Category Archives: In The News And On The Net

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Exercise. Not too much. Mostly Walking.

James H O'Keefe, MD, cardiologist and Medical Director of the Charles and Barbara Duboc Cardio Health & Wellness Center at Saint Luke’s Mid America Heart Institute.

James H O’Keefe, MD, cardiologist and medical researcher.

Are we exercising for health, fitness, or longevity?  I must have watched this TED Talk by Dr. James O’Keefe Jr. about a dozen times, and it hasn’t gotten old!  His message is extremely and immediately important to every exerciser; and it is counterculture to the direction that exercise has gone in this country – towards excess and extremism.

In my practice I frequently advise folks on their exercise habits and I find that many mistakenly associate the approaches that lead to cardiorespiratory fitness and athletic strength with their goals of feeling better in their bodies and maintaining health and physical independence as they age.  To my mind, the goals of improving both health and fitness are compatible, and health and longevity are as well, but fitness and longevity may not be.  I know this may be tough to chew for fitness enthusiasts and professionals alike, but wouldn’t most anyone agree that ‘too much exercise’ is a bad thing?  I suspect so, and I also suspect that watching the video below will present quite a surprise when O’Keefe presents research on just how much exercise constitutes too much exercise… at least, with regards to living longer.

To my mind this video should be shown to all who are taking up exercise, and serve as informed consent for those who are seeking athletic heights of fitness.  O’Keefe made a very important point that I think should give pause to all exercisers: we’ve only been doing this exercise thing for a few decades – lifelong results are just now coming in.  To sum it up, as he said towards the end: regular exercise is like alcohol consumption – don’t abstain from exercise and don’t frequently binge-exercise (January gym joiners and crossfitters take note).

Hippocrates, who also said "Foolish, the doctor who despises knowledge acquired by the ancients."

Hippocrates, also accredited with saying “Foolish, the doctor who despises knowledge acquired by the ancients.”

Again, this isn’t surprising advice; two and a half millennia ago, Hippocrates said “The right amount of nourishment and exercise, not too little, not too much, is the safest way to health.”  The surprise for me when I first watched the above video was at what point plenty of exercise becomes too much exercise.

And now, just in case everything has been pretty straight-forward and crystal clear up to this point, I would like to point out that exercise is synonymous with physical activity – it’s just that exercise is physical activity undertaken with the intention to improve or sustain health and fitness.  When O’Keefe presented some information from the impressively large Chinese study, he briefly mentioned that the “moderate exercise” was just walking, housework, being off one’s duff.  Including more physical activity in one’s life is what Drs. Mike Evans and James Levine are all about. These folks aren’t talking about tri-athletics; following their advice need not entail a gym membership.  Deciding to pace about while being on the phone or during commercials has helped my dad hit over 5,000 steps a day – doing the exact same things he would have done from a chair.  I’ll climb off my soap box before I get revved up, but I hope that you will have seen that exercise need not be frequent, long, and intense, and that walking shouldn’t be overlooked.  After all, Hippocrates also named walking as man’s best medicine.

By the way, has anyone caught the subtle tribute in the titling of this post :-)

UPDATED 2/2/15

A Little Daily Walking Can Do A Lot

Dr. Mike Evans

Dr. Mike Evans – internet video lecturer sensation

A few years back Dr. Mike Evans created this informative, inspiring, and highly entertaining video lecture on what he believes is the single most effective effort we can make in improving our health.  I have shared this with my family, friends, and for over three years, and now I am excited to share it with y’all!  Here’s the video description from Dr. Evans’ YouTube page:

“A Doctor-Professor answers the old question “What is the single best thing we can do for our health” in a completely new way. Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael’s Hospital.”

What jumped to the forefront of my mind while watching this video is that the potentially most effective health intervention is also immediately available to every one of us – old and young, rich and poor.  Walking is 100% natural and 100% free, and while some of us may live in areas where outdoor walking isn’t safe or convenient we can easily pace about our homes for a purposeful thirty minutes a day.  My dad and mom have been trying this out this winter, and they have been surprised by how many steps they rack up just getting up and walking during commercials and half times.  And anyone could even walk in place in front of the television during commercials and rack up about thirty minutes and over 2,000 steps in just one hour of TV watching, according to this study published in the journal Medicine & Science in Sports & Exercise.

Dr. David Katz

Dr. David Katz

And while I was intrigued by Evans’ statement that “obesity + exercise” ameliorated much of the negative health consequences with obesity (found in the fourth minute of his video) I wish to direct the interested reader to this article titled The Myth of Healthy Obesity from the Annals of Internal Medicine; and here’s a Health Day post on the same article, which is a lighter read and contains commentary from our own local authority, Dr. David Katz.  I want to be clear that the content of these articles doesn’t change my enthusiasm for daily walking for folks of all shapes and sizes; indeed, it turns out that not walking is worse for one’s health and longevity than being obese! and for those who are interested in going further with their daily walking I recommend Move A Little, Lose A Lot by James Levine.  (“Going further” need not be a pun – Levine created the first treadmill desk!)

BTW: I highly recommend visiting Evans’ home page,  Click the link to his “Whiteboard Med School” to see more of his video lectures on a variety of topics.

UPDATED 1/21/15