Wednesday, December 30, 2009
December 30, 2009, 12:01 am
Phys Ed: How Little Exercise Can You Get Away With?
By GRETCHEN REYNOLDS
Erik Isakson/Getty Images
NYT
Recently researchers trawled through a vast database of survey information about the health and habits of men and women in Scotland, hoping to determine how much exercise is needed to keep the Scots from feeling gloomy (or in technical terms, experiencing “psychological distress”). The answer, according to a study published in this month’s British Journal of Sports Medicine: a mere 20 minutes a week of any physical activity, whether sports, walking, gardening or even housecleaning, the last not usually associated with bringing out the sunshine. The researchers found that more activity conferred more mental-health benefits and that “participation in vigorous sports activities” tended to be the “most beneficial for mental health.” But their overall conclusion was that being active for as little as 20 minutes a week is sufficient, if your specific goal is mental health.
Phys Ed
The question of how much exercise is enough gains special piquancy at this time of year, when many of us dust off last year’s New Year’s resolutions and promise to be more diligent about working out in the coming year. Unfortunately, figuring out an ideal exercise dosage is not simple, in part because the amount of exercise needed depends on the benefits you hope to gain. Twenty minutes a week of vacuuming or other activity may, according to the Scottish study, increase your contentment, but it certainly won’t do much for your cardiovascular fitness and is unlikely to lessen your risks for a multitude of diseases and, ultimately, of premature death, benefits that a greater amount of exercise may provide. It also won’t help much with weight loss. That said, anyone resolving to increase the amount of housecleaning they do in the New Year is welcome to begin their regimen at my home.
In general, a wide reading of the latest sports science makes it clear that the “amount of physical activity necessary to produce health benefits cannot yet be identified with a high degree of precision,” according to the authors of the 2008 Physical Activity Guidelines for Americans report, which was produced by the Department of Health and Human Services and was based on the recommendations of an advisory committee scientists. These experts waded through dozens of studies on the health effects of exercise, looking at the impacts that exercise can have on people’s risks for heart disease, obesity, diabetes, cancer, depression and, in general, premature death. In some studies that were cited, exercise actually seemed to confer little if any disease-fighting benefits. In others, the benefits kicked in only if the exercise was quite strenuous; in yet others, a gentle stroll a few times a week was enough to lessen the risk of early death.
Despite the inconsistent results, caused in some part by even more inconsistent methodologies between the different studies, the advisory committee did ultimately reach some conclusions about how much — or, really, how little — exercise we each should be doing. That minimum amount of exercise required to see a significant lowering of your risk of dying prematurely was, they concluded, 500 MET minutes of exercise a week. Of course, unless you’re an exercise scientist, there’s a good chance you don’t know what a MET minute is. A single MET, or Metabolic Equivalent of Task, is the amount of energy a person uses at rest. Two METs represent twice the energy burned at rest; four METs, four times the energy used at rest; and so on. Walking at three miles per hour is a 3.3-MET activity, while running at 6 miles an hour is a 10-MET activity. The committee concluded that a person needs to accumulate a weekly minimum of 500 MET minutes of exercise, which does not mean 500 minutes of exercise. Instead, 150 minutes a week (two and a half hours) of a moderate, three- to five-MET activity, such as walking, works out to be about 500 MET minutes. Half as much time (an hour and 15 minutes per week) spent on a 6-plus MET activity like easy jogging seems, according to the committee, to have similar health effects.
Interestingly, they did not find that exercise beyond a certain point conferred significant additional health benefits. Instead, the “dose response” for exercise, the committee found, is “curvilinear.” In other words, people who are the least active to start with get the most health benefit from starting to exercise. People who already are fit don’t necessarily get a big additional health benefit from adding more workout time to their regimens. Which is not to say that if you are, for instance, a devoted runner or cyclist, you should reduce your workout time in 2010 to 500 MET minutes per week. You’re already well ahead in terms of health benefits. According to the Physical Activity Guidelines report, “It has been estimated that people who are physically active for approximately seven hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week.”
