Opinion | How to maximize health benefits from exercise
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For this week’s column, I wrote about three lifestyle changes that can make a big impact on health. One of them — incorporating small amounts of exercise into daily life — prompted many questions from Checkup readers. How can they measure how much exercise they are doing? And what type of exercise is best?
It makes sense that many people are interested in this. In the article, I cited a large meta-analysis of nearly 200 previous studies that found even 11 minutes a day of moderate-intensity exercise can significantly reduce the risk of cardiovascular disease, cancer and premature death.
People want to know more specifics. Janelle in New York, for example, is a 78-year-old woman who relies on her watch to track how many steps she takes. “Is it necessary to reach 10,000 steps every single day?” she asks. “I used to get to 15,000 from walking around the city, but after my hip replacement, I struggle to get half as much.”
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A study in JAMA Internal Medicine found that women in their 70s can reduce their risk of premature death if they take as few as 4,400 steps a day. Compared with women completing 2,700 or fewer daily steps, their risk of premature death was 40 percent lower. The risk of premature death continues to drop for women if they walk up to 7,500 daily steps, and then the benefits plateau.
Another large cohort study of nearly 80,000 men and women in Britain, published in JAMA Neurology, found that people who took about 10,000 steps a day had lower rates of dementia. Once again, there was a dose-response relationship — meaning that the more steps were taken, the more the risk of dementia fell, with the peak effect at about 9,800 steps.
My advice to Janelle is to walk what she can. Ten thousand steps is great if she can achieve it, but don’t obsess about the exact number, especially if she is able to add other forms of aerobic exercise into her routine.
“My wife and I love to take walks around our neighborhood,” Robert from Delaware writes. “We have a 14-year-old Labrador who needs to rest every block or so. Does it matter what speed our walks are?”
As it turns out, it does. Another study in Britain looked specifically at what walking speed is ideal. They found that people who walked a brisk 80 to 100 steps per minute each day had better health outcomes than those who walked a similar amount but at a slower pace.
Brisk walkers had a 35 percent lower risk of dying, a 25 percent lower chance of developing cardiovascular disease or cancer and a 30 percent lower risk of progressing to dementia. This was not in comparison with inactive people, but with individuals who took the same number of steps but at a lower intensity.
I’d recommend that Robert and his wife take some walks without their dog. Perhaps they could designate two paces, one that’s relaxed to spend time with their dog and another at a higher cadence for exercise.
“You wrote that people should do strength training in addition to aerobic exercise,” Emily from Washington, D.C., writes, adding that she finds going to the gym intimidating because of all the bodybuilders. “Is it really necessary, or is it enough that I run on a treadmill twice a week?”
Plenty of studies demonstrate the additive effect of strength training. One 2017 study of more than 35,000 healthy women, conducted by researchers at the National Institutes of Health and Brigham and Women’s Hospital, found that those who engaged in any form of strength training had a 30 percent reduced rate of Type 2 diabetes and a 17 percent reduction in cardiovascular disease compared with women who reported no strength training but participated in comparable aerobic activity.
Another study of nearly 13,000 adults, both men and women, found that less than an hour a week of resistance training was associated with a 40 to 70 percent reduction in heart disease and stroke. Strength and mobility training is particularly important for us as we age because it reduces the speed of bone loss and decreases injuries, including from falls.
I think it’s important to clarify that strength and resistance training don’t have to involve pumping iron. People who have access to a gym can use common equipment for low-impact workouts. The Post’s Well+Being has a great primer on six exercises for beginners. For those who don’t have a gym membership, there are strength exercises that can be done at home using just your body weight, such as squats, lunges and plank holds.
“I’m surprised you didn’t mention the best exercise of all — swimming!” Ralph from California writes. “It’s a total-body exercise, and I’m still going strong with my Masters swim team at 96-years-young.”
Bravo, Ralph! As a relatively new Masters swimmer, I agree with you about its benefits. And I appreciate your sentiment, that people should choose the type of exercise they like. Ideally, it should be aerobic exercise with some higher-intensity intervals combined with occasional strength training. The benefits of exercise are additive, and it’s never too late to start.
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