Cycling to work, occasionally taking a walk – many people think that just a little exercise is enough to keep the body reasonably fit. But meanwhile, experts recommend intensive training to keep the body healthy – even the heart benefits from it. And they go even further, advising to use training for therapy. "Sport acts like a medicine, but has much fewer side effects," says Martin Halle, professor and medical Director of Preventive Sports Medicine and Sports Cardiology at the Klinikum rechts der Isar, the university hospital of the Technical University of Munich. "Exercise lowers blood pressure as well as a tablet of a blood pressure medication – but the best thing is that active people are much less likely to have cardiovascular diseases, so exercise also prevents them." But how exactly does sports activity affect our cardiovascular system?
How messenger substances promote our health
First of all, sport trains the heart muscle: In people who exercise regularly, more blood can be ejected per heartbeat. Such a heart can supply the body with oxygen-rich blood with fewer beats than in untrained people. This has the positive effect that the resting heart rate is lower in sporty people. This so-called "athlete's heart" is larger than in untrained people and the heart walls are thicker. The changes in an athlete's heart are similar to the deviations that can occur with certain heart diseases. "In contrast to the inactive, this has no negative effects on the cardiovascular system," says Martin Halle. "In high blood pressure, the heart is often pathologically enlarged." It must then work harder against the higher pressure in the system to supply the body. To prevent these dangerous diseases, sports with intensive muscle strain help.
This is due to a relatively new insight: muscles are, in terms of mass, our largest body part. And they send out more than 600 messenger substances, which are called myokines. "Above all, they have a positive effect on a wide variety of body functions and the heart," says Christian Schmied, professor of preventive cardiology and sports medicine at the University Heart Center Zurich. "Through sport, you can ensure that these messenger substances are distributed more and more.«
Many positive effects of sport on the cardiovascular system are attributed to the myocines-also messenger substances from the bones, so-called osteokines, play a role. "Messenger substances such as emails between bones and muscles are exchanged," says Martin Halle. "In order for these to be released, you have to burden the bones and stretch the muscles - that's why we recommend strength training today in addition to endurance training."
How much and what kind of sport is healthy
The WHO guideline for movement recommends at least 150 minutes of moderate to intensive training per week, about 21 minutes a day. It should be 60 minutes a day for children between 5 and 17 years. "If you feel the pulse, this is moderate as soon as you get sweating, we speak of intensive stress," explains Michael Leitzmann, professor of epidemiology and preventive medicine at the University of Regensburg and co -author of the guidelines. The recommendations of the WHO are based on data of large, epidemiological studies that examine how the scope and intensity of physical activity are related to mortality and disease risks-especially for cardiovascular diseases.
Little has changed in the guidelines in the past ten years. However, the advice is relatively new to avoid inactivity and sitting. The focus is still on endurance training, but another form of training is very emphasized: "We have recently started the recommendation for strength training of all important muscle groups," says Michael Leitzmann. From the point of view of cardiac medicine, this is also positive, says Christian Schmied. »In the past, there was only endurance sports to prevent heart disease and rehab. In the meantime, however, we also recommend moderate strength and interval training; In this way you can enlarge the muscle mass and thus distribute more health -promoting messenger substances. «
Perhaps that's why even very short, intensive sports intervals are enough: recently an Australian study showed that even 15 to 20 minutes of intensive exercise per week lead to a 16 to 40 percent lower mortality risk. According to this, two minutes of physical exertion twice a day is already enough to reduce the risk of heart attack and stroke, with 50 to 57 minutes of exertion it decreases even further. "When I talk about sports, I don't mean chess and shooting," says Martin Halle. "It takes a certain intensity of muscle activation for the myokines to be released." Intensive sports also ensure that heart-damaging metabolic products increasingly disappear from the blood. "The muscles release interleukin 6," says Martin Halle. "A cytokine that, among other things, ensures that the muscles suck the glucose out of the blood for energy production.«
How can I intensify my training?
The role of cholesterol and visceral fat
The most important risk factor for cardiovascular diseases is an unfavorable blood fat profile. "Especially when the bad LDL cholesterol is too high, there is arteriosclerosis, the so-called artery calcification," says Martin Halle. "In the small coronary arteries, cholesterol is continuously deposited in the walls that can lead to high -grade vascular narrowing and even vascular closures with a result of a heart attack for years." The blood lipid is positively influenced by sporting activity - as is not yet completely understood. LDL cholesterol (low-density-lipoproteine; donkey bridge: "dissolved"), i.e. cholesterol particles with low density, are in a slightly lower concentration in athletes and are rather larger. The latter is more likely to stop entering the vascular walls and storing herself there.