Whether there might be an upper limit to the advisable amount of exercise is an issue that was not addressed by the group. It hasn’t been directly studied much by science, either, in part because of logistical and ethical barriers; you can’t run people until they drop. But there have been intimations that you can be too avid. As I reported in this column in October, laboratory mice that were made to run to exhaustion were more likely than mice that ran moderately to succumb to the flu. Similarly, a few small but provocative studies of the coronary health of long-time, competitive marathon runners have suggested that their efforts may not, in every case, be doing their hearts good, as I also reported this year.
So what does all this mean as you plan your 2010 exercise routines? First, because “activity affects so many organs and pre-disease states,” according to Frank Booth, a professor in the department of biomedical sciences at the University of Missouri at Columbia, who has extensively studied the health effects of exercise, “any activity is better than no activity.” For those contemplating their first regular exercise routine, consult a doctor before starting, of course. Then, get out and walk, working your way up to least 150 minutes a week. Although not all of the studies under review found health benefits from such relatively light aerobic exercise, enough of them did to support the recommendation of regular brisk walks or other moderate activities. (Moderate exercise, by the way, is defined by the Department of Health and Human Services as activities of between three and six METs, equivalent to about 45 to 64 percent of your maximum heart rate — or in simpler terms, activities during which it is possible for you to talk to a companion but too hard for you to sing the words to your favorite song.)
You do not necessarily have to divide your exercise time into daily allotments, either. Existing “scientific evidence does not allow researchers to say, for example, whether the health benefits of 30 minutes on five days a week are any different from the health benefits of 50 minutes on three days a week,” according to the activity guidelines. Do what suits your schedule. But, Mr. Booth says, do something. “Inactivity is looking more and more like one of the underlying causes of many chronic diseases,” he says. If, he adds, “you want to live to be 100,” which happens to be my New Year’s resolution, “then don’t just sit all day.”
Correction: An earlier version of this post misstated the name of the city in which the University of Missouri is located. It is Columbia, not Columbus.
Phys Ed: How Little Exercise Can You Get Away With?
By GRETCHEN REYNOLDS
Erik Isakson/Getty Images
NYT
Recently researchers trawled through a vast database of survey information about the health and habits of men and women in Scotland, hoping to determine how much exercise is needed to keep the Scots from feeling gloomy (or in technical terms, experiencing “psychological distress”). The answer, according to a study published in this month’s British Journal of Sports Medicine: a mere 20 minutes a week of any physical activity, whether sports, walking, gardening or even housecleaning, the last not usually associated with bringing out the sunshine. The researchers found that more activity conferred more mental-health benefits and that “participation in vigorous sports activities” tended to be the “most beneficial for mental health.” But their overall conclusion was that being active for as little as 20 minutes a week is sufficient, if your specific goal is mental health.
Phys Ed
The question of how much exercise is enough gains special piquancy at this time of year, when many of us dust off last year’s New Year’s resolutions and promise to be more diligent about working out in the coming year. Unfortunately, figuring out an ideal exercise dosage is not simple, in part because the amount of exercise needed depends on the benefits you hope to gain. Twenty minutes a week of vacuuming or other activity may, according to the Scottish study, increase your contentment, but it certainly won’t do much for your cardiovascular fitness and is unlikely to lessen your risks for a multitude of diseases and, ultimately, of premature death, benefits that a greater amount of exercise may provide. It also won’t help much with weight loss. That said, anyone resolving to increase the amount of housecleaning they do in the New Year is welcome to begin their regimen at my home.
In general, a wide reading of the latest sports science makes it clear that the “amount of physical activity necessary to produce health benefits cannot yet be identified with a high degree of precision,” according to the authors of the 2008 Physical Activity Guidelines for Americans report, which was produced by the Department of Health and Human Services and was based on the recommendations of an advisory committee scientists. These experts waded through dozens of studies on the health effects of exercise, looking at the impacts that exercise can have on people’s risks for heart disease, obesity, diabetes, cancer, depression and, in general, premature death. In some studies that were cited, exercise actually seemed to confer little if any disease-fighting benefits. In others, the benefits kicked in only if the exercise was quite strenuous; in yet others, a gentle stroll a few times a week was enough to lessen the risk of early death.
