As you share your questions with others and learn from our panel of experts, you'll learn a lot about the issues faced by women everywhere. You'll discover you're not alone in your search for ways to protect your heart and help your loved ones stay heart-healthy, too.

The Go Red For Women Expert Panel

Learn more about the distinguished panel of leading medical authorities who are here to answer your questions:

Mary Ann Bauman, M.D.
Medical Director, Integris Family Care Central, Oklahoma City, OK

A graduate of Wayne State University Medical School, Dr. Bauman has served in private practice as well as in a variety of teaching and administrative positions on medical school faculties. Board certified in Internal Medicine, she is a frequent motivational speaker on health topics and a committed advocate for healthy living. As an outreach to teens, her &quotOn Your Own™" program has reached thousands and has been in demand since it began in 1993.

Dr. Bauman's book Fight Fatigue: Six Simple Steps to Maximize Your Energy offers a novel, easy approach to finding energy that is designed to fit into the busiest of schedules. As a syndicated television journalist, she has given healthy living advice on CBS and NBC affiliate stations. What's more, she currently sits on the editorial board of Medical Economics magazine.

Barry A. Franklin, Ph.D.
Director of Cardiac Rehabilitation and Exercise Laboratories
William Beaumont Hospital, Royal Oak, MI

A long-established and celebrated expert in cardiac fitness, Dr. Franklin has been a senior member of the cardiac rehabilitation center at Michigan's William Beaumont Hospital since 1985. The recipient of numerous research grants, he now serves as a collaborating investigator for HF-ACTION, a randomized, controlled trial investigating outcomes of exercise training in patients with heart failure. That Dr. Franklin is also the recipient of as many as seven major awards is also a testament to his unique standing in his field. Since 1994, Dr. Franklin has been an appointee to the Governor's Council on Physical Fitness, health and Sports (State of Michigan).

Aside from the positions he has held at major university hospitals, Dr. Franklin has also held multiple leadership positions with the American Heart Association, both at the regional and national level. Currently, he serves as President of the American Heart Association, Greater Midwest Affiliate. As an author or editor of more than 500 publications, including 23 books, he has given over 600 invited presentations to local, state, national and international, medical and lay audiences since 1976.

Penny Kris-Etherton, R.D., Ph.D.
Distinguished Professor of Nutrition
Pennsylvania State University, State College, PA

A highly regarded expert in cardiovascular nutrition, Dr. Kris-Ehterton has conducted numerous controlled clinical nutrition studies designed to evaluate the role of diet on risk factors for cardiovascular disease (CVD). A hallmark of much of her research is that it has integrated clinical and basic research for the purpose of evaluating underlying mechanisms that account for the clinical responses.

A Fellow of the American Heart Association and a recipient of many awards, she has served on the 2nd Adult Treatment Panel of the National Cholesterol Education Program, the Dietary Reference Intakes for Macronutrients Committee of the National Academies, the HHS/USDA Dietary Guidelines Advisory Committee 2005, and the Nutrition Committee of the American Heart Association that published diet and lifestyle recommendations in 2006.

The author of over 175 scientific papers, 15 book chapters and co-author of 4 books, Dr. Kris-Etherton's research program has been funded by NIH, USDA and the private sector.

Ileana L. Piña, MD, FACC, FAHA
Professor of Medicine
Case Western Reserve University
Department of Medicine, Division of Cardiology
University Hospitals Case Medical Center, Cleveland, Ohio

Currently Co-Director of Case Western Reserve University's physician training program, Dr. Piña is the author of numerous publications, including Exercise and Heart Failure and The Year in Heart Failure 2004. A reviewer for Circulation, American Journal of Cardiology, and American Heart Journal, she also sits on the editorial boards of Journal of Cardiac Rehabilitation and Current Cardiology Reports. Among her many other accomplishments, Dr. Piña has collaborated with other professionals in her field to establish the Heart Failure Society of America (HFSA) guidelines and has acted as principal investigator in numerous clinical trials.

How to submit your questions
Here are answers to questions about the impact of exercise on your heart health, as answered Dr. Barry A. Franklin. If you have other questions for Dr. Franklin, or wish to ask about another heart-health topic, simply type your question here and SUBMIT. It's a great way to share information with other women, as we'll select questions and answers to display in this section every month.

