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Avid Walkers and Cardio Fanatics May Reap Similar Survival Benefits

You don't have to work out like a maniac to benefit from staying active.

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I confess: I'm a 54-year-old cardio fanatic who is well past his athletic prime, but still loves breaking a sweat doing vigorous aerobic workouts while blasting songs like "Maniac" from the 1983 Flashdance soundtrack.

As my 12-year-old daughter reminds me, I'm waayyyy past my adolescence in real-life. Nevertheless, I'm kind of like a prehistoric creature trapped in an amber-like time capsule from my teenage years during the late 1970s to early '80s. As might be expected, I still have a penchant for cranking-up "Eye of the Tiger" while lifting weights and my favorite self-nudging technique is doing "copy-paste prompts" that involve pretending I'm Sylvester Stallone in Rocky or Arnold Schwarzenegger in the 1977 movie Pumping Iron.

I know I'm a freak; evidence-based research shows that most people dislike vigorous workouts and avoid exercise. A new prospective cohort study (Zhao et al., 2020) of almost a half-million U.S. adults over age 18 found that only about one in six people (15.9 percent) met the weekly recommended physical activity guidelines of lifting weights twice a week and doing either 150 minutes of light-to-moderate physical activity or 75 minutes of vigorous aerobic exercise. These findings were published on July 1 in the BMJ.

The objective of this large-scale, population-based cohort study was "to determine the association between recommended physical activity according to the 2018 physical activity guidelines for Americans and all-cause and cause-specific mortality using a nationally representative sample of U.S. adults (N = 479,856)." (See "New [2018] Physical Activity Guidelines Based on Decade of Research")

For this study, all-cause mortality and cause-specific mortality included Alzheimer's disease, cancer, cardiovascular disease, chronic lower respiratory tract diseases, accidents and injuries, diabetes mellitus, influenza, pneumonia, and nephritis, nephrotic syndrome, or nephrosis. Mortality data was obtained from the National Death Index records.

From a public health perspective, the really good news from this large-scale epidemiological study is that any intensity of aerobic physical activity that met the current guidelines was associated with lower risk of death overall and from eight specific diseases. As the authors explain:

"Although survival was found to be slightly better for those engaging in at least 75 minutes/week of vigorous physical activity, we also found enhanced survival in those who engaged in at least 150 minutes/week of light-to-moderate physical activity."

A winning combo appears to be lifting weights at least twice a week and doing either 150 minutes/week (30 minutes per day, five times a week) of light-to-moderate physical activity (e.g., casual walking) or 75 minutes/week (15 minutes per day, five times a week) of vigorous aerobic exercise (e.g., brisk walking, jogging).

In comparison to study participants who did not meet the weekly physical activity guidelines, the risk of all-cause mortality was significantly lower in those who engaged in twice-weekly muscle-strengthening activities and any intensity of weekly aerobic activity that met the guidelines. Based on these findings, the authors conclude:

"Those who engaged in both aerobic and muscle-strengthening activities consistent with the recommended 2018 physical activity guidelines for Americans showed a reduced risk of all-cause mortality (40 percent reduction). Adults who engaged in recommended aerobic or muscle-strengthening activities also showed a reduced risk of all-cause mortality (29 percent and 11 percent reduction, respectively)."

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If You Don't Experience "Runner's High" and Dislike Jogging, Why Not Start Casually Walking a Bit More?

The reason I love vigorous exercise and sweaty workouts has very little to do with willpower and a lot more to do with how good it makes me feel. Although I've never had an fMRI neuroimaging scan, I suspect that my brain has an abundance of endogenous receptors for my "brain's own cannabis" (i.e., endocannabinoids) and my "body's own morphine" (i.e., endorphin). For me, "Sweat = Bliss" and gives me a runner's high.

That being said, a growing body of evidence suggests that lots of people may not experience a feeling of runner's high during or after vigorous exercise because they have fewer receptors for endogenous ("self-made") neurotransmitters and hormones that act like docking stations for endorphins and endocannabinoids.

Without an adequate number of mu-opioid and CB1 receptors, the analgesic and euphoric effects of "self-made" morphine and cannabis that are produced during vigorous exercise don't elicit a so-called "runner's high." Therefore, things like high-intensity interval training (HIIT) may feel like an absolute sufferfest without any silver linings for some people.

If you are someone who doesn't experience runner's high and avoids exercise because it feels like a disagreeable and joyless experience, it's understandable that you would be less inclined to meet the physical activity guidelines.

Hopefully, learning about the latest evidence-based research suggesting that casual walking for 150 minutes/week can have benefits comparable to jogging for 75 minutes/week will be a source of motivation that inspires you to start taking more leisurely walks that fit your lifestyle and schedule.

If you're among the estimated 84 percent of U.S. adults who don't meet the recommended guidelines for physical activity, you probably don't have to become an exercise fanatic to reap benefits associated with doing some type of low-intensity physical activity that you enjoy for about 30 minutes, five times a week. As Min Zhao et al. clearly state in their conclusion: "The beneficial effects on mortality risk are largely comparable between two intensities of aerobic activity each week (≥150 minutes of light-to-moderate intensity versus ≥75 minutes of vigorous-intensity)."

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Min Zhao, Sreenivas P. Veeranki, Costan G. Magnussen, Bo Xi. "Recommended Physical Activity and All Cause and Cause Specific Mortality in Us Adults: Prospective Cohort Study." BMJ (First published: July 01, 2020) DOI: 10.1136/bmj.m2031

Katrina L. Piercy, Richard P. Troiano, Rachel M. Ballard, Susan A. Carlson, Janet E. Fulton, Deborah A. Galuska, Stephanie M. George, Richard D. Olson. "The Physical Activity Guidelines for Americans." JAMA (First published online: November 12, 2018) DOI: 10.1001/jama.2018.14854