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From the Townsend Letter
August / September 2016

Anti-Aging Medicine
Anti-Aging Exercise Strategies: The Less-is-More Approach
by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP
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An anti-aging regimen does not necessarily need to include a grueling exercise routine or daily trips to the gym. Although physical fitness is pertinent to fighting cognitive and physical decline, a little can go a long way. For those who find it difficult to squeeze in daily exercise, lowering expectations of the amount of daily/weekly exercise may be the way to go. Even a few minutes of exercise can render positive results. Micro-workouts are steadily gaining in popularity, and for good reason: they are a great way to break up the workday. Getting a little in is better than nothing, and as an added bonus, the short duration helps to eliminate the "not enough time" excuse. Daily exercise should also ideally include approximately 7500 steps per day. Over the long term, this will give you the behavior modification that you need to incorporate walking activity in daily, which could potentially lead to a longer life. By using a pedometer, you can effortlessly and unconsciously train yourself to take additional steps and to be more active overall.
In this column, we review recent studies that suggest simple and effective ways to enhance physical health, with positive results for both the body and the brain. These studies show that even modest amounts of exercise can have a large impact.

Tudor-Locke C, Bassett DR Jr. How Many steps/day are enough?: Preliminary pedometer indices for public health. Sports Med. 2004;34(1):1–8.

The Quintessential Anti-Aging Essential
Engage in daily exercise, even at a modest level, to slash your risks of premature death.
A mountain of evidence documents that physical inactivity raises a person's risk of premature death, as well as the risks of diseases such as heart disease and cancer. Ulf Ekelund and colleagues from the University of Cambridge (UK) assessed the link between physical inactivity and premature death. The team analyzed data collected on 334,161 men and women across Europe, enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Over an average of 12 years, the researchers measured height, weight, and waist circumference, and used self-assessment to measure levels of physical activity. Data analysis revealed that the greatest reduction in risk of premature death occurred in the comparison between inactive and moderately inactive groups. The investigators estimated that daily exercise burning between 90 and 110 kcal ("calories") – roughly equivalent to a 20-minute brisk walk – would take an individual from the inactive to moderately inactive group, and reduce their risk of premature death by between 16% to 30%. The impact was greatest amongst normal weight individuals, but even those with higher BMI saw a benefit. In further calculations, the team reveals that 337,000 of the 9.2 million deaths among European men and women may be attributed to obesity (classed as a BMI greater than 30) – with double this number of deaths (676,000) attributable to physical inactivity. The study authors report: "The greatest reductions in mortality risk were observed between the 2 lowest activity groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be beneficial to public health."

Ekelund U, Ward HA, Norat T, et al. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition study (EPIC).
Am J Clin Nutr. January 14, 2015.

For Women, Less Is More
Engaging in physical activity a few times per week – and not necessarily with greater frequency – may be most beneficial among middle-aged women.
There is overwhelming scientific evidence to suggest a wide range of health benefits to regular physical activity, but there is some debate as to the extent and frequency optimal for such effects. Miranda Armstrong and colleagues from the University of Oxford (US) completed a large-scale study involving 1.1 million women residing in the UK, average age 56 years, who were free from cancer, heart disease, stroke, blood clots, and diabetes at the study's start. Women who performed strenuous physical activity – sufficient to cause sweating or a faster heart beat – 2 to 3 times per week were about 20% less likely to develop heart disease, strokes, or blood clots, as compared with participants who reported little or no activity. Interestingly, among active women, there was little evidence of further risk reductions with more frequent activity. The study authors report: "Moderate physical activity is associated with a lower risk of coronary heart disease, venous thromboembolic event, and cerebrovascular disease than inactivity."

Armstrong ME, Green J, Reeves GK, Beral V, Cairns BJ; Million Women Study Collaborators. Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United kingdom. 
Circulation. 2015 Feb 24;131(8):721–729.

