Healing Through Exercise: Scientifically Proven Ways to Prevent and Overcome Illness and Lengthen Your Life (23 page)

There are easy ways to make family life more mobile. To start with, children should not have their own television sets in their rooms, and the one in the living room should be switched off most of the time. In our house in Arlington, Massachusetts, there are three children and no television. Having been brought up in Europe, I am puzzled to see that many American households have one television set in most of the rooms and, even more disturbing, that the television is sometimes used to babysit toddlers. Americans spend nine times as many leisure hours in front of a screen than being physically active. As we saw earlier, the more time people spend in front of a screen, the more likely they are to develop type 2 diabetes.
¹⁷

The pediatrician Thomas Robinson at Stanford University examined 192 children at two elementary schools. The students at one of the schools were restricted at home to a maximum of one hour per day watching television. The students of the other had no limit—and seven months later they were more than two pounds heavier and their waistlines had increased by an average of one inch.
¹⁸

Another way to get started is to begin with small changes, like 60 seconds of exercise per day. This might seem ridiculous, but the trick is to train two minutes per day in the second week, three minutes per day in the third week, and so on. Half a year later, you will be a presentable athlete and need only to maintain your level. There are also many ways to integrate muscle use with daily life: walk your children to school; avoid escalators and elevators; switch to public transportation and get off the train or bus a few stops earlier, walking the remaining distance. People living in Manhattan are slimmer than the average American, no doubt in part because they walk more. Also, get rid of your second (and third) car and see if you can commute to work by bike. Or join community groups that engage in walking and other physical activities.

When it comes to judging the amount of exercise we get, it’s human nature that we tend to deceive ourselves. We perceive even decades of inactivity as an atypical period that will soon be over: “Once I get a promotion . . . once the baby is older . . . once we move nearer to the city.” We persistently think of ourselves as more athletic than we actually are. Perhaps we should follow the example of the Amish who agreed to walk around with pedometers. The devices cost around $15 to $20, sense body motion, and count footsteps. This count is converted into distance by knowing the length of your normal stride. Wearing a pedometer and recording your daily steps and distance can be a good motivating tool. If you have taken about 10,000 steps by evening, you can put your feet up and be happy—you have done your daily stint.

THE GLOBAL CHALLENGE

Physical inactivity is estimated to cause 2 million deaths worldwide annually, according to the World Health Organization. At least 60 percent of the global population fails to achieve its minimum recommendation of 30 minutes of moderate-intensity physical activity daily, and 17 percent are completely inactive.
¹⁹
Meanwhile, health-care costs in the United States and many other industrialized countries are escalating. Nations with universal health care have to pay more for coverage. In those without such coverage, as in the United States, millions of Americans cannot afford insurance, and there is no end of this cost explosion in sight. Dealing with the consequences of physical inactivity is a major part of health costs. In the United States, about $400 billion is spent each year to treat heart disease alone. At the same time, epidemiological studies show that at least one-third of all heart attacks would be avoided if people walked briskly 2.5 hours per week.

As for metabolic disorders, the consequences of not moving are even worse: 91 percent of all cases of type 2 diabetes can be traced back to lifestyle issues. People smoke, they overeat—and they let their muscles waste away. If we could magically remove the problem of physical inactivity from the world, the financial crisis we see in our health-care systems would be far easier to resolve.

So, should people asking for health insurance continue to have the right to be sedentary? In the wake of the emerging science of motion, doctors have started posing such questions: “From childhood, when unhealthy food habits begin and sedentary lifestyles are copied from parents, people must be educated about the risks of inactivity and overeating. The degree to which unhealthy behavior is regarded as a private issue should be publicly discussed,” state the cardiologists Rainer Hambrecht and Stefan Gielen in an essay in the medical journal
The Lancet
. “A balance needs to be struck between a reasonable minimum effort on the part of the individual to reduce the health-care costs associated with their lifestyle, and intrusion of an investigative health-care system into personal lifestyle.”
²⁰

In this vein, one option would be to make physically inactive people pay for their own medication if they are unwilling to change their lifestyles. One example would be high blood pressure, which is a direct consequence of inactivity and can be reversed through exercise. If a patient opts not to use this proven and cheap remedy and prefers to take drugs, why, then, should he not pay for them out of his own pocket?

The precondition for such an approach would be that patients be given professional consultations about the benefits of exercise. Because physical activity has turned out to be one of the most broadly effective therapies known, one without the adverse side effects of some drugs, it is absurd that there are still no real incentives to make doctors prescribe this miracle remedy.

Of course, it would be naive to assume that people will start exercising solely because they want to help our troubled health-care system. Regulations asserting that exercise is something like a duty of each citizen are unrealistic and undesirable in a free society. But becoming informed about the emerging role of exercise as preventive and curative medicine should be our duty to each other. Each of us can walk along this path. It’s never too late, and every step will be rewarded.

CHAPTER 1: THE HEALING POWER OF EXERCISE

1
Personal communication; I visited Wayne Sandler in his practice in Los Angeles in the summer of 2005.

2
Personal communication and talk by Carolyn Kaelin in Wellesley, Massachusetts, fall 2005; see also Carolyn Kaelin with Francesca Coltrera,
Living Through Breast Cancer
(New York: McGraw-Hill, 2005).

3
Wildor Hollmann and others, “Körperliche Aktivität und Gesundheit,”
Blickpunkt Der Mann
3 (2006): 11-15.

4
Christoph Schmidt-Hieber, Peter Jonas, and Josef Bischofberger, “Enhanced Synaptic Plasticity in Newly Generated Granule Cells of the Adult Hippocampus,”
Nature
429 (2004): 184-187.

