From The Desk Of Clarence Bass

Miracle of Movement

My mother complained that I thought exercise was the cure for everything. Well, according to Move Yourself: The Cooper Clinic Medical Director’s Guide to All the Healing Benefits of Exercise (Even a Little!) (Wiley 2008), physical activity makes just about anything that ails you better. “Our research says that however long you live, every day of your life will be far better if you are involved in physical activity,” write the authors (Drs. Tedd Mitchell and Tim Church, and health writer Martin Zucker). “Statistically you improve the quantity, and in the process you definitely improve the quality.”

The encouraging details, along with many enlightening case histories and programs to help you get moving and keep moving, are in the book. What I’d like to do here is give you a sense of the vast scope of ways in which exercise makes us healthier and happier. We’ll start with the big picture and then talk about specific diseases and problems.

When my mother first suggested that I might be taking Bob Hoffman’s editorials ( http://www.cbass.com/MUSCLETO.HTM ) a little too seriously, there wasn’t much solid evidence of the benefits of exercise. Sure, Aristotle and Hippocrates spoke and wrote about the value of exercise centuries ago, but there was no real science to back it up.  

Drs. Mitchell and Church say the “first dramatic scientific breakthrough” came in 1953 when Jeremy Morris, a British researcher, found that conductors who constantly walk up and down collecting tickets on London’s famous double-decker buses enjoyed better health and had fewer heart attacks than drivers who sat immobile for 90% of their shift. Morris reinforced his findings on the value of physical activity with another study showing that postmen who walk or cycle carrying the mail had fewer heart attacks than sedentary telephone operators and clerks.   

The evidence since then on the benefits of exercise has continued to mount. Inactivity has been elevated to major status as a risk factor. Based on evidence from the Cooper Clinic and elsewhere, sedentary living is now given the same status as smoking, high blood pressure, high cholesterol, and obesity as a predictor of health and longevity. In short, regular physical activity is as important to your health as eating a good diet and not smoking.

The longest chapter in Move Yourself is devoted to the many conditions that exercise helps. We already know that exercise helps control body fat, cholesterol levels, and blood pressure, and that it improves fitness. Let’s look at some of the lesser known benefits. Some of them are surprising and all of them are encouraging to those of us who want to take care of ourselves.

Diabetes

I recently had occasion to talk to a family member who is very concerned about developing diabetes, and was able to use the information in Move Yourself to explain how exercise helps keep blood sugar under control. Before I give the explanation, did you know that type 2 diabetes is no longer referred to as “adult-onset” diabetes? That’s because it is now being seen in an alarming number of children. “In 2002 the U.S. Centers for Disease Control and Prevention warned that one in three children born in 2000 will become diabetic unless kids start eating less and exercising more,” Mitchell and Church tell us.

Now for the explanation I gave my relative. The doctors say there’s a new focus in the control of diabetes—on muscle. We now have a greater appreciation for the fact that muscles both consume and store blood sugar. Skeletal muscles, the muscles that move the body, are the body’s biggest consumer of blood sugar. “When you aren’t active, your muscles don’t use or store glucose in a normal, efficient way,” the doctors explain. “When the muscle cells don’t open up for sugar intake, as happens in the prediabetic state of insulin resistance, the sugar builds up in the blood.” In short, muscles burn blood sugar during exercise—and exercise makes muscles more receptive (less resistant) to the storage of sugar for future use—when you exercise again.

“The impact of physical activity on blood sugar is spectacular,” the doctors relate enthusiastically. Blood sugar drops almost immediately. “If you are physically active today, your body will process glucose better the rest of the day, and tomorrow, and even the day after,” the doctors report. “You can practically argue that nothing in the body responds so positively and so quickly to physical activity as blood sugar.”

We know that exercise improves blood flow (http://www.cbass.com/Everymealcounts.htm ) and protects against heart disease (http://www.cbass.com/HeartFunction.htm ) and stroke, but we don’t hear much about the role of exercise in protecting against cancer.

Cancer

The first hard evidence that physical activity is protective against cancer came in 1922, when two independent studies showed that men from Australia, England, and the United States who did “hard muscular work” had lower rates of cancer than those doing less physically demanding jobs. The medical community didn’t pay much attention at the time, according to Mitchell and Church, and the idea dropped from sight until recent years, when evidence again began to accumulate.

In 1989, a major study from the Cooper Clinic, based on more than 13,000 patients followed for eight years, showed a “powerful link” between fitness level and death rates from all illnesses, including cancer. In 1996, another study by a Cooper Clinic researcher involving 25,000 patients “showed that physically active men had a much lower risk of dying from cancer than nonactive men.” The fittest men (top 20%) had a cancer death rate 81 percent lower than the least fit 20%.

