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Category: Exercise

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Get up every hour from your seat and walk a few minutes, and cut your risk of early death by 33% (by 41% in those with chronic kidney disease). Standing won't do it - have to move. Just make sure that little walk is not to the refrigerator. Other studies have found that sitting for long periods may increase the risk for chronic disease and early death. From Scientific American:

A Little Bit of Walking Can Add up to Improve Your Health

Want to reduce your risk of dying at a young age? Try walking casually for as little as 2 minutes per hour.While it is well known that intense exercise can help you get fitter, a new study has found that even a little exercise can still go a long way. Study participants who traded time on the sofa for a total of 30 minutes of walking during the day reduced their risk of dying over a three-year period by 33 percent.

For the participants with chronic kidney disease, the risk of dying was reduced by more than 40 percent, according to the findings, published today (April 30) in the Clinical Journal of the American Society of Nephrology.

The Physical Activity Guidelines for Americans, a complement to the government's diet guidelines, recommend that people do at least 75 minutes of high-intensity aerobic physical activity (such as running, swimming or biking), or 150 minutes of moderate-intensity activity (such as brisk walking) every week to reduce the risk of obesity, diabetes and other chronic diseases. But the researchers on the new study wanted to know what the minimum threshold was—the lowest amount of physical activity that could still provide health benefits, said Dr. Srinivasan Beddhu, a kidney specialist at the University of Utah School of Medicine in Salt Lake City and lead author of the new study. [How Many Calories Am I Burning? (Infographic)]

"This study specifically looked at what intensity of activity should be used to replace sedentary activity.... being sedentary is an active choice to indulge in activities that barely raise the energy expenditure above basal metabolic rate." That threshold of intensity, Beddhu said, appears to be low. The study found that "light-intensity activities," such as casual walking, are beneficial. In contrast, activities that are "low intensity," such as standing or writing at a desk, aren't enough to provide any meaningful health benefits, the study found.

For this study, Beddhu and his colleagues at the University of Utah and the University of Colorado used information from the National Health and Nutrition Examination Survey, which includes data collected from an accelerometer, a device that measures motion. This enabled the researchers to study the activities of more than 3,600 adults representing the general U.S. population, including 383 adults with chronic kidney disease. Over the course of three years, 137 of these participants died as a result of various causes. In general, those who exercised more were less likely to die during the study period.

Positive effects of exercise could be seen down to the level of 30 minutes per day of any kind of light activity....it could be attained merely by getting up to move around a few minutes every hour. The finding could be particularly beneficial for people with kidney disease, who tend to be sedentary and inactive throughout most of the day, Beddhu added.

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There has been a lot of discussion in the last few years of our gut bacteria (hundreds of species), the microbiome (the community of microbes living within and on a person (gut, nasal cavities, mouth, sinuses, etc.), probiotics, the finding of a link between bacteria and some chronic diseases, and how the modern lifestyle and antibiotics are wiping out our beneficial gut microbes. I am frequently asked how one can improve or nurture the beneficial bacteria in our bodies.

While no one knows what exactly is the "best" or "healthiest" microbial composition of the gut, it does look like a diversity of bacteria is best (may make you healthier and more able to resist diseases). Research also suggests that the diversity and balance of bacteria living in the body can be changed and improved, and changes can occur very quickly. And that the microbial communities fluctuate for various reasons (illness, diet,etc.). Diet seems to be key to the health of your gut microbial community. Prebiotics feed the beneficial bacteria in the gut, probiotics are live beneficial bacteria, and synbiotics are a combination of prebiotics and probiotics. But don't despair - you can improve your gut microbial community starting now. The following are some practical tips, based on what scientific research currently knows.

SOME STEPS TO FEED AND NURTURE YOUR GUT MICROBES:

Eat a wide variety of foods, especially whole foods that are unprocessed or as minimally processed as possible. Eat everything in moderation.

Eat a lot of plant based foods: fruits, vegetables, whole grains, seeds, nuts, and legumes. Think of Michael Pollan's advice: "Eat food. Not too much. Mostly plants."

Eat more washed and raw fruits and vegetables (lots of bacteria and fiber to feed and nurture the bacteria). Some every day would be good.

