Are you ready to unlock the secret to a longer, more vibrant life? Look no further, as this episode of Live Long and Well is brimming with actionable insights that promise just that. I'm Dr. Bobby Dubois, your fellow ironman triathlete and physician, and today I'm delving into the remarkable benefits of exercise for longevity and well-being. Embark on this journey with me, and learn about the profound 20% reduction in mortality rates among the active, as well as reduction in likelihood of cognitive decline, and cancer risk through vigorous activities. It's not just about extending your years but enriching them with quality time, be it playing with your grandchildren or conquering your next athletic challenge, or reducing symptoms of depression.
Imagine a future where your exercise routine is a tailored suit, perfectly fitting your aspirations and daily life demands. That's exactly what we're crafting in today's episode, as I guide you through designing a comprehensive workout plan. We're talking about a mix that keeps your heart robust, your muscles mighty, and your balance unshakeable. I'll help you distinguish between moderate and vigorous workout intensities and why both are important, ensuring your path to fitness is as effective as it is enjoyable. Forget about a one-size-fits-all approach; this is about strategizing for the long game and preparing your body for decades of vitality. Even older folks can gain muscle mass with strength training.
Wrapping up, let's not underestimate the value of a methodical and progressive exercise regimen. Starting small and consistently upping the ante paves the way for a sustained, healthy lifestyle that stands the test of time. And remember, this is just the beginning. In our next episode, we'll unravel the critical role of sleep in our health and longevity equation. So, let's step forward together on this path to a longer, more fulfilling life. For more insight beyond what we've shared today, don't hesitate to visit my website--it's your wellspring for living longer and better.
Are you ready to unlock the secret to a longer, more vibrant life? Look no further, as this episode of Live Long and Well is brimming with actionable insights that promise just that. I'm Dr. Bobby Dubois, your fellow ironman triathlete and physician, and today I'm delving into the remarkable benefits of exercise for longevity and well-being. Embark on this journey with me, and learn about the profound 20% reduction in mortality rates among the active, as well as reduction in likelihood of cognitive decline, and cancer risk through vigorous activities. It's not just about extending your years but enriching them with quality time, be it playing with your grandchildren or conquering your next athletic challenge, or reducing symptoms of depression.
Imagine a future where your exercise routine is a tailored suit, perfectly fitting your aspirations and daily life demands. That's exactly what we're crafting in today's episode, as I guide you through designing a comprehensive workout plan. We're talking about a mix that keeps your heart robust, your muscles mighty, and your balance unshakeable. I'll help you distinguish between moderate and vigorous workout intensities and why both are important, ensuring your path to fitness is as effective as it is enjoyable. Forget about a one-size-fits-all approach; this is about strategizing for the long game and preparing your body for decades of vitality. Even older folks can gain muscle mass with strength training.
Wrapping up, let's not underestimate the value of a methodical and progressive exercise regimen. Starting small and consistently upping the ante paves the way for a sustained, healthy lifestyle that stands the test of time. And remember, this is just the beginning. In our next episode, we'll unravel the critical role of sleep in our health and longevity equation. So, let's step forward together on this path to a longer, more fulfilling life. For more insight beyond what we've shared today, don't hesitate to visit my website--it's your wellspring for living longer and better.
Bobby Dubois:
Hi, I'm Dr Bobby Du Bois and welcome to Live Long and Well, a podcast where we will talk about what you can do to live as long as possible and with as much energy and vigor that you wish. Together, we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey and I hope that you feel empowered along the way. I'm a physician, ironman, triathlete and have published several hundred scientific studies. I'm honored to be your guide. Welcome everyone.
