February 11, 2025 • 43 mins
In this episode Jo interviews Dr. Jessica Brown, an expert in exercise science from Carroll University. Dr. Brown discusses the concept of exercise as medicine, detailing how physical activity can prevent and treat chronic diseases such as diabetes, hypertension, and cancer. They cover exercise guidelines, the benefits of different types of exercise like strength training, cardio, and HIIT, and the importance of making exercise a habit. They also discuss the role of exercise during cancer treatment and in improving mental health, explaining that the benefits of exercise go beyond weight management.
00:00 Introduction and Guest Introduction
00:11 Exercise as Medicine: An Overview
01:02 The Benefits of Exercise
02:54 Exercise Guidelines and Recommendations
10:40 Exercise Types and Their Benefits
27:18 Exercise During Cancer Treatment
35:12 Exercise and Mental Health
37:14 Practical Tips and Final Thoughts
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hi, everyone.
(00:00):
You have Joe here today on theboost your metabolism after age
30 podcast.
Today we have a special guestDr.
Jessica Brown.
I'll have Jessica introduceherself in a moment.
And so typically we talk aboutexercise as a strategy for
boosting your metabolism forincreasing your daily caloric
(00:21):
burn and a specific type ofexercising, mainly weight
lifting to help with thatprocess.
But today we're going to talk alittle bit more about how
exercise is actually medicine.
And this is Dr.
Brown's expertise.
So would you like to introduceyourself?
Yes.
Thank you very much, Jo, forhaving me.
My name is Dr.
Jessica Brown, and I'm anassociate professor of exercise
(00:45):
science at Carroll University.
So let's get into the heart ofthis.
Again, I think they all knowthat exercise is healthy for us.
But in specifically, what do youmean by the concept of exercise
as medicine?
What does that actually mean?
Yeah, that is a good question.
So I guess to start with, we allknow, as you said, that exercise
(01:06):
is good for us.
Physical activity is good forus.
In fact, one of the mantras Ilive by is this idea that
movement is life.
And what really this comes downto is we are not getting enough
movement in our lives anymore.
In developed countries, in theUnited States.
(01:26):
It's our technology, ouroccupations, our leisure, are
leading us to be more sedentarythan ever.
And unfortunately, what we'reseeing come from that is a rise
of preventable chronic diseasesand cancer diagnoses.
Right now, a little over half ofour entire adult population has
(01:48):
been diagnosed with a chronicdisease or cancer.
And this gets worse as we age.
So when we think about exerciseas medicine, we can see that
exercise can not only preventgetting chronic disease and
prevent some forms of cancer,but that exercise is the
medicine that can help treatAttenuate and cure almost all of
(02:13):
our lifestyle related chronicconditions.
And in that way, exercise trulyis medicine.
Okay, so it sounds like there'sa, it's a preventative medicine
and also a curative medicine.
Am I hearing you right?
That is exactly correct.
Okay, so I've always heardpeople say regardless of how
much you weigh, or if you are ahealthy weight there just is no
(02:36):
such thing as a sedentarylifestyle.
That is healthy.
Do you agree with that?
Yeah, I would say that we need.
Some form of physical activity,some form of movement, and I
like exercise to be morescripted physical activity.
We need that in our life to behealthy.
The American College of SportsMedicine literally has a
(02:58):
framework that says every adultshould get 150 minutes of
moderate intensity exercise aweek, or 75 minutes of vigorous
intensity exercise.
That is what we need to maintainhealth.
If we are combating a chroniccondition or cancer, we need
double that up to three to fivetimes more.
(03:21):
Oh, wow.
Okay.
Okay.
So you're thinking of it interms of those guidelines as
almost like a prescription takeyour multivitamin, take your
exercise.
And that's exactly how I look atit.
Every day I wake up and I have achoice.
Essentially, I can be physicallyactive or exercise or not.
And I think of it as, liketaking my multivitamin or
(03:43):
brushing my teeth, specificallybrushing my teeth.
People around me would want meto do that every day.
So every day I make a choice.
I should do something activebecause that is the way I will
preserve health.
Okay.
I guess thinking about that asexercise is a drug.
What do you think in terms ofit?
I guess drugs, sometimes drugshave negative side effects.
(04:07):
Do you think of exercise in thesame way?
Or is it really like a winconcept?
Yeah that's the big differenceis we can treat chronic
conditions.
We can treat them with exercise.
And we can treat them withpharmaceutical medications or
drugs.
But when we hear any type ofpharmaceutical or drug
advertisement or commercial,you'll hear all the great things
(04:30):
it'll do, followed by a superfast talking spiel at the end of
all of the terrible negativeside effects.
With exercise, they're almostonly benefits.
Benefits improved cardiovascularfunction, muscle building,
improvement in basal metabolicrate.
(04:50):
Reductions in fatigue,improvements in quality of life,
improvements in confidence.
Maybe there's occasional musclesoreness.
Or a risk of injury, but that issmall.
The benefits of exercise areparamount.
They're huge.
Okay.
Let's take the first part ofthis, which is exercise as like
(05:12):
a preventative med medicine.
Yep.
I guess what, how, what is it apreventative medicine for
specifically?
Again, I think we all generallyunderstand that exercise is
healthy for us, but maybe if youcan put some more specificity
around that.
What it actually prevents usfrom getting that might be
motivating to our listeners.
Yeah, so we know that exerciseis curative and can treat
(05:36):
conditions that are metabolic innature, such as obesity and type
2 diabetes.
Exercise improves cardiacfunction and preserves function
even following a heart attack.
Exercise can treat and attenuatehypertension or high blood
pressure better than manymedications or at least exactly
(05:57):
the same.
