Your heart on nitric oxide: protectant effects of exercise.

Say YES to NO with exercise!

Say YES to NO with exercise!

Regular robust exercise protects (and extends) your health in dozens of ways.  Recent research at Emory University focused on how exercise protects your heart by stimulating your heart into generating and storing the gas, nitric oxide. To be clear, this gas is not nitrous oxide (N2O), the anesthetic “laughing gas.”

The chemical formula for the important cellular signaling gas nitric oxide is NO. One of the main signalling functions of NO is the relaxation of smooth muscles surrounding blood vessels. The resulting vasodilation allows blood to flow easier and in greater volume. Blood pressure is reduced. Dr. Oz includes a graphic of NO molecules widening blood vessels in YOU: Staying Young. He advocates nose breathing to promote NO. NO plays an important role in erections through this blood flow mechanism and is a mechanism employed by Viagra.

In addition to vasodilation, NO protects the heart and arteries, specifically the endothelial lining of blood vessels, in other ways. NO, which is produced primarily in this endothelium, also helps the heart and arteries by preventing fatty deposits. Plaque build up is reduced. Oxidation in artery walls is lessened. Stickiness of platelets and monocytes is limited. All these factor help keep arteries clear and healthy.

In the heart, the Emory research showed that this nitric oxide creation and storage in the heart of NO metabolites, nitrite and nitrosothiols proved cardio-protective. They also point to the role of endothelial nitric oxide synthase a (eNOS) and β3-adrenergic receptors (β3-ARs). They conclude, “Our findings clearly demonstrate that exercise protects the heart against myocardial ischemia–reperfusion injury by stimulation of β3-ARs and increased cardiac storage of nitric oxide metabolites (ie, nitrite and nitrosothiols).”

This cardio-protective effect lasted about a week after ceasing exercise, presumably through the release of stored NO from its metabolites remaining in the heart. So say “yes” to NO by not letting a week go by without a good session of cardiovascular exercise. Ideally, it is a very good and healthy practice to exercise hard and long enough to produce quickened breathing and sweating on a daily basis.

Much of what is known about physiology is being redefined by the recent discovery and research into the endocannabinoid regulatory system. Few physiological processes seem untouched by this system and NO production is no different.

Running speed and prevention of cardiovascular disease.

Running speed a great indicator of health.

Running speed a great indicator of health.

The key role of cardiovascular exercise in keeping healthy and hearty has been confirmed in a couple of important studies. They point out the amount of time it takes you to run a mile is a great indicator of cardiovascular health and your danger of heart attack and stroke.

Reported in Red Orbit and elsewhere, two studies of this behavioral indicator of cardiovascular health, showed that for middle-aged men, the length of time required to run one mile (1,609 meters) predicted heart attack and stroke better than did blood pressure or cholesterol levels.

Faster times predict fewer heart and brain attacks. A 55 year old male who requires 15 minutes to walk/run a mile (only 4 miles per hour) faces a 30% chance of suffering cardiovascular disease. A man of the same age who can run a mile in just 8 minutes (7.5 miles per hour) faces far lower danger of cardiovascular disease, less than 10 percent.

One way to increase running speed is with interval training, brief bursts at higher speed. After warm up jogging, a common interval is one minute slow jogging speed followed by one minute high intensity running, then repeating the sequence up to 10 times. This writer has been experimenting with slow jog/fast walk for 90 seconds, interspersed with 30 seconds high speed. This rhythm seems well suited for a non-punishing work-out made plenty intense with the periods at high speed. These high speed intervals quickly boost heart rate and sweating, both goals of a good conditioning, fat-burning workout.

High levels of physical activity such as running seem to correspond with activation of the endocannabinoid regulatory system, the receptor based system also activated by the THC in cannabis. Indeed, the fabled “runner’s high” might be the result of this system, rather than (or in addition to) to endorphins. More about this in a future post.

Caution: For those poorly conditioned, increasing activity and especially trying to push up maximum speed can present some dangers. A consultation with your (fit) medical practitioner and taking a stress EKG test is a good precaution.

