In a previous blog, I wrote about my fifty-year-old patient Gigi who complained about feeling “doughy” and stiff. Like many middle-aged female patients, Gigi found that maintaining lean muscle mass was increasingly difficult as she got older. I get it: I find it hard too. And sometimes I need a pithy list of why I should bother. If you’re in the same boat, read on!
Gigi and I can’t avoid several inconvenient truths: The older you get, the more habitually tight and unstable your body can become. Aging begins in the muscles. First you lose the fast-twitch muscle fibers. Then you store more fat. What were once effortless activities – like playing with kids or grabbing falling objects – suddenly feel like a challenge. You’re more vulnerable to injury. As you get older, your aerobic capacity declines. Among middle-aged men, that decline becomes twofold greater if they’re sedentary rather than physically active. But regular exercise could slow this decline.
Even more exciting, new evidence suggests that longer term fitness improvements from high-intensity interval training (HIIT) do not wane with age, although the initial training period might be more challenging. So the good news is that people across all ages have a high potential for cardiovascular improvements. Hurray!
To gauge Gigi’s fitness, I started with measuring how quickly Gigi could run a mile. Well, to begin with, she couldn’t run a full mile at first, so she ran/walk one mile and it took 15 minutes. Gigi had a low fitness level according to a few studies, but with the tips from my blog, 7 Strategies to Increase Lean Body Mass—including strength and burst training—she could run a ten-minute mile within four weeks.
Lean body mass wasn’t the only reason I wanted to know Gigi’s mile time. Knowing her running time, I could also predict her risk for heart disease and other aging problems.
I based this on two studies. One, published in Circulation, looked at fitness levels in 66,371 people and found that the time it takes a person to run a mile in her forties predicts her heart health just like cholesterol level or blood pressure could. The second, published in the Journal of the American College of Cardiology, found women in their fifties who can run a mile:
- In nine minutes or less had a high level of fitness.
- In ten and a half minutes had a moderate fitness level.
- In over twelve minutes had a low fitness level.
Not only did we improve Gigi’s fitness and muscle mass, but Gigi also regained a sense of confidence, felt sexier, experienced deeper mental clarity, and for the first time in ages, turned heads as she walked into a restaurant.
Routine exercise prevents age-related physiological decline and chronic diseases. More specifically, when older adults regularly exercise, it improves blood pressure, diabetes, cholesterol levels, osteoarthritis, osteoporosis, and neurocognitive function. Yet seventy-five percent of older Americans don’t exercise enough to get these health benefits. Whether you fall into the sedentary or active category, exercise is the ultimate anti-aging strategy. Take a look at seven benefits that will, hopefully, get you or keep you moving.
- Telomere length. Exercise can positively impact aging at the cellular level. Telomeres, found on the end of DNA strands, protect your DNA during cell division and replication. Telomeres shorten with age, and the speed at which they shorten indicates how quickly you age. Older people with shorter telomeres are three times more likely to die from heart disease and eight times more likely to die from and infectious diseases. In addition to lack of exercise, numerous other factors – totally within your control – can impact your cells: Stress, toxicity, smoking, and a crappy diet all shorten those telomeres. In her New York Times blog, Gretchen Reynolds confirms these claims, writing, “Studies have found, for instance, that master athletes typically have longer telomeres than sedentary people of the same age, as do older women who frequently walk or engage in other fairly moderate exercise.”
- Mitochondrial function. Your mitochondria are the tiny power supply factories inside your cells that turn food and oxygen into energy, also known as metabolism. As you age, mitochondrial function declines, creating an ATP (energy) deficiency. (ATP stands for adenosine triphosphate, a small molecule that transfers chemical energy within cells and produces power.) As mitochondria get weaker, your risk for insulin resistance, obesity, Type 2 diabetes, and impaired muscle function increases. Just like you can lengthen telomeres, you can boost mitochondria. Regular exercise improves mitochondrial capacity and function to reverse obesity, Type 2 diabetes, and aging. Cutting out sugar can pay big dividends too. 
- Cancer Prevention. Exercise fights cancer—that alone is reason enough for me to stay active as I age. I have breast cancer in my family and do whatever I can to prevent cancer cells from taking hold and growing. Among women who exercise regularly, the incidence of several types of cancer, including breast and colon cancers, decreases. Studies also show exercise can improve cancer-related physical and psychological declines, improve immune function (particularly macrophage regulation), and normalize the inflammatory process, all of which boost anti-cancer effects and wound healing in older folks.
- Brain health. The more you work out, the better your brain functions. In one review published in the Journal of Aging Research, researchers combed through several studies with healthy older adults, frail patients, and people suffering from mild cognitive impairment and dementia to find physical exercise could prevent age-related cognitive decline and neurodegenerative diseases. There are other brain benefits, too, such as:
- Significant reduction in risk of dementia and mild cognitive impairment. Trials documented better cognitive scores after six to twelve months of exercise.
- Improved cognitive scores: More gray matter on brain scans (responsible for memory, attention, mental flexibility, mindfulness, thoughts, and emotional control).
- Cardiovascular health. The Heart Foundation tells us a little known fact: One in every three women dies from heart disease every year. (Compare that with the most well-known female disease, breast cancer, which claims one out of every thirty-one women annually.) To truly bring it home: Heart disease kills one woman approximately every minute. The good news is exercise can minimize your risk. That’s the reason it’s called cardio. You need cardio to keep your inner cardio healthy and strong. Exercise benefits elderly patients affected by heart failure, hypertension, and other impacts of cardiovascular disease.
