How exercise can increase longevity, from an orthopedic surgeon

It’s essential to keep in mind that people’s level of fitness matters, not the activity they use to get there. Physical fitness grants us a decreased risk of disease, not a specific activity – and not necessarily the total duration of exercise. As little as 6,000 steps a day can make a difference.

So physical fitness seems to influence longevity and better living, but how that aerobic fitness is achieved and maintained matters too! It is possible to achieve a desired fitness level without crashing every day. Think of it as moving more and moving more often.

Not surprisingly, the authors of one study found that the fittest among us had the lowest BMI (body mass index). But, they found that the fittest also had higher cholesterol and LDL readings. Hmmm.

Your cholesterol level alone is not the best predictor of heart disease or heart attacks. People with normal cholesterol levels die of heart attacks, and people with cholesterol levels above 200 mg/dl do not. Our bodies are very complex organisms.

Your body’s level of inflammation, triglycerides, small-particle LDL, Lp(a), ApoB, and other parameters help us better gauge your overall metabolic stability and risk of heart disease. Someone with triglycerides that are through the roof but a cholesterol level of 180 is probably more likely to develop heart problems than someone with normal triglyceride levels. High levels of triglycerides are associated with diseases such as metabolic syndrome, which elevates our levels of systemic inflammation. Extreme fitness, not extreme duration, is best.

An exciting part of this study was that people with “extreme” or elite level fitness were less likely to die than others at a lower level of fitness. It’s interesting. Previous studies have shown a U-shaped curve, or inverted J curve. Those who didn’t exercise and those who exercised too much had the same chance of dying from a heart problem. Only those who exercised moderately had a lower risk of illness and death from heart disease.

The data on this is still unclear. Three to four hours of movement per week is our goal. Every step counts to achieve this goal. Even your 5 minute walk from the parking lot. Call it what you will…exercise versus movement; the key is to move, to move often and occasionally with fierce intent.

This potential inverted J curve problem only applies to a minimal number of people who pound the pavement daily or even twice a day. But that’s good news because once we catch the exercise bug, we may not have to worry about how much we exercise.

Now, keep in mind that this study only looked at people’s level of fitness, not how they got to that level of fitness. Participants in this study with an elite level of fitness may not have run 100 miles per week. Past research is quite clear in this area. People who run ultra-marathons or exercise too much seem to have a problem with diminishing returns and perhaps a problem with not being as “healthy” as they think they are.

Your aerobic or cardiac fitness is important. And that matters a lot. How you get to that level matters to some (elite extreme athletes), but for the rest of us, it’s just about starting to make our days a little tougher. We should walk more, move more often, take the stairs, join our friends in their yoga class, and make an effort to improve our chances of living longer by simply trying to be more active every day. That works.

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