Guest Blog:Urgent Care Perspective – Need to HIIT The Gym

This post has come a little later than planned, but I’m hoping the start of March sees everyone still sticking firmly to their new year resolutions, and enjoying the rewards?

I’m actually doing pretty well on mine, although the carpet on the stairs is looking a bit thinner…To explain that statement cast your minds (or browsers) back to my last post, about obesity and weight loss. One of the recurrent messages in the research I did for that was about the beneficial effects of physical activity. I therefore resolved not to leave stuff at the bottom of the stairs until the next time I climbed them, but to take it up then and there. And to carry the laundry up in 3 separate piles, not one giant one. The change was achievable and maintainable – it only adds minutes to the tasks, and the tasks have to be done regularly. So, I’m still doing it. Over 2 months the steps have added up, and, importantly, I don’t view myself as having failed.

The point I’m making is that there is no benefit in making crazy promises to yourself about how much exercise you will do, if it is not sustainable with the way your life is. And it turns out that smaller resolutions are still ok, because science is telling us that even small increases in physical activity make measurable improvements to health. In 2019 Professor Ekelund and colleagues did a meta-analysis (where data from multiple different research studies is pooled, essentially creating a ‘super study’ to give a more reliable answer to the question) which assessed the risk of dying (from anything) against how much physical activity an adult was doing. The biggest drop in risk of death occurred when moving from the least active group, to the slightly more active group. The risk dropped further (but less steeply) on further increases in activity level, ending up with the risk of death in the least active group being around 4 times that of the most active group. For those undertaking only light physical activity the pattern was the same, ending up with the least active group being at about 3 times the risk of the most active. It also looks from this study as though too much time sitting still could independently increase the risk of death. Or put another way a person doing their recommended 150 mins moderate exercise per week, but sitting still for all the rest of the time, is at higher risk than someone who is doing the same exercise but moving about more the rest of the time. Both are obviously better off than someone doing less exercise.

This is pretty convincing evidence that not only exercise, but also just MOVING MORE, is good for our health. So even if you are not in a position to make a big increase in activity levels, anything that means you are moving more is doing you good.

You might now be wondering why the NHS advice (https://www.nhs.uk/live-well/exercise/) is to do at least 150 mins moderate or 75 mins vigorous exercise each week, as well as muscle strengthening activities on 2 days per week. This is based on the volume of exercise used in the available studies at the time when the chief medical officers needed to put together something concrete to address the crisis of inactivity in the UK. Since then the original advice has been reviewed in light of each new study, with tweaks made when needed, and you will note at the top of that web page it says ‘Any type of activity is good for you. The more you do the better’, which aligns it with the last paragraphs, but leaves the 150/75 mins targets to encourage us all to strive for more.

Those lofty targets looked daunting to this busy working mum, and I confess that it was only while preparing for the last post that I read further down the page. And it suddenly became clear that it isn’t so bad! Climbing the stairs is listed as vigorous activity, carrying children as muscle strengthening activity, and the total can be achieved flexibly in chunks as small as 10 mins. I realised that I’m already doing quite a lot of minutes, and made the resolution to move me a little closer to the target.

I would strongly recommend that anyone interested in living longer and more happily read the information at https://www.nhs.uk/live-well/exercise/. It really is an excellent resource, with links to free workouts, a plan to get into running (couch to 5K), and lots of other tips and ideas for how to get a bit more activity into our lives. I’ve seen lots of friends and patients get into running (and I mean totally hooked in some cases) after doing the couch to 5k, so that is particularly worth a look if you feel like you need to get more vigorous activity into your life.

I’d like to share a bit more of the science with you, particularly why exercise was described by the Joint Royal Colleges (top notch professionals from various branches of medicine) as ‘The Miracle Cure’ in their 2015 publication. That is some claim, and I think the figures quoted in the publication warrant sharing. For now let’s leave it that increased physical activity brings benefits to many aspects of health, and the NHS live-well website is a good place to start for ideas and inspiration if you need them. Hopefully we can all sneak a bit more activity into March, and celebrate when the next post highlights the magnitude of the benefits we have already started to achieve.

By Dr Kate Roberts-Lewis

References

https://www.nhs.uk/live-well/exercise/exercise-health-benefits/

Sedentary time: https://doi-org.ezproxy.nottingham.ac.uk/10.1111/obr.12642

Hepatobiliary axis: DOI: 10.1111/obr.12642

Sitting and standing: DOI: 10.1177/2047487317752186

Physical activity guidelines: https://www.gov.uk/government/publications/physical-activity-guidelines-infographics