
Not exercising worse than smoking, diabetes and heart disease study finds - nikolasavic
https://www.cnn.com/2018/10/19/health/study-not-exercising-worse-than-smoking/index.html
======
Gatsky
If there is one universal truth of human biology, it is that exercise is good.
It is good if you do a bit or a lot, if you are young, old, male, female,
trans, pregnant, trying to get pregnant, single, married, divorced, depressed,
a smoker, have cancer, have heart disease, have dementia, an astronaut, a pure
mathematician, a plumber, tall, short, liberal, conservative etc etc. There
isn't anyone that doesn't benefit basically. It's almost like breathing.

The message is important, but I think we can just stop doing studies about how
exercise is good. Researchers must love these kinds of studies because they
are ALWAYS POSITIVE. And the media loves promoting them, I guess because they
get a lot of clicks.

Getting people to do more exercise - that is the hard part. More randomised
studies of interventions to do that on a society level are needed. There is
going to be an extraordinary number of people transitioning from (admittedly
unpleasant and impoverished) more active lifestyles to sedentary work in the
next 50 years. Reducing the burden of disease in this group is essential.

~~~
Waterluvian
I worry about my health and often I have a really good try and making a habit.
But crap is it hard. It's not the money or the time. There's something else
about willpower and boredom. I wish I could get on an exercise bike, stare at
a brainwashing device, and "wake up" an hour later having remembered none of
it.

~~~
louprado
Then forget exercise for now, just take a _contemplative walk_ around the
block. Perhaps do it right before breakfast and/or after dinner. It's easy and
takes less than 10 minutes. Don't think of it as exercise and do it in any
clothes and with any shoes. No excuses, anyone can walk around 1 block and
everyone needs 10 private minutes to collect their thoughts.

Before you know it you'll find yourself walking around several blocks, then
swinging your arms, then walking faster, then you may even start jogging.
You'll feel motivated, you'll keep making progress, and most importantly,
you'll actually look forward to your walks.

I followed the advice above and now run almost daily before sunrise. It has
really boosted my self-esteem since I had always disliked running yet admired
those people who run before sunrise. But if someone had told me to start by
purchasing running clothes, finding the right running shoes, choosing a good
running route, stretching for 10 minutes... forget it! However, I will make
one recommendation. This mask is helpful on mornings when it is below 40F.
[https://www.amazon.com/gp/product/B0796R1DPG](https://www.amazon.com/gp/product/B0796R1DPG)
. Please, start tomorrow morning and report back. :)

~~~
seanp2k2
I got into running, thinking that I wanted to try for a half-marathon. I
actually worked up to the distance surprisingly quickly. I was under 30 at the
time and it took like 2 months, and before that I wasn't running at all or
doing any other exercise regularly. I started having some knee pain (flat feet
don't help) and stopped after it became painful to run even a mile or two.
About a year later, I fell on a skateboard on the same knee and injured my
bursae. I fear that my running days are over, but it was kind of fun in a
weird way after you get past ~mile 4. I still go mountain biking occasionally
and enjoy long walks (on vacation I'll walk 15+ miles in a day).

~~~
toasterlovin
Something like 50% of runners get injured in a given year. It’s insane. Do
something that’s easier on your body. If you want cardio, hike or bike. I like
weight lifting, personally. If you want to try weight lifting, check out
Starting Strength.

~~~
sorenjan
> Something like 50% of runners get injured in a given year.

That's because most people use bad technique and would probably benefit from
strength training as well. Sitting all day and then expecting your body to run
for 30-60 minutes and then sitting again will lead to high risk of injury. I
see a lot of people run like they're walking with longer strides, or hunched
over, or any number of bad habits. The feet should land under your center of
mass, not in front of it, and the turnover should be pretty fast. Short and
fast steps instead of long and slow. Don't run too fast, use your core for
stability, and keep an upright posture, slightly leaned forward at the ankles.

Look up proper running form, do some drills, and add body weight strength
training a couple of times each week if you're thinking of starting running.

~~~
scns
that is because most runners use padded shoes, which enable you to run in a
totally unnatural way.

>this kind of collision leads to a rapid, high impact transient about 1.5 to
as much as 3 times your body weight (depending on your speed) within 50
milliseconds of striking the ground (see graph a below).

