Take Very Good
Care of YourselvesDeuteronomy 4:15


Now with the holidays behind us and quite a bit of intensive eating, it is important to keep the right focus on exercise!---Read on to see how simple it really can be.

Big Benefits with Small Changes


You don't have to break a sweat to improve your health; you just need to get moving. 

By Harvey B. Simon, M.D.


Sweat has always been the elixir of exercise and the mark of its success. The aerobics revolution of the 1970s added theory to the practice of vigorous exercise. To benefit from working out, scientists told us, you had to push your heart rate to 70 to 85 percent of its maximum, keep pouring out sweat for 20 to 60 minutes at a crack and do it all over again three to seven times a week. And for the next two decades, exercise physiologists kept cranking out fancy data that seemed to confirm what your high-school coach barked at every practice: no pain, no gain.


The aerobics doctrine inspired the few but discouraged the many. I was one of the lucky ones who morphed from an over-stuffed couch potato to a slim distance runner. Flush with my own transformation, armed with the best current data and the best of intentions, I preached the Gospel of Aerobics. I told people that prolonged, continuous exercise was essential. Among other things, I said that golf was the perfect way to ruin a four-mile walk.


As it turns out, however, perspiration isn't the only answer; the coach and I were both wrong. You can reap enormous health benefits with no-sweat exercise—as long as you know what to do. In fact, everything that gets you moving—from gardening to housework—can and will contribute to your health.


How Active Are You?

You don’t need to go to the gym to stay fit—even household chores burn calories. Health and fitness expert Dr. Harvey Simon says 150 cardiometabolic exercise (CME) points a day can help you lose weight. See how your daily activities stack up.


I recently reviewed 22 studies that evaluated the impact of moderate exercise on cardiovascular disease and longevity. The research, collectively involving more than 320,000 male and female subjects from around the world, is eye-opening. Moderate exercise was credited with 18 to 84 percent reductions in the risk of heart disease and 18 to 50 percent reductions in the overall mortality rate.


I know what you're thinking: the catch is "moderate." But this time you're wrong. A few examples: in a Seattle study, gardening for just an hour a week appeared to lower the risk of sudden cardiac death by 66 percent, and walking an hour a week reduced it by 73 percent; in the Netherlands, men who walked or biked for at least one hour a week enjoyed a 29 percent lower mortality rate than sedentary men, and in the United States, walking at least a mile a day reduced the risk of heart disease by 82 percent over a 10-year period.


Moderate exercise can also help fight hypertension, lowering blood pressure as much as 20 points. It's an essential partner with diet for people who need to lose weight. And no-sweat exercise can help reduce the risk of stroke (by 21 to 34 percent), diabetes (16 to 50 percent), dementia (15 to 50 percent), fractures (40 percent), breast cancer (20 to 30 percent) and colon cancer (30 to 40 percent). If that's not enough to get you moving, consider that it is also the only known way to slow the aging process.


And you don't have to do your sweat-free exercise all at one time. A study of young female college students in Wisconsin found that daily exercise was equally beneficial whether it occurred in a single 30-minute session, two 15-minute sessions or three 10-minute sessions. And the benefits were substantial: in just 12 weeks the women shed nearly 10 pounds each. Scientists in the U.K. reported similar results, finding that three 10-minute walks a day had the same good effects on cholesterol and stress as a 30-minute daily walk.


As for golf, the sport I once maligned, some Finnish scientists showed me the error of my ways. Their subjects were 110 healthy but sedentary middle-aged men. During the trial, half the men played 18 holes of golf two to three times a week, always walking the course; the others didn't golf. All the men went through a series of tests before and after the 20-week experiment. In just that short period, funny pictures with captions the golfers pulled ahead, losing weight, reducing their girth and abdominal fat, increasing muscular strength and boosting their levels of HDL ("good") cholesterol.


What explains this seismic shift in our approach to exercise? Human biology has not changed between 1976 and 2006, but science has. The aerobics doctrine is based on experiments that measured how exercise affects aerobic fitness, on how much oxygen your body can suck in while you're going all out on a treadmill. It's still true that to attain maximal fitness you have to work out aerobically. But in figuring out how to build exercise into your busy life, don't make an artificial distinction between "exercise" and "physical activity." Intensity is great, but what matters most is that you simply get moving.


To help explain that, I've coined the term cardiometabolic exercise (CME) to emphasize the many health benefits of everything from moderate activity to aerobic training, from washing the car to hitting the elliptical. But how much CME do you need? The accompanying graphic assigns CME points to selected daily and recreational activities. For general health and gradual weight loss, aim for 150 points a day or about 1,000 points a week; for faster weight loss, build up to twice as many points. And many of us will get extra benefit by adding exercises for strength, flexibility or balance—not at a gym under the watchful eye of a trainer, but at home in just a few minutes a day.


Suppose you weigh 150 pounds but need to lose 15 of them. That may not seem like much, but a 10 percent weight loss is really quite hard to achieve. So you begin by walking 10 minutes twice a day—not huffing and puffing on a treadmill, but just getting off the bus a few stops early or circling the mall a couple of times, aiming to cover about a mile a day. The scale won't budge for the first few weeks, but don't give up. If you keep your caloric intake constant, you'll lose 10 pounds in the first year and you'll reach your target in 18 months, without ever breaking a sweat. And if that seems slow, remember that a study of the expensive diet pill orlistat (Xenical) showed that people who took three pills a day lost an average of 12 pounds after two years. Orlistat gives many people diarrhea, but the only "side effect" of walking is good health.


Want to lose more or lose faster? You can double your losses by eliminating a 100-calorie cookie from your daily fare or by walking for 40 minutes a day. And if you do both, you'll really win at the losing game. Economists tell us it's hard to get rich quick, but easy to get rich slowly. Scientists tell us the same about getting thin: small changes add up.


Simon is an associate professor of medicine at Harvard Medical School. For more information on exercise and health, go to health.harvard.edu.


Copyright Jewish Diabetes Association September 2017--reprints allowed --please contact us at:nechama@jewishdiabetes.org