DEAR DR. DONOHUE: I am a 55-year-old male who knows the benefit of lifting weights. I’ve been a gym rat since I was 40. I also realize the value of controlling cholesterol. I was diagnosed with an ascending aortic aneurysm, and, upon the advice of my doctor, I left my very physical job and the gym as well. I have a lifetime restriction of lifting no more than 20 pounds. I have been inactive for the past two years, and my cholesterol levels have been rising. My doctor says I should walk. I have opted for bike riding. It’s not strenuous. I never see anything about the advantage of this kind of physical activity. Will bike riding help lower cholesterol? Do niacin supplements help? — T.C.

ANSWER: An aneurysm is a bulge on an artery. It represents a weak spot. The aorta — the largest body artery — is prone to developing aneurysms. It receives blood right from the pumping heart, so it is subject to the maximal pumping pressure of ejected blood. Your aneurysm is on the first 2 inches of the aorta, the ascending aorta.

Genes, cigarette smoking, high blood pressure, artery hardening, aging and some inherited conditions are possible causes of aneurysms.

Exercise is encouraged for most people, even those with an aortic aneurysm. However, exercises that greatly raise blood pressure, even transiently, are dangerous for those with an aneurysm. Dr. John Elefteriades at Yale University has been a leader in warning of the danger coming from high-intensity weightlifting by those with an aneurysm. Weightlifting limits should be set by the person’s doctor and should be closely adhered to. Even an exercise like pushups could be a threat for someone with an aneurysm.

Bike riding isn’t a dangerous activity. It does lower cholesterol. All aerobic exercise does. Aerobic exercise is things like jogging, walking, swimming and biking.

Niacin (nicotinic acid) also lowers cholesterol and triglycerides, and raises HDL cholesterol, good cholesterol. The dose is somewhat high, 1 to 3 grams a day. Don’t take it, or any other medicine, without first talking the matter over with your doctor.

DEAR DR. DONOHUE: Please settle an issue that has sparked a heated discussion.

Isn’t running better for your heart than walking? I maintain that the harder the exercise, the greater are the benefits from it. I believe that you have to work up a sweat before you do yourself any good.

I’ve been challenged about this. What are your thoughts? — R.C.

ANSWER: Exercise intensity is one of the factors that determine the effectiveness of exercise in attaining and maintaining health. There’s no dispute about that.

However, there is a dispute about the need to break out in a drenching sweat to achieve health goals. Dr. Andrea Chomistek of Harvard University puts it succinctly and clearly. She asks if you burn 1,000 calories a week, does it matter if you burn them walking or running? Her answer is that running might provide a slightly greater benefit, but there’s not a huge difference between the two.

There is a difference between the strenuous exercise of a professional athlete and the less-than-strenuous exercise of a somewhat-sedentary person.

DEAR DR. DONOHUE: I am a 58-year-old male in excellent physical condition who works out five to seven days a week. Since I am still a competitive athlete, I am always looking for a nutritional edge. My reading has introduced me to a supplement called NT Factor. The article on it claims that clinical research has proven it can not only reduce fatigue, but it can also increase stamina. I would appreciate your comments. — B.M.

ANSWER: I have read the ingredients in NT Factor and find nothing harmful. I don’t know if it delivers all that it promises.

If you decide to try it, let me know the results. I am as sure as I can be about these matters that it won’t hurt you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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