When asked about the key to his remarkable longevity, Carmelo Flores Laura, who lived to the age of 106, attributed it to a simple practice: “I just walk a lot, that’s all.” As a shepherd, he led an active life, walking extensively every day. For a long time, his claim remained unverified. However, in 2018, groundbreaking research emerged, demonstrating that physical exercise could indeed rejuvenate our hearts.
Back in 1984, American rheumatologist Eliza F. Chakravarty and her team embarked on a study to investigate whether long-distance running might increase the risk of knee arthritis. Unexpectedly, their research uncovered a different revelation. Jogging was found to decelerate the aging process and extend life. Their study involved 538 runners aged 50 and above who were part of the Runners Association running club. A comparative analysis was conducted with 423 participants from the Stanford University Lipid Research Clinics Prevalence Study, comprising university staff and faculty. The two groups exhibited similar demographic characteristics.
Fast forward to 2005, and the study involved 284 runners and 156 individuals in the control group. Additionally, 73 more individuals from Stanford University who had taken up running to avoid a sedentary lifestyle were included before 2005. Mortality data for the participants were sourced from the National Death Index. Adjustments were made for factors such as age, gender, smoking, and body mass index. The runners experienced a delayed onset of disability, appeared more youthful, and this divergence grew with each passing year of observation. While the causes of death remained consistent between the study groups, runners tended to outlive these causes by a significant margin.
In 2013, a group of Finnish scientists embarked on a prospective study, focusing on pairs of same-sex twins born prior to 1958. Within these twin pairs, there were both heterosexual and homosexual pairs. While earlier research had indicated that regular physical activity contributed to better health and increased lifespan, this hypothesis was rigorously examined by the Finnish researchers. These twins shared identical genetics, grew up in the same environment, and had similar epigenetic factors. However, the question lingered: could moderate aerobic exercise influence their lifespans? A total of 11,325 individuals participated in this study. By the study’s conclusion, 458 twins who led a sedentary lifestyle had passed away, alongside 201 twins who maintained an active lifestyle. An active lifestyle was defined as engaging in sports or other physical activities at least six times a month for a continuous 30-minute duration, with an intensity equivalent to brisk walking. Remarkably, among the heterozygous twins who adopted an active lifestyle after the age of 50, an additional 4-5 years of life were observed when compared to their same-sex siblings. Unfortunately, the study couldn’t be extended to homozygous twins due to an insufficient number of pairs.
In another prospective observational study involving 55,137 individuals, which spanned 15 years and included 24% of barefoot runners, it was revealed that even minimal barefoot running, such as 1-2 times a week for less than 51 minutes or running 5-10 minutes a day at a leisurely pace, could potentially extend one’s lifespan by an extra three years. These findings serve as a motivating factor for individuals who are generally healthy but lead sedentary lifestyles.
The question naturally arises: can medications prescribed for cardiovascular diseases (CVD) in people at high cardiovascular risk effectively replace the benefits of regular running? Could combining medication with moderate jogging potentially enhance life expectancy even more than medication alone? A comprehensive Cochrane review and meta-analysis of randomized controlled trials (RCTs) conducted in 2016, which encompassed 14,486 participants, offered intriguing insights. The studies focused on individuals with ischemic heart disease (IHD) and evaluated the impact of moderate endurance aerobic exercises alongside CVD medication treatment. A majority of these studies were conducted in Europe (37 studies) and North America (12 studies), with participants averaging 56 years of age. The meta-analysis revealed that aerobic exercise, when combined with medication, not only reduced mortality rates but also increased the average life expectancy by approximately 2-3 years.
Physical activity has a profound impact on extending life primarily due to its rejuvenating effects on the cardiovascular system. Endurance training, even when initiated at an average age, can have transformative effects on the heart and blood vessels. Research from the RKI (Robert Koch Institute) demonstrates that just two years of regular training can significantly increase the stroke volume of the left ventricle of the heart, which measures the amount of blood the heart pumps with each contraction.
This increase in stroke volume indicates that the heart has become more efficient at pumping blood, a critical step away from heart failure. The heart becomes more youthful and elastic, as evidenced by a 19% reduction in the stiffness of its left ventricle.
Physical exercise is also known to alleviate symptoms of Ischemic Heart Disease (IHD). Dr. William Heberden, who first described angina, documented a clinical observation where consistent daily physical exercise over six months led to the nearly complete disappearance of angina symptoms. Furthermore, a comprehensive meta-analysis conducted by Taylor and colleagues, involving data from 8,940 patients with IHD across 48 Randomized Controlled Trials (RCTs), revealed that aerobic exercises can reduce overall mortality by 20% (adding approximately 2 years to life) and decrease deaths from cardiovascular diseases by 26% (extending life by 3 years for such patients).
