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Episode 100: Inbetweenie - The Hidden Cost of “Just Do Something” Fitness Advice
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In this episode of the Movement Logic Podcast, Sarah explores the commonly held belief that any amount of exercise is better than none. Using recent research, she discusses the benefits of minimal exercise on cardiovascular health and longevity but also highlights the limitations of this advice. She emphasizes the need for strength training and power exercises to meet the comprehensive physical needs of the body, especially as we age. Additionally, she discusses the socioeconomic barriers to regular exercise and suggests systemic changes to make meaningful physical activity more accessible to everyone.
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00:03 The Common Exercise Advice: Just Do Something
02:01 Scientific Evidence Supporting Minimal Exercise
06:58 Limitations of Minimal Exercise
10:01 Strength Training and Its Importance
16:35 Challenges and Practical Solutions for Exercise
22:12 Conclusion and Final Thoughts
References:
Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease
Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis
Recommended
Transcript
00:00:00
Speaker
I'm Laurel Biebersdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. With over 30 years of combined experience in fitness, movement, and physical therapy, we believe in strong opinions loosely held. Which means we're not here to hype outdated movement concepts. or to gatekeep or fearmonger strength training for women. For too long, women have been sidelined in strength training. Oh,
Introduction and Mission
00:00:22
Speaker
you mean handed pink dumbbells and told to sculpt?
00:00:25
Speaker
Whatever that means, we're here to change that with tools, evidence, and ideas that center women's needs and voices. Let's dive in.
Limitations of Common Exercise Advice
00:00:46
Speaker
Welcome to the Movement Logic Podcast. I'm Dr. Sarah Court. I'm a physical therapist. And on today's InBetweeny episode, I'm talking about one of the most often repeated exercise recommendations out there.
00:00:59
Speaker
Any amount of exercise is better than none. Also known as just do something, it's better than nothing. It sounds encouraging.
00:01:10
Speaker
It sounds accessible. And to a large extent, it's true. But if I'm being honest, it's always felt a little bit off to me, like it was missing some important caveats.
00:01:25
Speaker
And at the same time, I didn't want to be the person saying this generally good advice is not sufficiently good because it can easily start to sound like if you're only doing a little bit of exercise, you are lazy and worthless.
00:01:37
Speaker
And that's absolutely not what I mean. But it also just felt to me somehow like, we're giving up on people by asking them to just do something, as opposed to giving them more accurate information around what our bodies really need, and to also help them find the support out there so that people have a chance of actually meeting those needs.
00:01:59
Speaker
So I think it's time to unpack what the phrase is actually talking about, because it's not true for all of your body's physical needs to just do something. And let's also look at what the research says and then how that advice might be limiting for people, especially if it's the only message that they hear.
Health Benefits of Minimal Exercise
00:02:20
Speaker
So we're going to unpack three things today. Number one, the science that supports or does not support the claim that anything is better than nothing when it comes to exercise. Then we'll look at how oversimplifying exercise in this way leaves a lot on the table in terms of your body's overall needs.
00:02:38
Speaker
And then what kind of changes at the public health level would actually help to make more meaningful exercise accessible to more people. So let's start with the part that is 100% true. There is strong evidence that going from doing nothing to doing something is hugely beneficial, especially for cardiovascular health.
00:03:02
Speaker
For example, there was a 2019 meta-analysis by Echelund and colleagues published in the British Journal of Sports Medicine, and all of the links will be in the show notes. It included data from over 36 prospective cohort studies and more than 660,000 participants. That's a lot of people.
00:03:21
Speaker
The researchers found that the individuals engaging in even half the recommended level of physical activity, so that would be about 75 minutes of moderate intensity aerobic activity per week, had 22% lower risk of all cause mortality compared to those who were completely inactive.
Reinforcing 'Something is Better than Nothing'
00:03:42
Speaker
So that is fantastic news, number one. And it definitely 100% supports the argument that doing something is better than nothing because these were not people who were meeting the full requirements. These were people who were doing about half of the aerobic requirement for your weekly exercise.
00:04:02
Speaker
And they still saw a really, 22% is a huge percent for something like this, lower risk of all-cause mortality. So Something is better than nothing.