>This is equivalent to someone hitting you on the heel with a hammer using 1.5
to as much as 3 times your body weight. These impacts add up, since you strike
the ground almost 1000 times per mile!

taken from:

[http://barefootrunning.fas.harvard.edu/4BiomechanicsofFootSt...](http://barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html)

It is impossible to run this way with undamped shoes or barefoot.

I recommend this book (not affiliated):

[https://www.amazon.com/Born-Run-Hidden-Superathletes-
Greates...](https://www.amazon.com/Born-Run-Hidden-Superathletes-
Greatest/dp/0307279189/ref=sr_1_1?ie=UTF8&qid=1540110585&sr=8-1&keywords=born+to+run)

is really fun to read, it is about a indigenous tribe in mexico which run in
sandals cut from old tires, for 24 or 48 hours straight. In there is a
reference to another study where they found a correlation between cost of the
shoe and the rate of injuries: more expensive shoes with better damping had
higher rates of injuries, they weren't expecting this.

Our legs evolved to store the energy in our tendons and release it to propel
us forward. A QUARTER of the bones in our body is in our feet! Humans evolved
to be the best endurance runners on the planet, being "naked" (without fur) is
actually an advantage for running, enabling us to cool down our bodies by
sweating. There are still tribes hunting their prey by running after it for
prolonged periods till it collapses from overheating. There are races for
horses, humans started to compete in. Initially the runners where ridiculed
but someday a human won the race.

------
sambe
This quote sets off alarm bells for sensationalism:

"People who do not perform very well on a treadmill test," Jaber said, "have
almost double the risk of people with kidney failure on dialysis."

The quote doesn't appear to be part of the paper either. The first Google hit
for all-cause kidney disease mortality says:

"The absolute risk for death increased exponentially with decreasing renal
function in these studies. The magnitude of the unadjusted increase in risk
ranged from approximately 38% to >1100%"

Those numbers are for non-dialysis patients. You'd expect the dialysis
patients to be much worse due to the first sentence. The exercise paper says:

"The increase in all-cause mortality associated with reduced CRF (low vs
elite: adjusted HR, 5.04; 95% CI, 4.10-6.20; P < .001; below average vs above
average: adjusted HR, 1.41; 95% CI, 1.34-1.49; P < .001) was comparable to or
greater than traditional clinical risk factors."

I don't think low vs elite is a fair interpretation of "not doing very well",
so I'd take 41% as the increase in risk. That is very much not double
38-1100%. You'd assume it's certainly not double the exponentially worse-off
dialysis patients. You wouldn't think 504% was either, even if you are
charitable to the quote.

The findings seem interestingly strong. Overplaying them further should not be
necessary.

------
vladharbuz
The article's title is somewhat misleading. The study emphasises the level of
fitness rather than the regularity of exercise. [0]

> Question: What is the association between cardiorespiratory fitness and
> long-term mortality?

> Findings: In this cohort study of 122 007 consecutive patients undergoing
> exercise treadmill testing, cardiorespiratory fitness was inversely
> associated with all-cause mortality without an observed upper limit of
> benefit. Extreme cardiorespiratory fitness (≥2 SDs above the mean for age
> and sex) was associated with the lowest risk-adjusted all-cause mortality
> compared with all other performance groups.

> Meaning: Cardiorespiratory fitness is a modifiable indicator of long-term
> mortality, and health care professionals should encourage patients to
> achieve and maintain high levels of fitness.

[0]:
[https://jamanetwork.com/journals/jamanetworkopen/fullarticle...](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428?resultClick=3)

~~~
Boxxed
That's a little pedantic, even for HN, don't you think? "Oh, it's not the
exercise that's important, it's the stuff that happens BECAUSE you exercise."

~~~
ddebernardy
It's not pedantic at all. I'm ~40 and don't exercise at all, yet I'm still
perfectly fit. I presume it's due to doing groceries by foot several times per
week, having a standup desk, and carrying the kid around. Perhaps genes help
too. But the point I'd like to get across is: going to the gym isn't the _sine
qua non_ of making you fit. You can get enough "exercise" by simply living
without a car, standing, and walking.

~~~
shin_lao
I think you need to define perfectly fit. Can you do 10 pullups?

~~~
mr_toad
99% of the population can’t do 1 pull-up, let alone 10. Most of the people I
go to the gym with would struggle with more than a few.

