A prescription for life: exercise is a vital component in aging healthily

Edward T. Creagan

"Next to a leisurely walk, I enjoy a spin on my tandem bicycle. It is splendid to feel the wind blowing in by face and the springy motion of my iron steed. The rapid rush through the air give me a delicious sense of strength and buoyancy, and the exercise makes my pulse dance and my heart sing."

Helen Keller, The Story of My Life

I can't write a prescription for any medicine more powerful than exercise. Here's why.

When I speak to audiences around the country, I take a gallon of milk with me on stage. Why a gallon of milk? To make a point, because 70 percent of women and 25 percent of men in the audience will not be able to lift that full gallon of milk--weighing about 10 pounds--by the time they reach age 70. After age 30, as far as our muscles are concerned, we are truly over the hill. At that point, we start to lose 1 percent of muscle mass per year. Therefore, by age 65 we will have lost 35 percent of our muscle mass unless we have weight trained. This doesn't mean the hard-body, rippling-muscle, sweat-in-a-gym type of weight training. If you have soup cans at home, you have the makings of a weight-training program.

Likewise, 1 percent of flexibility is lost each year after age 30. Balance also worsens with age. The football running back assumes a crouched position for a very good reason--he is more stable and better able to withstand getting knocked on his head. So, too, older folks assume a crouch as they age--much of this is nature's way of creating stability. Individuals without the flexibility to bend forward have a higher risk for falls, which result in hip fractures and other serious problems. Take note--the most significant muscles you need to stay out of a nursing home are the thigh muscles. As these weaken, older people become unstable, Fall, buy a one-way ticket to a nursing home and their golden years quickly tarnish.

As a society, we have obviously become couch potatoes. Most of us don't get off the sofa to change the TV channel--we use the remote. An equal number of us don't even get out of our cars to open the garage door--we use the remote--and rarely walk instead of drive. Surprisingly, no one uses a remote to open the refrigerator door, but I suspect that's next.

We have become a sedentary society in which at least 40 percent of people are obese. Sixty percent of Americans do not engage in regular physical activity. Long-term studies of Harvard graduates and aging Baltimore residents unequivocally demonstrate that a sedentary lifestyle is as much a risk factor for early death as smoking, high cholesterol, high blood pressure and cancer. This is especially tragic among children and adolescents.

Cancer Risk

Inactive people seem to have a higher risk for certain cancers, such as colon and prostate. In terms of colon cancer, waste passes through the colon faster in physically fit individuals. Consequently, less contact occurs between waste materials and the colon lining, which may have something to do with the decreased cancer risk. High amounts of fiber in your diet may help create larger bowel movements and long-term population studies show societies in which large bowel movements are common because of high-fiber diets have a reduced colon cancer risk. Some African groups have diets with huge amounts of fiber and rarely get colon cancer. Logically, then, a high-fiber diet combined with physical activity moves stool quickly through the colon. This topic will make great table conversation at your next dinner party.

Why a fit man has less risk for prostate cancer is not clear, but an ideal body weight may have something to do with male hormone metabolism. Regular exercise appears to reset certain body systems, such as hormone production and fat storage, that are disrupted if you are overweight.

There is no doubt in my mind that the physically fit fare far better with cancer--as prevention and a buffer against the ravages of cancer treatment while enhancing the prospect for long-term survival--than unfit individuals.

Run Small Races

Growing up a skinny kid in New Jersey, I had no dates, social skills nor athletic talents and therefore was encouraged to become a distance runner. Fortunately, I was orthopedically gifted, have run multiple marathons and been able to run almost every day for over 50 years.

In training for a marathon, it is not a question of wishful thinking. I map out a plan and work out day by day, week by week, month by month, so when the gun goes off on the starting line and I'm looking down the barrel of 26.2 miles, I'm physically--and mentally--prepared to go the distance. I visualize my goal and take those small successes one step at a time.

The lesson is we all must run small races. Visualize your goal. In doing so, see yourself winning and moving on. Then, you can make your "pulse dance and heart sing."

This article is adapted from Creagan's book with Sandra Wendel, How Not to Be My Patient: A Physician's for Staying Healthy and Surviving Any Diagnosis (Health Communications, Inc., 2003). For more information, visit www.hownottobemypatient.com.

References

Manson, J.E., et al. "Walking compared with vigorous exercise for the prevention of cardiovascular events in women." N. Engl. J. Med., 347, no. 10 (September 5, 2002): 716-25.

Nelson, M.E., et al. "Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial." JAMA, 272, no. 24 (December 28, 1994): 1909-14.

Perini, R., et al. "Aerobic training and cardiovascular responses at rest and during exercise in older men and women." Medicine & Science in Sports & Exercise, 34, no. 4 (April 2002): 700-8.

Wei, M., et al. "Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men." JAMA, 282, no. 16 (October 27, 1999): 1547-53.

Edward T. Creagan, M.D., is a cancer specialist and professor at the Mayo Clinic Medical School.

COPYRIGHT 2004 Aerobics and Fitness Association of America
COPYRIGHT 2004 Gale Group