You know it’s good for you, but when you’re done with this read you’ll want more of it.

WHAT’S THE DOSE

Perhaps the most empowering way to relate to exercise is to dose it daily like medication. A medicine that makes you smarter, makes you look and feel younger, reduces the risk of the most common killers such as heart attacks, strokes, cancer and neuro-degenerative diseases. It also makes you more productive and yes even increases income.

From the World Health Organization (WHO) the amount of recommend exercise dosing is as follows:

“Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.

• Aerobic activity should be performed in bouts of at least 10 minutes duration.
• For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.
• Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.”

The biggest shift in these guidelines is the increase in duration and intensity. The graph below shows why intensity and duration are so important:

WHOSE GETTING IT?

According the WHO only 22% of women and 18% of men are getting the recommended amount of exercise. It’s unnatural for most humans to be sedentary. A fundamental principle of mammals is that they move. Movement is critical for us to reach our potential. We as a species no longer move to hunt, gather food, seek a mate, avoid predators, explore or to simply play as much as we did for eons. We’ve created a world that has eliminated adequate movement from our daily lives and this has gradually undermined our potential.

SELLING IT ALL WRONG

Doctors are not taught that exercise is medicine, how to dose it or help someone buy into it. Selling something they don’t get paid for, not knowing how to do it and not having adequate time to do it is frustrating for docs. Most will finally resort to the “F & S” tactic- aka “Fear and Shame.” This strategy doesn’t produce sustainable results and doesn’t make a patient feel good about themselves. People respond positively to support.

A physician can want the best for his or her patients but the patient must decide for themselves. The word “decide” has two components: “de” which means “to come away from”, and “cide” which means to ‘kill.’ The person must “step away from” and choose to “kill” their sedentary life. Acknowledging it, and helping someone channel their inner gladiator of health during this sentinel moment is key. The data clearly shows that support is a critical factor in helping someone change.

Fear and shame also doesn’t work because adrenal glands are made for dealing with an acute fight or flight situation. We need to get out of the business of escaping saber tooth tigers and set a comfortable and smart pace for the long run. Moving towards a better life that increases vitality, energy, productivity, accomplishment and intelligence is a superior strategy. Exercise moves you towards a physical, cognitive and emotional state that brings pleasure and abundance. It prepares the brain and mind to be more relaxed, fun and creative. If something is enjoyable and brings meaning to your life then it will become sustainable. I want your reason to exercise to be about what it gives you and not about fear or humiliation.

GET SMART AND FEEL IT

When we exercise profound changes take place within our bodies. Almost every chronic disease improves. Cholesterol, blood pressure and blood sugars all improve and that’s important but you don’t feel these changes. What makes exercise sustainable is when you feel and know what it does for your brain. When we can measure the effect it confirms your efforts.

These images show enlargement of gray and white matter volume in the brains of 60-79 year olds placed on 6 months of aerobic exercise (60-70% peak exercise capacity) for one hour three times/week. This is a clear and measurable effect of how exercise helps to prevent cognitive decline known as dementia.

Interestingly, BDNF levels are lower in people with major depression and are increased when they are placed on an antidepressant known as an SSRI (think Prozac or Zoloft) or start aerobic exercise. So we can see the mechanism by which the Emotional Well-being leg of the Table of Health comes into play with the Exercise leg. This also helps to explain why aerobic exercise is equally effective as the anti-depressant Sertraline (Zoloft) in treating depression. We know that for every bout of major depression or anxiety in a person’s life, risk for dementia is significantly higher later in life. BDNF is the crucial biological link between our thoughts, emotions and movement.

BDNF levels are also lower in Type II diabetics. With the majority of Americans overweight or obese and many experiencing diabetes/prediabetes lower BDNF levels are no doubt playing a role in their known cognitive decline and mood disorders. We now know that a sedentary lifestyle, high saturated fat and sugar diets all lead to lower levels of BDNF in the brain and lower cognitive functioning.  This may explain why soda drinkers – which often have diabetes – have lower cognitive test scores than non-soda drinkers.

Let’s talk dopamine. Dopamine basically makes us want to do things. Exercise stimulates motivation by increasing dopamine receptors and levels in the brain’s reward center. Thus exercise begets more exercise and increases productivity in other areas of our lives.

In addition to dopamine, serotonin and noradrenaline are all also increased with aerobic exercise resulting in improved mood, focus and overall well-being. All of these findings have changed the educational policies of the nations Taiwan and South Korea to require more exercise for their students. The outcome? Profound improvements in academic performance and behavior at all levels.

SWEET DREAMS

Now that your mood and brain is working better, what impact does exercise have on sleep? Regular aerobic exercise has been found to have moderate to strong effects on sleep latency (the time it takes to fall asleep) and sleep quality. These positive effects are quite significant. A good night’s sleep is critical for brain and heart health. Less than six hours of sleep per night significantly increases the risk of dementia and cardiovascular events.