Bit of Activity Boosts Health
A small amount of moderate-to-vigorous physical activity weekly may reduce the risks of death by as much as 22%, among older men and women.
While the health and longevity benefits of 150 minutes a week of moderate to vigorous physical activity are well established, many of us fail to reach this target. David Hupin and colleagues from Jean Monnet University (France) completed a meta-analysis of 9 published studies, involving a total of 122,417 participants, that assessed risk of death according to weekly physical activity for those ages 60-plus. Physical activity was measured in Metabolic Equivalent of Task (MET) minutes – an expression of the amount of energy (calories) expended per minute of physical activity: moderate intensity activity ranges between 3 and 5.9 MET minutes while vigorous intensity activity is classified as 6 or more. Pooled analysis of the data showed that activity less than 500 weekly MET minutes of physical activity associated with a 22% lowered risk of death compared with those who were inactive. As expected, the more physical activity an individual engaged in, the greater the health benefit: a 28% lower risk of death was found for those fulfilling the recommended weekly tally of MET minutes, and over 1000 MET minutes were associated with a 35% lower risk. Importantly, the data showed that a weekly tally of 250 MET minutes – corresponding to 75 minutes of moderate to vigorous physical activity (15 minutes a day), associated with health benefits – of which the first 15 minutes of physical activity seemed to have the greatest impact. The study authors submit: "A dose of [moderate-to-vigorous intensity physical activity] below current recommendations reduced mortality by 22% in older adults. A further increase in physical activity dose improved these benefits in a linear fashion. Older adults should be encouraged to include even low doses of [moderate-to-vigorous intensity physical activity] in their daily lives."

Hupin D, Roche F, Gremeaux V, et al. Even a low-dose of moderate-to-vigorous physical activity reduces mortlity by 22% in aduts aged ≥60 years: a systemic review and meta-analysis.
Br J Sports Med. 2015 Oct;49(19):1262–1267. doi: 10.1136/bjsports-2014-094306. Epub 2015 Aug 3.

Activity a Key Anti-Aging Investment
Incidental physical activity resulting from everyday activity can save lives and money.
Walking to catch a train to work or bicycling to errands may have vast and important benefits for the health of both an individual and society at large. Such methods of active transport may save lives and millions of health sector dollars. Marj Moodie and colleagues from Deakin University (Australia) analyzed the daily travel patterns and incidental physical activity, such as the time spent walking to get to transport, of over 29,840 people in Melbourne. Car drivers averaged 8 to 10 minutes of incidental exercise daily, public transport users 35 minutes daily, and walkers/cyclists 38 minutes daily. People in the inner city were found to be more than 6 times more likely to get sufficient physical activity from travel compared with people living in the outer suburbs. The team then calculated that incidental physical activity could result in 272 less deaths per year, 903 fewer new cases of disease, and savings of up to $12.2 million in the health sector and $22.9 million in lost production. The study authors urge: "Improving population levels of incidental [physical activity] may improve health and economic outcomes."

Beavis MJ, Moodie M. Incidental physical activity in Melbourne, Australia: health and economic impacts of mode of transport and suburban location. Health Promot J Austr. 2014 Dec;25(3):174–181.

Invest 25 Minutes to Gain 7 Years
A brisk 25-minute walk daily may reduce the risk of death from heart attack by half.
A mountain of evidence affirms the wide-ranging health benefits of regular physical activity. Sanjay Sharma and colleagues from the University of London (UK) report that gentle exercise can reduce the risks of dying from a heart attack by half among people in their 50s and 60s. Proposing that adults enjoy a daily brisk walk of 25 minutes, the study authors submit that "exercise buys you three to seven additional years of life," and may confer effects on mood and cognitive skills as well.

Merghani A, Malhotra A, Sharma S. The U-shaped relationship between exercise and cardiac morbidity.
Trends Cardiovasc Med. 2015 Jun 18. pii:S1050–1738(15)00171-1.
To stay updated on the latest breakthroughs in natural approaches to anti-aging exercise strategies, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, the A4M's award-winning weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

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