Good reasons to keep fit A recent study in obese patients indicated that both diet and exercise resulted in weight loss and a favourable effect on serum lipids: a reduction in triglycerides and an increase in HDL cholesterol. Other studies in patients undergoing cardiac rehabilitation that includes physical activity have demonstrated a preventative effect of exercise on postinfarction deaths. However, vigorous exercise initiated early (within 8 weeks of infarction) in the programme should be avoided because of an apparently increased risk of non-fatal infarctions. Further, regular, vigorous activity is not protective when hypercholesteraemia is present. The excess risk of coronary heart disease in physically inactive people was calculated to be 90%. The protective effects of exercise against sudden death appear to outweigh the increase in risk of sudden death during exercise. Therefore, brisk walking appears to be the most suitable form of exercise for sedentary, middle-aged people. Finally, the control of obesity should include a greater amount of energy expenditure as well as decreased energy intake. Blackburn H, Jacobs Jr DR. Phys1cal activity and the risk of coronary heart d1sease. New England Journal of Med1c1ne 319: t217·1219, 3 Nov 1988 8072

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INPHARMA"' 12 Nov 1988

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