Exercise Is Good Medicine
Exercise is a key component to improving health. Get more from sweat sessions by matching your workout to your health goals.
By Camille Noe Pagán
Exercise was once viewed as little more than sport. But during the past several decades, experts and enthusiasts alike came to realize that physical activity isn’t just for fun; it has major benefits for the body and brain, too.
In fact, studies have found that exercise can be as effective, or even more effective, than medication for preventing diabetes, treating depression and preventing cognitive decline. In some cases, like weight loss and weight maintenance, lifestyle changes that include exercise work where medications alone would fail.
Today, as science continues to uncover the many ways that exercise improves health – right down to the cellular level – there’s little doubt that working out can be, well, downright therapeutic.
That’s not to say that any one type of workout will cure all that ails you. While any exercise is better than none, “certain types are especially well suited for certain health goals,” says Pete McCall, an exercise physiologist with the American Council on Exercise (ACE). “Choosing the right activity – as well as the correct duration, intensity and frequency – can help you achieve the best results, and allow you to make the most of your time.”
Ready to get more from your workouts? Read on to learn more about the most effective exercises for eight health goals.
GOAL: Increase energy.
Type of exercise: Any – really. A review by researchers at the University of Georgia of more than 70 studies that spanned 50 years found that people who did cardiovascular, strength training and/or flexibility exercises for at least 10 minutes a day saw an improvement in their energy levels after four to eight weeks.
Frequency: Four or more days a week
Intensity: Mild to vigorous
How it works: Working out stimulates your cardiovascular and nervous systems and boosts your brain’s production of feel-good neurotransmitters. What’s more, “Physical activity targets the root of exhaustion by reducing the severity of – and in some case even reversing – energy-sapping health problems including obesity, high blood pressure, arthritis and depression,” says Michelle Olson, PhD, professor of exercise physiology at the Human Performance Lab at Auburn University in Montgomery, Ala.
The evidence: Persuasive. The University of Georgia researchers tested the idea that exercise could treat fatigue in 36 adults with persistent fatigue who were not regular exercisers. They split the group into thirds. One set was prescribed 20 minutes of moderate-intensity cycling on an exercise bike three times a week for six weeks. Another set followed the same routine, but at an easier, low-intensity pace. The last set didn’t exercise at all. Both exercise groups reported a 20 percent increase in energy levels by the end of the study, which was published in the February 2008 issue of the journal Psychotherapy and Psychosomatics.
GOAL: Ease osteoarthritis pain.
Type of exercise: Gentle stretching exercises (tai chi and yoga are good options) or water-based exercise like swimming or water aerobics during a flare. Add strength training for longer-term benefits.
Frequency: Ideally, do 150 minutes a week, but even just 20 minutes three times a week can help.
Intensity: Mild or moderate
How it works: Although it may be tempting, the last thing you want to do during a flare is to stop moving. “When you exercise, your body releases pain-relieving chemicals, including endorphins,” says McCall. Although the mechanism isn’t entirely understood, physical activity also appears to reduce cellular inflammation that could otherwise exacerbate inflammatory conditions, including arthritis.
The evidence: Strong. A 2008 report in the Cochrane Database of Systematic Reviews that looked at 32 studies of people with knee OA found that land-based exercise was as effective for knee pain as non-steroidal anti-inflammatory drugs, such as naproxen (Aleve) or ibuprofen (Advil). Another review of eight trials that studied the effect of exercise on pain in hip OA, which was published in the April 2009 issue of Evidence Based Medicine, found that exercise reduced the patient’s experience of pain by almost 50 percent.
GOAL: Reduce fibromyalgia pain & fatigue.
Type of exercise: A mix of aerobic activity, flexibility training and strength training is most effective.
Frequency: Start with as much as you can do – even five minutes is fine – and work up to a total of 120 to 180 minutes per week.
Intensity: Mild to moderate
How it works: Fibromyalgia is just beginning to be understood by the medical community, and because of that, experts aren’t entirely sure how exercise alleviates fibromyalgia-related pain. But the prevailing theory is that during exercise, the body releases endorphins, chemicals that act as natural pain relievers, says Jacob Teitelbaum, MD, medical director of the nationwide Fibromyalgia and Fatigue Centers. Exercise also increases energy by stimulating the cardiovascular and central nervous systems.