Bobby Dubois:
Today's journey begins with an exploration of the first of our six pillars, and that is exercise. As a reminder, the other ones that we'll come to in future episodes are nutrition, sleep, mind-body harmony, exposure to heat and cold and social relationships. During today's discussion, we're going to explore why is exercise so crucial to live long and well, what would a complete exercise program look like and how do we get started, and practical approaches to just begin the process or advance it. My hope is, by the end of the discussion, that you'll be ready to take the first step if you don't have an active exercise program, or take the next, most advanced step if you already have a program in place. Let's get started Well, exercise is the most powerful pillar to live long and well, and let's begin by talking about how exercise helps us live longer. So we're going to do that first and then we'll explore how exercise helps us live well.
Bobby Dubois:
As folks probably know although they may not know the true evidence behind it exercise reduces our overall risk of mortality. There's been many, many, many studies, and there was actually a summary of studies which is called the systematic review or it's called a meta-analysis, anyhow a number of studies that added up to about 600,000 folks and they followed them for a long period of time, and what they observed is, in people who exercise, compared to those that did not, there was a 20% reduction in mortality. That's a really substantial change. What's even more exciting is that with more exercise, that reduction got even better, and there's almost no limit to the benefit if you keep exercising. Additionally, now we're not going to have our entire life focused on exercise, but you can get a lot of benefit with a couple of hours a week, as we'll get to. Well, exercise reduces mortality, but now we got to figure out why.
Bobby Dubois:
What actual diseases are affected by exercise. So exercise reduces the risk of cardiovascular disease and death, which are heart attacks and those kinds of things. Now, as folks may know, cardiovascular disease is the number one cause of death in the United States as well as around the world, and in the US about 600,000 people die each year of cardiovascular disease, and it's been shown that sedentary lifestyle, or a lifestyle where we don't exercise, is one of the most important elements. Now, in all of my podcasts I'll try to provide evidence of what does and does not work from studies in people, not in lab studies or lab animals. Lab studies and lab animal studies are interesting, but they don't really tell us what works in people, and things that work in a test tube or in mice are often not the same as to what happens when you actually test it in people, and so we really need to test it in people. So one study that was done followed college graduates about 16,000 of them and they looked at the likelihood of dying related to exercise, and they found that again about a 20 to 30% reduction. Now how would this happen? How does exercise reduce the likelihood of cardiovascular disease? And I don't think we have the full answer here, but we do know that people who exercise can lower their blood pressure gets their weight more likely to be under control and improvements in cholesterol, and we know these three things are very important in predicting cardiovascular disease and death related to that.
Bobby Dubois:
Folks may have heard of the blue zones and we'll talk about this in a future episode, but these are places around the world where people routinely not everybody, but a significant number of people live to be 100. And in these blues zones the average person walks about 10,000 steps. So avoiding a sedentary lifestyle, getting up and getting around and doing exercise, really helps our heart. But it isn't just the heart that it helps. It also has a similar improvement in the risk of stroke. That's not surprising, because what happens in the heart often happens in blood vessels throughout your body and a stroke is really a blood vessel problem going to the brain. So again, about a 20-25% improvement shown in a number of studies.
Bobby Dubois:
But not just cardiovascular disease. Exercise reduces cancer risk. So there's a series of studies called the UK Biobank, so it was done in England. They have about 20,000 people and they follow them over decades and they measure lots of different things. So they've really been able to answer a lot of fundamental questions and they too found a reduction, but this time, a reduction in cancer risk. What made this study particularly interesting is they didn't just ask people, well, how much exercise do you get each week, didn't just ask people, well, how much exercise do you get each week. They put on monitors heart rate and activity monitors on these people and then they compared people who had lots of activity versus not, and they focused a little bit on what they called vigorous intermittent activity, meaning something that's really going to get your heart rate up, and they found that even three to four minutes a day not three to four minutes at a time, but three to four minutes in a day led to a substantial reduction in cancer occurrence. Okay, another study with about 750,000 people found reductions in breast and colon cancer, and what makes this particularly interesting is that it was what we call dose dependent In a lot of these studies, and my hope in the podcast is not only to convey information that might be useful and hopefully practical, but also to teach you a bit about how do you read studies, how would you interpret a headline in the newspaper and how might you delve into the study a little bit to figure out whether you can believe it or not.
