Tuesday, June 9, 2020

Serve others, live longer!

Are you interested in life extension strategy that doesn’t involve drugs, diet, or exercise?  Look no further than volunteering!  There is a large amount of observational data to suggest that those who volunteer live longer lives than those who don’t, lowering their mortality risk by approximately 20%. [1]

While this has been a relatively consistent finding in medical literature, it’s based on observational studies, which means that critics point out the many different variables and features of those that volunteer that may account for this difference.

 I would respond to this in two ways:

  1. The critics may be partially correct.  However, if those who volunteer have features that confer longer life outside of the act of volunteering itself, we should be trying to get some of those features.  “Success leaves tracks” as the saying goes, and spending time with those who will likely live longer may rub some beneficial traits off on us!
  2. The second response would be that there seems to be data that indicates that volunteering in and of itself DOES independently increase our life span.  A 2017 study followed 300,000 married people, and compared partners who volunteered with their spouse who did not, with the thought that following a married partner might account for some of the confounding variables (socioeconomic status for example).  At the end of three years, those who volunteered lowered their mortality risk by 22% (women) and 23% (men) compared to non-volunteers.  Their spouses who did not volunteer had no improvement in mortality.  The study concluded “This study provides further evidence that the lower mortality associated with volunteering is unlikely to be due to health selection or to residual confounding arising from unmeasured selection effects within households. It therefore increases the plausibility of a direct causal effect.” [2]

My recommendation:

Volunteer a few times per month (more if able) to help those in need or for a cause you believe in.  You will be helping make the world a better place, and you may just live longer because of it.  “Everyone can be great, because anybody can serve” – Martin Luther King Jr.

Traditional avenues for volunteering may be limited for the moment, but there are plenty of D-I-Y workarounds: bring a meal to a friend, do yard work for someone who needs help, offer to take a neighbor’s dog for a walk, go shopping for someone who isn’t able to, send a cheery note or make a phone call to someone who lives alone…the possibilities are limitless!

David Ellis MD

[1] Jenkinson C.E. et al. BMC Public Health 2013;13:773

[2] O'Reilly D. et al. Int J Epidemiol 2017;46(4):1295‐1302

Tuesday, June 2, 2020

Less hot, less sweaty: In defense of longer, slower exercise

Even though Dr. Hassell, my practice partner, frequently encourages the “breathless and sweaty” elements in exercise, a longer-duration, slower-pace approach to exercise also has proven benefit and may be right up your alley.  The important thing is that you make the time for it: as a medicine, other than perhaps optimal diet and sleep, exercise is without equal – especially when there’s a consistent pattern of activity.  It is also a profoundly important predictive factor: low peak exercise capacity has been shown to be a stronger predictor of increased risk of death than other traditional risk factors including hypertension, smoking, diabetes, and obesity [1]. 

Most people understand exercise as a stress that you willingly (or unwillingly) place on your body in order to gain a positive response.  Many patients are concerned that if they aren’t feeling tired, hot, and sweaty, they simply aren’t working hard enough for such a response to be beneficial.  While intensity is an important component of exercise (and there are specific benefits to be obtained from intense exercise that cannot be replicated elsewhere), exercise with longer duration and less intensity has significant value and should not be discounted.  Specifically, continued movement for >45 minutes at a pace that consistently elevates your heart rate but leaves you able to talk comfortably in complete sentences has been shown to improve rates of angiogenesis (new blood vessel formation) [2], equivalent improvements in VO2 max (the gold standard measurement for aerobic capacity) [3], and perhaps most applicably, higher rates of enjoyment [4] than more intense interval efforts.

My recommendation:
Exercise every day, but don’t let perfection be the enemy of progress.  If you aren’t ready to consistently get out of breath and sweaty in your pursuit of health, and would otherwise forego exercise due to lack of perceived value, rest assured that longer duration, lower intensity exercise is still a massive boon to your health and should be pursued with vigor!

David Ellis MD

[4] Foster, C. et al. J Sports Sci Med 2015;14(4):747–55