Increasing physical activity has a significant positive impact for women over 30
By David Dunaief, M.D.

Last week, I wrote about recognizing heart attacks. How can you reduce the likelihood that your symptoms are a heart attack? By reducing your heart disease risk.
Some risk factors, like family history and age, are not controllable; however, most are related to lifestyle and can be reduced significantly with simple lifestyle changes. Among these risks are high cholesterol, high blood pressure, obesity, sedentary lifestyle, diabetes and smoking.
If you need some encouragement, consider these results: In the Nurses’ Health Study, which followed 120,000 women for 20 years, those who routinely exercised, ate a quality diet, did not smoke and were a healthy weight experienced an 84 percent reduction in their risk of cardiovascular events, such as heart attacks (1).
Inspired? Let’s take a closer look at different factors.
How does weight affect heart disease risk?
The Copenhagen General Population Study showed an increased heart attack risk in those who were overweight and in those who were obese — whether or not they had metabolic syndrome, which is a combination of high blood pressure, high cholesterol and high sugar levels (2). “Obese” was defined as a body mass index (BMI) over 30 kg/m², while “overweight” included those with a BMI over 25 kg/m².
Heart attack risk increased in direct proportion to weight. Without metabolic syndrome, it increased 26 percent for those who were overweight and 88 percent for those who were obese.
This suggests that obesity, by itself, increases your risk. Of course, those with metabolic syndrome and obesity together were at greatest risk, but even without these, your risk is still higher if you’re carrying extra pounds.
What effect does physical activity have?
Let’s consider activity levels. An observational study found that these had a surprisingly high impact on women’s heart disease risk (3). Researchers found that, of four key factors — weight, blood pressure, smoking and physical inactivity — lack of exercise was the greatest risk factor for heart disease, including heart attacks, for those over age 30.
For women over age 70, they found that increasing physical activity might actually have the greatest positive impact on heart disease risk, more than addressing high blood pressure, losing weight, or even quitting smoking. The researchers noted that women should exercise on a regular basis to most significantly reduce their heart disease risk.
One potential inactivity driver is osteoarthritis. Traditional advice for those who suffer is that it is best to live with hip or knee pain as long as possible before having surgery. When should we consider joint replacement?
In a study, those with osteoarthritis of the hip or knee joints that caused difficulty walking on a flat surface were at substantially greater risk of cardiovascular events, including heart attack (4). Those who had surgery for the affected joint experienced substantially reduced heart attack risk. If you have osteoarthritis, it is important to improve your mobility, either with surgery or other treatments.
Are there any dietary ‘magic bullets’?
Studies show that dietary fiber decreases the risks of heart attack and death after a heart attack. In an analysis using data from both the Nurses’ Health Study and the Health Professionals Follow-up Study, results showed that higher fiber plays an important role in reducing the risk of death after a heart attack (5).
Those who consumed the most fiber had a 25 percent reduction in post-heart attack mortality when compared to those who consumed the least. Even more impressive is that those who increased their fiber intake after a cardiovascular event experienced a 31 percent mortality risk reduction.
The most intriguing part of the study was the dose response. For every 10-gram increase in fiber consumption, there was a 15 percent reduction in the risk of post-heart attack mortality. For perspective, 10 grams of fiber is just over eight ounces of raspberries or six ounces of cooked black beans or lentils.
You can substantially reduce your risk of heart attacks and even the risk of death after sustaining a heart attack by managing your weight, increasing your physical activity and making some updates to your diet.
References:
(1) N Engl J Med. 2000;343(1):16. (2) JAMA Intern Med. 2014;174(1):15-22. (3) Br J Sports Med. 2014, May 8. (4) PLoS ONE. 2014, 9: e91286 (5) BMJ. 2014;348:g2659.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.