The Power of Exercise: Transforming Health

In this episode of "Your Checkup," we tackle the age-old question: How much exercise do you really need to reap its incredible health benefits? Join us as we explore recommended exercise guidelines and dive into  the profound impact regular physical activity can have on your life. From boosting your mood and energy levels to preventing chronic diseases, the advantages are truly life-changing. With engaging stories, and a sprinkle of humor, we’ll persuade you to lace up those sneakers and embrace the power of movement. Don't miss this episode that promises to get you up and moving toward a healthier, happier you!

Takeaways

• 80% of US adults and adolescents are insufficiently active.
• Moderate intensity exercise includes brisk walking and playing volleyball.
• Vigorous intensity exercise includes jogging and high-intensity fitness classes.
• Exercise improves bone health, cardiovascular fitness, and mental health.
• Adults should aim for 150-300 minutes of moderate exercise weekly.
• Strength training is recommended at least two days a week.
• Children and adolescents need at least one hour of physical activity daily.
• Pregnant women should aim for 150 minutes of moderate activity weekly.
• Access to safe exercise environments is crucial for participation.
• Exercise can be tailored for individuals with chronic conditions or disabilities.

Keywords

exercise, health, physical activity, fitness, guidelines, benefits, intensity, recommendations, special populations, wellness

Transcript

Ed Delesky, MD (00:04)
Welcome to your checkup, where we bring health topics from the doctor's office to your ears. On this podcast, we try to bring medicine closer to with patients. I'm Ed Delesky a family medicine resident in the Philadelphia area.

Nicole Aruffo, RN (00:16)
And I'm Nicole Aruffo. I'm a nurse.

Ed Delesky, MD (00:17)
And we are

so excited that you can be back here with us today on our routine schedule.

Nicole Aruffo, RN (00:23)
Back on the Monday schedule.

Ed Delesky, MD (00:25)
Back on Monday, we had an exciting weekend. We went to go see a concert. My first concert. Well, my first country concert that is.

Nicole Aruffo, RN (00:32)
Turns out Eddie's a big concert guy now.

Ed Delesky, MD (00:36)
I mean, it was incredible. You could just like go there and you hear the songs of the people that you listen to live. And I know that's exactly the definition of a concert, but I gotta say it was magical.

Nicole Aruffo, RN (00:47)
And now we're tired. We

were going to go to the beach today, but we went to bed late and we're geriatric. So.

Ed Delesky, MD (00:55)
So we decided that we would stay local and maybe take some time to record another episode. And so that's exactly what we're doing.

Nicole Aruffo, RN (01:04)
What are we talking about today?

Ed Delesky, MD (01:06)
So today we're going to talk about and explore exercise, details involved in and about exercise, because it's something we've mentioned before.

Nicole Aruffo, RN (01:16)
And everyone knows exercise is good for you. And kind of like the two, I guess the two like pillars of quote unquote, like health or eat right and exercise. But we'll talk more about exercise, why it's good for us. Much, you know.

Ed Delesky, MD (01:31)
Yeah, because like

It's

like such a hand wavy thing to be like, you should exercise more. But it turns out that there's actually this document that you can Google yourself and you can read the headlines. I think you might need to like purchase something to actually read the whole article. But it's called the Physical Activity Guidelines for Americans. And that's what informs these recommendations that come out about how much exercise to do. Turns out it's based on how old you are and they break it down in that way.

So that's all pretty interesting. And I think today we'll also dive into what different levels of exercise are. Like we'll give definitions to moderate intensity and vigorous intensity exercise.

Nicole Aruffo, RN (02:15)
Maybe you'll listen to this while you're exercising. Mary can listen on her hot girl walks. We got called out by my mom when we called her one day. She was in the middle of a hot girl walk and she was mad that we hadn't uploaded a new episode on time last week to listen on her walk.

Ed Delesky, MD (02:18)
And maybe you will. Let's see.

But here we are, we're gonna try to get this one out on time. So when I was reading through this, they said that 80 % of Americans don't meet the right amount of exercise.

