Alter training for poor health?

Training Q&A [Moderated]
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Hi team,

My girlfriend prompted me to get a general check up with a doctor. I have had a full battery of tests - CBC, routine urinalysis, spec M, PSA, chest x-ray, whole abdomen ultrasound, and Treadmill Stress Echocardiography (suspected Coronary Artery Disease) - and the results have been surprising to me. I will be reviewing these with the doctor this week, but I would appreciate any insight, especially as it refers to my training.

I am male, aged 44, height is 183cm, and weight is 104kg, waist is 41”, BMI 31. I live in the Philippines.

In summary, the abnormalities (not sure if that is the correct term) are:

ECG / Treadmill Stress Echocardiography:
• I have incomplete right bundle branch block.
• Mild diastolic abnormality – slightly elevated atrial reversal velocity.

CBC:
• Haematocrit and lymphocytes slightly high.
• MCHC and RDW low.

Clinical chemistry:
• Cholesterol slightly elevated.

Whole abdomen ultrasound (impressions):
• Fatty liver
• Gallbladder/Cholesterol polyps
• Splenomegaly
• Prostatic concretions
• Urinary retention.

As I am overweight, and from previous examinations, I am unsurprised about my cholesterol being slightly high, but shocked about the fatty liver and enlarged spleen. I thought I was still healthy!

Yes I need to lose weight. I have already made some changes to improve my diet – especially reducing saturated fats. My GF had a higher cholesterol result that I did – so we will both eat healthier from now on.

I am aiming to lose about 1kg per week and to get down to mid 90kg (a circa 10% reduction), initially. I have restarted the BBM bodybuilding template. Is there anything I need to do differently i.e. more cardio? Or any other changes I ought to make to my training or other lifestyle interventions? Thank you for your work and for sharing your expertise.

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Hi there,

I agree that getting the waist circumference down to target ranges is the most important priority here. If you are able to adhere to any of our strength & conditioning templates, I don’t think that they need any special modifications in this situation.

You would do well by following the guidelines set forth in this article: Where should my priorities be to improve my health?

We also have a podcast on Fatty Liver Disease (Episode 204), and plenty of content on cholesterol (starting here: Cholesterol - Causes, Prevention & Treatment ). You should get your blood pressure checked, and consider a screening for obstructive sleep apnea.

Beyond this, any further individualized discussion of your test results and management strategies would be best handled via 1-on-1 consultation, which we’d be happy to help with if needed.

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Many thanks, Austin. Will check out the podcast and articles.

Splenomegaly / Cholelithiasis / Diet
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Radnor80: I think Dr. Baraki is spot on with regard to exercise, and an individual consultation would be wise. I would add a single additional point: the presence of gallbladder polyps is a known risk factor for future development of gallbladder cancer, so asking your PCP for a referral to General Surgery for a consultation to discuss that risk is also recommended. The VAST majority of gallbladder polyps are benign, but given your relatively young age and the length of time you could potentially still live, you might want to consider an elective removal of the gallbladder to mitigate the lifetime risk those polyps could pose.

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