Caution: Being poorly conditioned and not participating in physical activity presents an enormous risk of cardiovascular disease, along with obesity, diabetes and a host of other diseases.

Get Wellness: TIME Magazine, prevention and 10,000 steps a day.

TIME Magazine printed an important story in its January 10, 2011 issue. Get Wellness by Francine Russo. The story points out the Medicare change that will now pay for one wellness consultation a year. For the first time, physicians can get paid for not treating disease, but for actually trying to prevent it.  And the new health reform act provides other incentives and requirements for preventive wellness programs and counseling. The US health care (actually sick care) system would be wise to accelerate this new focus on prevention and wellness to balance its concentration on medical care and disease.

My main concern about last year’s health insurance reform act focused still on the sick care system, and gave too short shrift to behavioral preventive care. As the TIME article points out, about 3/4ths of the two and a half trillion dollar “health care costs stems from chronic disease, many of which may be prevented by lifestyle choices.” Indeed, a person’s own habits of exercise, eating and living are far more important, except for emergencies or accidents, to his or her health status than the entire medical care system. Little wonder that belatedly, insurance companies and health care providers are allocating resources to helping people help themselves live lifestyles that delay and prevent common infirmities. But as the TIME piece points out, most physicians are ill-equipped, by training and by incentive, to know anything about helping people adopt these positive health behaviors. The TIME article even included a graphic indicating the health wisdom of getting in 10,000 steps per day. How often do you see something like that at the doctor’s office?

Some good changes have taken place without much medical intervention. In the last generation, the USA has made substantial progress in one of the health care behaviors of its citizens. The rate of cigarette smoking has dropped in USA. This major cause of mortality and morbidity has waned, mainly though actions and social changes such as declaring no-smoking areas. Physicians have probably helped here some by advising patients to quit. In reality, though, a cigarette smoking habit should be seen as life-threatening by a doctor and an area for major concentration. Cigarettes still kill over 400,000 Americans each year, so there is a long way to go.

In other health behaviors, the news is less good. Distressingly, the past generation has seen a huge increase in Americans (and many of those in other lands) becoming obese. This trend is predisposing millions of people towards increased illness, disability and death by Type II Diabetes and other obesity-related maladies. The medical care industries can do little to cure these behavior-related diseases. These are essentially caused by poor health habits and can be cured only by healthy lifestyles. Once a year Medicare wellness consultations may help, but really obesity is now a pediatric disease, with victims as young as two years old. Fat babies usually become fat children and fat children usually become fat adults.

Blissful brains depend on strong bodies to support them. Bliss out your brain, improve your health and extend your life by taking 10,0000 steps per day, getting aerobic activity, doing weight training and eating right. A health-promoting lifestyle is your open-source health care. It is something you choose and do yourself. Perhaps now, though, some of you can even get a little preventive help with Medicare.

Cannabis dispensaries can be true wellness clinics.

Cannabis dispensaries and clinics are multiplying as citizens of ever-more American states vote to decriminalize medical marijuana. Many use the term “wellness” to describe their wider range of services. In fact, as medical cannabis becomes evermore accepted for the variety of conditions for which the herb provides benefit, dispensaries and clinics really can provide a mechanism for providing true wellness services.

The term “wellness” relates to a high level of health status, not simply the absence of disease, but the presence of behaviors that help prevent disease and cause the body to thrive. This behavioral perspective emphasizes the health practices that provide prevention effects from today’s causes of death and disability. High level wellness indicates a body not just disease-free, but strong, toned, nutritionally well fed, and free of excess tension. Wellness also refers to a relaxed but purposeful mental set, engaged with the world.

Several health behaviors are key determinants of our health status and our health future. A few of the physical activity behavioral goals may be beyond the capabilities of those with serious physical ailments, but serve as important guidelines to all. As a wellness center, the dispensary can communicate these basic practices and their importance to all patients in a variety of unobtrusive and complementary ways.