Nicole Aruffo, RN (02:47)
That's a high number. Is that 80 % of adult Americans?

Ed Delesky, MD (02:55)
They say 80 % of US adults and adolescents are quote insufficiently active. Which I mean that's like if you look in a room of 10 people, eight out of 10 of them aren't exercising enough. Which is kind of crazy for one reason or another. Is that shocking to you or did you think it would be more or less than?

Nicole Aruffo, RN (03:11)
I think it's shocking. Especially the adolescents, I think is shocking because I think maybe we just like both grew up doing a sport and it seems, I don't know. I feel like adolescents, like that's such a part of growing up and then becomes a huge part of your life or at least it did with both of us. So I guess my perception is like a lot of teenagers are out here doing sports and exercising, but maybe not.

Ed Delesky, MD (03:40)
I guess that might not be the case. So these recommendations are broken down in different ages, like, let's see, three to five years, six to 17 years, adults, older adults, and people with chronic conditions or disability and pregnancy. And they go through each of these categories and they talk about how much exercise one would get. I guess one thing I want to kind of talk about and set the stage for is what different types of exercises are and how they

explore them. They give definitions. So they talk about what a moderate intensity exercise is. And they also talk about what vigorous intensity exercise is. Because they base the time recommendations off of those. There are a few different ways that they go about that. But I guess in commonplace, what do you think of when you think of a moderate intensity exercise?

Nicole Aruffo, RN (04:33)
I feel like moderate, guess we would categorize just like if one is thinking of something like easy, moderate, hard. Right. So moderate is like you're working hard, your heart rates up, but you're not like totally exhausted.

Ed Delesky, MD (04:47)
Yeah, so they give different examples of moderate intensity activities. They talk about walking briskly at like two and a half to four miles per hour. They talk about playing volleyball or raking the yard as being examples of moderate activity. They also describe vigorous activity as something like jogging or running, carrying heavy groceries, or participating in a strenuous fitness class. Some other activities such as swimming or riding a bicycle.

can be moderate or vigorous depending on how intense you're doing them.

Nicole Aruffo, RN (05:21)
How are we? I'm assuming this is all like heart rate based or like perceived exertion even too.

Ed Delesky, MD (05:27)
So when we get into the conversation about how much or how hard you're exercising, there's absolute exertion and there's perceived exertion. And one little nerdy thing that they spent maybe a paragraph on in this article was what a met is, which I've seen on different devices in the gym or what have you. Have you seen a met before or thought about what it is? No.

Nicole Aruffo, RN (05:49)
I don't know.

Maybe I just wasn't paying attention to it.

Ed Delesky, MD (05:53)
So they actually spelled it out. It's a metabolic equivalent of a task. And it's not so relevant for person to person, because absolute exertion isn't as important. But a met is basically a measurement of your activity. So if you're sitting, not doing anything, riding on the couch, that's a one. And then as you go up, things get more intense. So something between like 3 to 5.9, met's.

is a moderate intensity activity. Anything six and above is a vigorous amount of activity. Practically speaking, that doesn't work in so much because everyone's activity level is relative to them. so that's perceived exertion is what people more so look at in terms of their exercise.

Nicole Aruffo, RN (06:39)
So you're a perceived exertion. So essentially how you feel during or after you do a certain exercise. think some people, I think some people and like us included will really pay more attention to your heart rate while you're working out, which we both do. And I mean, there are other like all different kinds of devices that do this. both use an Apple watch to kind of track our heart rate. we both been more mindful recently of.

what our heart rates are doing while we're working out, specifically when they connect to our pelotons and they're like right in front of our faces and we can kind of see where we are or like if we're super tired during a workout or feel like we're like overdoing it and it's like, because your heart rate is like the things read in your heart rates like 182 and you should probably chill. So.

Ed Delesky, MD (07:31)
Yeah, because that's anaerobic level. That's like your body's moving and accomplishing things without oxygen.

Nicole Aruffo, RN (07:37)
Yeah, we took a little bit of a deep dive into the whole zone two training and your heart rate, which we're not really gonna talk so much about now, but it was really interesting if you guys wanna do your own research on that, I guess.