Exercise can prevent stroke.
It prevents cancer, and it canreduce your risk of recurrence
of cancer.
So there are many ways thatexercise is beneficial, but for
almost every single chroniccondition that we struggle with
in America, the number onechronic disease is heart
(06:18):
disease.
Number two is cancer.
Exercise is curative andpreventative for both of those.
Okay let me ask you a bit of anuanced question.
So I think probably, and this isprobably how I think of it
mostly, and it might be wrong.
So I just want you to correct meif I'm wrong or maybe expand on
(06:38):
this thinking a little bit.
So to my mind, like it'scurative or preventative of
those diseases because itcounteracts obesity.
Is it doing something more like,is obesity the main causes of
these diseases?
And that's why exercise is goodfor us.
Because I know a lot of peoplethat exercise, they might say I
exercise, but I'm stilloverweight.
So I might why bother?
Is it doing something other thancounteracting the instance of
(07:00):
obesity and helping prevent andcure these illnesses?
Yeah, let's take type 2diabetes.
So typically, type 2 diabetesoccurs because we have too high
of blood sugar.
And our insulin is lesseffective at allowing our blood
sugar to enter our body into ourcells.
What exercise does is it allowsglucose or sugar entry.
(07:24):
into the body independent ofinsulin.
So the way I look at it is ifwe, our body, is a train
station, and each terminal ofthe train going down is a car
filled with people, these peopleare sugar.
When you need to utilize thatsugar, insulin will open a door,
and the people will get off thetrain and go to the target cells
(07:47):
to do their job.
When you have insulinresistance, the door is either
not large enough or So insteadof the people getting off the
train, they stay in the car andwe see that as hyperglycemia.
What exercise can do is it canopen up another door, a
different door, independent ofinsulin, to let the people or
(08:09):
the glucose, the sugar, off thetrain in a completely different
way.
Therefore, we can see thatexercise is just as effective as
common diabetes medications.
like metformin.
So if a patient or a client wassuffering from type 2 diabetes,
(08:30):
they could take their medicationand do exercise.
Over time, they can reduce theirreliance on the medication
because the exercise will slowlylower the blood sugar until they
are no longer insulin resistant.
Essentially, curing type 2diabetes.
And that is what we do in theclinic I run.
(08:54):
Literally, the name of theclinic is the Carroll University
Rehabilitative Exercise Clinic,or the CURE Clinic.
And we named it CURE becausealmost all of the diseases,
diabetes, hypertension, heartdisease, cancer, we can have a
curative approach by utilizingprescriptive exercise.
(09:17):
Okay, so I think what I'mhearing you say is that it's it
may help reduce obesity, but itmechanistically is doing other
things to help prevent and curedisease.
Yes.
100%.
Okay.
Because I know, especially as weget older, it does get harder to
lose weight.
And again, I think I hear whatyou're saying is that even if
you're not necessarily makinghuge strides and losing weight,
(09:40):
doing the exercise alone willhelp cure and prevent these
diseases.
Yes, that's exactly right.
And honestly, having excessadiposity or obesity does not
necessarily translate into poorhealth.
There are so many mechanisms bywhich exercise helps the body
that are seen through othermetrics that are not body
(10:01):
weight.
I, yes I'm glad that you've saidthat because I know for sure in
our clients, like we haveclients who, you would look at
their weight or even their BMIand say, oh, They're so
unhealthy, but they actuallyhave really healthy blood
markers.
They have low blood sugar.
They have low cholesterol.
They're by their blood markers.
(10:21):
They're very healthy.
And then conversely, we haveclients who appear to be a
normal weight, but some ofthose.
Conditions are not in the idealrange.
I think it's just good torealize that even if exercise
isn't doing what you want it todo aesthetically or on the
scale, it still has majorbenefits.
Okay, so let's get into thespecifics of what type of
(10:43):
exercise you're talking about.
That is preventative.
Yeah.
So this is actually a prettytough question.
Because the best exercise isgoing to be individualized based
on every person and based on anykind of condition that they are
treating or working with.
The best analogy I can give isif we are diagnosed with a
(11:06):
condition or a disease, And wego to our doctor.
Our doctor is going to take adetailed medical history and
probably do some level ofassessment, like blood work, and
take vitals.
And then the physician will picka specific pharmaceutical drug
and give us a specific drug witha specific dosage at a specific
(11:32):
time of day for a specificlength of time to treat our
condition.
And that is what we would thinkof as a drug prescription.
Exercise prescription is exactlythe same, that you need the
medical information, you needthe assessment results, and you
need this to come together tocreate an individualized
(11:52):
approach for each person basedon what their unique needs are.
Okay.
Generally speaking for again,someone who's just wanting to
take a preventative approach toall of this for all the diseases
that you mentioned what do yourecommend as an approach to
exercise?
First step, any exercise is goodexercise.
(12:14):
The best workout is the one thatyou do.
So at that point, the hardestpart is creating a habit of
exercise.
Small bouts of exercise, likesmall habits.
eventually become lifestylechange.
So my first recommendation, doanything that gets your heart
(12:34):
rate up, that makes your musclesfeel like they're worked,
anything is good.
And once that habit has beenestablished, then maybe we can
start branching out and creatingmore prescriptive types of
exercise and intensities.
Okay, so establish just thehabit of doing something, some
sort of exercise.
(12:55):
First, something is alwaysbetter than nothing.
Exactly.
Okay.
And I, yeah, I like to think ofit as like making space in your
life for exercise.
So that it is something you havetime and energy for.
Because if you don't, it's nevergoing to be part of your
lifestyle.