Virtually every person should:

  • Get sufficient exercise, especially walking.
  • Maintain good body composition with considerable muscle and little to moderate fat.
  • Practice good nutrition, focused on nutrient-dense, calorie-lean foods.
  • Avoid exposure to cigarette smoke.
  • Cultivate a supportive social life.
  • Manage and reduce stress.

Open Source Health Care

Two huge problems, besides the obscene cost, beset the current state of health care in the USA. One is the general non-availability of cannabinoid medications for most Americans. The other is the lack of prevention perspective; in fact, current “health care” is mainly medical care, focusing on relieving and curing established diseases.   Despite the fact that most of the ailments and diseases afflicting Americans are related to health behaviors, there is very little true prevention effort. The open source health care alternative for the 21st Century will enable people to harness cannabis for pain relief, anti-inflammation, glaucoma prevention and a dozen other conditions for which medical marijuana provides results superior to the mainstream medical/pharmaceutical approach. It will also provide a harm reduction, health promotion, preventive alternative to the current curative medical approach. Both these two problems could be addressed by dispensaries providing cannabinoid-based medications and true wellness services. Such services would address the health behaviors above:

Get sufficient exercise, especially walking. Most Americans walk far to little, depriving themselves of muscle and burdening themselves with fat. Taking at least 10,000 steps each day is a key health behavior of huge value to your health, and a crucial foundation for a preventive, wellness lifestyle. Even better is when some of these steps, or additional steps, are taken a faster pace, such as jogging a mile a day. Dispensaries could encourage patients to aspire to such basic fitness guidelines in a variety of ways:

  • Pedometers retail for $5. Providing each patient with one for no cost as part of the wellness services would send a profound message a hugely useful tool. The pedometer would of course bear the clinic’s logo.
  • Posters at the dispensary could impart more awareness of the 10,000 steps per day guideline.
  • If the clinic does the medical evaluations for eligibility for medical cannabis, this presents a perfect opportunity to encourage physical fitness goals such as 10,000 steps per day.

Maintain good body composition with considerable muscle and little to moderate fat.

America, and much of the world is suffering a crisis in body composition. Our bodies are composed evermore of excess fat. Plus we tend to carry too little muscle. Sufficient walking, see above, is key to building muscle tone and preventing fat, but additional muscle building is a healthy practice. A more muscular body composition helps burn calories, but more importantly provides a basic framework of physical strength that provides preventive and fitness dividends. Dispensaries could help patients gain the benefits of strength training with the same method as above, including posters and other messaging. The question of the obesity of its clients is important to a dispensary. Wanting to, “first, do no harm,” the clinic should confirm that its cannabis medication does not contribute to such problems. Cannabis is very effective at ending the wasting syndrome by helping people eat; its effect on people that are overweight may be less helpful. Obesity might even be seen as a contraindication in the prescription or recommendation of cannabis.

Practice good nutrition, especially nutrient-dense, calorie-lean foods.

  • The clinic or dispensary could educate on the quite incredible nutritional value of cannabis itself, in the form of hemp seed and hemp oil. Hemp seed is perhaps the most nutritious single food source, filled with essential fatty acids and proteins. The omega-3 profile of hemp seed is nearly optimal.
  • Good nutrition sets focus on nutrient-dense, calorie-lean foods, nearly the opposite of an American fast food meal.

Avoid exposure to cigarette smoke. The smoke from cigarettes, inhaled directly or as second-hand smoke, is a deadly toxin that kills over 400,000 Americans each year. Avoiding such exposure is a key preventive behavior. The reduction of cigarette smoking and proliferation of non-smoking areas providing freedom from this toxin have been a major public health victory in the last generation (and it was accomplished with zero SWAT raids and no one going to jail.

