Healing Through Exercise: Scientifically Proven Ways to Prevent and Overcome Illness and Lengthen Your Life (22 page)

The general public usually ignores this capacity for rejuvenation. Our society denies that older people have physical reserves. This ageism can be seen any time younger people start talking more loudly and using simpler vocabulary when addressing an older person. This discriminating approach can lead to a self-fulfilling prophecy. As a result of being treated like idiots, older people indeed start to walk slower, have impaired hearing, and become prone to cardiovascular diseases.

The psychologist Becca Levy at Yale University in New Haven, Connecticut, has studied this phenomenon among 90 healthy elderly persons. At first she tested the memories of these volunteers, then showed them positive attributes about aging, such as “wise,” “alert,” “learned,” and “sage,” and retested them. Afterward, their memories had improved and the participants even walked faster.

To check her findings, Levy showed her subjects such negative words as “decrepit,” “senile,” “dementia,” and “confused,” and carried out yet another memory test. Now, their memories were worse, and the participants walked significantly more slowly.
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A NEGLECTED REMEDY

Although exercise is one of the most potent and effective remedies in existence, it plays only a small role in medical-school training. For this reason, American doctors rarely recommend exercise. Even though some doctors do prescribe exercise, physicians can make a much greater profit with drugs and operations. Faith in the power of medicine is another reason why people tend to underestimate the value of exercise. The number of back surgeries has increased dramatically in recent years, while pills for high blood pressure and drugs to lower cholesterol have sales in the billions of dollars. This fuels the medical industry and might meet the expectations of many patients, but it still amounts to nothing more than tinkering with the symptoms.

This turn toward big pharmacology and invasive medical procedures is promoted by faulty financial incentives in the health-care system. One example is a booming procedure called angioplasty, which is the mechanical widening of a narrowed or totally obstructed blood vessel. In about 80 percent of these procedures a small tube, a stent, is inserted to keep the vessel open. However, in 20 to 40 percent of angioplasties, the affected area becomes narrowed again.

These results are less good than those produced by a landmark trial published in the journal
Circulation
.
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In this exercise program the patients had fewer complications, less pain, and their treatment was cheaper. Ignoring these impressive results, many physicians continue to recommend and carry out angioplasties. The procedure, introduced in 1977 by a German radiologist, has grown into an $8 billion annual industry in the United States alone, where it is performed 650,000 to 1 million times a year.
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Even when doctors are willing to use the new science of healing through exercise, they often find that patients would prefer an invasive procedure and drug regimen, rather than the supposedly silly advice of bicycling 30 minutes a day. Obese patients and smokers who cannot be coaxed into changing their behavior repeatedly frustrate such doctors.

Many middle-aged people cannot envision the long-term repercussions of complete physical inactivity—a life of continual ailments and increasing weight gain: “Obesity is not like running through a minefield, which kills you all at once or lets you run through it unscathed,” says David Allison, a biostatistician at the University of Alabama, Birmingham. “Instead, your risk increases over time. What you die of is the accumulated effects from years of obesity.”
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Fiatarone Singh emphasizes the absurdity of medical practices in industrialized countries: “Imagine the 85-year-old woman with cachexia [a wasting condition], congestive heart failure, osteoporosis, depression, recurrent falls, type 2 diabetes, hypertension, peripheral vascular disease, osteoarthritis, insomnia, and functional decline. Whereas a pharmaceutical approach to most of these problems is possible, and would be the usual course of action, the potential for iatrogenesis [further problems caused by the medical treatment], burden for the patient, and cost of such treatment is substantial. If exercise were taken seriously by her doctor, however, and used to its full potential, all of her clinical problems could be addressed in part by the prescription of a tailored exercise regime, which could reduce to a minimum the number and doses of medications needed.”
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The uses of exercise to treat diseases are so novel that many physicians are not taking advantage of them. Yet the paradigm is shifting, and many signs indicate that a new mind-set is gaining ground. In Seattle, the YMCA and Fred Hutchinson Cancer Research Center now offer an exercise program for cancer survivors. The 10-week program, called Exercise and Thrive, is available free to adults who have completed cancer treatment, regardless of where they were treated.
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The American College of Sports Medicine and the American Medical Association have now joined forces to launch a program called “Exercise Is Medicine,” designed to encourage patients to incorporate physical activity and exercise into their daily routines and to urge doctors to prescribe exercise to their patients.
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“Why physicians are so quick to accept research data on expensive medications while essentially ignoring even stronger data on the benefits of physical activity is at the core of this program,” says Robert Sallis, a past president of the American College of Sports Medicine. “We already advise against smoking; recommending exercise should be no different.”
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In Great Britain, general practitioners are turning to exercise therapy to help people with depression. The Mental Health Foundation, based in London and Glasgow, says that 22 percent of doctors now prescribe exercise therapy as one of their most common treatments for depression, compared to only 5 percent three years ago.
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Having a family doctor talk to patients about the importance of exercise appears to be the most effective way to get people going. It just takes some unorthodox but simple steps. What if doctors gathered their sedentary patients on a certain afternoon of the week and took them on a walk? Patients would be astounded how much their glucose level drops after just a few minutes of brisk walking.