00:04:13
Speaker
Yes. For all cause mortality, right? For longevity, for making your life longer. Yes, that is true. There was another large cohort study by Krauss et al. published in Circulation in 2019.
00:04:29
Speaker
They tracked over 88,000 U.S. adults through the National Health Interview Survey. And they found that people who engaged in 10 to 60 minutes, so that's even less of the less of the recommended amount, right?
00:04:45
Speaker
The prior group were around 75 minutes. This is 10 to 60 minutes of moderate intensity physical activity per week still saw a 20% reduction in mortality risk compared to those who did none.
00:04:59
Speaker
So 10 minutes, that's, oh God, I should have done the math beforehand. Please hold, beep, boop, boop, carry the two. Whoops, no, here we go. If you're doing 10 minutes per week, that's 6% of the amount that you're supposed to do. And those people still saw a 20% reduction in mortality risk.
00:05:22
Speaker
So all three of these studies 100% absolutely support the argument that something is better than nothing when it comes to
Complacency vs. Starting Point
00:05:30
Speaker
exercise. Okay, cool. Great. Nobody's arguing that that's not true.
00:05:34
Speaker
Also, please don't just listen to the intro to this episode, although I suppose it's a bit late now, and then write some mean review being like, Sarah's a total nasty person who doesn't understand reality, because we're going to talk about a lot of things related to this today.
00:05:48
Speaker
Okay. So then this study I thought was really, really interesting. It's from Stamatakis et al. It was published in Nature Medicine in 2022, and it used data from 25,241 participants in the UK Biobank who were self-described as non-exercisers.
00:06:09
Speaker
The UK Biobank is a large-scale longitudinal biomedical database and research resource that follows the health of half a million participants from the UK.
00:06:20
Speaker
It aims to improve the prevention, diagnosis, and treatment of a wide range of diseases by studying the genetic, lifestyle, and environmental factors that influence health and disease.
00:06:32
Speaker
So the researchers had people use wearable devices to track brief incidental physical activity throughout the day. The kind of like bursts of movement that we don't usually think about when we consider how much we're exercising, but would include things like climbing a flight of stairs or realizing you're late. So you jump up and you kind of run out the door, for example. And they found that as little as one to four minutes of what they called vigorous intermittent lifestyle physical activity, right? So these little moments of suddenly vigorous exercise, as little as one to four minutes of it per day was associated with a 40 to 49% lower risk of all cause and cardiovascular mortality.
00:07:21
Speaker
That's wild.
00:07:24
Speaker
But it really does... continue to support the argument that every little bit of exercise helps and is better than nothing. So, so far, all of these studies are showing, yes, even a small amount of movement per day can yield real longevity benefits, especially if you're starting from absolute zero.
00:07:44
Speaker
So if we stopped this conversation here today, we could only conclude that the advice to just do something that's better than nothing is good advice.
Beyond Aerobics: The Need for Strength Training
00:07:54
Speaker
And it is, but there's a catch, right?
00:07:58
Speaker
Better than nothing, I think, often turns into good enough. It can turn into, I'm doing something, which I know is better than nothing, so I'm good.
00:08:12
Speaker
And in terms of exercise goals, it can turn into the ceiling when it really should be the floor. Because yes, walking the dog is movement, taking the stairs instead of the elevator is movement.
00:08:27
Speaker
But there are a lot of needs that your body has, especially as we get older, that are likely not going to be impacted enough or even at all by these types of body weight only movements.
00:08:42
Speaker
So if we take a minute to look at the actual CDC public health guidelines for the United States, they recommend at least 150 minutes a week of moderate intensity aerobic activity or 75 minutes a week of vigorous aerobic activity or some combination of the two and strength training activities on two or more days per week.
00:09:12
Speaker
So if you're walking three times a week for 20 minutes, that's a great start. And that's definitely going to help with your longevity. We know that. But it's likely not touching any strength training needs that your body has.
00:09:29
Speaker
And look, I get it. I'm not trying to sound mean or like I don't understand the many issues that can be at play, which we will talk about. I understand just our own sort of reluctance in a way to do more than we need to.
00:09:45
Speaker
And I think there's a very biological drive for that in the sense of, you know, our lizard brain is always telling us to conserve energy because we don't know where our next energy source is coming from, but that's really not the case in modern day yeah America for most people. Right.