Although cannabis smoke appears far safer than cigarette smoke (marijuana smoking is not associated with lung cancer nor emphysema, two of the great risks of cigarette smoking, it is still smoke and contains toxins such as carbon monoxide (CO). Vaporizers provide a safe way to gain the medical benefits of cannabinoids with no exposure to smoke, and should be encouraged, and sold in dispensaries. With vaporizers, medical users can titrate dosages nearly as well as with smoking. In California, clinics, dispensaries and collectives have helped pioneer other ways of medicating with cannabis in a smoke-free manner. Tinctures with alcohol and edibles offer yet other alternatives. Invention, or rather reinvention of these medications (tinctures of cannabis were available to Americans 100 years ago) has been a major contribution of dispensaries in California.

Cultivate a supportive social life. Isolation is detrimental to physical and especially, mental, health. Although most important social interactions occur with family and friends, the dispensaries themselves could help provide some of this social glue so important to health.

Manage and reduce stress. Cannabis itself, especially types rich with a variety of cannabinoids, is a natural stress reducer. Indeed, much of the so called “recreational” use of cannabis helps users maintain a relaxed and happy state of mind. Stress reduction is of course a huge topic and the steps a clinic or dispensary might take are virtually limitless, from yoga classes, to progressive relaxation to massage.

Wellness and open source health care are giant topics that will be revisited.

Sitting, at least too much, is a health hazard!

Buddhists, The Thinker and a fun ad for a nature chair a few years ago read, “Don’t just do something, sit there.” That is good advice for meditation and viewing nature, but it turns out that too much chair time is a health hazard itself. Prolonged physical inactivity, such as sitting, appears incompatible with true physical health. Blissful brains and bodies, it seems, should not sit for too long.

The modern workplace is a hazardous environment from the standpoint of discouraging physical activity. Most white collar worker are anchored to desk, computer and office chair. Electronic connectivity circumvents much need to physically move. Your body, however, has a physical need to move. We evolved as walking, running, moving beings. The modern environment can result in short movements from chair to chair to another chair, then to bed. This lifestyle is toxic in bypassing the needed effects of physical activity and movement. It is also obesogenic, fattening, especially when combined with an environment studded with cheap, calorie-dense foods. As it turns out, we have to earn the right to sit down, and pay for it with physical activity.

Even for people who exercise regularly it appears that prolonged sitting remains a health hazard. Apparently, jogging for an hour after work is not enough. To be healthy we must frequently step away from the chair and move. Recent Swedish research affirms that failure to get up out of the chair frequently enough can contribute to a host of modern maladies. Sitting in place, especially for over 4 hours, seems to upset the body’s metabolism. Control of fats and glucose is upset, predisposing one to such maladies as metabolic syndrome, insulin resistance and diabetes.

Remarkably, Australian researchers recently reported an 11% increase in deaths for each daily hour of sit down time in front of the television!. Heart disease risks increased nearly 20% for each TV hour per day, a finding independent of other health habits.

When sleeping, a 160 pound office worker burns about 1 calorie each minute, 60 calories per hour, or less than 500 during an 8 hour night’s sleep. This is not much less than the 1.2 calories per minute spent by the same person while sitting and reading, only about 72 calories per hour. Light office work is not much more, less than 2 calories per minute. The seated worker burns less than 1,000 calories over an 8 hour work day.

The perfect antidote to prolonged sitting is walking. Avoiding over-long periods of sitting by interspersing short walks is a solution available to most seated workers. It takes only seconds to get up and begin walking. Immediately the body gains huge benefits. Blood circulation, made sluggish by sitting, immediately speeds up as your heart begins to accommodate the new demands caused by standing up and walking. The heart speeds up, flushing blood through your system, more air pulses into your lungs to oxygenate the coursing blood.

Walking quickly, a 160 pound office worker now quickly triples the rate his or her body burns calories, to six calories per minute. Breaking into a run, at a 10 minute per mile pace of 6 miles per hour, the jogger can double again calories burned per minute to 12! That’s is a calorie burned each 5 seconds.  Alternatively, if you have access to stairs, taking a few quick flights up and down can quickly counteract the ill health effects of too much sitting.