Despite the inconsistent results, caused in some part by even more inconsistent methodologies between the different studies, the advisory committee did ultimately reach some conclusions about how much — or, really, how little — exercise we each should be doing. That minimum amount of exercise required to see a significant lowering of your risk of dying prematurely was, they concluded, 500 MET minutes of exercise a week. Of course, unless you’re an exercise scientist, there’s a good chance you don’t know what a MET minute is. A single MET, or Metabolic Equivalent of Task, is the amount of energy a person uses at rest. Two METs represent twice the energy burned at rest; four METs, four times the energy used at rest; and so on. Walking at three miles per hour is a 3.3-MET activity, while running at 6 miles an hour is a 10-MET activity. The committee concluded that a person needs to accumulate a weekly minimum of 500 MET minutes of exercise, which does not mean 500 minutes of exercise. Instead, 150 minutes a week (two and a half hours) of a moderate, three- to five-MET activity, such as walking, works out to be about 500 MET minutes. Half as much time (an hour and 15 minutes per week) spent on a 6-plus MET activity like easy jogging seems, according to the committee, to have similar health effects.
Interestingly, they did not find that exercise beyond a certain point conferred significant additional health benefits. Instead, the “dose response” for exercise, the committee found, is “curvilinear.” In other words, people who are the least active to start with get the most health benefit from starting to exercise. People who already are fit don’t necessarily get a big additional health benefit from adding more workout time to their regimens. Which is not to say that if you are, for instance, a devoted runner or cyclist, you should reduce your workout time in 2010 to 500 MET minutes per week. You’re already well ahead in terms of health benefits. According to the Physical Activity Guidelines report, “It has been estimated that people who are physically active for approximately seven hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week.”
Whether there might be an upper limit to the advisable amount of exercise is an issue that was not addressed by the group. It hasn’t been directly studied much by science, either, in part because of logistical and ethical barriers; you can’t run people until they drop. But there have been intimations that you can be too avid. As I reported in this column in October, laboratory mice that were made to run to exhaustion were more likely than mice that ran moderately to succumb to the flu. Similarly, a few small but provocative studies of the coronary health of long-time, competitive marathon runners have suggested that their efforts may not, in every case, be doing their hearts good, as I also reported this year.
So what does all this mean as you plan your 2010 exercise routines? First, because “activity affects so many organs and pre-disease states,” according to Frank Booth, a professor in the department of biomedical sciences at the University of Missouri at Columbia, who has extensively studied the health effects of exercise, “any activity is better than no activity.” For those contemplating their first regular exercise routine, consult a doctor before starting, of course. Then, get out and walk, working your way up to least 150 minutes a week. Although not all of the studies under review found health benefits from such relatively light aerobic exercise, enough of them did to support the recommendation of regular brisk walks or other moderate activities. (Moderate exercise, by the way, is defined by the Department of Health and Human Services as activities of between three and six METs, equivalent to about 45 to 64 percent of your maximum heart rate — or in simpler terms, activities during which it is possible for you to talk to a companion but too hard for you to sing the words to your favorite song.)
You do not necessarily have to divide your exercise time into daily allotments, either. Existing “scientific evidence does not allow researchers to say, for example, whether the health benefits of 30 minutes on five days a week are any different from the health benefits of 50 minutes on three days a week,” according to the activity guidelines. Do what suits your schedule. But, Mr. Booth says, do something. “Inactivity is looking more and more like one of the underlying causes of many chronic diseases,” he says. If, he adds, “you want to live to be 100,” which happens to be my New Year’s resolution, “then don’t just sit all day.”
Correction: An earlier version of this post misstated the name of the city in which the University of Missouri is located. It is Columbia, not Columbus.
The New York Times
December 29, 2009
Books
Resilience, Not Misery, in Coping With Death
By ABIGAIL ZUGER, M.D.
Skip to next paragraph
THE OTHER SIDE OF SADNESS
What the New Science of Bereavement Tells Us About Life After Loss. By George A. Bonanno. Basic Books. 231 pages. $25.95.
Poets ramble on at length about mortality, but it was an anonymous World War I lyricist who probably said it best: “The bells of hell go ting-a-ling-a-ling for you but not for me.” We can visualize other people’s deaths, but not so much our own (“For me the angels sing-a-ling-a-ling”).
Unfortunately, this standard psychic defense routinely backfires. We may aim all our fears outward, but then they boomerang back to fill us with terror. When our loved ones die, how will we manage without them? When the worst possible news hits — and it will — how will we survive?
