Tabata et al.[1] found in the mid-1990s that just 2-4 minutes of "high-intensity intermittent training may improve both anaerobic and aerobic energy supplying systems significantly." This was popularized as "Tabata training" 20+ years ago. I generally believe that brief bouts of exercise can be very beneficial, especially because they're easier to do consistently over the long-term vs. more time-consuming routines. For a decade now, I've just been running through my neighborhood most days for 20-30 minutes (with some sprints mixed in) and doing one or two maximal sets of pushups or pullups or barbell exercises at home on a weekly basis. I know a lot of people who got really into longer (e.g. 60-90 minute) gym routines but couldn't sustain it for more than a few months, and then stopped doing anything.
I think for the average person, looking too carefully at individual studies is failing to see the forest for the trees.
Basically any time we do a study which asks "Is doing a bit more exercise better for you?" the answer is yes. Like doing a single walk around the block every week is better than doing none. Even five minutes of exercise is better than zero. But obviously these have much less positive impact than several hours of moderate to intense exercise weekly. There are diminishing returns but they don't really kick in until you're already pretty fit, they are only really a concern that athletes need to think about.
So in terms of individual decision making things are really simple. Are you not fit? Do you feel bad? Are your basic markers for this looking bad (blood pressure, weight etc.)? Do more exercise. Do what you enjoy, do it safely, and do as much of it as you can as intensely as is reasonable, and the numbers will go in the right direction. This will put you way ahead of the average American in terms of fitness, it's not until a higher level that things really start to get technical.
> There are diminishing returns but they don't really kick in until you're already pretty fit, they are only really a concern that athletes need to think about.
Unfortunately, it's people at both ends of the fitness curve that have to be careful about increased exercise frequency/intensity. On the less-fit side, the primary concern is accumulating minor injuries that reduce capacity for exercise even further leading into a downward spiral.
Not only what you say is objectively truth, it's motivating! Just start moving your ass!
Would only change "This will put you way ahead of the average American in terms of fitness, it's not until a higher level that things really start to get technical." striking out "American", just because it works everywhere.
While it's true that doing any amount more exercise is beneficial to the average person, they may not necessarily know/feel it. As we so often see super fit people in the media, it's easy to think we need to do hours of exercise daily for any benefit. Easy to then think "what's the point? I'll never be super fit" and do nothing. Recinforcing the narrative (including publication of studies) that no, even a small amount of execise is quite beneficial, is encouraging for the average person.
I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. I get it if you tried everything, but how many do?
When I stop compulsively eating and drinking, when I look for every opportunity to do something as an exercise, I snap out of my [self-diagnosed] depression and malaise in a few days, and feel great.
The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
I'm guessing you are in the US? There is a lot of medical advice here (UK, and Europe more widely) which is essentially “eat better and move around more”. A great many don't listen to that, but it is definitely said.
> When I stop compulsively eating and drinking [and do some] exercise
This is a key issue: not what doctors are prescribing but what people do to self-medicate. The harmful side of self-care when “a bit of what you like does you good” becomes overconsumption and underactivity. It can be even worse for those of us with significant mental issues over the norm (bit of a bipolar pillock myself, got a piece of paper saying so & everything, and like you describe with depression I find the right exercise, while not at all a panacea, helps regulate my mind quite a lot as well as stopping my body falling apart).
even in the US a lot of doctors say this because it is usually less of a pain in the ass than filling out referral paperwork to specialists that cost more for the patient anyways.
part of the problem in the US is that at least some medical practices/hospitals measure patient satisfaction as a metric to evaluate performance, but what is good for the patient and what makes them happy is not necessarily correlated. it's a factor into how the opioid epidemic got as bad as it did in the US. and also i'd imagine if you kept telling people this for decades and they didn't listen people might just not bother.
This really downplays the impact of clinical depression. It's often not solved by exercising alone, and if you talk to a psychologist about this, the first thing they do is recommend exercising or at least goeing for walks as an immediate measure before potentially therapy or medication starts.
When I went to a doctor complaining about low energy, literally the first question was about weight gain and exercising, so I'm not sure where your comment about the pills comes from.
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business"
which makes it appear as even with your “self-diagnoses” you’re under the impression that doctors rarely ask about exercise and diet and then move forward from there. which is the exact opposite of what i’ve seen from a college roommate, a close friend, and an ex who saw multiple different doctors, and each of those doctors first insisted on:
a) find a hobby, dive into it. and,
b) exercise multiple times per week. and,
c) get a nutritionist. and
d) only after those things showed little results would they prescribe SSRIs or other long term drugs.
i promise this isn’t coming down on you, i promise, but, we seem to have a massive trend of confidently wrong people implying they’re smarter than actual doctors or (just about any other subject it seems), they just guess what doctors do and don’t do. and even far more concerning is how often these confidently wrong people issue blanket advice to randoms online as if they’re at all qualified and as if they know any of the important intricate details of the randoms they’re advising.
we desperately need to get back to a place where people can confidently say “i don’t know” again. we’re (including myself) too desperate to chime in even if we’re woefully ill equipped.
maybe every secondary-university semester everyone should get a refresher session on the most basic ass socrates/plato: the smartest person is the one who knows, understands, and admits about how much they are ignorant.
Most people don't know what depression is. I'd say I've been depressed most of my life but the best periods have been the ones where I was physically active.
Now, there's a bit of a chicken and egg problem here -am I sedentary because I'm depressed or am I depressed because I'm sedentary?
I would agree with the previous poster that exercise brings me out of depression, but I spend most of my depressive periods thinking I should be more active, right now I'm in one and I keep trying to get into some healthy habits but I keep giving up because I just don't have whatever it is that I need to keep it going. I even get nearly immediate results, just a few weeks of activity has me feeling better already. But then I find some reason to take a break and then the break drags on and I'm back to where I started.
So maybe it's the depression keeping me down or maybe it's my lack of discipline causing depression but either way I'd say physical activity is important for how you feel on a daily basis and I genuinely think just getting into a regular rhythm of exercise even just one day a week can have huge impacts on your life.
? Doctors tell people to diet and exercise all the time.
The problem is that the doctor has very little to offer other than to tell people to do that, and the vast majority of people will nod and continue doing whatever they were doing.
I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic.
Bear in mind that for many people therapies like SSRIs and weight loss medications (or even counselling/therapy) can get them into the right mental and physical place to start doing more exercise and eat better.
It's easy to advise people to eat well and exercise, but it can be a bit like telling a miserable person with a migraine to smile more. Improve the underlying issue artifically, then they can have a better chance of starting the natural things. Doctors do need to do both, though, merely handing out medications without encouraging the next step is irresponsible IMO.
I've never suffered from a mental illness, so I'm genuinely curious; is exercise not ever used as a prescription for depression? Physical therapy is a thing, so it can be a prescription in some cases, no?
I think it'd be a great idea to perscribe physical therapy for people who need to exercise. Especially for the highly inactive who may not know how to start, and haven't made it a routine. That would send patients to a therapist who would help make sure they aren't doing more than they should and that they're working out correctly, and also provide the doctor with feedback/monitoring of their progress.
The problem is that in the US no doctor is going to do that because no insurance company will pay for it. In the US even people who have serious injuries and need physical therapy to recover properly from them often can't get their insurance to pay for physical therapy or to pay for enough of it (for example insurance might only cover 3 sessions when they need 12)
Insurance companies would rather have doctors print out a a few sheets of paper that kind of explain several exercises (maybe with a couple black and white pictures if you're lucky) and then expect the patients to figure it all out on their own at home, in the exact same environment they have been in, surrounded by distractions, and with no one to help them which leads to poor compliance and zero data to give back to the doctor.
Insurance companies are criminally stupid in this sense. They'd rather not pay for things that would make people healthier like physical therapy, preventative medicine, medical tests, or even gym memberships, even when by not doing those things it will clearly end up costing them more down the road.
Oh, it absolutely is, and from what I've read, it can work really well! It's just not necessarily a 'one size fits all' which is what makes medicine complicated and good doctors valuable.
If someone's hit the point where they're thinking "I'd rather be dead than leave the house", improving their mental health by any means necessary should be the first step. But not everyone should be given pills as the first option and many doctors are guilty of such laziness (over prescription of opioids and antibiotics are other examples of this – some patients urgently need them, most don't).
Compliance matters. Once a day pill is much easier to do than rework routine especially when patient has the "can't anymore" disease. Read Darkness Visible if you want to hear all about what that looks like.
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
That's because advice like this is useless. Everyone knows they should eat more vegetables, you need someone to guide you through habit formation, which is not what the doctors are for.
I think is exactly what the comment addresses (at least how I understood it). Just do whatever makes you happy, but move! Is not about being a model, it is about being heathier than moving less.
I wish someone had told me this: once you put muscle on your frame it tends to stick around.
If you bulk up and turn into Hercules over the course of a few years you can scale back your training volume dramatically and as long as you keep your diet right, you will continue to be a jacked and cut dude for many many years.
I'm sure this gets less true as you age but it seems to apply to me in my 40s.
Maintenance is just way easier than the initial buildup.
I discovered this pretty much on accident when I scaled back the volume and intensity of my own training and noticed... Huh would you look at that... Very little changed.
Like on some level, it would be harder to return to the state of roly poly schlub that I was once in, than to continue being the fairly fit person I am now. I just autopilot twice a week to the gym after work, zone out and listen to podcasts for an hour while doing some pretty moderate intensity lifts, and the body stays in pretty decent shape. I barely break a sweat now compared to the first year or two.
Yeah, I'm pretty sure that Shannon Sharpe was doing a lot more than one hour per day of training when he was playing competitively. It's my observation that two workouts or practices per day is typical for collegiate athletics, even in the sports and at the schools that don't bring in money.
But after that? Yeah, no doubt that one can maintain most of that fitness with a small fraction of the time and effort.
As I said up-thread, I started running as an Army cadet, and I've continued to take annual fitness tests throughout my career. The fastest guys on those tests are guys who (unsurprisingly) were serious runners or soccer players in high school / college but who (surprisingly) did very little running after that. They could jump into the test cold and laugh their way to two miles in 12:00 (11:00 if they were really trying). I, on the other hand, basically didn't start running until I joined the Army, and I had to put in a lot of miles to break 13:00. For several years after that, though, I was able to reduce my mileage too and still run circles around a lot of people.
Eh... I disagree. I've not bought his training but I have been actively fit since I was in highschool and have bought training before. There is value is getting regimens and techniques from really experienced athletes.
Edit:
Also, I've been on a 4 day Bukgarian split before and had very good results. If you want proof there is a 30 minute routine that can kick your ass I recommend looking up Ryan Humiston's take on it.
Um, not really any reason to doubt as there's nothing wrong with selling what you find works
Moreover, my experience in having formerly trained to compete at top international levels, studied exercise physiology and worked as a trainer, is very similar.
The really short oversimplified version is: more intensity, shorter training, and more rest — it is the balance of exercise and rest that is key. And world-class results are definitely possible with relatively brief workouts; in fact, it's the best way to do it.
The simplified concept is the muscles gain strength with stimulated rest. The training/exercise only provides the stimulus for the muscles to grow, the exercise does not actually grow the cells, it degrades or damages them. It is the repair process that strengthens the muscle. Too much exercise and too little rest (=repair+growth) just degrades the system; too much rest without exercise stimulus wastes potential growth time.
Some is good, but more is not necessarily better.
While there is no question that some exercise is almost always better than none, if you want peak results, intensity is the key. By intensity, we mean pushing the muscle to failure, so the end of each lifting set is not a predetermined number of reps, but the rep where you push as hard as possible and simply cannot complete the lift (after ~5-25 reps depending on focus on strength vs bulk, respectively). Do that one to three times for each muscle in the workout, then give it some days rest. A 45-min workout is sufficient to work the upper, mid, or lower body zone. Doing only one zone each day fits a max of six workouts per week, and monitoring vital signs (pulse/bp/temp) for overall stress will usually reduce that to around four weight workouts per week. This is what worked for me and the people I trained, and I'm not the least bit surprised to find it also worked for Dorian Yates (and no, I'm not selling anything related to exercise programs).