Ed Delesky, MD (07:52)
Yeah, it really did change how I make big changes to how I was like working.

Nicole Aruffo, RN (07:57)
Like we both kind of feel now we don't have to feel, there's our intern. Like we both don't feel like we need to completely out of breath and need to like lay down for the rest of the day after a workout.

Ed Delesky, MD (08:10)
Yeah. And so that's the talk on level of exertion. And so we gave some earlier definitions about what a moderate intensity exercise is and what a vigorous intensity exercise. And before we talk about the actual recommendations, I think maybe it would be helpful if we start at the benefits, just to really grab people and

Nicole Aruffo, RN (08:32)
Why do people tell us that exercise is so good?

Ed Delesky, MD (08:34)
Right. Like, why is that? Turns out they actually do look into this and they break it down by a...

Nicole Aruffo, RN (08:40)
So when we're talking benefits, they break it up into children and adolescents and then adults and older adults. So for children and adolescents, starting as early as age three is improved bone health and even improved weight status, even at such a young age. And then starting more around six, we have improved cardio, respiratory and muscular fitness, improved cardio metabolic health, improved cognition, and then

a reduced risk of depression, which are all really important.

Ed Delesky, MD (09:15)
huge.

Yeah. And if you know, that's early, that's young, three years old. And we'll see how those recommendations play in later. But even then we have evidence that these things get better and are improved. You're healthier. You're more fit. Even in early teens, lower risk of depression with more activity. I mean, that's incredible. That's awesome. So then why don't we talk about the benefits and

Adults and older adults.

Nicole Aruffo, RN (09:48)
So as we get older, we have a lower risk of just all around causes of mortality. that's essentially what that means. Not essentially, literally. That's what that means.

Ed Delesky, MD (09:54)
literally makes you die less.

Which is crazy! Yeah. That's great.

Nicole Aruffo, RN (10:04)
Well, it's the I forget what episode when you talked about the live longer method about exercising. Now I forget what it is. Do you want to remind us what that is?

Ed Delesky, MD (10:12)
That was in hypertension.

Yes, it was in the hypertension episode. And at that time I was talking about 150 minutes of exercise a week. But by doing this episode, I kind of realized that that's a little not as detailed as it could be. Like there's deeper advice to be given there. So for adults and older adults and adults, lower risk of mortality from exercise. What else do we have?

Nicole Aruffo, RN (10:38)
So we have a lower risk of cardiovascular disease, which then turns into a lower risk of cardiovascular disease mortality.

Ed Delesky, MD (10:46)
Okay, so that's like a heart disease and stroke.

Nicole Aruffo, RN (10:51)
We have lower risk of hypertension, type 2 diabetes.

Ed Delesky, MD (10:56)
as if there wasn't an episode on that.

Nicole Aruffo, RN (10:58)
We have a lower risk of bad cholesterol and then actually lower lower risks of bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach cancers. Which is a long list.

Ed Delesky, MD (11:02)
bad cholesterol.

Yeah, I'll say I didn't review the individual articles that they cited. read, I read. No, no, I think we should include it because they wrote in their, their recommendations in the physical activity guidelines for Americans that is heavily cited. But all those reduced risk of cancer. What else we got here?

Nicole Aruffo, RN (11:25)
at lower risk of cancer.

Lots of mental things like improved cognition reduces our risk of dementia. Wow. Reduces anxiety and depression. Okay. Can improve our sleep. Overall improves quality of life, the kind of obvious, slower reduced weight gain and then weight loss, which sometimes is our goal.

Ed Delesky, MD (11:52)
improved sleep

Right, but even here, looking at all this, itself has so many benefits, even if you're not losing weight from it.

Nicole Aruffo, RN (12:10)
Yeah, which I think sometimes actually I would probably say most of the time people are exercising with the goal of losing weight or I feel like probably the goal of always losing weight. But then there are so many other benefits if not just making you feel better or sleep better.

