Do Doctors Understand Exercise? Like nutrition, exercise isn't an area of expertise for most physicians

I got a physical examination from a new doctor last week.

Young guy. Very self-assured. Interviewed me while typing on his computer.

“So what kind of exercise do you get?” Tap, tap.

“I lift weights,” I said. “I swim and bike two or three times a week, but I’m most serious about going to the gym and hitting the machines. I lift at least four times a week, an hour at a time.”

Tapping stopped. He looked me in the eye. “Lifting weights makes you look good, but there’s absolutely no evidence it does anything for your health,” he said. “You need to do aerobic exercise to actually improve your health and lower your risk of death.”

Later that day, I got the results of my physical. Blood pressure, weight, A1C, glucose, triglycerides, all ideal. Pretty rare in a 61-year-old.

Just luck, I guess.

Same Old, Same Old

Seriously, this doc appeared to be no more than 35 years old, so it was disheartening to hear the same old nonsense coming from his generation of physicians.

Physicians are extensively trained in drug and surgical interventions. Lifestyle advice? Not so much.

Typically, they’ve advised patients that the only exercise that boosts health is aerobic activity, such as jogging.

But it’s wrong!

The evidence for the value of weight-bearing exercise, known technically as “resistance training,” particularly as we age, is, in my view, more compelling than the data for aerobics.

Studies make it clear resistance training lowers cancer risk,1 improves bone density2 and lengthens life3 more effectively than any other type of exercise.

Most exciting, consider a 2007 study4 titled “Resistance Exercise Reverses Aging in Human Skeletal Muscle,” which concluded that 596 genes were affected in seniors who took part in a weightlifting program.

The expression of those genes was “markedly reversed back to that of younger levels…”

In other words, in a deep biological sense, lifting weights makes you younger.

Yet none of this is surprising. Physical strength is the basic currency of successful aging, because it can reverse sarcopenia, the age-related muscle-mass loss that defines getting older.

The term “frail” is just a shorthand way of saying “suffering from severe, unchecked sarcopenia.”

So check it. Lift something.

But My Doctor Told Me…

My examining room chat underscored an important point.

If you are in the throes of a medical emergency, place yourself into the hands of your physician. For example, if you get hit by a freight train, go to a high-tech emergency room and let these guys work their magic.

But if you are 1) healthy or 2) have a chronic but nonemergency condition such as Type 2 diabetes, fatigue, memory lapses or just plain aging, most modern physicians are ill-equipped to give you the best lifestyle advice to address it.

Optimal daily habits that promote robust health just aren’t part of their training.

The jogging myth (like the meat-will-kill-you myth) is just folklore, something they’ve heard other physicians say during patient consultations and that has assumed a life of its own, divorced from what the latest data actually say.

No one is infallible. Including, obviously, yours truly. But in my defense, my day-to-day job is digging deep into serious, well-conducted studies on lifestyle interventions that lead to better health.

While physicians are seeing patients — a noble undertaking! — I’m seeing what studies of hundreds or thousands of people reveal about safe, gentle, natural lifestyle measures that data indicate actually work.

That’s why my medical philosophy is built on the insights of scientific researchers, not physicians. Marcia Angell, former editor-in-chief of The New England Journal of Medicine, has written that “doctors are not scientists” and that it’s vital for patients not to confuse these two professions.

To be clear, some MDs are scientists, meaning they spend their working days either performing experiments or parsing experimental data.

But most are not.

Bottom Line

Physicians are not omniscient, especially about healthy lifestyles. It’s important to listen to them respectfully, but also consider other sources that may be more motivated to dredge up better, more current information.

Personally, I’ll keep lifting weights. And if you are over 60 and a gym-based, challenging program of weight-bearing exercise isn’t possible for you, at least make it a point to engage in resistance training in a way that fits your life and health.

One of the best? Using lightweight dumbbells of five–10 pounds at home, according to a program called Dumbbell Strength Training for Seniors. This eight-exercise program is within the capacity of virtually any ambulatory person, can be completed in less than 30 minutes and can yield dramatic improvements in physical and mental health.

Aerobics are not worthless. I am a fan of occasional jogs and regular, brisk walks for seniors.

But — my doctor’s protests notwithstanding — resistance training as we age is absolutely invaluable.

To your robust health,

Brad Lemley

Brad Lemley

Citations

1 Ruiz JR, Sui X, Lobelo F, et al. Muscular strength and adiposity as predictors of adulthood cancer mortality in men. Cancer Epidemiol Biomarkers Prev. 2009
2 Cooper R, Kuh D, Hardy R. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ. 2010
3 Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008
4 Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A. Resistance exercise reverses aging in human skeletal muscle. PLoS ONE. 2007

About Brad Lemley

I am a science journalist who has written for the Washington Post, Discover Magazine and dozens of other national publications. I've written or co-written 10 books, most on health and fitness. I am a passionate advocate for self-directed, nature-based health care, and believe strongly that robust health is within reach of anyone who possesses the right information.