00:10:03
Speaker
But, you know, i I do get it. I recently, i had a weekend where I did two big hikes on back to back days. And those two hikes worked out to over 300 minutes of moderate exercise. So I would argue that I banked two weeks worth of cardio right there. And so then I don't need to do any cardio in the week following, right?
00:10:25
Speaker
Makes sense. Wrong, sadly. I mean, I knew that it was wrong. I was just trying to have somebody agree with me, but I picked the wrong person because I told Laurel and she very rightly told me that that made no sense.
00:10:38
Speaker
But I also should have known that someone who enjoys running and just did a marathon would have no sympathy for my questionable cardio math. But here's the real crux of what we know about cardiovascular exercise. It is not going to address major needs that our bodies have, in particular, as we get older.
Benefits and Goals of Strength Training
00:10:59
Speaker
The first need is muscle mass and strength. As we get older, our bodies lose muscle mass unless we are doing something to actively combat it. And I will say, i lift weights two to three times a week, at least.
00:11:14
Speaker
That I never miss because I much prefer it to cardio. But I can confidently say that I have a lot more muscle mass on my body now at age 50 than I did at age 28. it's not so it's not an impossible situation that you can't overcome.
00:11:28
Speaker
You can actively put muscle on your body. You just have to work at it, right? Now, while walking may improve your aerobic capacity and endurance, it's not going to provide the mechanical tension or progressive overload required to maintain or increase lean body mass.
00:11:46
Speaker
There was a study in 2022 by Yu et al. and it was published in the JAMA Network Open. And they conducted a meta-analysis including over 80,000 adults.
00:11:57
Speaker
And they found that resistance training, even just once or twice a week, was associated with a 15% reduction in all-cause mortality, a 19% reduction in cardiovascular mortality, and a 14% reduction in cancer mortality.
00:12:14
Speaker
And these benefits held independent of aerobic activity levels, which means that regardless of how much aerobic activity each person did, they still got these same benefits from resistance training or strength training.
00:12:28
Speaker
So that's huge. And what we could take away from this is that adding strength training will also benefit your longevity, though not as much. If you think back to the studies about aerobic activity that I mentioned, it's not as much as aerobic activity will, but it's not nothing.
00:12:45
Speaker
Then if we look at the impact on your strength from strength training, a systematic review from 2016 by Schoenfeld et al. looked at resistance training for older adults, who are the people who are most at risk for muscle loss.
00:13:00
Speaker
And they found that training each muscle group twice per week led to greater improvements in muscle strength compared to once weekly training. However, both frequencies once a week or twice a week resulted in significant strength gains.
00:13:14
Speaker
So that suggests that even once weekly resistance training can be beneficial for improving muscle strength in older adults. So if you are older or if you have limited time or both, incorporating resistance training once a week is still going to yield meaningful improvements in your muscle strength.
00:13:36
Speaker
Twice weekly sessions may offer additional benefits, but starting with once a week is a really practical and effective approach to counteract age-related muscle loss. And it's much easier to keep a habit where you just try to do something new once a week than deciding, like a lot of people do, i'm going to start strength training three times a week, Monday, Wednesday, Friday, you do it once.
00:13:59
Speaker
And then the following week, you're like, oh my God, i have to do it again. And it's impossible. So I never tell people to start with two or three times a week when they're trying to start new habits once a week.
00:14:11
Speaker
Set realistic goals that you can achieve. Get that realistic goal built as a habit for a while and then think about adding something else. Right?
00:14:21
Speaker
So if you're thinking about adding exercise to what you're already doing, and if what you're already doing does not involve any external load or resistance band, if it's all mostly aerobic, like you walk, you hike, you do yoga, then see what happens. If you start adding some sit to stands to a chair, which is basically like doing a squat, right? Just holding a dumbbell at your chest a couple of times a week, see what happens.
00:14:49
Speaker
But again, this this is the floor, right? This is not the
The Role of Power Training
00:14:52
Speaker
ceiling. So if you start to introduce some strength training like this, you're going to want to increase what you're doing. We don't want to just stop here and be like, well, this is enough. Another element that we know that steady state cardiovascular exercise like walking is not going to improve that we need to work on is the capacity of power.