Hell, even marines and rangers have lower fitness standards (3 and 6 dead hang
chin ups respectively).

~~~
graeme
That's a gtoss misrepresentation of the marines' standards. The tables are
here:
[https://www.marines.mil/Portals/59/Publications/MCBUL%206100...](https://www.marines.mil/Portals/59/Publications/MCBUL%206100%20DTD%2015DEC16.pdf?ver=2016-12-27-125044-450)

3 is for men over 51. And that's the bare minimum, not get kicked out of the
marines threshold.

To reach top rank scoring is more like 15-17 for most ages. Mid rank is about
11 or up.

Maybe 99% of the population can't do a pullup, but I feel that's an
overestimate. In any case, that says more about our overall societal weakness
than anything else.

What are your gym friends doing if they couldn't do more than a few? Are they
strength training or just doing cardio? Serious question, I'm curious. With a
few months training ar age 26 I was able to do 5 reps of my bodyweight + about
40 pounds IIRC. And now, even when I periodically stop strength training, I am
rarely below 8-10 when I start again.

Chin-ups are hard, but they're not _that_ hard if you train them or do any
activity that works those muscles.

------
ilovecaching
My work provides a gym, and I go there for at least an hour every weekday. I'd
rather do poorly at work then skip exercising to be honest. I see some of the
older employees coming in trying to reverse the effects of a sedentary
lifestyle and I do not envy that position. It's crazy how people will
deprioritze their health. It should always be a person's #1 priority to live
as long as possible.

Of course, diet is also a huge factor as well. I stick to an intermittent
fasting routine unless I can devote more time in the gym to bulking. I think
fasting and caloric deficiency have some promising research behind it, and I
think intuitively it makes sense that our ancestors would be eating only
intermittently and probably never enough to put on a lot of weight. My
nutritionist cautioned me, however, that there's still no scientific consensus
and it still has a fad smell to it. It also takes quite a bit of mental
discipline.

Also, if you're struggling with getting fit, GET A PERSONAL TRAINER AND
NUTRITIONIST. You could not do more with your money than get professional help
in steering your body in a direction that works for you. At the end of the
day, you have to do what's right for your physiology and these trained
professionals no how to make that easy for you.

~~~
Jill_the_Pill
"It should always be a person's #1 priority to live as long as possible."

Living as well and as beneficently as possible might be higher priorities. The
older folks with the desk jobs are often quite literally sacrificing their own
well-being for their family's, "deprioritizing their health" for another
priority.

"You could not do more with your money than get professional help in steering
your body"

You could donate to help poor people survive, to help sick people get well, to
heal the natural environment, to educate children, to encourage peace and
justice, to strengthen your community, or to advance knowledge.

~~~
ilovecaching
Your first priority should be taking care of yourself. Remember the plane
safety demonstration? You always put your own mask on first, even if it seems
selfish.

You're in the best position to help others and make good decisions when you
feel stability in your own life. Making sure you'll be around a long time also
makes you last longer as a resource to society, and to your family.

You can't do any of those things you mentioned if you're dead, sick, or
miserable.

~~~
kopo
Ya right. I work with politicians day to day. You have no idea how much
society would benefit if they all died in their 60s.

~~~
andai
How about before they get elected?

------
manmal
Put bluntly, exercising creates new mitochondria in your cells. Since disease
is often due to low cell energy (making cells underperform or malfunction), it
makes sense that adding mitochondria (=adding ability to convert cellular
energy) is very beneficial.

Here is a quite technical paper on exercise and mitochondrial biogenesis:
[http://m.jbc.org/content/282/1/194.full](http://m.jbc.org/content/282/1/194.full)

~~~
doombolt
I wonder if we can have a pill to maintain high level of mitochondria in all
our cells in background.

It seems that modern humans have a lot of power-saving traits which are active
deterrent as of now when food is abundant, since they lead to obesity, muscle
loss and mitochondria problems here. Other mammals don't seem to have such
problems en masse.

~~~
collyw
Our bodies evolved to be a lot more active than the average person today. I
would be surprised if it's the only thing that exercise helps and as such I
would be skeptical about how beneficial a pill would be.

