To judge by social media, unless you’re in your 20s or 30s and young, fit and beautiful, and doing 10,000 steps a day, sea swimming weekly, having cold baths and saunas, sweating profusely while lifting your body weight above your head 50 times a minute – and pushing through the pain – exercise is not worth it.
No pain, no gain we are told. But that’s absolute rubbish. And a dangerous mantra at that, putting the rest of us off exercising. Which is bad news for our health – and the health of the nation.
Because even a small amount of exercise is the most effective drug we can all take.
Every week there’s another report about what our health service needs: more doctors, more scanners, more hospitals, more tests. They’re presented as the answers to our nation’s health crisis; the long waiting lists, the overcrowded A&Es and the rising sickness in the working population.
But they’re not the solution. Yes, they matter, but they just treat the symptoms of a much deeper problem.
Crucially, what I’ve never seen is a push for the one single test that is, without question, the most powerful predictor of future ill-health.
It is a test that doesn’t involve blood being drawn or being put through a scanner – it doesn’t even need to happen in a hospital.
It’s a test as simple as this: can you exercise to the level expected of someone your age?
Even a small amount of exercise, such as walking, is the most effective drug we can all take
Around 6,000 to 7,000 steps a day appears to be enough to keep blood sugar and cholesterol in check, improve circulation, reduce inflammation and preserve muscle and bone strength
In your 30s, you should be able to run 5km in under 30 minutes and manage around 30 good press-ups in one go. In your 40s, can you jog 5km in under 35 minutes and do 20 press-ups? And as you enter your 50s and 60s, you should be able to walk briskly for three or four miles and do around ten press-ups. After 70, the most predictive medical test of all: can you walk for half an hour without getting out of breath?
Because if you can, and regularly, the chances of you living a long, healthy life are so much higher.
When it comes to exercise, we’ve allowed the conversation to be hijacked by the wrong people, pushing the ‘exercise until you drop’ philosophy.
But the fact is the people who benefit most from exercise are ordinary people. Those in their 40s and 50s, approaching retirement, semi-retired, or already there.
And now two compelling new studies show that for the un-Adonis-like, small amounts of movement – a bit of walking, some light resistance work, anything that gets the heart rate up – make a huge difference.
As you age it helps keep your independence, your balance – and your health.
In the first study, by Harvard University, published last month in the British Journal of Sports Medicine, the walking habits of more than 13,000 healthy women in their 70s were analysed (based on data from a motion-tracking device they wore for a week).
Eleven years later, the results were striking: those who managed around 4,000 steps a day, even if they only achieved that one or two days a week, were 26 per cent less likely to die during the study period – and 27 per cent less likely to develop heart disease – than those who did less.
If they managed it on three or more days a week, their risk of dying over the next decade fell by around 40 per cent. These weren’t athletes. These were ordinary women who were walking to the shops, walking round the garden, or going out with friends.
The sweet spot seemed to be about 6,000 to 7,000 steps – the equivalent of a brisk 30-minute walk – on most days. Beyond that, the benefits levelled off.
And, crucially, it didn’t matter whether those steps – 4,000, 6,000 or 7,000 – were spread evenly across the week or crammed into one or two days. What counted was the total movement (i.e. if you walked 49,000 over the week, you got the maximal benefit).
Researchers think this ‘sweet spot’ reflects how the body adapts to moderate, consistent movement. Around 6,000 to 7,000 steps a day appears to be enough to keep blood sugar and cholesterol in check, improve circulation, reduce inflammation and preserve muscle and bone strength.
Beyond that, the benefits start to plateau because many of the key physiological systems – such as the heart, metabolism and vascular function – are already operating at their healthiest range. More steps aren’t wasted, but they don’t add much extra protection.
What that means is extraordinary. It shows that you don’t need to hit the magical 10,000-step target drilled into us by fitness trackers and adverts (which was never scientific – it came from a 1960s Japanese pedometer called the Manpo-kei, which literally means ‘10,000-step meter’: the company chose it because the Japanese character for 10,000 looks like a person walking).
The second recent study, by Fujian Medical University in China, looked at strength training for older adults with ‘cognitive frailty’ – people whose bodies and minds were both starting to slow.
Half were given a simple exercise programme, three times a week – 40 minutes doing a mixture of seated and standing exercises, such as arm curls and leg lifts.
After just three months, the difference was remarkable, reported the journal BMC Geriatrics. Compared with the control group, those who took part in the programme walked faster and performed significantly better on tests of memory, attention and processing speed. They also reported feeling stronger, more confident and more independent.
This isn’t magic. It’s biology. Every time you move, your muscles contract and release tiny chemical messengers called myokines. These travel through your bloodstream to the brain, where they calm inflammation, help brain cells repair and even form new connections.
One of them, irisin, also helps turn white fat – which stores energy – into brown fat, which burns it.
Exercise doesn’t just make you fitter. It gets your blood flowing, keeps your sugar levels steady and quietens the background stress that wears your body down.
We sometimes talk about exercise as though it’s a lifestyle choice. It isn’t. It’s a biological necessity. The body expects and needs exercise – both aerobic (walking and jogging) and resistance training (such as doing 20 minutes of weights a day). And when it doesn’t get it, everything starts to fall apart.
Both of these studies – one on walking, one on resistance training – make the same points: You don’t have to do much. You don’t have to have a gym membership. You just have to move regularly and with purpose.
When I started medical school more than 30 years ago, we were taught that most illnesses were down to bad luck or genes, and that the solution was drugs, surgery or technology.
But after treating thousands of patients, I’ve realised how wrong that was. We can’t test or medicate our way out of problems caused by inactivity.
The crucial test everyone needs to take isn’t another blood sample or CT scan: it’s whether you can exercise to the levels someone your age should be able to – both resistance exercise (i.e. lifting weights) and aerobic, such as running, cycling or swimming.
If you can’t, don’t despair – start slowly and build up.
Those simple tests and a willingness to make the effort to exercise, will determine your health far more than any test or treatment that I, as a doctor, can order.
@drrobgalloway
Diet drinks don’t help obese childrenÂ
Every parent knows how hard it is to get kids off screens and away from snacks. But new official figures from the National Child Measurement Programme (which records the height and weight of children in reception and Year 6) show how serious things have got.
In some parts of England, more than one in three primary school children are now overweight or obese.
The fixes aren’t complicated or costly. They start in school, where every child should do a daily mile (ten to 15 minutes of jogging) before lessons, learn how to cook, and be given proper food. No ultra-processed lunches and no fizzy drinks pretending to be ‘diet’ options. They don’t make anyone slimmer, they just mess with your insulin levels (the body thinks it’s getting sugar anyway) and encourage weight gain.
And it shouldn’t stop when the bell rings. We need fewer fast-food outlets near schools and healthier food made more affordable. If that means taxing the junk to make it happen, then fine. Because unless we tackle childhood obesity, we’ll have a generation growing up in poor health, with poor quality of life, and becoming a crushing burden on the NHS.