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