He is also 56 years old and has the muscle definition of a man in his 20s, when biology shows building and retaining that kind of quality muscle at that age is very difficult even with a history of physical fitness. I'll just say it, he's probably on TRT or some other gear..
Nitpick: In Tabata's research, "high intensity" meant 170% of VO2max - definitely not easier to do consistently, even if you can voluntarily sustain 170% VO2max. Popular "HIIT" methodology is only loosely inspired by it, and the mechanisms for their merits would be largely unrelated to that of the original Tabata protocol's benefits (which was about demonstrating a way for elite athletes to push anaerobic capacity at the same time as aerobic, not shaving 50 minutes off their cardio routine).
The growing research into how even a small amount of activity can confer significant benefits to the sedentary may be yet another mechanism entirely.
I agree shorter workouts are much easier to stick to though, especially since I'm easily bored.
Right. I once experimented with organizing my running workouts according to the original Tabata protocol, as closely as possible, for about six weeks[1]. I wasn't an elite athlete by any means, but I was a 21 year-old Army cadet in the top quartile of cadets in terms of fitness. I found that it's indeed difficult to strike a legitimate 100% effort, even when it's only for 20 seconds and only 5-10 times. My point is not that people should adopt the protocol as a sustainable, long-term routine; it's just that there's been evidence for a long time that short workouts can have disproportionate benefits in addition to being easier to program into day-to-day life.
[1] The results on my running performance, specifically over two miles, weren't clear, by the way. I wasn't running my best times when I started the experiment, nor at the end of it. But at least I didn't get worse despite averaging only six miles per week. I've done much better on 15-25 miles per week with a wider variety of speed work.
HIIT or Tabata must not be done day-to-day, everyday. With no recovery days, there will be no gains. A 21 year old is able to recover like crazy, a good 9 hours of sleep might be enough to mostly recover. For others it would not work well and would lead to over-training. In overtraining, the 100% efforts will be 90% efforts, impact the immune system, generally just not good all round.
For disproportionate benefits, one needs to define which benefits exactly. A max effort will burn a lot of calories quite quickly and potentially increase V02 max (which is highly correlated to overall longevity). Zone 2 training has become popular and has other benefits, notably increases 'fat max' threshold - which gives different benefits (specifically the ability to work harder for longer while still using fat as an energy source for the exercise).
> I found that it's indeed difficult to strike a legitimate 100% effort, even when it's only for 20 seconds and only 5-10 times.
This is essentially the point. At the end of Tabata, the last interval should be the last bit of energy you have in the tank. It should be entirely draining. Doing this routine daily will not allow recovery to then properly do the training well.
FWIW, I heard it paraphrased as this: the body has essentially too modes, hard & easy. When going hard, it only matters how hard you go, not how long. When going easy, it only matters how long you go for, not how hard. At the same time, zone 2 training and HIIT/Tabata are not mutually exclusive in their benefits, but it's more which systems receive the most benefit while other systems in the body receive benefits but to a lesser degree.
The original experiment was four days per week of the "exhaustive intermittent training" and a fifth day was 30 minutes of zone 2. That's what I followed. It does seem like that fifth day has been forgotten when people talk about Tabata. Like you said, "zone 2 training and HIIT/Tabata are not mutually exclusive," and I've gotten my best results when doing a few hours per week of zone 2 running with a dash of higher-speed intervals or repeats one day.
Now that I'm quite a bit older, despite maintaining my body weight and two-mile running time since then, I'd probably get hurt if I repeated the experiment.
That is true of any exercise regime with much intensity. For muscular activity: pushing towards anything like your limits technically causes lots of minor damage, which the body repairs back better. If you don't give yourself sufficient recovery time within your weekly routine you miss out on a lot of that benefit because the body's repair/improve systems don't have time to properly do their thing. This is one of the reasons¹ why overtraining injuries are a thing. In terms of cardio this still applies, the heart is a set of muscles. Mentally I think there is a similar effect, but pinning down a cause for this is much more hand-wavy and subjective compared to the far better understood² mechanisms of how the body repairs, regulates, and improves, physical structures.
Some people seem to manage with minimal recovery time, but they are either lucky³, kidding themselves, or storing up issues ready for a big nasty surprise later.
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[1] Other similar reasons include damage & fatigue in parts of the body other than muscles, and sometimes just being tired to the point of getting form wrong and hurting yourself through that.
[2] though still not entirely understood
[3] I'm counting being young as being lucky here. I'm trying to get back into running and other regular exercise (after a period of illness, looking after family with medical issues, and general burn-out) and the biggest thing getting in the way of improving from here is that I'm now in my mid/late 40s rather than early 30s like last time I was at this level of conditioning!
..In the states. Ask people from Amsterdam or Berlin about running out of breath from stairs.
I even remember seeing a study that claimed that people who lived in higher floors with no elevator had in average better cardiovascular health, an easy peasy way to nudge people into the right direction.
I am going to work by bike, and in the beginning, I could still get to zone 2. Now this is really hard to achieve. It becomes really hard to push yourself enough.
>I agree shorter workouts are much easier to stick to though, especially since I'm easily bored.
Walking is one of the best mild exercises, if you can do it in a safe place, where you can't trip or fall into a hole or be mugged (or some other risk), because you can think while walking. So you can use the time to think about your work (if applicable, like for software people, at least in some cases), or your life, or anything else. You can also not think deliberately (although thoughts may come anyway), and just enjoy the walk.
For example, I think about my side projects while walking, and have been surprised to find that I have sometime made good progress on some of them while doing so.
Tabata makes you want to vomit if you don't have at least a moderate level of fitness. Even if it's great conditioning. So here's the problem.
We go on about what's optimal from a raw time perspective, but time slows subjectively when you suffer. So people who don't conceptualize themselves as athletic, they may have insecurities if not outright skepticism, aren't going to last.
You can make a culty cultural glue to get habits to stick (because fitness is all about habits). You can do CrossFit, the social and positive aspects. That encouragement can bring habit and a change of self perception.
But if you're just a self-driven type, and you're dipping your toes in the water, my observations are that whatever is fun (an individual experience) is what you'll be creating a habit with, and time foes quickly. So explore a brunch of things until you encounter fun. Tennis, running club, weightlifting club. Etc.
So my point is that fitness is a problem around how people experience exercise and training, instead of what's optimal in a paper or in terms what's efficient in terms of time.
Was this prematurely dismissive? Maybe, I'm going by the comments.
> So people who don't conceptualize themselves as athletic, they may have insecurities if not outright skepticism, aren't going to last
I have always been thin and tried to start workouts on my own several times over many years, and never could do it, mostly because I didn't know what I was doing. Hiring a personal trainer, if you can afford it, is a great way to get over this hump. I quit after a couple of years and workout on my own now, but couldn't have done it without the trainer.
this is true. at some point i was so unfit that i probably was going to die if i continued eating and being as sedentary as i was. a single game of soccer changed my life. it was fun to chase a ball around and i got addicted to this "after glow" effect.
According to the link you shared, the Tabata research involved a TINY number of athletic, male, Japanese undergrads. I remember being stunned when I first looked it up years ago.
It's not at all obvious that their findings - which became part of Crossfit "religion" - generalize to both sexes, all fitness levels, and all ages.
60-90 minutes is far too long at the gym. If you space your sets correctly, you can have a very effective workout in 25 minutes. Change your muscle groups every day.
Do people want to spend 60 minutes as some kind of gym time standard? Where does this number come from?
Why not? HIIT is based on that person's body. They will hit their bpm much faster than a trained person.
I started with HIIT last year in august (2023),reaching 181 bpm max and averaging 176 (I'm 35).
Now, 1.5 years later, I do the same exercise (with a lot more strength) and hit 156 bpm average, 176 max. If I halt for 10 seconds (phone ringing), my bpm plummets (150 or even 148) and it's hard to bring back.
On top of that, I have to be more careful not injuring myself: my muscles are a lot stronger, so if I use all my strength in an attempt of pushing my bpm, I can hurt my body.
I feel terrible with HIIT either way, which means it does work
And I mean, psychologically, the feeling of nearly dying would have been enough to scare me off any exercising had I started with that. Being able to push yourself physically, and enjoying it, is a skill that needs to be learned gradually for most people.
I was completely sedentary for 2-3 years.
I did practice intense sports over the year and I already had experience with sedentary/active lifestyle changes, so I'm familiar with the "throw up" feeling. That goes away in a couple of weeks.
My mother did always describe to me the feeling of being exhausted after sport as a pleasant one, so I do perceive it as pleasant.
The reason why I hate it is because I could be doing something enjoyable. I tried looking for sports that I actually enjoy but I found only windsurf, which is highly impractical, expensive and very time consuming. I'd rather spend that time with my kids, my wife, playing board games and playing videogames.
I remember reading something about Tabata/HIIT being something you don't want to do every day, due to the high intensity and strain on your CNS. Is this not the thinking anymore?
The original experimental protocol was "only" four days per week, so it was never suggested to be an everyday thing. The extreme thinking among runners is probably three days per week of short intervals or repeats. The more conventional thinking is more like one day per week with a much higher volume of easy zone 2 running on the other days.
Yep. I hated running when I made it an option. The mental struggle around whether to run today took up many brain cycles. Now, I run weekday mornings. Tired? Go run. Don’t feel great? Go run. Busy day ahead? Go run. Read an article about the optimal workout routine in mice aged 25-35? Go run. Routine sucks until it works, and then it’s great.
I don't know if it works for everyone, but for me I tell myself "you HAVE to go for a 1 minute run, then just see how you feel" and every time I just end up doing a decent run anyway.
I do something similar, I gave my body "no option" to skip a workout session. If I skip, I did 2 workout sessions the next day. I hated it, still hate it, but my body now sees it as work and it's committed to doing it.
I still hate it though, but it doesn't take as much effort
For me, this would lead to growing to hate running and stopping to do it entirely. Especially when life is stressful and overall sux, strong "irrational" rules are first I end up resented. Irrational as in "this adds one more time consuming chore to already sucky life".
I got myself injuries from overtraining for not listening to body already twice. And I was not fit or competitive, anything like that. Just physically average person being more ambitious then is reasonable.
Yeah I would say in general habits are the most powerful force in health. Finding an activity you enjoy is 1000x easier to stick with than anything that feels like a grind.
Same thing for food. Trying to switch to a healthier but difficult diet wholesale fails essentially always. But what's relatively easy is finding a healthier alternative to one single thing you eat regularly, that you like just as well. This takes some experimenting, but is usually doable. Then once you've gotten used to the healthier option it becomes automatic.
Then you can replace a single other food, and so on. I think that gradual and sustainable are the most important things to focus on for most people looking for general health improvement.
This is what everybody seems to overlook. Gym is usually 15 minutes, add shower and dressing/undressing, the total can easily add 1 hour.
I'm so glad I have a gym under my building, because with 30 minutes workout I usually waste an additional 15 minutes (shower, change)
I was about to be put in blood pressure medication. Then I started a gym, with a trainer. I noticed that, after the exercise, blood pressure would immediately drop and stay low for a few hours.
Over time, the amount of time it spent lower than average increased, and it got lower and lower. It crossed 24h.
Now? I can go to the gym Mon/Wed/Fri and it will remain low at all times. I did stop for a couple of weeks and it started creeping back up so it's not a 'cure', but functionally, as long as I keep it up, I have normal BP.
I still have some weight to lose, that can further help things, most likely. And removing sugars also did help since I dropped a lot of liquid I was retaining.
Great that you have the time to do it. I just cycle the children to kindergarden and then to work everyday. I am lucky to fit in one evening of sports every week. Plus owning no car saves lot of money. I guess I am quite lucky.
That is how I do it too. I don’t have time for much dedicated exercise with a full time job and two small kids, but cycling allows me to get a decent amount of exercise every day while saving both time and money. (And about time, if you work in a city and have less than a 10 km commute, cycling is almost always faster during rush hour. )
I would guess that they did it using a blood pressure meter. That's how I do mine. They are cheap and reasonably accurate. Mine is from Omron, very similar to the one my doctor uses.
