Franklin V. Cobos II

Exercise – Intensity or Duration?

November 6, 2022 by Franklin V. Cobos II - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

When you start an exercise program, you will begin slowly and build up gradually. This increases can be in exercise duration, or in intensity of the exercise routine. When do you go for longer duration, and when do you want to increase exercise intensity? And how do you go practically to maximize the benefits of your exercise program, while your fitness levels are improving?

I left you last time with the simple instructions to walk for 5–10 minutes, once or twice daily. Now, I had asked you to simply walk. I know that’s nothing fancy, nothing hard; just walking. But I did that for a simple reason. Let me explain.

The rationale behind the time and frequency recommendations I made at first is that by committing to the necessary time required to exercise, you are more likely positioned for success regardless of what activity you chose to do during that time. Think about this: if you have no regular time available, then it matters not what activity you plan to do… because you won’t actually be doing it anyway! So, let’s move forward assuming you now have a new habit of spending time in physical activity every day. And currently, for you, that activity is walking.

There are many, many people who, if they simply keep walking, and regularly increase the duration and/or intensity of that walking, will see very impressive results in their overall health. Further, because it can be done at nearly anytime, under nearly any weather condition, by people of nearly any physical status, with virtually no additional cost for equipment, it is an ideal choice for anyone starting out with an exercise program. This includes those who are carrying excess weight, who have diabetes, hypertension and have trouble sleeping.

On the other hand, there is a large second group of people who are either naturally more energetic or carry no medical diagnoses at all. They will find that walking is not an ideal exercise. For them, it may not be sufficiently challenging to provide any internal psychological sense of accomplishment, indue visible external physical improvements in their physique, or increase their level of performance.

No matter what group you find yourself in, let me offer some instruction that will be universally applicable. Once you successfully commit to both regularly spending some time exercising and then choose a specific activity, then it’s time to alter either the duration or the intensity of your exercise. You have to do this because both the mind and the body will adapt quicker than you wish they would to these types of challenges. That adaptation will lead to you experiencing a performance plateau… and your improvements will stall. You don’t want that to happen. All of us can do better, all the time, even if it’s just a little bit better.

Duration

In the case of walking, you can increase the duration of time you walk in several different ways to fit your personal schedule. Focus on picking a pattern that is practical for your life’s routine. Try a few ways that in your assessment are most likely to work well and not be unnecessarily challenging to implement. Eventually, as you increase the duration of your walks, there will be a limit you reach that no longer allows adding more time.

For example, imagine you start walking a bit after breakfast and before you go to work. Or, maybe on your lunch break. There is a finite amount of time you can add to those periods of your day before you are creating a conflict with previous, higher obligations. That’s fine, no problem. Recall that the healthful effects of exercise are cumulative, right? You can put more minutes in wherever they fit best in your schedule. Don’t feel bad if you have to break up your walking sessions. So long as you walk more minutes this week than you walked last week, you have succeeded in increasing the duration portion of your exercise routine. Strong work!

But perhaps you couldn’t find a way to increase the time spent each day walking, Monday through Friday? Well, you could add some time walking during the weekend when time restraints are maybe not so tight. Maybe like me, you regularly have to take call at work, at irregular calendar intervals, making life routinely fall out of any recognizable rhythm. So, you hit it hard on your pre-call day, or take time on your post-call day off to make up for any deficiencies that occurred because you got slammed at work and spent absolutely no meaningful time exercising at all during those 36 hours at work. You were just happy to sleep, let alone get exercise, right? Again, no problem. Don’t get discouraged, and don’t let that break your habit of exercising. The benefits can still accumulate over time, you can make it up.

Intensity

Now, moving on from the strategy of increasing your duration of physical activity, let’s talk about adjusting the intensity. For walking, two easy ways of doing that include going up hills or carrying some extra weight while you walk. I tend to caution against combing both early on in a new exercise program. Focus on sustainability.

