How Exercise Can Increase Longevity, From An Orthopedic Surgeon

Your level of fitness matters more than the time spent exercising. More is not always better. We can become fit without having to exercise ourselves to exhaustion every day. Drinking water is healthy too, but drinking gallons a day is not. Drink to thirst. Not more than that. Whether it be exercise, medication, or water, the dose matters.

Achieving aerobic fitness will take some effort. And the method you choose will be the one you enjoy most. Walking, swimming, spinning, yoga, dance, cycling, and running all have their place...within reason. Your heart doesn't care what is causing your heart rate to rise.

It is also of the utmost importance that you respect your body's need to recover. Recovery is a weapon for those who compete, but it's critical to rest and sleep well to achieve proper metabolic health. Your risk of a heart attack is higher, your immune system's function diminishes, and your insulin resistance increases after a poor night's sleep.

Every physiological process in our body is adversely affected by a poor night's sleep. Proper sleep, hopefully eight hours per day, is optimal for most.

It is essential to keep in mind that people's fitness level is important, not the activity they utilize to get there. Fitness grants us a decreased risk of disease, not a specific activity—and not necessarily the total amount of time exercising. As little as 6,000 steps a day can make a difference.

So, fitness appears to influence longevity and living better, but how that aerobic fitness is achieved and maintained matters too! It is possible to achieve a desired level of fitness without crushing yourself every day. Think of it as moving more and moving more often.

Perhaps not surprisingly, the authors of one study found that the fittest among us had the lowest BMI1 (body mass index). But they found that the fittest had higher cholesterol and LDL readings, too. Hmm.

Your cholesterol number in isolation is not the best predictor of cardiac disease or heart attacks. People with normal cholesterol levels are dying of heart attacks, and people with cholesterol levels above 200 mg/dl aren't. Our bodies are very complex organisms.

Your body's level of inflammation, triglycerides, small particle LDL, Lp(a), ApoB, and other parameters help us craft a better assessment of your overall metabolic stability and risk for cardiac disease. Someone with triglycerides that are through the roof but a cholesterol level of 180 probably has a higher chance of developing cardiac issues than someone with normal triglyceride levels. High triglyceride levels are associated with diseases such as metabolic syndrome, which elevates our levels of systemic inflammation. Extreme fitness, not extreme duration, is best.

An exciting part of this study was that people with "extreme" or elite-level fitness were found to have a lower chance of dying than others at a lower level of fitness. That's interesting. Previous studies have shown a U-shaped curve, or reverse J-curve. Those who didn't exercise and those who exercised too much had similar chances of dying from a cardiac issue. Only those who exercised moderately had a lesser chance of disease and death from cardiac disease.

The data on this subject is still unsettled. Three to four hours of movement each week is our target. Each step counts toward that goal, even your five-minute walk from the parking lot. Call it what you like...exercise versus movement; the key is to move, move often and occasionally with ferocious intent.

This potential reverse J-curve issue applies to only a minimal number of people out there pounding the pavement every day or even twice a day. But it's good news because once we catch the exercise bug, we may not need to worry about the amount we exercise.

Now, keep in mind that this study only discussed people's fitness level, not how they achieved that level of fitness. Participants in this study with an elite fitness level might not have been running 100 miles a week. Previous research is pretty clear in this area. People who run ultramarathons or exercise too much seem to run into an issue of diminishing returns and possibly a problem with not being as "healthy" as they think they are.

Many people want to initiate an exercise program, whether it is to lose weight or simply improve their overall health. "How much should I exercise?" has become a common question I hear every week. Unfortunately, until recently, the answer has not been easy to come by. Research2 has shed some light on this topic3. The U.S. Government suggests that we exercise 20 to 30 minutes at a moderate intensity at least five days a week. Moderate intensity means you should elevate your heart rate to 60 to 70% of your maximum heart rate.

Tracking your heart rate during any exercise can be very useful to monitor your intensity. The Fitbit Charge is the most popular tracker for this purpose. Two recent reports have shed further light on this subject of just how much we should exercise—and what the overall benefits are. The authors of a recent review in U.S. News are both active physicians who conclude, based on their studies, that we do not know what might constitute "too much" exercise.

A certain level of exercise may be too much for some but just right for others. The possibility that exercising too much is harmful should NOT be used as an excuse not to exercise at all. Obviously, sitting all day has been proven bad for our health. Sitting for hours on end can negate the benefits of a 30-minute run earlier in the day. Simply getting up and walking around the office for a minute every 30 minutes or holding a walking meeting with a colleague will do the trick.

The two studies I referenced above show: There is a 30% decrease in mortality if you follow the government guidelines and exercise 120 minutes a week at a moderate pace. There is a 19% improvement if you perform a less vigorous physical activity, such as walking around every few hours. There is a 39% decrease in mortality in people who perform 1 hour of moderate-intensity exercise each day. That seems to be the maximum gain we can achieve with exercise alone.

Now, all this assumes you are healthy enough to exercise, but most of us can walk. Review your plans with your doctor and consider a tracker with a heart rate monitor. And start moving.