How Exercise Improves Heart Health: Must Compare to Medications


I couldn’t agree more, or write it any better than this post by Dr. Mercola on the benefits of Exercise for the Heart Health. I especially like the discussion about how it should be compared to medication studies. I have regularly heard at Cardiac Rehabilitation conferences about the benefits of exercise can be similar or better to the use of stents for treating heart disease.

How Exercise Improves your Heart Health

By Dr. Mercola

Did you know that exercise is one of the safest, most effective ways to prevent and treat chronic diseases such as heart disease?

This common-sense advice was again confirmed in a meta-review conducted by researchers at Harvard University and Stanford University,1 which compared the effectiveness of exercise versus drug interventions on mortality outcomes for four common conditions:

  • Diabetes
  • Coronary heart disease
  • Heart failure
  • Stroke

After reviewing 305 randomized controlled trials, which included nearly 339,300 people, they found “no statistically detectable differences” between physical activity and medications for prediabetes and heart disease.

Exercise was also found to be more effective than drugs after you’ve had a stroke. The only time drugs beat exercise was for the recovery from heart failure, in which case diuretic medicines produced a better outcome.

The drugs assessed in the studies included:

  • Statins and beta blockers for coronary heart disease
  • Diuretics and beta blockers for heart failure
  • Anticoagulants and antiplatelets for stroke

Exercise Should Be Included as Comparison in Drug Development Studies

The featured review is a potent reminder of the power of simple lifestyle changes, as well as the shortcomings of the drug paradigm. If you’re interested in living a longer, healthier life, nothing will beat proper diet and exercise.

Exercise is in fact so potent, the researchers suggested that drug companies ought to be required to include it for comparison when conducting clinical trials for new drugs! As reported by Bloomberg:2

“The analysis adds to evidence showing the benefit of non-medical approaches to disease through behavior and lifestyle changes.

Given the cost of drug treatment, regulators should consider requiring pharmaceutical companies to include exercise as a comparator in clinical trials of new medicines, according to authors Huseyin Naci of Harvard and John Ioannidis of Stanford.

‘In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition,’ Naci and Ioannidis said in the published paper. In the meantime, ‘exercise interventions should therefore be considered as a viable alternative to, or, alongside, drug therapy.’”

There are glimmers of hope that change is possible, slow and begrudging as it may be. Dean Ornish, founder of the Preventive Medicine Research Institute, spent 16 years proving that a vegetarian diet along with exercise and stress management is more effective than conventional care for the treatment of heart disease.

And, as of January 2011, Medicare actually began covering the Ornish Spectrum—Reversing Heart Disease program,3 under the benefit category of “intensive cardiac rehabilitation.”

How Exercise Benefits Your Heart and Health

Heart disease and cancer are two of the top killers of Americans, and exercise can effectively help prevent the onset of both, primarily by normalizing your insulin and leptin levels.

Other beneficial biochemical changes also occur during exercise, including alterations in more than 20 different metabolites. Some of these compounds help you burn calories and fat, while others help stabilize your blood sugar, among other things.

In a nutshell, being a healthy weight and exercising regularly creates a healthy feedback loop that optimizes and helps maintain healthy glucose, insulin and leptin levels through optimization of insulin and leptin receptor sensitivity.

And, as I’ve mentioned before, insulin and leptin resistance—primarily driven by excessive consumption of refined sugars and grains along with lack of exercise—are the underlying factors of nearly all chronic disease that can take years off your life.

Previous research has shown that exercise alone can reduce your risk of cardiovascular disease by a factor of three.4 However, endurance-type exercise, such as marathon running, can actually damage your heart and increase your cardiovascular risk by a factor of seven…

Research5 by Dr. Arthur Siegel, director of Internal Medicine at Harvard’s McLean Hospital found that long-distance running leads to high levels of inflammation that can trigger cardiac events. Another 2006 study6 found that non-elite marathon runners experienced decreased right ventricular systolic function, again caused by an increase in inflammation and a decrease in blood flow.

All in all, such findings are a powerful lesson that excessive cardio may actually be counterproductive. In the featured review, the types of exercise, frequency, intensity and duration varied widely across the included studies, which made it impossible to ascertain the specifics of what was most or least effective for the prevention and treatment of disease.

