Exercise, a Modern Problem?

Love it, tolerate it or even hate it, exercise is synonymous with the quest to live better. It’s accepted dogma that exercise is a healthy activity but why is it so hard to make it happen? Why do we start with great intentions but succumb to the little voice in our heads telling us to stop?

One significant reason is modernity and the mismatch between our environments and physical needs. Physical activity let alone exercise is incredibly avoidable in the 21st century leading to physical inactivity being labelled a global pandemic (1). The consequences of this pandemic cannot be understated with significant increases in metabolic diseases and musculoskeletal pain disorders, leading to a great deal of suffering (2).

‘We evolved to be physically active through necessity but modern lifestyles reduce the necessity to be physically active’

300,000 years ago, the human form as we know it had evolved and we were hunters and gatherers with two instinctive purposes, survival and reproduction. Achieving this required a delicate balance of energy availability. Using too much energy would risk weakness increasing vulnerability to predators and illness. However, using too little would risk not finding food and water or having adequate shelter.

Hunter-gatherers, therefore, engaged in regular physical activity including walking and slow jogging up to 5-10 miles a day, carrying children, digging and foraging (3). Modern-day hunter-gatherers continue to live this way, rarely staying in a single wakeful position for more than 15 minutes, switching between standing, squatting, or lying (4). The notion of exerting themselves physically, without a purpose was not intuitive or necessary.

In contrast, the average modern westerner walks about 2-3 miles per day, does not search far for food or water, carries very little and sit’s and lie’s for hours on end in comfortable and supportive chairs, sofas and beds (5).

When contrasting these different lifestyles we can see how we evolved to be physically active through necessity but modern lifestyle reduces the necessity to be physically active. This mismatch requires a conscious effort to introduce exercise into our life. This is most troublesome as we evolved to move but our minds have not evolved to want to exercise!

We evolved to move!!

Through the historical necessity of physical activity, our bodies developed remarkable mechanisms to support and promote such behaviours improving our chances of survival and our ability to reproduce. As a thought experiment, consider who was more likely to survive and thus reproduce. A human possessing good bone health, muscle function, reduced inflammation and stable mental health or one who did not?

Moderate and intense levels of physical activity, for instance, result in a pro-inflammatory followed by a stronger, longer-lasting anti-inflammatory response (6,7). Together these form the basis of why physical activity can maintain, repair, and build stronger and healthier tissues and reduce chronic inflammation.

Physical activity also promotes the utilisation of sugars within the bloodstream, reduces harmful organ fat, enhances immune function, and even increases brain-derived neurotrophic factor, a molecule that facilitates the repair, maintenance, and creation of brain cells (8).

It makes sense therefore that our brains increase the quantity of motivational, reward, and feel-good molecules and their receptors such as dopamine, serotonin, and endorphins in response to physical activity (9). One of the reasons why exercise is associated with improving symptoms of depression (10).

Unfortunately, overweight and inactive individuals have a higher risk of lower levels of such molecules and receptors, often having to exercise for weeks or months before they normalise (11). Furthermore, it takes over 20 minutes of rigorous exertion before feel-good endorphins are increased, requiring a moderate degree of fitness in the first place (12).

Conversely, highly active individuals may get addicted to exercise through increases in these molecules (13). Fortunately, when in a healthy balance most of us will just feel the urge to move as these levels deplete.

OK, so how much is enough?

150-300 minutes of moderate and/or vigorous physical activity per week will increase your odds of living longer by up to 30% at any given age (14) Fig 1. In fact, anything above 90 minutes per week (13 minutes a day!) will improve longevity and the benefits of physical activity compound even greater as we age, increasing the odds of living longer by 50% (15). Therefore, some is better than none, and starting late may even prolong your fate.

Fig 1

Despite this evidence and the fact that 150 minutes represents just 2% of our wakeful hours, large numbers of people are doing far less (16). Typical hunter-gatherers on the other hand spend up to 14 hours doing moderate and a further 2.5 hours doing vigorous activities (17), up to 6 times more active than individuals who are the borderline minimum recommendations.

It’s little wonder therefore hunter-gathers demonstrate at least average upper body strength compared to western counterparts despite no formal exercise (18,19). Furthermore, they lose strength at significantly slower rates as they age and their blood pressures remain like that of an individual in their twenties in their later years (20,21).

