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Never too late: Exercise helps late starters

The Industrial Revolution changed America forever, and the Information Era has changed it still further. More than ever before, men are working with their brains instead of their backs. It’s great progress, but it does have unintended consequences, including global economic competition and unprecedented levels of stress. Another consequence is diminished physical activity. Now that most men don’t need to exercise to earn their keep, many view exercise as kids’ stuff, the fun and games that fill childhood — or used to in the days before video games and flat-screen TVs.

America has become a nation of spectators. That deprives men of the exercise that improves cholesterol levels, lowers blood sugar, burns away body fat, strengthens muscles and bones, improves mood and sleep, and protects against diabetes, dementia, certain cancers, and especially heart attacks and strokes.

Men who stay physically active throughout life reap these benefits and more. But what about men who slide into sloth once they’re too old for school sports? Can a late start make up for years of sedentary living?

Second chances are rare in this life. But when it comes to exercise, research reinforces earlier studies that tell older men not to act their age.

Starting late in Sweden

A 35-year study from Sweden provides strong evidence that starting to exercise late in life is better than never starting at all — much better, in fact.

The subjects were 2,205 male residents of the municipality of Uppsala. All the men were between the ages of 49 and 51 when they volunteered for the study between 1970 and 1973. During the course of the investigation, the men were evaluated five times, at ages 50, 60, 70, 77, and 82. At each evaluation, the men submitted detailed information about their exercise, smoking, and drinking habits, and the researchers measured body height and weight, blood sugar and cholesterol levels, and blood pressure.

The researchers divided the men into three groups based on their exercise levels. At age 50, most of the men rated their own health as good, and there was little difference in body mass index, blood pressure, or cholesterol between the low-, moderate-, and high-exercise groups, but smoking was less prevalent in high- versus low-level exercisers (47% vs. 61%). Over the next 35 years, though, major differences in health emerged. Most importantly, men who were highly physically active at age 50 were 32% less likely to die during the study than those who were least active; moderately active men enjoyed a smaller, but still respectable, 13% lower death rate than the least active gents.

The protective effect of regular exercise comes as no surprise. But the long-term nature of the Swedish study allowed the scientists to follow men who were sedentary at age 50 but who increased their exercise level between ages 50 and 60. For the first five years, the major result was disappointment, since these men continued to die at the same high rate as men who remained inactive. But over the next five years, the benefit kicked in; by 10 years of follow-up, the men who adopted exercise in middle age enjoyed the same low mortality rate as men who began before age 50. All in all, men who adopted exercise after 50 had a 49% lower death rate than the men who remained inactive, a benefit even greater than the 40% risk reduction experienced by men who quit smoking after age 50. And the protective effect of exercise remained significant even after the scientists adjusted their results for the impact of smoking, drinking, obesity, diabetes, cholesterol, blood pressure, and socioeconomic status.

Men looking for an excuse to stay on the couch may suspect a catch, wondering if they have to become long-distance runners to benefit from taking up exercise in midlife. Quite the reverse. According to the Swedish study, men were classified as moderate exercisers if they simply took frequent walks or often went cycling for pleasure. And high-level exercise involved a minimum of just three hours of serious gardening or recreational sports a week. And in case you’re tempted to cook up another excuse, you’ll soon see that this important study does not stand alone.

Turning back the clock

Ponce de Leon learned it the hard way: There is no fountain of youth. But an interesting study tells us that exercise can make arteries act younger.

As people age, their arteries tend to constrict (narrow), reducing the tissue’s supply of oxygen-rich blood. To find out if exercise can improve age-related vascular function, scientists compared 13 healthy men with an average age of 27 and 15 healthy men with an average age of 62. As expected, the older gents’ arteries were more prone to constrict and less apt to dilate (widen). But for the next three months, eight of the older men began an exercise program, averaging nearly five hours a week of moderate aerobic training. At the end of that time, the arterial function tests were repeated, and the men who began to exercise in their 60s scored younger.

The great 17th-century physician Thomas Sydenham said, “A man is as old as his arteries.” Twenty-first–century research suggests older men can use their legs to turn back the hands of their arterial clock.

Late bloomers in Britain

Between 1978 and 1980, scientists evaluated 7,735 men from 24 British towns. In 1992, researchers were able to re-evaluate 5,934 of the men, who then had an average age of 63 years. The scientists tracked these men for an additional four years, comparing their risk of illness and death to their amount of physical activity.

At each evaluation, the researchers collected information about recreational and occupational exercise, smoking, drinking, social class, obesity, and health status, but they did not measure cholesterol, blood pressure, or blood sugar levels.

As in the Swedish study, the British research revealed a strong link between exercise and survival. Even light exercise was protective, reducing the rate of death by 39%; moderate exercise was even better, cutting the mortality rate by 50%. Most importantly, exercise was beneficial for men who were sedentary in 1978–80 but who began exercising sometime during the next 12 to 14 years; men who began to exercise later in life enjoyed a 45% lower mortality rate than men who remained sedentary throughout. And the benefits of late-life exercise were evident in men who already had heart disease by the time they became active as well as in men who were still healthy when they began to exercise.

News from Norway

A third European study, this time from Norway, confirms the findings from Sweden and England. Beginning in 1972, researchers evaluated 2,014 healthy men who were 40 to 60 years old. When the study began, each man got a comprehensive medical work-up and an exercise test. The evaluations were repeated between 1980 and 1982, and the scientists continued to keep track of the men through 1994.

