Originally published in the Fall 2015 issue of Robb Report Health & Wellness as “Wellness ROI”
Maximize health benefits with the minimum amount of physical activity.
In the landscape of today’s exercise culture, there are two extremes. On one side are the folks who won’t, don’t, or can’t do any physical activity beyond the simple tasks of living. We all know that is a problem, because we have been barraged by headlines that say a lack of exercise is linked to everything from obesity and heart disease to diabetes and memory problems. Simply put, if you don’t move around, you aren’t going to be around.
The other side is one that has really taken over in the last few years: the extreme exercisers. Those are the ones who run mud races and get thrills through activities that many folks would think are way too advanced for the general population. While those people are indeed active, I do fear one thing: that the extreme side sends a message to the slothy side that exercise has to be that way to get the optimal dose for your health. As in, if you cannot make it across butter-greased monkey bars with zombies chasing after you, then heck, just sit back and have another couple of doughnuts.
The least exercise for the most benefits
What really happens with physical activity is you change the way your genes function. Much of your DNA that is not your genetic material consists of switches that govern whether your genes are “on” (producing proteins) or not. This is such a breakthrough because the future of personalized medicine is not just knowing which genes you have but also turning on the ones that you want on and turning off the ones that you want off. Right now we know you can turn on some key healthful genes and turn off some disease-promoting genes with physical activity.
More-than-optimal amounts of exercise will not get you healthier; fitter, maybe, but not healthier. The truth is that for optimal health—for weight control, for longevity, for preventing cancer and arterial diseases, for keeping up your sex drive, for maintaining brain health—you do not need extremes, but you do need four types of physical activity.
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[ 1 ] 10k a day, every day
Ten thousand steps a day provides about half of the total benefit of maximum physical activity for your health, adding 9 years to longevity for women and 8.1 years for men.
What I like best about this prescription is that when you think of exercise, you may assume that an overhaul has to be a monumental change. You do not have to get it all in one chunk or only by walking. You just have to make an effort to move around more. I park the farthest I can from my office. I walk on the treadmill while catching up on TV shows. The point is that if you take 30 minutes a day and devote it to walking or other exercise, and then just rethink how you spend some of your other time, you can manage 10,000 steps every day. Walking is one of nature’s greatest preventive medicines. That 10k a day makes you age slower and develop fewer disabilities, all while giving you more energy. In fact, 10k a day breaks down insulin resistance much better than 8,000 steps, and 12,000 does not help more than 10,000 (yes, you may get more fit, but your health does not improve over the long term). Walking those 10,000 steps is the limit at which insulin resistance seems to decrease substantially.
In addition, walking (and exercise in general) increases the size of your brain’s memory center, your hippocampus, by up to 2 percent a year. But stay on the couch and this key region may shrink 0.5 percent per year, adding to memory lapses. Exercise increases levels of brain-derived neurotrophic factor, a “brain fertilizer” that helps you grow new cells and encourages better memory formation. A 2010 Harvard study looked at more than 13,000 women to see who reached or passed age 70 in “super-healthful” condition: no cancer, diabetes, heart attacks, cognitive impairment, or physical or mental health limitations. What these subjects had in common was physical activity. Those who did the most in their 60s (and that was nearly 10k a day) were about twice as likely to be super-healthful after age 70 as people who did the least activity.
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[ 2 ] Show some resistance
Ignoring resistance training is ignoring your health. Experts acknowledge that one of the secrets to a healthier body is doing some sort of training in which you move some kind of weight (even your own body) against gravity to put your muscles under tension.
By “some,” I mean a short routine twice a week to get maximum health benefits. When you perform resistance training, you break down muscle fibers. In the days that follow, the fibers rebuild the muscle stronger in anticipation of the next time you try to break them down. So over time, you are adding muscle to your body, and that makes you better able to protect your joints. Resistance exercises for the muscles above and below your knee, for example, are the best way to prevent and maybe even ease the symptoms of knee arthritis. Those muscles act as shock absorbers. More muscle means fewer injuries, so you are more likely to stick to your routine and stay healthy.
You need to do resistance training only two days a week, for about 15 to 20 minutes each session. To get the most benefit, aim to do exercises that work your largest muscle groups, such as those in your legs and back, and all the muscles in your core. The core consists of the abdominal muscles, as well as those in your hips and especially your butt. Strengthening your core is about providing a sort of anatomical back brace to improve your posture and balance and prevent injury.
When lifting weights—especially at the beginning—choose a weight that is light enough and use that until you can do 12 repetitions with no problem. If you can do an exercise more than 12 times without feeling fatigued in the muscle area you are working, it is time to graduate to a heavier weight. But go slowly and use perfect form. If you cannot perform that move at least eight times, you need a lighter weight.
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[ 3 ] Buy a jump rope
This is one of the best exercises for preventing frailty, and one you can do quickly and have fun with your kids and impress your grandkids. (Or is it the other way around?) You can’t beat it for your bones. All you need is 40 jumps a day to gain a maximum increase in hip bone strength. But more than that will give you some cardio—or heart rate increase—and step credits toward your 10k a day.
For jumping technique, keep your back straight and your head up and turn the rope from your wrists.
[ 4 ] Sweat three times a week
A major way to improve heart function is to sweat more than a kid in the principal’s office. Why? Cardiovascular activity reduces blood pressure and makes blood vessels more elastic. Aim for a minimum of 60 minutes per week of cardiovascular or sweating activity—ideally in three 20-minute sessions—in which you raise your heart rate to 80 percent or more of its age-adjusted maximum (220 minus your age) for an extended period. Low-impact activities such as swimming, cycling, or using an elliptical trainer get your heart rate up without compromising your joints. Also try interval training—that is, alternating periods of maximum effort with periods of recovery—for the maximum heart benefit. (Check with your doctor beforehand; he or she may want you to try it in the controlled setting of a stress test first.)
Above all, do not give up when you fail to follow your exact plan. It will happen. Being creative, buddying up, and showing intention are the most powerful tools you can use to take your days’ unexpected (and expected) challenges with flexibility and grace.
Michael F. Roizen, MD is the chief wellness officer and chair at the Wellness Institute of the Cleveland Clinic. He is the author of RealAge and coauthor of the You series of books, corecipient of the 2011 Paul G. Rogers Health Communications Award from the National Library of Medicine, and a member of the Robb Report Health & Wellness editorial board.