Exercise and New Year resolutions!

Dr Derrick Aarons

Sunday, January 21, 2018

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The New Year is now three weeks old, and while some of us may be sticking fervently to the resolutions we made for 2018, others may already be slipping and back-sliding on their promised commitments. However, for us to be able to carry out all our resolutions as well as experience a good quality of life, we need to be in good health.

Good health is promulgated through 'eating right' and exercising regularly, and the importance of exercise in this process cannot be over-emphasized. Innumerable research studies have confirmed the great benefits of lifelong exercise for all persons, even for those whose health may have been already adversely affected.

A sedentary lifestyle

Recently, research found that persons who led a sedentary lifestyle prior to beginning exercise subsequently experienced significant beneficial effects to their heart. A randomized research study published in the January 2018 edition of the journal Circulation found that two years of regular exercising that began in middle-age could restore the elasticity of the heart muscle in adults who were previously sedentary, and so forestall or prevent the development of heart failure.

Researchers at the University of Texas Southwestern Medical Center in Dallas, USA, and the Baker Heart and Diabetes Institute in Melbourne, Australia, found that persons who were advancing in age and who led a sedentary lifestyle developed small, stiff left ventricles (the chamber of the heart that pumps blood to the body). They also found that older, competitive Masters athletes who train at least six days a week over their lifetime have large, compliant left ventricles that look like those of healthy 30-year old persons!

Yet when the researchers put sedentary seniors (with an average age of 70 years) through one (1) year of moderate-intensity exercise training 5 - 6 times a week, they found the exercise had little effect on left ventricular stiffness. Other research suggested that the heart actually makes the transition from being a young healthy heart to the aged type of heart muscle (with reduced plasticity) during the middle age of a person. So, starting to exercise at age 70 years was too late to confer any significant beneficial effects on the heart muscle.

Exercise training

The research enrolled 61 healthy, sedentary middle-aged (45 - 64 years) adults and randomly assigned them to 2 years of yoga and balance training or supervised exercise training 4 - 5 times a week, totalling 150 - 180 minutes each week. The program included three to four 30 – 45-minute moderate exercise sessions for the first three months, with either the frequency of exercise or the duration being increased each month.

Aerobic intervals were then added, consisting of four minutes of exercise at 95% peak heart rate, followed by three minutes of active recovery at 60 - 70% peak heart rate, repeated four times. Each interval was followed by a recovery day that included 20 - 30 minutes of walking or light aerobic activity.

By the sixth month, the exercise group was training 5 - 6 hours per week, including two interval sessions, and one long (greater than one hour) and one 30-minute session performed at moderate intensity (meaning that the participant would break into sweat but still be able to carry on a conversation). One to two weekly strength-training sessions were also prescribed.


Participants then began a maintenance phase at 10 months, with training adjusted to reflect test results. To keep them fresh and to avoid injuries, participants were encouraged to use a variety of exercise equipment and to exercise outdoors.

The researchers found changes occurred similar to that occurring in an athletic heart, with an extraordinary reversal of the stiffening that occurs in the heart during sedentary living. Further, exercise training lowered participants' heart rate from 63 to 58 beats/min (a sign of increased efficiency of the heart).

A critique of the research noted that the study group was small in size, but its strength lied in the research being a randomized controlled trial with marked improvements in exercise capacity. Further, there was a concern whether middle-aged sedentary adults would stick to the intensive exercise regimen. However, the researchers responded that if the exercise is viewed as being a part of their daily routines such as bathing or the brushing of teeth, then sedentary persons would succeed.

Promote physical activity

Reducing the development of a small, stiff heart caused by sedentary lifestyle in an aging population should therefore be a high priority. Instead of just paying for tablets, all health care systems should pay for the required infrastructure to support various forms of physical activity.

This should include counselling in physical activity, and emphasizing the importance of assessing cardio-respiratory fitness as a part of the global assessment of individual health. Exercise training is among the most powerful tools existing to improve health.

So, this year, let's all begin some form of exercise training as we would wish to be healthy to carry out our various resolutions!

Dr Derrick Aarons MD, PhD - is a consultant bioethicist/family physician, a specialist in ethical issues in health care, research, and the life sciences, and is the Ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA).

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