Lee Kirksey, MD  
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Is the Benefit of exercise overblown!!

Jun 20, 2009 - 5 comments

Weight Loss






Heart Disease



I recently came across this article in the NY Times. It raises the question about the benefits of exercise. It reminds me of a comment that I heard from a patient. I asked him if he was exercising to better his health and control his weight. He told me "I believe that God has given me a set number of steps that I will walk on this earth. No more, no less. Why should I waste those predetermined number of steps walking on a treadmill". Of cource the man was being facetious, but there are always questions about the true benefits derived purely from exercise.

The gist of this short article, is that exercise certainly has significant benefits over a sedentary life. How much exercise and how intense is unclear. Also, why its beneficial is multifactorial. People who make a committment to exercise generally commit to living a healthier life by eating well, visiting a doctor and adhering to a safe and prevention driven existence. Furthermore, many of the illnesses that we suffer are related to obesity and as we age falls and bone fractures become a large concern. It is clear that active seniors have less falls and are less likely to become obese.

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Bottom line. Although we cant answer the question completely...moderate exercise is safe and effective. Read On....

Kevin Moloney for The New York Times

Kaoko Obata, a Japanese marathoner, runs at the Boulder Reservoir in Colorado.

In Brief:

While exercise can boost mood, its health benefits have been oversold.

Moderate exercise can reduce the risk of diabetes in people at risk. Exercise may reduce the risk of heart disease and breast and colon cancers.

Though the evidence is mixed, exercise may also provide benefits for people with osteoporosis.

Physical activity alone will not lead to sustained weight loss or reduce blood pressure or cholesterol.

Exercise has long been touted as the panacea for everything that ails you. For better health, simply walk for 20 or 30 minutes a day, boosters say — and you don’t even have to do it all at once. Count a few minutes here and a few there, and just add them up. Or wear a pedometer and keep track of your steps. However you manage it, you will lose weight, get your blood pressure under control and reduce your risk of osteoporosis.

If only it were so simple. While exercise has undeniable benefits, many, if not most, of its powers have been oversold. Sure, it can be fun. It can make you feel energized. And it may lift your mood. But before you turn to a fitness program as the solution to your particular health or weight concern, consider what science has found.

Moderate exercise, such as walking, can reduce the risk of diabetes in obese and sedentary people whose blood sugar is starting to rise. That outcome was shown in a large federal study in which participants were randomly assigned either to an exercise and diet program, to take a diabetes drug or to serve as controls. Despite trying hard, those who dieted and worked out lost very little weight. But they did manage to maintain a regular walking program, and fewer of them went on to develop diabetes.

Exercise also may reduce the risk of heart disease, though the evidence is surprisingly mixed. There seems to be a threshold effect: Most of the heart protection appears to be realized by people who go from being sedentary to being moderately active, usually by walking regularly. More intense exercise has been shown to provide only slightly greater benefits. Yet the data from several large studies have not always been clear, because those who exercise tend to be very different from those who do not.

Active people are much less likely to smoke; they’re thinner and they eat differently than their sedentary peers. They also tend to be more educated, and education is one of the strongest predictors of good health in general and a longer life. As a result, it is impossible to know with confidence whether exercise prevents heart disease or whether people who are less likely to get heart disease are also more likely to be exercising.

Scientists have much the same problem evaluating exercise and cancer. The same sort of studies that were done for heart disease find that people who exercised had lower rates of colon and breast cancer. But whether that result is cause or effect is not well established.

Exercise is often said to stave off osteoporosis. Yet even weight-bearing activities like walking, running or lifting weights has not been shown to have that effect. Still, in rigorous studies in which elderly people were randomly assigned either to exercise or maintain their normal routine, the exercisers were less likely to fall, perhaps because they got stronger or developed better balance. Since falls can lead to fractures in people with osteoporosis, exercise may prevent broken bones — but only indirectly.

And what about weight loss? Lifting weights builds muscles but will not make you burn more calories. The muscle you gain is minuscule compared with the total amount of skeletal muscle in the body. And muscle has a very low metabolic rate when it’s at rest. (You can’t flex your biceps all the time.)

