Fitness Prescription for a Healthy Heart: Cardiovascular Wellness with Dr. Todd Duhamel

On this episode of Exercise Snacks: Bite Size Science Dr. Todd Duhamel joins Krissy Vann. Dr. Duhamel is  a leading researcher in the field of cardiovascular health and physical activity. As a Principal Investigator at the Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Dr. Duhamel dives into the pivotal role of physical activity in preventing and treating cardiovascular diseases.

Dr. Duhamel's remarkable track record includes securing over $2.4 million for research as a Principal Investigator and an additional $7.4 million for collaborative projects. His expertise extends to publishing over 100 peer-reviewed contributions, including a groundbreaking smartphone application.

In this podcast episode, we explore Dr. Duhamel's groundbreaking research, which challenges conventional notions about exercise and behavior change. Discover how simple shifts in mindset and daily habits can significantly impact physical activity levels and overall health. From debunking myths about exercise to unveiling strategies for incorporating movement into sedentary lifestyles, Dr. Duhamel offers practical insights for listeners of all backgrounds.

Gain valuable insights into the ENCOURAGE project, where Dr. Duhamel investigates innovative approaches to encourage physical activity among employees. Learn about the project's success in motivating individuals to embrace a more active lifestyle, even amidst busy schedules and sedentary routines.

Dr. Duhamel's perspective on physical activity transcends traditional fitness paradigms, emphasizing the importance of finding activities that align with personal interests and values. Whether it's enjoying outdoor work or engaging in culturally relevant physical activities, Dr. Duhamel highlights diverse pathways to staying active and healthy.

Join us as we uncover Dr. Duhamel's key recommendations for helping people overcome exercise barriers and cultivate sustainable habits. From understanding personal motivations to integrating movement into daily routines, this episode offers actionable advice for listeners seeking to enhance their well-being through physical activity.

Don't miss this opportunity to gain invaluable insights from Dr. Todd Duhamel and embark on a journey towards a healthier, more active lifestyle. Tune in to our podcast for inspiration, motivation, and transformative perspectives on exercise and cardiovascular health.