If you don’t have any hills to walk up, weight can be added by simply carrying a full water bottle or two in some way as you walk (in your hands, in a day pack). You could consider buying special ankle weights, small handheld dumbbells, or weighted vests, but I suggest first considering a low-cost solution like a forgotten day pack in the closet filled with increasing amounts of water bottles or cans of beans as added weights. If you can stick to something easy like that and you like it… then revisit the idea of spending a little extra money on yourself for those other items in a month or two.

Call to Action

Keep up with your consistent walking regimen! And find some ways to step up with your exercise regimen, so to reap the benefits you are looking for!

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This article was originally published on the Time to Get Ready website.

How Much Physical Activity Is Enough?

October 9, 2022 by Franklin V. Cobos II - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

I tend to cringe inside when people ask me how much exercise they should do. I do this because typically they are seeking answers that I cannot give them. At times they want some form of affirmation that they are already active enough and that for them, no change is necessary. And, often they are disappointed to hear that they aren’t meeting the recommendations.

I admit that it can be discouraging to think about how difficult it may be to add the recommended amount of activity on top of their already hectic, overbooked daily routine. So, before we look at ways of managing the psychological aspects of a good exercise program (which I believe is just about as important as the exercise program itself), let’s at least give some short answers to the questions concerning how much exercise do experts recommend. Once we get that out of the way, we can move on to focus on the practical aspects of an exercise prescription.

Starting Small Is Okay!

Let me begin with some great news for everyone: any amount of physical activity above what you are accustomed to has some benefit. So long as you are doing more than you used to do there is a degree of self-congratulations in order, however small, at first. If you park at the edge of the parking lot and walk further than you want to the storefront when you stop at the store… that qualifies! If you can stand more and sit less during your day, that’s great. Maybe you can take one flight of stairs instead of just one of the floors you would otherwise stop at when riding the elevator. Maybe that’s your “one small step,” or “one giant leap for mankind” (depending on your level of fitness). So, to repeat: any amount of physical activity above what you are accustomed to has some benefit. Got it? Good. Let’s get it!

Now to be clear, I don’t want you to think is that a little bit of improvement is enough. For my bi-lingual friends, I might say it like this: A little bit is better than nada, but it’s sure not the whole enchilada! Small starts, little changes in habits are indeed important. My friend Vicki Griffin likes to emphasize this truth and highly recommends people read one of her favorite books, Atomic Habits, by James Clear.((Clear J. Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones. Penguin Random House))

The point or purpose of making small changes though is to be able to work your way towards achieving larger and lasting changes in your lifestyle. Let’s see what those larger goals are as outlined in the latest CDC guidelines for physical activity.((Physical Activity for Different Groups https://www.cdc.gov/physicalactivity/basics/age-chart.html))

There are separate guidelines for different populations/age groups. I will summarize the recommendations for the main groups below:

Ages 6-17: One hour of moderate to vigorous aerobic activity every day. On 3 days of the week, these periods of activity should include strength training for muscles and bones as well.
Adults 18 years and over: A range of 150-300 minutes of moderate aerobic activity per week, or 75-150 minutes of vigorous aerobic activity per week. A range is given because the resulting health benefits are measurably dose-dependent (just like most medications), as well as interchangeable (75 minutes of vigorous activity is equivalent to 150 minutes of moderate activity). Aerobic activity is best spread throughout the week. Additional benefits are seen if you include at least 2 days of the week during which strength training is done for all major muscle groups.
Pregnancy: A range of 150-300 minutes of moderate aerobic activity per week. If before becoming pregnant, a mother was habitually accustomed to more intense levels of physical activity, these may continue. Her pregnancy should be monitored throughout the prenatal period by qualified professionals.
Those with chronic medical conditions or disabilities: Recommendations are identical to adults 18 and older if their abilities allow for it. Otherwise, they should avoid inactivity and engage in regular physical activity to the extent allowed by their medical condition.

