Visiting Great Ormond Street Hospital, I had the good fortune to observe the service that cares for kids who have had heart surgery, which has helped me better understand the care and treatment pathway for these patients as they approach adolescence and how to recommend safe exercise guidelines for them.
1 out of 100 infants are impacted by congenital heart disease (CHD)
25% of CHD patients require surgery or procedure before they are 1 year old
It was a great experience being a guest speaker at a Cardiomyopathy UK support group.
Arrhythmogenic right ventricular dysplasia / cardiomyopathy (ARVD/C) and Dilated Cardiomyopathy (DCM) are challenging conditions where patients and even clinicians lack knowledge when advising safe exercise practices.
Today’s talk “Exercising Beyond Diagnosis” was about empowering patients to better understand their condition and learn the right questions to ask.
I wouldn’t have been able to advise these patients if I hadn’t been working in cardiac rehab where I frequently see these patients, working privately with these conditions or without the advanced knowledge and understanding I’ve been gaining from my MSc Sports Cardiology at St. George’s University, London.
Carbohydrates and weight loss can be confusing especially when you are told they are both good and bad for you. The important thing to understand are the different types so you can make an informed decision. They provide the fuel to keep your body going especially during high intensity or long duration exercise. Our aim is to eat mainly unrefined complex and fibrous carbs while limiting simple carbs and refined carbs.
The 3 main sources of carbs are:
The simplest form of carbohydrates is glucose (sugar). Simple sugars that are found in foods include sucrose (table sugar), fructose (found in fruit) and lactose (found in milk). Not all simple carbs are bad as the ones found in milk and fruit are perfectly healthy. So if weight loss is your goal stay away from sugary foods, drinks and sweets.
These are also made up of sugars but they are strung together to form longer more complex chains. Unrefined carbs include whole grains, peas, beans which are all rich in vitamins minerals and fiber. These keep you fuller for longer and are great for weight loss.
Unfortunately the mistake people make here especially when looking for weight loss is they choose refined carbs (white rice, white bread, white pasta etc.). This is where the high fiber parts have been removed thus losing all the properties that make it a healthy choice. As a result they cause sudden energy bursts that result in you feeling fuller for a shorter period of time and wanting to eat again.
These are rich sources of vitamins, minerals, nutrients and are full of fiber (tend to be green leafy vegetables). As a result the food passes straight through the gut and is not absorbed so they become great colon cleansers which keep the digestive process running clean and healthy. So with regards to weight loss they are very low in calories.
Below is a sample of each of the groups to eat:
| Fibrous Carbohydrates | Complex Carbohydrates | Simple Carbohydrates |
| Asparagus | Oatmeal | Fruit |
| Aubergine (Eggplant) | Legumes | Dairy products |
| Brussels sprouts | Potatoes, Yams, Sweet Potato | |
| Green Beans | Brown rice | |
| Broccoli | Whole wheat pasta | |
| Brussels Sprouts | Whole wheat/ Multi-grain bread | |
| Mushrooms | Sweet corn | |
| Cabbage | Whole grain cereals (e.g. muesli, shredded wheat) | |
| Carrots | Whole Barley | |
| Cauliflower | Buckwheat | |
| Celery | Rye | |
| Cucumber | Millet |
Thank you for reading.
In part 2 we will look at carb cycling.
Gym Workouts – Less than 20 minutes
Before you start any of these exercises please ensure you have completed a warm up (increases heart rate) of at least 5-8 minutes on a piece of cardiovascular equipment of your choice such as cross trainer, bike etc. This will ensure that the muscles and body temperature increases thus decreasing the risk of strains while also enabling your muscles to work more efficiently.
(If you are unsure of any of these exercise please ask myself and I will be happy to demonstrate. As there are risks involved in participating in any exercise please ensure you use safe form through a pain free range of motion.)
I’ve attached 5 categories of exercises pick 1 exercise from each group. Perform this exercise for 30sec. with 10sec. rest inbetween for 2-3 rounds with 30-60sec. rest between rounds. Use dumbbells where you feel capable. When you have completed the workout perform a cool down (reducing heart rate) of another 5-8 minutes to ensure adequate recovery from session through the use of cardiovascular equipment.
| Cardio | Upper | Lower | Core | Full Body |
| Jump Squats | Push Ups | Squats | Curl Ups | Burpees |
| High Knees | Tricep Dips | Lunges | Side Plank | Push Press |
| Jumping Lunges | Superman’s | Clockwork Lunges | V-Ups | Renegade Row |
| Ski Hops | Shoulder press | Lateral Lunge | Plank With Toe Taps | Mountain Climbers |
Tabata timer – You can download an app such as ‘tabata timer’. This will make things easier so you don’t have to keep looking at your watch or a clock as it beeps each time notifying you when to go, rest and finish.
This is just a guide for the healthy individual to use when shopping. This just gives examples of food you should be looking to buy under the headings proteins, grains etc.
I am a motivated and confident Clinical Exercise Specialist working at Imperial College NHS trust while also studying an MSc. Sports Cardiology part-time at St. George’s University of London while working full-time within Phase 3 Cardiac Rehabilitation. I have knowledge and experience in providing specialised advice and exercise prescription to patients and family members following coronary artery disease (myocardial infarction, angina, CABG), post Implantable Cardioverter (ICD) Defibrillator or Cardiac Resynchronisation Therapy (CRT-D), valve disease, heart failure, heart transplants and inherited cardiac conditions.
I am also qualified in Exercise Training for Chronic Respiratory Disease. I am continually developing my knowledge and skills through participation in continuous professional development courses in order to undertake all aspects of clinical duties while working as an autonomous practitioner.
shanepurcell pt 