Ed Delesky, MD (12:26)
It's not exercising to lose anything. Think of how many things you gain from exercise. I'm seeing other things like improved bone health, physical function. And then for our older adults, good Lord is this important? A lower risk of falls. Wow. Because can they be devastating if you haven't thought of that for yourself, a loved one or a neighbor? What a fall can do.

Nicole Aruffo, RN (12:52)
Well, and also, I think specifically, this wasn't specifically on our outline, which I don't know if it's later, like weightlifting specifically for women and improving our bone health because we know that's an issue as we age.

Ed Delesky, MD (13:08)
Right? Some more frail bones, risk of osteoporosis, weight-bearing exercise is the recommendation. So here we are, exercise again, saving the day. Okay. And so in that segment, we were able to discuss all of the tremendous benefits of exercise. And it's not just about losing weight, all of these things that you gain. And we're so excited about that. So then let's take some time and explore what the actual recommendations are.

when you're thinking about yourself, a loved one, or a neighbor.

Nicole Aruffo, RN (13:39)
forget about the neighbors. Make sure they're exercising. Exercise with your neighbors.

Ed Delesky, MD (13:44)
Exercise with your neighbor. And we're going to explore that exercise everywhere isn't always the safest thing, that there are certain barriers that we totally get.

Nicole Aruffo, RN (13:52)
especially if you live in Center City. You might get hit by a car while you're running.

Ed Delesky, MD (13:57)
But let's talk about if you're a preschool age child, obviously they're not listening to us. But if you are responsible for one, Nick, can you tell us generally what they say? It doesn't seem very specific here.

Nicole Aruffo, RN (14:10)
So generally we have our preschool ages like three to five. The recommendation, which I feel like is pretty easy, is just active throughout the day, which I feel like kids are because they're like little psychos just like running around. So they've got that covered, I think, without even thinking about it.

Ed Delesky, MD (14:27)
Yeah, and that's pretty much the recommendation.

Nicole Aruffo, RN (14:31)
And then so for children and adolescents, we're going to say six to 17 years old, recommending about one hour or more of moderate to vigorous physical activity a day. Yeah. And a lot again, kind of going back to what we said in the beginning, or at least I thought it seems like or less than I thought. Children and adolescents were this physically active every day because I don't know, I guess I'm just like in my bubble where

We grew up doing sports and doing something every single day, but maybe not.

Ed Delesky, MD (15:05)
It might not be the case.

I feel like there were different groups and marketing plans. I'm just reminded of NFL Play 60. was that? It was this marketing plan from the NFL where they wanted kids to get outside and play for 60 minutes a day. mean, not that there's any evidence in this guideline doesn't talk about this, but I feel like access to the internet, social media, and a lot of activities are inside.

Nicole Aruffo, RN (15:21)
yeah.

Ed Delesky, MD (15:34)
and are mainly, that are more sedentary, which in and of themselves leads to less activity. And so that's the recommendation, 60 minutes of moderate to vigorous physical activity. So there's a little more wiggle room for adults and think back to our definitions of moderate to vigorous because these recommendations are stratified based on those.

Nicole Aruffo, RN (15:57)
So the adult recommendations, this is.

Ed Delesky, MD (16:00)
We're gonna do some math for you guys here, because this is a little...

Nicole Aruffo, RN (16:03)
Yeah, we have this. So the recommendations for adults, which will talk more about officially 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity aerobic activity weekly. So what does that come out to? Because we don't talk in minutes.

Ed Delesky, MD (16:25)
Not at all. So if you were to exercise doing moderate activity seven days a week, that's 21 minutes a day. And then if the mat is like, if you're going to do it during the work week, that's five days, that's 30 minutes a day, which seems doable. If you were to do 300 minutes and aim for that one for yourself and you do that over the course of the seven day week, that's 42 minutes of moderate intensity exercise a day.

Nicole Aruffo, RN (16:33)
Right, so not a lot.

Just doable.

Ed Delesky, MD (16:54)
And that includes brisk walking. if you're, I mean, right here in the city, we are walking everywhere. And I think we relatively hit that pretty easily.