However, it was clear that exercise in general is comparable to many of the drugs used for heart disease, heart failure, and stroke. That said, other research has clearly demonstrated that short bursts of intense activity is safer and more effective than conventional cardio—for your heart, general health, weight loss, and overall fitness.  One of the easiest ways to exercise is simply by performing body weight exercises.

Are You Exercising Effectively and Efficiently?

The answer is to exercise correctly and appropriately, and making certain you have adequate recovery, which can be as important as the exercise itself. There is in fact overwhelming evidence indicating that conventional cardio or long-distance running is one of the worst forms of exercise there is. Not only have other studies confirmed the disturbing findings above, but they’ve also concluded it’s one of the least efficient forms of exercise. Research emerging over the past several years has given us a deeper understanding of what your body requires in terms of exercise.

High-intensity interval training, which requires but a fraction of the time compared to conventional cardio, has been shown to be FAR more efficient, and more effective. This type of physical activity mimics the movements of our hunter-gatherer ancestors, which included short bursts of high-intensity activities, but not long-distance running. This, researchers say, is what your body is hard-wired for. Basically, by exercising in short bursts, followed by periods of recovery, you recreate exactly what your body needs for optimum health. Twice-weekly sessions, which require no more than 20 minutes from start to finish, can help you:

  • Lower your body fat
  • Improve your muscle tone
  • Boost your energy and libido
  • Improve athletic speed and performance

This type of exercise will also naturally increase your body’s production of human growth hormone (HGH)—a synergistic, foundational biochemical underpinning that promotes muscle and effectively burns excessive fat. It also plays an important part in promoting overall health and longevity. Conventional cardio will NOT boost your HGH level.

Interval Training—A Much Better Cardio Workout

Most people still think that in order to improve your cardiovascular fitness, endurance training is a must. But this is actually not true. Quite the contrary. According to fitness expert Phil Campbell, getting cardiovascular benefits actually requires working ALL your muscle fibers and their associated energy systems. Interestingly enough, this cannot be achieved with traditional cardio, and here’s why: Your body has three types of muscle fibers: slow, fast, and super-fast twitch muscles, and your heart has two different metabolic processes:

  • The aerobic, which requires oxygen for fuel
  • The anaerobic, which does not require any oxygen

Slow twitch muscles are the red muscles, which are activated by traditional strength training and cardio exercises. The fast and super-fast twitch muscles are white muscle fibers, which are only activated during high intensity interval exercises or sprints. Activating the fast and super-fast muscles is also what causes the production of therapeutic levels of growth hormone, as mentioned earlier. Many athletes spend $1,000 a month on HGH injections, which carry certain health risks, but there’s really no need for that. With Peak Fitness exercises and the use of the Power Plate, you can increase your levels of HGH to healthy young normal’s.

Now, traditional cardio exercises work primarily the aerobic process, associated with your red, slow-twitch muscles. High-intensity interval training, on the other hand, work both your aerobic AND your anaerobic processes, which is what you need for optimal cardiovascular benefit. Quite simply, if you don’t actively engage and strengthen all three muscle fiber types and energy systems, then you’re not going to work both processes of your heart muscle. Many mistakenly believe that cardio works out your heart muscle, but what you’re really working is your slow twitch muscle fibers, associated with the aerobic process only. You’re not effectively engaging the anaerobic process of your heart…

Demonstration of an Effective High Intensity Interval Session

In the case of high intensity exercises, less is more, as you can get all the benefits you need in just a 20-minute session performed twice to three times a week. It’s inadvisable to do them more than three times a week. If you do, you may actually do more harm than good—similar to running marathons. Because while your body needs regular amounts of stress like exercise to stay healthy, it also needs ample recuperation, and if you give it more than you can handle your health will actually begin to deteriorate. As a general rule, as you dial up the intensity, you can dial back on the frequency. While the entire workout is only 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You’re really only working out intensely for four minutes:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should feel like you couldn’t possibly go on another few seconds
  • Recover at a slow to moderate pace for 90 seconds
  • Repeat the high intensity exercise and recovery 7 more times

For Optimal Health, Add Variety to Your Fitness Routine

While high intensity interval exercises accomplish greater benefits in a fraction of the time compared to slow, endurance-type exercises like jogging, I don’t recommend limiting yourself to that alone. Of equal, if not greater importance, is to avoid being too sedentary in general. Compelling research now tells us that prolonged sitting can have a tremendously detrimental impact on your health even if you exercise regularly. The reason for this is because your body needs to interact with gravity in order to function optimally. Therefore, make sure to get out of your chair every 10 minutes or so, as suggested below.

