EXERCISE 360!

A phrase commonly heard in the medical community is "Sitting is the new smoking," alluding to the myriad health problems that arise from a sedentary lifestyle. Jim Rohn said “Take care of your body. It’s the only place you have to live.” I also believe that "Good things come to those who sweat." While medications and surgical interventions certainly have their place in healthcare, exercise stands out as a profoundly effective, low-cost, and low-risk and highly effective prescription for a multitude of ailments—both physical and psychological. It is not a cure-all, but its benefits are so numerous that it would be a mistake not to include exercise in a comprehensive healthcare strategy. I will briefly describe why exercise should not be overlooked as a crucial component in maintaining and enhancing one's overall health.

Exercise, particularly aerobic exercise like walking, running, and swimming, has been shown to improve the efficiency of the cardiovascular system. Regular exercise lowers the resting heart rate and increases stroke volume—the amount of blood pumped by the heart with each beat. This efficiency allows the heart to perform the same amount of work but with less strain. Hypertension or high blood pressure is a significant risk factor for cardiovascular diseases, such as stroke and heart failure. Exercise helps to dilate blood vessels and improve blood flow, which contributes to lower blood pressure.

Exercise has also been demonstrated to increase levels of high-density lipoprotein (HDL) or "good cholesterol," while reducing levels of low-density lipoprotein (LDL) or "bad cholesterol," thereby mitigating the risk of arterial plaque buildup.

One of the lesser-known but extremely critical benefits of exercise is the increased sensitivity to insulin. This helps in better regulation of blood sugar levels, reducing the risk of Type 2 Diabetes. While diet plays by far the dominant role in weight management, exercise facilitates calorie burning and muscle building, which aids in maintaining or losing weight. Exercised muscle tissue is metabolically active and burns more calories even at rest, compared to fat tissue.

Physical activity has been shown to lower levels of stress hormones like cortisol. It also triggers the release of endorphins—often referred to as "feel-good hormones"—which act as natural mood lifters.

Regular exercise, especially aerobic exercise, has been shown to have a protective effect against cognitive decline as we age. Exercise improves blood flow to the brain and encourages the growth of new neurons.

Weight-bearing exercises like walking, jogging, and strength training help improve bone density and reduce the risk of osteoporosis. Exercise such as stretching and yoga improves the flexibility of joints and increases the range of motion, reducing the risk of joint disorders like arthritis. Weight or strength training has significant benefits as we age. One of the most noticeable changes that occurs with aging is the loss of muscle mass, known as sarcopenia. This can lead to loss of mobility and falls. Weight training helps counteract this process by stimulating muscle growth and preserving existing muscle tissue. Maintaining muscle strength is crucial for maintaining mobility and functional independence.

Weight training places stress on the bones, stimulating them to become denser and stronger, reducing the risk of fractures, a common consequence of aging. Weight training helps strengthen the muscles and connective tissues around joints. This added support can alleviate joint pain and reduce the risk of age-related conditions such as osteoarthritis. Aging can lead to a decline in balance and coordination, also increasing the risk of falls. Weight training enhances proprioception, the body's sense of its position in space, which, in turn, improves balance and reduces the likelihood of falls.

Emerging research indicates that regular exercise can reduce the risk of certain types of cancer, including breast and colon cancer. The mechanisms are not entirely understood but may involve hormonal balance, immune system enhancement, and anti-inflammatory effects. Perhaps the most compelling argument for exercise is that it has been associated with increased longevity and healthspan. Exercise reduces the risk of chronic diseases and lowers the mortality rate, offering not just a longer life but also a healthier, more vibrant one.

The benefits of exercise are overwhelmingly positive and extend across various dimensions of physical and psychological health. It is a prescription that comes at a low cost, has minimum side effects, and offers a host of benefits. Exercise should be as integral to your healthy life plan as any medication or dietary regimen. Always consult your healthcare provider before beginning an exercise plan to tailor an exercise regimen that suits your specific health needs and take a step—literally and figuratively—towards lifelong wellness.

Aerobic Exercise (Cardio)

• Walking
• Running
• Swimming
• Cycling
• Dancing

Benefits

• Improves cardiovascular health
• Increases lung capacity
• Aids in weight loss
• Boosts mood and mental well-being

Modifications

• Low-impact options: Aqua aerobics, elliptical training, or brisk walking for those who need joint-friendly options.

