There is a 2,100 mile-long footpath on the East Coast of the United States that extends from Springer Mountain Georgia through the Blue Ridge Mountains and the Great Smokey National Forest, up through the Shenandoah National Park, the Alleghanies and the Adirondack Mountains of New York and Vermont, to the majestic Presidential Range in the White Mountains of Vermont and on to Baxter State Park where it ends at Mount Katahdin Maine. I hiked just over 1000 miles of that trail in one shot when I was 15 years old. I can’t really remember what got me interested in hiking the AT, but my Father’s family is from Chattanooga, Tenn., which is very near to the southern end of the trail, so I like to think there was some family element involved, but for a 15-year-old it was probably just that it just seemed like a good idea at the time, and it did.
Unless you come straight from military boot camp, there is absolutely no way to get in good enough shape to make hiking up and down the Stekoa mountains in Georgia easy. When you reach the flat ridges of the Shenandoah Mountains in Virginia, you are in what will probably be the best shape of your life and the terrain is so flat up on the ridge that you can and should walk well over 30 miles a day if you want to complete the trail in one season; early March to when the snow flies in Maine the same year. I have it written somewhere in the maps I used at the time, but I think I made it 40 miles on two or three days in the Shenandoah. That isn’t easy and something only a 15-year-old attempts! All advice to long-distance hikers that I read about the Shenandoah National Park said to avoid the public campsites, lodges and tourists there because what are called “through hikers” are mini-celebrities at that point. Moms from everywhere want to stuff you with all of the treats that are unavailable to you while hiking and the enticement of a hamburger and strawberry pie has pulled many a through hiker off of their Katahdin dream of completing the AT. I didn’t listen to a word of that and got caught in the lure of the Shenandoah and it ended my AT adventure just north of 1,000 miles.
As soon as the weather gets even a little bit warm in Georgia, the enormous black flies and other insects become such an issue that as soon as you stop walking, they cover you like a blanket and not in a good way! By far, the most effective, cheapest and coolest way to deal with the black fly issue is to puff on cigars and drive them away with the smoke. It’s the only thing that works 100 percent of the time with every species of flying insect. In the South, Swisher Sweet cigars are available everywhere, so that is what we all smoked. Now, you don’t need to inhale these things and most cigar smokers don’t generally inhale, but I did a few times and liked it.
There are a lot of things I took away from this Appalachian Trail hiking experience; a love of the earth and the outdoors and a concern for environmental conservation, an appreciation of what exercise will do for you and an understanding of what archiving small daily goals contribute to a larger project. But I also came away with a smoking habit that I maintained for 30 years. I went back to my job as a dishwasher at the Farm Shop restaurant in Waterbury, Conn. and after telling me that I couldn’t smoke cigars in the restaurant, the manager–Larry Kerouac, I still remember his name–tossed me a pack of Camel non-filters and that was that. I smoked two packs a day plus until I was 41 years old. I quit in 2002, just one year before I initially ran into heart disease and started my lifestyle modification.
Smoking is the first risk factor for heart disease identified by the Framingham Heart Study. Elevated cholesterol was the third. In a 26-year follow-up, Dr. William Castelli, director of the Framingham Heart Study, identified being overweight as an independent risk factor for heart disease. Those are two other genetic predispositions that my family history gave me.
I can trace my appreciation of different flavor profiles back to my first taste of a hamburger in kindergarten when I lived in Orlando, Fla. I can still taste the way onion and dill pickle play off of each other as set against the backdrop of mayonnaise, mustard, ketchup, salt, pepper, sweet and savory with the texture of crispy lettuce, the deep umami and acidy of tomato and the smooth fat from the flame-broiled burger and cheese, all on a soft puffy white bread bun; mmmm. Later in life, I discovered that in other countries, children are taught moderation as well as appreciation, but here in America, we do excess and I embraced that, leading to an overindulgence in calorically dense fatty foods and simple sugars that lasted almost 40 years.
Even though I drastically changed my lifestyle in 2003, you can not underestimate the damage done to my arteries during the first 42 years of my life. The following analogy illustrates this point well.