Ideally, to truly optimize all aspects of your health, you’d be wise to design a well-rounded fitness program that incorporates a variety of different exercises. Without variety, your body will quickly adapt, so as a general rule, as soon as an exercise becomes easy to complete, you’ll want to increase the intensity and/or try another exercise to keep it challenging. I recommend incorporating the following types of exercise into your program:

  1. Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods.
  2. Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you’re really optimizing the possible health benefits of a regular exercise program. You can also “up” the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
  3. Avoid Sitting for More Than 10 Minutes. This is not intuitively obvious but emerging evidence clearly shows that even highly fit people who exceed the expert exercise recommendations are headed for premature death if they sit for long periods of time. My interview with NASA scientist Dr. Joan Vernikos goes into great detail why this is so, and what you can do about it. Personally, I usually set my timer for 10 minutes while sitting, and then stand up and do one legged squats, jump squats or lunges when the timer goes off. The key is that you need to be moving all day long, even in non-exercise activities.
  4. Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.

Foundation Training, created by Dr. Eric Goodman, is an integral first step of a larger program he calls “Modern Moveology,” which consists of a catalog of exercises. Postural exercises such as those taught in Foundation Training are critical not just for properly supporting your frame during daily activities, they also retrain your body so you can safely perform high-intensity exercises without risking injury. Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.

  1. Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching, you hold each stretch for only two seconds, which works with your body’s natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.

Exercise Tips for Those with Chronic Health Problems

Remember that even if you’re chronically ill, exercise can be a potent ally. That said, if you have a chronic disease, you will of course need to tailor your exercise routine to your individual scenario, taking into account your stamina and current health. For example, you may at times need to exercise at a lower intensity, or for shorter durations, but do make a concerted effort to keep yourself moving. Just listen to your body and if you feel you need a break, take time to rest. But even exercising for just a few minutes a day is better than not exercising at all.

In the event you are suffering from a severely compromised immune system, you may want to exercise in your home instead of visiting a public gym. But remember that exercise will ultimately help to boost your immune system, so it’s very important to continue with your program, even if you suffer from chronic illness.

Exercise Is More Effective Than Potent Medicines

The take-home message here is that one of the best forms of exercise to protect your heart is short bursts of exertion, followed by periods of rest. By exercising in this way, you recreate exactly what your body needs for optimum health. Heart attacks, for example, don’t happen because your heart lacks endurance. They happen during times of stress, when your heart needs more energy and pumping capacity, but doesn’t have it. So rather than stressing your heart with excessively long periods of cardio, give interval training a try.

During any type of exercise, as long as you listen to your body, you shouldn’t run into the problem of exerting yourself excessively. And, with interval training, even if you are out of shape you simply will be unable to train very hard, as lactic acid will quickly build up in your muscles and prevent you from stressing your heart too much.

Most importantly, the featured review is a powerful message to anyone considering taking a medication to address risk factors and lower your risk of heart disease. There’s simply no evidence suggesting that statins or beta blockers are any more effective than exercise, which means you can forgo all the side effects and exorbitant expense associated with such drugs.

Remember what these Harvard and Stanford University researchers concluded after reviewing 305 studies comparing exercise versus drug treatment: “[E]xercise interventions should… be considered as a viable alternative to, or, alongside, drug therapy.”What could possibly be more empowering than that?

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5 thoughts on “How Exercise Improves Heart Health: Must Compare to Medications

  1. I definitely agree that exercise Improves heart health. People should understand that prevention is better than cure. Exercise while we are still young and healthy because when heart diseases start, medication and surgery is the only option.

  2. I definitely agree that exercise Improves heart health. People should understand that prevention is better than cure. Exercise while we are still young and healthy because when heart diseases start, medication and surgery is the only option.

    • Thanks for the reply. Yes we must build prevention as a family goal, not taught through school only. Start from day one eating healthy, exercising, and managing stress as the best form of prevention.

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