And it could skyrocket for example if you get into a stressful situation. And you wouldn't notice that you are over 180+. And one day you get a stroke and become paralyzed. Sure, do not take the medication. These exists since the 40s, there is nothing wrong with them.
The point is that exercise can remove the underlying problem. And those who stay active enough don't develop it in the first place. Doc was amazed that I wasn't on any maintenance meds at 55. (Since then I've gone on blood pressure meds but if other health issues were resolved I don't think I would need them.)
Anybody can spike to 180 in a sufficiently stressful situation. (And, personally, I would very much notice 180. Otherwise calm, I'll probably notice 140.)
Do you have experience living with high blood pressure for 20+ years? Have you ever experienced blood pressure spikes and the after effects in stressful situations?
With the caveat that I'm just a random non-expert on the internet who has nevertheless spent too much time reading scattered studies and scholarly opinion articles:
We don't need "more" evidence exactly, but rather a better model of how the effects of exercise map to a given individual's physiology. Exercise is good overall, but it's also considerably overhyped due to a procession of weak and narrowly-applicable results being misconstrued as adding up to a massive pile of benefits that applies to the average person. In reality, the average person does not get anywhere close to the sum of all the touted benefits; they get some constellation of some of the benefits, while other outcomes are flat or even regress [1].
So yes, "exercise is good" at a sufficient level of abstraction, but it's much harder to make the case that it's "good for [specific outcome] for [specific person]". Which is one reason that it's such an obnoxious trend for specific health complaints to be met with generic recommendations to exercise (or exercise more, or exercise differently).
It seems a bit silly to me that in many circumstances it's just way more acceptable for exercise to be zero part of your life than the reverse, and that an argument needs to be made for geting more than even 30 mins worth of movement in a week. A culture of getting exercise by default seems like the way things should be, and the should be an affordance for those who can't rather than a luxurious escape from not having to.
It's not as true in some places in some circles, but it's hard not to notice a difference when you temporarily visit the others.
I think you're right overall, but a lot of that is an unexamined reaction to a built environment designed for motor vehicles, rather than being designed for humans. In suburban America, it too often doesn't occur to people to walk even modest distances, and when they decide to try, the experience can be scary considering that they're likely to interact with inattentive truck/SUV drivers while crossing intersections. If I just crossed the major intersection on the way to work without being paranoid about vehicle traffic, I'd probably be wheelchair-bound by now.
Until society has better work-life balance to allow for exercise while allowing for cost effect doctor visit to assign supportive and recognized improvement. Cheerleaders are more useful then people think.
This is a big problem in the UK I think. The idea of having a regular checkup with a doctor is unheard of and will get you some weird looks if you ask for it.
The NHS doesn't seem (as an outsider looking in) to do well with preventative care. I firmly believe (without necessarily a lot of evidence) that if we focused more on healthy lifestyles and made them more cost effective for people the amount of money we plough into the NHS every year could be reduced drastically.
I suspect that regular check-ups for most people would simply regularly confirm what they already know: they need to lose weight, stop smoking, take more exercise, eat more fruit and veg.
The UK now has a sugar tax on soft drinks that seems to be having a measurable positive effect. Whether it is a meaningful effect remains to be seen though:
"The findings suggest that a year after the sugar tax was introduced, adults reduced their daily free sugar intake by about 10.9g, and a reduction in soft drinks accounted for over half of this reduction. This translates to a reduction of around 40 calories daily, which if maintained, and assuming no other changes, could lead to 1.5kg weight loss over a year."
Yes a regular check-up wouldn't be the silver bullet but it would help expose larger problems under the surface which could be prevented with prescribed exercise, diet, etc.
Ultimately it's down to the patient to put in the work but if the NHS focused more on creating community practices where these things could be more widely available then maybe we should see more meaningful change.
This could get far more mileage with people by saying "activity" instead of "exercise." It is amazing how much people can get out of a simple walk around the house. Make it out and around the neighborhood, and you start getting absurdly good results.
Agreed. I've always struggled with intense structured exercise. Instead I walk quickly, park at the far end of lots, run up the stairs instead of the elevator, do some jumping jacks while waiting for the microwave, and lots of small things like that and it seems to work. You can get a lot of exercise minutes and increased heart rate out of doing routine activities with gusto. Admittedly, it's not so good for building muscle, though.
You only need a 20ish pound set of weights to build muscle, oddly. Don't even have to spend a ton of time on it. Can do a basic set of curls/whatever while cooking breakfast.
Body weight exercises feel like they should be even easier to do, but realistically are a lot harder. Pushups, are free and can be done anywhere, sure; but are not a place to start at.
> You only need a 20ish pound set of weights to build muscle, oddly. Don't even have to spend a ton of time on it. Can do a basic set of curls/whatever while cooking breakfast.
Eh, you can do almost anything with anything at a sufficient intensity frequently enough that you'll build muscle, and you definitely should, but I just feel like the more important thing is to find a good feedback cycle. Everyone is a little different, some people end up liking calisthenics or climbing or hiking or a combination of them, some people like the gym or free weights at home, but you gotta engage with it enough to have a serious possibility of either feeling results or other rewards, or lack thereof enough to move onto another idea.
If you don't see or feel results at the gym in the first month, if you set yourself up right you might meet someone to chat with and that may help spur you to keep going regardless.
If you don't feel results hiking after your first time, you've at least had an outdoor adventure. You may still have no motivation, try the other idea, go swimming whatever, but there are at least some other qualities present that help reinforce the desire to do the activity.
Eventually, you might find that your new default mode of operation in every other facet of life becomes activity first rather than something to fit in just during breakfast. At that point, it's harder to not work out or get activity than the reverse. 3 days go by and it feels odd that you've not done anything demanding in a while, and although it takes effort, it becomes easy enough to maintain long term after a certain threshold.
I'm using "you" in the general sense here, and otherwise agree with you, I just think the easiest and most private activities tend to reduce your surface area for discovering other ancillary benefits.
A good feedback cycle is good. Agreed on that. A shorter commitment cycle is also good. Gym memberships are particularly tough. You have to have the time for the exercise, no matter where you do it. You also have to have time for the commute to and from if it isn't at a place you were going to be anyway. Which is why I would suggest starting with just basic dumbbells at home. Every day.
This isn't even unique to exercise. Any added friction to doing something decreases the chances of it happening. Is why online shopping goes out of their way to make it easy to buy something. Even if it is something you want.
While I see your point (0 > 1, by definition) I think this sends the wrong message.
You need several hours of relatively strenuous exercise per week. Walking around the neighborhood, or your house, or whatever has diminishing returns. You need to steadily increase load to continue to see results. The body is incredibly good at adapting. People will read your statement and walk around their house twice, sit down, and not move for the rest of the night.
My point is only on lowering the friction to do an activity. The more friction there is to something, the more likely it will get dropped. Such that I'm not aiming to get people to think just one walk will do them for the day. Rather, I'm aiming to get people to realize you don't have to "exercise." I don't know why that framing is problematic for folks. But I would wager money that it is.
Uh, yeah? Note that I'm not claiming people don't do any walking at all. But a lot of people that would easily do another walk around the house before settling down to watch TV will balk at exercise.
FYI, the absolute fastest way to lower blood pressure is to lose weight if you are obese.
Rule of thumb is that your systolic blood pressure will drop by 1 mmHg per 1 lb of weight loss, eventually slowing down to 1 mmHg per 2 lbs of weight loss as you get back down to more normal blood pressure range / weight range.
Source: went from 160/110 to 120/90 in several months by dropping 60 lbs.
Yep, I found weight loss was pretty much the only thing that would drop my blood pressure. Though it didn't drop linearly like you're describing. From 215lb to 180lbs, it didn't really change much at all. Once I got down below 180lbs, it quickly dropped (from ~150/90 to ~120/80) and stayed there. When I slacked off my good eating habits and went back above 180lbs, blood pressure shot right back up to ~150/90. I'm back down again to about 172lbs and clearly get it now, I have to stay here.
Interesting! I wasn't really thinking it was linear, but your example does highlight the fact there's probably a few steady states that the body prefers to operate at.
I've had similar results with blood pressure, although a smaller weight loss (about 30 lbs) and smaller decrease. Another 10-20 pounds to go.
For what it's worth, I'm on a intermittent fast. I only eat between 5pm to 10pm, with no real restrictions on what I eat. I was surprised how quickly weight fell away, and how easy a diet it was to stick to. 'Eat after work' was a simple behavior to adapt to.
People are very individual, and this might not work for a lot of people, but it's doing great for me. I didn't want to spend the rest of my life on blood-pressure drugs.
I think the usual window is 8 hours, so people should first try eating between lunch and dinner, say 12PM-8PM.
A lot of people eat breakfast out of habit, and I found that once I got older, I just stopped needing it. It made me bloated and sluggish. You just don't need that many calories per day when you stop growing or not working in construction.
IF typically starts at 16/8 but 20/4 or 23/1 (One meal a day) variations seem pretty common too. A 5 hour window is not bad because that still gives room to get in 2 meals.
This is true but not the only cause of high blood pressure. It may be worth adding that many people about 1 in 200 have thyroid issues that also raise heart rate and thus BP. There are other causes as well, too many to list. It took me a long time to find some of my causes after losing weight.
I don't deny that reducing overweight is very likely to improve your health, certainly for the obese.
However, high blood pressure and weight are not as simple as one might think.
My friend has had problems with blood pressure since his 40s, but he is not overweight at all and has never been. He exercises at least weekly.
I am 60, at least 15 kgs overweight for the last 20 years (not obese), but my blood pressure is very good. I have always excercised daily, often for 1 - 2 hours, but at low intensity. Nowadays even lower because I have knee problems. Probably lower weight would have helped with those.
While it does appear to work for many, I personally lost about 20% weight or 40lbs, with seemingly zero effect on blood pressure. I do measure it around the same time of the day, same place, nearly same condition... So it is not about inconsistencies of measurement - I had elevated blood pressure for as long as I remember. My BP does respond to exercise (or more likely to body heating up) for short period of time, and to meds, but meds make it very inconvenient since I have to plan it around my day - having meds and working on something outside in Texas heat = too low BP.
I relied heavily on extended water fasting (3-7 day fasts). It's both easy and hard, easy in the sense it doesn't take any extra work to lose weight, but hard in terms of dealing with cravings/discomfort.
I have a neighbour who's in his 60s. Blood pressure was of the charts while in his 40s. The guy was cycling to work everyday (and thought that was enough exercise) and was living a stressful family and work life.
Doctor never prescribed any drugs but told him that he had to start exercising. Signed up for judo class. He couldn't believe the amount of exercise he got from the warm up alone. Been doing judo 3 days a week for 20 years now. Haven't had any heart or blood pressure issues since.
And here I was, thinking my daily cycling would be enough. It's not. I've been cycling all of my life, cycling daily and I'm still categorised as obese according to all weight to height ratios.
My long term avg blood pressure varies with weight. It's lower when I lose weight, higher when I gain weight.
I guess generalising health advice isn't necessarily useful. Health advice should be tailored to individuals, instead.
My take on exercise is that our bodies are really good at efficiency. Cycle daily for the same general distance and effort and eventually you are completely attuned to doing that, meaning what used to take a lot of effort now simply doesn't. Maybe increasing intensity or distance or just starting something new along with it would help.
There's no way around getting having the nutrition part figured out too, meaning you need to stop eating like crazy. Saying this from a personal account, where I went down from 20% body fat to 13% in just 3 months and saw various health metrics improving.
Magnesium will lower your blood pressure, just take magnesium. The crazy thing is the diuretics that are prescribed to lower blood pressure cause magnesium deficiency.
Getting a little beyond the headline, we find they had people wear blood pressure monitors and accelerometers and concluded:
> More time spent exercising or sleeping, relative to other behaviors, was associated with lower BP. An additional 5 minutes of exercise-like activity was associated with estimated reductions of –0.68 mm Hg (95% CI, –0.15, –1.21) SBP and –0.54 mm Hg (95% CI, –0.19, 0.89) DBP. Clinically meaningful improvements in SBP and DBP were estimated after 20 to 27 minutes and 10 to 15 minutes of reallocation of time in other behaviors into additional exercise. [1]
Somewhat related is Betteridge's law of headlines:
> Any headline that ends in a question mark can be answered by the word no. It is based on the assumption that if the publishers were confident that the answer was yes, they would have presented it as an assertion; by presenting it as a question, they are not accountable for whether it is correct or not.