Eat more soluble and insoluble types of fiber, and increase how many servings you eat every day. A variety of  fiber foods every day, and several servings at each meal, is best. Think fruits, vegetables, whole grains, legumes, nuts, seeds. (See How Much Dietary Fiber Should We Eat? - also has a chart with high fiber foods, and Recent Studies Show Benefits of Dietary Fiber)

Eat as many organic foods as possible. There is much we don't yet know, and pesticides are like antibiotics - they kill off microbes, both good and bad. Somehow I think that lowering the levels in your body of pesticides (as measured in blood and urine) can only be beneficial. Also, organic foods don't contain added antibiotics and hormones. (Eat Organic Foods to Lower Pesticide Exposures).  But even if you can't or won't eat organic foods, it is still better to eat non-organic fruits, vegetables, and whole grains than to not eat them.

Eat some fermented foods such as kimchi and sauerkraut (they contain live bacteria), kefir, and yogurts with live bacteria. Eat other bacteria containing foods such as cheeses, and again a variety is best (different cheeses have different bacteria).

Try to avoid or eat less of mass-produced highly processed foods, fast-foods, preservatives, colors and dyes, additives, partially hydrogenated oils, and high-fructose corn syrup. Read all ingredient lists on labels, and even try to avoid as much as possible "natural flavors" (these are chemicals concocted in a lab and unnecessary). Even emulsifiers (which are very hard to avoid) are linked to inflammation and effects on gut bacteria.

Avoid the use of triclosan or other "sanitizers" in soaps and personal care products (e.g., deodorants). Triclosan promotes antibiotic resistance and also kills off beneficial bacteria. Wash with ordinary soap and water.

Avoid unnecessary antibiotics (antibiotics kill off bacteria, including beneficial bacteria).

Vaginal births are best - microbes from the birth canal populate the baby as it is being born. If one has a cesarean section, then one can immediately take a swab of microbes from the mother's vagina (e.g., using sterile gauze cloth) and swab it over the newborn baby. (See post discussing this research by Maria Gloria Dominguez Bello )

Breastfeeding is best - breastfeeding provides lots of beneficial microbes and oligosaccharides that appear to enrich good bacteria in the baby’s gut.

Live on a farm, or try to have a pet or two. Having pets, especially in the first year of life,  ups exposure to bacteria to help develop and strengthen the immune system, and prevent allergies. Pets such as dogs and cat expose humans to lots of bacteria.

Get regular exercise or physical activity. Professional athletes have more diverse gut bacterial community (considered beneficial) than sedentary people.

Can consider taking probiotics - whether in foods or supplements. They are generally considered beneficial, but not well studied, so much is unknown. The supplements are unregulated, and the ones available in stores may not be those that are most commonly found in healthy individuals. Research the specific bacteria before taking any supplements. Researchers themselves tend to stay away from probiotic supplements and focus on eating a variety of all the foods mentioned above (fruits, vegetables, whole grains, seeds, nuts, legumes, fermented foods) to feed and nurture beneficial bacteria.

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The statements in this editorial may be obvious to many, but it is nicely written and needs to be said. Basically it says that exercise will not help you overcome the ill effects of a poor diet. I agree with what was said, but felt that what was missing was mention that a poor diet also has negative effects on the microbiome (the community of microbes living within the person) - which we know is linked to health problems.

From Medscape: Workouts Do Not Work Off Ill Effects of Poor Die

Exercise enthusiasts cannot work off the ill effects of an unhealthy diet, say the authors of an editorial published online April 22 in the British Journal of Sports Medicine. "Let us bust the myth of physical inactivity and obesity," the authors write. "You cannot outrun a bad diet."

Physical activity levels in Western nations have remained flat during the past 3 decades, even as obesity rates have exploded. That observation is just one sign that calories, not lack of exercise, are driving the obesity crisis, argue Aseem Malhotra, MD, honorary consultant cardiologist at Frimley Park Hospital, United Kingdom, and science director for Action on Sugar, United Kingdom, and colleagues.

"However, the obesity epidemic represents only the tip of a much larger iceberg of the adverse health consequences of poor diet," the authors write. They say that the Lancet global burden of disease reports concluded that poor diet contributes to more disease than a combination of inadequate physical activity, alcohol, and smoking. As many as 40% of people with normal body weight will suffer from metabolic abnormalities typically associated with obesity, the authors write, including hypertension, dyslipidemia, nonalcoholic fatty liver disease, and cardiovascular disease.

Dr Malhotra and colleagues blame food industry marketing for promoting exercise over diet, comparing food industry public relations with discredited tactics used by the tobacco industry in the past. They say Coca Cola "pushes the message that 'all calories count'; they associate their products with sport, suggesting it is ok to consume their drinks as long as you exercise. However science tells us this is misleading and wrong."