I have worn many types of white shirts over the years, depending on the type of washing and pressing available. Since I do my own wash in Smith Center, I selected a wrinkle-free shirt that presented nicely without much attention to care. I ran into an issue with the cuffs and creases starting to fray after just a few months. Following emails to the manufacturer, I discovered that the chemicals they use to make the fabric wrinkle-free demand specific washing and drying techniques that I wasn’t adhering to. You can’t use bleach or hot water and you can only dry on low heat. Though these warnings were on the shirts, they were not on the web page I purchased from, so I missed them. I replaced the shirts that were too frayed to wear and changed my washing habits. About a month later, I noticed two of the shirts started to fray. I began writing a terse email back to the manufacturer when I realized that I hadn’t replaced these two shirts early on. So they had already experienced the long-term effects of incorrect washing and drying procedures and that’s why they were starting to fray now. In my mind, I extended the time that I had been washing and drying correctly, forgetting that those two shirts were already seriously damaged.
Similarly, I have extended the amount of time that I have been living a healthier lifestyle. The fact is that 20 years of living a healthy life is great, but it won’t completely erase 40 years of long-term damage that a poor lifestyle will produce. I am not going to go into the details of my unhealthy lifestyle here. Let’s just say that the first 40 years worth of miles on my body were not highway miles; they were heavy use, stop and go city miles! The kind of miles that do severe long-term damage to your arteries in every way imaginable.
When I was starting to think about why I, of all people, should have a heart attack, I was reminded of that smoking 30-year smoking habit and other lifestyle issues. I have been eating right and exercising for a while and certainly to look at me now, it is surprising that I had a heart attack; but is it really? There are a few important things at play here. The first thing is genetic predisposition coupled with the long-term effects of lifestyle and the second is family history and genetics.
Heart disease is all over my family history on both sides of my family. I also have a separate genetic predisposition to gain weight easily and have uncontrolled cholesterol, two markers for heart disease. Lifestyle changes can indeed erase some aspects of heart disease, but if you have a family history and a genetic predisposition for some heart disease markers the way I do, you are at an elevated risk of having a heart attack. One survey of four studies involving 55,685 participants published in 2016 in The New England Journal of Medicine placed that higher risk at 91 percent. Another review published in Current Cardiology Reports in 2019 suggests that even with a healthy lifestyle, those with genetic risks are at significantly higher risk of coronary artery disease. These studies tell us that if you have a family history and a genetic predisposition for some heart disease markers, you need to be 100% compliant with a healthy lifestyle; 100 percent! That’s not something we are always good at; self-included. Aside from that, I will add that it might be wise to use both medication and lifestyle modification in a combined effort to protect against heart disease. I don’t think that any doctor would disagree with that. Sometimes proponents of lifestyle modification downplay the importance of adding medication. I have been guilty of that myself, but especially if you have an established family history and a genetic predisposition for some heart disease markers, that would be a mistake. Take the meds as well as practice a healthy lifestyle!
The American Heart Association warns of increased risk if your family shows a history of cardiovascular disease and then suggests 7 risk factors that people can improve through lifestyle changes to help achieve better cardiovascular health even if you are genetically predisposed. The American Heart Association calls that Life’s Simple 7®.
Bob Harper, the personal trainer who hosted The Biggest Loser on television, suffered a near-fatal heart attack. There is no better example of living a healthy lifestyle with low-risk factors than Bob Harper. He had a near-fatal heart attack followed by a medical procedure to place stents in his heart. ABC News has a 30-minute news video on that subject that you might find interesting.
We will take up this topic again from time to time as I come to terms with my recent heart attack adventure. Until next week Eat Well – Be Well!
Here are the references for today’s Healthy Eating Tip:
Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983 May;67(5):968-77.
Kannel W.B., T.R. Dawber, A. Kagan, N. Revotskie, J.I. Stokes. 1961. Factors of risk in the development of coronary heart disease six-year follow-up experience; the Framingham Study. Annals of Internal Medicine. 55:40.
Khera, Amit V, Emdin, Connor A, Drake, Isabel, et al. Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease. The New England Journal of Medicine, 2016-12-15, Vol.375 (24), p.2349-2358.
Said MA, van de Vegte YJ, Zafar MM, et al. Contributions of Interactions Between Lifestyle and Genetics on Coronary Artery Disease Risk. Current Cardiology Reports. 2019;21(9):89.
American Heart Association. Health Topics. Consumer Healthcare. What is Cardiovascular Disease? Family History and Heart Disease. Accessed 3/12/2021.
American Heart Association. Healthy Living. Healthy Lifestyle. My Life Check – Life’s Simple 7 Accessed 3/12/2021.
ABC News. Health. Video. ABC News Lives Presents Prescriptions for Health: Your Heart and You. Accessed 3/12/2021.