5
Personal communication. See also the review paper by Henriette van Praag, “Neurogenesis and Exercise: Past and Future Directions,”
Neuromolecular Medicine
10 (2008): 128-140.

6
Jean Marx, “Preventing Alzheimer’s: A Lifelong Commitment?”
Science
309 (2005): 864-866.

7
Michael Babyak and others, “Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months,”
Psychosomatic Medicine
62 (2000): 633-638.

8
Nicola T. Lautenschlager and others, “Effect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease,”
Journal of the American Medical Association
300 (2008): 1027-1037.

9
B. K. Pedersen and B. Saltin, “Evidence for Prescribing Exercise as Therapy in Chronic Disease,”
Scandinavian Journal of Medicine & Science in Sports
16 (Suppl.1, 2006): 3-63.

10
Carol Derby and others, “Modifiable Risk Factors and Erectile Dysfunction: Can Lifestyle Changes Modify Risk?”
Urology
56 (2000): 302-306.

11
Personal communication, June 6, 2008.

12
Thorsten Schulz, Christiane Peters, and Horst Michna, “Bewegungstherapie und Sport in der Krebstherapie und-nachsorge,”
Deutsche Zeitschrift für Onkologie
37, no. 4 (2005): 159-168.

13
The life-prolonging effect was just confirmed by two new studies among women with breast cancer: Crystal N. Holick, et al., “Physical Activity and Survival After Diagnosis of Invasive Breast Cancer,”
Cancer Epidemiology Biomarkers & Prevention
17 (2008): 379-386; and Melinda Irwin, et al., “Influence of Pre-and Postdiagnosis Physical Activity on Mortality in Breast Cancer Survivors: The Health, Eating, Activity and Lifestyle Study,”
Journal of Clinical Oncology
26 (2008): 3958-3964.

14
Personal communication, July 1, 2008.

15
Rainer Hambrecht, “Sport als Therapie,” (Physical Exercise as Treatment Strategy)
Herz
29 (2004): 381-390.

16
Amy A. Hakim and others, “Effects of Walking on Mortality Among Nonsmoking Retired Men,”
New England Journal of Medicine
338 (1998): 94-99.

17
Heinz Mechling, “Körperlich-sportliche Aktivität und erfolgreiches Altern,”
Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz
48 (2005): 899-905.

18
Randolph Nesse and George Williams,
Why We Get Sick
(New York: Vintage Books, 1995).

19
Lynn Cherkas and others, “The Association Between Physical Activity in Leisure Time and Leukocyte Telomere Length,”
Archives of Internal Medicine
168 (2008): 154-158.

20
Frank Booth and others, “Waging War on Physical Inactivity: Using Modern Molecular Ammunition Against an Ancient Enemy,”
Journal of Applied Physiology
93 (2002): 3-30.

21
Heinz Mechling, “Körperlich-sportliche Aktivität und erfolgreiches Altern,”
Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz
48 (2005): 899-905.

22
The physician Barron H. Lerner published an essay on the role of coincidence in medicine:
New York Times
, September 19, 2006.

23
Allen Warburton and others, “Health Benefits of Physical Activity: The Evidence,”
Canadian Medical Association Journal
174, no.6 (2006): 801-809.

24
Annette Becker, “Activating Medicine—A New Approach to Illness” (Schonungslose Medizin-Der neue Umgang mit dem Kranksein),
Zeitschrift für Allgemeinmedizin
82 (2006): 338-342.

25
Rüdiger Reer, et al., “Bewegungstherapie als therapeutisches Prinzip,”
Bundesgesundheitsbl-Gesundheitsforsch Gesundheitsschutz
48 (2005): 841-847.

26
Ibid.

27
Linn Goldberg and Diane Elliot,
The Healing Power of Exercise
(New York: John Wiley, 2000).

28
Thomas S. Kuhn,
The Structure of Scientific Revolutions
, 3rd ed. (Chicago: University of Chicago Press, 1996).

29
Reer and others.

CHAPTER 2: THE DANGERS OF GOING TO BED

1
Annette Becker, “Activating Medicine—A New Approach to Illness” (Schonungslose Medizin—Der neue Umgang mit dem Kranksein),
Zeitschrift für Allgemeinmedizin
82 (2006): 338-342.

2
It was Sir Richard Asher’s intention “to justify placing beds and graves in the same category.” He concluded his report about the “dangers of going to bed” with the following poem:

“Teach us to live that we may dread

Unnecessary time in bed.

Get people up and we may save

Our patients from an early grave.”

Richard Asher, “The Dangers of Going to Bed,”
British Medical Journal
2 (1947): 967-968.

3
Thomas Mann,
The Magic Mountain,
trans. H. T. Lowe-Porter (New York: The Modern Library, 1992).

4
Jules Romains,
Knock,
trans. James B. Gidney (New York: Barron’s Educational Series, 1962).

5
Chris Allen and others, “Bed Rest: A Potentially Harmful Treatment Needing More Careful Evaluation,”
The Lancet
354 (1999): 1229-1233.

6
Ibid.

7
Thomas Gill and others, “Hospitalization, Restricted Activity, and the Development of Disability Among Older Persons,”
Journal of the American Medical Association
292 (2004): 2115-2124.

8
Angelika Abt-Zegelin, “Prävention von Bettlägerigkeit,”
Die Schwester Der Pfleger
3 (2006): 210-213.

9
Almut Schmid and others, “Nährstoff-und Bewegungsmangel im Altenheim weitverbreitet,”
Geriatrie Journal
1-2 (2001): 31-34.

10
Abt-Zegelin, 210-213.