Walk to your heart's content - A step-by-step plan to keep your ticker ticking

Golf Digest, Feb, 2000 by Scott SMith

In our October 1999 issue, Golf Digest introduced "Links for Life," a nationwide campaign to reduce the number of deaths by sudden cardiac arrest on the golf course-and off.

The focus of Part 1 of the Links for Life initiative was our call for golf facilities to put in place an effective "First Responder" strategy for dealing with on-course health emergencies. This effort centers on the deployment of automated external defibrillators (AEDs), portable devices that are the only effective way to restart a heart.

The response has been heartening, to say the least. As we reported in "Straight from the heart" (December 1999), individuals and clubs around the country are now taking steps toward making their facilities safer places to play and to work.

For the third installment of our Links for Life campaign, cosponsored by the American Heart Association and leading organizations from the golf industry and beyond (see related story, page 90), we're taking a more pre-emptive approach. On the following pages we'll give easy, effective ways to lower your risk of developing heart disease in the first place.

Although sudden cardiac arrest often has no warning signs at all, the fact remains that many forms of heart disease can be prevented. Indeed, over the past 10 years, changes in diet, exercise habits and smoking rates have helped to bring about a slight decline (about 2 percent) in deaths from all forms of cardiovascular diseases.

But diseases of the heart still kill more than 726,000 Americans each year. And health experts fear that the recent decline in death rates will not last. "As the baby-boomer generation continues to age and as the average life span continues to lengthen, we expect the downward trend in deaths from heart disease to reverse itself in the next few years," says Dr. Lynn Smaha, president of the American Heart Association.

What's all this have to do with golf? Everything-if you want to lower your risk of developing heart disease or stroke and enjoy golf now and on through your golden years. In fact, golfers have at their disposal ready-made strategies to fight heart disease. Let's work from the ground up.

The benefits of walking

Study after study has documented the benefit that aerobic activity provides in lowering blood pressure, improving cholesterol profiles and decreasing the risk of heart disease. But many golfers assume that because of the stop-and-go nature of the game, walking the golf course doesn't "count" as exercise.

Though golf may be, in the immortal words of Samuel Clemens, "a good walk spoiled," it remains a good walk nonetheless: The average player covers five miles or more during each 18-hole round. "We've long known that walking is a great form of exercise for all Americans," says Dr. C. Everett Koop, former Surgeon General. "Studies have shown the strong health benefits walking can also have in protecting golfers against heart disease."

These new, often golf-specific studies are beginning to document exactly how beneficial walking while playing golf can be. In Sweden, researchers examined the physiological demands placed on middle-age golfers who walked the course. Despite the short walking intervals, the golfers' exercise intensity ranged from 40 to 70 percent of maximum aerobic power, researcher Gi Magnusson reports in Golf Science International. The findings led the Swedish team to calculate that four hours of activity on a golf course is comparable to a 45-minute fitness class. Magnusson concludes: "Golf is unique in the way it motivates middle-age and elderly individuals to walk a fairly long distance on a regular basis."

The results of a long-term study of Hawaiian men provide even more encouraging news. In tracking 2,678 men ages 71 to 93, researchers found that the risk of developing heart disease decreased 15 percent for each half mile walked per day (see graph, above). Those who walked a mile and a half or more per day had less than half the rate of heart disease compared to those who walked less than a quarter mile a day. It did not matter what speed they walked as long as the distance was covered.

In another groundbreaking study, cardiologist Edward A. Palank evaluated the effect of walking the golf course on cholesterol levels, including levels of high-density lipoprotein (HDL) cholesterol and low- density lipoprotein (LDL) cho-lesterol. In hacker's terms, HDL is considered the "good" cholesterol; LDL is the "bad" cholesterol.

In Palank's study, one group of middle-age men played golf three times a week for four months, walking the course while making no other changes in diet or undertaking any other form of exercise. A control group of similar-age men did not play golf or engage in any regular exercise.

In the golf group, LDL levels de-creased significantly, while levels of HDL, the good cholesterol, remained roughly the same. "The key is in im-proving the ratio of good cholesterol to bad, which walking the course succeeded in doing," Palank says.

The bottom line for golfers: Lose the golf cart and start hoofing it. Any form of walking is good for your ticker, even if that means you're just chasing after your 150-yard banana ball all day long. Hire a caddie, use a pullcart, or sling a carry bag over your shoulder-walk the course whenever possible.