I like to swap out any of these maybe-headlines with the exact opposite. It may help us, or it may not.
> Just five minutes of activity a day was estimated to potentially reduce blood pressure, while replacing sedentary behaviours with 20-27 minutes of exercise per day, including uphill walking, stair-climbing, running and cycling, was also estimated to lead to a clinically meaningful reduction in blood pressure.
Sounds like 5 minutes of exercise is where it has a statistically significant measurable impact in blood pressure, but 20-27 minutes is where it's a meaningful impact.
The headline is about a study that showed increased activity was correlated with decreases in blood pressure.
So, no, it's not equally accurate to say the opposite is "equally accurate" unless we're playing pedantic games where we ignore the study and pretend it's all just meaningless words.
GASP, exercise is good!? No way. The hard part is finding time and having the motivation. Particularly the latter. There's constantly about 49 other things that feel like they need doing more than purposely exercising and wearing myself out even more than I'm already worn out.
The greatest misconception about exercise is this "if you're tired your best course of action would be to abstain from the thing that will make you more tired" train of thought. Exercise doesn't always work like this. Yes you'll have bad days, but you'll find yourself more energised most of the time and mentally more at peace. Thinking it will make you more tired can often be just a preconception.
It's like that classic sedentary worker ailment of the sore back. Many people take this as a sign to rest more, but these types of issues are often caused by weak musculature and the best thing to do is start resistance training. Obviously not a blanket solution, but one that definitely seems overlooked.
> Exercise doesn't always work like this. Yes you'll have bad days, but you'll find yourself more energised most of the time and mentally more at peace.
Is there anything that will convince you this isn't true for all (perhaps not even most) people?
The right type of exercise matters. I've often gone on bouts of cardio on a treadmill for months at a time (multiple times a week - at least 30 minutes each session). It never ceased to suck.
I can do a hike and never feel bad. But a treadmill or cycling device? Always feels bad. I hope it benefits me in the long run, because it definitely reduces the quality of life on days I do it.
My only real hope is to find some other kind of cardio that doesn't annoy as much.
Exactly. It always seems weird to me that "going to the gym" is virtually synonymous with getting some exercise when the gym is the most boring place to do exercise.
Can you watch anything fun while doing your cardio? I look forward to working out because that's when I catch up on my Netflix shows. There's no way I'd stick with it if I didn't have something to take my mind off the grind.
BeatSaber maybe? Something addictive is better even if it is less effective. I also do FitXR, which is more effective, but requires more of a grinding mindset so I often mix it with BeatSaber, which doesn’t grind.
I would experiment at least, there are things. A good instructor in an aerobics class can also help, although I find that too hit or miss to be sustainable.
I've been a runner of some sort most of my life. Raced other kids around the block when I was 6. Sprints back and forth across the field in middle school. Four years of cross-country and track in high school. Two state championships. Joined the Army as an adult. Hit a snag with spine injuries in my mid to late 30s, but back on the wagon and running 50+ miles per week in my mid 40s.
At every point in my life, including right now, I would agree 100% that a treadmill and stationary bike suck and I would not do those.
I will agree though. Before going on a long cross-state bike trip, I had some back issues and was cramming in work (too much sitting). I went out with lower back pain, resolved itself after a few days of riding for most of the day.
I very much agree that counter-intuitive behavior is often what is called for. The exercise or sedentary habits are habits. They really become normal one way or the other quite quickly.
possibly counter to intuition, I find that since I have started to religiously use my stationary bike in the morning, I have a lot more energy for the day, not less. I suppose if you're butting up against caloric/nutrient limits you might suffer. I personally find exercise clarifies my thoughts and improves my mood, even if its the last thing I want to do when I do it.
The mind-body connection is quite real. Improving your physical state will almost certainly have a non-zero improvement on your mental state. Exercising can really help you make sense of all those other things you have going on. Not to mention that being in shape and strong makes every physical thing you do easier.
I'd recommend trying without the entertainment too. Boredom can be good, letting your mind wander can be fun, or simply focusing on the current task and your body's experience can improve the experience.
Agree. Anything that is done over the course of one week or one month is pretty meaningless. When starting training, the only thing a person needs to do is to do anything. Just get out there, build consistency. That is the very first goal. Timings, intervals, HR monitor, those are all well past the point of consistency. The other side of the coin, the accumulation of training/activity over long time is what matters. Those that work on larger projects learn this, some things you can't just cram the night before. It requires hundreds of hours of sedentary or active living, hundreds of meals, for effects of a good or a bad diet (or active/sedentary lifestyle) to be realized.
>The hard part is finding time and having the motivation.
Motivation certainly, but if we accept the results of the study, you really don't think you can find 5 minutes of time in your day to walk up some stairs or do some jump rope?
If you live in an area with decent infrastructure, cycling to and from work is a great way to get exercise in without sacrificing much time (in some cases you even save time)
I'm not over 60, yet, and I feel there are likely many, myself included, who don't know what a "set of full squats" is, exactly.. when you recommend such things could you at least say what that is thanks?
A "set" probably refers to 5 or more repetitions per set, so 3 sets are 3*5+ repetitions of squats. A "full" squat probably means to go so low that your butt goes below your knees.
the research metric I'm interested in is "if you exercise for 5 minutes, you should expect to live 1 minute longer" and I would look at that and say "so I lost 4 mins? no thanks"
but if it ever comes out with a surplus, I'll turn on a dime (and turning on a dime for 5 minutes a day probably lowers blood pressure)
your point gets made over and over and over, I get it, health nuts have a list of things that they think are healthy.
My point, that there's a cost to all this that might not get repaid, is a fresh take that you never see unless you've read one of my other comments making the point.
This research exists. This study [1] suggests a 2.7 year increase in life expectancy. Doing some math, 5 minutes per day for 80 years is around 0.2 years.
So sure I might have gone fishing a bit to respond to a random HN comment but the data is out there and you have a brain.
If you are waiting for studies that perfectly model every variable before you spend 5 minutes walking, you are unlikely to be satisfied within your rapidly decreasing lifespan.
I really don't think "walk briskly for five minutes a day" is a health nut thing. That sounds more like the advice your doctor gives you when she knows you won't do anything a health nut says.
some people just have a bad genetic soup and do exercise and diet and such and still have hbp well beyond the numbers designated as meaning "high" ultra high etc I didn't see any hard numbers of reduction in the article either, I've read that smoking raises bp by 5-10points which is largely marginal when you look at how inaccurate most bp readings are. I'm skeptical in this selling environment we live in that this isn't all just to sell drugs to people for their whole lives, these are the same people who want to decimate human populations btw
5-10 points isn't marginal just because there is measurement variance to account for. And just because there's variance doesn't mean you can't fuzz out real numbers. It's like thinking you can stop a timing attack with sleep(random()).
I'd be very skeptical of defending something like high blood pressure. People do the same with high cholesterol. It's a bunch of cope and wishful thinking that they're very different from everyone else who gets heart disease, our #1 killer.
There was a point in history where medics were not aware of concept of “normal body human temperature”.
Then somebody took a sample of people, and measured their body temp and also asked if they were feeling well.
Average among those who felt well was 36.88 °C (98.38 °F) and that was declared normal.
(Then in geneal education books it was rounded+shifted and any variation found by the study forgotten)
I found it quite interesting, because I knew normal temp value whole my life, but never even stopped to think where it came from. (I guess in passing thought I imagined that this value was fundamental constant of the universe derived from quantum physics)
My conclusions:
- Studies by necessity are performed on groups on people.
- when it comes to healing an individual, medical knowledge is huge and complex network of rules of thumb (that work on average but there is no such thing as whole medicine field tailored for you)
- there is no better way (listening to your doctor is a good idea)
Except those two don't really matter when predicting heart attack or stroke risk. HRV results, EKG results, labile hypertension; these are the indicators of whether or not you're at a risk for a heart attack or stroke. Getting a regular stress test is more important than blindly throwing anti-hypertensives at someone who may not need them in the first place.
My smart ring detects if there are potential arrhythmia, same with the Apple Watch. Wearables are far more effective at determining heart attack risk than measuring blood pressure which fluctuates in correspondence with your circadian rhythm.
> Except those two don't really matter when predicting heart attack or stroke risk.
Some cursory googling leads to recent research showing that they do: "According to new research, both high systolic and high diastolic blood pressure can lead to heart attack and stroke." [1]
> HRV results
I feel there is hype over HRV. Mainly a new thing that watches and other monitors can measure, and the number is being hyped. That put aside, the sources I've listened to have concluded that HRV is not really that valuable. Do you know of research showing otherwise? (grant it, some research is good here, for most things medecine and science there needs to be a lot of research. My impression there is a lot of research around blood pressure, thus I am not digging out more sources to show the counter-point).
Tabata et al.[1] found in the mid-1990s that just 2-4 minutes of "high-intensity intermittent training may improve both anaerobic and aerobic energy supplying systems significantly." This was popularized as "Tabata training" 20+ years ago. I generally believe that brief bouts of exercise can be very beneficial, especially because they're easier to do consistently over the long-term vs. more time-consuming routines. For a decade now, I've just been running through my neighborhood most days for 20-30 minutes (with some sprints mixed in) and doing one or two maximal sets of pushups or pullups or barbell exercises at home on a weekly basis. I know a lot of people who got really into longer (e.g. 60-90 minute) gym routines but couldn't sustain it for more than a few months, and then stopped doing anything.
[1] https://journals.lww.com/acsm-msse/Fulltext/1996/10000/Effec...
I think for the average person, looking too carefully at individual studies is failing to see the forest for the trees.
Basically any time we do a study which asks "Is doing a bit more exercise better for you?" the answer is yes. Like doing a single walk around the block every week is better than doing none. Even five minutes of exercise is better than zero. But obviously these have much less positive impact than several hours of moderate to intense exercise weekly. There are diminishing returns but they don't really kick in until you're already pretty fit, they are only really a concern that athletes need to think about.
So in terms of individual decision making things are really simple. Are you not fit? Do you feel bad? Are your basic markers for this looking bad (blood pressure, weight etc.)? Do more exercise. Do what you enjoy, do it safely, and do as much of it as you can as intensely as is reasonable, and the numbers will go in the right direction. This will put you way ahead of the average American in terms of fitness, it's not until a higher level that things really start to get technical.
> There are diminishing returns but they don't really kick in until you're already pretty fit, they are only really a concern that athletes need to think about.
Unfortunately, it's people at both ends of the fitness curve that have to be careful about increased exercise frequency/intensity. On the less-fit side, the primary concern is accumulating minor injuries that reduce capacity for exercise even further leading into a downward spiral.
Thats why we recommend obese people to walk first, even if they think they would enjoy running.
Not only what you say is objectively truth, it's motivating! Just start moving your ass!
Would only change "This will put you way ahead of the average American in terms of fitness, it's not until a higher level that things really start to get technical." striking out "American", just because it works everywhere.
Yeah people just need to focus on doing the basics right [0].
[0] https://www.barbellmedicine.com/blog/where-should-my-priorit...
While it's true that doing any amount more exercise is beneficial to the average person, they may not necessarily know/feel it. As we so often see super fit people in the media, it's easy to think we need to do hours of exercise daily for any benefit. Easy to then think "what's the point? I'll never be super fit" and do nothing. Recinforcing the narrative (including publication of studies) that no, even a small amount of execise is quite beneficial, is encouraging for the average person.
I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. I get it if you tried everything, but how many do?
When I stop compulsively eating and drinking, when I look for every opportunity to do something as an exercise, I snap out of my [self-diagnosed] depression and malaise in a few days, and feel great.
The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
I'm guessing you are in the US? There is a lot of medical advice here (UK, and Europe more widely) which is essentially “eat better and move around more”. A great many don't listen to that, but it is definitely said.
