The fittest may indeed survive the longest, according to new research suggesting that physical fitness is more important in death risk than even high blood pressure, high cholesterol or smoking.
The study of more than 6,200 US men who underwent treadmill testing for cardiovascular disease found that the risk of death over the next 6 years declined as exercise capacity rose. This was true of both men with cardiovascular disease and those whose exercise tests were normal.
Exercise capacity was the best predictor of death risk among men with cardiovascular disease. And among all participants, those in the group with the lowest exercise capacity were about four times more likely to die during the study period compared with the fittest group.
Overall, fitness mattered more in death risk than such classic cardiovascular risk factors as high blood pressure, smoking and body mass index.
For instance, a man who had high blood pressure but was among the fittest was about half as likely to die as a man with high blood pressure and low fitness levels.
Findings like this, the researchers write, "confirm the protective role" of exercise, even in individuals with other health risk factors.
The study also showed the less-fit can improve their survival by becoming more physically active.
Current US guidelines for exercise recommend that all healthy adults take up some moderate physical activity for at least 30 minutes a day on most, and preferably all, days of the week. People with cardiovascular disease should consult their doctors about an appropriate exercise plan.
The New England Journal of Medicine March 14, 2002;346:793-801, 852-853
Many of us forget that exercise can be used as a drug, and in the above study it appeared to be even more effective than high blood pressure, smoking or high cholesterol, in predicting long-term survival.
It is also one of the absolute best treatments for insomnia, weight control, and reducing insulin resistance.
When using exercise as a drug, it will be important to have as a goal at least one hour per day, every day. Obviously, depending on one's current condition, one needs to work slowly up to this level. My experience is that weight-bearing exercises, such as walking, jogging, running, Nordic Track, Health Rider are better than cycling and swimming. If you have access to a health club, my favorite piece of equipment there is the elliptical machine.
Cycling and swimming take far longer to produce the same benefit and each have their own problems. If you are cycling outdoors you run the risk of being killed or injured by a motor vehicle. Swimming is usually done in chlorinated pools, which has its own problems. However, if you are able to swim in the ocean, the salt water provides an incredible synergism that far exceeds the value of the exercise.
The practical problem with using exercise in depression is that the desire to pursue any activity, let alone exercise, is not very high. The converse though also needs to be considered. Just because one exercises, that does not mean you cannot become depressed. Exercise makes it easier to treat depression, but it certainly does not cure it in everyone.
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