Nicole Aruffo, RN (17:03)
And also add to for the recommendation for adults, there's now more of an importance on muscle strengthening activities. So like our weightlifting for about two or more days a week, at least two days a week.

Ed Delesky, MD (17:16)
And I haven't been recommending that. I usually just have my canned spiel of 150 minutes a week of moderate intensity exercise. And I haven't been including the nuance, but the two days a week of strength training is very important, which also plays in, because I've been doing a lot more cardio recently, and I was leaving out the strength training.

Nicole Aruffo, RN (17:41)
Yeah, he did a 10 minute bicep workout yesterday and he's...

Ed Delesky, MD (17:46)
Now my alarm is practically functional. So then to the vigorous exercise, they recommend 75 to 150 minutes of vigorous activity. So if you were to do 75, so this is like HIIT training, this is jogging, HIIT training stands for high intensity interval training. If you were to do some of that every day, that's 10 minutes a day. So that's

Nicole Aruffo, RN (18:11)
Yeah.

So either like 10 minutes of or, that was just 75. So 150 would be like 20 minutes a day. Yeah. So anywhere from 20 ish minutes of more high intense workout or 30 to 40 ish minutes of a more moderate piece a day is, I mean, pretty doable.

Ed Delesky, MD (18:34)
It feels like it's an investment in yourself, right? We already talked about all of those benefits and including some muscle strength activities. So we're at 20 to 40 minutes a day of exercise, doing it somewhere between like five and seven days a week. But I mean, is that easy to incorporate? Is it not? Why do you think about that?

Nicole Aruffo, RN (18:55)
Well, one, think, well, I think first and foremost, you make time for the things that are important to you. So I think that if you want to start incorporating exercise into your daily routine, you'll make it important. So that in and of itself will make it kind of less daunting if it seems like a lot for you off the bat. If you're just starting to incorporate it, I probably wouldn't go all out and do even five to seven days a week at first, because it's just going to be it.

Like that's a lot at first. Maybe start with like two or three days a week and then add a day every week might be an easier way to do it. That way you're not, you know, after a whole week of exercising every day, you're so tired and you don't want to do it.

Ed Delesky, MD (19:40)
And you don't get discouraged too, because if you yourself up like that, then you most likely won't hit that goal. And then you might look at it as a failure. But as we talked about, even doing it has so many benefits.

Nicole Aruffo, RN (19:54)
And then I think also just making it a part of your day, makes it easier. And that way you just know you're going to do it. If you work all the time, maybe you work out before work, you just get up, you work out, and then that's it. you, which a lot of times we do, we come home, walk Ali, and then we work out. then that's part of our day. It's just not a question. That's just a part of what we're doing. We go to work, we work out.

walk ollie, like the three main things that we do every day without fail. Or I mean, a lot of people are working from home now. So I know a lot of people will kind of take their lunch break to do a workout. So maybe instead of, I don't know, doing whatever you would do during lunch to, you know, take that break from work, but also might not be so productive, you can get a couple minutes of exercise. Because I think it can be daunting.

Ed Delesky, MD (20:48)
That's awesome.

Totally. It's a lifestyle change. It's one of the biggest lifestyles.

Nicole Aruffo, RN (20:56)
And

if you, if you, if that was never your lifestyle, like it's easy for us because now I'm going to talk about us being ex athletes again. But like that was what we did. We went to school, we went to practice and that's what we did. And now it's like, okay, we go to work. We go to the gym.

Ed Delesky, MD (21:13)
Right. So we're going to transition to conversations about the older adults. I'm sorry for all of our listeners. This guideline stated 65 years and older. Oops. And they endorsed the same amount within the limitations of your chronic health conditions of exercise as the younger adult. And so you can just, we refer back to that part of the episode earlier, but they also focus on pieces of exercise, including balance and focusing on that.

And I suspect that the main reason they're doing that is for falls and try to reduce that.

Nicole Aruffo, RN (21:48)
Alright, so we have all ages. I we can touch also on pregnant and postpartum women because exercise is very important during the...