Okay.
So once someone has okay.
done that and they're gung hoabout exercising and they want
(13:16):
to optimize this.
What do you recommend?
Yeah, so you mentioned italready.
Resistance exercise, strengthtraining is one of the most
important methods and modes ofexercise.
By building lean tissue, bydoing strength training,
naturally we improve basalmetabolic rate, we increase lean
(13:37):
tissue, we improve our bonehealth.
And work on preventingosteoporosis, this works to
offset orthopedic limitations,musculoskeletal imbalances, and
we've seen that improvements instrength.
are directly correlated toimprovements and quality of life
(14:00):
because you're able to do thethings you want to do every day
with ease and without pain.
So my first recommendation,strength training.
I love strength training.
It's good for everyone.
Do we need more than strengthtraining?
My second recommendation cardioexercise is deeply beneficial.
(14:21):
That is the modality that onestrengthens our heart and lungs.
But two, burns the mostcalories, which is something
that we do need to focus onsince we have so many K cals.
and calories around us insociety.
There's a lot of foodeverywhere.
My recommendation is higherintensity interval training.
(14:43):
So we call that hit trainingwhere you'll take your heart
rate up higher for a smallperiod of time.
Drop it down until you'rerecovered and then go up and
down that type of exercise Hasproven to increase the amount of
calories that you burn bothduring But also in this magic
(15:04):
window for about 12 hoursafterwards So when you get your
heart rate up, it's a beneficialthen And later.
So that's one of the methods Irecommend.
It also helps keep you engaged.
Sometimes doing steady statecardio or walking or jogging for
(15:26):
periods of time, that can feelboring.
With interval training, oftenit's, wouldn't call it exciting,
but at least keeps your mindengaged in going up and down and
you can listen to some music.
That is a recommendation I havefor a lot of clients is keeping
it moving with the intervaltraining.
(15:46):
I don't know if that makessense.
Yeah, it does.
It does.
Yeah.
And I'm just thinking of hitexercise classes are very
popular now, whether that's orjust basically interval
training, whether that's likespinning, where you're taking
your heart rate up and down, oreven things like orange theory,
which is.
Interval training and, yeah,you're so focused on doing the
next thing that it does helpwith monotony and boredom.
(16:09):
So I've been reading a lotabout, or hearing a lot about
zone 2 training, which I thinkis your more classic study state
cardio.
And so I haven't beenimplementing more of that in my
in my exercise.
Routine I got and what I havefound is that for me, it's just,
it's easier to get it done.
It doesn't feel it's probablybecause mentally, you have to
(16:29):
work yourself up for hit.
You're going to be tired, but dodoes hit in steady state.
Can you or the zone 2 and byzone 2, what they were talking
about is you get your heart rateinto a moderate.
Moderately increased heart ratezone, usually what 60 to 70
percent of your max heart rateand you stay there for a period
(16:51):
of time rather than thatinterval, which you're probably
working more in what, 80 to 90percent of your heart rate max.
Yeah, exactly.
Yeah.
So I guess what are yourthoughts on zone 2?
Yeah.
So zone two, or like you said,60 to 70 percent of heart rate
max, or about 70 percent ofheart rate reserve is what we
would classically call the fatburning zone.
(17:12):
Not only is this the intensitywhere fat becomes the primary
fuel source, but it is also theintensity, like you mentioned,
that is the most pleasant.
That you can sustain for largerperiods of time.
There is nothing wrong with anyof the types of cardio training.
I think that if our goal is tomake exercise a priority, then
(17:35):
the first step should be pickingwhatever intensity makes us most
likely to continue.
And if, for that, if, if that iszone 2, and steady state where,
we can, Listen to a good book orwatch a television show or go
for a jog outside and seenature, then that's the right
choice.
If the time is limited and it'ssomebody who doesn't want to
(17:58):
think about doing it for a largeduration, then maybe HIIT
training is the option becauseyou can get the workout in and
done pretty fast, but it'll feellike you're working.
Both are beneficial and bothwill create good benefit.
Again, I like HIIT trainingsimply because I think it's a
little bit more effective in ashorter period of time.
(18:22):
But the literature is veryclear.
The higher the intensity ofexercise, the lower the
retention.
So adherence to exercise goesdown with high intensity if
you're at the beginning of thejourney.
So in which case, pick theintensity that makes it more
likely to stick to it.
(18:43):
That makes total sense.
Yeah.
Is there, are there differentbenefits to doing HIT or Zone 2?
Yeah, with zone 2 cardio, thetypical calorie burn is coming
from fat stores as the fuelsource but the calorie burn is
essentially happening whileyou're exercising.
So what is what you get.
(19:04):
With higher intensity cardio,you utilize glucose and glycogen
stores as your fuel source.
because they're faster to burnthan fat.
But that doesn't mean you don'tburn fat.
So the difference is, you'llincrease K Cal expenditure with
HIIT cardio because you'll burnthe calories during.
(19:25):
But then, during a phase calledEPOC, for about 12 hours
following, your body will try toheal itself and replenish energy
stores.
So it will then pull from fatstores later to offset the
carbohydrate use.
So you burn more caloriesoverall with HIIT training and a
(19:46):
lot of literature suggests thatyou increase heart strength and
heart health faster with HIITtraining.
So the effects are morenoticeable.
That being said, it always comesdown to what will make what
you'll most likely do.
And so for some clients, zone 2is the thing that makes them get
(20:08):
out of bed in the morning.
It's the thing they want to do.
That is the right choice forthem.
For others, it might not be.
Yeah, I think that makes sense.
