OTHER MAJOR RISK FACTORS

The American Heart Association reports the major life-style cardiac risk factors as lack of exercise, smoking, and obesity. Not far behind are two institutions as American as apple pie: a diet high in fat, especially saturated fat, and our fast-paced, stressed-out way of life. Fortunately, swimming, by itself, can ameliorate all these factors.

Lack of Exercise

Exercise does much more than improve the total cholesterol to HDL ratio. For instance, it builds heart and lung capacity and improves circulation. Yet, more than two decades into the fitness revolution, and after hundreds of scientific studies proving the many health benefits of physical fitness, an estimated 60 percent of American adults still get no exercise. Citing this fact, the American Heart Association in 1992 added inactivity to its list of major risk factors for heart disease. An AHA committee headed by Dr. Gerald F. Fletcher noted that a sedentary way of life was as big a risk factor for heart disease as high cholesterol, high blood pressure, or smoking.

According to Ralph S. Paffenberger, a professor of epidemiology at Stanford Medical School and one of the pioneers in studying the health benefits of exercise, if every American exercised, deaths from heart attacks and strokes might drop an additional 25 to 30 percent, and deaths from all causes might decline by as much as 15 percent. “That’s equivalent to what you’d get if you abolished smoking,” Paffenberger says.

Paffenberger was the author of a seminal study that first clinched the argument for exercise. In it he followed 17,000 Harvard alumni, ages thirty-five to seventy-four, for twenty years. People who made a lifetime habit of regular exercise (for example, swimming at least three times a week) had about half as many heart attacks as those who were sedentary. Even smokers, obese people, and those with high blood pressure or family histories of heart disease benefited from exercise. Another study, of 6,000 San Francisco longshoremen over twenty-two years, produced the same results.

Smoking

Americans are finally getting the message about tobacco: in terms of the number of people affected, it is the deadliest drug around. Since 1965 the percentage of people who smoke has declined steadily; by 1993 only about one in four Americans were still puffing away.

Nevertheless, cigarette smoking remains one of the AHA’s top-ranking coronary risk culprits. Aside from being by far the most important cause of lung cancer and a major factor in other forms of cancer, it also affects the heart; smoking is implicated in about one fourth of deaths from all causes. How does it do all this damage? By speeding up the heart rate, raising blood pressure, constricting blood vessels, and depressing HDL levels. Smokers are twice as likely as nonsmokers to have a heart attack and three times as likely to die from heart disease. The AHA estimates that more than 150,000 deaths from heart disease alone could be avoided each year in the United States if people gave up smoking.

While there have been no conclusive scientifically controlled studies to test whether regular swimming will cause you to stop smoking, two studies I conducted thirteen years apart suggest that almost all smokers who begin swimming for health and fitness reasons give up the nasty weed. Those few who do not quit altogether significantly reduce the number of cigarettes they smoke each day. These studies are detailed in Chapter 5.

Obesity

Related to high blood pressure, high cholesterol, and lack of exercise is obesity. In plain English, being too fat. Obesity is a major cardiac risk factor in itself. But as well, people who are fat are more likely to have high blood pressure, a high cholesterol count, and a sedentary life-style.

Fortunately, there is a painless cure for obesity: swim. As the next chapter will show, contrary to what some experts contend, swimming is one of the best ways to lose weight, especially when combined with a prudent diet. Far more important, it is an ideal way to decrease body fat.

Let’s say you can swim a mile in forty minutes—the equivalent of running the same distance in ten minutes. That will burn about 415 calories—more if you swim a stroke other than freestyle. If you swim your mile four times a week, you will lose about a pound each week, most of it fat. So not only will you be losing weight but much of the weight you lose will be fat.

Take, for example, a 180-pound man with 25 percent body fat. He is lugging around 45 pounds of fat on his frame. Although that is about average for a thirty-five-year-old American male, it is well over the 19 percent that signals the onset of cardiovascular risk. And he is only 2 percent away from being classified as morbidly obese.

Five months after beginning a program of swimming a mile a day, four or five times a week, our typical American male will have dropped to a svelte 160 pounds and, no doubt, will be out purchasing a new wardrobe. More significant, he will have reduced his body fat to about 18.7 percent of his total body weight, or approximately 30 pounds. That’s enough to get him below the level of risk for developing cardiovascular disease. Still, he has a way to go before reaching the “ideal” 15 percent body fat level that medical experts say indicates physical fitness. Another six to eight weeks of swimming should do the trick.

Or consider a woman weighing 135 pounds with 33 percent body fat. Again, although she is about average for a thirty-five-year-old American female, she’s already well beyond the 24 percent figure that puts a woman at risk for developing heart disease. And she is only a single percentage point from the medical classification of morbid obesity.

Half a year after beginning a swimming program of just one mile a day, four or five days a week, our model American female will have dropped her weight to about 115 pounds. With fat constituting most of the weight loss, her body fat percentage will be down to 24—significantly lower than the average thirty-five- or even twenty-five-year-old and within striking distance of the “ideal” 22 percent level that defines physical fitness for women. More important, she will have eliminated the risk that comes with being obese.

There is nothing unusual about these examples. I have seen such transformations happen hundreds, perhaps thousands, of times. And at Masters swim meets, I see all around me men and women in their fifties, sixties, and older with the bodies of twenty- and twenty-five-year-olds. They look the way the human animal is supposed to look: trim, well-muscled, flexible, healthy, and strong. What they have done is simply kept a promise to themselves to do the best form of exercise there is—swimming—on a regular basis. The payoff—a healthy heart, an attractive body, boundless energy, a renewed enthusiasm for life—more than justifies the time commitment. And if they can do it, so can you.

Modern Life

Some of the standard components of life in modern industrial society also constitute significant risk factors for heart disease. Among these are stress and a diet high in saturated fat. Once again, these factors are often seen in combination with other risk factors—for instance, hypertension and high cholesterol—which magnify their negative effects.

Rhythmic, aerobic exercise has been discovered to be an effective means for reducing stress and so has helped many Americans deal with their lives in a more healthy way. But it remains true that no exercise is better for reducing stress than swimming.

Much has been written about “runner’s high,” the endorphin-induced state of relaxation that often accompanies distance running. Actually, the name is a misnomer, for the state can be induced by many activities, among them swimming. Not only does swimming provide the same high and the same stress-reducing benefits as running or biking but it does so in an environment, water, that is especially soothing to the body and psyche. When I finish a swim, no matter how tough or tiring, I always feel a sense of inner peace and relaxation.

As for diet, swimming cannot affect what you eat directly. You can fill your body with high-fat junk food whether you work out or not. But once most people commit themselves to improving their health through exercise, they also begin to experience a taste for a healthier diet. Chapter 4 will explain what constitutes a healthier diet and how swimming and diet can work hand in hand to reward you with optimal health throughout your life.