Bobby Dubois:
So observational studies are where you just follow patients over time, and there's a whole host of reasons why that isn't always the most accurate way to do it. We love randomized control trials where one group gets something like a placebo, the other group gets the other thing and then we see what happens, and that's the sort of gold standard in this area. But one of the things we look at if it is an observational study is what's called dose dependence, which means the more of what you're looking at, that you do or get, the better off you are. So it wasn't just the people who had a certain amount of exercise had a lower risk of breast and colon cancer. What they found is, with each increment of additional exercise, the risk of breast and colon cancer went down further. Not only is that interesting in terms of motivating us, but it also makes it more likely that the findings in these types of admittedly not perfect studies might actually be accurate. So that's just one of the things that we will look at Now.
Bobby Dubois:
How could it reduce the risk of cancer we talked about in cardiovascular disease? It might reduce your blood pressure, your cholesterol level and such. I don't think we really know. There have been studies where they measure inflammatory markers in the blood and they find that increased amounts of exercise reduces some of these inflammatory markers, and it's felt that inflammation may be a part of the development of cancer. So the study that showed an increase or a reduction I'm sorry of inflammatory markers was in a small group of patients in a pretty rare disease, but at least it gives us a mechanism that might point us in the right direction.
Bobby Dubois:
Well, the third thing I want to talk about, in terms of living long or longer, is that exercise reduces the risk of Alzheimer's or cognitive decline, and this is critically important, and folks may worry more about cognitive decline than even dying at a somewhat younger age. So this is really critical and it's really reassuring that exercise helps here as well. Is that related to blood vessel changes? Is it related to parts of the brain changes? I don't think we really know. It did appear that the most benefits occurred in people who did quite a bit of exercise, not just the absolute minimum and, for whatever reason, the study showed that it was more likely to help people in the first 15 years that they follow them, rather than after that. It's possible that you can put it off a while, but then, maybe based on genetics, it catches up with us. So we don't know, but it does appear that exercise does reduce the risk of Alzheimer's or cognitive decline, that exercise does reduce the risk of Alzheimer's or cognitive decline. So this is the sort of end of the motivational segment, and I hope that you get a sense of the fact that the data do support a reduction in risk of diseases that cause death. But now let's shift gears, because this podcast is live long and well, so now we have to understand how exercise helps us live well. Most importantly, it allows us to maintain our ability to do the important physical activities that we love.
Bobby Dubois:
Now people have often viewed exercise in what I would like to call a one-size-fits-all way. Oh, exercise. People need to go to the gym, you know, twice a week, and they need to take long walks, brisk walks, for a certain amount of time each week. And if you do that, you're done, and that would be great. Now I don't believe it's that easy or simplistic. I'm a person who believes strongly in what Stephen Covey wrote in his Seven Habits of Highly Effective People, which is a great book for all sorts of reasons, and one of those habits is what he calls start with the end in mind and then basically work backwards. So I believe when we think about our exercise program, we need to do the same thing.
Bobby Dubois:
So look out into the future and say what is it I want to be doing in a decade, two decades, three decades? What do I think will be fun, enjoyable and really a critical part of my life? Now, once you've sort of begun to think about it, then the answer is is it playing golf? Is it riding your bicycle? Is it hiking up hills and rocky trails? Is it playing with your grandchild and lifting them up? Is it travel and the ability to take a rollerboard and put it in the overhead bin? Is it just doing simple things like buying groceries and carrying up a flight of steps or two or three? Buying groceries and carrying up a flight of steps or two or three? So what I like to think about and encourage people to think about, is to build an exercise program that will help you not only for the things you're doing today make you a better tennis player or less likely to injure yourself and pick a ball but also will help you do the things you want to do in the future.
