Show 1414: Finding Your Exercise Prescription for Life

This week, two leading exercise physiologists tell us why we each need a lifelong exercise prescription. Dr. Benjamin Levine worked with the Dallas Bed Rest and Training Study to discover that three weeks of bed rest harms fitness over 30 years of normal life. Dr. Claudio Battaglini prescribes exercises to cancer patients so that they will be healthier once cured of their malignancy.

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An exercise prescription as part of our daily hygiene:

Many people think they should exercise, but most of the time they don’t feel like it. Maybe that’s how you felt when you first started flossing. Many of the things we do every day as part of our daily hygiene—showering and shampooing, washing dishes, changing clothes—aren’t really fun, but we feel better when we do them. Dr. Levine argues that we should approach physical activity the same way. If we make activity part of our daily routine rather than making it a special event that requires a schedule and extra effort, it has the power to improve our health.

Which exercise is best?

There’s no doubt here: the best exercise is the one you actually do. Maybe, like Joe and Dr. Levine, you like to play tennis. Because it’s fun, you make time whenever you can. Maybe you like running, dancing, swimming, or walking in the woods. What you value most is a good place to anchor your exercise prescription.

Get a varied activity regime:

Tennis is great for those who love it, but it alone is not enough. We also need to pay attention to the “dose”. We each need a time in the week where we exercise intensely. Dr. Levine likes a Norwegian approach called 4 by 4. You exercise as hard as possible for four minutes, then rest for three minutes. Repeat this sequence four times. There are also other ways to get vigorous activity: climbing stairs works for some people. Others like cycling. If you can’t handle it yourself, recruiting friends or signing up for a class can help.

We all need to strengthen our muscles and bones too. Therefore, we should find a way to challenge them with resistance training. This could be push-ups, pull-ups, squats or burpees. Or it could be training with weights or on machines designed to help you build strength.

Recovering from an injury or heart attack:

In the 20th century, heart attack patients were often told to avoid exercise. The current idea is that people should start moving as soon as possible after a heart attack, gently at first, by walking around the room or down the hospital corridors. Once they are ready to leave the hospital, the exercise prescription will likely be for a cardiac rehabilitation exercise program with careful cardiac monitoring. For most people, this will last about three months and the insurance will pay. Then they can move on to exercising without supervision.

When people are recovering from an injury, they also need an exercise prescription so they don’t lose too much fitness before they get better. This will likely mean 20 to 30 minutes a day of physical activity without stressing the injured limb.

A variety of exercise specialists:

Our conversation with Dr. Battaglini began by clarifying the roles of different types of exercise specialists. Exercise physiologists, like him, are scientific researchers. Coaches and physiotherapists put into practice the data discovered by exercise physiologists. The coach helps athletes achieve their best performances while the physiotherapist helps an injured person recover to the best of their ability. In both cases, they use evidence to provide an exercise prescription.

Dr. Battaglini’s area of ​​practice and research involves cancer patients. Staying physically active throughout our lives can help reduce our risk of developing many cancers. However, if a person develops cancer, treatment can be exhausting and cause fatigue. As with heart disease, mentalities have changed. Oncologists believed that physical activity would make their patients’ fatigue worse. However, data now shows that appropriate activity can actually reduce fatigue. Exercise prescription should be personalized to the patient.

Train alone or in a group:

As part of his work, Dr. Battaglini provided exercise programs to breast cancer patients. Each patient received individual attention from a student or intern who served as a coach. But when he read patient reviews, many wished they could exercise in a group with other patients. When he made this change to the program, it was a great success. Everyone followed their individual exercise plan and the group provided strong emotional support to each other.

One of the barriers to the broader use of exercise in the treatment of cancer patients is the lack of buy-in from insurance companies. The lack of reimbursement makes it more difficult for cancer centers to provide this important healing service.

This week’s guests:

Benjamin Levine, MD, FACC, FACSM, FAPS, FAHA, is a professor in the Department of Internal Medicine at UT Southwestern Medical Center and a member of the Division of Cardiology. He holds the Distinguished Chair in Exercise Science. He is the founding director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital in Dallas, where he also holds the S. Finley Ewing Jr. Chair in Wellness and the Harry S . Moss Heart for cardiovascular research. https://utswmed.org/doctors/benjamin-levine/

Claudio L. Battaglini, PhD, FACSM is Professor of Exercise Physiology and Director of the Exercise Physiology Graduate Program at the University of North Carolina at Chapel Hill. He is co-director of the Exercise Oncology Laboratory in the Department of Exercise and Sports Sciences at UNC Chapel Hill. Dr. Battaglini is also a member of the UNC Lineberger Comprehensive Cancer Center.
https://exss.unc.edu/faculty-staff/claudio-battaglini/

Listen to the podcast:

The podcast of this program will be available on Monday January 20, 2025, after broadcast on January 18. You can stream the show from this site and download the podcast for free.

Download the mp3.