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Transcript

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For millions of years humans adapted to be moving. And what's happened over the last 100 years is really, we've gained so much mechanical advantage in industry and with machines that we've really engineered our environment where we get less physical activity now than we just started. It's time for another edition of exercise snacks bite size science presented by Alln1 SuperBlend the complete nutrition drink with a full supply of daily vitamins and minerals, and two full servings of vegetables. It's super food for superhumans visit all in alln1superblend.com. We also have a giveaway going on for you to win your very own super blend starter kit, you can head to ATFW.CA to enter. On today's episode, we welcome Dr. Todd Duhamel, who's a professor in the Faculty of Kinesiology and Recreation Management at the University of Manitoba, and principal investigator at the Institute of Cardiovascular Sciences at the General Hospital in Winnipeg. Now we know that insufficient physical activity is the single largest risk factor contributing to development of chronic diseases in the world today. Sedentary time is not the opposite of exercise, it's actually its own risk factor. Now being Heart Health Month today, we're going to explore his research that highlights that avoiding exercise might not be about discipline, but rather how physical activity is viewed. He provides science backed insights into understanding people's motivations as a way to help them find more suitable and enjoyable exercise that's easier to integrate into daily life and sustain in the long term. Before we get to the snack sized episode, be sure to hit like and subscribe. We have new episodes weekly featuring industry thought leaders and influencers. I'm your host, Krissy Vann and this is ATFW. I am so pleased to have you because it is Heart Month. And I know here at all things fitness and wellness, we speak so often to how our fitness and our overall health is really influenced by movement. And we do have this physical inactivity crisis within Canada. And unfortunately, the numbers and percentages that we see of the populace that aren't getting physically active, really hasn't changed or pivoted that much in a very long time. So I think a lot of us are trying to crack the code on how do we get more people to embrace movement in our lives. And I know that this is an area that you are an expert in. But before we get to it speak to me a little bit more about our cardiovascular health and how exercise is actually something that can really help us enhance that. Yeah, well, there's a number of ways that exercise is good. Physical activity is even better because we do it because we it's interesting to us more than anything else, we can accumulate physical activity just by going out and hanging out with friends. So the heart pumps harder blood gets flowing, that's good for your vasculature. Because the as the blood rubs the vascular walls, you get more nitric oxide that leads to vasodilation. Lots of good things, their muscles are released extra kinds, which are kind of hormones and different things, signaling molecules that are released during exercise. Those go signal faraway places, make your brain work better, your liver work better and other tissues like that. And there has to be recognition that, you know, for millions of years humans adapted to be moving. And what's happened over the last 100 years is really, we've gained so much mechanical advantage in industry and with machines that we've really engineered our environment where we get less physical activity now than we historically have you bring up such a good point I actually had a guest on recently who was working with a movement specialist. And she kept asking him, you know, what's the ideal amount? How much should I be going? And he's like, you're telling me ideal world. And if it's ideal world, we actually wouldn't be setting aside time to exercise at all, it would have been foundations built in our everyday lives because of how we had to live. And now convenience lifestyle, I'm sure many of us in 2024 Very glad we quite literally have the world at our fingertips, but it is coming at this cost. So talk to me a little bit because I know human behavior is such a specialty of yours. explain some of the misconceptions we have in regards to incorporating movement into our daily lives because the code doesn't need to be as hard to crack as it seems like we're making it. Yeah, I always get worried that when we talk about these fitness crazes, and things we worry about people that consider themselves to be athletes. And athletes are easy, right? Like they can make themselves go out and exercise they're willing to go do crazy type of Olympic training and different things. And so we don't have to worry about Olympic athletes much we don't have to worry but we can worry or as much because those people are making good choices. The people that I really worry about are the ones that hated phys ed. So think back to grade school in high school. How many people would sit on the sidelines there right very few initially in grade school. But as you got to high school people started hating because for whatever reason, some people just never Really enjoyed doing the volleyball or the different sports that were there. And we created kind of a phys ed program that was really sport based and not really lifestyle based. So people that you see active as they age are people that walk in their neighborhood people that go out and do gardening people that find ways to have an active lifestyle rather than go exercise. Because those people that are choosing to go to the gym to workout, that's awesome, that's better for you than just walking. But it's the people that are in healthcare are the ones that were likely to probably have hated presented in the old days, if they think back in their lifestyle. Everybody knows exercise is good. The hard part is is how do you get up and do it, you highlight something that speaks to me so greatly because I was the kid that was really terrible at sports. And I had a lot of gumption. So I would I warmed a lot of benches, because I would try out for everything and then just get sidelined because I was terrible. And because of that I was Phys Ed was one of the first classes I actually dropped in high school. So you saying that I actually, you gave me that aha moment in my own brain. And eventually, as an adult, I kind of circled into fitness and gym spaces, because