Jack Wilmore, an exercise physiologist at Texas A & M University, calculated that the average amount of muscle that men gained after a serious 12-week weight-lifting program was 2 kilograms, or 4.4 pounds. That added muscle would increase the metabolic rate by only 24 calories a day.

Exercise alone, in the absence of weight loss, has not been shown to reduce blood pressure. Nor does it make much difference in cholesterol levels. Weight loss can lower blood pressure and cholesterol levels, but if you want to lose weight, you have to diet as well as exercise. Exercise alone has not been shown to bring sustained weight loss.Just ask Steven Blair, an exercise researcher at the University of South Carolina. He runs every day and even runs marathons. But, he adds, “I was short, fat and bald when I started running, and I’m still short, fat and bald. Weight control is difficult for me. I fight the losing battle.”

The difficulty, Dr. Blair says, is that it’s much easier to eat 1,000 calories than to burn off 1,000 calories with exercise. As he relates, “An old football coach used to say, ‘I have all my assistants running five miles a day, but they eat 10 miles a day.’”

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by ginger899, Jun 20, 2009
Exercise is natural. It's what we're meant to do.
Sedentary lives seem normal, but they are unnatural.

Exercise (like 1-5 hours a day of walking, interspersed with going up hills, or even a little running) will give anyone a great health and fitness advantage.
I've been walking miles and miles all of my life. I used to have to climb down 1000 feet and back up again (and I MEAN climb!) -just to get my shopping! I'm 56 now. My 'body-age' is 32. (I had this calculated at my doctor's)
I eat mainly healthy food, but also eat chips and chocolate, pastry bread and cake. My cholesterol is normal. I am slim.

Exercise when done regularly and as a lifestyle exercises and strengthens:

675347 tn?1365464245
by ginger899, Jun 20, 2009
(BTW.....however...sometimes it makes your feet ache!.....)

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by HVAC, Jun 21, 2009
Humans are meant to be active. Most animals do better when they get exercise. I have MS, arthritis, and asthma and I walk three miles a day and do yoga for an hour a week.

Avatar universal
by garyjw, Jun 23, 2009
im disabled from severe back pain and can only walk short distances. Before all the back stuff happened -- three surgeries, including a fusion -- I worked out four times a week and was fit and healthy and trim. That was 10 years ago. After all this time hardly doing anything but walking short distances, I am weak, tired all the time, and experience far more chronic back pain that I did when I was excersising. But I'm walking a tightrope. I've gone tons of PT -- and I always hit a wall about three weeks in and I can't get past it and end up stopping. It's not "good" pain from being sore. It's "bad" pain from being injured.  I've not gained weight during all of this, I don't eat a lot, on purpose, because I know I"d bloat up like Elvis. But I'm really worried about what will happen to a 50 year old guy who sometimes doesn't get out of bed for days because it just hurts too much. I go through frequenbts, but short periods where I walk, but even walking hurts. I know: EVERYTHING will hurt because I am so out of shape. But I can also easily injure myself, and perhaps even do something physically that may require more surgeries (god forbid) so I don't know which way to go. I KNOW light exercise is good for me. Perhaps a pool,

But this idea of "getting me back into shape" when I've had three surgeries, and have developed all these spinal disorders from DDD. and I have all these bulging discs and muscles and nerve pain in my back and legs. Serious exercise for me would land me in the hosptial -- I "fear". Seems like all the PTs are trained to get you moving "no matter what".

The last PT -- long on enthusiasm but short experience and tact == joked to me one day

:"Yeah, we have a saying around here: We'll either kill you or cure you....but something's gonna  happen...".

I didn't laugh.
And I didn't go back.
But I know: THE BODY WANTS TO MOVE. And if you keep it from moving, it will not like you.

675347 tn?1365464245
by ginger899, Jun 23, 2009
Hard exercise when you are badly injured isn't a good idea. It will make it worse. I am sorry these things have happened with your back. Swimming exercise might be better. You do need a good physio. Someone who isn't just out of the Army!

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