Happy Father’s Day! I’m writing this in advance as on the day this goes out I have travelled up to my home village in Warwickshire to see my Dad. This will be the first Father’s day without Mum at home, and whilst he always said he thought Father’s Day was a made-up Americanism and not as important as Mother’s Day, I’m sure he will have appreciated having family around him. I also will have this morning visited my Mum in her dementia nursing home. She will not know my name, but I’m hoping she recognises me, and above all else that she seems happy. We shall see.
My usual exercise routine has been interrupted this week, as rather annoyingly I was in a car accident. I was in stationary traffic when the car behind ploughed into the back of me. I was thrown forwards but thankfully the airbags didn’t go off. I was pretty shaken as one might imagine, and the car needs a new rear end, but got away largely unscathed. My back was sore for a few days though, so kept exercise down to stretching. What has been really noticeable is how difficult it has been to get off to sleep without a workout during the day, my body really needs that. I was also reflecting on how I was able to be very mindful about the whole thing. Years gone by I would have been so mad, and would have ruminated endlessly. There was no guarantee that I would make it home without a car accident, and life’s goalposts always move. Accept it, and move on.
I saw an interesting research trial this week that I thought I would actually write about rather than video. Most trials of coronary artery disease are about different stents, operations, medications and so on. Lifestyle intervention trials are rather hard to conduct for various reasons, not least human behaviour is hard to control! This trial took patients with heart artery disease and various risk factors. All the usual bits and pieces – diabetes, blood pressure, smoking, and they also involved an expert nutrition assessment and dietary counselling. They combined all these data into an overall risk score.
The patients were split into 2 groups. In one, there was really intensive lifestyle intervention, in the other, standard of care (ie leaving patients to their own devices). An important point of lifestyle intervention was really regular reviews with their heart team and nutritionist. They underwent non-invasive PET scanning (which is a way of determining whether there is any significant reduction in blood flow to the heart.
At 5 years, the researchers demonstrated a significant reduction in the patients’ combined risk score. In addition, there was a significant reduction in hard endpoints including death, heart attack, stroke, the need for stents or a CABG operation. An extended follow up at 11 years showed even more benefit.
To my knowledge, this is the first randomised clinical trial of lifestyle interventions that have shown a reduction in these parameters, hence my wanting to share this with you today. Not only that, the results actually look even more favourable than some of the big trials in the cardiac world of things like stents and medicines for heart disease.
You may have heard of something called ‘the Hawthorne effect’, which tells us that a human’s behaviour is modified simply by observing them, and in my view this may have been in play here. In the run up to a dental visit do you find you floss more often? I do. If you are under regular check ups with your heart team in a research trial, are you more likely to live healthily? I expect so. Clearly the infrastructure needed to be put in place to achieve this outside of a randomised clinical trial is simply unachievable in any healthcare system. However, it does strike me that even reading my blog each week, (or perhaps only once in a while) is still likely to push you more towards healthy behaviours than otherwise. Repeatedly reading the benefits of a range of heart-healthy activities over time will likely help you make better health decisions. I really don’t think this is wishful thinking. It almost certainly also helps me make better lifestyle choices, as I do feel some responsibility to lead by example! My kids say I must have been a real ‘science nerd’ at school (thanks guys!) and they are probably right, but I love bringing science to life and feeling the day-to-day benefits.