Bobby Dubois:
I mentioned this in the first episode that unfortunately there's an unavoidable reality, and that is as we age perhaps starting as early as age 30, we lose 1% to 2% of our muscle mass each year. So do the math you will lose, you know, 10 to 20% in a decade. And then, as each decade goes on, it happens again and again, and again. So you might've heard of the phrase use it or lose it, and my belief is that we need to overuse it or lose it. Now, what do I mean by that? What I mean by that is it's not enough to say, well, I'm going to want to be able to lift up my rollerboard, which is 20 pounds, into the overhead bin. I can do that today, that's great. Well, the problem is your muscle mass is going to fall over the next years and decades, so probably you need to be able to do that type of thing with a 40-pound rollerboard or 40-pound weight, simulating that today, so that, as the inevitable loss of muscle may occur, you're ahead of the game. And that's something that, as we talk about strength training, in a few minutes we'll come back to. All right, so hopefully people are now motivated, excited that by exercising, good things can happen.
Bobby Dubois:
Now I want to pose the question how do you build a complete and effective exercise program. Now I'm going to talk about a variety of different things, but they will all be summarized in a table and I'll briefly talk you through the table later. But it will also be in the show notes and there's something in one piece of paper. You can sort of get a lot of the information that can help you. So people say, okay, so what should my exercise program look like? Well, my answer to that is well, it depends, and it depends upon, as we just talked about, what do you want to do physically in the years to come. So think about those activities and make them your North Star. So if pickleball is what you think you're going to want to do over time, you might focus a bit differently on your exercise regimen than if hiking is your passion or playing with your grandkids and being able to lift them up and care for them, and so we'll keep that in mind as you think about what balance means.
Bobby Dubois:
Balance in pickleball is a little bit different than balance on walking on an uneven road or a hike. So what are the key elements? And there are four in number and we'll go through each one of these in turn. So there's aerobic efforts that need to go in your program strength training, as I've alluded to. The third is a combination of balance and flexibility. And the fourth is anaerobic or high intensity interval training. Unfortunately, just doing the aerobics won't get us where we want. It might help us a little bit with living long, but it won't help us with living well. So we really need to think not only about aerobics but the other three.
Bobby Dubois:
Now the World Health Organization and similarly the CDC in the US. They recommend 150 minutes, which is two and a half hours, up to 300 minutes, which is five hours, of moderate intensity physical activity, or about half that if it's vigorous. So that could just be brisk walking, taking the dog, and not sort of going slowly, slowly but actually walking at a brisk pace, and that will do it. Or it could be being on a treadmill, or it could be riding a bike, or it could be a Peloton class. All of these meet that criteria.
Bobby Dubois:
Now, one way to figure out if you're exercising hard enough is that you'll be a bit short of breath, not huffing and puffing, but if you're trying to talk to somebody, you'll be able to talk, but only a sentence or two, and then you'll pause, take a breath or two and then talk a bit more. That's a good way of figuring it out. It's probably also if you know your maximum heart rate. It's 60 to 70% of maximum. It's not a perfect number, but if you use the formula 220 minus your age, that will get you pretty close, so that will be a sort of a guideline. Now, as I mentioned before, 150 minutes is good, but doing more is even better, and so try to get to 300. If you have more time and you enjoy long bike rides or other things over the course of a week, do more Because, as we would like to see, more seems to be better, seems to be better.
Bobby Dubois:
Now, what about other things that aerobic fitness might help? Well, it's an interesting study that looked at the effectiveness of exercise in treating depression. Now, this isn't severe suicidal depression, but it's more moderate, maybe chronic depression, and what they found was medication worked, but exercise was just as effective, and that's a really nice way to think about exercise and helping us to live well. All right, so we're done with aerobics. It's two and a half to four or five hours a week, 60 to 70% of your heart rate, and find stuff you enjoy.