Indeed physically active individuals and exercisers typically experience better health during their lifespan. They have less risk of metabolic diseases like diabetes, heart disease, and cancer and report fewer episodes and severity of musculoskeletal problems like muscle and joint pains. Unsurprisingly, they need fewer prescription medications and generally report better quality of life (22,23).

I do not like exercise though

No problem, simply try to increase the necessity of physical activity in your life, for example

· Use public transport and stand for the journey. Besides helping the environment the extra minutes on your feet and inevitable perturbations will challenge your balance and stability.

· Replace the hoover with a hard bristle broom and manually clear all the dust and dirt from your carpets and floor. The push and pull actions engage the entire body and from experience, gets a sweat on!

· At the supermarket park the trolley and use a basket or two, as they get heavier you can put them down, take a short break, and then go again. Over time, you will get stronger and find that you can complete this trip quicker and with fewer breaks.

· At work, introduce walking meetings, not only do they increase physical activity but may stimulate thought, creativity, and productivity (24). Crazier yet, whoever is speaking can carry something heavy, you will be surprised how quickly someone may get their point across!

I want to try to exercise

Excellent! In that case, choosing activities that are fun and or purposeful is vital to amplify our brain's reward mechanisms. Our ancestors occasionally ran and danced in groups in the name of spirituality and social bonding (25). Indeed, exercising in a group is likely to reduce stress, increase exercise time, and intensity compared to exercising alone (26).

Running or dancing is not for everyone, fortunately, though there are a plethora of exercise classes, groups, teams and events to perk your interest and match your current abilities. After trial and error, you are likely to find something you can tolerate and perhaps even enjoy. Remember, shifting from feelings of discomfort and angst to pleasure and satisfaction may take weeks or months!

Making exercise, a weekly habit, therefore, is essential in order to recognise its full benefits. Motivating oneself week to week will last only so long, just ask 80% of January sign up’s who quit the gym within 5 months (27).

Make exercise happen

Let’s face it when choosing between chilling on the sofa or going to exercise, the sofa is naturally more appealing. Therefore, to make exercise happen one needs to learn the art of self-coercion. Will you require a gentle prod or a strong push to make it happen? Here are some examples

Gentle prod

· Schedule exercise for the same time and day each week

· Make your exercise clothes visible and accessible

· Wake up in your exercise clothes – ready to work!

· Ask a spouse or friend to remind you to exercise

Strong push

· Schedule exercise with a group or friend in advance – you are accountable for showing up.

· Join an exercise class – when you are slowing or stopping the group will drive you on

· Get a coach – A fitness instructor will set you targets and hold you accountable

· Set an achievable goal – specific body weight or complete an event. Post about your progress and outcomes on social media.

Turn a strong push into a full-on shove by signing a commitment contract on a website such as SticKk.com. Pledge money to an organisation or cause you dislike and your nominated referee updates SticKk weekly about your progress.

For example, an animal rights friend of mine pledged £120 to Countryside Alliance, an organisation promoting the right to hunt and shoot certain animals. If she did not walk or run, at least 30 miles a week for 12 weeks (Approx. 10,000 steps a day for 6 days of the week) Countryside Alliance benefited. ‘Countryside ain’t getting a penny’ as my friend would say.'

Strengthen and support these habitual aids by reappraising negative thoughts and interpretations during and after exercise to more factual and realistic ones. For example, reappraising signs of breathlessness and aches as signs of poor fitness and weakness to proof that you are stretching your current physical limits making you fitter and stronger. Evidence shows this can increase your exercise time, how difficult it feels and reduce the risk you will quit (28). How we talk to ourselves matters!

Do not beat yourself up!

Finally, when trying to exercise we are competing against thousands of years of evolutionary biology and all of modernity’s luxuries. Our minds have not evolved to choose exercise over comfort so when you struggle and falter do not beat yourself up.

Start simple and make basic physical activity more necessary in your life. When you are ready to start exercise, accept it will be hard, over time it will get easier and the benefits outweigh the health shocks of inactivity.

Thanks for reading, it would be great to hear about your experiences and challenges with exercise and how you have tried to tackle them.