The kind of calorie matters too, they emphasize. Calories from sugar promote fat storage and hunger; fat calories induce satiety. For every 150 calories consumed from sugar, there is an 11-fold increase in the prevalence of type 2 diabetes independent of weight or physical activity levels compared with consumption of 150 calories of fat or protein.

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Well worth reading in its entirety. In summary: Anyone who is physically capable of activity should try to reach at least 150 minutes of physical activity per week (walking is good) and have around 20 to 30 minutes of that be vigorous activity. This significantly lowers the risk of dying prematurely. (NOTE: the second study mentioned was in the April 8, 2015 post: Physical Activity That Makes You Sweat Is Good ) From the New York Times:

The Right Dose of Exercise for a Longer Life

Exercise has had a Goldilocks problem, with experts debating just how much exercise is too little, too much or just the right amount to improve health and longevity. Two new, impressively large-scale studies provide some clarity, suggesting that the ideal dose of exercise for a long life is a bit more than many of us currently believe we should get, but less than many of us might expect. The studies also found that prolonged or intense exercise is unlikely to be harmful and could add years to people’s lives.

The current broad guidelines from governmental and health organizations call for 150 minutes of moderate exercise per week to build and maintain health and fitness. But whether that amount of exercise represents the least amount that someone should do — the minimum recommended dose — or the ideal amount has not been certain.

In the broader of the two studies, researchers with the National Cancer Institute, Harvard University and other institutions gathered and pooled data about people’s exercise habits from six large, ongoing health surveys, winding up with information about more than 661,000 adults, most of them middle-aged. Using this data, the researchers stratified the adults by their weekly exercise time, from those who did not exercise at all to those who worked out for 10 times the current recommendations or more (meaning that the exercised moderately for 25 hours per week or more). Then they compared 14 years’ worth of death records for the group.

They found that, unsurprisingly, the people who did not exercise at all were at the highest risk of early death. But those who exercised a little, not meeting the recommendations but doing something, lowered their risk of premature death by 20 percent. Those who met the guidelines precisely, completing 150 minutes per week of moderate exercise, enjoyed greater longevity benefits and 31 percent less risk of dying during the 14-year period compared with those who never exercised.

The sweet spot for exercise benefits, however, came among those who tripled the recommended level of exercise, working out moderately, mostly by walking, for 450 minutes per week, or a little more than an hour per day. Those people were 39 percent less likely to die prematurely than people who never exercised. At that point, the benefits plateaued, the researchers found, but they never significantly declined. Those few individuals engaging in 10 times or more the recommended exercise dose gained about the same reduction in mortality risk as people who simply met the guidelines. They did not gain significantly more health bang for all of those additional hours spent sweating. But they also did not increase their risk of dying young.

The other new study of exercise and mortality reached a somewhat similar conclusion about intensity.  {NOTE: SEE APRIL 8, 2015 POST FOR DETAILS}

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A big question for many adults is: how can one age well and live to a ripe old age? The author of the book The Blue Zones has dedicated a lot of time to studying communities throughout the world where there are a lot of centanarians and they age well (healthy). What are their secrets to aging well? The answer seems to be: while the diets vary, overall they have a lot of plant based whole foods, they have a lot of physical activity, are committed to their families, take time to de-stress, and they have social networks with healthy behaviors. From NPR:

Eating To Break 100: Longevity Diet Tips From The Blue Zones

Want to live to be 100? It's tempting to think that with enough omega-3s, kale and blueberries, you could eat your way there. But one of the key takeaways from a new book on how to eat and live like "the world's healthiest people" is that longevity is not just about food.

The people who live in the Blue Zones — five regions in Europe, Latin America, Asia and the U.S. researchers have identified as having the highest concentrations of centenarians in the world — move their bodies a lot. They have social circles that reinforce healthy behaviors. They take time to de-stress. They're part of communities, often religious ones. And they're committed to their families.

But what they put in their mouths, how much and when is worth a close look, too. And that's why Dan Buettner, a National Geographic explorer and author who struck out on a quest in 2000 to find the lifestyle secrets to longevity, has written a follow up to his original book on the subject. The new book, called The Blue Zones Solution, is aimed at Americans, and is mostly about eating.

