Exercise therapy is “better than drugs” for common type of heart failure

Greek Dancing at Sunset

Image by DanaTentis from Pixabay

By Jo Nova

A new review of studies came out a few weeks ago pointing out that trials of 700 people with the most common kind of heart failure show they did better after an exercise program than they did with drugs.

I’d like to say “Big Pharma won’t be happy” but Big Pharma probably couldn’t care less. The money, the industry, the regulatory agencies, Hollywood, and a lifetime’s habit means most people will keep returning to largely well-meaning but busy doctors who will prescribe the latest something, whatever it is.

But ultimately the people who get out there and do supervised exercise of any kind a few times a week  get more benefits than those taking the latest patented drug. They’ll also have a higher quality of life. In this study they’re looking at people with the most kind of common heart failure called HFpEF. The exercise is supervised because there is some risk in people who may be quite unfit or unhealthy.

How much of our lives is spend working to pay for a bloated health-care system that finds expensive ways to employ many people to do what we could have done better ourselves?

This, from the abstract, is medical-speak for “the drugs were useless”, and we already know exercise works much better:

Until recently, most pharmacological intervention trials for HFpEF [a common type of heart failure] yielded neutral primary outcomes. In contrast, trials of exercise-based interventions have consistently demonstrated large, significant, clinically meaningful improvements in symptoms, objectively determined exercise capacity, and usually quality of life.

Exercise therapy is safe and helps improve recovery, study finds

By Annie Lennon in Medical News Today

Heart failure occurs when the heart can no longer pump blood and oxygen around the body. The condition represents around 8.5% of heart disease deaths in the United States.

Heart failure with preserved ejection fraction (HFpEF) causes around half of heart failure cases in the U.S. It happens when the heart’s left ventricle stiffens, increasing pressure inside the heart.

For the study, the researchers analyzed results from 11 randomized controlled trials investigating supervised exercise therapy on HFpEF outcomes.

The studies included over 700 participants, mostly aged between 60 and 70 years old. Participants engaged in various activities, including walking, Greek dancing, and high intensity training three times per week for 1-8 months.

We can’t get exercise in a pill:

“The benefits of exercise cannot be duplicated by medication or procedures. Regular exercise of 2.5 hours weekly or that equivalent increases life expectancy, reduces the incidence of heart disease complications, and has been linked to reduced risk for some cancers, such as colon.

A similar review 5 years ago in Europe showed much the same thing. Except in that case, they studied mortality too and an increase in peak oxygen uptake of 13% translated into 11% lower all-cause mortality.

The European study saved lives: Mortality was down 11%

Professor Emeline Craenenbroeck in 2017 explains how big the problem is and how remarkable exercise can be:

More than 14 million Europeans suffer from heart failure (HF). Despite significant improvements in the treatment of HF, morbidity and mortality remain unacceptably high [1]. In addition, the costs for HF care approach 2% of the healthcare expenditure in Western Europe. One of the hallmarks of HF is severe exercise intolerance with pronounced fatigue and dyspnoea, even at low workloads, resulting in a markedly decreased quality of life.

With regard to benefit on exercise capacity, a meta-analysis of 29 randomised controlled trials (RCT) including 848 patients revealed a mean improvement of VO2peak of 2.16 ml/kg/min [4]. Although modest in absolute terms, this means an increase of 13% which translates into a considerably better quality of life [5].

This study showed in an intention-to-treat analysis that exercise training was associated with an 11% lower adjusted risk for all-cause mortality or all-cause hospitalisation and a 15% lower adjusted risk for cardiovascular mortality or HF hospitalisation.

Any kind of exercise will help:

Supervised exercise called better than drugs for common type of heart failure

March 21 (UPI) — Supervised exercise like walking, stationary cycling and even dancing about three times per week was more effective than drugs in helping people with symptoms of one of the most common types of heart failure, according to a new scientific statement.

The studies that were examined looked at numerous types of exercise, from walking, stationary cycling, high-intensity interval training, strength training and dancing in facility settings and home-based training.

The statement characterized supervised exercise therapy as being conducted three times per week, and the duration of the programs varied from one month to eight months.

