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Physical fitness: fact or fiction?

Photo courtesy of the Illinois Governor's Council on Health and Physical Fitness.

The effectiveness of exercise for making someone live longer is still unproven.

By Stuart Frank, M.D.

I don't know how many people exercise regularly. I have read estimates ranging from 12 million to 55 million. I'm not sure where authorities get these numbers. They probably come from a small and theoretically representative sample of the population which is then extrapolated to the entire population, or perhaps from a questionnaire to a select group, or possibly from an estimate of how many jogging shoes were sold last year.

I hesitate to suggest that some authorities simply make up a number — say 22 million, which then becomes authoritative dogma for someone like me to copy with confidence. I think we can all conclude that there are many, many people who are out in the parks and on our city streets exercising with varying degrees of regularity.

A quest for health

I would suggest that 80 percent of these 22 million joggers or cyclists exercise at least in part, if not entirely, because they think it is good for their health. Most people exercise more out of commitment to good health than for fun, pleasure, excitement or competition.


Illinois Parks and Recreation 20 March/April 1985


This means that 17.6 million people (my arbitrary 80 percent of my totally imaginary 22 million people) are undergoing a type of health treatment. They are spending perhaps 30 minutes to an hour a day jogging, swimming, dancing, lifting weights and so forth to improve their health. An hour a day means nine weeks a year (calculated on a 40 hour-week basis) just for exercise alone.

I wonder what the Food and Drug Administration (FDA) would rule if some scientist proposed this new form of treatment (called "exercise") to prevent heart disease and presented it for approval. The FDA requires that a new form of therapy must be demonstrated as safe and effective before it can be utilized. It seems quite certain, based on reasonable expectations and on what the FDA currently requires as proof, that "exercise" is far from safe. Also, the case for its effectiveness for the treatment or prevention of anything is far from established with even remote legitimacy or scientific proof.

Benefits and hazards

Nevertheless, literally millions of people are running hundreds of millions of miles through the parks and swimming countless laps across YMCA pools. No one would or should tell them all to stop exercising because what they are doing is a foolish waste of time. People exercise for a vast variety of reasons, most of which are related to their health. Some people exercise to lose weight, improve muscle tone, enhance their sex appeal or help stop smoking, each of which alone entirely justifies the effort.

Photos on this page courtesy of the Springfield Recreation Department.

Sad to say, despite everyone's conviction to the contrary, there is no convincing evidence as yet that exercise will prevent a heart attack or will make one live longer. For some, perhaps, the exercise is foolish and futile. For others it may be potentially hazardous. The benefits and hazards depend on the pattern of exercise. Most people fall into one of the following groups.

The early dropouts

These are the folks who get overly enthusiastic too soon and peak very early, or the people who grudgingly start to exercise because "someone else" thinks it's a good idea for them. In this group we find those who are simply catching on to the latest trend or those who view exercise more as a social event. These are the people who lack the motivation, don't understand what it's all about and wonder why all the enthusiasm prevails.

This group achieves zero benefits from their transient brush with exercise. Fortunately, they don't suffer from any of the consequences or complications, except perhaps a large dose of guilt generated in part by a nagging spouse or doctor.

The periodic exercisers

Here we find the weekend or the occasional jogger. He likes to exercise sometimes, but not too often, and only when it's convenient. Some weekends perhaps, but not all, and sometimes only once a week instead of twice.

In this group we find the intermittent or interrupted exercise pattern. There is a surge of enthusiasm for a few days (or a few weeks) which is then discarded or set aside like a Christmas toy. It is to be picked up again when the weather is nicer or some other inspiration fires one's enthusiasm.

There is no cardiovascular benefit whatsoever in this group and probably some real hazards. These are the people who end up with the acute orthopedic injuries — sprains, tears and stiffness. These early injuries charitably usually take this crowd off the road relatively early and spare them the guilt of being a "quitter."

