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An integrative physician to hard-driving Manhattan professionals, Dr. Frank Lipman encounters a lot of stressed-out patients. Some of them are stressed from working 12-hour days. Others are stressed from working 12-hour days while trying to fit in time for the gym. Still others are stressed from working 12-hour days, going to the gym when they can and feeling guilty or anxious when they can't. "I try to get my patients to see exercise not as exercise but as movement," Lipman says. "To get them to move as much as possible in their everyday lives rather than feeling that they have to keep to a rigid exercise regime."
Lipman's perspective is informed more by traditional Chinese medicine than the latest sports science, but as it turns out, his view supports new revelations in exercise science. In the past several years, research has shown that exercise isn't just what happens when you sweat for at least a half-hour running, biking or doing strength or cardio training at the gym; exercise can also be any movement you do during the day, and it can be just as effective at improving health, controlling weight and, in some cases, maintaining or even boosting fitness.
The idea of exercise as a sustained activity separate from the rest of your day dates back to the 1970s, when the American College of Sports Medicine recommended continuous workouts of at least 20 minutes, based on research on elite athletes. "The implication was that if you didn't reach a certain number of minutes, it wasn't worth your while. But that's not true," says Glenn Gaesser, an exercise physiologist at Arizona State University.
Gaesser recently conducted a study to see if short bouts of activity done throughout the day could deliver the same benefits as one continuous workout. He asked a group of people to walk briskly on a treadmill for 30 minutes or at the same pace for 10 minutes three times a day. He found that participants' blood-pressure levels were "significantly lower" on the 10-minute interval days.
Previous studies have also shown that taking multiple short walks lowers blood sugar more effectively than sustained walking. Researchers think that being active more frequently throughout the day forces the body to shuttle sugar from food to working muscles instead of storing it as fat.
Cumulative exercise contributes to weight loss in more significant ways, too. A recent Danish study found that when people didn't work out as long at the gym, they had more energy to move throughout the day, adding up to a bigger caloric burn. The science supports a concept called NEAT, shorthand for "non-exercise activity thermogenesis," which is the number of calories we burn when we're not eating, sleeping or doing sustained exercise. It includes every movement you make, from momentary activities like bending over to tie your shoes and gesturing during a conversation to conscious activities like walking a few more blocks and taking the stairs instead of the escalator. When you do enough of these movements, NEAT can cause you to burn up to 2,000 more calories per day.
Consider an average day: drive to work, sit at a desk, sit through lunch, sit in a meeting, drive home, watch TV. Through small changes, we can integrate intentional effort into this same schedule: walk instead of driving, or park farther away; use a standing desk or sit on a Swiss ball; take a walking lunch break; pace the office with your phone glued to your ear; do wall sits while watching TV.
Mayo Clinic endocrinologist Dr. James Levine, who coined the term "NEAT," thinks being proactive about intentional activity can add up, as shown by the Amish, who live without computers, cars, TVs and smartphones. According to statistics, an Amish man takes 18,500 steps a day, while the average American walks only 5,000. And research shows men need to walk only 3,500 more steps per day, less than two miles, to lose 8.5 pounds in a year without changing their diets.
Yet the Amish, as healthy as they may be, don't produce a lot of strong recreational runners or tennis players. To be these things, you need fitness, which requires pushing the body beyond its comfort zone. When you stress or overload your cardiovascular system, it adapts to meet the increased load: the heart pumps more blood and oxygen to muscles, where muscle cells increase in number. But can you accomplish all this simply by walking and standing up more frequently?
Maybe. How much exercise a person needs to increase fitness will be particular to that person, dependent upon current activity and genetics. Yet some research shows that cumulative exercise can improve fitness. Researchers in an Irish study asked two groups of people to either walk vigorously 30 minutes a day or split up the workout into three 10-minute walks at the same pace, similar to Gaesser's setup. After six weeks, scientists found that frequent short walks provided a bigger boost to VO2 max, which is our ability to process oxygen and is one of the classic measures of fitness.
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If you want to build strength without the gym, you can get similar benefits by doing some pushups here, sit-ups there and a little body squatting at random. Mini strength workouts done throughout the day can add up to more work than most people can handle in a single session, says Dr. Tim Church, a preventive-medicine researcher at the Pennington Biomedical Research Center in Baton Rouge, La. Better yet, they can be done at home, in a closed office or in an empty conference room.
How can you tell if your "exercise" during the day is paying off? Monitor yourself. If, over time, you're accomplishing the same work, the same number of flights of stairs and the same number of pushups with less effort, you're getting fitter and stronger. If your weight drops or stays the same, you're also getting a similar caloric effect to the gym.
There are also significant benefits to reducing the time you spend sitting. An impressive body of research now shows that prolonged sitting increases the risk of cancer, heart disease and other chronic illnesses, no matter how much you exercise, by slowing blood flow, heart rate and cell turnover. University of Southern California professor of medicine Dr. David Agus has compared the risk incurred by prolonged sitting to smoking a pack and a half a day, while one study found that sitting for eight hours daily increases the risk of premature death by 15 percent, even for those who work out.
If science has loosened its grip on the five-days-a-week gym habit, it has also shown us that less time at the gym is more. Research on high-intensity training suggests that you can maximize exercise's payoff by working out at a higher intensity for a shorter time. Martin Gibala, a professor at Ontario's McMaster University, has published mind-blowing research which concluded that six to nine minutes a week of all-out pedaling on a stationary bike can produce the same fitness gains as five hour-long workouts conducted at a comfortable pace. As for weight loss, while short intervals don't torch as many calories per week as five hour-long workouts, caloric burn during and after doing intervals is significantly higher.
The message is this: less is more. "There aren't many studies that have proved a minimum effective dose for exercise. But there are many studies that disprove the need to be in the gym for hours per week, let alone per day," says Tim Ferriss, author of The 4-Hour Body. As the evidence in favor of shorter workouts accumulates, so too does data suggesting that long workouts make less sense for those of us who aren't elite athletes. Recent research has found that joggers who run fewer miles tend to outlive those who run more than 20 miles a week.
"There is a law of diminishing returns," Gaesser says. "My guess is that beyond 300 minutes a week of moderate to vigorous exercise, the additional health benefits become rather negligible." So when you're at the office or home with the kids, don't stress about not being at the gym. Movement is movement, and it all counts. "I coach my kid's baseball team, so I'm running around all over the place," says Church. "I work hard at not making it a sedentary activity."