“Exercise capacity is an independent, clinically meaningful patient outcome, and research has indicated that guided exercise therapy is actually more effective at improving quality of life for people who have [heart failure with preserved ejection fraction] than most medications.”

From the paper itself: Peak oxygen capacity was improved in every study in this latest review:

Peak oxygen capacity is so important it actually predicts all cause mortality.

And the US study improved VO2 almost exactly the same amount as the European one, so presumably it would have saved lives too:

[The Review] found that supervised exercise training may lead to increased peak oxygen uptake 12 to 14%, increased total exercise time by 21% and improved quality-of-life scores on the Minnesota Living with Heart Failure questionnaire 4 to 9 points.

Earlier this month, a University of Cambridge study suggested that brisk 11-minute daily walks can be enough to lower a person’s risk of heart disease, stroke and cancer.

The kind of patients this study was aimed at were:

Dr. Hermel added: “Supervised exercise programs such as cardiac rehab have demonstrated significant benefit for patients with recent heart attack or another acute coronary syndrome, chronic stable angina, congestive heart failure, pulmonary hypertension, after stent placement, coronary artery bypass surgery, heart valve surgery or cardiac transplant.”

As usual, the most important scientific work is often done by volunteers:

This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association and the American College of Cardiology.

In the three weeks since this important review was released the article metrics tell us it was picked up by 24 news outlets, bogged by 2 and tweeted by 144. In other words, hardly anyone.

REFERENCE

Sachdev et al (2023) Supervised Exercise Training for Chronic Heart Failure With Preserved Ejection Fraction: A Scientific Statement From the American Heart Association and American College of Cardiology, Circulation

10 out of 10 based on 56 ratings

64 comments to Exercise therapy is “better than drugs” for common type of heart failure

  • #
    David Maddison

    At one point (1977) the Australian Government did run a “Life. Be in it.” campaign to encourage physical activity.

    The importance of exercise was recognised, back in the day.

    One of the ads is at: https://youtu.be/GNjEge3Awl8

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    • #
      Gee Aye

      A campaign run by Phillip Adams.

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      • #

        So why didn’t he lose any weight?

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      • #
        Sceptical+Sam

        It was not run by Phillip “Fat Boy” Adams.

        The advertising agency (MDA) that Fat Boy was a partner in, created the “Norm” adverts. Fat Boy presented the ads to the Victorian government Minister who drove the campaign (the Hon Brian Dixon MP) before he (Dixon) convinced the Commonwealth to roll it out nationally.

        Adams did bugger-all other than bank the tax-payers’ cheques, notwithstanding his claims to be the auricle on all things.

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    • #
      David Maddison

      Note that the ad wouldn’t be considered “woke” today due to the “body positivity movement” and the “fat acceptance movement” – people who seriously believe morbid obesity is OK.

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    • #
      John Connor II

      Life be in it is still showing on tv.😉

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  • #
    Neville

    I certainly think that daily exercise like walking is good for us, but some people are just lucky enough to have the right DNA or parents.
    One very close friend who died at 101 lived a good life and worked hard BUT he was also a heavy smoker until his 60s and a steady drinker.
    Also his sisters lived to their late 90s as did his mother and AFAIK none of them smoked ever.
    Then again I can count a number of School friends who died young, at 42, 36, 32 and a couple in their 50s.
    The school friends were definitely not overweight and seemed very fit and I can’t remember that any of them were smokers.
    Just to finish a family who bought my business had an elderly father who was a very heavy smoker for all of his life and lived to his 90s.
    So I think some people are just lucky or unlucky enough to have the right or wrong parents.
    I can think of other examples but I’ll leave it there.

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    • #
      Muzza

      The old adage of ‘Choose Your Parents Carefully’ is certainly a truism…..

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    • #
      Fran

      In addition to good genes, the subjects who exercise are the ones who can. With your actual heart failure, you cannot even lie down without gasping and coughing due to pulmonary oedma. The first thing is to take the diuretic – this is lifesaving. This permits both sleep and ability start gentle exercise. Anyone who implies that just exercise is sufficient has never seen a genuine heart failure patient. The implication in Jo’s blurb above is that you can drop all drugs. The study cited deals with exercise as an addition and does not mention the fact that most heart failure subjects are probably concurrently taking blood pressure medication +/- continuing diuretics.

