Active mind/body, healthy mind/body

Spring is just around the corner and if you're ready to reboot one of your New Year's resolutions, here's why exercise should be at the top of the list. Current medical research continues to robustly establish vigorous physical exercise as a major influence on overall health and well-being, in addition helping in the treatment of many diseases including depression, cardiovascular disease, diabetes, and arthritis. A recent study found that regular, intense exercise beneficially influenced the action of 400 genes — that's right, 400 genes, a huge number — that produce proteins increasing the healthy functioning of mitochondria, the energy-producing machinery inside every cell. Exercise is synergistic with medicines and surgery. Developing, undertaking, and maintaining an exercise regimen is one of the best steps a person can take toward a self-actualized style of medical care.

An exercise "prescription"

We are a physician couple who have been physically active all our lives. We prescribe exercise regularly in our practices (one of us is a neurologist, the other a psychiatrist) and approach it in exactly the same way that we approach prescribing a medication, informing patients of dose and frequency benefits, possible side effects, and mechanisms of action. We describe a concrete regimen of exercise rather than simply saying, "exercise" and leaving it at that. Many patients don't know how to get started, and specific details about using machines, weights, running, and other techniques prove valuable. Practical details are important, and we take time to answer any and all questions a patient might have. The physician-patient partnership around overall health goals is crucial. As partners, they can work together to include exercise as one tool among many to help achieve good health.

Follow-up is also key to encourage continued elaboration of goals, to educate about the interventions, and to support motivation. An exercise regimen is not static, and for best effect changes organically over time.

We have also found it is important to describe our own exercise experience, as a way of modeling what is possible.

Here's how we make room for exercise

We have discovered many techniques that help us maintain our exercise routines in the face of the daily demands of busy lives. Here is a partial list.

• On Sunday night, when you think about your week, schedule your exercise just as you plan for work, errands, and other commitments. It's easier to stick with it when you have concretely planned time.
• Mix it up. Plan different types of exercise to challenge different muscle groups, as research shows us this is the best way to stay in shape and develop endurance and muscle mass.
• Don't get bogged down if you don't have a lot of time. Research has demonstrated that intense, short bursts of exercise can be as effective as a longer workout, perhaps more so.
• Get your heart rate up, but watch it recover to baseline too. Wearing some type of heart rate monitor can be helpful.
• Try something new. Winter is a great time to try cross-country skiing. In the summer, why not go for a kayak paddle? Everything physical that you do counts as exercise.
• Find an exercise buddy. That way, if you want to beg off, your partner can motivate you, and vice versa. Our cardinal rule is: never miss your exercise session!
• Consider a consult with a personal trainer. You don't need to commit to the time or expense of regular meetings, but a one-time consult can be informative and motivating.
• Keep an exercise journal, at least at the start. You will be surprised when you concretely see how much progress you are making (be sure to set goals).

Do remember to get an okay from your PCP before you start. And one last thing — it never fails to motivate us that exercise can decrease your risk of developing cognitive impairment. That thought has us lacing up our running shoes and heading out the door every time. Hope we see you out there.

Sources

Enhanced Protein Translation Underlies Improved Metabolic and Physical Adaptations to Different Exercise Training Modes in Young and Old Humans. Cell Metabolism, March 2017.

Three Minutes of All-Out Intermittent Exercise per Week Increases Skeletal Muscle Oxidative Capacity and Improves Cardiometabolic Health. PLOS One, November 2014.

Christopher Bullock, MD, MFA (1947–2018), was a psychiatrist, psychoanalyst, and writer. He loved Gary Snyder's poetry; "all the junk that goes with being human" was a quote that inspired his life, his work, and his illness.

In a new online course from Harvard Health Publishing, Starting to Exercise, today's leading fitness instructors show you workouts that work...the exercises that will help you enjoy a healthier, more vigorous, and longer life. You can access Starting To Exercise on your smart phone, tablet, or desktop computer. With easy log-in and simple-to-navigate screens, this online course is designed for adults of all ages.