In hospitals and nursing homes, the time is also ripe for change. Being bedridden should no longer be regarded as an inevitable fate but as a side effect of bed rest. Mobilizing patients at risk of being bedridden could be achieved with more and better-educated nursing personnel and improved facilities, including better-designed furniture and rooms. In hospitals especially, there should be more time and money available for training to reverse the disastrous consequences of too much bed rest.

LESS IS MORE

When people decide to change their lives, they often set themselves unrealistic goals they cannot achieve. They want to become athletic and slim in no time. They go out and buy sneakers and sporting clothes, sign up at the gym, and start with great enthusiasm. This period of euphoria usually lasts four weeks. Then exercise turns into a burden. Month after month, gym fees are charged to credit cards whose owners hardly work out anymore.

Energy Expenditure per Hour

There is no need to have such ambitious targets. Fortunately, science shows that surprisingly small amounts of exercise suffice to put health and well-being on the right track. Formerly, exercise recommendations were based on the assumption that sweat-inducing drudgery was needed to achieve therapeutic effects. But a recent review of 44 studies revealed that most of the good effects start appearing at an intensity corresponding to the burning of 1000 kilocalories per week. Among sedentary adults, even the expenditure of just 500 to 800 kilocalories produces slight improvements.
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One general recommendation is to perform 30 minutes of moderate activity, five or more days per week;
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the exercise can be brisk walking, jogging, or bicycle riding. This amount is apparently enough to meet the evolutionary needs hardwired into our bodies, which are still adapted to the Stone Age. If a person walks for 30 minutes, he or she burns 200 to 250 kilocalories. Doing this five times a week, plus some work in the garden and home, and a person uses nearly 2000 kilocalories per week.

This surprisingly low minimal requirement has two advantages. First, the risk of injury is extremely low, and one need not fear sore muscles. The benefit of this low-intensity exercise is much greater than the potential harm. One can start slowly and increase intensity step by step. People who were completely inactive for years, or who are already sick or ailing in some way, can reclaim their bodies through exercise, though they should talk to a physician before starting to set up an individual training program.

Second, one can get small bits of exercise that in turn add up to the recommended daily total. Each errand we run and each chore we do helps. Weeding, vacuuming, sweeping the sidewalk, climbing stairs, walking to the grocery store: if we integrate such activities into our daily lives, we can reach calorie expenditures large enough to improve existing medical conditions and stave off further diseases.

It is fascinating to see that these good effects often multiply and improve other aspects of life. After adopting an active lifestyle, many people abandon other bad habits; they switch to a balanced diet, reduce the number of cigarettes they smoke, or quit smoking altogether. Furthermore, they sleep better and—because they lead by example—increase the activity of their children.

FIT IS MORE IMPORTANT THAN FAT

Finally, we benefit from exercise even when we are not losing weight. Overweight men are especially protected against heart attacks by physical activity. Similarly, women who are overweight but active have a slightly lower risk for heart disease than slim but inactive women. Being overweight does not harm one’s health—as long as a heavy body is kept in motion.

This is also the message of a recent study by doctors and physiologists at the University of South Carolina in Columbia.
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They measured the body mass index, waist circumference, and body fat of more than 2,600 adults aged 60 years or older, assessed their fitness by a treadmill exercise test, and followed the group for 12 years. “Fitness was a significant mortality predictor in older adults, independent of overall or abdominal adiposity,” the scientists reported in the
Journal of the American Medical Association
. Active heavyweights live longer than inactive slim people—fit is more important than fat. And nobody needs to become an athlete. According to the study, walking for 30 minutes on most days of the week already increases the chances to “achieve a healthy lifestyle and to enjoy longer life in better health.”

To be sure, these effects can be enhanced. Exercise and health are directly correlated; the more we use our muscles, the bigger the gain. Imagine 60 minutes of moderate exercise, five or more days per week—what a treat for body and soul that would that be! This program would also be the right one to fully prevent colon and breast cancer, ideally combined with light strength training two or more days per week.

Still, one should not overtrain the body because there can be too much of a good thing. Regular exercise corresponding to an expenditure of 3,500 kilocalories per week or more can lead to adverse effects.
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Those trying to lose weight by starving themselves for long periods are bound to fail. Our Stone Age genes are programmed in such a way that we long for the juiciest ham and the sweetest fruit. Dieting fads have come and gone for the past 50 years, but a miracle regimen has yet to be found. If a person manages to be on a diet for 15 weeks, he or she can lose up to 24 pounds. Yet the effect usually vanishes within three to five years. It would be much smarter to exercise more while keeping food intake the same or reducing it slightly. If we burn 700 kilocalories more than we consume every day, our weight inevitably goes down, by about one pound per week. I would recommend documenting this by recording one’s weight every morning.

A WAY OF LIFE

Physical exercise can help us, whatever we do and wherever we go, as long as we allow it to become our permanent companion. The magic formula is to do a little every day and to establish well-being in small but constant steps. At stake is the maintenance of our bodies. If we asked our dentist which teeth we should floss, he would answer: only those you want to keep. The same is true for physical activity: move those muscles you want to keep.