~~~
doombolt
Well, too bad, we need to find ways to change those settings.

~~~
collyw
Exercise can be pretty enjoyable if you find a way that suits you. Personally
I can't stand the monotony of the gym, but I love mountain biking or white
water kayaking. The later has benefited me in my life so much - it has taken
me to amazing countries that I doubt I would have visited otherwise and I have
made some amazing people through the sport. There is no way that a pill could
compete with that.

------
armada651
> It's crazy how people will deprioritze their health. It should always be a
> person's #1 priority to live as long as possible.

My #1 priority is to achieve my goals and have fun. If that means I die
earlier so be it. I do exercise in ways I find fun, but I will not go to a gym
and lift weights just because it increases my chances of living long enough to
enjoy my pension.

The real challenge in life is not to live the longest, but to have lived a
life worth living.

~~~
fizx
Do you also not brush your teeth?

Strength training can be as simple as doing one of squats, pushups, or pullups
every day. Work towards 2-3 sets of 10-20 reps. Add weight (or reduce
assistance) as necessary.

You've just made a huge difference in how your body feels, and it takes as
much time each day as brushing and flossing your teeth.

~~~
graeme
I agree with you, but someone couldn't do the squats portion at home without a
squat rack, right? Or substituting something like pistols.

I definitely think all homes should have a pullup bar. They can be had
cheaply, and easily attached to doorframes. A good way to add quickly pulling
motions for $30.

~~~
fizx
Do body-weight squats to start, but do more of them. Then grab a couple 30lb
dumbbells and hold them while you squat. If you can do 100 squats holding 30lb
dumbbells, you are _way_ ahead of the curve.

~~~
graeme
Fair enough. Structurally, are dumbbell squats safe like barbell squats? Or
are they only good at lower weights?

I may try higher rep dumbbell squats, I've been looking for a way to workout
purely at home. Is there a deadlift targeting version too?

~~~
fizx
Dumbbell squats are safe, but I don't like doing as much weight as I do with
bar squats, because I find 60+lb dumbbells very hard to manage.

I also prefer using one dumbbell held with both hands (e.g.
[https://www.youtube.com/watch?v=x3siyLMUr_Q](https://www.youtube.com/watch?v=x3siyLMUr_Q))
to holding a dumbbell in each hand. I think its easier to maintain good form
engaging the posterior chain, but ymmv.

I've never liked deadlifts personally, so I'm a bad person to ask. I tend to
target lower back with back extension machines, or supermans if no machines
around.

------
dhnsmakala
I think these headlines promoting exercise for long term benefits might do
more harm than good, people have a hard time doing things for super delayed
gratification.

I exercise because the immediate effects are evident on my mood and
wakefulness. It just feels good to exercise. The first couple of weeks/months
consistently going to the gym maybe took some more discipline, because
everything feels weird at first. The elliptical. These machine contraptions.
It's unfamiliar. But once you're used to it, it's smooth sailing. You don't
have to be so strict about it...just do it until you're comfortable and then
go when you feel like it.

Another note, keep in mind it is MUCH easier to maintain fitness than to build
it. When it comes to weight training, I was serious about it for a couple of
years following a plan I found online. Since then, I lift weights a few times
a month and have mostly maintained the strength/appearance from the time of
consistency.

------
raffael-vogler
So the study measures relative fitness on the treadmill and associates that
with cardio respiratory health - but isn't this pretty much just the two sides
of the same coin? If you measure 1000 people's performance in some fitness
exercise - isn't it obvious that the result will correlate with the observable
health?

------
js2
There's a gentleman who spends an hour or so every night walking around the
neighborhood. He's usually watching something on his phone as he walks, and he
always smokes a cigar at some point.

I've always wondered if he'd be better off not exercising and not smoking that
cigar. I guess now I know.

~~~
newnewpdro
They're not really comparable.

What good is being fit when you die in your 50s from lung cancer?

~~~
cultus
Cigar smokers typically don't inhale. It's more of a oral cancer risk.

~~~
kazinator
Cigar smokers don't inhale through the cigar, but they inhale, just like
second-hand smokers inhale.

~~~
cultus
It is less worse though. Cigar smokers do have quite a bit lower rates of lung
cancer.

[https://www.cancer.gov/about-cancer/causes-
prevention/risk/t...](https://www.cancer.gov/about-cancer/causes-
prevention/risk/tobacco/cigars-fact-sheet)

------
carlosrg
People that are fit tend to take care of themselves in more ways, like for
example, eating healthier food consistently. So I doubt it can all be
simplified to exercise like the article claims.

~~~
forapurpose
Does it seem possible that the distinguished, experienced scientists and
doctors who conducted the research thought to control for other factors,
including well-known ones such as the effect of diet?

