Making Reachable Resolutions for the New Year with Dr. Sonia Tolani

Faith: Faith here. To begin the New Year, Courtney Allison talked about getting the year off to an active start with a sports cardiologist, who gave us some great advice for making fitness promises to yourself that you can actually keep. Happy New Year, everyone!

Courtney: Welcome to Health Matters, your weekly dose of the latest in health and wellness from New York Presbyterian. I’m Courtney Allison.

We’re just a few days into 2024, and it’s a perfect opportunity to work on our goals for health and fitness.

To get some expert perspective on easy ways to incorporate exercise into our busy lives, I talked to Dr. Sonia Tolani, a sports cardiologist at New York Presbyterian and Columbia. Dr. Tolani gave some actionable tips and explained why starting with small fitness goals can lead to big rewards for your health.

[THEME OUT]

Courtney: Hi, Dr. Tolani. Thank you so much for being here today.

Dr. Tolani: Hi, Courtney. Thank you so much for having me.

Courtney: So, it’s the new year. Welcome to 2024.

Dr. Tolani: Thank you.

Courtney: I think a lot of people, myself included, we might have some big resolutions, big goals we want to pursue. You’re a cardiologist. You’re an expert in exercise. What’s your big advice for people who are looking to start something new?

Dr. Tolani: Yeah. I mean, I think New Year’s is a great time because you get a lot of company, right? Everybody wants to do something. So I always tell people: make your goal Achievable. Don’t start out saying you’re gonna join a gym and go five days a week. If you’re going from zero exercise, that’s not sustainable, right? We’re looking for what can you actually do? So I would say I’m gonna start doing something physical

Courtney: Mm hmm.

Dr. Tolani: for 15 minutes, three days a week. You know, that’s sustainable. Once you develop the habit, then you build.

Courtney: Yes.

Dr. Tolani: Then it becomes easier to do 20 minutes. You know, my thing was I never stretch. I’m a terrible stretcher. I hate stretching. I don’t what my problem is I was like, you know what? I’m just gonna do a couple stretches and then once I’m down there doing the stretches, then I’m like, Oh, why don’t I just do a little abs? I’ll do a little, do a little, uh, you know, some sit ups and some bicycles here, you know, once I’m down there doing it, it’s like I’m doing it. It’s just getting started. So just get started and then build. And try to keep it consistent. Be kind to yourself. You know, allow yourself to have some failures. There’s going to be times where you get sick, you get off track, you’ve got other things that are going on and just remember to come back.

And find a friend to do it with. You know, I have a group of friends who also just want to—they’re busy and they want to stay healthy, and they keep me on track. I have a little text group, a friend of mine is like, we’re going to do a hundred squats from now until the end of the year. We’re going to do a hundred squats every day. And we have a little text chain and everyone’s like, did the squats, did the squats. So sometimes you just need a little help from your friends.

We don’t realize that, you know, making exercise a regular part of your day is such an important part for your longevity and your long term fitness and your heart health. Not only, um, for your heart, but for your bones, for your muscle strength as you’re getting older in your 60s and 70s to be able to be a stable walker and not fall, and for keeping your brain healthy. Regular exercisers have lower rates of dementia. One thing that I have noticed in my patients and, I’ve been in practice now for more than a decade and I’ve seen patients go from their 50s to their 60s and their 60s to their 70s and 70s to 80s and what I think has been a defining characteristic for health have been my patients that are regular exercisers.

Courtney: Mm

Dr. Tolani: I can really see that they have less arthritis, less pain. Their gaits are steadier. They’re more independent. They’re happier. And it—just a light went off for me. You know, we should be exercising at all times in our life, but I think in middle age, when you have young kids, your career is very busy, it can be very hard to find that time to exercise regularly.

The issue is, is just keeping it regular. So if you’re not a runner, then you could be a walker, you know, and it’s just making that time and carving the time. If you look down at your schedule, I mean, I looked at my schedule, how am I going to do this?

Instead of going out for a dinner with drinks, I found other friends that run. I say, hey, do you want to go for a jog instead? All I want to do is chat and catch up. It doesn’t need to be over a bottle of wine. I’m just more in touch with how I want to spend my time and the focus on exercise and physicality and making it part of my life and not a chore.

Courtney: And one of the things we’re thinking about with this advice, one big reason exercise is so key, is that it’s such a key part of protecting ourselves against cardiovascular disease, right? So, help us understand, how dangerous is cardiovascular disease?

Dr. Tolani: Cardiovascular disease is the number one cause of death for both men and women. And 80 percent of it can be prevented through healthy diet and lifestyle. But I don’t think all of us are waking up and saying, “Hey, got to get out there and exercise to prevent that heart disease, the number one cause of death. Got to, got to get out there and eat healthy, get that Mediterranean diet in me.”

Part of our jobs as cardiologists and doctors is, is to talk to our patients about it and spread the word that, working on your cardiovascular fitness is helping you prevent the number one cause of death.

Courtney: Right. Well, and it’s kind of like we were talking at the beginning of the conversation about making time for exercise, which I then helps you sleep better a little bit, helps you eat better, it kind of reframes, and then you’re taking care of your heart. Yeah,

Dr. Tolani: All of it. Yeah. And it’s not easy! I work with patients and sometimes I feel like how can I ask you to do more? I see what you’re doing. I have a patient who, had a heart attack. He’s the sole breadwinner for his family. I was like, I really would like you to do cardiac rehab to help back in shape after this heart attack. He couldn’t find the time, you know, and now what he’s doing is he’s walking with his kids because they want to try to walk a 5K together,

Courtney: Right.