These findings were corroborated in a 2011 meta-analysis encompassing 47 RCTs with 10,794 patients engaging in aerobic exercises for 6 to 12 months. The result was a significant reduction in mortality from cardiovascular diseases. Additionally, an updated Cochrane review in 2019 reaffirmed the decrease in mortality from cardiovascular diseases associated with moderate aerobic exercise. Prospective RCTs have even demonstrated that combining optimal medical therapy with rehabilitation through running or walking is as effective as interventional methods for patients with small areas of myocardial ischemia (less than 10% of the heart muscle) and stable angina.
Now, let’s delve into how physical activity impacts the heart. A common cardiovascular issue is stenosis, or the narrowing of blood vessels, often caused by the formation of atheromatous plaques. When stenosis completely obstructs the vessel’s lumen, it restricts the flow of oxygen and nutrients to the heart muscle, potentially leading to myocardial infarction (heart attack). Currently, coronary stenting is recommended when vessel lumen narrowing reaches 70% or more, addressing this critical issue.
Indeed, the level of stenosis, or the narrowing of blood vessels, can be positively influenced through aerobic exercise. The extent of change in minimum stenosis diameter depends on the type and intensity of physical activity the patient engages in. Research has indicated that individuals who engage in aerobics for 5-6 hours per week, burning at least 2200 calories during this activity, coupled with a dietary plan aimed at reducing cholesterol and inflammation, have been able to achieve substantial improvements in coronary plaque. Specifically, there was a regression of stenosis in the proximal left coronary artery, reducing it from 70% at the beginning of the exercise regimen to 59% after 12 months of consistent training.
However, it’s worth noting that engaging in aerobics for just 150 minutes per week may not yield the same benefits. To effectively improve cardiovascular health and reduce stenosis, it is necessary to commit to a more substantial exercise routine, ideally totaling 300-360 minutes per week. It’s recommended to start with light exercise loads and gradually increase the volume of training over a span of 6 months.
Now, when considering the long-term benefits of aerobic exercise over many years, studies have provided valuable insights. The optimal exercise duration that offers maximum life-extending benefits falls within the range of 150-180 minutes per week. Activities that are less intensive, totaling less than 90 minutes per week, may not produce significant benefits in the long run. Importantly, moderate aerobic exercise within the 150-300 minute per week range has been associated with the slowest rate of aging in the immune system. However, it’s essential to avoid excessive training, exceeding 360 minutes per week, as this can potentially be more harmful than leading a sedentary lifestyle. Finding the right balance in exercise duration and intensity is key to reaping the full benefits of physical activity over the years.
Chinese Tai Chi exercises can have a positive impact, possibly due to their moderate aerobic nature. Researchers from Vanderbilt University in the USA discovered that engaging in regular moderate-intensity exercises reduces the risk of mortality from any cause and can increase life expectancy by roughly two years. While Tai Chi practice was found to have a similar influence on mortality as walking and running, it was somewhat less pronounced. The study involved the observation of 61,491 men between the ages of 40 and 74 over a six-year period, with the lowest mortality rates associated with 5-6 hours of physical activity per week.
In a comprehensive 34-year study conducted in the United States involving 123,219 participants, the benefits of physical activity on longevity became even more apparent. On average, physical activity extended life by 12 years for men and 14 years for women when compared to individuals who smoked, had unhealthy diets, and led sedentary lives. Those who embraced an ideal lifestyle, which includes regular physical activity of at least 30 minutes a day, enjoyed an additional average of 5 years of life, offering the potential for a remarkable 20-year extension in total.
How to Combat Muscle Aging
Muscle aging is a natural part of the human life cycle, but there are effective ways to delay its onset and mitigate its impact. Between the ages of 18 and 50, the average number of muscle fibers remains relatively stable. However, by the time we reach 80, it decreases by a staggering 50%. This decline is associated with a condition known as sarcopenia, which is characterized by the degeneration of skeletal muscle mass, quality, and strength as we age, often exacerbated by a sedentary lifestyle. Typically, individuals start losing about 1-3% of muscle mass per year after the age of 50, and in some cases, this process begins as early as 35. Sarcopenia not only leads to a reduction in muscle mass but also results in decreased muscle strength and overall physical fitness. One telltale sign of its development is when a person’s walking speed falls below 1 meter per second in daily life. Sarcopenia can ultimately lead to disability and even mortality, robbing individuals of their ability to move independently.