Some people might love to get upand be very motivated to go do
an Orange Theory class wherethat sounds.
Murderous does other people andthey just let her go, for a nice
slow jog outside.
(20:29):
Okay.
Let's talk about so we've talkedabout type of exercise and I
guess one last question, wheredo like yoga maybe Pilates,
those sorts of exercises.
Or that type of workout, wheredo you see that fitting in?
Yeah, I think that those areamazing modalities that
obviously yoga and Pilatesimprove strength more in a
(20:49):
muscular endurance way, andflexibility and obviously range
of motion.
I found that those programs arevery effective at improving
mood, reducing fatigue.
So our psychological measuresclinically are improved.
very heavily by yoga andPilates.
(21:11):
Likewise, of course, flexibilityis improved.
I like to utilize thosemodalities.
As a way to augment resistanceexercise and cardio exercise.
I think of cardio and resistanceas the foundational pillars, and
then yoga and Pilates as amazingsupplements that simply make
(21:31):
everything better.
Okay.
Okay.
Now let's talk about, you hadmentioned earlier we should be
getting 150 minutes of exercisea week.
So talk to me about is that 150minutes?
Does that include.
Everything like your cardio andyour weight lifting and your
yoga and Pilates is that youneed 150.
I've heard 150 minutes ofcardio.
(21:53):
How do you break that up?
And then how hard should we beworking in our exercise
sessions?
Yeah, so the American College ofSports Medicine's recommendation
for the 150 minutes is first inthe moderate range.
So that would be the steadystate zone two that we talked
about.
That's the recommendation.
(22:14):
And that's primarily for cardiobased exercise.
But it is recommended to get atleast two days a week of
resistance exercise that cancount inside of that 150
minutes.
Okay, so I can count my strengthtraining towards the 150
minutes.
Yes, typically most people thinkof it as cardio, but we should
(22:35):
be getting the two days ofresistance inside that.
Okay, so if I work out, I lift 3hours a week, get cardio and on
top of that, I'm trying reallybad.
So that would be 180 minutes,and then how much cardio do I
need on top of that?
The American College of SportsMedicine is more cardio based,
so their foundation is generallycardio specific.
(23:00):
What they're trying to do isensure that we're strengthening
our heart and our lungs.
So I think the question wouldbe, it depends on what type of
resistance exercise.
So if we're, there's lots ofresistance programs.
that are maybe faster or morecircuit based where we're
lifting and our heart ratesgetting staying up the whole
time.
I think that's the best of bothworlds.
(23:21):
Your heart rates up, you'relifting weights.
Otherwise, if it's traditionalstrength training, sitting down,
lifting three sets of 12 or 10and you're resting in between, I
think then you do need to addcardio on top of that to ensure
that you're hitting heart,lungs.
And muscles.
Okay.
So if you're doing a circuitbased weightlifting program, 3
(23:44):
times a week and keeping yourheart rate at least in the zone
2 or above range you may notneed extra cardio.
Yes, but if it's not doing that,then add in some cardio to round
things out.
Okay.
Yep.
What about walking?
Where do you think that fits inwhen your heart rate like.
So I, and we usually try to giveour clients a step goal because
(24:08):
to my mind the steps equate togeneral activity.
And again, they're very doable.
You don't have to do it all atonce.
Pretty much anyone can walk.
All you really need is.
A decent pair of shoes, maybe acoat.
Yeah, how do you view walking tofit in all of this regimen?
Yeah, walking, I consider formost people physical activity as
(24:30):
opposed to exercise.
Now, I think that for certainability levels and training
levels, walking, especially at agood pace, with good arm
movement, Can be exercised aslong as the heart rates up.
I think the perfect program orthe perfect lifestyle is a
combination of physicalactivity, like walking or
(24:53):
playing with kids and structuredexercise.
I think physical activity iswonderful, but the way I look at
it is, if all we do is physicalactivity, we may not be
overloading our systems enoughto create the change necessary
to either combat disease.
or prevent disease.
(25:14):
So I think of it as my mantra issimilar to the idea of no pain,
no gain, which kind of has anegative connotation.
But really, if it doesn'tchallenge you, it doesn't change
you.
So if every time we're doingphysical activity or exercise,
we don't feel ever challenged,Whether it's our muscles or our
(25:37):
lungs and heart, it may not bethe most effective, but walking
is great.
I just think it should probablybe paired with other things.
Yeah, I think the way I bestunderstand this, or people have
explained that makes sense to meis that we want to be sent.
We want our the way thatexercise is helpful as it causes
(25:58):
adaptations in our bodies thatare beneficial.
I suppose that.
The way that non exercisingcould cause adaptations in our
bodies that are not very helpfulto us.
And so if you're not doingenough to stimulate your body to
adapt to something new, thenyou're probably not getting the
benefit of it.
So exactly.
Yeah.
So walking is.
(26:18):
We want to get be generallyactive and walking is a good
proxy for that.
But we also need the structuredresistance training and
cardiovascular training toreally stimulate those
adaptations that are going toprevent the disease or cure the
disease.
Exactly.
And that's where I thinkprescribing exercise more in a
fine tuned way is also helpfulbecause you'll see that
(26:41):
different chronic conditions,different cancer types,
different cancer treatments willimpact the body in different
ways.
And so what we're able to do isfind the type.
of exercise and the intensitythat best offsets those specific
problems.
And then almost like a mirrorimage, you find the toxicity or
(27:04):
the side effect, you find thebenefit of exercise and you
marry the two together.
And that's how you make aprescriptive exercise program
for each person dependent ontheir medical history.
Yeah, that makes a lot of senseto me.