~~~
carlosrg
I'm not talking about the study itself, but about the CNN article.

------
antirez
This approach is interesting because, if you ask people "do you go to the
gym", you are faced with the fact that 90% of gym attenders actually do not
train, but pretend to train. So instead the treadmill test is a much better
predictor I guess since it meters the results of your training as athletic
performance.

------
CapitalistCartr
I took a new job in January that is mostly desk-bound and promptly gained 10+
pounds (5kg). I'm at my heaviest ever: 170# (77kg). So last weekend I went
hiking with some friends on a trip I instigated a couple months earlier, with
no preparation. Its my favorite hobby, but my pack was too heavy, body too
flabby. In the swamps of South Florida (Myakka for the locals), it was flooded
and brutal and I about died. If I want to enjoy life, planning out body care
is just one of the requirements. I've also noticed I'm tired more, sicker
since this job started. I know why, same old story: Diet & Exercise.

~~~
taway_1212
It’s also possible that you’re more tired and sick because of the workload’s
burden on the body.

------
pnathan
A book on barbell work for older (> 50y/o) adults defines a particular symptom
set as "Sick Aging Phenotype". Diabetic, overweight, and physical inability
are hallmarks of that symptom set.

One of my aims as someone who spends his work hours sitting is to avoid that
fate. This is largely within my capability. I can choose to invest regularly
in my enjoyment of life down the road. I can't control all sorts of things in
life; but I can control if I can find time to swing a kettlebell.

------
tim333
Interesting survey but it doesn't really separate cause and effect - you could
be rubbish on a treadmill because you are ill rather than via versa.

------
lifeisstillgood
What I am missing here is what they call "performing badly on treadmill"

I run a mile or two each day, but I am still obese and frankly old and unfit.
What is the criteria they are using here? Five minute mile pace? Ten minutes?
Can't actually walk a mile?

~~~
brandonmenc
Probably a CPX test.

------
wslh
Not sure how can they claim this. As an anecdote If I see around me and
including my family, relatively healthy people, mainly women, live longer even
if they don't do any exercise. Beyond the anecdote this is an observation that
can be checked with basic stats information. These are averages!
[https://en.m.wikipedia.org/wiki/List_of_countries_by_life_ex...](https://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy)

~~~
Buldak
I'm confused as to why you think the article you cite supports your claim.

~~~
wslh
I am saying that the article claims are ridiculous based on averages.

------
choot
I wonder what if those who were not performing exercises were already not well
in some ways which compelled them to not exercise in the first place.

------
londons_explore
Not exercising could be caused by some other underlying health condition.

I have not yet seen a study which can say with good confidence "Exercise makes
people healthier".

Sure you can say "People who exercise are healthier", but establishing cause
and effect requires an intervention experiment.

I suspect the commonly held belief that exercise is good for health is true,
but it still seems to be bad to publish it as advice so widely without the
cause/effect established.

------
downandout
...and then we see that exercising an hour per day (7.5 hours or more per
week), which people trying to lose weight often do, can cause damaging calcium
buildups in your heart, especially if you are a man [1]. So we're damned if we
do and damned if we don't. I really hate these conflicting studies.

[1] [http://time.com/4987426/too-much-exercise/](http://time.com/4987426/too-
much-exercise/)

~~~
learnstats2
7.5 hours or more per week of gym is an extreme amount that elite athletes
might think twice about, not to mention that it's not recommended by anyone.
Where is the conflict?

That article itself says: “This [study] doesn’t apply to 99% of people”

~~~
grecy
> _7.5 hours or more per week of gym is an extreme amount that elite athletes
> might think twice about_

I personally have plenty of friends that run, swim or gym session for an hour
7 days a week.

Elite athletes are doing more like 2-5 hours per day. My brother in law runs
ultra marathons (just for fun), and runs somewhere between 1-3 hours every
single day of his life. For fun.

~~~
learnstats2
I personally do more than 7.5 hours of "exercise" but all the people I know
doing 7.5 hours of "gym" are highly injury-prone.

I guess the article doesn't make it clear what counts.