Research conducted by American scientist Doress Wagner at John Hopkins Hospital in the United States has shown that sarcopenia is associated with a higher risk of mortality within the three years following diagnosis. A significant contributing factor to the development of sarcopenia is the lack of physical exercise. Even highly trained athletes who continue to exercise throughout adulthood experience a gradual decline in muscle mass and strength, albeit at a slower rate than those with sedentary lifestyles. Masters of sports, including marathon runners and weightlifters, typically experience a decline in muscle performance after the age of 40, with peak muscle performance decreasing by about 50% by the age of 80. The experiences of both elite athletes and previously sedentary older individuals who undergo well-designed, carefully monitored exercise programs provide compelling evidence that age-related muscle atrophy, weakness, and fatigue can be slowed down, if not entirely halted.
In a comprehensive review conducted by John Kristy at Queen’s University in Belfast, known as the Kokreyevsky review in 2009, it was established that physical exercise in old age can significantly improve physical performance and muscle strength. Despite advancements in technology, physical training remains the most effective method for preventing and addressing sarcopenia. The most efficient approach involves a combination of 2-4 weekly training sessions that focus on muscle strength development, aerobic endurance (such as running or swimming), and flexibility. During muscle strength training, the tension in muscle fibers activates crucial signaling pathways, including mTOR, protein kinase, and calcium-dependent pathways. This activation directly stimulates muscle protein synthesis, promoting muscle growth and increasing the body’s growth hormone levels. Importantly, unlike growth hormone injections, physical exercise does not carry the risk of cancer or atherosclerosis development. Instead, it naturally regulates the body’s growth hormone production. However, it is essential to engage in these exercises under the supervision of a qualified specialist to minimize the risk of injury.
Researchers at Tufts University in the United States conducted a study involving 57 adults aged 65-94. Their findings revealed that strength exercises performed three times a week led to increased muscle strength in as little as 12 weeks, regardless of age. This underscores the notion that regular physical activity can be a powerful tool in the fight against muscle aging.
Practical Guidelines:
Step 1: Invest in a heart rate monitor to track your heart rate during runs. Calculate your target heart rate range as follows:
Minimum Heart Rate: (220 – Your Age, in years) × 0.6 = Minimum Heart Rate Maximum Heart Rate: (220 – Your Age, in years) × 0.85 = Maximum Heart Rate
For example, if you’re 40 years old, your target heart rate after 5 minutes of exercise would be:
Minimum: (220 – 40) × 0.6 = 108 beats per minute Maximum: (220 – 40) × 0.85 = 153 beats per minute
Step 2: Before commencing your training regimen, consult with a healthcare professional to conduct an electrocardiogram (ECG) and a heart ultrasound. This is essential to identify any potential contraindications for exercise. Contraindications for running include:
- Unstable angina
- Recent myocardial infarction
- Uncontrolled heart arrhythmia
- Severe aortic stenosis or other heart valve defects
- Decompensated heart failure
- Acute myocarditis or pericarditis
- Bradycardia (abnormally slow heart rhythm, not related to “athlete’s heart”)
- High blood pressure (systolic blood pressure >200 mm Hg, diastolic blood pressure >110 mm Hg)
- Severe anemia
- Electrolyte imbalances (diagnosed through blood tests)
- Hypertrophic cardiomyopathy
Step 3: Select your preferred type of exercise. Research suggests that barefoot running offers unique benefits for longevity compared to other forms of aerobic activity like cycling or swimming. Pay attention to the duration of your weekly workouts and your heart rate during exercise.
Step 4: Choose appropriate gear, such as comfortable clothing and proper footwear. It’s advisable to seek advice from experts, particularly for running, where specialized shoes can reduce knee impact.
Step 5: Master your technique. Whether you’re running or engaging in Nordic walking or any other form of aerobics, correct technique is vital to minimize the risk of injury.
Step 6: Gradually increase your workload. If you’re new to running, start with three sessions per week, each lasting 40 minutes of walking. Monitor your heart rate using your heart rate monitor and progressively increase your distance. Over time, your walking will transition into running. The adaptation period varies for each individual, so focus on staying within your target heart rate range as calculated earlier.
Step 7: Incorporate strength training exercises into your routine, such as push-ups and pull-ups, to enhance your overall fitness.
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