Okay let's now talk aboutexercise as a medicine during
the treatment of disease.
The best example I can give is,someone going through treatment
(27:27):
of cancer.
Yeah, so what does that looklike?
Yeah, when you start, whenyou're diagnosed with cancer,
you'll, most likely there'sseveral treatments, surgery,
radiation, and chemotherapy, andthese treatments, whether done
separately or concurrently, Allhave pretty drastic side
effects.
We see that with fatigue, withdecreased immune function, but
(27:52):
many of the side effects alsohappen systemically.
Many chemotherapy drugs directlydamage the heart, directly
damage the lungs, cause musclewasting.
And what's special aboutexercise is that it is able to
directly offset and attenuatealmost all of the treatment
(28:13):
related side effects.
of cancer and chemotherapy andradiation.
So patients who do exerciseduring and immediately following
cancer and its treatments willsee improvements in
cardiovascular health, muscularstrength, muscular endurance,
(28:33):
their functional ability, andtheir flexibility and range of
motion, which are all negativelyaffected from the cancer
treatments and surgery.
Okay and then does it also, doesexercise while being treated for
cancer directly impact outcomes?
So aside from helping manage theside effects of medicine, does
it also impact, the overalloutcome?
(28:56):
Yeah what's really special isthere are certain chemotherapy
agents that directly damage theheart.
And over the years, oncologistshave learned that they actually
have to temper the amount ofthese chemotherapy drugs given
to patients.
because they'll cause heartfailure.
What we've found is thatexercise, specifically cardio,
(29:19):
during the administration ofthese chemotherapeutic agents
directly stops and blocks any ofthe damage to the heart.
So what that means now is thatoncologists can work directly
with an exercise physiologist tohave the physiologist prescribe
cardio exercise Duringchemotherapy administration, so
(29:41):
that the patient can toleratemore of the drug with no side
effects and thus increases theefficacy of the cancer
treatment.
So we're able to actually takemore cancer treatment drugs
while exercising, which means wehave a greater chance of
healing.
killing all of the cancer cells.
(30:01):
Yeah, I guess intuitively thatkind of makes sense to me
because you're probablymetabolizing more of it, right?
Through exercise.
And yeah, it seems like youwould be able to tolerate more
of it.
I guess my question on this isthat probably most people when
they're having chemo orradiation or undergoing cancer
treatment, probably don't feellike exercising.
Yep.
And it may not feel like it'sgood for them if you feel pretty
(30:25):
rotten.
So How do you deal with that?
Yeah, fatigue is the number oneside effect of cancer and its
treatments.
followed closely byimmunosuppression.
What's really unique aboutexercise is that once you start
exercising, when you are goingthrough treatment and when you
(30:45):
are that fatigued is it's almostlike a like a fog has lifted the
way I've been, I've heard itdescribed.
And all of a sudden you can seea little bit clearer, you feel a
little bit better and you feelbetter at the end of the
exercise.
Then you did when you startedand every day it makes it a
little bit easier to want toexercise and the literature is
(31:09):
pretty clear.
Exercise is probably the mostpowerful stimulus for reducing
cancer related fatigue, so it'smore of that first step taking
that first step to try toexercise when you're that
fatigued is the hard part, but Ipromise that once you do, you
will feel better.
So how does this work for say wehave a listener who's actively
(31:32):
undergoing cancer treatment andthey're not currently exercising
or they think they can't ordon't feel good enough.
Is this just something theyshould talk to their oncologist
about?
And are there clinics that youmight go to, like a PT clinic or
something that helps, peoplebeing treated for cancer,
understand what exercise isgoing to be best for them and
how to work it into their, totheir life while they're getting
(31:53):
treatment.
Yeah programming and that'sactually my entire goal of my
career and my mission is to makeexercise based cancer rehab more
available for patients.
The idea is that an oncologistwould directly refer a patient.
To an exercise physiologist orcertified exercise professional
(32:14):
with an expertise in cancer tothen help create an
individualized exercise planbecause the time point during
treatment.
Is, a critical point.
And so working with aprofessional is pretty important
in that moment, because we wantto make sure that the exercise
dosage is appropriate so that wedo not cause harm as well.
(32:38):
Yeah, it seems like it could bea real like Goldilocks formula
and a little too much could betoo much.
Yeah, but you want to be doingenough to for it to be
effective.
So that is exactly correct.
Okay, so something to talk toyour oncologist about it, if you
are undergoing cancer treatmentand want to explore this as a
(32:59):
way to, boost the effects ofyour cancer treatment.
Okay.
How does exercise does itaffect.
remission rates?
How does it work after you'vebeen treated for cancer?
Does continuing to exercise helpprevent the cancer from coming
back?
Yeah, not only does exerciseimprove the efficacy and
(33:20):
outcomes of cancer and itstreatments, but the data is very
clear that exercising followinga cancer diagnosis reduces
recurrence and hospitaladmittance rates.
Okay, that sounds Prettypersuasive to me.
And again, is this still I thinkstill people like, we'll get in
(33:40):
this mindset but if I'moverweight, or even if I'm
exercise, if I'm not losing theweight, there's no point in the
exercise, like that it's doingsomething beyond helping manage
your weight.
Yeah, honestly, I think, I thinkyou and I have touched on this.
I think body weight is probablyone of the worst metrics to
determine health.
There are so many other ways.
Even resting heart rate, ifyou're resting heart rate starts
(34:03):
to go down, that directly meansyour heart got stronger.
There are so many ways tomeasure our success that has
nothing to do with the scale.
Okay I'm so glad that you saidthat, because I think we get so
stuck on that.