00:15:12
Speaker
Now, power is strength at speed. So it is explosive motions. It is hopping, jumping, all those kinds of things. And that is something that we will absolutely lose our capacity for as we get older if we don't train it.
00:15:28
Speaker
The good news is that it's trainable. You can work on it. It's something that you really need in terms of not falling. So a lot of people think, oh I'll just practice balancing and then I won't fall.
00:15:39
Speaker
But what you really need is in that moment when you lose your balance, because everyone loses their balance, you need some quickness. You need the ability to quickly move your foot forwards or backwards or whichever way you're going so that you do not actually fall, so that you catch yourself.
00:15:54
Speaker
And that is something that you can practice and and should start to try to incorporate if you are a regular exerciser and there's no power training going on. That might be something to start to include. It's as simple as jumping rope, hopping, skipping, jumping up onto a low step, things like that.
00:16:13
Speaker
And then the other thing that we absolutely know for sure will not improve with purely aerobic exercise
Weightlifting vs. Walking for Bone Density
00:16:18
Speaker
is bone density. And if you've been listening to this podcast for a while, you know that we talk a lot about bone density. And we even have a six-month barbell course called Bone Density Course Lift for Longevity, where we teach, so far only women, but men are welcome, women how to lift barbells safely and effectively to improve their muscle mass and also to potentially help with their bone density.
00:16:39
Speaker
There are tons of studies out there to show that moderate to heavy weightlifting and impact training are the most efficacious ways to build bone. And old advice like walking for osteoporosis have been proven generally ineffective except in the cases of extremely sedentary or deconditioned people.
00:16:58
Speaker
One you've heard us talk about often is the Lift More trial. But we're also going to be taking a look at a lot more studies that compare moderate and even light resistance as a means of building bone and discussing what that might mean on a practical level for people in our first episode of next season. So keep an eye or I guess an ear out for that.
00:17:21
Speaker
Now, let's get real for a second. Telling people to do more isn't helpful if they don't have the time, the money, or the access to make that happen.
00:17:34
Speaker
And the reality is that in this country, these are real issues for a lot of people. You might think, oh, walking is free. Everyone can at least start there.
00:17:45
Speaker
Sure. But what if you live in a neighborhood that doesn't have safe streets or even viable sidewalks to walk on? Maybe you work three jobs to make ends meet. And by the end of the day, it's dark outside and it's not safe for you to walk around.
00:18:01
Speaker
And then somebody being like, you need to exercise. It just sounds like a ridiculous ask made by like an out-of-touch wellness influencer. If we refer to Maslow's hierarchy of needs, and if you're not familiar with this, it's a psychological theory that describes the different levels of human needs from basic physiological needs to higher level growth needs. And it's usually visualized as a pyramid with the most basic things on the bottom and the more sophisticated things at the top, the bottom level.
00:18:36
Speaker
our most basic physiological needs, these are just survival needs like food, water, shelter, sleep, breathing. There are a lot of people who are living at this level and are just struggling to keep these needs met.
00:18:55
Speaker
And the idea of introducing something that feels not like a basic need, like exercise, something that you would have to try to find time and money and energy and a safe place to do, just sounds ridiculous.
Barriers to Exercise and Solutions
00:19:11
Speaker
The second level in the hierarchy has to do with safety and security and health. But again, you know, let's say you've got your first level basic needs met and you're somewhere dealing with that second level.
00:19:24
Speaker
There could be safety issues around accessibility that make regular exercise hard to figure out. So we have to consider the social and economic context around physical activity.
00:19:38
Speaker
Not everyone can afford a gym membership, even one that you might consider cheap, like the Y, or has somewhere that has childcare, again, that they would have to pay for so they can go lift weights for 45 minutes, right?
00:19:53
Speaker
And frankly, our public health infrastructure does not generally support people's needs around exercise beyond giving us these CDC guidelines. I mean, you know, yeah there's, yes, there's those parks that have those weird exercise machines where you're just like get on and you swing side to side, or you're doing some sort of like pushing and pulling, to you know what talking about?
00:20:12
Speaker
But both local governments and federal government could be doing a lot more than just plonking down some machines in a park and calling it a day. And, you you know, to be fair, when I researched this, there are a lot of programs out there that are supposedly working on creating safe walking areas for people or giving tips and suggestions on how to sit less and move more. But frankly, I think I think we're really beyond that.