Dr. Tolani: And he’s finding the time in the way that he can. So I know the ask is a big one, but the reward is big too. So even exercise “snacks,” even if people can’t train for a marathon or walk 30 minutes, five days a week at a moderate level, which is what we recommend, just do 10. There’s a lot of studies that show that even some snacks, “exercise snacks,” we call them, have a great reward for your cardiovascular fitness. It’s better than nothing.

My two things I always tell my patients is one, don’t wait to be perfect. There’s never going to be a time where miraculously life slows down and you’re going to be able to go to the gym and do all the classes and do it all the perfect way you want. You know, it’s not happening. So just start doing it. It’s not going to be your ideal of what you think you’re going to do, but just start doing it. And, and number two is: something is better than nothing.

Courtney: Mmhmm.

Dr. Tolani: You do just ten minutes of jumping jacks, or dance around to music for three songs, get yourself sweaty and a little breathless, that’s better than you having done nothing that day. Your heart is seeing that. You put a couple of those together in a week, and you’re gonna be healthier than you were not doing it.

Courtney: That is such great advice. I love that. “Your heart is seeing that.” I’m gonna remember that. So for people listening, what about for different populations? Men, women, people of various ages. Can you describe the risk factors for heart disease?

Dr. Tolani: Well, I think what the big thing is, is that women have to know that heart disease is the number one killer for women as well.

Courtney: hmm.

Dr. Tolani: And, um, that’s not out there. This is a really important thing for cardiovascular fitness, is that there’s a lot of concentration on weight in our society. That, you know, you gotta lose weight, you gotta be at this body mass index, there are studies that show that women in particular will put off going to the doctor because they don’t want to be shamed about their weight. And even though weight can contribute to risk factors there are a lot of people out there that are not at their ideal weight, but are regular exercisers. Their risk factors, like their blood pressure, their cholesterol, their blood sugar, are good. They don’t smoke. And I really do think that, in some ways being a regular exerciser is far more achievable than losing weight. What’s important is your fitness, and that’s what your heart is going to see. Your heart’s seeing the fitness. So if you exercise regularly, I think you’re a healthier person than someone who might be at their ideal weight, who’s really doing nothing but sitting on their couch and dieting.

A lot of women in their childbearing years, right, go through this period where you gain like 20 percent of your body weight when you’re the busiest in your life.

Courtney: Yeah.

Dr. Tolani: And then you’re supposed to exercise and like do all this other stuff. It’s like, it’s unimaginable. So again, it’s this concept of just trying to do what you can, right? I have, I have an eight and a nine year old. They’re 19 months apart. I could barely, walk out the door with the same shoes on, you what I mean, and my hair brushed, let alone, if somebody would have told me to go to the gym and exercise, I literally was like, “well, maybe if I sign up for this expensive gym, it’ll be, I’ll shame myself into going,” and I literally would walk by and just be like, “la, la, la, la, I don’t, I don’t see you!” And, and there’s so much shame in not being able to meet our expectations. But it’s a long game. So do the little things you can when you’re busy and then once you start having more time, your job gets a little bit more routine, you know, your kids are a little older, where you can leave them for 15 minutes in the morning to go for a quick run. Then just find the time, like, it’s the long game. Little things when you can do them.

The other population that I think we have to really inform about heart health is our older women who may not be going to the doctor regularly, may just going to the GYN for their GYN care. High blood pressure in older women is a major risk factor for stroke and heart attack. And it’s, high blood pressure is what we call the silent killer. Unless you go to the doctor and get checked, you’re not going to know you have it, until it can cause a lot of havoc. Exercise, regular exercise, can bring that down. So, there’s a lot that we can do.

Courtney: I love what you said about the snackable things because I think we all do that: “Oh, I’ll do it when things get a little calmer. I’ll, you know, I’ll start week.” It never happens. And I want to go back to something you just said. Um, you gave some advice. Hey, just try to go for a quick run if you can. So again, I just think that’s really inspiring for people listening, you know?

Dr. Tolani: Yeah. I mean, honestly, uh, I, I, that was running was the only thing I was able to do because of my time and schedule. And when I first went for a run, I literally went half a mile and I felt like I was going to die. I was like, this is, how do people do this? This is not possible. But you know, like anything, just: regularity, routine. I ran 13 miles a couple weeks ago and it wasn’t that hard for me because I put the work in.

Courtney: Yeah.

Dr. Tolani: But that just means that doing 10 minutes of vigorous exercise in your house is doable. You know what I mean? You just have to, maybe you start with five minutes.

 Courtney: And I think you can celebrate the five minutes as much as you celebrate a marathon, honestly. They both take a lot of work.

Dr. Tolani: A hundred percent! A hundred percent. Getting in any regular routine. The nice thing about a regular routine is not only does it prevent heart disease, but it’s a check, right? So if you’re sitting on your couch, you don’t know what’s going on with your heart. But once you get moving if you find like hey, listen I’ve been doing this walk around the block a couple times and every time I go up that hill, you know, I get a little chest pressure. Like most people who have sudden cardiac death have had some sort of warning. If you’re not doing anything, you’re not testing out your heart. You don’t even know that there may be a problem. Being in touch with your body involves using it. And listening to it.

Courtney: I like what you said, too, about don’t beat yourself up. I think a lot of people, when don’t hit your goal, then you feel down.

Dr. Tolani: Then you give the whole thing up!

Courtney: Exactly.

Dr. Tolani: Life is long. You know, we’re the long game. Prevention is a long game. Okay, just stay in the game.

Courtney: I love that. Stay in the game. Thank you so much, Dr. Tolani, for your time. This was absolutely wonderful. I can’t, personally, I got so much out of this. Thank you so much.

Dr. Tolani: Thank you for having me.

[THEME PLAYS THEN FADES UNDER]

Faith: Our many thanks again to Dr. Sonia Tolani.

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