      The prescription for exercise lets out all with serious joint issues. I have several friends who did all the right things and still needed hip replacements. In the year+ on wait lists they were crippled, and if they had had, in addition, heart failure, they would have been considered poor surgical risks. A lot of elderly heart failure patients also have spinal collapse. Also excluded are those with depression, another common concomitant of heart failure.

      The recommendation of exercise also lets out those who cannot get to and afford an exercise program after the experimental period (most of the studies of exercise involve supervised exercise). Another group that is not included in exercise studies is those with even mild dementia.

      In other words, the exercising group is the healthiest of those with heart failure. They are the ones that recover enough to exercise. And of course they live longer than those unable to exercise.

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      • #
        aspnaz

        Most people are too lazy to exercise. If you are on a trolley then you are past the exercise date, even though this study suggests there may be some hope for you. If you want to live a healthy life, you exercise and you don’t look for reasons, such as sore knees, to not exercise. We have all known this forever, there is no secret.

        I am in my sixties and I exercise every day. I really don’t care if people die of laziness, that is their business, but the excuses for being lazy really piss me off.

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  • #
    David Maddison

    Once the anti-energy lobby have achieved their utopia of banning cars (for non-Elites) and established “15 minute cities” I guess we’ll be walking everywhere anyway….

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    • #
      Lawrie

      If they manage to get rid of guns as well I guess we can get our excercise chasing the Bast**ds down and manually wringing their necks.

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  • #
    David Maddison

    Micronutrients are also important as most people on this blog would know, e.g. Vitamin D and K2 as well as others.

    Many people in Western countries are deficient in both.

    Vitamin D is even a common deficiency in sunny Australia. Little attention is paid to K2 deficiency for some reason.

    Big Pharma has expensive products to treat diseases or conditions caused by deficiencies of both.

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    • #
      David Maddison

      E g. Apart from exercise being important for prevention or minimisation of osteoporosis there are either Big Pharma or Vitamin K2 supplement options.

      Prolia as a twice yearly injection for osteoporosis costs $255+ per dose in Australia (but taxpayer subsidy applies) as compared to much cheaper daily Vitamin K2 tablets which may (or may not) also reduce incidence of osteoporosis (but this is not medical advice, do your own research).

      SEE e.g. https://melioguide.com/osteoporosis-nutrition/vitamin-k2-for-osteoporosis/ and references therein.

      Effectiveness of Prolia is:
      https://www.drugs.com/tips/prolia-patient-tips

      Prolia reduced the risk of vertebral fractures by 4.8%, hip fractures by 0.3%, and nonvertebral fractures by 1.5%.

      Bone mineral density was increased by 8.8% in the spine, 6.4% in the hip, and 5.2% in the neck after three years of treatment with Prolia.

      Effectiveness of K2 as quoted in top link:
      https://pubmed.ncbi.nlm.nih.gov/16801507/

      The meta-analysis found that high levels of Vitamin K2 were associated with reduced:

      Vertebral compression fractures (approximately 60%).
      Hip fractures (approximately 77%).
      Non-vertebral fractures (approximately 81%).

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      • #
        Lawrie

        Recently my dog probably ate a rat that was crook due to me laying baits for rodents in the ceiling. The dog then received a small but effective dose of blood thinner. I asked a vet but they needed to see the dog so I sent a photo. My Pharmacist was more helpful. He could not dispense Vitamin K without a prescription but said broccoli would do just as well. I blended a large head of broccoli and mixed it with some mince. The dog gulped it down and improvement was rapid. $16.30 against $80 to see a vet then the cost of treatment. 10 years ago a dog ate a bait and treatment cost $1559.30. It is imprinted on my mind whereas other stuff is in limbo.

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        • #
          David Maddison

          Vitamin K2 is not a prescription drug in Australia so, assuming you are here, I am surprised the pharmacist required a prescription. I’m glad your dog was OK.

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          • #
            Ted1.

            17 years ago last week they put me on Warfarin after diagnosing Attrial Fibrillation.

            I knew it was rat poison when overdosed, and protected me from blood clotting with a low dose, but I looked it up.

