Exercise


by: CLAUDIA KLAB


K AREN MAYES, 45, is no marathoner, but she’s in excellent shape. Almost every day for the last 10 years, Mayes has walked up and down the hills in her tree-lined neighborhood in Cleveland Heights, Ohio. A few years ago she added a Pilates class to tone her muscles. “My goal is to still be able to do things when I’m 80,” she says. Even over the holidays, Mayes trooped through snow and ice for a payoff she knew she could count on. “I feel better, sleep better, eat better and look better,” she says. “Exercise is a great thing:’


IF ONLY THE REST OF AMERICA FELT THE SAME WAY. Unfortunately, too many of us sit for hours at desk jobs, relying on e-mail, cell phones and, when we finally get home, the TV remote. Technology has fast- forwarded our minds, but slowed our bodies—and dangerously so. One in four adults in this country leads a completely sedentary lifestyle and more than 60 % of the population doesn’t do enough physical activity to gain vast health benefits, chief among them a dramatic drop in the risk of dying prematurely.


WE ALL KNOW WE SHOULD EXERCISE.But we’re too busy and too tired. And we’re also increasingly confused: How much is necessary? Is it 60 minutes (gasp!) most days of the week, as the Institute of Medicine suggested last fall? Or 30 minutes? Three days a week or five? Running or mall walking? Researchers are attacking those questions and they’re delving even further into how physical activity affects our bodies at the molecular level. No matter how far the science goes, though, there’s one finding that will remain in-disputable: any amount of exercise is better than none. “Being active and fit is good for you whether you’re young or old, man or woman, tall or short, skinny or fat,” says Steven Blair, president of the Cooper Institute in Dallas, a health-research group.


THAT’S NOT A REVELATION


Scientists dating back to Hippocrates have known that exercise bolsters health. But it wasn’t until the mid-2Oth century that data about the specific benefits of physical activity began building to what is now a breathtaking list: lower cholesterol and blood pressure; a reduced risk of heart disease, stroke, osteoporosis, diabetes and colon cancer; strengthening of bones, joints and muscle, and an improvement in anxiety and depression. No pill will ever come close to being such an elixir. Or such a cost-saver: the Centers for Disease Control and Prevention estimates that getting inactive Americans exercising could save this country $76.6 billion a year in dollars otherwise spent on treating chronic disease. “Inactivity” says Russell Pate of the University of South Carolina’s school of public health, “is one of the great public-health challenges of this century?


Our sedentary habits led public-health officials to pursue a dramatic shift in exercise recommendations in the mid-1990s. For years, the emphasis had been on getting the heart revved at least three times a week through vigorous aerobic activity like running, as recommended by the American College of Sports Medicine in 1978. But as it became increasingly clear that only a sliver of the population was actually going to leap up and start sprinting, researchers realized there was an urgent need to scale back expectations. In 1996, the surgeon general issued a land-mark report on physical activity and a bold new directive: at least 30 minutes of moderate-intensity exercise--- the kind you can fit into your daily routine, like brisk walking, bicycling and gardening—on all or most days of the week. Rather than get a handful of people super-fit, officials theorized, let’s get the masses up and moving.


Still, vigorous exercise may offer even greater benefits than moderate-intensity activity. In a study published in The Journal of the American Medical Association in October, 2002, Harvard researchers found that men who ran for an hour or more each week reduced their risk of heart disease by 42 % compared with non-runners. Men who walked briskly for more than half an hour per day had an 18 % reduction, and the faster their pace, the greater the drop in risk. “The more you do, the less heart disease you’re going to have,” says study coauthor Dr. Mihaela Tanasescu. There was more good news for runners in a study published in November. 2002, Members of a California runners club over the age of 50 who ran for about four hours a week dramatically reduced their likelihood of disability later in life compared with a control group who ran an average of 20 minutes per week. And the controls had a death rate three times higher than the runners during the study’s 13-year follow-up.


For those who are already active, picking up the pace is a worthy goal. But right now, experts are focused on the positive and growing links between exercising more often at a moderate pace and good health. In a study of 73,743 postmeno-pausal women published in September, 2002, researchers led by Dr. JoAnn Manson, chief of preventative medicine at Harvard’s Brigham and Women’s Hospital, found that women cut their risk of heart disease by 30 to 40l% whether they exercised vigorously in sports like jogging, swimming and aerobics or walked briskly for 30 minutes a clay. “The important question is, does moderate-intensity exercise provide benefit? And the answer to that is an unqualified yes,” says Blair. If every American walked briskly for 30 minutes a day, he says,“ the public-health battle would be Won.”