As in the other studies, men who were physically fit enjoyed substantial protection from cardiovascular disease and early death; in all, the most fit men had a 55% lower mortality rate than the least fit. In addition, men who took up exercise and improved their fitness levels between 1972 and 1982 reduced their risk of dying during the study — but men who let their exercise slide lost the protective effect of physical fitness.

American veterans

The benefits of catch-up exercise are not confined to Europeans. A 2010 study of 5,314 male veterans ages 65 to 92 shows that fitness pays off on both sides of the Atlantic. All the volunteers underwent exercise tolerance testing at VA Medical Centers in Washington, D.C., and Palo Alto, Calif. Researchers followed the men for up to 25.3 years. During that time, the men who were most fit enjoyed a 38% lower mortality rate than those who were least fit. But the men who began to exercise during the follow-up period nearly caught up with the men who were in shape at the start of the study; unfit individuals who improved their fitness had a 35% lower mortality rate than their peers who remained unfit.

Not by exercise alone

Men who become physically active later in life enjoy better health and a lower death rate than men who remain sedentary. That’s good news for couch potatoes everywhere — but will reforming other health habits in midlife also help?

A study of 15,708 American men and women ages 45 to 64 says the answer is an emphatic yes. At the start of the study, only 1,344 people had all four of these healthy lifestyle habits: eating five or more servings of fruits and vegetables daily, not being obese, not smoking, and exercising regularly. But over the next six years, another 970 people adopted the healthful habits. The late adopters were quickly rewarded with improved health; over the next four years they enjoyed a 35% lower risk of cardiovascular events and a 40% lower death rate than their peers who failed to reform.

Exercise was one of the newly acquired health habits, but since the benefits of starting to exercise later in life take five years to kick in, exercise itself can’t account for these rapid improvements. Better late than never, and better all than one.

It’s a simple but powerful message, but it seems to fall on deaf ears. Only 8% of Americans between the ages of 40 and 74 have all four of these health habits plus moderate alcohol use — and that percentage has actually declined from a still woeful 15% in 1988.

Harvard men, too

These four studies that show it’s never too late to get fit confirm and extend the findings of an earlier American investigation that focused on middle-aged men. A 1993 report evaluated 10,269 Harvard alumni who were 45 or older when the study began in 1977. Over the next eight years, researchers tracked the effects of lifestyle changes on mortality. Previously sedentary men who began exercising after age 45 clearly benefited, enjoying a 23% lower rate of death than their classmates who remained inactive. The maximum benefits were linked to an amount of exercise equivalent to walking for about 45 minutes a day at a pace of about 17 minutes per mile. Not surprisingly, the Harvard study found that other lifestyle changes also helped, even if they did not occur until after age 45; quitting cigarette smoking, maintaining normal blood pressure, and avoiding obesity were all associated with less heart disease and longer life.

Which changes matter most? To find out, researchers evaluated some 36,500 male Harvard graduates and 21,000 male and female graduates of the University of Pennsylvania. All in all, sedentary individuals gained 1.6 years of life expectancy from becoming active later in life, smokers gained 1.8 years from quitting, and those who maintained normal blood pressure gained 1.1 years. Best of all was a combination of changes; sedentary smokers gained 3.7 years from quitting and becoming active.

Never too late

From both sides of the Atlantic, the message is clear: exercise is beneficial for all stages of life, and it’s never too late to start. But men who start exercising after age 50 also need to exercise caution. Here are some tips:

  • Get a check-up to be sure that you’re healthy. In addition to checking for diabetes, hypertension, abnormal cholesterol levels, and evidence of cardiovascular disease, your doctor should be sure your joints and muscles don’t merit special precautions.

  • Pick an activity that’s right for you. For many older gents (and for younger guys, too), walking is ideal. Biking and swimming are also excellent sports, and physically active hobbies such as serious gardening fill the bill, too.

  • Set a realistic goal. Aim for 30 to 40 minutes of moderate exercise, such as brisk walking, nearly every day. But don’t try to morph from couch potato to jock all at once. Instead, start out gradually and build up to your goal slowly but steadily. For example, you may want to begin exercising for 15 minutes three times a week, and then add minutes and days as you improve. And even when you’re in top shape, it’s always smart to alternate hard workouts with easier ones and to vary your routine.

  • For best results, add stretching exercises, which are ideal for warming up before and cooling down after your workout. Remember, too, that strength training will complement aerobic training to build a balanced exercise program; all it takes is two to three sessions a week.

  • Once you find yourself enjoying exercise, don’t be afraid to extend yourself. Walkers, for example, might try a little jogging, golfers should walk the course, and doubles tennis players could switch to singles (or find younger partners).

  • Get practical advice from friends and relatives who enjoy exercise and know the tricks of the trade. Consider professional guidance from a trainer or pro, and don’t hesitate to spend a few bucks on good shoes or other gear.

  • Make exercise part of a comprehensive health makeover. It’s particularly important to avoid tobacco in all its forms and to eat right, control your weight, reduce stress, get enough sleep, and get regular medical care. But just as you’ve eased your way into exercise, make the other lifestyle changes you need gradually, and don’t get down on yourself if you backslide.

  • Above all, listen to your body. In most cases, you’ll hear sounds of improvement, but if you detect distress signals — particularly chest pain or pressure, undue fatigue or breathlessness, or an irregular heartbeat or lightheadedness — back off and report it to your physician.

It’s never too late to start taking care of yourself, and it’s never too early, either. Whether you started early or later, keep going throughout life. And spread the gospel of exercise for health to the younger generations, who have grown distressingly fat and lazy. One of the best ways to lead is by example.

Posted by: Dr.Health

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