> When I stop compulsively eating and drinking [and do some] exercise
This is a key issue: not what doctors are prescribing but what people do to self-medicate. The harmful side of self-care when “a bit of what you like does you good” becomes overconsumption and underactivity. It can be even worse for those of us with significant mental issues over the norm (bit of a bipolar pillock myself, got a piece of paper saying so & everything, and like you describe with depression I find the right exercise, while not at all a panacea, helps regulate my mind quite a lot as well as stopping my body falling apart).
even in the US a lot of doctors say this because it is usually less of a pain in the ass than filling out referral paperwork to specialists that cost more for the patient anyways.
part of the problem in the US is that at least some medical practices/hospitals measure patient satisfaction as a metric to evaluate performance, but what is good for the patient and what makes them happy is not necessarily correlated. it's a factor into how the opioid epidemic got as bad as it did in the US. and also i'd imagine if you kept telling people this for decades and they didn't listen people might just not bother.
This really downplays the impact of clinical depression. It's often not solved by exercising alone, and if you talk to a psychologist about this, the first thing they do is recommend exercising or at least goeing for walks as an immediate measure before potentially therapy or medication starts.
When I went to a doctor complaining about low energy, literally the first question was about weight gain and exercising, so I'm not sure where your comment about the pills comes from.
My comment comes from the seeming ease of procuring these drugs - with people going on Ozempic out of pure vanity.
you did end your comment with:
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business"
which makes it appear as even with your “self-diagnoses” you’re under the impression that doctors rarely ask about exercise and diet and then move forward from there. which is the exact opposite of what i’ve seen from a college roommate, a close friend, and an ex who saw multiple different doctors, and each of those doctors first insisted on:
a) find a hobby, dive into it. and,
b) exercise multiple times per week. and,
c) get a nutritionist. and
d) only after those things showed little results would they prescribe SSRIs or other long term drugs.
i promise this isn’t coming down on you, i promise, but, we seem to have a massive trend of confidently wrong people implying they’re smarter than actual doctors or (just about any other subject it seems), they just guess what doctors do and don’t do. and even far more concerning is how often these confidently wrong people issue blanket advice to randoms online as if they’re at all qualified and as if they know any of the important intricate details of the randoms they’re advising.
we desperately need to get back to a place where people can confidently say “i don’t know” again. we’re (including myself) too desperate to chime in even if we’re woefully ill equipped.
maybe every secondary-university semester everyone should get a refresher session on the most basic ass socrates/plato: the smartest person is the one who knows, understands, and admits about how much they are ignorant.
Most people don't know what depression is. I'd say I've been depressed most of my life but the best periods have been the ones where I was physically active.
Now, there's a bit of a chicken and egg problem here -am I sedentary because I'm depressed or am I depressed because I'm sedentary?
I would agree with the previous poster that exercise brings me out of depression, but I spend most of my depressive periods thinking I should be more active, right now I'm in one and I keep trying to get into some healthy habits but I keep giving up because I just don't have whatever it is that I need to keep it going. I even get nearly immediate results, just a few weeks of activity has me feeling better already. But then I find some reason to take a break and then the break drags on and I'm back to where I started.
So maybe it's the depression keeping me down or maybe it's my lack of discipline causing depression but either way I'd say physical activity is important for how you feel on a daily basis and I genuinely think just getting into a regular rhythm of exercise even just one day a week can have huge impacts on your life.
? Doctors tell people to diet and exercise all the time.
The problem is that the doctor has very little to offer other than to tell people to do that, and the vast majority of people will nod and continue doing whatever they were doing.
Every doctor I’ve ever been to starts out recommending lifestyle changes. I think it’s the patients that ask for the medication.
I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic.
Bear in mind that for many people therapies like SSRIs and weight loss medications (or even counselling/therapy) can get them into the right mental and physical place to start doing more exercise and eat better.
It's easy to advise people to eat well and exercise, but it can be a bit like telling a miserable person with a migraine to smile more. Improve the underlying issue artifically, then they can have a better chance of starting the natural things. Doctors do need to do both, though, merely handing out medications without encouraging the next step is irresponsible IMO.
I've never suffered from a mental illness, so I'm genuinely curious; is exercise not ever used as a prescription for depression? Physical therapy is a thing, so it can be a prescription in some cases, no?
I think it'd be a great idea to perscribe physical therapy for people who need to exercise. Especially for the highly inactive who may not know how to start, and haven't made it a routine. That would send patients to a therapist who would help make sure they aren't doing more than they should and that they're working out correctly, and also provide the doctor with feedback/monitoring of their progress.
The problem is that in the US no doctor is going to do that because no insurance company will pay for it. In the US even people who have serious injuries and need physical therapy to recover properly from them often can't get their insurance to pay for physical therapy or to pay for enough of it (for example insurance might only cover 3 sessions when they need 12)
Insurance companies would rather have doctors print out a a few sheets of paper that kind of explain several exercises (maybe with a couple black and white pictures if you're lucky) and then expect the patients to figure it all out on their own at home, in the exact same environment they have been in, surrounded by distractions, and with no one to help them which leads to poor compliance and zero data to give back to the doctor.
Insurance companies are criminally stupid in this sense. They'd rather not pay for things that would make people healthier like physical therapy, preventative medicine, medical tests, or even gym memberships, even when by not doing those things it will clearly end up costing them more down the road.
Oh, it absolutely is, and from what I've read, it can work really well! It's just not necessarily a 'one size fits all' which is what makes medicine complicated and good doctors valuable.
If someone's hit the point where they're thinking "I'd rather be dead than leave the house", improving their mental health by any means necessary should be the first step. But not everyone should be given pills as the first option and many doctors are guilty of such laziness (over prescription of opioids and antibiotics are other examples of this – some patients urgently need them, most don't).
Compliance matters. Once a day pill is much easier to do than rework routine especially when patient has the "can't anymore" disease. Read Darkness Visible if you want to hear all about what that looks like.
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".
That's because advice like this is useless. Everyone knows they should eat more vegetables, you need someone to guide you through habit formation, which is not what the doctors are for.
I think is exactly what the comment addresses (at least how I understood it). Just do whatever makes you happy, but move! Is not about being a model, it is about being heathier than moving less.
Shannon Sharpe works out at my gym.
Huge guy. Former NFL tight-end. Still very fit.
I notice he only does 1 hour at the gym and then he leaves.
Granted, this is very low quality anecdata.
But seeing how brief his workout is opened my eyes to the benefit of consistency over volume.
I wish someone had told me this: once you put muscle on your frame it tends to stick around.
If you bulk up and turn into Hercules over the course of a few years you can scale back your training volume dramatically and as long as you keep your diet right, you will continue to be a jacked and cut dude for many many years.
I'm sure this gets less true as you age but it seems to apply to me in my 40s.
Maintenance is just way easier than the initial buildup.
I discovered this pretty much on accident when I scaled back the volume and intensity of my own training and noticed... Huh would you look at that... Very little changed.
Like on some level, it would be harder to return to the state of roly poly schlub that I was once in, than to continue being the fairly fit person I am now. I just autopilot twice a week to the gym after work, zone out and listen to podcasts for an hour while doing some pretty moderate intensity lifts, and the body stays in pretty decent shape. I barely break a sweat now compared to the first year or two.
Yeah, I'm pretty sure that Shannon Sharpe was doing a lot more than one hour per day of training when he was playing competitively. It's my observation that two workouts or practices per day is typical for collegiate athletics, even in the sports and at the schools that don't bring in money.
But after that? Yeah, no doubt that one can maintain most of that fitness with a small fraction of the time and effort.
As I said up-thread, I started running as an Army cadet, and I've continued to take annual fitness tests throughout my career. The fastest guys on those tests are guys who (unsurprisingly) were serious runners or soccer players in high school / college but who (surprisingly) did very little running after that. They could jump into the test cold and laugh their way to two miles in 12:00 (11:00 if they were really trying). I, on the other hand, basically didn't start running until I joined the Army, and I had to put in a lot of miles to break 13:00. For several years after that, though, I was able to reduce my mileage too and still run circles around a lot of people.
Dorian Yates (former mister Olympia) claimed he trained 4 times a week for 45 minutes while preparing for the contest. But very intense training.
He also sells training so there is reason to doubt anything he says about the topic.
Eh... I disagree. I've not bought his training but I have been actively fit since I was in highschool and have bought training before. There is value is getting regimens and techniques from really experienced athletes.
Edit: Also, I've been on a 4 day Bukgarian split before and had very good results. If you want proof there is a 30 minute routine that can kick your ass I recommend looking up Ryan Humiston's take on it.
Um, not really any reason to doubt as there's nothing wrong with selling what you find works
Moreover, my experience in having formerly trained to compete at top international levels, studied exercise physiology and worked as a trainer, is very similar.
The really short oversimplified version is: more intensity, shorter training, and more rest — it is the balance of exercise and rest that is key. And world-class results are definitely possible with relatively brief workouts; in fact, it's the best way to do it.
The simplified concept is the muscles gain strength with stimulated rest. The training/exercise only provides the stimulus for the muscles to grow, the exercise does not actually grow the cells, it degrades or damages them. It is the repair process that strengthens the muscle. Too much exercise and too little rest (=repair+growth) just degrades the system; too much rest without exercise stimulus wastes potential growth time.
Some is good, but more is not necessarily better.
While there is no question that some exercise is almost always better than none, if you want peak results, intensity is the key. By intensity, we mean pushing the muscle to failure, so the end of each lifting set is not a predetermined number of reps, but the rep where you push as hard as possible and simply cannot complete the lift (after ~5-25 reps depending on focus on strength vs bulk, respectively). Do that one to three times for each muscle in the workout, then give it some days rest. A 45-min workout is sufficient to work the upper, mid, or lower body zone. Doing only one zone each day fits a max of six workouts per week, and monitoring vital signs (pulse/bp/temp) for overall stress will usually reduce that to around four weight workouts per week. This is what worked for me and the people I trained, and I'm not the least bit surprised to find it also worked for Dorian Yates (and no, I'm not selling anything related to exercise programs).
He is also 56 years old and has the muscle definition of a man in his 20s, when biology shows building and retaining that kind of quality muscle at that age is very difficult even with a history of physical fitness. I'll just say it, he's probably on TRT or some other gear..
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Nitpick: In Tabata's research, "high intensity" meant 170% of VO2max - definitely not easier to do consistently, even if you can voluntarily sustain 170% VO2max. Popular "HIIT" methodology is only loosely inspired by it, and the mechanisms for their merits would be largely unrelated to that of the original Tabata protocol's benefits (which was about demonstrating a way for elite athletes to push anaerobic capacity at the same time as aerobic, not shaving 50 minutes off their cardio routine).
The growing research into how even a small amount of activity can confer significant benefits to the sedentary may be yet another mechanism entirely.
I agree shorter workouts are much easier to stick to though, especially since I'm easily bored.
Right. I once experimented with organizing my running workouts according to the original Tabata protocol, as closely as possible, for about six weeks[1]. I wasn't an elite athlete by any means, but I was a 21 year-old Army cadet in the top quartile of cadets in terms of fitness. I found that it's indeed difficult to strike a legitimate 100% effort, even when it's only for 20 seconds and only 5-10 times. My point is not that people should adopt the protocol as a sustainable, long-term routine; it's just that there's been evidence for a long time that short workouts can have disproportionate benefits in addition to being easier to program into day-to-day life.
[1] The results on my running performance, specifically over two miles, weren't clear, by the way. I wasn't running my best times when I started the experiment, nor at the end of it. But at least I didn't get worse despite averaging only six miles per week. I've done much better on 15-25 miles per week with a wider variety of speed work.
HIIT or Tabata must not be done day-to-day, everyday. With no recovery days, there will be no gains. A 21 year old is able to recover like crazy, a good 9 hours of sleep might be enough to mostly recover. For others it would not work well and would lead to over-training. In overtraining, the 100% efforts will be 90% efforts, impact the immune system, generally just not good all round.