Orthodox psychology has long emphasized the grim slog in store for those who must live without the people they cannot live without. Freud called it “grief work,” a process of painfully severing the emotional ties to the deceased. Elisabeth Kübler-Ross mapped out five morose stages of effective grieving.
But if you actually talk to the bereaved, says George A. Bonanno, you find these classic perspectives are pure — well, Dr. Bonanno doesn’t actually say baloney, but so he implies in his fascinating and readable overview of what he calls “the science of bereavement.”
Just as meticulous observation and experiment transformed astronomy from a compendium of mythology and wishful thinking into a coherent science, the same tools are changing the psychology of loss.
A professor of clinical psychology at Columbia University, Dr. Bonanno has now interviewed hundreds of bereaved people, following some for years before and after the fact, looking for patterns.
His conclusion: the bereaved are far more resilient than anyone — including Freud, and the bereaved themselves — would ever have imagined.
Dr. Bonanno has not written a self-help book in the ordinary sense, but his message winds up being just about as comforting as if he had. Don’t worry, he says. When the worst possible news breaks, you will almost certainly get through it unscathed. Almost everyone does. And if your friends and neighbors mutter that you aren’t grieving normally, don’t worry; you probably are.
In other cultures, Dr. Bonanno points out, it is the ceremonies of death that are the focus of public attention; the community makes sure they are carried out with precision. In our own navel-inspecting society, it is the emotions of death that well-meaning observers focus on instead. Why isn’t that widow shedding at least one little tear? How could the boyfriend be off at the ballgame like that? What is wrong with that bizarrely cheerful orphaned child? Surely they all need therapy.
Not so, Dr. Bonanno maintains. In contrast to the grim slog of Freudian grief work, the natural sadness that actually follows a death is not a thick soup of tears and depression. People can be sad at times, fine at other times. The level of fluctuation is “nothing short of spectacular”; the prevalence of joy is “striking.”
Over all, we are hard-wired to move on, helped by innate mechanisms that may seem maladaptive or abnormal but are actually quite common and effective.
One of those tools may well be the ability to smile through the worst of it. Humans are inherently drawn to comfort sad people, but can seldom tolerate more than a few minutes in the presence of the seriously depressed. The fact that the bereaved can shake it off periodically means that people will willingly stay with them, protecting them from a spiral of self-involved solitude.
Other tools are less convoluted. Almost everyone idealizes the deceased and spends long solitary sessions remembering good qualities, overlooking bad ones. Some talk to the deceased regularly. Some indulge in what Dr. Bonanno calls “ugly coping” — anger at the damn doctors, the damn hospital or the stupid minister’s stupid eulogy can make the bereaved feel better about the loss.
And some realize early on that their lives have actually improved. The consuming worry about incurable illness is over. Old dramas end.
Dr. Bonanno uses his own tense relationship with his father to illustrate this last point: the two were mired in a classic “go to college or get out of my house” situation for many years, long after Dr. Bonanno had grown tired of his self-imposed James Dean role. “It felt to me that I had been living my life as if in a stage play,” he writes.
“When my father died, it was as if the house lights had come on. To my surprise, I found that the theater was empty. Not only was I the only one left on the stage, but I was the only person in the entire theater. I had been acting out a play by myself. I could have stopped at any point, but I hadn’t known it.”
His sadness for his father is continuing — the closing chapters of the book find him burning joss paper in ceremonial Chinese mourning for the old man — but “in fact, my life opened up after my father’s death.” In his view, it is perfectly normal for the two emotions to coexist, with no need to “process” or “resolve” further.
Medical science being what it is, there are undoubtedly rebuttals to Dr. Bonanno’s appealing analysis out there somewhere. But it still makes good reading, a sensitive and sensible view of loss (applicable not only to death, one suspects, but also to lost love, lost opportunity, even lost time) to warm the waning days of the year.
December 29, 2009
Books
Resilience, Not Misery, in Coping With Death
By ABIGAIL ZUGER, M.D.
Skip to next paragraph
THE OTHER SIDE OF SADNESS
What the New Science of Bereavement Tells Us About Life After Loss. By George A. Bonanno. Basic Books. 231 pages. $25.95.