For a long time it was thought that exercise directly increased the concentration of the "good" HDL cholesterol particles (high-density lipoproteins; donkey bridge: "Hab-Dich-Lieb"), and this increased the transport of the "bad" LDL cholesterol - and thus prevented deposits in the vessels. However, sport does even more, which is not yet understood: because if doctors increase the HDL level with medications, this alone does not yet have a preventive effect with regard to cardiovascular diseases. "What we know is that enzymes are released in the vessels as a result of exercise," says Martin Halle. "These dock in the liver and muscles, change the cholesterol particles to less vessel-damaging cholesterol and blood fats.«
Doctors have identified certain fat pads as particularly heartbeat, but they do not have to do with cholesterol or blood fats and have a negative impact on them. A distinction is made between fat that is under the skin and those that surrounds the organs inside the abdominal cavity or literally enforces them as with the liver. The latter, the visceral fat, is particularly unhealthy because it constantly forms inflammatory messenger substances and releases into the blood. "In people who have too much of it, the liver, the pancreas and the heart are greased," says Martin Halle. "This local adipose tissue ensures a constant inflammatory reaction and this mainly causes an early arteriosclerosis and stiffening of the heat."
However, excess visceral fat is broken down during exercise before the other fat pads. "Getting rid of visceral fat is crucial to reduce the risk of heart disease," says Christian Schmied. However, the body mass index often used to determine obesity is unsuitable for measuring progress through sport. "In patients who start exercising, muscle mass grows – and this is heavier than fat," explains Christian Schmied. "Under certain circumstances, these people even gain weight through sport, many worry about it – but this weight gain is positive."
A good measure of visceral fat is the abdominal circumference. "It is easy to measure and does not depend as much on stature as weight and BMI," says Christian Schmied. You just put a measuring tape around the belly at the thickest point: for men, the critical area starts at 94 centimeters, from 103 you are definitely too thick. For women, the critical interval starts at 80 centimeters, and from 88 it is definitely recommended to lose weight and go in for sports.
Arteries and veins need movement
On the vessels, physical exertion also has a positive effect, especially on the arteries that bring the oxygen -rich blood from the heart into the body. They stay more elastic among people who live actively. "Due to regular physical activity, arteries can quickly put from far to tight and vice versa to regulate blood pressure," says Halle. "This also makes up a young, healthy vascular system." The mechanism is probably caused by the pressure wave, which the heartbeat causes in the arteries, as a pulse. The vascular walls, which also contain a layer of muscles, are stretched. This leads to the release of nitrogen monoxide (NO), increased in physical activity. In the case of athletes in motion all the more, since the heart lives out a larger amount of blood at once. "No is formed in the vessel wall and sets a cascade in motion, as a result of which fewer collagen is stored in the vascular wall," explains Martin Halle. "This is a conversion process - you can regenerate the vascular system a bit through sport."
The veins, those vessels that bring the oxygen-poor blood from the tissues back to the heart, also benefit from exercise. They, unlike the arteries, do not have a muscle layer. When the skeletal muscles work, especially in the legs, they contract. As soon as it becomes tense, it also squeezes the veins, similar to how compression stumps do. The blood on the way to the heart is thereby accelerated. "This is the so-called muscle pump, " explains Martin Halle. It makes the work of the heart easier: it has to suck less strongly in order to bring the blood back to the heart, because there is less blood sagging in the legs.
Sport calms down and is good for the psyche
"The muscles work for our health, but even when we sleep," says Christian Schmied. This is conveyed via the nervous system. This is how resting pulse and blood pressure fall in people who do sports regularly. Sport makes calm more relaxing - and the body more efficient when it comes to stress. "If an athlete is trying, the body can rapid up quickly," says Christian Schmied. If you do sports, you are more relaxed after the active phase, also mentally. Because sport activates the parasympathicus, the part of the nervous system that has a calming effect. This is conveyed, for example, by releasing less activating messenger substances such as noradrenaline after effort. This also affects the heartbeat: it slows down and the blood pressure sinks in peace.
It is likely that sport also releases messenger substances that have a direct positive effect on the psyche. Studies have shown that depression could be treated more successfully with psychotherapy such as cognitive behavioral therapy in conjunction with sports sessions than without. In addition, people who exercise regularly have a lower risk of developing depression.
With all the positive effects that physical activity has: sports muffle should not start too abruptly with too high intensity. "You should start slowly and increase the intensity steadily – in the case of previous illnesses, it is best after consultation with the doctor," says Michael Leitzmann. "But even at an advanced age or in case of illness, it is still better to move than to let it be.«