The fair-weather fellows

These people wait for the spring with enthusiasm and take their exercise quite seriously — for three or even six months. Then enthusiasm wanes when the leaves fall and the jogging shoes or the tennis rackets are put away for the winter. This group is not only seasonal, but also periodic. It is characterized by serious exercise with no continuing commitment. Here are those whose "spirit is willing but whose flesh is weak."

The cardiovascular benefits in this group are, unfortunately, relatively transient. The value of exercise does not persist for very long once the program is discontinued. The flower which has flourished all summer dies


Illinois Parks and Recreation 21 March/April 1985


quickly without nourishment. The cardiovascular conditioning, the effect on pulse and blood pressure, and the benefit in terms of blood platelets and blood lipids are all relatively transient.

In 10 days to two weeks after regular exercise has been discontinued, most of these parameters have returned to their pre-exercise level and no value of the previous exercise can be measured. The sad message is that if exercise is to be of any cardiac value, it must not only be regular, but it also has to be a continuing commitment. A little bit, for a short while is good, maybe, but only for a little bit and for a short while.

The exercise fraternity

This is a small group of serious exercise enthusiasts. These are the people who know what they are doing, take their exercise quite seriously and enjoy it. Here we find the competitors and those who make exercise literally part of their lives, not something extra added on when there is time or opportunity. These often are the people who started exercise in adolescence. Few people achieve this level of commitment and fewer still who start late in life belong to this group.

If anyone is to achieve any longterm cardiovascular effects of exercise, it is likely to be the people in this group. With regular and sustained exercise the cardiac effects may be substantial. However, the benefits in terms of prevention of heart attacks or prolongation of life are curiously hard to document. It is probable that the effect on longevity in this group is small, and hard to separate from other more potent risk factors which influence our lives.

Unfortunately, this is the group that will probably be making the orthopedists very rich 10 and 15 years in the future. These people are the group of potential hip, knee and ankle problems of the future, not with the simple tears or sprains, but with disabling injuries which are the result of chronic, recurrent minitrauma to the bones and joints.

The exercise zealots

These are the people who make a religion out of exercise. These people don't feel good if they miss a day.

Here are people who are compelled to exercise to satisfy a different need other than the exercise itself. These are the folks who get "their miles in" regardless of the weather, even when they are sick, often at the expense of other responsibilities, their families, their jobs or their health.

It is hard to know if these exercise fanatics achieve any cardiovascular benefits from their efforts. The value of the exercise is hard to separate from the other overwhelming idiosyncrasies of their life style, their diet, their abstinence from alcohol and tobacco, and their obsession with weight and good health. The benefits are impossible to determine. The hazards of this life style are equally obscure.

If you belong to the exercise fraternity, you and your heart are probably going to benefit, although hard scientific proof is still not available. The price is high, however, and everyone has to decide for himself if the small benefit is worth the major effort.

The early dropouts, periodic exercisers and fair-weather fellows should continue to exercise if they enjoy it or for whatever reason motivates them, but not because it's improving their health. It doesn't. The fanatics in the last group have my sympathy.

ABOUT THE AUTHOR: Dr. Stuart Frank is an associate professor and chief of the Division of Cardiology at Southern Illinois University School of Medicine in Springfield. He is also president of the American Heart Association, Illinois affiliate.

DOC sets new policy for licenses

Initial resident and nonresident commercial fishing device licenses are being sold only through the Illinois Department of Conservation's (DOC) Springfield office.

In the past, licenses were consigned to DOC license vendors throughout the State. The change was made so the DOC could more accurately monitor the poundage and value of the annual State commercial fish harvest, as required by State statute.

Gear licenses will continue to be sold through local license vendors.

The fee is $25.50 for residents, and $100.50 for nonresidents. Applications may be obtained from the Department of Conservation, Commercial Permit Section, 524 S. Second St., Springfield, IL 62706 (217/ 782-2965).


Illinois Parks and Recreation 22 March/April 1985


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