Do you really need to exercise?

Wondering about the benefits of exercise? Debating whether you actually need to go to the gym? The GQ Doctor reveals what happens to our bodies when we do... and when we don't!

By Dr Nick Knight, GQ

Fifty Shades Of Grey has nothing on the ambiguity of exercise. The questions roll of the tongue of millions each day. "Why do it?" "What do I do?" "When do I do it?" And, of course, to help with the confusion, the market for information has exploded exponentially, with advice now not only coming from your friend in the pub but from all corners of social media – in all shades of brilliance and bull. So, while we sit and panic that our body mass indexes are sliding out of control faster than eleventh hour Brexit talks, here is a calming five-part snapshot of what you need to know about you and your exercise.



1

Why should I exercise?

While the international cheer squad for exercise has an open-door policy and only one simple rule – movement trumps inertia – it often circumvents the question of why, preferring instead to focus on its kaleidoscope of betterment. It's a trick missed though, as knowledge and understanding breeds motivation. Naturally there are multiple answers and here are my top three.

Exercise improves your cardiovascular profile

In response to exercise, your heart muscle grows (hypertrophy) and becomes more efficient. In doing so, the volume of blood (supply) pumped from it each minute (cardiac output) serves your body (demand) with less effort. Almost symbiotically, the coronary blood vessels directly supplying the heart muscle with oxygen and nutrients, and other blood vessels throughout your body, cope better against any stress damage to their endothelial cell linings. The result is an efficient heart, able to respond to any increased metabolic demand in the body by pumping a supply of oxygen and nutrient-rich blood to the cells in need, via a healthy, pot-hole free vascular motorway.

Exercise improves your cellular and metabolic profile

Exercise places healthy stress through your bones. And bones respond by maintaining their mineral density, thanks to cells such as osteoblasts. Additionally, regular exercise enables a more stable internal equilibrium (homeostasis) which helps deal with potentially disease-enabling sugars and cholesterols. For sugar, there is improved sensitivity and efficiency in its metabolism and storage; while for cholesterol, exercise lowers their harmful lower-density lipoproteins, keeping our blood vessels unclogged from atherosclerotic plaques. As if that wasn't good enough, exercise also help reduces levels of free radicals (which damage cells) and boosts immune function, all contributing to a reduced cancer risk.

Exercise improves your anthropometric and psychological profile

Muscle hypertrophy, optimal body fat levels, improved communication between muscles and nerves (neuromuscular) and between joints and nerves (proprioception) all facilitate your body's functional performance with greater precision, economic efficiency and lower injury risk. And not only should you feel great, with reduced stress and anxiety but courtesy of exercise-induced neuronal development, you'll feel smarter, with better memory and cognitive performance.

Despite these complicated networks of adaptations, the reward of exercise has always remained simple. After all, in a life where you wish to live as full, hard, happy and healthy as humanly possible, having a body and mind with more efficiency, more performance and more reserve is irreplaceable.



2

How much should I exercise?

Our needs will all be different. Perhaps you want to lose 25lbs, recover from a hip replacement, control your type 2 diabetes or just get ripped. In 500 words, that's impossible to cover. Instead let's focus on one we should all universally care about: not dying young. To achieve this, we need a balance of cardiovascular, respiratory, bone, immune and metabolic health. And that’s the abridged list.

Thankfully, being a nation that loves order, the Department Of Health duly stepped up and prescribed a recommended weekly exercise target for adults. This comprises 150 minutes a week of moderate to vigorous activity that can be made up of as little as ten-minute sessions (or two 75-minute vigorous sessions), accompanied by two muscle-strengthening sessions and advice to minimise time spent sedentary. If you're unsure how to grade the intensity, the sing-talk test will help: if you can sing, it's low; if you can talk but not sing, it's moderate; and if you can't even talk it's vigorous.



3

Is there a specific exercise I should do?

This is a very common question and depending on how you ask it you’re going to get a range of sensible to ridiculous answers. My honest answer is no. Just think about it this way, if we were talking about nutrition, there is no one food that we must eat. The answer, as with most things in health, is to do a variety. Mix up your exercises to give you the best-rounded fitness. But if you put a gun to my head, I’d say deadlifts is my No1 exercise for musculoskeletal health and swimming is my No1 exercise for cardiovascular health (low impact on joints).



4

How can I get the most out of my exercise?

We could be here for a long time if we pick apart all the different aspects that apply to all the different types of exercise we might do. So, as we all have lives to get on with, let’s look at five principles that can be applied to whatever you are thinking about doing.

Set yourself "smart" goals

S for specific: Your target goal should be tangible (eg, run ten kilometres in under and hour or walk the kids to school)

M is for measurable: Your target goal should be quantifiable so that you can monitor progress
A is for achievable: Your target goal should be one that is suitable for you
R is for realistic: Your target should be a realistic given your time, fitness and resources

T is for time-based: Your target should have a timeline for completion

Have recovery as part of your training

Whatever exercise you do, the adaptations to your body occur in the rest and recovery phase. Without this, there isn’t sufficient time for them to occur. The knock-on effect if you don’t allow this recovery is that you begin to accumulate fatigue, fail to progress and develop over-training syndrome. The amount of rest you give yourself is up to you, but remember, if you want to keep your training load up, you can just rest a body part and exercise another part the next day.

Avoid boredom with cross training

While being specific to your goal is important (eg, if you want to get fit for a half marathon your specific exercise is running) you can diversify. By cycling or swimming you are still exercising your cardiovascular system, which is the cornerstone to your running success. Strength endurance (high repetitions with a lighter weight) training is now a key part of any endurance training to further build neuromuscular endurance. Plus, you won’t get bored just running every day – or knacker your knees.

Aim for gradual progressive loading

Whatever your goal, you need to gradually increase your training loads so that you continually stimulate more adaptation in your body. It’s a marathon not a sprint here and patience is key. Have a target goal and then, week on week, slowly add more load when you feel you are ready. For example, half marathon training may see your total distance increase by a few miles each week then plateau for a few before then increasing again. The same with weight training – as the sets and repetitions become easier, that’s the time to load more weight.

Fuel and hydrate

They say the gains in training are found not in the gym or parks but in the kitchen. Make sure you refuel with a balanced diet that has a good amount of protein (the magic number is 1.2-1.5g of protein per kilogram of bodyweight per day for most training activities). And drink to thirst so that you yield clear or straw-coloured urine. No rocket science there.



5

The final message

If you find this frustrating, please don't. I'm trying to show you that not only are we all physiologically unique, but that our goals will likely be as well. And besides, exercise should not become a number-driven target. That's the stick approach. The carrot incentive is finding an activity that you enjoy and invest time in. This is the surest first step to exercising regularly. After that, more often than not, you will find yourself creeping towards meeting the national guidelines and your performance goals come into view. If you don't meet the guidelines, don't get too downhearted. Exercise of any kind is an investment that will always give you a return, one way or another.

That's why exercise is medicine.