I realized that was me against me and for myself personally became a space to really exercise my mental muscles as much as my physical. But that disconnect in fitness, they lost me there because it was entirely sports based. And as somebody that as much as I tried, it wasn't a talent. I was like, Well, I guess physical activity is not for me, which we clearly know is not the answer. So I know that you worked on the encouraged projects. So first of all, explain what that was, yeah, encouraged is a great acronym that we came up for, because what we wanted to do is encourage people to be more active. And we make connections with two different primary care clinics, and Winnipeg. So we partnered with the regional health authority we have here. And we actually put a kinesiologist into these two clinics, and their job was three things. One is to be able to help the physicians and nurse practitioners to be able to better prescribe exercise to their own clients. So they were a resource for that. The second thing that they did was actually counsel patients on how to become more physically active so that Kinesiologist would meet with their own clients at the primary care clinics, and then prescribe exercise. And then the third thing, and this was actually probably the biggest learning primary care clinics aren't necessarily well integrated into their neighborhoods. So if you think about it, you go see your doctor, you go into the doctor's office, and then you leave, and there's no connection to community. Well, if you can go to your doctor's office and actually be given information on where's the closest yoga place, or where's the closest place to go on a walking trail, and you see lots of health promotion activities listed there. And then your physician or your nurse that you're seeing, if they tell you more about exercise? How many different times can people give you information? before it starts thinking that you know what, actually being active is easier than I thought, and my health care providers telling me it's a good thing. So you're getting an exercise prescription from a doctor, you're getting it from a kinesiologist. And you're seeing that there's opportunities around? What would you do if your if your physician told you, by the way, did you know there's a pool of about a kilometer from here, just around the corner? Would you think about going more? That was kind of the ideas of what occurred was doing how do we how do we more holistically integrate physical activity counseling into health care? So what were your findings when that was being integrated in regards? Because I mean, we know for so long, we're habitual creatures, it's very easy to fall back into our patterns of how we're living our lives. So was this influence and reminders from somebody that I think most of us respect our health care providers opinions? And so we go to in our time of need, so was this effective? Yeah, so we had several 100 referrals to the program, even for things that we didn't expect. Physicians were referring people with pain to us, people with chronic diseases, women that were pregnant, that physicians wanted them to become more active, so they would refer them to their program. And on average, people are adding at least 1500 steps to their daily activities. Normally, we can talk about how to prescribe exercise a variety of ways. One of the easiest is to do step counts, Heart and Stroke Foundation of Canada recommends people do what 10,000 steps a day. The reality is, is most people that are 45 and older, might accumulate about 3000 steps. So if you have 1500 steps, so that that's actually increased 50%. So they're moving more, they're not necessarily meeting the guideline that hurt strokes recommending they might not be meeting candidates 24 Hour Movement Guidelines, which is about a two and a half hours of moderate vigorous physical activity, plus getting enough sleep plus reducing their sanitary time. But you know what, anything, any movement is better than what you did yesterday. And if you can do more tomorrow, that's success. So when you think about these people that are in health care when you walk in and you see people that are sick for various reasons. Again, they're the people that didn't necessarily love doing sports. So how do we get them doing more so I think a lot about my grandmother, she guard until she was 85. She would go out and she would just put her in the garden. Now you might not think about that. is exercise for people. But what does high intensity interval training look like to somebody that's 85 years old. Right? It's different than what it looks like for an Olympic athlete who we would normally give high intensity interval training to. But when she had to walk down and carry her, her gardening supplies were there. And she had to work for a little while tilling the ground with their hands and shovel and stuff. That was hard work for my grandma. And I actually think that that kept her alive a long time, it was good for her mentally, it was good for her to do physically down there. So that exercise prescription looks different than maybe what you give an athlete and why I want us to contextualize, doing more than you did yesterday is successful physical activity. It's a message and anybody can have. So when you, I'm aware of a program at Ottawa Heart Institute, and they do high intensity interval training with older adults that have had heart disease. And that inner that prescription they give is dancing, just stands for a minute, until you get tired, then catch your breath. If you look at a different disease state, like peripheral artery disease, we tell those people walk as fast as you can until your legs hurt, and you get this pain called claudication. Pain. It's kind of like angina. But when you have peripheral artery disease in your legs, you feel the pain in your legs. So walk as fast as you can, until you feel that pain, sit down and take a break, and then get up and do it again. Right, so that prescription looks different than it does for an Olympic athlete. But it's intensity paced, it's it's duration based. And it's progressive in that as you get the people doing this over a few weeks, they actually will walk longer before they feel that pain, they'll walk faster before they feel the pain. It's really good. So in our research in Winnipeg, we use walking speed as a predictor of cardiac surgery outcomes. So the faster you can walk five meters actually predicts how many days you'll be in hospital after heart surgery. So that's really interesting. So how do you how do we