We've reached the point in the year when New Year's workout resolutions and goals to work off holiday sweets-induced pounds have fallen to the wayside. By the time we hit February and March, that initial burst of exercise among the general population most often gives way to a return to our normal routines.
While exercise often gets framed through a superficial lens — like desires to lose weight for appearance or wanting to tone up muscles — that mindset overlooks the most important potential of workouts.
Exercise is medicine.
"I feel like if there was like a magic pill for our health it would be exercise accompanied by good nutrition," says Laura Wambold, who has worked for a decade as a clinical exercise physiologist specializing in cardiac rehab at Providence St. Luke's Rehabilitation Medical Center.
"Beyond thinking of physical activity and exercising as recreation, it absolutely is medicine. In fact, it's the best medicine known to man," says Glen E. Duncan, professor and chair of Washington State University's Department of Nutrition and Exercise Physiology. "Let's say you have high blood pressure, and you take a medication to reduce your blood pressure, that drug impacts the systems that control blood pressure. But it doesn't have major positive effects on other systems in the body. When you do something like physical activity, it affects the entire body."
Studies have shown over and over how beneficial exercise is to our full body health and quality of life. Besides the obvious cardiovascular and strength upsides, Scandinavian studies have shown that being highly fit drastically reduces your chances of developing dementia. Stateside studies have also shown exercise to help slow the declines caused by Alzheimer's and Parkinson's diseases. Carrying less weight can put less stress on one's joints and reduce inflammation. Consistent exercise vastly lowers the risk for diabetes and an array of heart ailments (as Wambold points out, people often forget that the heart is a muscle – one that needs to be exercised). There's also evidence to support the emotional benefits working out can have on one's mental health.
What counts as "exercise"? The generally accepted benchmark is 150 minutes of moderate intensity physical exercise per week, or working out for 30 minutes five days per week. While Duncan stresses this isn't a panacea with 100 percent effectiveness for everyone, it's a goal to shoot for.
It's also important to note that the "moderate intensity" exercise should be approached on a sliding scale. While that might mean something like intense runs or pickup basketball for a younger, fitter person, it could be a brisk long walk or semi-leisurely bike ride for an older one. It's all relative to the individual.
"The three things that we all kind of should be trying to fit in with our lifestyle are cardiovascular exercise, strength training, and then some stretching or flexibility, mobility," says Wambold. "Those are three components of fitness."
So if exercise is the best medicine, why aren't people "taking" their meds?
"To me, the million-dollar question is why people don't exercise?" says Duncan. "The benefits of physical activity are well documented, they have been for, for decades, for centuries. You can go back to historical literature from Hippocrates, and there's comments about the active body being healthy and the inactive body being sick. So it's not a news flash."
But there are plenty of barriers keeping us from realizing the medicinal benefits of exercise. It could be we are simply overwhelmed by work and a busy schedule, family obligations. Maybe we'd rather devote free time to nonactive entertainment options like bingeing TV shows.
Wambold, who previously served as a coach at the Spokane CrossFit-esque Farmgirlfit, emphasizes that planning exercise into one's weekly schedule can help make the workout goals more achievable. And the key to maintaining a health-beneficial workout routine is finding activities you actually enjoy doing regularly.
COVID restrictions have certainly not helped people stay active, when many gyms and indoor workout spaces have been closed or at least risky to attend, but other modern innovations like watches and fitness bands that track steps or YouTube workout programs have made getting on top of your fitness easier. It may seem overly simplistic, but if you hate lifting weights or hopping on the treadmill but enjoy pickup basketball or neighborhood jogs, do those things that invigorate you. From a psychological standpoint, don't devise a workout plan that makes you dread exercising.
Finding the right location to stay active can also boost one's chances for success. Take, for example, the Marimn Health Wellness Center in Plummer, Idaho. Since opening in 1998, it's been focused on providing a variety of fitness options to help keep both Native and non-Native locals active in order to curb preventable diseases like diabetes. And while they offered the obvious exercise options — group classes, swimming, basketball, racketball, and the like — they also tailored programs to the community. One such endeavor was Powwow Sweat, which focused on teaching tribal powwow dances to keep community members active. (Powwow Sweat videos can still be found on The StyleHorse Collective's YouTube page, for those who want to try it at home.)
But perhaps Americans' inability to initiate better medicinal exercise routines isn't a problem that most of us can fix on our own. Some nutrition and exercise scientists like WSU's Duncan think of issues with obesity not as personal problems, but as a large-scale societal issue.
"I have completely moved away from the behavior change model," says Duncan. "That's kind of the classic model for diet and activity studies — you recruit a sample of sedentary people, give them an exercise prescription, and you follow them over time to see what health benefits they derive. We've hit this behavior change nail for decades, and it obviously just hasn't worked."
"The reason it hasn't worked is because we live in an obesogenic environment," Duncan continues. "So an obesogenic environment is an environment that supports poor behaviors. In other words, behavior change doesn't have a chance of working in an environment that doesn't support it. I think we have it 100 percent backwards. And I think this is a uniquely American thing. We're all fixated on the person, you know, pull yourself up by the bootstraps. It's just missing the greater picture. And the stark truth is that the society we live in is not conducive to good behavior change, as we've defined it. At least not for the majority of people."
Duncan and others in his scientific realm believe that placing the burden of health on the individual should be secondary to the ways we construct cities to benefit public health, the policies that mandate food production, and the cost controls on healthy and unhealthy foods. He points to Scandinavian countries that engineer towns with dedicated bike and walking paths away from traffic as a way that other countries foster active lifestyle choices, as opposed to America's car-oriented society.
"I know the car counterargument," he says. "It usually comes from big business and people who are all about individual personal responsibility. 'We need to move cars, and we need to move freight, and we need what's good for business.' But guess what? The other side of the coin is, this is bad for our health. And it's clear with our ineffective medical system, it's just not ... working. We have higher health consumption spending per capita than most high-income countries, yet we have some of the worst health outcomes among those countries."
The societal barriers preventing people from living healthier lifestyles full of exercise aren't just the obvious structural ones either. They can also include things like people being hesitant to go running or biking because of neighborhood safety concerns or not having the leisure time or energy due to lack of child care or having to work multiple jobs to keep up with expenses.
Duncan thinks a good parallel for changing the obesogenic society is actually the way people moved away from smoking cigarettes in the U.S. The behavior change among the large population didn't come just from telling people that smoking was harmful — much as public health experts now hammer away on the points that exercise is good and junk food is bad. It took years of "scene-based" policy changes like warning labels and indoor smoking bans to create an environment that actively discouraged or punished the unhealthy smoking choices. Litigation targeted the tobacco industry. It was change on a macro level, rather than a micro level.
"The greater point is we didn't get people to not smoke by telling them smoking was bad," Duncan emphasizes. "We did a whole bunch of societal shifts."
Consider these three tips to help you include exercise in your daily life
Consistence: We all need to fit in certain components of fitness (strength training, flexibility/mobility, and cardiovascular exercise), but how we fit them in is up to us, so choose activities you enjoy because consistency is key!
Accountability: Stay on track with the support of a workout buddy. You can also turn to technology. Fitbits and Apple Watches are great ways to keep yourself accountable.
Persistence: Workout routines may look different during different phases in our lives and that's okay. Keep moving!
— Courtesy of Laura Wambold