Why should we pay attention to what the people in the relatively isolated Blue Zone communities eat? Because, as Buettner writes, their more traditional diets harken back to an era before we Americans were inundated with greasy fast food and sugar. And to qualify as a Blue Zone, these communities also have to be largely free of afflictions like heart disease, obesity, cancer and diabetes. So clearly they're doing something right.

But in a nutshell,Buettner in 2004 rounded up a bunch of anthropologists, demographers, epidemiologists and other researchers to travel around the world to study communities with surprisingly high percentages of centenarians. He and the scientists interviewed hundreds of people who'd made it to age 100 about how they lived, then did a lot of number crunching to figure out what they had in common. A year after that book was published, the team announced they'd narrowed it down to five places that met all their criteria. They gave them official Blue Zone status: Ikaria, Greece; Okinawa, Japan; Ogliastra Region, Sardinia; Loma Linda, Calif.; and Nicoya Peninsula, Costa Rica. 

In the new book, which was released April 7, Buettner distills the researchers' findings on what all the Blue Zones share when it comes to their diet. Here's a taste: - Stop eating when your stomach is 80 percent full to avoid weight gain. - Eat the smallest meal of the day in the late afternoon or evening. - Eat mostly plants, especially beans. And eat meat rarely, in small portions of 3 to 4 ounces. Blue Zoners eat portions this size just five times a month, on average. - Drink alcohol moderately and regularly, i.e. 1-2 glasses a day.

Ikaria, Greece You may remember this Blue Zone from Buettner's wonderful 2012 New York Times Magazine article entitled "The Island Where People Forget To Die." As we've reported, health researchers have long praised the Mediterranean diet for promoting brain and physical health and keeping chronic diseases at bay. 

"Their tradition of preparing the right foods, in the right way, I believe, has a lot to do with the island's longevity," writes Buettner. And "what set it apart from other places in the region was its emphasis on potatoes, goat's milk, honey, legumes (especially garbanzo beans, black-eyed peas, and lentils), wild greens, some fruit and relatively small amounts of fish."Ikaria has a few more "top longevity foods:" feta cheese, lemons and herbs like sage and marjoram that Ikarians use in their daily tea...The Ikarians do eat some goat meat, but not often.

Sardinia, Italy ...Buettner writes that the Sardinians explain their exceptional longevity with their assets such as "clean air," "locally produced wine," or because they "make love every Sunday." But when Buettner brought along a researcher to dig deeper, they found that pastoralism, or shepherding livestock from the mountains to the plains, was most highly correlated with reaching 100.

So what are those ancient Sardinian shepherds eating? You guessed it: goat's milk and sheep's cheese — some 15 pounds of cheese per year, on average. Also, a moderate amount of carbs to go with it, like flat bread, sourdough bread and barley. And to balance those two food groups out, Sardinian centenarians also eat plenty of fennel, fava beans, chickpeas, tomatoes, almonds, milk thistle tea and wine from Grenache grapes.

Loma Linda, Calif. There's a Blue Zone community in the U.S.? We were as shocked to learn this as you may be. Its members are Seventh-day Adventists who shun smoking, drinking and dancing and avoid TV, movies and other media distractions. They also follow a "biblical" diet focused on grains, fruits, nuts and vegetables, and drink only water. ...Another key insight? Pesco-vegetarians in the community, who ate a plant-based diet with up to one serving of fish a day, lived longer than vegan Adventists.Their top foods include avocados, salmon, nuts, beans, oatmeal, whole wheat bread and soy milk.

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More benefits of exercise or physical activity (this time lowering risk of early death), especially if there are short bursts of vigorous activity. The researchers suggest it for people of all ages.

From Science Daily: Working up a sweat: It could save your life

Physical activity that makes you puff and sweat is key to avoiding an early death, a large study of middle-aged and older adults has found. The researchers followed 204,542 people for more than six years, and compared those who engaged in only moderate activity (such as gentle swimming, social tennis, or household chores) with those who included at least some vigorous activity (such as jogging, aerobics or competitive tennis). They found that the risk of mortality for those who included some vigorous activity was 9 to 13 per cent lower, compared with those who only undertook moderate activity.

"The benefits of vigorous activity applied to men and women of all ages, and were independent of the total amount of time spent being active," said lead author Dr Klaus Gebel from James Cook University's Centre for Chronic Disease Prevention."The results indicate that whether or not you are obese, and whether or not you have heart disease or diabetes, if you can manage some vigorous activity it could offer significant benefits for longevity."