            In the 1920s near the border between the USA and Canada they had trouble with cattle dying with uncontrollable bleeding. Investigating they found that these cattle had been eating mouldy clover hay.

            Apparently the drug was in the mould. They isolated it and decided it was good for rat poison, then later for people at risk of strokes. As I see the other oldies when I go for my monthly blood test I wonder if Warfarin is the biggest contributor to the ten year increase in life expectancy we have experienced over the last 50 years.

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      • #
        Custer Van Cleef

        Also David, my understanding of vitamin K2 is that:

        1) it keeps calcium away from where you DON’T want it — i.e. in the walls of your arteries where it causes calcified arteries/heart disease.

        2) if you are raising your vitamin D with pills — or by sunbathing — you probably need upping your vit.K2 as well. That’s because in the first place, the extra vit.D improves calcium absorption so you’ll probably need extra K2 to get all the calcium to the right place (bones), not the wrong place.

        However, still some QUESTIONS in my mind around taking more vitamin K2:

        3) For people with ‘calcified arteries’ (same as Atherosclerosis ?), does more K2 lead to undoing some of the calcification? Would that create ‘Unstable Plaque’?
        Is that better or worse that ‘having more plaque but stable’? Happy for one of our experts to jump in here. 🙂

        Thanks to an older post, I’ve pretty much dumped yogurt from my diet: being low-fat it only has small amounts of K2. Jo posted a link to 20 good food sources sometime last year(?).

        Anyway, I’m not a doctor, so as they say “Do your own research!”.

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    • #
      Hanrahan

      Vitamin D is even a common deficiency in sunny Australia.

      Only mad dogs and Englishmen go out in the midday sun, even in Aus.

      https://youtu.be/BifLPGi4X6A?t=14

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  • #
    Global Cooling

    This is difficult to review. It was a meta study. There was variety of the length of the training programs from one to 8 months, numerous types of exercises and variety of patients.

    The improvement of VO2 max is not a standard. Losing weight is one way to do it (note ML/kg/min). It may be easier at the beginning and tough for top athletes.

    And still VO2 is a proxy for overall mortality.

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    • #
      Kevin T Kilty

      There was variety of the length of the training programs from one to 8 months, numerous types of exercises and variety of patients.

      That is generally what a metastudy consists of.

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  • #
    Kalm Keith

    Have previously written about my experience in taking vaccinations in 2020. Since I definitely wasn’t taking the CV19 VaXXine I decided to up my protection by getting others; still then a believer.

    Shortly after I was feeling strange while breathing and scans showed extensive clotting of both lungs. Just a month or so after the VaXXines.

    On anticoagulants for 11 months and a new scan showed clear lungs.

    The thing is after I initially got out of hospital I walked gently every day up and down a few 20 metre hills for twenty minutes to half an hour.

    I’m now a serious doubter when dealing with the products marketed by big Pharma, especially the Shingles VaXX.

    Exercise and movement: the Jabberwocky can get stuffed.

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    • #
      Ross

      I watched progressively as our and most western country governments became vaccine sales people during 2020/2021 on a huge, unprecedented scale. Bought, marketed, distributed, administered and provided liability for the pharma industry products. Then they became Shingles vax sales reps via ads on commercial radio (didnt notice TV) and pop ups on internet sites. A lot would say the uptick in Shingles was due to the COVID vaccines. Then our governments became early anti-viral salespeople by advertising the likes of Paxlovid etc. But not direct adverting, because that is disallowed in Australia. More subtle, go see your doctor if your are concerned about shingles, etc. A pharmaceutical marketing executive’s wet dream. Quite incredible.

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    • #
      Peter C

      Thanks Keith for sharing that story.

      Do you remember which vaccines you had?

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      • #
        Kalm Keith

        Can find the printout but from memory they were: pneumovax, flu VaXX which I’d stopped a couple of years earlier and the Shingles. All in the space of a couple of weeks.

        Was pushed to the Shingles VaXX by a photo of someone with shingles on the doctors wall. Had also had a couple of friends contract shingles a few years before and it didn’t seem nice.
        Am now left wondering if those two had been VaXXed before they caught shingles.

        The exact details are filed somewhere.
        Needless to say I’m unlikely to take any VaXXine in future.