Precisely how exercise protects against cancer is unclear, but Mitchell and Church say scientists believe that exercise stimulates the body’s ability to fight off cancer in various ways, which are listed in the book. Here’s my overview using the doctor’s words.

“Every day we have cells that turn cancerous,” the doctors relate. “The body needs to eliminate them.” A sedentary body “works sluggishly,” and simply doesn’t do the job as well as a fit body. Exercise bolsters the ability of our immune system “to clean house.”

As this was being written, a case was reported in the New England Journal of Medicine (June 19, 2008) showing the cancer fighting power of the body. Doctors cured an Oregon man with late-stage skin cancer by injecting him with five billion of his own white blood cells, which had been withdrawn and multiplied in a Petri dish. The cancer, which had spread to his lungs and groin, disappeared completely and stayed away for more than two years. Perhaps exercise revs up the immune system in a similar fashion.

Mitchell and Church say the evidence of the protective benefits of exercise is especially strong for some types of cancer. Dr. I-Min Lee, a member for the Cooper Clinic Scientific Advisory Board and an assistant professor of medicine at Harvard, is an expert on the role of exercise in the prevention of cancer. Lee says the association between physical activity and prevention is strongest for colon cancer, lung cancer, ovarian cancer, and breast cancer.

[Dr. Ben Johnston, an emergency medicine specialist and frequent visitor to our site, told us about a landmark study on exercise and breast cancer published in the Journal of the National Cancer Institute (May 21, 2008). Ben wrote: “This study shows exercise has an associative correlation with decreased risk in breast cancer in premenopausal women. This is particularly important as it is the first study to show that association and the association is significant at a 23% reduction for the most active women.” The background portion of the study says that the most difficult to treat breast cancers are generally found in premenopausal women.  (Premenopausal women are, of course, exposed to higher levels of estrogen.) “We don’t have a lot of prevention strategies for premenopausal breast cancer,” lead researcher Graham Colditz said, “but our findings clearly show that physical activity during adolescence and young adulthood can pay off in the long run by reducing a woman’s risk of early breast cancer.” Dr. Colditz added that a later correction indicates the actual risk reduction may be 39% for the most active women compared to the least active. This suggests that “our original estimate of a 23% lower risk was an underestimate,” he explained. In summary, regular exercise appears to protect women of all ages against breast cancer—and a lot.]

Exercise wards off osteoporosis and depression, and improves brain function. You knew that, right? But did you know that it also gives you more energy, and helps you sleep better? Let’s look at what the Drs. Mitchell and Church say about that next.

Energy and Sleep

It might seem counterintuitive that exercise, which tires you out, also makes you more energetic—but it’s true. It’s a simple matter of use it or lose it. “Our bodies are made to be used,” the doctors write. “If we don’t use it, we lose it.”

Mitchell and Church did a quality-of-life survey for their book involving 10,000 patients. Among the many things they found is that “physical activity is a great energy booster.” Twenty six percent of patients with low fitness reported unexplained fatigue, compared to 16 percent for moderately fit patients—and only 11 percent for high-fit patients.

“Sedentary living robs you of energy,” the doctors write. “Physical activity brings it back and reduces fatigue.”

“Physical activity makes all the body’s systems operate better, from top to bottom,” the doctors state. “As a by-product, your body generates more energy.”

That’s really what exercise is about, isn’t it? Tire the body, let it rest, and you’ll tire less easily the next time. Stress, rest, and improve.

The flip side is that you’ll also sleep more soundly at night if you exercise and tire yourself out during the day.

“Keep in mind that nature is based on cycles of rest and activity,” the doctors counsel. “If you don’t get enough of one, the other is affected.”

“Sleep has a great deal to do with energy,” they explain. If you exercise during the day, “instead of waking up with the battery 75 percent or less charged, you wake up fully charged.” Drain your battery during the day and “fall asleep faster and experience more restful and restorative sleep.”

This advice works best, the doctors tell patients, if exercise and sleep are scheduled properly. They emphasize two important don’ts.

1. Don’t sacrifice sleep to exercise early in the morning. Adjust your day to fit in exercise. If you don’t get enough sleep, it makes you less productive in everything you do, including exercise. What’s more, the doctors say sleep deprivation makes you produce less leptin, the satiety hormone, causing you to eat more and gain weight. Make a firm appointment with yourself to exercise during the day, and keep it.

2. Don’t exercise shortly before going to bed. That makes it harder to fall asleep. “You put your body into a physiologically excited state,” the doctors explain, “that makes it harder to settle down.” 

*  *  *  *

Sorry Mom, but I was pretty much right about exercise. It makes just about everything better, including sex, PMS, digestion and elimination, heartburn, constipation, gallstones, liver function, back pain, headache, and life in general. Read all about it in Move Yourself: The Cooper Clinic Medical Director’s Guide to All the Healing Benefits of Exercise (Even a Little!).

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