Bobby Dubois:
So the next is strength training, and again I mentioned that the strength program is not one size fits all. You're going to want to think about your activities today and your activities moving forward. Now, one really interesting study that came out looked at is it too late to begin? Because people say to me, dr Bobby, what happens? I'm in my 60s? Is it too late? And the answer is no. The study looked at 12 weeks of training and showed 10% improvements in people who were 65 and similar improvements in people who were 85 years old or more. So what? This study and again, this was one study and it's not you know absolutely the answer but suggests that even people above age 65, above age 75, do really well and make great gains.
Bobby Dubois:
Now look, if you have a gym membership, wonderful, but carrying your groceries walking upstairs instead of the elevator or the escalator, just carrying a gallon of milk around or doing squats with a gallon of milk or five pounds of sugar, will do what you need to do as well. So you don't need fancy equipment. You don't have to go buy weights or anything like that. Of course, is it easier and better in some ways with those things? Sure, but there's no reason not to get started with stuff that's likely around your house and doing things that you're doing anyways, like dealing with groceries and walking up to your apartment or whatever it might be. Now, in all honesty, strength training is what I don't get around to doing enough. I do the aerobics, I love that and I do plenty of that, but I kind of find myself avoiding the strength training and going for a jog. So I know myself and I realize that as much as I know I need to do the strength training and I know somewhat how to do it. I need a trainer. I need somebody that's going to keep me focused so that each week I have at least one session of strength training. So keep that in mind. It might be a group class at your gym, it might be a trainer at the gym or just doing it with a friend that sort of you keep each other accountable, all right.
Bobby Dubois:
The third area is blank balance and flexibility. Now this is the segment on living well, and the reason we care about balance and flexibility is it helps us to avoid injury. If you're young and you're exercising and you're playing tennis or pickleball and you're playing tennis or pickleball, injuries happen. The more your balance and flexibility are good, the less likely that a fall could happen or a fall would be problematic. Because what has happened to me many, many, many times and to others is that if you trip on a rock on the sidewalk, if you're jogging, you're likely to tumble over. But if you're able to very quickly get your leg in front of you and get your balance back, you might avoid it. Or if you do fall, it won't be as bad as it otherwise might be.
Bobby Dubois:
So I use a wobble board, which is basically a board that has like a tennis ball on the center and you stand on it and it falls all over and you have to concentrate hard to keep it upright. But you can also do it by standing on one leg like a flamingo while you're brushing your teeth so you have your hand next to the sink in case you lose your balance and just raise your leg one leg, raise it a couple of inches, then try to raise a little more, then try to raise it all the way, and if that's working, the next level of doing it more intensely is to try to do a one-legged squat. So you're on one leg, you've raised up the other one and just squat down a little bit, maybe an inch or two at first and then work your way further. And if you really want to make it challenging, close your eyes and you'll find that it's really interesting and much harder. So do what you can. Get started, give it a go.
Bobby Dubois:
Stretching is also very helpful, especially if you have recurring muscle strains in your back or elsewhere. Helpful especially if you have recurring muscle strains in your back or elsewhere. There's a lot of discussion around you stretch before exercise, after exercise, after 10 minutes when your muscles are warm. I think if you're gentle, it probably doesn't matter when you do it. Obviously, if you're really really stretching hard, you could hurt yourself at times. Really stretching hard, you could hurt yourself at times.
Bobby Dubois:
The last piece of the puzzle is anaerobic fitness, or high intensity intervals. Now, if you go back 10 years, people didn't really know much about this, but now, with Peloton classes and other things, these classes are called HIIT classes. Everybody now is more aware of the fact that there's high intensity, which means basically giving it your all for a few minutes. Now this happens in regular life. If you were to walk up four flights of stairs, especially if you try to do it briskly, looking for your car in a garage, that's a lot like doing a hit interval. Obviously, if you go very, very slowly, it won't be high intensity. But if you kind of keep going at a reasonable pace, after the first flight of stairs it's going to start to get harder and harder and harder to keep up a reasonable pace. So that would be a great thing, cost you nothing, and if you park in a garage with a couple of floors, give it a go.