Poets ramble on at length about mortality, but it was an anonymous World War I lyricist who probably said it best: “The bells of hell go ting-a-ling-a-ling for you but not for me.” We can visualize other people’s deaths, but not so much our own (“For me the angels sing-a-ling-a-ling”).
Unfortunately, this standard psychic defense routinely backfires. We may aim all our fears outward, but then they boomerang back to fill us with terror. When our loved ones die, how will we manage without them? When the worst possible news hits — and it will — how will we survive?
Orthodox psychology has long emphasized the grim slog in store for those who must live without the people they cannot live without. Freud called it “grief work,” a process of painfully severing the emotional ties to the deceased. Elisabeth Kübler-Ross mapped out five morose stages of effective grieving.
But if you actually talk to the bereaved, says George A. Bonanno, you find these classic perspectives are pure — well, Dr. Bonanno doesn’t actually say baloney, but so he implies in his fascinating and readable overview of what he calls “the science of bereavement.”
Just as meticulous observation and experiment transformed astronomy from a compendium of mythology and wishful thinking into a coherent science, the same tools are changing the psychology of loss.
A professor of clinical psychology at Columbia University, Dr. Bonanno has now interviewed hundreds of bereaved people, following some for years before and after the fact, looking for patterns.
His conclusion: the bereaved are far more resilient than anyone — including Freud, and the bereaved themselves — would ever have imagined.
Dr. Bonanno has not written a self-help book in the ordinary sense, but his message winds up being just about as comforting as if he had. Don’t worry, he says. When the worst possible news breaks, you will almost certainly get through it unscathed. Almost everyone does. And if your friends and neighbors mutter that you aren’t grieving normally, don’t worry; you probably are.
In other cultures, Dr. Bonanno points out, it is the ceremonies of death that are the focus of public attention; the community makes sure they are carried out with precision. In our own navel-inspecting society, it is the emotions of death that well-meaning observers focus on instead. Why isn’t that widow shedding at least one little tear? How could the boyfriend be off at the ballgame like that? What is wrong with that bizarrely cheerful orphaned child? Surely they all need therapy.
Not so, Dr. Bonanno maintains. In contrast to the grim slog of Freudian grief work, the natural sadness that actually follows a death is not a thick soup of tears and depression. People can be sad at times, fine at other times. The level of fluctuation is “nothing short of spectacular”; the prevalence of joy is “striking.”
Over all, we are hard-wired to move on, helped by innate mechanisms that may seem maladaptive or abnormal but are actually quite common and effective.
One of those tools may well be the ability to smile through the worst of it. Humans are inherently drawn to comfort sad people, but can seldom tolerate more than a few minutes in the presence of the seriously depressed. The fact that the bereaved can shake it off periodically means that people will willingly stay with them, protecting them from a spiral of self-involved solitude.
Other tools are less convoluted. Almost everyone idealizes the deceased and spends long solitary sessions remembering good qualities, overlooking bad ones. Some talk to the deceased regularly. Some indulge in what Dr. Bonanno calls “ugly coping” — anger at the damn doctors, the damn hospital or the stupid minister’s stupid eulogy can make the bereaved feel better about the loss.
And some realize early on that their lives have actually improved. The consuming worry about incurable illness is over. Old dramas end.
Dr. Bonanno uses his own tense relationship with his father to illustrate this last point: the two were mired in a classic “go to college or get out of my house” situation for many years, long after Dr. Bonanno had grown tired of his self-imposed James Dean role. “It felt to me that I had been living my life as if in a stage play,” he writes.
“When my father died, it was as if the house lights had come on. To my surprise, I found that the theater was empty. Not only was I the only one left on the stage, but I was the only person in the entire theater. I had been acting out a play by myself. I could have stopped at any point, but I hadn’t known it.”
His sadness for his father is continuing — the closing chapters of the book find him burning joss paper in ceremonial Chinese mourning for the old man — but “in fact, my life opened up after my father’s death.” In his view, it is perfectly normal for the two emotions to coexist, with no need to “process” or “resolve” further.
Medical science being what it is, there are undoubtedly rebuttals to Dr. Bonanno’s appealing analysis out there somewhere. But it still makes good reading, a sensitive and sensible view of loss (applicable not only to death, one suspects, but also to lost love, lost opportunity, even lost time) to warm the waning days of the year.