Ed Delesky, MD (21:59)
It

and I think it can be confusing, like can I, can't I. So what amount of time are they recommending for a pregnant and postpartum woman?

Nicole Aruffo, RN (22:10)
So for our pregnant and postpartum ladies, the recommendation, and obviously speak with your own doctor about this, disclaimer because everyone's different, you may or may not have any kind of limitation during your pregnancy, is about at least 150 minutes weekly, which turns out, like we said, about 20 minutes a day of moderately intense aerobic activity per week. There are a lot of benefits of

working out while you're pregnant and then postpartum really all of the same health benefits that we already talked about. I've never had a baby but people say that like being active during their pregnancy has made their labor easier. So you might want to set yourself up for success there and then you know same benefits after you've had the baby. I imagine it also would help significantly with the upstairs if you're dealing with that huge hormonal shift and

just might make you more cognitively clear and feel better. things to think about getting outside and going for a moderately intense walk with your new little fetus might do a lot of good. Right?

Ed Delesky, MD (23:24)
And it's worthwhile and you should do it and as an investment in yourself if we haven't said it before. And so our last section is discussing those individuals with chronic conditions or disabilities and how they might be able to get the exercise that they need. They still maintain the benefit of exercise that they would get like any other person, but you may have to be creative and tailor the exercise regimen, both aerobic and muscular strengthening to be within a range of things that

that individual is able to accomplish. And it's still worthwhile and you should still go out and do it. And we think there are plenty of resources out there to be creative. And I mean, one person came to mind.

Nicole Aruffo, RN (24:05)
yeah, the Peloton instructor Logan who he has one arm, but he like he even in some of his classes I don't know if you've ever taken them like the strength classes specifically there'll be there will be like adaptations or if he's like doing a plank he has a little box that he like leans on and I mean I'm doing the workout with two arms and I still think it's so hard so it's not I don't know I think sometimes things are only a limitation if you make them but you know

Got that one out of a Hallmark card.

Ed Delesky, MD (24:35)
I don't think any of this is said without the realization that access to safe and affordable exercise is also something that we wanted to mention. Not every neighborhood is the safest to be able to go outside and play. And we know that. And it's a barrier that exists. And you try to do the best that you can. And equipment can be expensive. But there are also different ways to be creative, to get your exercise in within your own home as well, if you're motivated to do it.

Because at the end of the day, here's this thing that you can do for whatever amount of time you're recommended for that gives you so many benefits in your life. And why wouldn't you? You mentioned earlier in one of our other episodes a really clever use of insurance, your health insurance, right?

Nicole Aruffo, RN (25:16)
Yeah, why wouldn't you?

Yeah, there are you can Yeah, so a lot of insurance companies will offer some sort of incentive for their member to Exercise like a lot of them will have either a free gym membership I know one of my friends her husband's Work pays for their peloton membership or though I know not us A lot of them will do like a thing where you like

check in X amount of times over the year and then you a gift card or you know, some kind of, if we've been paying for this Peloton membership that your hospital is offering to pay, we're going to have an issue, my friend.

Ed Delesky, MD (25:59)
haven't felt that the people.

And

so that's another episode for us today. And we're really happy that you were able to come back and join us. We talked about exercise today. We gave it definitions of moderate and vigorous. We talked about the key critical importance of exercise and the benefits that it can give you. And then we talked about the different recommendations for different ages and abilities and parts of life that you're in and how much exercise you should do when you're in each of those. And we're so excited that you're able to join us today.

Hopefully you learned something for yourself, a loved one or a neighbor. And make sure you subscribe, rate and review wherever you listen to your podcasts. Follow our Instagram, your checkup podcast. And most importantly, stay healthy, my friends. Until next time, I'm Ed Delesky I'm a woman without. Thank you. Goodbye. Bye.

Nicole Aruffo, RN (26:53)
colors.

Ed Delesky, MD (27:05)
This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person.

This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor and make sure you go get your own checkup with your own personal doctor.

Nicole Aruffo, RN (27:42)
I am not your nurse.