At the workplace, until a just a few years ago, the cigarette break was viewed as a reasonable activity. In 2010, the cessation of work for the purpose of inhaling poisons is less common. Surely the “walking break” or “stair-climbing” break can now be seen as an important activity that not only invigorates employees, as well as reducing their health care costs. Avoiding maladies caused by excess sitting is basic to the open-source health and wellness model. So don’t just sit there, for too long at least.

Medicine Grown by Hand: Medical Cannabis as an open-source model.

In his near-future dystopian novel, World Made by Hand, James Howard Kunstler presents a bleak portrayal of a small upstate New York town a couple of decades hence. The federal government had collapsed, Washington DC was nuked and the availability of gasoline and electricity ended. Ex-motor cycle toughs run the community’s central resource, the old town dump, now the source of riches such as nails. In this new world, owning a horse makes one wealthy.

In the novel, the system no longer provides medication nor medical care. The town’s doctor is the protagonist. He faces the frustrations and tragedies of having to practice medicine with no modern supplies, tools or services. With pharmaceuticals unavailable, the good doctor grows medicinal herbs. A key medication for pain relief and succor from various ailments is one not freely available before the collapse, cannabis. Treatment with cannabis is part of open-source health care in this new world. Seeds are the open source. Such self-treatment will become an ever more important part of our own health care future.

In health care, the term open-source includes self-care, with the individual taking more responsibility for his or her health and treatment. In some cases, the person (the term patient not quite right) becomes the source of treatment. Self-care itself is part of a larger wellness model that focuses upon a preventive lifestyle, especially with sufficient exercise and mindful nutrition, as key aspects of health.

Without doubt, more open-source medication, especially with cannabis, will be part of America’s health care future. For many people, including the 45 million uninsured Americans, the current health care system does not work. It has many problems:

  • The current medical care colossus sucks up one dollar out of 5 in the American economy.
  • The American system is by far the most expensive, and offers far less care for the dollar than in other countries.
  • Much of what passes for medical care is in reality too late and inefficient. It does not do well treating the huge class of auto-immune inflammatory disorders that most afflict the health of Americans with chronic degenerative diseases.
  • Medicine is (over)used to try to stave off injury of primarily a behavioral nature. Medical technology is used to try to fix damage caused by behaviors such as cigarette smoking and sedentary lifestyle.
  • Pharmaceutical drugs are prescribed for most ailments. Mortality from these drugs alone is a major cause of death.

The choices and actions of Americans, especially regarding physical (in)activity and (over)eating behaviors underlie much of what ails us. In most of the degenerative, inflammatory diseases that bedevil modern Americans, much medical care is merely palliative, relieving just the symptoms, symptoms of behavior-caused damage. Obesity, flaccid body composition and sickly organs damaged from cigarette smoking and alcohol poisoning are examples.

Type II diabetes is essentially a self-chosen disease; walking 10,000 steps a day is a robust preventative, even cure for Type II diabetes. Personal health actions such as increasing physical exercise, if universally adopted, could abolish many of the inflammatory ails that now pass for disease.

  • To ignore these preventatives and to proceed as before with a late intervention, medical and pharmaceutical approach to life-style-based health problems is folly.
  • Just as the pre-diabetic can literally walk away from diabetes, so too our general health practices determine how healthy we really are. The 10,000 steps-a-day prescription is not just for those threatened by diabetes or obesity, but serve as a good goal for nearly everyone. Such activity is open-source self-care at its best.
  • Eating daily 5 to 9 fruits and vegetables is the core of healthy nutrition. Rich in nutrients and sparse in calories, this plant based foundation provides much fiber. High fiber helps us stay full and tune the digestive system.

Aspirin-taking is open-source self-medication. Because aspirin is a legal and available drug that provides relief for a wide variety of ailments, we are free to use it for self-medication. Aspirin is very useful, but not without some dangers, such as attacking the stomach. Like most drugs, it has a lethal dose and several hundred people die from aspirin poisoning each year. Still, its ability to reduce pain and inflammation and to provide protective cardio-vascular effects make it a key open source medication.