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    • #
      Hanrahan

      I was a 21 yr old serviceman, 3 yrs in so they gave me my booster, TABT or something similar. Not long after I would tire quickly if gardening and would have brief periods of sickness when my arm where I had the jab would be red and itchy. I had self-diagnosed TB and when I coughed blood it was confirmed, but I should not have caught it.

      I had had the test some years before which came up red which meant I had been infected [A year at an AG college?]so had an Xray – clear. Again I was Xrayed on enlistment, obviously clear.

      I am now agnostic on jabs generally although I know the diseases they control can be terrible afflictions.

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  • #
    Broadie

    Taking responsibility for yourself in what are often lifestyle choice health issues before over servicing on subsidized care has been the target of Dr. Ben Carson.

    My understanding of Ben Carson’s plan was to have a public health system where people could chose to use ‘credit’ in the account at their own discretion. Choosing a less costly exercise plan rather than progressing to say a type 2 diabetic treatment. The idea being that yes there was subsidized care though limited and you could save your credits or give them to someone needy.

    The ‘free’ universal health systems like the Obamacare he was attempting to fix, do not work as in all ‘from each according to their ability and to each according to their needs schemes’, we end up with over-servicing and queues before a collapse in both availability and quality of care, as the system runs out of other peoples money.

    In Australia, Bill Hayden was made fully aware that he would be destroying one of the worlds best public health systems when he brought in what we now know was a classic Totalitarian and Fabian Socialist plan to give everyone a number. For their free health treatment of course! As we know their best laid plans always fail due to an inability to properly administer the serfs. They took care from the communities and centralized a more efficient system. Now you die waiting in queues.

    In place of Obamacare, Dr. Carson proposes giving each individual the power to choose the health care plan that suits his or her unique health care needs. His plan focuses on the expansion of tax-protected Health Empowerment Accounts (HEAs), currently known as Health Savings Accounts (HSAs). An HEA will be automatically opened for every citizen at birth and would be available to everyone in the current system who has a Social Security number. An individual HEA owner can grow his or her account over a lifetime; spend every dollar on medical care without first having to meet deductibles or pay additional copays; and have the option of transferring the account across state lines and to family members.

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  • #
    Bill Burrows

    Yes KK – Zoostavax (Merck product), a live attenuated vaccine has been withdrawn from the USA market. Why? Yet it is still available in Australia. Why? My wife & I both received this free shingles vaccine for the elderly. My wife had chicken pox as a child while I did not (advice from my mother, a past RN). In 2022 we both got shingles, which in my wife’s case was expressed as a very severe & painful eye infection. I would not recommend the taking of Zoostavax to anyone.

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    • #
      Broadie

      Err? Bill?

      Did you take any other injections? For instance an experimental ‘vaccine’?
      A couple of common side affects of this ‘safe and effective’ treatment were shingles and eye problems according to the trial data and we certainly saw that in our community. That is along with clots, myocarditis, one pharmacy assistant was so shocked by the demand for pregnancy tests she exclaimed, “they are breeding like rabbits” due to the disruption in menstrual cycles after these injections.

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      • #
        Bill Burrows

        No Broadie. The shots we received were part of the Australian governments shingles prevention campaign launched about 2014-16 I think. Free shots for old timers. No reactions until after we had shots for another ‘free’ series of injections starting in 2021 (Guess what they were for). But of course no evidence of cause & effect. My concern was that in my case I trust my mother’s advice that I never suffered from childhood chicken pox. If this was indeed true then there is a strong possibility that my 2022 episode could have been set off when the recent unrelated vaccine excited the live virus previously injected via Zoostavax. All speculation on my part of course, but it gels with background research I undertook via internet sources. Merck has been defending class actions in many countries & this may explain the withdrawal of Zoostavax from the USA market in 2020 I think It was.

