Katie Wiskar, fellow in General Internal Medicine at the University of British Columbia, and Kate Shoults, general internist in the Greater Vancouver Area, are joining us on The Rounds Table this week! They are covering the association between cardiorespiratory fitness and long-term mortality, and vitamin D and omega-3 fatty acids and the prevention of cancer death and cardiovascular disease.
Cardiorespiratory fitness is linked to better health – but does this always hold true that the more exercise the better? Kate covers an article on this in a cohort of patients who underwent exercise stress testing primarily for obstructive coronary artery disease. She discusses all-cause mortality as it relates to cardiorespiratory fitness and whether or not this plays a role as a prognostic variable.
It is known that vitamin D is good for bone health and osteoporosis. It has been suggested that in regions with the most sun exposure, there may be lower incidences of cancer and cardiovascular disease; however there have not been any randomized control trials on this. Moreover, the Canadian Cardiovascular Society recommends omega-3 fatty acids for patients with heart failure. What is the evidence behind this? Katie walks listeners through two articles (VITAL trial) on vitamin D supplementation and omega-3 fatty acids compared to placebo and the prevention of cancer and cancer death and major cardiovascular events.
Finally, the Good Stuff segment. Kate shares an article in The Washington Post on the importance of understanding probability and the accuracy of tests that we rely so heavily on in medicine. Katie shares a blog post that summarizes the top 50 innovative ideas in medicine brought forth at a four-day gathering called the Exponential Medicine 2018.
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Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.
The Papers
1. Fitness: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428
2. VITAL: https://www.nejm.org/doi/full/10.1056/NEJMoa1809944
Good Stuff
1. What the tests don’t show: https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature/doctors-are-surprisingly-bad-at-reading-lab-results-its-putting-us-all-at-risk/?noredirect=on&utm_term=.80217dfb1858
2. Exponential Medicine 2018: http://www.gregoryschmidt.ca/writing/exponential-medicine-2018-top-50-ideas
Music Credits
The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW
My MSer hub and I have done a few half marathons–not fast, but we get there–and plan to do more. Look for races that publish a good course map online ahead of time (you could start researching now for next year’s races). Good maps will show you the number and location of water and ‘comfort’ stops. It really varies–some races will only have a few, while others have them about every mile or so, which is about as good as it gets. Other pieces of advice are to look for out-and-back courses (you pass each comfort stop twice, plus you have an opportunity to scope things out on the way out). Loop courses with lots of stops also work well. The downside of point to point courses https://enrgifitness.com/fitness-and-stress/ is that you will typically have a shuttle ride to one end or the other; usually these are on something along the lines of a school bus, so in other words no facilities on board. If the race offers a VIP option you may want to pay up for that; usually these include some kind of favorable restroom access for before/after the race. None of this provides the same kind of immediate relief as the proverbial stop in the shrubs, but they can make it a little easier to manage. Happy running!