- Bone health. You’re no doubt aware of your increased risk for osteoporosis as you age. So while you need cardio for your heart, you need strength training for your bones. While both significantly improve quality of life for elderly patients with osteoporosis,  weight-bearing exercises increase bone mineral density and improve the lumbar spine and femoral neck for older adults.
- Diabetes prevention. The sad news: Fat-free mass declines about fifteen percent between the third and eighth decade of life. As you age, increased body fat and abdominal obesity increase your risk for Type 2 diabetes. Fitness can improve body composition and insulin sensitivity, reducing your risk for pre-diabetes that paves the way for diabetes and all its complications. Among my patients, I’ve found high-intensity interval training (HIIT) or burst training coupled with strength training to be the most effective way to optimize blood sugar and insulin levels.
No surprise: I’ve written a lot about exercise, including how it boosted my anti-aging growth hormone and how it can double as meditation. I’ve also tested out and graded a number of different workouts, including barre (excellent) and chronic cardio (meh). The important thing is to find fitness that works for you. Walk outside, join a yoga class, or find social exercise such as a running club or a dance class. Move more, period. If you enjoy it, you’ll stick with it long term. The more consistent you are at improving fitness, the slower you’ll age.
I’d love to hear about your favorite way to move and the anti-aging benefits you’ve experienced from fitness. Share your story in the below comments section, or on my Facebook page.
For more tips and lifestyle habits that will help you age gracefully and beautifully, order your copy of Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.
 Larson, E. B., et al. “Health benefits of exercise in an aging society.” Archives of Internal Medicine 147, no. 2 (1987): 353-356; Garatachea, N, et al. “Exercise attenuates the major hallmarks of aging.” Rejuvenation Research 18, no. 1 (2015): 57-89.
 Støren, Ø., et al. “The Impact of Age on the VO2max Response to High-Intensity Interval Training.” Medicine and Science in Sports and Exercise (2016).
 Gupta, S., et al. “Cardiorespiratory fitness and classification of risk of cardiovascular disease mortality.” Circulation 123, no. 13 (2011): 1377-1383.
 Berry, J. D., et al. “Lifetime risks for cardiovascular disease mortality by cardiorespiratory fitness levels measured at ages 45, 55, and 65 years in men: the Cooper Center Longitudinal Study.” Journal of the American College of Cardiology 57, no. 15 (2011): 1604-1610.
 Ciolac, E. G. “Exercise training as a preventive tool for age-related disorders: a brief review.” Clinics 68, no. 5 (2013): 710-717.
 Nied, R. J., et al. “Promoting and prescribing exercise for the elderly.” American Family Physician 65, no. 3 (2002): 419-426.
 Shammas, M. A. “Telomeres, lifestyle, cancer, and aging.” Current Opinion in Clinical Nutrition and Metabolic Care 14, no. 1 (2011): 28.
 Reynolds G. “Does exercise slow the aging process?” New York Times October 28, 2015, accessed 2016 Aug 31. http://well.blogs.nytimes.com/2015/10/28/does-exercise-slow-the-aging-process/?_r=0
 Toledo, F. et al. “The role of weight loss and exercise in correcting skeletal muscle mitochondrial abnormalities in obesity, diabetes and aging.” Molecular and Cellular Endocrinology 379, no. 1 (2013): 30-34.
 Kemppainen, E., et al. “Mitochondrial dysfunction plus high-sugar diet provokes a metabolic crisis that inhibits growth.” PloS One 11, no. 1 (2016): e0145836.
 “Physical activity and cancer.” National Cancer Institute July 22, 2009, http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet
 Kilari, D., et al. “Designing exercise clinical trials for older adults with cancer: Recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting.” Journal of Geriatric Oncology (2016).
 Goh, J., et al. “Exercise enhances wound healing and prevents cancer progression during aging by targeting macrophage polarity.” Mechanisms of Ageing and Development 139 (2014): 41-48.
 Hogan, C. L., et al. “Exercise holds immediate benefits for affect and cognition in younger and older adults.” Psychology and Aging 28, no. 2 (2013): 587.
 Bherer, L., et al. “A review of the effects of physical activity and exercise on cognitive and brain functions in older adults.” Journal of Aging Research (2013).
 Ahlskog, J. E., et al. “Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging.” Mayo Clinic Proceedings, 86, no. 9 (2011): 876-884.
 “Heart Disease: Scope and Impact,” The Heart Foundation, 2015, http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/
 Vigorito, C., et al. “Effects of exercise on cardiovascular performance in the elderly.” Frontiers in Physiology 5 (2014).
 Russo, C. R. “The effects of exercise on bone. Basic concepts and implications for the prevention of fractures.” Clinical Cases in Mineral and Bone Metabolism 6, no. 3 (2009): 223-228.
 Shanb, A. A., et al. “The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis.” Journal of Family & Community Medicine 21, no. 3 (2014): 176.
 Marques, E. A., et al. “Exercise effects on bone mineral density in older adults: a meta-analysis of randomized controlled trials.” Age 34, no. 6 (2012): 1493-1515.
 Evans, W. J., et al. “Nutrition, exercise, and healthy aging.” Journal of the American Dietetic Association 97, no. 6 (1997): 632-638.
 Ryan, A. S. “Exercise in aging: its important role in mortality, obesity and insulin resistance.” Aging Health 6, no. 5 (2010): 551-563.
 Poblete A., et al. “Effects of high intensity interval training versus moderate intensity continuous training on the reduction of oxidative stress in type 2 diabetic adult patients: CAT.” Medwave 15, no. 07 (2015).
 Strasser, B., et al. “Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms.” BioMed Research International 2013 (2013).