Why you *need* to exercise

You may think that subject line seems a little self-serving considering that I operate a gym and co-operate an online training business and lifting event. But that doesn't change the fact that you and everyone else (myself included) really do need to exercise. At least, we do if we want to increase the probability of leading long, healthy lives. Let me explain...

I'm currently reading Outlive: The Science and Art of Longevity, by Peter Attia, MD. It's quite an interesting book that is as much about healthspan — the quality of one's health throughout life — as it is about lifespan, which is obviously the length of one's life.

If you're thinking it's a bit pretentious for anyone to say there's a specific formula that improves both and that s/he knows all the answers for arranging the variables in the formula, you're right. And Attia doesn't make such a claim.

His goal is instead to present the science of what we do (currently) know and to offer enough insight into what we think we know so that readers are able to ask the right questions and implement what might be idiosyncratically viable for them. That's where the "art" part comes into play.

Hopefully you already realize that exercise is not the only broad category that we need to consider in this case — there's also nutrition, sleep, and emotional health, among others — but the tactics that we might employ in the exercise realm is where Attia starts (halfway through the book, after a science-dense first half explaining the age-related degradations we're up against).

Here are a few stats about exercise and its effect on longevity:

• You're not alone if you don't currently exercise. Apparently 77% of the U.S. population doesn't do so regularly (or at all).
• Even a small amount of exercise is beneficial. Increasing from zero to just 90 minutes/week—that's point nine percent of a week—can reduce our risk of dying from all causes by 14%. As Attia states: "It's hard to find a drug that can do that."
• An individual's level of peak aerobic cardiorespiratory fitness affects mortality by a staggering degree. For example, according to a variety of studies (the most recent being from 2022 using a sample size of 750,000 people of both sexes, all races, and ages thirty to ninety-five), people in the lowest 20% of cardiorespiratory fitness for their age and sex had a mortality rate over 4 times greater than those in the top 2%. For comparison, a smoker has a mortality rate only 1.4 times greater than a non-smoker.
• Muscle mass (and strength) is almost as powerfully correlated to mortality as cardiorespiratory fitness. A ten-year study with roughly 4,500 subjects (ages 50+) indicated that those with low muscle strength had double the risk of death as the controls, and those with low muscle mass and/or low strength plus metabolic syndrome had greater than triple the risk.
• In a side-by-side comparison of randomized clinical trials, a Stanford scientist found that exercise-based interventions performed as well as or better than a variety of pharmaceuticals at reducing mortality from coronary heart disease (except heart failure), diabetes, and stroke.
• By age 80, the average person has lost 8 kg (almost 18 pounds) of muscle compared to the peak amount during their younger years. Lower muscle mass and strength affects balance, among other characteristics, and is highly correlated with an increased incidence of falling—a leading cause of accidental death in those aged sixty-five and older. Exercise slows that muscular decline as well as that of cognitive and emotional health.

To sum all of that up, Attia states:

"The data demonstrating the effectiveness of exercise on lifespan are as close to irrefutable as one can find in all human biology. Yet if anything, I think exercise is even more effective at preserving healthspan than extending lifespan. There is less hard evidence here, but I believe that this is where exercise really works its magic when applied correctly. I tell my patients that even if exercise shortened your life by a year (which it clearly does not), it would still be worthwhile purely for the healthspan benefits, especially in middle age and beyond."

The moral of this story then becomes this: Find a way to exercise. Work to improve mobility, strength, and endurance. And plan to continue the process, to some degree, for your entire life. (Attia also points out that it's never too late to start!)

Putting it into practice

A common human tendency is to read something like this and think that you need to implement major changes overnight. But as I try to point out in this section each week, implementing tiny practices that you can complete frequently and consistently is a much better strategy if you want to still be doing them and experiencing their benefits ten days, ten months, and ten years from now.

So, this week take a look at your current exercise practices (or lack thereof), and figure out what you're missing.

Are you in the 77% of the U.S. population that doesn't regularly exercise? If so, consider adding a 15-minute walk after dinner. If you do that only six days per week, you're already at the 90 minutes of exercise that may reduce your mortality risk by 14%. (It's also a good strategy for enjoying nature, connecting with your spouse, walking the dog, and temporarily avoiding doing more sedentary activities like watching TV!)

Could you do more? Sure. But build one habit first. More can be added later.

And if you happen to be in the other 23% of the U.S. population that does exercise frequently: Does most of your exercise fall into a single category (e.g. strength training, cardiovascular training, or stretching)? If so, consider how you might add or change a single training session each week to focus on some of the other areas you're missing.

Remember that anything is better than nothing as far as exercise is concerned. And the sooner you get started or add a missing component to your current strategy, the better.