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How much exercise is optimal for heart health?

Doing as little as 15 minutes a day can make a difference. Logging extra time helps—but only up to a point.

Regular exercise helps fend off high blood pressure, heart attacks, strokes, and a host of other chronic diseases. Despite these well-publicized benefits, most Americans aren’t physically active on a daily basis. One reason may be a mistaken belief that exercise requires heart-pounding exertion and sweat. While that level of effort makes sense if you’re training for a race or other athletic event, it’s simply not necessary if your main concern is staying healthy.

“Unfortunately, most people have blurred the distinction between exercising for health and well-being and exercising for fitness in an athletic, competitive sense,” says Dr. Harvey Simon, associate professor of medicine at Harvard-affiliated Massachusetts General Hospital. “The truth is that if you’re exercising for health, it takes very little effort to see enormous benefits,” he says.

An antidote to the aerobics craze

The aerobics craze of the 1970s and ’80s may be partly to blame. In 1968, the “father of aerobics,” Dr. Kenneth Cooper, developed a simple way to measure a person’s oxygen uptake, which led to studies of oxygen-requiring (aerobic) exercise such as running, swimming, and the like. Subsequent research showed that boosting oxygen uptake through repetitive, vigorous exercise could increase aerobic fitness. Higher aerobic fitness translates into better athletic performance and a lower risk of cardiovascular disease.

Dr. Cooper’s doctrine inspired the few but discouraged the many, says Dr. Simon. “There are people who say, ‘I can’t keep my heart rate up—that’s too hard for me. So why bother doing anything?'” While Dr. Simon himself was among the inspired (he’s completed 70 marathons), his efforts to encourage his patients to run often failed. But as evidence for the health benefits of moderate exercise accumulated, he switched tactics. During his 34 years as a primary care doctor, he persuaded many of his patients to start walking, and the benefits were often striking. People lost weight, their blood pressure dropped, and so did their cholesterol readings, he says.

A longer, healthier life

In a recent article in The American Journal of Medicine, Dr. Simon reviewed current research on the health effects on both ends of the exercise spectrum, from minimum to maximum. Modest activity—even as little as one hour of walking or gardening per week—was linked to lower rates of heart attack, stroke, and death from all causes, according to an analysis of 22 studies that included more than 320,000 adults. One found that people who did moderate exercise just 15 minutes a day tended to live an average of three years longer than their inactive peers.

While more exercise is even better for your health, the benefits plateau beyond 45 to 60 minutes of daily moderate exercise. Do more exercise if you enjoy it, but from a health standpoint, there are diminishing returns after the first hour, says Dr. Simon.

The other end of the curve

Is there any danger from doing too much exercise? On this matter, the research is reassuring. In one study, researchers tracked more than 660,000 people from the United States and Sweden, using the current U.S. exercise guidelines as the minimum recommended amount of weekly exercise (150 minutes of moderate or 75 minutes of vigorous). Compared with people who didn’t exercise at all, even those who did less than the minimum amount had a 20% lower risk of dying during the follow-up period, which lasted an average of 14 years. Those who did double the minimum amount lowered their risk by 31%, and those who did three to five times the minimum had a 39% lower risk. Beyond that, more exercise didn’t earn any additional survival benefits. But there was no evidence of any downside—even at levels 10 times more than the minimum.

In addition to believing exercise is too hard or sweaty, many people say they don’t have the time. But if you go over your daily routine, you can usually a find a way to add in few short walks or flights of stairs, says Dr. Simon. Aim for a daily goal of 30 minutes of moderate walking (see “What do we mean by moderate?”). But you can do it in increments of 10 minutes and at whatever pace suits your body. To those who say they’re too busy, Dr. Simon quotes Edward Stanley, the Earl of Derby, who in 1873 said, “Those who think they have not time for bodily exercise will sooner or later have to find time for illness.”

What do we mean by moderate?

Exercise intensity levels are very subjective and affected by your current fitness level, but these descriptions will give you a sense of the different levels. Brisk walking is great, but walking at a moderate pace will also reap health rewards.

Type of walking

Pace

How it feels

Intensity

Easy

Leisurely stroll

Light effort, breathing easily; you can sing

Light

Moderate

Purposeful, like you have some place to get to

Some effort, breathing more noticeable; you can talk in full sentences

Light to moderate

Brisk

In a bit of a hurry

Moderate effort, breathing harder; you can talk in full sentences but need to take more breaths

Moderate

Fast

Late for an appointment

Hard effort, slightly breathless; you can talk in phrases

Moderate to vigorous

Posted by: Dr.Health

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