The current advice from the World Health Organization -- and health authorities in countries including the US, UK and Australia -- is for adults to accumulate at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week.

So who should get huffing and puffing, and how much do you need to do? "Our research indicates that even small amounts of vigorous activity could help reduce your risk of early death," Dr Gebel said."Previous studies indicate that interval training, with short bursts of vigorous effort, is often manageable for older people, including those who are overweight or obese."

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Another excellent reason to exercise - for better erectile and sexual function in men! The researchers say that their research supports the idea that "that exercise might one day be prescribed as a treatment for erectile dysfunction".

And they're not talking about that much exercise: the highly active men in the study did a moderately intense activity such as brisk walking, cycling, or tennis at least an hour 3 to 4 times a week. Other research has suggested that erectile dysfunction can be reversed naturally by changing lifestyle factors see October 27, 2014 post Reversing Erectile Dysfunction Naturally). From Reuters:

Older men who exercise more have better erectile function

Men who exercise more have better erectile and sexual function, suggests a small study of older overweight men. The authors say their results support the idea that exercise might one day be prescribed as a treatment for erectile dysfunction.

Vidal and colleagues examined exercise habits and sexual function in 295 healthy men who were part of a research project evaluating prostate cancer risk at the Durham Veterans Affairs Medical Center in North Carolina. On average, the men were about 62 years old, and they were all overweight or obese. Roughly one third had diabetes or a history of chest pain or heart attacks. About three quarters were current or former smokers. Ninety-three men, or about a third of the group, were African-American.

Men were scored based on a measure known as metabolic equivalent of task (MET) hours per week and placed in four categories ranging from sedentary, with three or fewer MET hours/week, to highly active, with at least 18 MET hours/week. Most often, the men were sedentary, with 44 percent reporting little activity. But a substantial proportion, 26 percent, were highly active.Researchers also questioned the men about their sexual function, focusing on their ability to get erections and have orgasms, as well as the quality and frequency of their erections...Added up, responses could lead to a total score from 0 to 100....Men who reported more frequent exercise also reported higher sexual function scores. Half of the highly active men reported sexual function scores of at least 70, compared with a median score of about 33 for sedentary men.

SOURCE: bit.ly/1NilZYI The Journal of Sexual Medicine, online March 20, 2015.

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People have asked me if it is healthy to exercise or ride a bicycle in the congested and polluted New York metro area. According to this much quoted in the past week study from the University of Copenhagen - it is better to exercise than not in polluted cities when looking at death rates. But is their air pollution even comparable to ours? What does it do to our lungs to bicycle daily behind smoke belching buses?

Even the researcher said:"It is also important to note that these results pertain to Denmark and sites with similar air pollution levels, and may not necessary be true in cities with several fold higher air pollution levels, as seen in other parts of the world." They also stated: "...we would still advise people to exercise and cycle in green areas, parks, woods, with low air pollution and away from busy roads, when possible." From Science Daily:

Exercise can outweigh harmful effects of air pollution

The beneficial effects of exercise are more important for our health than the negative effects of air pollution, in relation to the risk of premature mortality, new research shows. In other words, benefits of exercise outweigh the harmful effects of air pollution.The study shows that despite the adverse effects of air pollution on health, air pollution should be not perceived as a barrier to exercise in urban areas. "Even for those living in the most polluted areas of Copenhagen, it is healthier to go for a run, a walk or to cycle to work than it is to stay inactive," says Associate Professor Zorana Jovanovic Andersen from the Centre for Epidemiology and Screening at the University of Copenhagen.

It is well known that physical activity reduces, while air pollution increases the risk of premature mortality. Physical activity amplifies respiratory intake and accumulation of air pollutants in our lungs, which may increase the harmful effects of air pollution during exercise."However, we would still advise people to exercise and cycle in green areas, parks, woods, with low air pollution and away from busy roads, when possible," she adds.

The Danish study includes 52,061 subjects, aged 50-65 years, from the two main cities Aarhus and Copenhagen, who participated in the cohort study Diet, Cancer and Health..,5,500 participants died before 2010, and the researchers observed about 20% fewer deaths among those who exercised than among those who didn't exercise, even for those who lived in the most polluted areas, in central Copenhagen and Aarhus, or close to busy roads and highways.

"It is also important to note that these results pertain to Denmark and sites with similar air pollution levels, and may not necessary be true in cities with several fold higher air pollution levels, as seen in other parts of the world," concludes Andersen.