Exercise chartSO WHERE DOES THE 60-MINUTE RECOMMENDATION FIT IN? When it was issued in September, 2002, the Institute of Medicine report seemed to fly in the face of the surgeon gcneral’s guidelines, but the two may not be quite as incompatible as they seem. The 30 minutes is aimed at reducing the risk of chronic disease in the future. The 60 minutes, on the other hand, is paired with dietary recommendations and focuses on weight control in the present. Researchers found that among healthy people with a body mass index (a ratio of weight to height) of less than 25 (with 18.5 to 25 being desirable), 60 minutes of physical activity was necessary to maintain body weight and avoid excess gain. But the finding should not negate what the CDC recommends, says Dr. Ben Caballero, who was a member of the Institute of Medicine panel and is director of the Center for Human Nutrition at Johns Hopkins school of public health. The two guidelines, he says, “are complementary.”


If you’ve made it to even half an hour a day, congratulations. You’re near the top of a very small heap. You deserve a big glass of water. The rest of us, however, need a kick. Start by setting goals and “make sure those goals are realistic,” says Bess Marcus, director of physical-activity research at Brown University’s Centers for Behavioral and Preventative Medicine. Don’t focus on weight loss; reducing your dietary intake will help a lot more in that department. Think instead about your health, which will improve no matter how much you weigh and whether or not you lose any pounds. If you’re investing in your first pair of athletic shoes, walk for a few minutes a day until you work up to 30 or more. A brisk pace is critical: to get the fill health benefits, you must complete a mile in 15 to 20 minutes max. You should feel your heart beat faster, your breath quicken, your sweat drip. “We want to avoid the Sunday stroll,” says Marcus. Consider using a pedometer, which tracks the number of steps you take per day, and aim for 10,000. Make physical activity part of your regular daily routine (no, you don’t have to go to a gym), and make it a priority. And yes, you can accumulate that half hour throughout the day. Studies have shown that exercising in three 10-minute sessions is comparable to a workout in 30 minutes all at once. ‘Whether it’s walking to work, walking a little extra after you park the car or doing planned exercise, everything counts’ says the CDC’s Dr. Michael Pratt.


Any exercise program should also include resistance training for 20 minutes three times a week, using weights or exercise bands, or doing push-ups or squats. Weight training increases muscles and improves bone density—critical for baby boomers who’d rather bungee-jump than use a walker. “There’s no other way you retain muscle mass and strength,” says William Haskell, an exercise specialist at the Stanford School of Medicine. Better strength also means fewer falls, which are the leading cause of death from injury in people older than 65. And new research suggests resistance training can even be good for the ticker, too: the Harvard runners study found that men who trained with weights for 30 minutes or more per week cut their risk of heart disease by 23 %.


Physical activity is as imperative for kids as it is for adults. Nearly half of all teens and young adults between the ages of 12 and 21 are not vigorously active on a regular basis. That’s not surprising: the vast majority of kids travel to school by car or bus and watch more than three hours of television a day. The University of South Carolina’s Pate says kids’ exercise patterns are heavily influenced by the environ-ments in which they spend large chunks of time. “A kid who goes home and puts a video in the VCR is going to be a lot less active than a kid who spends time at the Boys & Girls Club,” he says. Parents can make a positive impact by supporting their children’s involvement in sports, driving them to games or clubs and playing with them in the park.


Even with all the evidence that has accumulated, researchers are continuing to dig deeper into the connection between exercise and the body, and at an even more microscopic level. A study led by Duke University researchers published in Novem-ber 2002, zeroed in on the precise changes in cholesterol after exercise. Researchers found that overweight, sedentary people who were assigned weekly exercise prog-rams produced more and larger HDL particles (the good kind of cholesterol) and fewer LDL particles (the bad) than those who did no exercise. Other researchers are looking at how cells activated during exercise regulate glucose, a critical link in the onset of diabetes. And scientists like Frank Booth, of the University of Missouri -Columbia, are examining the genetic underpinnings. Booth believes humans were programmed to be physically active: our genes, in other words, expect us to he moving. By becoming sedentary, he says, we’ve messed with the blueprint and are now suffering the consequences of disease. Rather than study the benefits of doing some exercise, Booth is waging war against the detrimental effects of doing none.


As the science gets more finely tuned, doctors may one day be able to prescribe a specific dose of exercise at a specific intensity for a specific condition, says Duke’s Dr. Bill Kraus: a 25-year-old who wants to get fit, for example, versus a 55-year-old with high cholesterol or a 70-year-old diabetic. Behavioral researchers are also looking hard at how to get people better motivated, one of the greatest challenges in the field. And others are studying the design of our suburbs, cities and schools (are there sidewalks or bike paths?), figuring out how to fit exercise more naturally into our daily lives.


In the meantime, it’s up to you. If you’re not bounding off the couch by now, consider two more pieces of data: a recent Stanford study of more than 6,000 men found that tolerance for exercise (tested on a treadmill) was a stronger predictor of risk of death than high blood pressure, smoking, diabetes, high cholesterol and heart disease. And, finally, in the study of 73,743 women, just sitting for longer periods of time predicted an increased risk of cardiovascular disease. Heart disease, by the way, is the nation’s No. 1 killer.


So, stand up. And get moving. NOW!



SOURCE:

NEWSWEEK Magazine, Inc.

January 20, 2003, (pgs.59-64)


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