like, theoretically, how could you get people to get out of hospital sooner, get them to walk better, right. And that starts out by having people with really low fitness levels doing more today, tomorrow, the next day, and that progressively builds up. So it's really about how do you get people to get activity into their daily living, more than getting them out to a certain gym to a certain program to a certain routine, if you can get people moving more now, that's the benefit that everybody can can really gain from. I really liked that example, because we talk about that a lot that low fit or no fit to low fit segment, and how that is an absolute win if you find something that is accessible, and that they embrace and ultimately you hope that they enjoy with this prescription model did the research explore at all in regards to adherence for more longer term outcomes? Like if this mindset shift is obviously happening for people that are taking part? So how did that work from the adherence side? Because we know people have a lot of, you know, intrinsic motivation at the beginning, there may be excited that they're starting something new, but that's a very fleeting feeling. Yeah, so one of the things we would we would recommend is try to find some friends to do with having friendships and people to go with give you a support group. And that leads to better adherence. We have seasonal effects in Winnipeg, right? It's wonderful to be Winnipeg Sunny is can be, I compete against anybody in Canada for weather in the summer. You know, I used to be a weather anchor. So I'll give you that. Most years, though, when it gets cold in January, February typically can be minus 40. So we see activity levels plummet, but there's still ways to be active lot of people go mall walking or different places. So the motivation changes through the year. But the exercise prescription should change during the year, what you want to do might change during the year, there's actually evidence showing that knitting has health benefits, or just standing and doing nothing else. But standing can actually improve glucose control. So if you're a low fit person, you can get a lot of benefits from doing small activities. And then as time as you get more fit, then you should be doing more purposeful activities, you should be going more intense longer. And maybe you go from being a non exerciser to somebody that actually likes being doing exercise. Maybe your identity changes a bit. So from an adherence perspective, everybody falls off the wagon sometime. It's about what do you do to get up? So if you don't like exercising per se, which is a purposeful, intentional thing, do a stealth intervention, find a way to trick yourself into it? So we actually created an app, it was called the encourage app, it was workplace based thing. And it was it was simple reminders would come up every 30 minutes on your phone, go fill the printer with 500 pieces of paper, right and it's a ridiculous thing to do. But you walk home, you get up from your desk, you walk to the machine, the printer, you put in one roof of paper, you walk back to your desk and it's like a brief exercise snack. I know when he contacted me, you mentioned exercise, snacks. These are wonderful things. So we've actually looked at population level data through different datasets we can get and we actually looked at can a brief 32nd bout actually reduce frailty and people and we've shown this This idea that if you just sit there and be sedentary for a while, and you do a 32nd bout of intense exercise, and then go back and sit down, there's actually health benefits to that. And the idea kind of came from a joke where when I was talking with my students, I'm like, hey, when I watch football on Sundays, and this is relevant to the Super Bowl this weekend, I sit there and watch the play, a commercial comes on, and I run to my fridge, I run back to my chair, and I sit down and I eat whatever nachos are brought home, right brought over. But I said, Is there health benefits to me running to my fridge and running back, it only lasts for 30 seconds. So we basically research that question, and we're showing that that 32nd interruption to the sedentary time I'm getting sitting in my chair, actually has health benefits. So like, that's the place to start. If that little bit of exercise can help somebody. Imagine what doing more of that can do. So this is where the high intensity models that are out there that people do one minute on one minute off kind of things. Intensity seems to be the biggest driver of fitness changes or strength changes, and can affect everybody. And we use these models with people with heart disease, as well as the Olympic athletes. One of the more poignant things that you shared in this that stood out to me is when you were speaking to the reduction in days in hospital, from implementing some of these activities. And you know, nobody ever considers that unless they're actually faced with an illness. I think that we just have this mindset that they will never be me, it's always someone else until it is you and then all of a sudden you go shoo, I really should be taking charge and being an active participant in what my health looks like. But through your research, were there any other discoveries that made you go like, wow, I didn't realize that even just this little bit of effort could have such a big impact on my overall health. So the good news is, it's never too late to start being more active than you were yesterday. So even if you've perhaps been unfortunate and had a heart attack, you could actually start exercising within three days after heart attack safely. And every single time that you do a high intensity exercise bout after heart attack cuts your risk of a future heart attack in half. That's data shared by the American College of Sports Medicine. So that statistics always stuck with me because it means that even when you're at your sickest, he couldn't get up and just walk from your bed to the nursing station and back. That's a good thing. So we actually talk about exercise differently after surgery. A lot of times we talk about early mobility, how do we get people home sooner, and one of the things that seems to work is getting them up out of bed going to the washroom, you know, sometimes you're lucky enough where there's a bathroom, maybe 10 feet away from your bed and the nurse has always occurred, you get up and go to the bathroom. Right, we don't realize that that's an early mobility intervention that they're doing really want to know if we can walk that