For disproportionate benefits, one needs to define which benefits exactly. A max effort will burn a lot of calories quite quickly and potentially increase V02 max (which is highly correlated to overall longevity). Zone 2 training has become popular and has other benefits, notably increases 'fat max' threshold - which gives different benefits (specifically the ability to work harder for longer while still using fat as an energy source for the exercise).
> I found that it's indeed difficult to strike a legitimate 100% effort, even when it's only for 20 seconds and only 5-10 times.
This is essentially the point. At the end of Tabata, the last interval should be the last bit of energy you have in the tank. It should be entirely draining. Doing this routine daily will not allow recovery to then properly do the training well.
FWIW, I heard it paraphrased as this: the body has essentially too modes, hard & easy. When going hard, it only matters how hard you go, not how long. When going easy, it only matters how long you go for, not how hard. At the same time, zone 2 training and HIIT/Tabata are not mutually exclusive in their benefits, but it's more which systems receive the most benefit while other systems in the body receive benefits but to a lesser degree.
The original experiment was four days per week of the "exhaustive intermittent training" and a fifth day was 30 minutes of zone 2. That's what I followed. It does seem like that fifth day has been forgotten when people talk about Tabata. Like you said, "zone 2 training and HIIT/Tabata are not mutually exclusive," and I've gotten my best results when doing a few hours per week of zone 2 running with a dash of higher-speed intervals or repeats one day.
Now that I'm quite a bit older, despite maintaining my body weight and two-mile running time since then, I'd probably get hurt if I repeated the experiment.
> With no recovery days, there will be no gains.
That is true of any exercise regime with much intensity. For muscular activity: pushing towards anything like your limits technically causes lots of minor damage, which the body repairs back better. If you don't give yourself sufficient recovery time within your weekly routine you miss out on a lot of that benefit because the body's repair/improve systems don't have time to properly do their thing. This is one of the reasons¹ why overtraining injuries are a thing. In terms of cardio this still applies, the heart is a set of muscles. Mentally I think there is a similar effect, but pinning down a cause for this is much more hand-wavy and subjective compared to the far better understood² mechanisms of how the body repairs, regulates, and improves, physical structures.
Some people seem to manage with minimal recovery time, but they are either lucky³, kidding themselves, or storing up issues ready for a big nasty surprise later.
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[1] Other similar reasons include damage & fatigue in parts of the body other than muscles, and sometimes just being tired to the point of getting form wrong and hurting yourself through that.
[2] though still not entirely understood
[3] I'm counting being young as being lucky here. I'm trying to get back into running and other regular exercise (after a period of illness, looking after family with medical issues, and general burn-out) and the biggest thing getting in the way of improving from here is that I'm now in my mid/late 40s rather than early 30s like last time I was at this level of conditioning!
Walking up a flight of stairs briskly is way above VO2 max for the vast majority of people, yet doesn't feel "extreme"
> for the vast majority of people
..In the states. Ask people from Amsterdam or Berlin about running out of breath from stairs.
I even remember seeing a study that claimed that people who lived in higher floors with no elevator had in average better cardiovascular health, an easy peasy way to nudge people into the right direction.
I am going to work by bike, and in the beginning, I could still get to zone 2. Now this is really hard to achieve. It becomes really hard to push yourself enough.
>I agree shorter workouts are much easier to stick to though, especially since I'm easily bored.
Walking is one of the best mild exercises, if you can do it in a safe place, where you can't trip or fall into a hole or be mugged (or some other risk), because you can think while walking. So you can use the time to think about your work (if applicable, like for software people, at least in some cases), or your life, or anything else. You can also not think deliberately (although thoughts may come anyway), and just enjoy the walk.
For example, I think about my side projects while walking, and have been surprised to find that I have sometime made good progress on some of them while doing so.
Tabata makes you want to vomit if you don't have at least a moderate level of fitness. Even if it's great conditioning. So here's the problem.
We go on about what's optimal from a raw time perspective, but time slows subjectively when you suffer. So people who don't conceptualize themselves as athletic, they may have insecurities if not outright skepticism, aren't going to last.
You can make a culty cultural glue to get habits to stick (because fitness is all about habits). You can do CrossFit, the social and positive aspects. That encouragement can bring habit and a change of self perception.
But if you're just a self-driven type, and you're dipping your toes in the water, my observations are that whatever is fun (an individual experience) is what you'll be creating a habit with, and time foes quickly. So explore a brunch of things until you encounter fun. Tennis, running club, weightlifting club. Etc.
So my point is that fitness is a problem around how people experience exercise and training, instead of what's optimal in a paper or in terms what's efficient in terms of time.
Was this prematurely dismissive? Maybe, I'm going by the comments.
> So people who don't conceptualize themselves as athletic, they may have insecurities if not outright skepticism, aren't going to last
I have always been thin and tried to start workouts on my own several times over many years, and never could do it, mostly because I didn't know what I was doing. Hiring a personal trainer, if you can afford it, is a great way to get over this hump. I quit after a couple of years and workout on my own now, but couldn't have done it without the trainer.
this is true. at some point i was so unfit that i probably was going to die if i continued eating and being as sedentary as i was. a single game of soccer changed my life. it was fun to chase a ball around and i got addicted to this "after glow" effect.
According to the link you shared, the Tabata research involved a TINY number of athletic, male, Japanese undergrads. I remember being stunned when I first looked it up years ago.
It's not at all obvious that their findings - which became part of Crossfit "religion" - generalize to both sexes, all fitness levels, and all ages.
60-90 minutes is far too long at the gym. If you space your sets correctly, you can have a very effective workout in 25 minutes. Change your muscle groups every day.
Do people want to spend 60 minutes as some kind of gym time standard? Where does this number come from?
HIIT is and feels awesome, but no way a sedentary person can start straight with that.
Why not? HIIT is based on that person's body. They will hit their bpm much faster than a trained person. I started with HIIT last year in august (2023),reaching 181 bpm max and averaging 176 (I'm 35). Now, 1.5 years later, I do the same exercise (with a lot more strength) and hit 156 bpm average, 176 max. If I halt for 10 seconds (phone ringing), my bpm plummets (150 or even 148) and it's hard to bring back. On top of that, I have to be more careful not injuring myself: my muscles are a lot stronger, so if I use all my strength in an attempt of pushing my bpm, I can hurt my body.
I feel terrible with HIIT either way, which means it does work
Were you completely sedentary before starting?
And I mean, psychologically, the feeling of nearly dying would have been enough to scare me off any exercising had I started with that. Being able to push yourself physically, and enjoying it, is a skill that needs to be learned gradually for most people.
I was completely sedentary for 2-3 years. I did practice intense sports over the year and I already had experience with sedentary/active lifestyle changes, so I'm familiar with the "throw up" feeling. That goes away in a couple of weeks.
My mother did always describe to me the feeling of being exhausted after sport as a pleasant one, so I do perceive it as pleasant.
The reason why I hate it is because I could be doing something enjoyable. I tried looking for sports that I actually enjoy but I found only windsurf, which is highly impractical, expensive and very time consuming. I'd rather spend that time with my kids, my wife, playing board games and playing videogames.
I remember reading something about Tabata/HIIT being something you don't want to do every day, due to the high intensity and strain on your CNS. Is this not the thinking anymore?
The original experimental protocol was "only" four days per week, so it was never suggested to be an everyday thing. The extreme thinking among runners is probably three days per week of short intervals or repeats. The more conventional thinking is more like one day per week with a much higher volume of easy zone 2 running on the other days.
wow, never knew what Tabata meant back in my crossfit days :)
Now i do -- its a persons name
system > goals
Yep. I hated running when I made it an option. The mental struggle around whether to run today took up many brain cycles. Now, I run weekday mornings. Tired? Go run. Don’t feel great? Go run. Busy day ahead? Go run. Read an article about the optimal workout routine in mice aged 25-35? Go run. Routine sucks until it works, and then it’s great.
I don't know if it works for everyone, but for me I tell myself "you HAVE to go for a 1 minute run, then just see how you feel" and every time I just end up doing a decent run anyway.
Yes! I do something similar. I tell people I don’t have a running habit.
I have a getting out the door in the morning with my running shoes on habit.
Whatever happens after that is a bonus. The goal is to just step outside in the morning ready for a run.
I do something similar, I gave my body "no option" to skip a workout session. If I skip, I did 2 workout sessions the next day. I hated it, still hate it, but my body now sees it as work and it's committed to doing it.
I still hate it though, but it doesn't take as much effort
For me, this would lead to growing to hate running and stopping to do it entirely. Especially when life is stressful and overall sux, strong "irrational" rules are first I end up resented. Irrational as in "this adds one more time consuming chore to already sucky life".
I got myself injuries from overtraining for not listening to body already twice. And I was not fit or competitive, anything like that. Just physically average person being more ambitious then is reasonable.
Yeah I would say in general habits are the most powerful force in health. Finding an activity you enjoy is 1000x easier to stick with than anything that feels like a grind.
Same thing for food. Trying to switch to a healthier but difficult diet wholesale fails essentially always. But what's relatively easy is finding a healthier alternative to one single thing you eat regularly, that you like just as well. This takes some experimenting, but is usually doable. Then once you've gotten used to the healthier option it becomes automatic.
Then you can replace a single other food, and so on. I think that gradual and sustainable are the most important things to focus on for most people looking for general health improvement.
I'd love a replacement for Salami and Bacon. I don't think there is a healthy alternative that comes close.
tabata is the worst, i've tried and i was not feeling well for hours
Add travelling and dress/undress time and you got an extra 15-30 minutes tacked on
This is what everybody seems to overlook. Gym is usually 15 minutes, add shower and dressing/undressing, the total can easily add 1 hour. I'm so glad I have a gym under my building, because with 30 minutes workout I usually waste an additional 15 minutes (shower, change)
That is why I got more equipment to home. I don’t have space for much but pull up bar and stationary bike is enough - for many that’s already a lot.
Bike is getting dusty but pull up bar is great for “well I am passing by, let’s do 3 reps”.
How much more evidence do we need, that exercise is good and any amount is better than none?
Well, I personally do not.
I was about to be put in blood pressure medication. Then I started a gym, with a trainer. I noticed that, after the exercise, blood pressure would immediately drop and stay low for a few hours.
Over time, the amount of time it spent lower than average increased, and it got lower and lower. It crossed 24h.
Now? I can go to the gym Mon/Wed/Fri and it will remain low at all times. I did stop for a couple of weeks and it started creeping back up so it's not a 'cure', but functionally, as long as I keep it up, I have normal BP.
I still have some weight to lose, that can further help things, most likely. And removing sugars also did help since I dropped a lot of liquid I was retaining.
Great that you have the time to do it. I just cycle the children to kindergarden and then to work everyday. I am lucky to fit in one evening of sports every week. Plus owning no car saves lot of money. I guess I am quite lucky.
That is how I do it too. I don’t have time for much dedicated exercise with a full time job and two small kids, but cycling allows me to get a decent amount of exercise every day while saving both time and money. (And about time, if you work in a city and have less than a 10 km commute, cycling is almost always faster during rush hour. )
That’s amazing. How did you regularly monitor your blood pressure?
I would guess that they did it using a blood pressure meter. That's how I do mine. They are cheap and reasonably accurate. Mine is from Omron, very similar to the one my doctor uses.
Presumably with a blood pressure monitor?
And it could skyrocket for example if you get into a stressful situation. And you wouldn't notice that you are over 180+. And one day you get a stroke and become paralyzed. Sure, do not take the medication. These exists since the 40s, there is nothing wrong with them.
The point is that exercise can remove the underlying problem. And those who stay active enough don't develop it in the first place. Doc was amazed that I wasn't on any maintenance meds at 55. (Since then I've gone on blood pressure meds but if other health issues were resolved I don't think I would need them.)
Anybody can spike to 180 in a sufficiently stressful situation. (And, personally, I would very much notice 180. Otherwise calm, I'll probably notice 140.)
Do you have a well-regarded source that recommends taking medication for blood pressure that is well-managed by exercise and diet?
Do you have experience living with high blood pressure for 20+ years? Have you ever experienced blood pressure spikes and the after effects in stressful situations?
The doctors will remove medication when the blood pressure goes down. You are literally supposed to take them only when the pressure is actually high.