Another substance to relieve a wide variety of symptoms such as pain and inflammation is cannabis. Unlike aspirin, no deaths are associated with its use. Like aspirin, cannabis is medically useful not just for a small array of discrete problems. Although it does provide fairly specific prevention and therapy of maladies such as glaucoma, and works wonderfully for reducing the worse symptoms of chemotherapy, its applications are broad. It is useful in treating a dozen major diseases. Other benefits are less specific. The cannabinoids in cannabis are antioxidant, anti-inflammatory, neuroprotective and analgesic. The latter, pain relief, points to the more generalized medical benefits of cannabinoids.

Pain is one of the chief reasons people seek medical care at all. What percentage of the humankind, what single person, does not experience pain at sometime in life? To quell pain is the reason most people take an aspirin. To quell pain is the main reason tens of millions of Californians in the future may take a tincture of cannabis.

  • A century hence, and hopefully far sooner, Americans will regain the pain-relieving, self-health remedies available to their ancestors. They already have in California and a dozen other states.

In a country supposedly searching for national health care answers, the open-source, self-care benefits of medical cannabis must not be ignored. Medical cannabis will not be ignored by those without insurance, nor those increasing millions who become aware of the superiority of pain relief and other medical benefits available to them with cannabis. Bizarrely, conservatives who worry that a national health care system would deny medical choices are the first to deny totally American citizens the right to choose cannabis-based medications.

Americans will make these choices anyway, using the cannabis seed as the open-source basis for their medication. Hopefully they will have state laws in place to provide them some safety from the dangers inflicted upon them by their government, as they again produce their medicine grown by hand.

Bliss out (and pump up) your brain with exercise.

Just as doing push-ups pumps up the size of your triceps, so does aerobic exercise appear to increase the volume of your brain! American researchers reporting in the British Journal of Sports Medicine show that physical exercise, especially aerobic activity, improves the functioning and structure of the brains of older people.

Improvements in brain size, with increased volumes of grey and white matter, and better brain function were found in both those with and without dementia. The so called functions of “executive control,” that help us carry on our lives planning, remembering and changing tasks are those first attacked by dementia. But study co-author Art Kramer of the University of Illinois notes that these functions are those most helped with exercise. Dementia is not only forestalled, but in some ways actually reversed with 6 months of aerobic activity. Brains benefiting from the exercise exertions of their owners maintained plasticity, essentially the capabilities to continue growing, developing and learning.

Although huge rewards accrue to both brain and body from simply walking, these researchers point out the increased benefit from more rigorous aerobic activities, such as jogging, that cause increases in heart rate and rate of breathing. So by all means walk your 10,000 steps a day, at least 5 miles, but also pick up the pace for some of those steps.  Jogging one of those five miles and moving your heart rate up into your age-appropriate training zone will yield great benefits, toning your body and growing your brain. Professor Kramer summarized, “We can safely argue that an active lifestyle with moderate amounts of aerobic activity will likely improve cognitive and brain function, and reverse the neural decay frequently observed in older adults.”

If you bliss out your brain with exercise, there is now good evidence your brain will return the favor. “Runner’s high,” is a flowing, blissful, pain-free experience associated with aerobic exercise. Formerly, the enjoyable mental and physical state was associated solely with endorphins, the body’s natural opiates. With the discovery of the endocannabinoid receptor system and endogenous cannabinoids produced by our own bodies, such as anandamide and 2-AG, this explanation is taking a new turn. After you begin exercising, your level of natural bliss cannabinoid anandamide elevates, and more of these bliss molecules float in your bloodstream, ready to jump the blood-brain barrier and activate CB1receptors on your nerve cells. The result is pain reduction and mood elevation.  So, in addition to endorphins, endocannabinoids such as anandamide reward you for your exercise efforts.

Better adaptive functioning and increased brain volumes are, at least in part, due to neurogenesis, the birth of new brain cells. Both exercise and cannabinoids promote neurogenesis. So, to gain huge health rewards, second-by-second, year-by-year, for your entire life, bliss out your brain with exercise. Walk every day, run some too, lift some weights, and every cell in your brain and body benefits.