For the past two decades, fitness experts have been telling
us that to get the benefits of exercise you had to do
aerobics. And you had to work out hard. There was even a
way to calculate whether your exercise was hard enough to do
any good: You were supposed to subtract your age from 220,
exercise intensely enough to get your heart rate up to 70–85
percent of that number and keep it there for twenty minutes.
Lose Weight, Get Healthy, And Live Longer
Now it turns out that the advice we were given was very
far from the whole picture. “Moderate exercise can really produce
enormous gains for health,” says Harvey Simon, MD, associate
professor of medicine at Harvard Medical School. Dr.
Simon should know. He was one of the strongest advocates
for the “more is better” philosophy that’s predominated in the
fitness industry for the last twenty years. “I used to say that golf
was the perfect way to ruin a four mile walk,” Dr. Simon says
ruefully, “because it was only exercise at a moderate level, it
didn’t bring your heart rate up and your walk is constantly interrupted.
Then a study was published in the American Journal
of Medicine that found men who simply added golf playing to
their normal daily routine lost weight, lowered their girth and
improved their cholesterol levels. That got me thinking.”
Dr. Simon began researching the literature and found that
indeed moderate exercise had profound benefits. Then why
had the experts touted heart-pounding heavy exercise for so
long? “The problem had to do with what we call “end-points,”
Dr. Simon said. “When you want to find out if something is working, you have to choose some specific
end point to measure. So if, for example,
you're investigating a new teaching
technique for reading, you want to
measure whether kids actually read
better. That's the 'end-point.' The old
studies on exercise were looking at the
'end point' of aerobic capacity—how
much oxygen your lungs could hold
and how efficiently your body used it,
he explained. To improve that specific
measure of fitness—called VO2 Max,
indeed, harder aerobic exercise is needed.
But when you look at the 'endpoint'
of good health, a very different story
emerges.
"I reviewed 22 studies, involving
320,000 people, that evaluated the
impact of moderate exercise on
cardiovascular disease and longevity,"
Dr. Simon said. "The results were
eye-opening. Moderate exercise was
credited with 18.84 percent reductions
in the risk of heart disease and 18.50
percent reductions in overall mortality. If
you look at breast cancer, colon cancer,
depression, heart attacks, stroke,
sudden cardio death, diabetes, obesity,
hypertension, even dementia, exercise
is extremely beneficial," said Dr. Simon,
"and it doesn't take aerobic exercise as
traditionally defined to achieve those
benefits."
Dr. Simon, in his, The No Sweat
Exercise Plan has come up with a term
called "Cardiometabolic Exercise" to
describe the kind of moderate exercise
he's talking about. "My theory is that
all physical activities anywhere on the
spectrum can benefit the heart and
can benefit metabolism—things like
blood sugar and body fat," he said. In
his book, Dr. Simon assigns points to
various activities so that people can set
a goal for how many points they need
a week to achieve measurable health
benefits. He calls these CME points (for
Cardiometabolic Exercise). Dr. Simon
recommends that you achieve 150 CME
points per day or 1000 CME points per
week to attain significant health benefits,
but you can work up to that over
the course of nine weeks starting with
as little as 25 CME points per day. (See
table on previous page of CME points
for selected activities).
Walking is the core exercise in Dr.
Simon's "No-Sweat Exercise Program"
and it gets a table all it's own in the
book. The number of CME points you
get for walking depends on both your
weight and on your speed, but typically
a 160 pound individual would chalk up
about 125 CME points for every 30 minutes
of walking. "I'm not at all opposed
to harder exercise," Dr. Simon said,
"and if people want to earn their 1000
weekly CME points by doing hard aerobics
or weight training or sports, that's
just fine. The point of this is not that
those exercises aren't valuable, but that
much more moderate exercise confers
great benefits as well."
Those benefits include 21.34 percent
reduction in the risk of stroke,
15.50 percent reduction for dementia,
40 percent for fractures, 30 percent for
breast cancer and 30.40 percent for
colon cancer. "Many of these benefits
were obtained with as little as 55 flights
of steps a week, an hour of gardening,
or two to four hours of light leisure time
activity." said Dr. Simon. "The little
things really do add up."
In one study, after just three weeks
of inactivity, healthy twenty-year-old
men developed many physiological
characteristics of men twice their age.
After just eight weeks of exercise there
was an improvement in virtually every
physiological and metabolic measure,
including cholesterol, heart rate stiffness,
digestion, muscle mass and metabolic
rate. "Exercise is just the best anti-aging medicine we have," Dr. Simon
said.
From Bottom Line's interview with Harvey
B. Simon, MD, associate professor
of medicine at Harvard Medical School
and the founding editor of Harvard Men's
Health Watch. Dr. Simon is the award-winning
author of five previous books on
health and fitness, and received the London
Prize for Excellence in Teaching from
Harvard and MIT. His book is The No
Sweat Exercise Plan (McGraw-Hill, 2006).