Don't they remove it/lower the dosage when your BP is below 120/80?
regular exercise + healthy diet / weight >> any medication you can take...
With the caveat that I'm just a random non-expert on the internet who has nevertheless spent too much time reading scattered studies and scholarly opinion articles:
We don't need "more" evidence exactly, but rather a better model of how the effects of exercise map to a given individual's physiology. Exercise is good overall, but it's also considerably overhyped due to a procession of weak and narrowly-applicable results being misconstrued as adding up to a massive pile of benefits that applies to the average person. In reality, the average person does not get anywhere close to the sum of all the touted benefits; they get some constellation of some of the benefits, while other outcomes are flat or even regress [1].
So yes, "exercise is good" at a sufficient level of abstraction, but it's much harder to make the case that it's "good for [specific outcome] for [specific person]". Which is one reason that it's such an obnoxious trend for specific health complaints to be met with generic recommendations to exercise (or exercise more, or exercise differently).
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC6818669/
It seems a bit silly to me that in many circumstances it's just way more acceptable for exercise to be zero part of your life than the reverse, and that an argument needs to be made for geting more than even 30 mins worth of movement in a week. A culture of getting exercise by default seems like the way things should be, and the should be an affordance for those who can't rather than a luxurious escape from not having to.
It's not as true in some places in some circles, but it's hard not to notice a difference when you temporarily visit the others.
I think you're right overall, but a lot of that is an unexamined reaction to a built environment designed for motor vehicles, rather than being designed for humans. In suburban America, it too often doesn't occur to people to walk even modest distances, and when they decide to try, the experience can be scary considering that they're likely to interact with inattentive truck/SUV drivers while crossing intersections. If I just crossed the major intersection on the way to work without being paranoid about vehicle traffic, I'd probably be wheelchair-bound by now.
Until society has better work-life balance to allow for exercise while allowing for cost effect doctor visit to assign supportive and recognized improvement. Cheerleaders are more useful then people think.
This is a big problem in the UK I think. The idea of having a regular checkup with a doctor is unheard of and will get you some weird looks if you ask for it.
The NHS doesn't seem (as an outsider looking in) to do well with preventative care. I firmly believe (without necessarily a lot of evidence) that if we focused more on healthy lifestyles and made them more cost effective for people the amount of money we plough into the NHS every year could be reduced drastically.
I suspect that regular check-ups for most people would simply regularly confirm what they already know: they need to lose weight, stop smoking, take more exercise, eat more fruit and veg.
The UK now has a sugar tax on soft drinks that seems to be having a measurable positive effect. Whether it is a meaningful effect remains to be seen though:
"The findings suggest that a year after the sugar tax was introduced, adults reduced their daily free sugar intake by about 10.9g, and a reduction in soft drinks accounted for over half of this reduction. This translates to a reduction of around 40 calories daily, which if maintained, and assuming no other changes, could lead to 1.5kg weight loss over a year."
https://theconversation.com/how-do-we-know-the-uks-sugar-tax...
So perhaps instead of exhorting people to do better the state should continue to try to make bad habits more expensive and good habits cheaper.
Yes a regular check-up wouldn't be the silver bullet but it would help expose larger problems under the surface which could be prevented with prescribed exercise, diet, etc.
Ultimately it's down to the patient to put in the work but if the NHS focused more on creating community practices where these things could be more widely available then maybe we should see more meaningful change.
Yes, Cheerleading is great exercise and the population would probably be healthier if everyone did it.
Cheerleading is actually incredibly dangerous with the number of catastrophic spinal or brain injuries exceeding the combined totals of all other female sports. https://www.nytimes.com/2024/10/22/magazine/cheerleading-jef...
Interesting article. I hadn't considered the injury aspect.
More
The detail is in how regular are the exercises? Doing one hour at end of day after sitting 8 hr straight is worse then spreading it out.
Of course doing 1 hour a day is better than nothing but it may not be effective
This could get far more mileage with people by saying "activity" instead of "exercise." It is amazing how much people can get out of a simple walk around the house. Make it out and around the neighborhood, and you start getting absurdly good results.
Agreed. I've always struggled with intense structured exercise. Instead I walk quickly, park at the far end of lots, run up the stairs instead of the elevator, do some jumping jacks while waiting for the microwave, and lots of small things like that and it seems to work. You can get a lot of exercise minutes and increased heart rate out of doing routine activities with gusto. Admittedly, it's not so good for building muscle, though.
You only need a 20ish pound set of weights to build muscle, oddly. Don't even have to spend a ton of time on it. Can do a basic set of curls/whatever while cooking breakfast.
Body weight exercises feel like they should be even easier to do, but realistically are a lot harder. Pushups, are free and can be done anywhere, sure; but are not a place to start at.
> You only need a 20ish pound set of weights to build muscle, oddly. Don't even have to spend a ton of time on it. Can do a basic set of curls/whatever while cooking breakfast.
Eh, you can do almost anything with anything at a sufficient intensity frequently enough that you'll build muscle, and you definitely should, but I just feel like the more important thing is to find a good feedback cycle. Everyone is a little different, some people end up liking calisthenics or climbing or hiking or a combination of them, some people like the gym or free weights at home, but you gotta engage with it enough to have a serious possibility of either feeling results or other rewards, or lack thereof enough to move onto another idea.
If you don't see or feel results at the gym in the first month, if you set yourself up right you might meet someone to chat with and that may help spur you to keep going regardless.
If you don't feel results hiking after your first time, you've at least had an outdoor adventure. You may still have no motivation, try the other idea, go swimming whatever, but there are at least some other qualities present that help reinforce the desire to do the activity.
Eventually, you might find that your new default mode of operation in every other facet of life becomes activity first rather than something to fit in just during breakfast. At that point, it's harder to not work out or get activity than the reverse. 3 days go by and it feels odd that you've not done anything demanding in a while, and although it takes effort, it becomes easy enough to maintain long term after a certain threshold.
I'm using "you" in the general sense here, and otherwise agree with you, I just think the easiest and most private activities tend to reduce your surface area for discovering other ancillary benefits.
A good feedback cycle is good. Agreed on that. A shorter commitment cycle is also good. Gym memberships are particularly tough. You have to have the time for the exercise, no matter where you do it. You also have to have time for the commute to and from if it isn't at a place you were going to be anyway. Which is why I would suggest starting with just basic dumbbells at home. Every day.
This isn't even unique to exercise. Any added friction to doing something decreases the chances of it happening. Is why online shopping goes out of their way to make it easy to buy something. Even if it is something you want.
While I see your point (0 > 1, by definition) I think this sends the wrong message.
You need several hours of relatively strenuous exercise per week. Walking around the neighborhood, or your house, or whatever has diminishing returns. You need to steadily increase load to continue to see results. The body is incredibly good at adapting. People will read your statement and walk around their house twice, sit down, and not move for the rest of the night.
My point is only on lowering the friction to do an activity. The more friction there is to something, the more likely it will get dropped. Such that I'm not aiming to get people to think just one walk will do them for the day. Rather, I'm aiming to get people to realize you don't have to "exercise." I don't know why that framing is problematic for folks. But I would wager money that it is.
Is this really a high bar these days?
Uh, yeah? Note that I'm not claiming people don't do any walking at all. But a lot of people that would easily do another walk around the house before settling down to watch TV will balk at exercise.
FYI, the absolute fastest way to lower blood pressure is to lose weight if you are obese.
Rule of thumb is that your systolic blood pressure will drop by 1 mmHg per 1 lb of weight loss, eventually slowing down to 1 mmHg per 2 lbs of weight loss as you get back down to more normal blood pressure range / weight range.
Source: went from 160/110 to 120/90 in several months by dropping 60 lbs.
Yep, I found weight loss was pretty much the only thing that would drop my blood pressure. Though it didn't drop linearly like you're describing. From 215lb to 180lbs, it didn't really change much at all. Once I got down below 180lbs, it quickly dropped (from ~150/90 to ~120/80) and stayed there. When I slacked off my good eating habits and went back above 180lbs, blood pressure shot right back up to ~150/90. I'm back down again to about 172lbs and clearly get it now, I have to stay here.
Interesting! I wasn't really thinking it was linear, but your example does highlight the fact there's probably a few steady states that the body prefers to operate at.
I've had similar results with blood pressure, although a smaller weight loss (about 30 lbs) and smaller decrease. Another 10-20 pounds to go.
For what it's worth, I'm on a intermittent fast. I only eat between 5pm to 10pm, with no real restrictions on what I eat. I was surprised how quickly weight fell away, and how easy a diet it was to stick to. 'Eat after work' was a simple behavior to adapt to.
People are very individual, and this might not work for a lot of people, but it's doing great for me. I didn't want to spend the rest of my life on blood-pressure drugs.
Isn't that an extreme version of IF?
I think the usual window is 8 hours, so people should first try eating between lunch and dinner, say 12PM-8PM.
A lot of people eat breakfast out of habit, and I found that once I got older, I just stopped needing it. It made me bloated and sluggish. You just don't need that many calories per day when you stop growing or not working in construction.
IF typically starts at 16/8 but 20/4 or 23/1 (One meal a day) variations seem pretty common too. A 5 hour window is not bad because that still gives room to get in 2 meals.
This is true but not the only cause of high blood pressure. It may be worth adding that many people about 1 in 200 have thyroid issues that also raise heart rate and thus BP. There are other causes as well, too many to list. It took me a long time to find some of my causes after losing weight.
I don't deny that reducing overweight is very likely to improve your health, certainly for the obese.
However, high blood pressure and weight are not as simple as one might think.
My friend has had problems with blood pressure since his 40s, but he is not overweight at all and has never been. He exercises at least weekly.
I am 60, at least 15 kgs overweight for the last 20 years (not obese), but my blood pressure is very good. I have always excercised daily, often for 1 - 2 hours, but at low intensity. Nowadays even lower because I have knee problems. Probably lower weight would have helped with those.
While it does appear to work for many, I personally lost about 20% weight or 40lbs, with seemingly zero effect on blood pressure. I do measure it around the same time of the day, same place, nearly same condition... So it is not about inconsistencies of measurement - I had elevated blood pressure for as long as I remember. My BP does respond to exercise (or more likely to body heating up) for short period of time, and to meds, but meds make it very inconvenient since I have to plan it around my day - having meds and working on something outside in Texas heat = too low BP.
Achieving five minutes of daily exercise is easier than dropping 60 lbs. Nice work though
I relied heavily on extended water fasting (3-7 day fasts). It's both easy and hard, easy in the sense it doesn't take any extra work to lose weight, but hard in terms of dealing with cravings/discomfort.
Achieving five minutes of daily exercise is easier than dropping 60 lbs.
I love hearing stories like this, well done.
I have a neighbour who's in his 60s. Blood pressure was of the charts while in his 40s. The guy was cycling to work everyday (and thought that was enough exercise) and was living a stressful family and work life.
Doctor never prescribed any drugs but told him that he had to start exercising. Signed up for judo class. He couldn't believe the amount of exercise he got from the warm up alone. Been doing judo 3 days a week for 20 years now. Haven't had any heart or blood pressure issues since.
And here I was, thinking my daily cycling would be enough. It's not. I've been cycling all of my life, cycling daily and I'm still categorised as obese according to all weight to height ratios.
My long term avg blood pressure varies with weight. It's lower when I lose weight, higher when I gain weight.
I guess generalising health advice isn't necessarily useful. Health advice should be tailored to individuals, instead.
My take on exercise is that our bodies are really good at efficiency. Cycle daily for the same general distance and effort and eventually you are completely attuned to doing that, meaning what used to take a lot of effort now simply doesn't. Maybe increasing intensity or distance or just starting something new along with it would help.
There's no way around getting having the nutrition part figured out too, meaning you need to stop eating like crazy. Saying this from a personal account, where I went down from 20% body fat to 13% in just 3 months and saw various health metrics improving.
It sounds like diet might have worked in this case.
Magnesium will lower your blood pressure, just take magnesium. The crazy thing is the diuretics that are prescribed to lower blood pressure cause magnesium deficiency.