far. Because if you can walk that far, well, then maybe you can walk three times as part of the nursing station. And if you're able to work to the nurse to the nursing station, that shows that you're able to go home, right. And then these are good things, right. So there's other data out there showing that just being able to do stairs, keeps keeps older adults in their homes longer. Simple things like being able to open a heavy door is predictive of your quality of life, and different things. So even if you're sick, if you can walk better, and just add some activity, you'll you'll be healthier. And then if you can really keep that going, which is the hard part, people sometimes change and they can't continue doing it. what it might mean is, is that stop doing the same thing, you're getting bored of it, go find something different that you can do that spot. So one of the things that we we've done with some of our different initiatives is think about people that you like to have fun with. What do you do when you're hanging out with that person? Right? Rarely is it watching TV and not talking? Right? Rarely is it just watching your iPhone alone by yourself. It's usually with someone. So if you think about that really good feeling you get with your friend or with your aunt or uncle or maybe your grandparents, you're always doing something. So go do something. That's the first thing do something that's better than sitting. It's funny, even on my way into my studio today I was having a conversation with my mom who's in her late 60s. And she was quite a sedentary person. Funny enough, also worked in health care previously 12 hour shifts night shifts, no time in her world and her view for physical activity. And it wasn't until these later years it started with pickleball. And now it's pickleball Aquafit. But the thing that stood out to me in the conversation because I said to her I'm so proud of you, you've made this move. But the biggest thing is actually the social elements that have come out of it, as well because she's like now I have a walk scheduled with Anne that I met at Tai Chi and this, that and the other and her entire world that she lives in has completely changed around her because she has now this community and because of that community, it's encouraged her to try more, try more. And that's for somebody that really was like I can't I don't know how and was very married to that mindset. So it is really be possible at any point in life to mix things up. But you know for ourselves here at at DFW, we speak to a lot of fitness professionals, right up to the C suites kind of thing. And and everyone's asked themselves the same question for many years of how do we get people to hold on? How do we keep them moving. So you've shared a lot of great tips here. But if you were in their role, and really working to get people to like Ed here, and fall in love with fitness, those people that are like my mom, that was like, Nah, not for me, what would be your like, biggest overarching message for them to put into practice? Now I tell everybody go live life, it's the most important thing you can do. Right? Because if you're living life, and you're and you're making life enjoyable for yourself, you're gonna be doing things you're gonna be moving, it's gonna be in the background. Now, if you like going and doing particular fitness classes, that's awesome, do it. If you like lifting weights, go do it. If you don't like doing those things, though, there's other ways to do that. We don't even realize you're lifting weights. If we need to get people to go out and exercise per se, which is purposeful, that's great. But they have to want to do it. If they don't want to, then they're not going to show up consistently. So find the one find the WHO that makes them want to do those things. And I think that it'll be a lot easier for people to be able to stay motivated, or at least to adapt and do something different when it's time to change because they're getting bored with something I really appreciate. Because I know so many people talk about the why, but the who, that's a really good takeaway, because that really can be all the difference when they can visualize and know who they're doing it for who they want to be there for who they want to play with, participate with. So and longevity, luckily, is such a bigger part of the conversation, especially from the fitness industry perspective, the narrative shift has been very refreshing because I do think unfortunately, the way advertising was particularly when I grew up, it hasn't been helpful nor effective. Nobody wants to hear every year about the shred. Like that's not the goal. I so appreciate your time. And your insight. Is there anything else that you'd like to share with us today on the topic? Yeah, a lot of our work with heart disease is actually focused on frailty and aging, and aging. We all know somebody who's 100 years old and can run a marathon or do something that's fantastic. And it's so wonderful. But what they've done is they've been able to move enough to counteract frailty. And this idea of frailty that I want to share with you, as we leave here is its two components, what is physical frailty, the strength that they have the endurance that they have, but it's also frailty has a social component to it. If people are alone, they tend to become sedentary, they tend to do less activity. And it's the loneliness. That's a big part. So, earlier on, we talked about the hoop. I think that's a really important of why people actually get out and live life and do things. So think about that. How do you not become frail, you get out you live life, you do things with people that motivate you to do things or that you have fun doing things with. And if you do that, I think people will then do the higher intensity, the programs, the exercise that we really promote, right, but it has to start with the physical activity in wanting to do well thank you so much. I really appreciate your time. I always love having a fellow Canadian on as well. So I hope that you have a wonderful rest of your day and I appreciate you sharing your expertise with us today. Yeah, go live life. Perfect. That's the like mantra of the day. Thank you. You've just listened to the All Things fitness and wellness podcast posted by Krissy Vann This episode was brought to you by fitness world your fitness your way. Be sure to hit like and subscribe. We have new podcast episodes weekly featuring industry insiders and influencers. Together we're on a mission for everyone to live a life fit and well