We all know it: we are spending far too much time sitting and not enough on our feet and it is doing us no good at all.
But while we all know we should exercise, how much is enough? After all, we don’t all aspire to be champion athletes.
Livehealthy asked three experts to give their views and the good news is that a little exercise goes a long way. No need to spend an hour working flat out in the gym every day – just keep active, keep it consistent and remember that the real benefits are happening on the inside of your body
Dr Philip Fischer is a consultant in pediatric and adolescent medicine at Sheikh Shakhbout Medical City. Newly-arrived in Abu Dhabi, he spent 22 years at the world-famous Mayo Clinic in Minnesota. He has conducted research into exercise as related to chronic fatigue.
Dr Ayaz Virgi is medical director of the New York University Abu Dhabi Health and Wellness Center.
Mustafa Adnan transformed his health radically after getting a scary prognosis when he was still a teenager. He is the co-founder of Strike, an outdoor gym in Abu Dhabi.
How is our sedentary lifestyle affecting us?
Dr Ayaz Virgi: Sitting is the new smoking. We are seeing a rise in diabetes, heart disease, cancer and sleep apnea (a potentially serious sleep disorder in which breathing repeatedly stops and starts) – not just in adults but in adolescents and children, too. By 2030, fatty liver, which is caused not by alcohol but by obesity and inactivity, will be the number one reason for liver transplants.
What people don’t know is that while obesity and an inactive lifestyle are linked, they are independent conditions. Obesity is a chronic inflammatory condition in itself, but even if you don’t have excess body weight, an inactive lifestyle is a separate, independent risk to your health.
Fat cells are metabolically active – they are not inert at all, and they secrete 50 different hormones.
Dr Philip Fischer: We know obesity is dangerous and can lead to strokes and high blood pressure even in children and teenagers. It also makes Covid worse.
Being overweight is a problem but being inactive is a problem too, and together they’re both worse.
Mustafa Adnan: When I started my fitness journey I used to have only two meals a day. The problem? I was sitting most of the time, playing computer games and so I gained a lot of weight in a short time. It’s not about how many meals you eat, it’s about how active you are.
What is the real marker of what good health looks like?
Dr Fischer: As a pediatrician I treat a lot of adolescents who are dealing with peer pressure. The health effects of being active are more internal than external and those internal factors relate to health, quality of life, mood and even infection.
Cortisol hormones build up at night and get used up in the day so exercise and activity are a good way to keep those hormones circulating well.
Having visible six-pack abs is a sign of specific types of exercise, but internal effects don’t depend on what the external body looks like. Most people with abs are fit and healthy but that’s because they’re doing other things besides working on their abs. What we need is balanced healthy activities. Abs or biceps are not the whole answer.
Dr Ayaz: Looking good is a nice side effect, but one very important effect of activity is on the immune system.
We have three layers of immunity and they work more efficiently when you’re active. You get better protection against viruses, too, like the flu. The risk of dying from flu or post-operative sepsis is higher if you’re inactive. The risk of any bad outcome is higher.
Mustafa: My wake-up call came at 16 when a nurse told me I already had high cholesterol, high blood pressure and was at risk of diabetes. I lost the weight but not in a healthy way and that puts your immunity at risk. My skin changed, my mood was bad, both at work and with my family.
How often do we need to exercise to be healthy on the inside?
Dr Ayaz: It depends why you’re doing it. Some people may need to improve sporting performance or cardiovascular fitness. The World Health Organization recommendation for kids and adolescents is 60 minutes of moderate to intense activity on most days. For adults it’s 30 minutes of moderate to intense activity on most days.
The point is, what can you do that’s sustainable? What’s easy for you? Working out intensely for a month and then stopping isn’t going to help. It’s got to be a lifestyle change.
The modern built environment is not a bad thing, but we have engineered physical activity out of our lives. Lifts are very good for those who need them, like the disabled, but you can take the stairs.
There was a fascinating study done in the 1950s on postal workers. There was 30 percent less incidence of cardiovascular disease in the men who were out every day delivering the mail than in the clerks in the office.
Dr Fischer: Sixty minutes may sound like too much but remember, the recommendations also say moderate as well as intense, so break it down like this: at least 30 minutes of vigorous exercise, like cardio aerobic, where you’re breathing faster than normal, and then 30 minutes of moderate, which can mean just doing some normal physical activity outside, like gardening.
It’s vitally important to integrate activity into our lives and we can all do it. Get up and walk down the hall to talk to someone instead of calling. I’ve seen pictures of escalators carrying people up to go exercise in a gym!
Mustafa: Our outdoor gym became popular during Covid because it was outside and people felt better not being in a confined space. Unfortunately, because of the weather, it’s part of the culture here that people don’t walk much. Instead of walking to the grocery store, they sit in their car and honk the horn until someone comes out to serve them.
What about women? They react differently from men, especially around menopause?
Dr Ayaz: Good point, because women do change physiologically, especially around menopause. Any active lifestyle must be customized to the individual. It’s about what you can do rather than what you must do.
Rather than think about where they should be with their fitness, I tell patients to focus on where they are now. If they’re walking for 10 minutes three days a week, let’s try for 20 minutes. Let’s try for a speed of three to four miles an hour, which gets your heart rate up but you’re still able to hold a conversation. This is where a personal trainer can be helpful.
Dr Fischer: The issues with calcium and vitamin D in bones, which I see in kids can apply equally to menopausal women. For bone health, weight-bearing exercise is the most helpful so that means walking rather than water aerobics.
How do we know if we’re exercising too much?
Dr Fischer: Losing more weight than you should, feeling overtired after exercise and, in girls, irregular periods or no periods.
Dr Ayaz: Shin splints and stress fractures on the feet.
Mustafa: Low testosterone. If you’re eating very few carbs or very little fat, you’ll lose testosterone and that’s no good for building muscles or for your general health.
What about diet?
Dr Ayaz: Again, it depends on what you’re trying to do. Nutrition should be addressed with a scalpel, not a machete.
Building muscle and reducing fat are very different. To build muscle, eat protein with a higher insulin index, like whey. For fat-burning you need a lower insulin index protein, like egg protein.
What’s important is the quality of the nutrients. You don’t want refined proteins because then there’s a risk of colon cancer; not bad carbs, such as potato chips, but good carbs from fresh fruit and vegetables; good fats and not trans fats.
Dr Fischer: Everyone should make sure they’re getting enough iron. Deficiency in iron is more common in women because of their monthly blood loss. If you’re feeling run down or more tired than usual, iron deficiency is one of the first things I would check for. It’s a balance issue and not something for a quick fix with a quick fad.
One piece of advice from each of you?
Dr Ayaz: Figure out a way to put activity into your life. Take the stairs, park the car a bit further away. Have one of those standing desks so that your posture muscles will get the benefit. And get outside, as that’s good for your mental health. Mustafa’s outdoor gym sounds perfect!
Mustafa: There’s no single look that means you’re healthy but whatever you do, don’t take it to extremes. Have a life as well.
Dr Fischer: Looking better should not be the ultimate goal, but that’s often where a teenager is going to start. Set a tangible, realistic goal that you can implement into your life and just do it. The most important step is the next step.
Dr Philip Fischer, Dr Ayaz Virgi and Mustafa Adnan were the guests in a panel discussion at the Livehealthy Festival on January 22, 2021. The panel moderator was journalist and global influencer Danae Mercer.