Questions for Barry A. Franklin, Ph.D. Director of Cardiac Rehabilitation and Exercise Laboratories William Beaumont Hospital, Royal Oak, MI

Julie, age 35 from Texas asks I already do 30 minutes of moderate activity on an almost daily basis. How come I am not losing any weight?

By Barry Franklin, PhD. 30 minutes of physical activity is associated with a relatively small caloric expenditure – about 100-150 calories for most people. If you drink a glass of juice or a cola (in addition to the food and drink you normally consume) after you exercise, all the calories you burned are cancelled out. If the goal of your exercise is to lose body weight and body fatness, you may need more than 30 minutes of exercise each day.

The latest research suggests that 60 minutes is more likely to benefit weight loss, and some formerly obese individuals may need as many as 90 minutes to maintain their weight loss. You can break the exercise time up into 10-15 minute sessions and still realize the benefits.

Recognize that reducing the number of calories you take in is a more effective way to lose weight than physical activity when you first start trying to lose weight. Physical activity is a complement to reducing calories and it is the most common ingredient for those who are successful in maintaining weight loss. Check out the American Heart Association No Fad Diet for tips on deciding the right caloric intake.

Consider that regular physical activity is not just important to help you lose weight. It's part of an overall health/fitness regimen. Fit people, whether they are normal weight, overweight or obese, have much lower death rates than unfit people. Physical activity is an essential part of both overall health and cardiovascular health.

Our culture has engineered physical activity out of our lives, and we're simultaneously taking in more calories than we did in past years. It's a deadly combination. You need to think beyond what we call “structured” exercise – walking or going to the gym or whatever for a certain period of time. Physical activity needs to become a part of your daily routine. We're awake 16-18 hours a day; 30 minutes is only a fraction of that time.

You may get as much benefit from increased physical activity in daily routines as you get from structured exercise. Take the stairs at work, park somewhere that adds a few more steps to the door, take the long way to the break room - get creative about adding movement to your daily routine. The bottom line: Move more throughout the day. You'll lead a longer and stronger life.

Miriam, age 27 from Orlando asks: If I could only do one type of exercise the rest of my life, which would offer considerable health benefits?

By Barry Franklin, Ph.D. Science News has shown that major health benefits come from a habit of brisk walking. Why? It's easy to do, requires no special equipment other than a good pair of walking shoes, it's accessible, has a lower dropout rate and causes fewer orthopedic and musculoskeletal problems. Walking has proven to help lower cardiovascular risks by improving blood pressure, cholesterol and insulin and glucose homeostasis.

Walking can also be modified to give even greater benefits. Putting on a light backpack will give you similar calorie expenditure to jogging. If you're walking on a treadmill, adding a little grade can give you greater benefits. Walking the dog is also a great way to increase your expenditure. And if you have orthopedic problems, walking in the pool can provide significant benefits.

Is walking vigorous enough? Yes it is. Studies that show more than 80% of previously sedentary men and women can improve their cardiovascular fitness by simply walking at a brisk pace (3–3 ½ miles per hour). That raises the heart rate and metabolism enough.

How long do you have to walk to get the benefits? I used to tell people if you're going to save a dollar, put the whole dollar in the piggy bank at once. Now I tell them that you can break that dollar bill up into four quarters and still get the same benefit. For example, instead of walking for 30 minutes at once, try walking 10 minutes three different times. Those three ten-minute bouts will give you pretty much the same benefit. And it's easier to make ten-minute sessions part of your daily routine.

If one of your goals is weight loss, you may need to accumulate 60 or 90 minutes daily. I suggest that everyone get a good pedometer and track the number of steps you take each day, especially those done at a brisk pace averaging 3 mph. An average American takes 3500–4000 steps per day. A recent study found that Amish men take an average of 18,000 steps daily and Amish women an average of 14,000 steps daily. And only 5% of them had a BMI (body mass index) greater than 30, signifying obesity. That gives you some idea of the benefit of walking.

Ideally, you should set a goal of at least 10,000 steps per day, which is approximately 5 miles. Breaking that up into 10-minute periods will help you achieve the goal. And remember, to get the most benefit, walk briskly whenever you can. Get to the door of the store from the car briskly. Walk down the hallways briskly. Whenever you're walking, walk like you've got some place to go. Take advantage of every step you take.