The evidence: Limited, but growing. A study of 20 women with fibromyalgia published in the September 2008 issue of the Archives of Physical Medicine and Rehabilitation found that a combination of strength training and aerobic exercise improved symptoms, particularly fatigue.
GOAL: Relieve depression.
Type of exercise: Aerobic exercise such as biking, walking, jogging, swimming and aerobics
Frequency: 30 minutes at least three times a week. That said, the effects seem to be somewhat dose-dependent, so exercising most days of the week is ideal.
Intensity: Moderate to vigorous
How it works: “There’s good evidence that aerobic activity increases the brain’s levels of serotonin, dopamine and norepinephrine, three neurotransmitters that elevate mood,” says Stacey Rosenfeld, PhD, a licensed clinical psychologist in private practice and staff psychologist at Columbia University Medical Center in New York City. What’s more, she adds, “Completing even a short workout gives you a sense of accomplishment, and self-esteem is tied to a reduced incidence of depression.”
The evidence: Several studies have shown that exercise positively impacts mental health. One of the latest, from the Pennington Biomedical Research Laboratory at Louisiana State University in Baton Rouge, found that sedentary women who began exercising even moderately reported improvements in their quality of life, a measure of the physical and mental skills required to cope with everyday challenges. The more exercise the women got, the better they felt, even if they didn’t lose weight.
GOAL: Maintain weight.
Type of exercise: Aerobic exercise
Frequency: One study from Duke University found that just 30 minutes of moderate exercise a day was sufficient to prevent weight gain. However, other studies have found that most people who successfully lose weight and keep it off for a year or more do 60 minutes of cardiovascular exercise (usually walking) no fewer than five days a week.
Intensity: Mild, moderate or vigorous
How it works: Maintaining weight requires the same thing as losing weight: burning more calories than you take in. “Study after study shows that most weight-loss winners keep their calories in check through consistent, steady aerobic exercise – and the majority of the time, the activity of choice is walking,” says Olson. Still, she notes, those who add resistance training do themselves a favor because the extra muscle they obtain increases their calorie burning, making it that much easier to keep the pounds off.
The evidence: Strong. Ninety percent of participants in the National Weight Control Registry, a group of more than 3,000 people who have successfully maintained at least a 30-pound weight loss for a minimum of one year, consider exercise to be crucial to their long-term weight maintenance. They report, on average, burning 2,687 calories a week, the equivalent of walking four miles each day.
GOAL: Prevent osteoporosis or reduce bone loss.
Type of exercise: Any weight-bearing exercise (that is, exercise that requires your bones to support your body weight). Resistance training is most effective, but many forms of aerobic exercise, including walking, fit the bill.
Frequency: At a minimum, 15 minutes of resistance training two to three times a week, and 20 minutes of aerobic exercise three times a week, says Vijay Vad, MD, a sports medicine specialist and arthritis researcher at the Hospital for Special Surgery in New York City.
Intensity: Mild to moderate
How it works: “Weight-bearing exercise puts stress on your bones. Your bones’ cells react by creating additional bone mass,” explains Michael Gloth, MD, an associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore who helped develop the National Osteoporosis Foundation guidelines for osteoporosis. Dr. Gloth notes that people who’ve already developed the condition will need to supplement their workouts with a calcium and vitamin D in supplement and/or dietary form in order to effectively rebuild density and prevent further loss.
The evidence: One long-term study by researchers in Germany found that a mixed program of running, jumping (like skipping rope), weight-training and stretching performed four times a week helped a group of 86 premenopausal women with osteopenia preserve their bone density over two years, compared to a less-active control group. While the control group lost 2.3 percent of the bone mass in their spines in 26 months, the exercising group saw no change. The study was published in the May 24, 2004 issue of the Archives of Internal Medicine.
Exercise intensity guidelines.
Mild: You should be able to hold a detailed conversation with another person. If you’re using a heart rate monitor, aim for 40 to 50 percent of your maximum heart rate.
Moderate: You can say a few words (“I’m doing good”) but would find it hard to hold a conversation. Aim for 50 to 70 percent of your maximum heart rate.
Vigorous: You’re edging out of your comfort zone, and would find it hard to hold a conversation. You’ll be walking 4 miles an hour or faster. Aim for 70 to 80 percent of your maximum heart rate.
Note: Always contact your physician before starting any exercise routine.