00:20:34
Speaker
We don't need more information. Move more messages. We need systems that make meaningful movement easier, fun, and integrated into daily life.
00:20:46
Speaker
Because most people know that they're supposed to be exercising more than they are, but they just can't figure out how to do it. And I think it would be really useful to create some more direct incentives. For example, in Romania, there's a town where they did this ah experiment where you want to take the bus, you show up at the bus stop, and there's a camera set up and you perform 20 squats in front of the camera and it spits out a free bus ticket.
00:21:16
Speaker
This program is known as the health ticket, and it was designed to promote physical activity among residents of this town by allowing them to earn a free bus ride after completing 20 squats in front of a specially equipped kiosk. I think that's genius.
00:21:30
Speaker
You know, it seems almost too easy in in how smart it is. And if you're thinking, well, what have we come to that we need to incentivize exercise to get people to do it?
00:21:45
Speaker
I don't think you're really considering the human psyche's drive to minimize energy loss and the relative inertia that it can create.
Motivation and Modern Lifestyle
00:21:53
Speaker
We've built this world of convenience for ourself where daily activities that used to require a lot more movement, like doing the laundry.
00:22:02
Speaker
You'd put it in a bucket, you'd get water into the bucket, you would scrub clothing with your hands up against a scrub board, whatever those things are called, washboard, and then you would have to squeeze it out, and then you would have to rinse it, and then you would have to hang it, right? It was way more physical than just I drag my laundry basket to the machine, I dump it in, I hit a button, I walk away.
00:22:23
Speaker
These daily activities that used to require a lot more of us from a physical standpoint have been taken off our hands so that we can be more productive little workers. So if you think that people should just want to do 20 squats and not need a prize for it, i just don't think that's realistic.
00:22:40
Speaker
This is a really big topic, this idea of like, why aren't people internally motivated to exercise just because? And maybe we'll do an episode on this next season because there are there are a lot of things that go
Progressing Exercise Goals
00:22:53
Speaker
into that. And I'm just kind of touching the surface of it with this right now.
00:22:58
Speaker
But if we go back to where we started, which is how useful is this phrase, just do something, it's better than nothing when it comes to exercise. Yes, that is true. And it's a very good place to start. Just doing something, even if it's getting off your butt and taking a walk around the block and coming back, has been shown to make your life longer.
00:23:21
Speaker
But it's not a good place to stop.
00:23:26
Speaker
The research shows that even small bouts of movement improve cardiovascular health and lower your risk of an earlier death than you should have. But cardio alone won't protect your bones or preserve your muscle mass or build the kind of power and physical capability that helps you stay independent as you age.
00:23:48
Speaker
So Yes, start where you are, do whatever you can, whether it's a lap around the block or 10 squats every time you get up from your desk. Sometimes I internally incentivize things for myself. I make up rules that are, you know, it's not really a rule. I made it up, but that's how I get myself to do something. So if there's something I want, like a treat, I will say, okay, you can have the treat after you finish writing this podcast episode, for example.
00:24:16
Speaker
But maybe that's how you incentivize it for yourself, right? Whatever works. I think some of it is also really understanding your own personal psychology and what works for you. I'm very treat driven.
00:24:27
Speaker
So just dangle a treat in front of me, tell me to do something and I'll do it. I mean, not everything, but you get the sense. Figure out what motivates you, start to do it, and then keep going.
00:24:41
Speaker
raise the bar for yourself because strength, power, and aerobic capacity, which are the big three of exercise, these are all trainable. They're all things you can get better at.
00:24:53
Speaker
And you're capable of more than you have been told.
Conclusion and Promotion
00:24:58
Speaker
That I truly, truly believe.
00:25:03
Speaker
All right, friends, thank you for listening. If you liked this episode, this little in-betweeny, forward it to a friend. And as always, we love it if you rate, review and subscribe so that more people can hear the thoughts from inside my brain and Laurel's brain.
00:25:22
Speaker
We are, as always, in the middle of our bone density course right now. We've got a current cohort running that's doing great. If it's something you're interested in doing, if you've heard about it and you're like, that sounds interesting, you can sign up to get on our wait list for the next cohort, which will be starting in November.
00:25:42
Speaker
All right. We will see you in two weeks.