Garlic will also lower your blood pressure: https://www.examine.com/conditions/high-blood-pressure
true but at a heavy cost
Or just exercise a more normal amount.
My anecdote is that my BP was typically around 135/90. I started exercising regularly and now it's usually around 115/75.
Exercise has changed my life for the better. I'm not a fit-geek but 20 minutes of light running really helps me clear my head
"Could" is an interesting choice of word. I know researchers are cautious but that wording makes it meaningless.
Getting a little beyond the headline, we find they had people wear blood pressure monitors and accelerometers and concluded:
> More time spent exercising or sleeping, relative to other behaviors, was associated with lower BP. An additional 5 minutes of exercise-like activity was associated with estimated reductions of –0.68 mm Hg (95% CI, –0.15, –1.21) SBP and –0.54 mm Hg (95% CI, –0.19, 0.89) DBP. Clinically meaningful improvements in SBP and DBP were estimated after 20 to 27 minutes and 10 to 15 minutes of reallocation of time in other behaviors into additional exercise. [1]
[1] https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.0...
Somewhat related is Betteridge's law of headlines:
> Any headline that ends in a question mark can be answered by the word no. It is based on the assumption that if the publishers were confident that the answer was yes, they would have presented it as an assertion; by presenting it as a question, they are not accountable for whether it is correct or not.
I like to swap out any of these maybe-headlines with the exact opposite. It may help us, or it may not.
https://en.wikipedia.org/wiki/Betteridge%27s_law_of_headline...
From the article:
> Just five minutes of activity a day was estimated to potentially reduce blood pressure, while replacing sedentary behaviours with 20-27 minutes of exercise per day, including uphill walking, stair-climbing, running and cycling, was also estimated to lead to a clinically meaningful reduction in blood pressure.
Sounds like 5 minutes of exercise is where it has a statistically significant measurable impact in blood pressure, but 20-27 minutes is where it's a meaningful impact.
Quite. "5 minutes of exercise a day could raise blood pressure" is equally accurate.
The headline is about a study that showed increased activity was correlated with decreases in blood pressure.
So, no, it's not equally accurate to say the opposite is "equally accurate" unless we're playing pedantic games where we ignore the study and pretend it's all just meaningless words.
That is what we were doing. We were complaining about the use of the word 'could'.
GASP, exercise is good!? No way. The hard part is finding time and having the motivation. Particularly the latter. There's constantly about 49 other things that feel like they need doing more than purposely exercising and wearing myself out even more than I'm already worn out.
The greatest misconception about exercise is this "if you're tired your best course of action would be to abstain from the thing that will make you more tired" train of thought. Exercise doesn't always work like this. Yes you'll have bad days, but you'll find yourself more energised most of the time and mentally more at peace. Thinking it will make you more tired can often be just a preconception.
It's like that classic sedentary worker ailment of the sore back. Many people take this as a sign to rest more, but these types of issues are often caused by weak musculature and the best thing to do is start resistance training. Obviously not a blanket solution, but one that definitely seems overlooked.
> Exercise doesn't always work like this. Yes you'll have bad days, but you'll find yourself more energised most of the time and mentally more at peace.
Is there anything that will convince you this isn't true for all (perhaps not even most) people?
The right type of exercise matters. I've often gone on bouts of cardio on a treadmill for months at a time (multiple times a week - at least 30 minutes each session). It never ceased to suck.
I can do a hike and never feel bad. But a treadmill or cycling device? Always feels bad. I hope it benefits me in the long run, because it definitely reduces the quality of life on days I do it.
My only real hope is to find some other kind of cardio that doesn't annoy as much.
Exactly. It always seems weird to me that "going to the gym" is virtually synonymous with getting some exercise when the gym is the most boring place to do exercise.
Can you watch anything fun while doing your cardio? I look forward to working out because that's when I catch up on my Netflix shows. There's no way I'd stick with it if I didn't have something to take my mind off the grind.
I listen to podcasts. Boredom is not the problem.
BeatSaber maybe? Something addictive is better even if it is less effective. I also do FitXR, which is more effective, but requires more of a grinding mindset so I often mix it with BeatSaber, which doesn’t grind.
I would experiment at least, there are things. A good instructor in an aerobics class can also help, although I find that too hit or miss to be sustainable.
Thrill of the fight is such a great game for excercise. You want to knock down your opponent so you can get really into it.
Ya, but it requires lots of space I think? Anyways, there are fun options if you don’t want to grind.
I've been a runner of some sort most of my life. Raced other kids around the block when I was 6. Sprints back and forth across the field in middle school. Four years of cross-country and track in high school. Two state championships. Joined the Army as an adult. Hit a snag with spine injuries in my mid to late 30s, but back on the wagon and running 50+ miles per week in my mid 40s.
At every point in my life, including right now, I would agree 100% that a treadmill and stationary bike suck and I would not do those.
> best thing to do is start resistance training.
Doing so very carefully!
I will agree though. Before going on a long cross-state bike trip, I had some back issues and was cramming in work (too much sitting). I went out with lower back pain, resolved itself after a few days of riding for most of the day.
I very much agree that counter-intuitive behavior is often what is called for. The exercise or sedentary habits are habits. They really become normal one way or the other quite quickly.
possibly counter to intuition, I find that since I have started to religiously use my stationary bike in the morning, I have a lot more energy for the day, not less. I suppose if you're butting up against caloric/nutrient limits you might suffer. I personally find exercise clarifies my thoughts and improves my mood, even if its the last thing I want to do when I do it.
The mind-body connection is quite real. Improving your physical state will almost certainly have a non-zero improvement on your mental state. Exercising can really help you make sense of all those other things you have going on. Not to mention that being in shape and strong makes every physical thing you do easier.
Figure out how to get entertainment in the form of audio, like Youtube debates or audiobooks, so then exercise is simply multitasking.
Youtube debates sound like a way to raise blood pressure immensely
There is trump vs harris; or vi vs emacs. One will raise blood pressure more than the other.
Especially when you discover that Trump uses Emacs, and Harris uses vi. No wonder she lost the election. Trump simply typed M-x win-election.
I'd recommend trying without the entertainment too. Boredom can be good, letting your mind wander can be fun, or simply focusing on the current task and your body's experience can improve the experience.
> The hard part is finding time and having the motivation.
As I've said here several times: the best exercise is the one you'll stick with over the long haul.
Put another way: anything you'll still be doing in 2026 is better than anything else you'll quit before next Memorial Day.
Agree. Anything that is done over the course of one week or one month is pretty meaningless. When starting training, the only thing a person needs to do is to do anything. Just get out there, build consistency. That is the very first goal. Timings, intervals, HR monitor, those are all well past the point of consistency. The other side of the coin, the accumulation of training/activity over long time is what matters. Those that work on larger projects learn this, some things you can't just cram the night before. It requires hundreds of hours of sedentary or active living, hundreds of meals, for effects of a good or a bad diet (or active/sedentary lifestyle) to be realized.
>The hard part is finding time and having the motivation.
Motivation certainly, but if we accept the results of the study, you really don't think you can find 5 minutes of time in your day to walk up some stairs or do some jump rope?
If you live in an area with decent infrastructure, cycling to and from work is a great way to get exercise in without sacrificing much time (in some cases you even save time)
It actually shocks me that someone could manage to regularly go a day without even exercising for 5 minutes.
The car centric lifestyle seems like such a prison.
At that point if you don't walk 10k+ steps a day nor lift weight every other day you can't say you care about your long term health.
But my blood pressure is already too low, though I barely exercise.
For anyone over 60 I recommend 3 sets of full squats before bed for a good night's sleep and strength for hill walking and climbing stairs.
I'm not over 60, yet, and I feel there are likely many, myself included, who don't know what a "set of full squats" is, exactly.. when you recommend such things could you at least say what that is thanks?
A "set" probably refers to 5 or more repetitions per set, so 3 sets are 3*5+ repetitions of squats. A "full" squat probably means to go so low that your butt goes below your knees.
How does 3 sets of 5 differ from 15?
the research metric I'm interested in is "if you exercise for 5 minutes, you should expect to live 1 minute longer" and I would look at that and say "so I lost 4 mins? no thanks"
but if it ever comes out with a surplus, I'll turn on a dime (and turning on a dime for 5 minutes a day probably lowers blood pressure)
You need to consider quality of life too. Maybe you only gain one minute, but you'll age much better with a habit of exercise and stretching.
your point gets made over and over and over, I get it, health nuts have a list of things that they think are healthy.
My point, that there's a cost to all this that might not get repaid, is a fresh take that you never see unless you've read one of my other comments making the point.
This research exists. This study [1] suggests a 2.7 year increase in life expectancy. Doing some math, 5 minutes per day for 80 years is around 0.2 years.
So sure I might have gone fishing a bit to respond to a random HN comment but the data is out there and you have a brain.
[1] https://pubmed.ncbi.nlm.nih.gov/9794712/
If you are waiting for studies that perfectly model every variable before you spend 5 minutes walking, you are unlikely to be satisfied within your rapidly decreasing lifespan.
I really don't think "walk briskly for five minutes a day" is a health nut thing. That sounds more like the advice your doctor gives you when she knows you won't do anything a health nut says.
> that might not get repaid
This is the part that we know is false. The benefits outweight the costs. But fine, suffer if you want.
it would be more like: if you exercise for 5 minutes, you should expect to live 1 day longer
NHS cardiac rehab videos on YouTube are quite good too. More like 20 min though.
I thought blood pressure is at first order an effect caused by too much sodium.
See also https://www.examine.com/conditions/high-blood-pressure
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some people just have a bad genetic soup and do exercise and diet and such and still have hbp well beyond the numbers designated as meaning "high" ultra high etc I didn't see any hard numbers of reduction in the article either, I've read that smoking raises bp by 5-10points which is largely marginal when you look at how inaccurate most bp readings are. I'm skeptical in this selling environment we live in that this isn't all just to sell drugs to people for their whole lives, these are the same people who want to decimate human populations btw
5-10 points isn't marginal just because there is measurement variance to account for. And just because there's variance doesn't mean you can't fuzz out real numbers. It's like thinking you can stop a timing attack with sleep(random()).
I'd be very skeptical of defending something like high blood pressure. People do the same with high cholesterol. It's a bunch of cope and wishful thinking that they're very different from everyone else who gets heart disease, our #1 killer.
There was a point in history where medics were not aware of concept of “normal body human temperature”.
Then somebody took a sample of people, and measured their body temp and also asked if they were feeling well.
Average among those who felt well was 36.88 °C (98.38 °F) and that was declared normal. (Then in geneal education books it was rounded+shifted and any variation found by the study forgotten)
I found it quite interesting, because I knew normal temp value whole my life, but never even stopped to think where it came from. (I guess in passing thought I imagined that this value was fundamental constant of the universe derived from quantum physics)
My conclusions:
- Studies by necessity are performed on groups on people.
- when it comes to healing an individual, medical knowledge is huge and complex network of rules of thumb (that work on average but there is no such thing as whole medicine field tailored for you)
- there is no better way (listening to your doctor is a good idea)
Except those two don't really matter when predicting heart attack or stroke risk. HRV results, EKG results, labile hypertension; these are the indicators of whether or not you're at a risk for a heart attack or stroke. Getting a regular stress test is more important than blindly throwing anti-hypertensives at someone who may not need them in the first place.
My smart ring detects if there are potential arrhythmia, same with the Apple Watch. Wearables are far more effective at determining heart attack risk than measuring blood pressure which fluctuates in correspondence with your circadian rhythm.
> Except those two don't really matter when predicting heart attack or stroke risk.
Some cursory googling leads to recent research showing that they do: "According to new research, both high systolic and high diastolic blood pressure can lead to heart attack and stroke." [1]
> HRV results
I feel there is hype over HRV. Mainly a new thing that watches and other monitors can measure, and the number is being hyped. That put aside, the sources I've listened to have concluded that HRV is not really that valuable. Do you know of research showing otherwise? (grant it, some research is good here, for most things medecine and science there needs to be a lot of research. My impression there is a lot of research around blood pressure, thus I am not digging out more sources to show the counter-point).
[1] https://www.medicalnewstoday.com/articles/325861