And if we don't see that scalegoing down, we don't think
anything that we're doing ishaving any effect.
And, it's probably a little bitmore nuanced than that.
(34:25):
And our day to day habits areprobably a little more.
Just more nuanced and how theyaffect our health than just
looking at the scale and seeingif it's going down and then
translating that into betterhealth.
Okay.
In terms of impacting remissionrates.
Is there a type of exercisethat's better than another?
Or is it just depend on thecancer diagnosis and your
treatment and that sort ofthing?
(34:47):
Yeah, really depend on the typeof cancer.
But really that well roundedkind of multimodal approach with
resistance, exercise, cardio,and then some form of
flexibility or functional worklike the yoga and Pilates.
I think if we're looking for theperfect program, the perfect one
is a mix of everything with afoundation and strength and
(35:10):
cardio.
Okay.
And I guess one thing that wehaven't talked about at all, but
I know for me, It's veryimportant or exercise is very
important as mental healththoughts on the impacts of
exercise and mental healthagain, putting what the scale
says aside, what does exercisedo for people's mental health?
What doesn't it do right toimprove our mood exercise makes
(35:32):
us feel better in the moment.
It improves confidence, othersdemonstrated evidence of reduced
depression, improved quality oflife.
Strangely, exercise improvesfatigue across the board,
whether it's cancer relatedfatigue or just you had a rough
day.
Really, exercise is the fountainof youth.
(35:53):
It is.
It is medicine.
Exercise is probably the onething we should do every single
day to feel better.
And when we were talking aboutways to gauge success.
The scale is not a great method,but how you feel every day.
When you get done with theworkout, when we all get done
with an exercise session, wealways feel better.
(36:14):
And then it translates to therest of our day.
When you get up the nextmorning, you feel better.
And so I feel the only badworkout is the one that you
don't do.
Exercise improves all of thosefeatures.
Yeah, I agree.
And I think if you went to thedoctor and said, give me
something that improves my mood,helps me feel more productive,
helps me sleep better at nightregulates my appetite.
(36:37):
And the doctor said, Oh, I havethis pill.
Everyone would sign up for it.
No, that is a perfect way.
If we had an infomercial ofexercise, sign up here, if you
did this, or if you want this,and this, all you have to do is.
Exercise like that's it.
It's miracle.
I think it's just it's work.
So it's not as convenient asmaybe popping a pill every day.
(36:58):
But but I know for me, it'sgotten to the point.
I probably started, was mostlymotivated by vanity.
And now I just it's such anintegral part of my.
Energy management, having goodenergy, managing mental health
that I would never not do it.
Okay this has been sointeresting.
Can you give us any partingthoughts or practical tips that
you have about exercise asmedicine in our day to day
(37:20):
lives?
Yeah.
Sorry, you're waiting for thatreally nice mic drop, Joe.
I'm trying to think.
We said so many great thingsalready.
We did.
Yes, you did.
Yeah.
I think we know exercise ismedicine, but I think that we
all know that it is so good forus.
It improves all of ourpsychological functioning.
(37:40):
It improves physicalfunctioning.
It prevents disease.
It cures disease.
But I think the hardest part ofexercise is making it a habit
and doing it.
And I think that that lifestylechange is actually probably the
hardest component of all ofthis.
And so one of the ideas I alwaysimpart to my clients and
(38:01):
patients is this idea that itjust takes small steps.
Every day we make a small stepto create a habit and these
small habits over time lead tolarger habits and eventually
that becomes our lifestyle.
And I think you said finding away to fit it into our day to
fit it into our life that thereal secret isn't necessarily
(38:25):
the type of exercise, the modeor the intensity.
I think the real secret isfinding a way to make this part
of everything that we do andevery day.
And that is how we preventdisease is simply by having any
exercise.
Yeah.
Yeah.
And, as I think about it, Ithink about myself or other
(38:45):
people that that I know who arevery fit or have a very strong
exercise habits.
It's a process.
And so I know, I started outrunning and then I did aerobics
and then I went back to runningand then I didn't get into
weightlifting until I was in my40s.
And so no one ever starts outlike with a perfect regimen.
(39:07):
It builds on itself.
And I think everyone, no, thatmight.
Mean that it starts out fordoing yoga three times a week
and you just get in the habit ofdoing that and then that makes
you feel better.
And then you wanna add in somecardio or some strength training
until you get to a place whereyou have a well-rounded exercise
program.
Exactly.
Also.
I also think if, and this ismost people we talk a lot about
(39:28):
this in our, the coaching partof our program is I don't know
if you've heard of GretchenRuben and the 4 tendencies and
how we're motivated.
Most people are.
Motivated by externalaccountability and so if you are
someone that isn't going to dothis, unless you hire a coach,
or you have a trainer that youshow up for, or you pay for a
(39:48):
class, because, you don't wantto waste the money and, you will
show up to the class.
To me, health is your bestinvestment.
And so it's okay to expend thatmoney or make that investment.
Because it's just ultimately aninvestment in your longevity and
your quality of life.
And your health.
As you age.
That's perfectly fine.
And you should do that.
(40:09):
If it will help you form thehabit.
No, you're really right.
And honestly, most habits startwith those extrinsic external
forces getting us there and youhave to build a series of those
external facets until it becomessomething more internal.
That makes perfect sense.
Yeah.
Yeah.
And it, I don't think anyonealso ever just starts out loving
(40:31):
it.
It does feel like a chore atfirst Yes, that is true.
Sometimes it still feels a chorelike a chore, even if we've been
doing it for a long time.
And that's why I like the hitexercise.
I, instead of thinking about thefact that I'm doing exercise,
I'm just thinking that I'm gonnadie the whole time and then it's
over.
