Is Exercise the Magic Pill?
December 04 2011
This was the title of the presentation I gave a week back. If you know anyone who doesn't exercise, send this to them please. Everyone kind of vaguely knows that exercise is important, but they got no clue about the breadth and depth of the benefits we are talking about.
Heart Disease: Heart disease is the leading cause of death in United States. Almost 300,000 people die of heart disease every year. In short, 1 out of 3 people would die of heart disease.
Exercise Beneifts: Number of observational studies have shown exercise to cut the risk of heart disease and the risk of deaths from heart disease by almsot 50%. Exercise capacity has shown to be a stronger predictor of death than established risk factors such as hypertension, smoking, and diabetes. As shown in the graph, it is now clear that as your physical fitness (exercise capacity) increases, the risk of dying decreases in a dose-response manner in both healthy and people with heart problems(1,2).
Cancer: Cancer is the second leading cause of death in USA. 1 out of 4 people would die of Cancer. 1 out of 8 women will be diagnosed with breast cancer.
Exercise Benefits: There is strong evidence to show that exercise may decrease the risk of colon cancer by almost 50% and breast cancer by about 30% from observational studies. Colon cancer is the most common form cancer in both men & women. And there some evidence to suggest that exercise lowers the risk of endometrial, lung and prostate cancer. Exercise has shown to lowers the risk of cancer recurrence or death in colon, prostate and breast cancer survivors too. It also improves the quality of life and lowers fatigue in cancer patients(3).
Diabetes: Diabetes is the 7th leading cause of death in the states. 1 out of 13 people would die of diabetes. Diabetes is the leading cause of amputations in the country.
Exercise Benefits: Number of observational studies & experimental studies have shown to cut the risk of diabetes by almost 60%. Exercise is also beneficial for treating diabetes. The famous study - Diabetes Prevention Trial - showed that exercise and diet cuts the risk of diabetes by almost 60% compared to the most popular diabetic drug- Metformin, whiich showed a 30% reduction(4).
Osteoporosis: Osteoporosis is the loss of bone density which can lead to bone fractures. 1 out 5 women over the age of 50 will develop osteoporosis. 1 In 5 women over the age of 75 who sustains a hip fracture will die within the next 2 years. Half of the survivors will end up dependent on others.
Exercise Benefits: Exercise, especially weight bearing exercises can be beneficial to prevent and treat osteoporosis bone density. It seems like we need more high quality studies to quantify the effect of exercise on osteoporosis.
Cognition: Cognition is just a big word for mental processes like memory, learning, attention and so forth. Recently, there has been an intense interest in the benefits of exercise on brain cognition.
Children: There is a growing body of studies that show a positive relationship between exercise and cognition and children. Exercise has shown to have a positive relation to cognition in 8 cognitive measurement categories (math test, verbal test, memory, academic readiness, perceptual skills, IQ and achievement) except for memory for all age groups.
Exercise has also shown to improve academic performance. A few studies have shown no change in academic performance with exercise. But none of the studies have shown a decline in academic performance by increasing the time allotted to exercise. The below graph shows a significant improvement in academic scores with exercise in elementary school children after 3 years compared to a control group. This is ironical considering physcial education is the first to be cut from the curriculum owing to financial constraints.
Older Adults: Now there is an overwhelming number of studies to show that exercise is important for maintaining brain functions with age and also in lowering risk for cognitive decline and dementia.The greatest improvement is seen with executive cognition function which involves tasks such as planning, scheduling, inhibition, and working memory. In fact, executive cognitive processes suffer the most with ageing (5,6,7).
Depression: 1in 10 adults are affected by depression. Women are almost 70% more likely than men to suffer depression. Half of the deaths due to suicides is attributed to depression.
Exercise Benefits:There are 2 studies which show that exercise is as effective as anti-depressant drugs in reducing depression in people with mild to severe depression. The study also showed that exercise reduces the chances of the depression returning. After 6 months, only 8% in the exercise group relapsed compared to 30% in the drug group. It is safe to say that evidence is only suggestive and we need better quality studies to show a conclusive evidence of exercise for depression (8,9).
Side Effects: The side effects of exercise are almost zero, if done properly and gradually. It is typical for doctors to carefully evaluate to see if the side effects of the drug exceed the benefits of the drug. Just like exercise, aspirin works well to prevent heart attacks, but the side effect is cerebral bleeding.
I didn't really talk about the effects of exercise on obesity, treating pain, and preventing the loss of muscle mass since most people are aware of it. I also talked a bit about the minimum exercise required for achieving these benefits. Exercise research is still in its infancy; there will be more and more studies looking at the effect of exercise on other health conditions in the coming years.
Is there any pill out there which can prevent and/or treat so many major diseases, improve quality of life, has almost zero side effects, and costs almost nothing?
One hand went up in the crowd. A bit perplexed, I asked, “which drug is that?”
She said, 'exercise' - with a smile.