Related Links
Choose To Move: Free 12-week physical activity program for women www.choosetomove.org Healthy Heart Walking CD

Sara, age 44 from Omaha asks: I know aerobic activity like walking is good for my cardiovascular health, but what about strength training? Is there any reason to look into it? 

By Barry Franklin, Ph.D. My answer is absolutely, yes. It's a great complement to an aerobic exercise program. It's good because of the resistance involved. Resistance increases muscle strength and endurance by up to 100% or even more, and interestingly enough, the greatest increases in endurance have been reported in elderly or frail adults. Several years ago a study published in the Journal of American Medicine (JAMA) showed that resistance training yielded a 174% increase in strength in a group of people over the age of 90.

Strength training helps maintain or increase lean body mass, and muscle burns calories. That helps with weight control. As we get older, our body mass changes, and strength training can help us maintain a leaner body as we age. It can also improve glucose metabolism and the way our bodies handle sugars. It may also improve overall cholesterol profile by modestly lowering LDL ("bad") cholesterol and triglycerides and raising HDL ("good") cholesterol levels.

If you do strength training regularly, your heart rate and blood pressure are less likely to rise high during certain activities like lifting or carrying, and the demands on your heart are reduced. So not only does strength training enhance functionality, especially for the elderly, but it also improves cardiovascular function. And recent studies have shown that stronger people have a lower mortality rate.

My recommendation for a strength training routine is one set of 8-10 different exercises with 8-15 repetitions per set, using the upper and lower extremities. If you're a regular exerciser, you can do three sets, but studies have shown that one set can give novice exercisers almost the same benefits in muscular strength and endurance as three.

Related Links
Health and Fitness Benefits of Resistance Training 

Jan, age 55, from Princeton asks: Can getting regular physical activity actually help lower my blood pressure and how so? Does it also do anything for my cholesterol? 

By Barry Franklin PhD: Physical activity has shown to lower blood pressure, though we are not sure exactly how. One theory is that physical activity lowers the heart rate and this is what lowers the blood pressure. Another theory is that physical activity reduces stress. Stress is tied in with the catecholamine hormones, epinephrine and norepinephrine, which are known to raise blood pressure. Lowering stress and consequently lowering catecholamines may lower blood pressure.

Physical activity can also reduce body weight and body fatness, and sometimes as body weight decreases, so does blood pressure. Regular physical activity may also have a direct effect on the vascular system, which ultimately results in decreased peripheral resistance. People with mild hypertension tend to get the most benefit on their blood pressure from exercise. Generally it's lowered an average of 5-7 mm Hg after an exercise session.

My exercise prescription to optimally reduce blood pressure would involve frequency, intensity and time. Get endurance (aerobic) exercise most, and preferably all, days of the week at 40-60% of your capacity for an accumulated time of at least 30 minutes per day and complement this aerobic exercise with resistance training 2–3 days of the week.

As far as cholesterol goes, physical activity may be beneficial, but it only changes the levels modestly. It's not the best way to lower cholesterol. Generally the favorable changes in cholesterol are from the reductions in body weight or fat stores that come from regular exercise, so it's an indirect relationship. For exercise alone to increase your HDL, or "good" cholesterol, some studies suggest that you would need to walk or jog at least 10 miles every week.

Even though I recommend at least 30 minutes, and preferably 60 minutes of physical activity most days of the week, you shouldn't let those time limits keep you from doing as much as you can. For example, if you're currently doing nothing and you can manage 8-10 minutes of walking three days a week, that's great. Something IS better than nothing! Do what you can. You'll find that's it's pretty addictive, and if you can just get started, your body will help you add minutes. A body at rest tends to remain at rest. A body in motion tends to remain in motion. That's just physics! Take the first step. Take action!

The same goes for losing weight. If you're a 300-pound person and you think you can get to 280, work for that. Don't overwhelm yourself. It's self-defeating. Worry about getting to 180 only after you've had several 10 or 20 pound weight loss successes. The long and short of it is, do whatever you can. Don't deny yourself the benefits of a little physical activity because you don't think you can get a lot. Every minute counts, and remember, more fit people - whether they are thin, overweight or obese - have a lower mortality rate than less fit people of the same body habitus (physique). So even if you're not losing weight, you're adding quality and time to your life when you become more active.

Related Links
Choose To Move in 12 weeks
What happens to blood pressure during exercise? 
Get your target heart rate