Strength Training (Anaerobic)

• Weightlifting
• Resistance band exercises
• Bodyweight exercises like push-ups, squats, and pull-ups
• Pilates

Benefits

• Increases muscle mass and strength
• Improves metabolic rate
• Enhances bone density
• Helps in toning and sculpting the body

Modifications

• Light weights with more repetitions for beginners
• Machines instead of free weights for more control and less risk of injury

Flexibility and Mobility Exercise

• Stretching
• Yoga
• Pilates
• Tai Chi

Benefits

• Increases range of motion
• Reduces muscle tension
• Enhances posture
• Helps in stress relief

Modifications

• Chair yoga or assisted stretches for those with limited mobility
• Shorter ranges of motion to start, progressively increasing over time

Balance and Stability

• Balance exercises on one foot
• Stability ball exercises
• Certain yoga and Pilates poses
• Tai Chi

Benefits

• Improves proprioception (awareness of body position)
• Reduces risk of falls, especially important for older adults
• Enhances functional fitness for daily activities

Modifications

• Using a chair or wall for support while practicing balance exercises
• Beginning with simpler poses and progressing to more advanced ones

 I want to highlight the benefits and step goals for walking. Walking is an exercise that is available to everyone and can be done almost anywhere. You can track the number of steps on your smartphone and set your own personal goal. I strive for at least 10,000/day but I come close to 20,000 often. The notion of a specific number of steps to achieve health benefits has become popularized in recent years. The "10,000 steps a day" guideline is often touted, but this number is somewhat arbitrary and originated as a marketing slogan in Japan in the 1960s. However, research has since provided some insights:

While 10,000 steps a day can be a beneficial target for many, it's not a one-size-fits-all recommendation. For sedentary individuals, even modest increases in daily steps can yield health benefits. A 2019 study published in the journal JAMA Internal Medicine found that women who took as few as 4,400 steps a day had a 41% lower mortality rate compared to women who took 2,700 steps a day. The benefits capped at around 7,500 steps, beyond which no significant decrease in mortality was observed.

The number of steps needed for weight management will vary depending on factors like diet, metabolism, and the intensity of the steps taken (e.g., walking briskly vs. strolling). However, aiming for higher targets, like 10,000 steps or more, in conjunction with a balanced diet can support weight loss efforts. Diet is by far, the most important determinant of weight loss. While there isn't a set number of steps for mental health, walking in any capacity can alleviate symptoms of depression and anxiety, boost mood, and reduce stress. This can be attributed to the physical activity itself, as well as the potential for exposure to nature and sunlight, both of which have known mood-enhancing properties. Taking a “mindful” walk can also help mood by focusing on one’s surroundings and sensations during the walk, rather than one’s problems.

Personal factors such as age, fitness level, and medical conditions will influence how many steps are beneficial for an individual. For some, 5,000 steps might be a significant achievement, while others may aim for 15,000 or more. The key is to set realistic and safe targets, gradually increase activity levels if needed, and consult with healthcare professionals or fitness experts to determine the best plan for one's individual circumstances.

 There are plenty of opportunities to exercise as you go about your day. For example, if you take public transportation to work and have the opportunity to walk to the next bus stop, do so. If you have break time at work, get out of your workplace and walk. If your workspace is on an upper floor, take the stairs. If you can’t make it all the way, walk up as many flights as you are able and take the elevator from there. Grab a basket in the supermarket and carry your food to checkout rather than using a cart. If you live in a city, walk instead of taking a car service or at least walk part way.

Many forms of exercise, like circuit training or boot camp classes, combine elements of strength, cardio, and flexibility. These offer the benefits of various exercise types, making it a time-efficient way to improve overall fitness.

Remember, the best exercise regimen is the one that you enjoy and will stick with in the long run. It's perfectly acceptable to mix and match different types of exercises based on your preferences, needs, and lifestyle. Exercise isn't a one-size-fits-all affair. It offers a buffet of options, each with its own set of benefits and limitations. Consult your healthcare provider before beginning any new exercise program, especially if you have preexisting health conditions. With proper planning, virtually anyone can find an exercise regimen that fits into their life and contributes to a healthier, happier existence.