A man playing basketball in a wheelchair

How to Get Started

There you have it. Those are the shortest answers you can get, inclusive of a wide range of circumstances, that is based on the latest scientific evidence. Of course, all these things are more easily said than done. Everyone needs to start somewhere, even if it is from a place of no exercise at all. In fact, getting little to no exercise at all is not an uncommon situation. If this describes you, please do not be discouraged.

After watching people start and stop, succeed and fail, in their exercise plans (as well as other lifestyle changes), I have come to a settled opinion regarding the initial phase of starting to make changes. My belief is this: in order to maximize the likelihood that someone keeps a commitment to change the way they live, they must first change how they manage their time. I believe that if you do not succeed in setting aside a period of time during which you always do your exercise, something else will easily, without thought or effort, use up that time. You will inevitably find yourself at the end of the day, week, or month having had no time/opportunity to fulfill your exercise goals. Then you may feel like a failure or give up hope.

Don’t Give Up!

Instead, make it a point to establish a habit to spend 5-10 minutes, once or twice every day, focusing on physical activity. By doing it every day, you will within several weeks have established a new habit; a strong new habit of dedicated time for physical activity.

Two major advantages are built into this approach. One is that the new habit is formed as quickly as possible, with as little effort as possible, and without excessive disruption of your current way of life. The second advantage is that it also maximizes the benefit you realize because you’re doing something every day. And THAT is important for making you stick with the program.

This strategy creates a space in time (5-10 minutes 1-2 times a day) for physical activity that is easily obtainable and allows each person to pick whatever type of exercise they want. Being consistent with the time commitment is the key. Unless, and until, people have a consistent amount of time with which to exercise, not even an expert trainer and the perfect plan will amount to anything.

You may be thinking, “How will 10 or 20 minutes transform my life?!” Well, it may not initially. But it will if you then extend those 5-10 minute sessions to 30-60 minute sessions over time. I tell people to start with 5-10 minute commitments because it’s easier to achieve, and they can form a habit of daily exercise. After having success with the time commitment, they usually are set for an activity commitment.

Call to Action

So the important thing is: Start with something today! Next time, I’ll talk with you more about various activities. Until then…carve out some time each day and start forming your exercise habit.

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This article was originally published on the Time to Get Ready website.

Is Exercise Medicine?

September 11, 2022 by Franklin V. Cobos II - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Despite the resistance of some, I personally continue to insist that exercise plays a vital role in the maintenance of wellness. Exercise has proven to be more than merely a preventative measure that simply maintains a pre-existing state of good health; it is also very therapeutic and can slow or reverse serious illness. And we know much today how exercise can help you to improve your immune system.

I find it strange and disappointing that mice with cancer will spontaneously choose to use an exercise wheel placed in their cage and enjoy measurably improved health outcomes, but that human counterparts will actively resist the prescription of exercise programs and thus lose the proven benefits that they would otherwise accrue.((Hojman P, Gehl J, Christensen JF, Pedersen BK. Molecular Mechanisms Linking Exercise to Cancer Prevention and Treatment. Cell Metab. 2018 Jan 9;27(1):10-21. doi: 10.1016/j.cmet.2017.09.015. Epub 2017 Oct 19. PMID: 29056514.)) I just have to ask, “Why is that!?” Why is it that animals will voluntarily do the right thing, but often with only great difficulty will people be coerced to do what is in their own best interests? It reminds me of when all the animals spontaneously showed up on their own to board Noah’s ark after 120 years’ worth of failed attempts to give away free tickets to ride out the coming storm and cataclysmic, worldwide flood!

If exercise is medicinal, how “medicinal” is it? Well, in the aforementioned study involving mice with cancer researchers deprived a control group of mice of having the option to freely exercise on spinning wheels inside their cages.((Hojman P, Gehl J, Christensen JF, Pedersen BK. Molecular Mechanisms Linking Exercise to Cancer Prevention and Treatment. Cell Metab. 2018 Jan 9;27(1):10-21. doi: 10.1016/j.cmet.2017.09.015. Epub 2017 Oct 19. PMID: 29056514.)) This dramatically reduces their physical activity. These mice were then compared to a matched group of cancerous mice that were granted their very own, private little version of Planet Fitness inside their cages (totally free of charge to them and open 24 hours a day, seven days a week).

