Austin Bush, MD
Few things are as predictable as the New Year’s resolution to make healthy changes to our lifestyles. Equally predictable are the broken resolutions that fall prey to well-worn lifestyle patterns and our culture’s incessant marketing of food, drink and seasonal treats. By Valentine’s Day, whatever resolve we had for a healthier lifestyle has disappeared along with the Valentines chocolates and cinnamon gummy hearts that have been marketed since the day after Christmas.
In my experience, one of the greatest barriers to sticking with lifestyle changes is the “all or nothing” mentality. This mindset tells us that unless we’re making BIG changes to our diet and exercise routines we may as well do nothing. If, for example, we can’t commit to an hour at the gym several times a week, we just won’t go at all. After all, what difference can 15 or 20 minutes make?
According to data from a recent Oxford University study, quite a bit.
For the first time, a long-duration study has been conducted on a large group using accelerometers (think FitBit or Apple watch) to determine the effectiveness of differing levels of exercise. The importance of this work was the objective nature of the data, as opposed to self-reported exercise data. Previously, a major barrier to obtaining accurate data was “Recall Bias”, where those providing the data unintentionally have errors in the accuracy of their reports when submitting.
In the study, 90,211 participants in the UK submitted data from an accelerometer that they wore for 7 days in a row to gauge their general physical activity trends over a week. The study took place from 2013-2015 to allow for a wide range of participants to provide data from a variety of occupations and backgrounds. The research team then extrapolated data on weekly energy expenditure based on the degree of movement seen on the accelerometer for each participant. These participants were then followed for an average of 5 years to see who would go on to develop new heart disease or stroke.
Compared with the control group of individuals participating in <8 hours of moderate intensity physical activity a week, those getting between 8-11 hours a week showed a 30% reduction in their likelihood of being diagnosed with cardiovascular disease over the next 5 years. Further benefits were seen for those getting 15 of more hours a week in with a 40% risk reduction. 8 hours a week might sounds like a lot, but activities included in the moderate category include walking, household cleaning and chores, and gardening.
For those participating in vigorous physical activity the time requirement was even more achievable. Vigorous activities include running, walking stairs, swimming, competitive sports, and shoveling. Participants getting only 10-20 minutes of vigorous activity in a week showed a 30% risk reduction. Those getting greater than 40 minutes a week showed a 60% risk reduction. One important point to mention is that participants in the study who showed these levels of vigorous physical activity also had higher levels of moderate activity, so sitting all day and then working out with high intensity for 10-20 minutes is likely not as preventative as a consistent lifestyle of increased physical activity.
Any intervention that has the potential to reduce the burden of cardiovascular disease is important as the US approaches record levels of heart disease with 12% of the adult population currently diagnosed. This number also sharply increased for those over 65, with numbers around 25%.
This study provides real-world evidence of the positive impact even more modest levels of exercise delivers. It also provides encouragement to pursue a greater level of movement as the benefits continue to grow along with the increased exercise. It is of interest that the study did not show a “tipping point” where more exercise ceased to be of benefit, though we all need to do what we can to assure we are creating balance in our lifestyles.
For the office worker, the executive or pastor who is challenged to regularly break away for extended times of exercise, making a decision to move intentionally can literally be a life-saver.
For some, the idea of trying to squeeze an hour of moderate exercise into the day may seem like an impossible feat, but when you break it down into small, readily achievable goals it becomes much more manageable. For example, parking further away and spending 5 minutes walking to your destination and car just knocked 10 minutes off your daily goal. Taking a 2-3 minute walk break every hour during your work day could add another 25 min to the total as well as help with mental health (set your watch to remind you). Finishing the day with a 25 minute walk around the block with pets or family could round out the daily hour. Spending some time working around the house or gardening on the weekend, and your cardiovascular risk has dropped by 30%.
While we’re rarely encouraged to “lower the bar” of our goals, perhaps there’s an opportunity for greater success if we will resolve to do some simple things consistently and succeed, rather than shoot for the moon and fail. As we’re learning from this recent Oxford study, a little exercise can go a long way.