In the Long Run, Part I: Training for Life
A lone runner strides up the hill. In the distance, the sun slowly begins its morning ascent reflected
against the faint, pinkish clouds of a chilly December morning. The road is quiet other than a few
passing cars. Alone in her thoughts, she ponders what the day will hold and other reflections and
fleeting tunes. Last night ended late, and the morning alarm came much too early. But as she has for
many years, she dragged herself out of bed because she knew that it was good for her even though it
certainly didn’t seem like fun. Gradually, though, as the world around her began to illuminate, she
found herself settling into a comfortable, quiet rhythm mirrored by her faint, misty breaths and the
muffled melody of her footsteps touching the road. By the time she got home, her abrupt wakeup call
had been replaced by a gracious awareness that she had come.
From the beginning of time, we have been a people of movement. Migrating out of the Great Rift Valley
in East Africa where the earliest human remains exist, we have always moved out of necessity and out of
leisure. Whether hunting for prey, searching for food, or dancing in jubilation, we are a people whose
activity has defined much of who we are, and where we will go (and have been). Up until the last couple
of hundred years, physical activity generally occurred because it was a requirement to live and love the
way we were called. But the industrial, and most recently technological revolution, have redefined
when and how and why we move as modern conveniences have removed much of the demand that
once existed. Gone are the days of our ancestors when the average person reportedly walked up to 12
miles a day simply to survive. Now some barely need to walk a few hundred yards to get through their
day.
With the advent of a more sedentary life and a plethora of calorie rich, tasty, and inexpensive foods,
exercise has never been more important for our livelihood. Yet as I will detail more in the next article in
this series, many still find themselves falling woefully short of what they need to both survive and thrive.
In addition to the issue of food and convenience, we are also faced with the lure of quick fixes and
ready-made alternatives to our health woes, whether it is diet pills, cholesterol medications, or gastric
bypass surgeries. For now, despite our bulging waistlines, we are living longer than ever before
although sinister signs suggest a downward shift if trends don’t change. Still, in the midst of this new
norm, serious questions loom about whether we are missing a massive opportunity through exercise to
not only add years to our life, but life to our years.
Most of us know the basic advantages of regular exercise. Weight loss (and maintenance) and improved
endurance, increased metabolism, improved sleep outcomes, decreased mortality risks (from cardiac
issues, diabetes, and other conditions), and even decreased irritability and edginess are just a few of the
benefits that have been repeatedly shown to improve. But beyond the basics, we are now learning and
exploring avenues that will peak the interest of even the most seasoned physician. For starters,
researchers are finding that exercise and overall energy expenditure (EE) appears to be associated with
how our chromosomes evolve as we grow. Telomeres are structures at the end of our chromosomes.
Telomere length is associated with a number of physical and psychological risk factors, such as heart
disease and cancer, and decreased life span. New evidence indicates that exercise and other lifestyle
factors may protect us against various negative factors that can lead to decreased telomere length, and
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thus potential negative outcomes. Consider also that as our chromosomes evolve, it is very likely that
our offspring inherit these changes to a certain degree as children are conceived and born.
Beyond the obvious physical benefits, tons of other physical connections are found with exercise. Even
though asthma sufferers often fear intense movement, regular exercise has been shown to actually
improve lung functioning and decrease asthma symptoms. Through increased blood flow, exercise is
one of the keys to healthy skin. Regular, moderate physical activity is vital for arthritis suffers as it
improves flexibility, reduces fatigue, and lessens joint pain. New findings suggest that exercise may
reduce the risk of macular degeneration in protecting vision by increasing the density of brain-derived
neurotrophic factors in the retina. Treatments for headaches are most likely to be effective if, you
guessed it, exercise is part of the regimen. Physical activity has also been called the "most effective
weapon against fibromyalgia." Recent research has even indicated that 50% of cancers could be
prevented through lifestyle changes, including increased physical activity. Strikingly, researchers
estimate that improved rates of leisure time physical activity could reduce “cancer incidence by as much
as 85% in 5 to 20 years.”
From the physical dimension to the psychological one, we find a similar account. Repeated studies have
found that sustained exercise can be as effective in treating mild to moderate depression as medication
and therapy. Similar findings are emerging for anxiety. Intellectual benefits have also been long known
whether it is improved performance in academic domains, or recovery from a stroke, or protection from
various types of dementia. Many studies have even found that individuals with Alzheimer’s who
exercise regularly end up socializing better, regulate emotions more effectively, and reason and
remember more clearly than those who don’t. Even bad habits, such as smoking, appear to be
addressed better when exercise is part of the equation. And for all who are 50 or older, physical fitness
has been shown to be the best predictor of their psychological and intellectual functioning.
Regardless of your opinion of regular physical activity, it seems rather clear that we are reaching a point
in this country where unless we start moving more, we might implode (financially or otherwise) under
the weight of our excess (e.g., food) and the stagnation of our bodies. Consider a few points. Obesity is
quickly becoming the biggest health crisis our country knows, soon to overtake tobacco use as the
leading preventable cause of death. In the United States, the prevalence of pediatric obesity has more
than tripled during the past 4 decades. One-third of adults today [worldwide] have high blood pressure
when in 1900 only 5 percent had high blood pressure. Beyond even leisure time physical activity, it is
striking just how much we are willing to invest to remove even the slight inconveniences that may also
involve more physical movement. Although I am focusing on intentional exercise, the reality is that
many of our calories are (or can be) burned through normal activities during the day. But as the
internet, mobile devices, and other conveniences redefine how much we have to move, research is
suggesting that less “incidental” calories are probably being used daily than just a couple of decades
before.
In the late 70’s, researchers looked at factors related to longevity (pg. 548) for individuals at 45 years of
age. They found that seven lifestyle factors were strong predictors of increased lifespan from this point
forward: not smoking, controlling body weight, eating breakfast, eating regularly, consuming alcohol
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moderately (or not at all), sleeping 7-8 hours a night, and of course, regular physical activity. For those
who engaged in all 7 practices, they had an average life expectancy of about 11 years more than those
who had adhered to three or fewer of these guidelines. Comparatively, with all of the medical advances
from the early 1900’s, the life expectancy of men who reached age 45 had only increased by a modest
four years. No matter how far medical science may come, it suggested that our life will always be
largely bound by just how much we commit ourselves to healthy activities each day, including regular
exercise. I believe that the message remains just as true today. If so, then the (literally) trillion dollar
question remains: Just what stops us from training for life, and what can we do to change?
James F. Schroeder, Ph.D., HSPP
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