Exercise
It is all from one single form of treatment – but the treatment is not a pill,
it is exercise.
In the 1970’s, certain research centers began tracking the overall health,
including the fitness level (usually gauged by a treadmill test) of people who
came into their clinics for physical examinations. The upshot of these
studies was the article published in the Journal of the AMA in 1989, by Dr.
Steve Blair, in which he reported that exercise had increased the longevity
rates for athletes. However, reviewing his data in preparation for a
television interview, he realized that it was not just the trained athletes or
the devotees to regular exercise routines that had increased longevity.
The approximately 40% of people who were not following an exercise program but
were active, not couch potatoes, also had an increase in health almost
equivalent to that of athletes. Since that time many more studies have
been done, and it is surprising how just a bit of gardening, taking the stairs
instead of the elevator, taking a regular walk, helps increase health.
I can still find no agreement among the different reports on how much exercise
it takes to help improve health. The standard has been the Surgeon
General’s report in 1996, which stated that 30 minutes a day of exercise
maintained health. To lose weight, or gain control over diabetes, more
like 45-60 minutes a day was necessary. However, I have also recently
read an article that stated that 9 minutes a day was enough to have a
substantial impact on health. I suspect that since we all metabolize at
slightly different rates, we each have slightly different needs for exercise,
and hence the variation in the studies and lack of consensus on just how much
exercise benefits us.
Here are some results from various studies: walking just one hour per week
lowers the risk of blocked blood vessels to the heart by 51%. Exercising
just 30 minutes twice a week results in a 43% lowered risk of death (increases
longevity, in other words). Just one hour of gardening per week reduces
the risk of sudden cardiac death to a mere 1/3 of what it would be for a couch
potato. A 2001 report which combined the results of 44 different exercise
studies (a meta-analysis) showed that the overall benefits of exercise (all
those things listed in the introduction) occur with the first 1000 calories of
increased activity each week. If the numbers on my treadmill are right,
at the slight incline at which I have it set, I need to walk a little less than
2 miles a day just 5 days a week to et maximum benefit. Since I also garden,
and dance tango 2-3 days a week, I should be well within the range of health
without a very intense exercise program at all.
Of course, those of you who have studied much about exercise know that it is
more than just walking on a treadmill that really gives us the full
advantages. A total program consists of three parts: stretching exercises
for agility and limberness, aerobic exercise to increase heart rate and dilate
blood vessels, and weight training to increase strength of specific muscle
groups. Over and over in my own life, I get “too busy” and leave out one
aspect or another of these three forms of exercise, and my overall sense of
well-being decreases as a result. There are also specific forms of
exercise for specific problems. I myself have a back problem I was
probably born with, and a set of exercises for the abdominal muscles including
some I’d never heard of were given to me by Dr. Anna and Shaun Kahn, with the
result that I now hardly every have any back pain. It is aerobic exercise
specifically that has been shown in repeated studies to actually provide a cure
for fibromyalgia. However, someone with chronic fatigue syndrome along
with fibromyalgia has to be very careful with their level of exercise, as it is
very easy for them to “overtrain” with just a 20 minute brisk walk.
Here are some really basic rules to follow to get yourself exercising:
Increase its priority. My usual excise, and the one I hear most from
patients, is that their life allows no time for exercise. If just ten
minutes can make a difference, make it a high priority to find those ten
minutes. Your energy levels will be better, and you’ll feel like you have
MORE time if you do so. If it is because you are tied down by your
children, take them walking with you and start them on a habit of a lifetime
that will increase their lifespan and life quality.
Do something: If you cannot do your whole program n a day, do just a
part of it. Walk for 2 minutes instead of 10, get on a rebounder for 5
minutes instead of 20. Just do something, so you won’t get out of the
habit of moving.
Take a friend: We are such social creatures, studies have shown
repeatedly that exercisers will continue walking better than any other form of
exercise, and will stay with a walking program better if they walk with a
friend or with a pet.
Don’t get bored: You don’t have to do the same thing every day. In
fact, it is better if you don’t. Garden on day, skip around the block
another, walk on the treadmill if the weather is bad, take the dog on a walk
around Lake Harrison if the weather is gorgeous and the newly hatched ducklings
are swimming around.
Stop mechanizing everything: Sometimes it is better to dig the garden
with a shovel than use the new tiller, even though it takes longer. There
is a mental slowing down process that also helps the health when we walk
instead of drive, shovel instead of till, hand carry the wood to the porch
instead of truck it. Put on some music and pause to dance a bit while dusting
or changing the oil in the car. The chore will take longer, but you’ll be
healthier in every way for slowing down your mind, and speeding up the movement
of your body.
Don’t overdo: Overtraining is a very real phenomenon – just ask any
marathoner who did not take a break in her or her workout before the day of the
big race. There is a cyclist who overtrained to a point that he
apparently did permanent damage to his cell membrane permeability and essentially
has a form of chronic fatigue syndrome for over-exercising. When the
exercise stops feeling good, and begins to feel like overexertion, stop.
Warm up, cool down: Take the time to get the circulation flowing, and
the muscles warmed up. When you finish the peak intensity of your
workout, don’t just sit down in a heap. Walk around, do some stretches,
let the body unwind.
There is so much more to know about exercise, and it is such an important
topic, that I hope in our large, quarterly newsletters to start a regular
column on exercise from one or two of the fitness experts I know.
Meanwhile,
Alice R. Laule, MD