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  • #
    Ross

    Just imagine for a second. Representatives from gym and exercise equipment companies were allowed to visit doctors and update them on their latest products. That those reps gave out free gym memberships or maybe installed free stationary bikes with VO2 monitors in most doctors rooms. GP’s etc were updated on the latest exercise findings such as Jo has written about. Doctors who signed up significant numbers of patients for gym memberships were then offered further incentives or maybe free holidays to lovely beach resorts in order to discuss all the latest exercise findings. Perhaps the government could then advertise such findings or encourage people to go see your doctor to get advice on exercise programs. GP practices could have gyms installed alongside and employ physios and exercise consultants, so you could just walk out of the consult straight into a gym. Wouldn’t that be wonderful? In fact, it sounds very similar to that the marketing tactics of some other major health industry. Can’t put my finger on it right now, I’m sure it will come to me.

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    • #
      PeterPetrum

      See my comment down at #18 Ross. Certainly worked for me.

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      • #
        Ross

        I see that as Comment #20, but nevertheless you are living proof. What’s the bet your doctor recommends you stay on BP meds?? Or changes to a new wonderful BP product with less side effects – in fact he’s probably going to say, “here have some, the pharma rep just dropped off some free samples for me “:-)

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  • #
    RickWill

    Just taking a tea break from my daily dose. Very pleasant morning in SE Melbourne to be out at the log pile splitting wood for winter; both sun and exercise. Now 13C but heading for 21C.

    Had the first fire for 2023 on Monday. Was not bitterly cold but snow was falling in the mountains and the fire made it very comfortable for the grandkids while their dad and I watched Hawthorne get a whipping from Geelong.

    May is usually the month when my off-grid solar system has struggled in one of every three years. That is the time when the oceans adjacent the temperate regions of Australia are cooling and clouds become entirely condensing as ocean surface gets down below 15C. Currently 15C off Strahan:
    https://earth.nullschool.net/#current/ocean/surface/level/overlay=sea_surface_temp/orthographic=-212.68,-38.71,1321/loc=143.970,-41.772

    That moist air forms persistent condensing cloud over the coastal land on the southern side. The warmer water off the east and west coast ensures plenty of rain is advected to the faster cooling land along these coastlines. Northern shores still exposed to the most powerful convective instability and the self-supporting severe storms over oceans above 28C.

    These weather patterns will be in play when Liddell shuts down permanently at the end of the month. And only a Tassie Liberal to blame when the rolling load management sets in.

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    • #

      And all that Brown Coal in Sictoria will just stay in the ground.

      Mother Nature delivers and the Left Wing Nut Jobs (Desperate Dan and many, many others) ignore the bounty. Along with all that Gas and Oil. Oh well, back to splitting wood and burning it. Good exercise too and a nice way to keep warm.

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    • #
      b.nice

      “These weather patterns will be in play when Liddell shuts down permanently at the end of the month”

      As I said at the bottom of the Wednesday thread.

      Closing Liddell will put the NEM straddling a razor-wire fence… hoping to h*** that it doesn’t slip. !

      Closing Eraring will lead to far worse. !

      Expect large disruptions to viewing sporting events on TV !

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  • #
    STJOHNOFGRAFTON

    Exercise is much cheaper and more beneficial than drugs like statins, calcium channel blockers and beta blockers. All of these have long term and sometimes short term side effects. If you look at the information sheets for these drugs you’ll get an idea of what to expect. If possible stay off these drugs but consult with your medico as to possible alternatives. One of the best is regular exercise. However, lifelong committment is required for a good outcome.

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  • #
    Steve of Cornubia

    Walking each day in a nearby national park in my preferred mode of exercise. I can’t abide all that running, cycling and treadmill malarky, especially in a gym. It’s mind-numbingly boring. I much prefer to disguise my exercise as something else.

    Our daily morning walk provides exercise but also fresh air, sunshine and wonderful opportunities to observe flora and fauna. Nothing gives me a boost like walking through gum-filtered sunshine while being entertained by baby wallabies and listening to a choir of Magpies, Butcher Birds, Fairy Wrens and chattering Friarbirds. Then a waft of aniseed drifts by from a flowering Wattle to complete the experience.

    Bliss.

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    • #
      Graeme No.3

      And if you want something a little more strenuous I suggest pursuing a politician with a pitchfork. Get yours before they are banned.

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  • #
    Hanrahan

    I recently had shingles. The doc prescribed an anti-viral which I immediately looked up when I got home. It was recommended that it be taken with Zn and D3 [where have we heard that before?] but he failed to mention that. That bloody prescription pad is all they know.