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It is important to identify protective factors as well as risk factors for cataracts because cataract surgery is the only treatment for cataracts. Cataracts are a medical condition resulting in clouding of the normally clear lens of the eye, which results in blurred vision.

From Medscape: Physical Activity May Reduce Cataract Risk

High levels of total and long-term physical activity, as well as specific types of physical activity, may decrease the risk for age-related cataract later in life, researchers report in an article published in the February issue of Ophthalmology. Of 52,660 men and women 45 to 83 years of age who completed questionnaires to assess physical activity as part of two large population-based cohorts, 11,580 developed age-related cataract during a 12-year follow-up period...

Participants with the highest quartile of physical activity had a 13% decreased risk of developing cataracts relative to those with the lowest levels of physical activity, after adjustments for multiple factors including fruit and vegetable intake, antioxidant supplement use, and alcohol intake ...In addition, increased amounts of long-term total physical activity both at 30 years of age and at the beginning of the study (mean age, 59.4 years) decreased the risk for cataract by 24% compared with low levels of activity, according to the researchers .

When the investigators looked at specific activities, they found that walking or bicycling 60 minutes per day or more decreased the risk for cataract by 12% compared with hardly ever walking or bicycling, and work or occupational activity requiring heavy manual labor decreased the risk for cataract by 16% compared with mostly sedentary occupations. Compared with individuals reporting less than 1 hour of leisure time inactivity per day, those who were physically inactive for 6 or more hours of leisure time daily were 27% more likely to develop age-related cataract, they write.

"Our results on different types of physical activity suggest that being physically active on a regular daily basis may contribute to decreased risk of cataract, rather than short weekly episodes of exercising/training," Selin explained in an interview with Medscape Medical News.

Keep in mind that statin use is linked to increased risk of cataracts. From Science Daily:

New study strengthens evidence of connection between statin use and cataracts; any risks should be weighed against benefits

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Excellent for those who want to exercise more, but don't want something complex. This is so simple that there is NO excuse for not doing this: walk fast for 3 minutes, then 3 minutes of strolling, and repeat 5 times (total=30 minutes).

From NY Times: Walk Hard. Walk Easy. Repeat.

Intense, interval-style workouts — brief bouts of very hard exercise broken up by periods of recovery — have been shown to improve the health and fitness of people who exert themselves for only a few minutes a week. Such efficiency is alluring, and has helped this kind of conditioning attract widespread media attention in recent years (including in this column). But high-intensity interval training programs aren’t for everyone....That doubt is what makes some news out of Japan about a much-less-punishing form of interval training so welcome.

A decade ago, scientists led by Dr. Hiroshi Nose at the Shinshu University Graduate School of Medicine in Matsumoto, Japan, started developing walking programs. They knew that walking was physically the easiest (and also the most practical) exercise for those in middle age and older, but the researchers suspected that people might need to push themselves to achieve the greatest health benefits. So they created a regimen consisting of three minutes of fast walking at a pace that Nose says approximates a 6 or 7 on a scale of exertion from 1 to 10. Each “somewhat-hard” three-minute spell was followed by three minutes of gentle strolling.

In their original experiment, the results of which were published in 2007, walkers between the ages of 44 and 78 completed five sets of intervals, for a total of 30 minutes of walking at least three times a week. A separate group of older volunteers walked at a continuous, moderate pace, equivalent to about a 4 on the same exertion scale. After five months, the fitness and health of the older, moderate group had barely improved. The interval walkers, however, significantly improved aerobic fitness, leg strength and blood-pressure readings.

In their latest study, which came out in December in the Journal of Applied Physiology, Nose and his colleagues report that most of the participants stayed with the walking program long after their original five-month commitment ended. Two years later, almost 70 percent of the walkers with whom the researchers remained in contact were still following their regimen at least three times a week and had retained or improved their health gains. Those who quit often cited “family, health and job issues,” says Dr. Shizue Masuki, the new study’s lead author, but they rarely complained about the complexity or difficulty of the training.

So those who have considered high-intensity interval training but have been apprehensive about its demands should go for a walk. “Perform the training for 10 minutes in the morning, 10 minutes in the afternoon and 10 minutes in the evening,” Masuki suggests. Three days of exercise per week is best, but if that’s too challenging, she says, “do it on the weekend” and cram the workouts into two days. Doing so, Masuki adds, “can have a profound effect on physiological regulation.”