Reference 1 | Reference 2 | Reference 3 | Reference 4 | Reference 5
Reference 6 | Reference 7 | Reference 8 | Reference 9
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| Mon December 05, 2011
“Is there any pill out there which can prevent and/or treat so many major diseases, improve quality of life, has almost zero side effects, and costs almost nothing?”
Maybe that “pill” called ‘real food’ can also do all those things, but exercise may win even that one.
Anoop | Tue December 06, 2011
Thanks for the comment.
To be honest, the more and more I started reading the literature, the more I was amazed at how much exercise can do for you. If we had the money like those pharmaceutical companies we can have several big studies to show exercise maybe even more powerful than some of the leading drugs. There is also a practicality issue with conducting these exercise studies. It is just hard to get people stick to it compared to taking a pill you know.
There is a good book by one of the Harvard professors called ‘Spark’. The book talks about why exercise is better for the brain than your body! Check it out when you get a chance.
And after the presentation one lady came up and asked the same question. She asked where does diet falls in all this. I really wish more people could attend the presentation or read this article.
I think it is weird that people ( the majority) only start thinking about exercise when they have to lose some weight to look good for a wedding or vacation. They just think that’s what exercise does: Makes you look good and that’s all.
| Tue December 06, 2011
Thanks for the book tip! You did mean ‘The Revolutionary New Science of Exercise and the Brain’ by John J. Ratey, right?
Does he only talk about steady state aerobic exercise or does he also include more intensive forms of exercise?
I often tell people that their health will deteriorate more and more with age if they don’t work at their strength and vascular condition (and eat real food). I get your frustation.
Anoop | Wed December 07, 2011
Yep . That’s the book. He talks about both. Most studies are done with aerobic exercises, but the evidence seems to be leaning towards aerobic type exercises. And that’s what research is trying to figure out which activity is best and such. We know that for diabetes both strength training and cardio work via independent mechanisms.
Most people are unaware of the magnitude of the benefits we are talking about. The classic line is “I don’t need to exercise, I am happy with the way I look”. That just shows they completely missed the boat
If people can’t spend 3 days a week for half an hour to save their life, our species is doomed.
| Wed December 07, 2011
Here’s an extremely related youtube vid
Anoop | Wed December 07, 2011
I just saw that video today in somasimple forum. It’s a really cool video and sends the message across very well. He could have added the cancer risk reduction in there too I thought.
| Wed December 07, 2011
What type of exercise must be done? Cardio,weights,both? How long and much sessions have to be done?
Anoop | Thu December 08, 2011
The minimum is 5 days a week for 30 min of moderate activity (brisk walking). You can also just do 3 days of vigorous activity (jogging and such) for 20 min. The 30 minute can be broken down to 3- 10 minutes phases.
A recent meta-analysis done on exercise and cardiovascular risk and deaths note that men 50 years of age must be capable of continuous walking at a speed of 4 mph and women must continuously walk at 3 mph for prevention of CHD. This was the minimum cardiovascular fitness required. It seems like that more you can do, the better. And it is one of the areas where research is actively focused on.
Full body weight training 2 days/ week. Resistance training is also important, but aerobic training seems to have the most evidence for disease prevention.
| Sat December 10, 2011
Good one Anoop
Anoop | Thu December 15, 2011
Thanks for taking the comment! Hope you and Chandana are working out!
| Mon December 19, 2011
Very nicely done Anoop!
| Tue January 17, 2012
Another home-run Anoop. Your take on exercise is very similar to a post I wrote myself about how exercise is the closest thing we have to the fountain of youth http://www.joe-cannon.com/exercise-the-fountain-of-youth/
I often ask people how much they would pay for a pill that would reduce the risk of the 3 greatest killers of people - heart disease, cancer and stroke. Only exercise will do that - and do many other things simultaneously.
A recent study of people in Taiwan noted that only 15 minutes of walking per day increases mean lifespan by 3 years.
It comes down to a body in motion, stays in motion…
| Sun February 05, 2012
I think this would be an excellent ted talk(www.ted.com). I did you should seriously consider it.
| Wed May 30, 2012
Do you think three strength oriented workouts a week are enough to reach the minimum cardiovascular fitness? (Something like Starting Strength or StrongLifts)
Anoop | Wed May 30, 2012
I don’t think strength training will give you the cardiovascular benefits. Why not just do a 10-20 min interval training after the program 2 times a week.
| Fri June 01, 2012
Yeah, I figured. Thanks!
Are there any studies about exercise and positive body image?
Do you know of any other possible benefits of exercise?
I’m more interested in short-term benefits or ‘quality of life’ improvements.
I believe ‘health’ is too ambiguous and too long-term for most people. Short-term improvements might be easier to sell.
Anoop | Sun June 03, 2012
Look up the book: http://www.amazon.com/Spark-Revolutionary-Science-Exercise-Brain/dp/0316113506
There are lot of studies on short term benefits like improve mood, confidence, reduce stress, anxiety and so forth.