Yeah, I can relate to that.
Okay.
I I think that's all we have fortoday.
I really appreciate you comingon and discussing this topic.
(40:53):
It's a really valuable messageagain.
I think my big takeaway fromthis, and I hope all of our
listeners will understand that.
Exercise, regardless of whatit's making the scale do, is
going to be good for you.
Don't throw the baby out withthe bath water, and just
because, the scale isn't goingin the way that you think, or
you don't think it's making youlose weight, or making you look
(41:14):
the way that you want, it'sstill very good for you, and you
should continue doing it.
That's my public serviceannouncement for today.
But thank you for coming on.
Is there, are you on socialmedia or if people want to learn
more about what you discussed ormore about you, where can they
find you?
Yeah.
We have a website on the Carrolluniversity website and I can
(41:34):
leave that information with you,Joe.
Most of my information is onthere as well as information on
the Carroll universityrehabilitative exercise clinic,
which is a Cancer and ChronicDisease Rehabilitation Clinic
and Program designed to exactlydo this, use exercise as
medicine to be that change thatwe need to see.
(41:55):
Awesome, and I will put a plugin for our very own coach
Leanne.
She trained under you, Ibelieve, or was 1 of your
students.
If you like this approach, andyou like what you're hearing our
very own coach Leanne definitelyknows all these principles and
is really how she thinks about,structuring programs for our
clients.
Okay thank you for your time.
And it was great talking to youand thanks everyone for tuning
(42:16):
in.
Thank you.
Hi, everyone.
(00:00):
You have Joe here today on theboost your metabolism after age
30 podcast.
Today we have a special guestDr.
Jessica Brown.
I'll have Jessica introduceherself in a moment.
And so typically we talk aboutexercise as a strategy for
boosting your metabolism forincreasing your daily caloric
(00:21):
burn and a specific type ofexercising, mainly weight
lifting to help with thatprocess.
But today we're going to talk alittle bit more about how
exercise is actually medicine.
And this is Dr.
Brown's expertise.
So would you like to introduceyourself?
Yes.
Thank you very much, Jo, forhaving me.
My name is Dr.
Jessica Brown, and I'm anassociate professor of exercise
(00:45):
science at Carroll University.
So let's get into the heart ofthis.
Again, I think they all knowthat exercise is healthy for us.
But in specifically, what do youmean by the concept of exercise
as medicine?
What does that actually mean?
Yeah, that is a good question.
So I guess to start with, we allknow, as you said, that exercise
(01:06):
is good for us.
Physical activity is good forus.
In fact, one of the mantras Ilive by is this idea that
movement is life.
And what really this comes downto is we are not getting enough
movement in our lives anymore.
In developed countries, in theUnited States.
(01:26):
It's our technology, ouroccupations, our leisure, are
leading us to be more sedentarythan ever.
And unfortunately, what we'reseeing come from that is a rise
of preventable chronic diseasesand cancer diagnoses.
Right now, a little over half ofour entire adult population has
(01:48):
been diagnosed with a chronicdisease or cancer.
And this gets worse as we age.
So when we think about exerciseas medicine, we can see that
exercise can not only preventgetting chronic disease and
prevent some forms of cancer,but that exercise is the
medicine that can help treatAttenuate and cure almost all of
(02:13):
our lifestyle related chronicconditions.
And in that way, exercise trulyis medicine.
Okay, so it sounds like there'sa, it's a preventative medicine
and also a curative medicine.
Am I hearing you right?
That is exactly correct.
Okay, so I've always heardpeople say regardless of how
much you weigh, or if you are ahealthy weight there just is no
(02:36):
such thing as a sedentarylifestyle.
That is healthy.
Do you agree with that?
Yeah, I would say that we need.
Some form of physical activity,some form of movement, and I
like exercise to be morescripted physical activity.
We need that in our life to behealthy.
The American College of SportsMedicine literally has a
(02:58):
framework that says every adultshould get 150 minutes of
moderate intensity exercise aweek, or 75 minutes of vigorous
intensity exercise.
That is what we need to maintainhealth.
If we are combating a chroniccondition or cancer, we need
double that up to three to fivetimes more.
(03:21):
Oh, wow.
Okay.
Okay.
So you're thinking of it interms of those guidelines as
almost like a prescription takeyour multivitamin, take your
exercise.
And that's exactly how I look atit.
Every day I wake up and I have achoice.
Essentially, I can be physicallyactive or exercise or not.
And I think of it as, liketaking my multivitamin or
(03:43):
brushing my teeth, specificallybrushing my teeth.
People around me would want meto do that every day.
So every day I make a choice.
I should do something activebecause that is the way I will
preserve health.
Okay.
I guess thinking about that asexercise is a drug.
What do you think in terms ofit?
I guess drugs, sometimes drugshave negative side effects.
(04:07):
Do you think of exercise in thesame way?
Or is it really like a winconcept?
Yeah that's the big differenceis we can treat chronic
conditions.
We can treat them with exercise.
And we can treat them withpharmaceutical medications or
drugs.
But when we hear any type ofpharmaceutical or drug
advertisement or commercial,you'll hear all the great things
(04:30):
it'll do, followed by a superfast talking spiel at the end of
all of the terrible negativeside effects.
With exercise, they're almostonly benefits.
Benefits improved cardiovascularfunction, muscle building,
improvement in basal metabolicrate.
(04:50):
Reductions in fatigue,improvements in quality of life,
improvements in confidence.
Maybe there's occasional musclesoreness.
Or a risk of injury, but that issmall.
The benefits of exercise areparamount.
