, our muscles become more resistant to the protein we consume, so we need more protein—along with strength training—to maintain our muscle mass and strength. A good rule of thumb for gauging our daily protein needs is to multiply our body weight in pounds by 0.50 to identify our minimal protein intake and then multiply our body weight by 0.75 to calculate the upper range of daily protein consumption. For example, a 150-lb person should consume between 75 (150 x 0.50) and 112 (150 x 0.75) grams of protein each day.
Ed’s advice to those who want to ramp up their daily physical activity is to first get in shape to get in shape. When we’re unfit, it hurts to exercise, so it’s a good idea to gradually build up to making exercise a part of each day, rather than just try to jump right into an exercise routine that will inevitably cause fatigue and soreness. Spend a few weeks slowly increasing the duration and intensity of exercise—walking more/faster each day is a good way to start—before trying other fitness routines. In other words, take Ed’s advice and get in shape to get in shape.
For more information on heart healthy diets and exercise to get in shape to get you in shape, check out Dr. Murray and Dr. Rosenbloom’s book, Food & Fitness After 50, available at Amazon.