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    • #
      Lance

      My father in law had shingles. No vax. The only thing that helped was acyclovir. Shingles is a variant of chicken pox or some other herpes virus family. The “cyclovir” drugs were developed for chicken pox. https://www.drugs.com/acyclovir.html

      I had a shingrix vax. Not sure if it works or not. But, no shingles so far. Shingles is a nasty affair and not something to underestimate in terms of pain and discomfort. Anyone who has ever had chicken pox ought to take note.

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      • #
        Hanrahan

        I have been taking most of the common supplements for ages. It could have been much more painful than it was, I suspect.

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      • #
        Ted1.

        Different experience.

        I had chickenpox when aa kid. Very itchy, and I was never a good patient. Just itchy.

        Thirty years later my wife and kids got it. Every spot was an excruciating ulcer. Some of those were in the mouth. I didn’t catch it. Thank Heaven.

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  • #
    Doctor T

    As a sports and exercise physician, my profession has been aware of this for years.
    The benefits for exercise over drugs for treatment of hypertension, mental health disorders, diabetes, as well as reducing cancer recurrence is clear, but does not help Big Pharma.
    As you mention Jo, few GP’s either know, or feel confident in avoiding drug prescription for these conditions, and both undergraduate and postgraduate medical training omits any teaching of exercise as a prescribed treatment.
    The business model is: poor lifestyle (junk food, sedentary activities) => health issues (overweight/ diabetes/ hypertension) => drugs.

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    • #
      John Connor II

      Quite so.
      No-one’s mentioned a primary cause of heart attacks, namely inflammation, caused by the typical western sugar-laden diet.
      Exercise COUPLED with a decent ketogenic eating plan (I shun the word “diet”) will do absolute wonders and I speak from experience.
      Joining a gym is usually a revolving door and a waste of time and money unless you have the right mindset.
      One need only run the numbers on calorie burn rates to see how critical quality nutrition is. You can exercise until you drop but ignoring nutrition makes it a waste of time.
      There’s nothing like a life-threatening wakeup call to make people change their ways but unfortunately that’s exactly what it takes.

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  • #
    Charles k May

    My cardiologist insists that swimming and rowing are the best exercises for the heart.

    I have a cousin in Seattle who was on the University of Pennsylvania crew team that won the Henley Regatta in 1957. He is in his 90s. A couple of years ago, he went to a reunion, and only one member of the crew had passed away.

    I have my own experience.

    At the age of 45, I used to swim 3000 yards three or four times a week. I could swim that in about 45 minutes. My heart rate was only 46.

    Subsequently, I received a flu shot, and I reacted to it. My sitting heart rate increased to 140. I had an enlarged heart.

    I have a few thoughts on this. I got through this because I had put a lot in the bank. Even with my damaged heart, I still swam but not very fast. My ejection factor was 9. The doctors were amazed that I did not need oxygen.

    I suffered from this for a few years and then had an ablation procedure, and my heart rate returned to 70. I was a story on local TV news. I filmed a commercial for the hospital that they never used.

    I turned 76 not long, and I must schedule an echocardiogram soon.

    Still hanging in there.

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  • #
    John Hultquist

    In the three weeks since this important review was released the article metrics tell us it was picked up by 24 news outlets, bogged by 2 and tweeted by 144. In other words, hardly anyone.” [bogged ?]

    Try this; use an images search box (I use duckduckgo) with the words “fat people”. Or similar.
    Many folks are beyond help, so it seems.

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  • #
    David Maddison

    Bill Maher is an old-style Leftie and therefore somewhat rational and even he is against the “fat acceptance movement” and “body positivity movement”.

    https://www.foxnews.com/media/bill-maher-slams-americas-fat-acceptance-movement-orwellian-supporters-have-blood-their-hands

    Bill Maher slams America’s ‘fat acceptance’ movement as ‘Orwellian’, supporters have ‘blood on their hands’

    Maher called the ‘body positivity’ movement a ‘disturbing trend’ that enables addicts

    During the latest episode of HBO’s “Real Time with Bill Maher,” the comedian took aim at America’s obesity epidemic and torched the culture for promoting not only “fat acceptance,” but “fat celebration.”