The results of the study indicate that tumor growth was reduced in all mice that exercised. In cases of liver and lung cancer, the reduction was 59% and 58% respectively. And in mice with melanoma, tumor growth was reduced by 67%. That’s medicinal enough to grab my attention, how about you? If I had cancer, I would be happy to engage in therapy that had those kinds of proven outcomes. Especially if I didn’t have health insurance, or didn’t want to risk experiencing the known side effects and adverse events associated with standard cancer treatments such as chemotherapy.

At this point, you should probably be asking the questions, “How does exercise actually achieve these amazing immune-enhancing effects?” Before pharmaceutical agents are approved for general use in the public, regulatory requirements typically demand evidence of their mechanism of action. If it’s not a placebo, then you should expect to see some scientific reason that explains exactly why it works to help people. So then, what is it that happens in the body when one exercises that is so beneficial as to consider it to be medicinal? For simplicity, I will narrow the discussion of the known mechanisms whereby exercise improves how the body more successfully fights against disease. The mechanisms are complex and many, so let’s start with one that is not too hard to understand. Relax, I’ll try to make this less complex than your average doctor would!

Role of Natural Killer Cells

One of the important issues we have identified is the role that natural killer (NK) cells have in immune function. NK cells are a sub-type of lymphocytes. They make up about 5-15% of all your lymphocytes, which in turn make up around one-third of all your white blood cells (WBCs). These are the ones that respond to help you fight infection, as opposed to red blood cells (RBCs) which contain the hemoglobin that transports oxygen throughout the circulatory system.

What makes normal functioning NK cells so interesting and important is that they do not require any knowledge, prior instruction, or memory of an invader to identify, attack, and destroy it. No antibodies are required, no previous exposure or vaccinations (just like the conditions presently dominating the SARS-CoV-2 pandemic). If you isolate NK cells from a healthy person and put them into a culture with cancer cells, it only takes a few hours before most of the cancer cells are dead! How this happens is largely beyond the scope of this article. BUT… I will tell you how exercise improves NK cell’s function.

3d illustration of immune system cells attacking cancer cells

Catecholamines (epinephrine, for example, is one of them) are released into the bloodstream during exercise. NK cells have receptors on their surface that respond favorably to these catecholamines, making NK cells move around more, and become more active in their assault against your body’s enemies (both foreign and domestic). Research showed that after 30 minutes of moderate exertion on a stationary exercise bicycle the number of lymphocytes in the bloodstream increased by 100%.((Graff RM, Kunz HE, Agha NH, Baker FL, Laughlin M, Bigley AB, Markofski MM, LaVoy EC, Katsanis E, Bond RA, Bollard CM, Simpson RJ. β2-Adrenergic receptor signaling mediates the preferential mobilization of differentiated subsets of CD8+ T-cells, NK-cells and non-classical monocytes in response to acute exercise in humans. Brain Behav Immun. 2018 Nov;74:143-153. doi: 10.1016/j.bbi.2018.08.017. Epub 2018 Aug 30. PMID: 30172948.)) And, the specific sub-type of lymphocytes that increased the most, 400-500%, was the NK cells! Researchers continued taking blood samples, and within only 5 minutes from stopping exercise, about half of all those NK cells had left the bloodstream and entered adjacent tissues looking for a fight to win.

Call to Action

These types of laboratory findings have hopeful implications for the current pandemic, suggesting those who follow the recommended guidelines for regular exercise could reasonably expect to have a much greater margin of safety for their immune function when they are exposed to others around them who are actively shedding viruses (of all types). What those recommendations are, and how one might go about beginning to implement them into daily practice will be the topic of upcoming articles, along with additional encouraging research findings relating to exercise and immune function.

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This article was originally published on the Time to Get Ready website.