May 16, 2019 Exercise: How Important Is It? Exercise! For some of us, this makes us cringe with the thoughts of being sweaty and tired and feeling even more out of shape. For the other lucky ones, they love the challenge, the endorphin release and the sport. So how important is exercise? A recent article in the Canadian Family Physician tells us that exercise or “cardiorespiratory fitness” is one of the strongest predictors of long-term survival, surpassed only by our age. In other words, keeping our hearts and lungs healthy, via exercise, we will allow us to live longer. In the 1990s and beyond, we worked really hard to lower blood pressures, encouraged our patients to quit smoking and reduced cholesterol levels with the then new “statin” drugs. And these measured really helped reduce our risk of heart attack and stroke, but these efforts have been offset by the fact that we are getting fatter! Obesity drives up our insulin levels, causes diabetes and generally, clogs our arteries with harmful plaques. Cholesterol lowering drugs work, but even when we lower our LDL (bad) cholesterol levels to the max, 2 out of 3 “cardiovascular events” still occur. So, pills don’t fix the problem in and of themselves. John Bosomworth, who wrote the article in the Canadian Family Physician notes that “while statin (cholesterol lowering drugs) benefits are well established, it might be less appreciated that physical activity is equally effective in preventing cardiovascular death” in people who we know have heart and blood vessel disease. And it isn’t just heart disease, physical activity helps prevent diabetes, keeps us from getting fat, and lowers the rates of all cancers except for melanoma (which is from sun exposure). We feel better when we exercise and our quality of life improves. So we, as primary care providers, talk about exercise, but we need to do a better job of spreading the word! Some people don’t lose weight with exercise and that is discouraging but moderate exercise for 30 minutes per day 5 days a week with some resistance training does help your heart and blood vessels to stay healthy. Even if you cannot do that level of exercise, moving from a couch potato to a low level of any kind of activity makes a difference. Maybe don’t think of it as “exercise” but rather just moving more! You may note that I haven’t addressed diet in this blog, but more is coming…… So what can we do to improve things with exercise: If you really don’t move much at all, think about moving a bit more through the day. Even if you park your car a wee bit further away, you will walk a bit more. Instead of sending your kids to the mailbox, walk there yourself. Take the stairs instead of the elevator. Little changes mean a lot Make an appointment and have your height, weight and body mass index calculated. If you want to get moving but you are highly unfit, buy a pedometer or download a walking app and work on adding 1000 to 2000 steps per day to your regular step count for example, if you normally only walk 1000 steps, try to get up to 2000 steps and when that is easy, increase to 3000 steps per day. Aim to get up over 5000 steps per day brisk walking for 15 min per day can reduce your rate of death by 14% over 8 years and 30 % over 15 years If you are motivated but are too busy, try and increase your steps throughout the day by using the stairs, walking to work, walking during breaks and counting your steps. To really reduce your risk, 30 min of moderate activity, 5 days per week (ie., walking quickly but you can still talk), with 75+ minutes of vigorous activity (jogging, swimming laps, hill hiking and cross country skiing) and 2 days of resistance training will dramatically help. Despite this, you may not prevent weight gain if you are still eating too much. To avoid gaining weight, you really need to have 45 to 60 minutes of moderate activity per day. 7000 steps per day + should help. So, just focus on how to move more….you won’t regret it!