Longevity Medicine: How Much Exercise Really Makes A Difference?

People being people, they are always on the lookout for the easiest route to anything fun and worthwhile and most would rather add years to their lives by doing something simple, like taking nutritional supplements. Add healthful eating, reducing alcohol, stopping tobacco altogether, and the road to longevity gets more challenging. Start recommending regular exercise and there’s the greatest challenge of all.

During the WholeHealth Chicago new patient intake, we routinely ask about supplements, eating habits and exercise. By far, the commonest answer we hear about exercise is, “Not as much as I’d like.”

But interestingly when it comes to exercise, instead of feeling guilty, better to ask two questions:

1. How much exercise do I really need? and
2. What exactly is “good exercise”?

Let’s start with another issue, right up front: Do not exercise if your only goal is weight loss. You can blame your recent weight gain on inactivity, but if you get on the scale and in a panic renew your health club membership or start jogging, and expect the pounds to melt away, you will be disappointed. The number of times I have heard this sentence, “Dr. E., I am in the health club five days a week, spinning, on the elliptical, I walk everywhere, and I can’t shed a pound,” must now be in the thousands.

This recent article from Time Magazine showed that exercise was useful to keep you from gaining weight, but only when someone exercises to a degree of almost bodily punishment did any weight loss occur.

So, skip the “exercise for weight loss” goal.

Instead, exercise to maintain your entire body in its best possible condition. Dozens of studies have shown that regular exercisers live longer, have fewer chronic illnesses like heart disease, diabetes, stroke, Alzheimer’s disease, osteoporosis, depression, anxiety, and even cancer.

Exercise for longevity.

The next question, “how much exercise?”.

A lot of research has gone into answering this question, and I do suggest you click to this recent piece in the New York Times.

The answer is: 150 minutes a week of “moderate to vigorous physical activity”. Moderate exercise means those that increase your breathing and heart rate so that whatever you’re doing feels like a ‘5’ or a ‘6’ on a scale between ‘1’ and ‘10’. High intensity interval training sessions are usually 15 to 20 minutes and would be classified as vigorous. But really, just about anything that gets you off your duff and moving around, especially if you do it with speed (walking to work quickly, taking the stairs quickly) can, as the NYT piece puts it, be called “exercise snacks” and count toward your 150 minute per week goal.

If I can do it, so can you

• Up at 5 a.m. as I need coffee before I can even find the health club, much less exercise in it. I arrive about 5:30am (“do it early and get it over with” is my motto) and start with 45 minutes of high-resistance elliptical, followed by 15 minutes of weight training. Sixty minutes. Not one minute more, ever. OR

• When weather allows (30 degrees F or higher), I replace the health club with a 90-minute, five-mile power walk, moving literally as fast as I can walk. I used to jog, but knees and hips…you know the story OR

• I will plow through twenty minutes of High Intensity Interval Training. There are numerous online videos giving you examples. You need to work F-A-S-T. Quite exhausting, actually.

• I also try to walk or bicycle everywhere, but I don’t regard either as exercise.

Useful hints learned over three decades:

• If you’re a health club person, find a health club geographically nearby. Mine is about 75 yards from my front door. If a piece of architecture is capable of inducing guilt, the Ray Meyer Fitness Center sneers its contempt if I’ve missed an exercise day.

• Starting early in the day makes a real difference. If this isn’t possible for you, go immediately after work. Evening exercise can interfere with sleep.

• Some readers may disagree with me on this one, though I suspect they’re already exercising regularly and enjoy it: accept the fact that exercise is intrinsically boring. Consider the original dictionary definition of “treadmill.” It was a “prison punishment,” and also “a wearisome and monotonous routine”.

• So, make your exercise routine interesting. Instead of listening to health club music (the musical version of a root canal), listen to your own music or an audiobook. Or, if you can manage while on an elliptical, read a book. It took three months of power walking for me to finish the audiobook of Proust’s Remembrance of Things Past, truly wonderful experience. Take one of the terrific Great Courses. Change something basically dumb (walking on a treadmill) into something that will make you very smart. You’ll be able to impress your friends with phrases like: “I’ve finally gotten the hang of postmodern theory by listening to lectures from this Harvard guy. Let me tell you all about Derrida!”.

• Go with a friend. You’ll have someone to keep you honest…and berate you when you don’t show up.

My only anxiety about all this exercise stuff is that someday clinical research will discover (or I’ll learn in the afterlife) that exercise only extends your life the precise number of hours you’ve actually exercised and not one minute more.

“Let me see here…”, says St. Peter (Admissions Coordinator of a popular gated community). “We’ve got you here at 10,400 lifetime hours of exercise. I’m impressed. Just to let you know, you received 433 extra days of life.”

“Are you telling me God keeps track of how many hours I exercise?”

“Yep.”

Oh, for Heaven’s sake, just…

Be well,