    Maher declared the “disturbing trend” to be “Orwellian” and urged Americans to stop spinning obesity as a positive and lose some weight.

    “There is a disturbing trend going on in America these days,” the HBO host began, describing it as, “rewriting science to fit ideology to just fit what you want reality to be.” Maher explained that Americans’ current views on being overweight are part of this trend.

    “We’ve gone from fat acceptance to fat celebration. That’s new. That is new,” he said emphatically. “To view letting yourself go as a point of pride? We used to at least try and be fit and healthy and society praised those who succeeded,” he lamented.

    SEE LINK FOR REST

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    John Connor II

    Quite so.
    No-one’s mentioned a primary cause of heart attacks, namely inflammation, caused by the typical western sugar-laden diet.
    Exercise COUPLED with a decent ketogenic eating plan (I shun the word “diet”) will do absolute wonders and I speak from experience.
    Joining a gym is usually a revolving door and a waste of time and money unless you have the right mindset.
    One need only run the numbers on calorie burn rates to see how critical quality nutrition is. You can exercise until you drop but ignoring nutrition makes it a waste of time.
    There’s nothing like a life-threatening wakeup call to make people change their ways but unfortunately that’s exactly what it takes.

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    John Connor II

    As luck would have it, I downloaded this the other day:

    Fat and Cholesterol Don’t Cause Heart Attacks and Statins are Not The Solution

    This book is dedicated to Uffe Ravnskov, MD, Ph.D. for his seminal and propaedeutic achievements in disputing the dogma that fat and cholesterol cause coronary heart disease, and that statins are safe and cardioprotective for everyone. As will be seen, no studies support the notion that restricting fat reduces coronary morbidity or mortality. More importantly, government recommendations mandating low fat diets are likely the cause of the escalating epidemic of obesity and type 2 diabetes. Several chapters detail the panoply of significant adverse health effects of statins that have been ignored or suppressed in reports of drug company sponsored trials. These include promoting the development of coronary atherosclerosis and congestive failure. In addition, the putative benefits of statins are clearly unrelated to lowering LDL or cholesterol, but rather anti-inflammatory and especially anticoagulant activities. This clotting or “atherothrombotic” hypothesis appears to explain all of the factors known to cause or protect against coronary heart disease

    http://libgen.li/ads.php?md5=e7b4bc8edbbbfba5218387799f837854

    Click “Get” at the top of the page.

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    PeterPetrum

    I am now in my 80’s. At the age of 33, and slightly overweight, I was advised by the company doctor to start running. For many years after that I would run almost every night after work for at least 5k in hilly country. All that ended about 8 years ago after a hip replacement and, despite maintaining a one acre garden (with my wife an an excellent support) I was aware that my fitness was wearing thin.

    I am on blood pressure medication and my normal pressures was about 130/90. About three months ago I joined the local gym and submitted myself to a supervised weight lifting regime. I go six days a week in the early morning when the gym is quiet.

    The change in my body shape has been amazing. I was not fat, but now I have improving muscle tone and shape on arms chest and abdomen.

    On a whim, I took my blood pressure today – 114/70 – looks like I need to see my medico and get off my BP pills. There is no doubt that the change in my body shape and general health, as well as BP, is the result of the regular exercise and I fully intend to keep this up, as I really enjoy my morning exercise hour.

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    NuThink

    Sick Around the World

    https://www.youtube.com/watch?v=h4rg-DJBd34

    PBS Frontline “Sick around the World” 2008, an enlightening documentary about different approaches to health care in 5 countries. They each have their pros and cons, described in this evenhanded report, but they all appear to be superior to the US system in the important ways. Uploaded as a public service.

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    Indur Goklany

    Also, try sunshine. It’s free. Walking and sunshine are the best therapies, but don’t neglect some cardiovascular routines.

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    Craig

    Not sure what the information achieved but I was selling hypertensive medication 15 years ago and the Drs knew to advise patients that exercise in combination with their medication was important to optimise heart health.

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    Kevin a

    https://www.youtube.com/watch?v=ANGwEol3F28
    Everyone Was Pushing The Vaccine Agenda Because Of The Revenue 💉🤑 – Robert F. Kennedy

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