Bobby Dubois:
This high intensity is also important if you think about having a child in a market or a grandchild, if you're getting older and you have grandchildren. So the child might stay next to you in the market, but as you go out to the car, where it starts to get dangerous, the grandchild might see a squirrel or a bunny rabbit or a dog and take off. And here you are with your cart and the child or grandchild is off and running. You're going to need to and want to run as fast as you can, perhaps 50 feet, perhaps 100 feet, to catch up with the little character, and that's a very dangerous moment with cars in a parking lot. So you want to be able to do that, not only now but as you get older.
Bobby Dubois:
So what are high intensity intervals. What would they look like? To be specific, they don't have to be extensive Try a minute, try two minutes, try four minutes and do a series of them. You don't have to do a lot of them, you know. You could do a minute or two and rest for two or three minutes and then do it again. There was a study that was done of folks who began a high intensity program and they did four minute intervals. They did four of them at a time and they did this over the course of six months, and there were about 60 people in the study, and what's really fascinating is that they showed a reduction in plaque, or the narrowing in arteries. The plaque is what causes narrowing, and these are people that already had coronary disease, heart disease, and what they found is it really did make a difference in terms of what was happening inside the arteries. So keep that in mind, and it's another motivator for that.
Bobby Dubois:
Okay, where do we go now? We want to get started. Well, before we get into the specifics, there was a study I found fascinating where they asked the question does it matter what time of day that I exercise? Does it matter if I do it in the morning versus the afternoon versus the evening, and the good news, based on 26 different studies that were summarized is it doesn't really matter. You know, the benefits we're talking about happen if it's in the morning, the midday or the afternoon or evening, so whenever works for you is a great time to do it.
Bobby Dubois:
Now there's a saying that everybody's probably heard Rome wasn't built in a day, and if you aren't in a regular exercise routine at this point, start slowly. Make it easy to do. You know five minutes a day, 10 minutes a day of walking, or go to the gym. You know a certain number of times a week and stick to it. If you're already exercising, take a look at what you're doing. Are you doing the four components? Are you doing aerobic strength, balance and high intensity? If you're not, can you add one of the missing elements this week or the next? So, yes, you do your brisk walking, but you're really not doing any strength work. Fine, so do some squats at home, grab a milk bottle and do some biceps curls. Do something while you're just walking around or talking to somebody on the phone that you can do at home. This is a great way to add another element of the four. And then, of course, if you have a gym, you have a trainer, whatever, that's even better. Another thing you can do is say, okay, I was doing 30 minutes of aerobics, maybe I can do 40 minutes. Just increase little by little they talk about. Don't increase more than 10% a week because you might injure yourself.
Bobby Dubois:
Now again, I mentioned that I will put together a chart with each of the four activities, how often to do them and the amount of time you might target for them. But for those that don't have the show notes in front of them, it really is for aerobics, 30-minute sessions a few times a week. That's the first. The second is strength training. You know, if you do 30 minutes once a week, that's a great way to go. If you can do it twice a week, wonderful. But once a week is really wonderful.
Bobby Dubois:
The flexibility and the balance. If you can do it daily for a few minutes, that's wonderful. If you can only do it a few times a week, that's a great place to begin. And the high intensity intervals, which I also don't like very much because they feel painful. You know, it's only a few minutes and you only need to do it once a week and then, of course, you can increase over time. So that's it. If you're already doing a program, this is a way to incrementally improve it If you're not get started in very simple ways.
Bobby Dubois:
So we're just about at the end and let me summarize what we've discussed. The first is exercise as a pillar is incredibly powerful and can truly help us live longer and live well. Take your time, as the saying goes. This is a marathon, not a sprint. Don't try to do too much, just start gradually and continue and stick with it. Well, next time we're going to talk about sleep, the often overlooked secret to longevity, and I hope you will join us the next time. Thanks so much for listening to Live Long and Well with Dr Bobby. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at drbobylivelongandwellcom. Drbobbilivelongandwellcom.