They're huge.
Okay.
Let's take the first part ofthis, which is exercise as like
(05:12):
a preventative med medicine.
Yep.
I guess what, how, what is it apreventative medicine for
specifically?
Again, I think we all generallyunderstand that exercise is
healthy for us, but maybe if youcan put some more specificity
around that.
What it actually prevents usfrom getting that might be
motivating to our listeners.
Yeah, so we know that exerciseis curative and can treat
(05:36):
conditions that are metabolic innature, such as obesity and type
2 diabetes.
Exercise improves cardiacfunction and preserves function
even following a heart attack.
Exercise can treat and attenuatehypertension or high blood
pressure better than manymedications or at least exactly
(05:57):
the same.
Exercise can prevent stroke.
It prevents cancer, and it canreduce your risk of recurrence
of cancer.
So there are many ways thatexercise is beneficial, but for
almost every single chroniccondition that we struggle with
in America, the number onechronic disease is heart
(06:18):
disease.
Number two is cancer.
Exercise is curative andpreventative for both of those.
Okay let me ask you a bit of anuanced question.
So I think probably, and this isprobably how I think of it
mostly, and it might be wrong.
So I just want you to correct meif I'm wrong or maybe expand on
(06:38):
this thinking a little bit.
So to my mind, like it'scurative or preventative of
those diseases because itcounteracts obesity.
Is it doing something more like,is obesity the main causes of
these diseases?
And that's why exercise is goodfor us.
Because I know a lot of peoplethat exercise, they might say I
exercise, but I'm stilloverweight.
So I might why bother?
Is it doing something other thancounteracting the instance of
(07:00):
obesity and helping prevent andcure these illnesses?
Yeah, let's take type 2diabetes.
So typically, type 2 diabetesoccurs because we have too high
of blood sugar.
And our insulin is lesseffective at allowing our blood
sugar to enter our body into ourcells.
What exercise does is it allowsglucose or sugar entry.
(07:24):
into the body independent ofinsulin.
So the way I look at it is ifwe, our body, is a train
station, and each terminal ofthe train going down is a car
filled with people, these peopleare sugar.
When you need to utilize thatsugar, insulin will open a door,
and the people will get off thetrain and go to the target cells
(07:47):
to do their job.
When you have insulinresistance, the door is either
not large enough or So insteadof the people getting off the
train, they stay in the car andwe see that as hyperglycemia.
What exercise can do is it canopen up another door, a
different door, independent ofinsulin, to let the people or
(08:09):
the glucose, the sugar, off thetrain in a completely different
way.
Therefore, we can see thatexercise is just as effective as
common diabetes medications.
like metformin.
So if a patient or a client wassuffering from type 2 diabetes,
(08:30):
they could take their medicationand do exercise.
Over time, they can reduce theirreliance on the medication
because the exercise will slowlylower the blood sugar until they
are no longer insulin resistant.
Essentially, curing type 2diabetes.
And that is what we do in theclinic I run.
(08:54):
Literally, the name of theclinic is the Carroll University
Rehabilitative Exercise Clinic,or the CURE Clinic.
And we named it CURE becausealmost all of the diseases,
diabetes, hypertension, heartdisease, cancer, we can have a
curative approach by utilizingprescriptive exercise.
(09:17):
Okay, so I think what I'mhearing you say is that it's it
may help reduce obesity, but itmechanistically is doing other
things to help prevent and curedisease.
Yes.
100%.
Okay.
Because I know, especially as weget older, it does get harder to
lose weight.
And again, I think I hear whatyou're saying is that even if
you're not necessarily makinghuge strides and losing weight,
(09:40):
doing the exercise alone willhelp cure and prevent these
diseases.
Yes, that's exactly right.
And honestly, having excessadiposity or obesity does not
necessarily translate into poorhealth.
There are so many mechanisms bywhich exercise helps the body
that are seen through othermetrics that are not body
(10:01):
weight.
I, yes I'm glad that you've saidthat because I know for sure in
our clients, like we haveclients who, you would look at
their weight or even their BMIand say, oh, They're so
unhealthy, but they actuallyhave really healthy blood
markers.
They have low blood sugar.
They have low cholesterol.
They're by their blood markers.
(10:21):
They're very healthy.
And then conversely, we haveclients who appear to be a
normal weight, but some ofthose.
Conditions are not in the idealrange.
I think it's just good torealize that even if exercise
isn't doing what you want it todo aesthetically or on the
scale, it still has majorbenefits.
Okay, so let's get into thespecifics of what type of
(10:43):
exercise you're talking about.
That is preventative.
Yeah.
So this is actually a prettytough question.
Because the best exercise isgoing to be individualized based
on every person and based on anykind of condition that they are
treating or working with.
The best analogy I can give isif we are diagnosed with a
(11:06):
condition or a disease, And wego to our doctor.
Our doctor is going to take adetailed medical history and
probably do some level ofassessment, like blood work, and
take vitals.
And then the physician will picka specific pharmaceutical drug
and give us a specific drug witha specific dosage at a specific
(11:32):
time of day for a specificlength of time to treat our
condition.
And that is what we would thinkof as a drug prescription.
Exercise prescription is exactlythe same, that you need the
medical information, you needthe assessment results, and you
need this to come together tocreate an individualized
(11:52):
approach for each person basedon what their unique needs are.
Okay.
Generally speaking for again,someone who's just wanting to
take a preventative approach toall of this for all the diseases
that you mentioned what do yourecommend as an approach to
exercise?
First step, any exercise is goodexercise.
(12:14):
The best workout is the one thatyou do.
So at that point, the hardestpart is creating a habit of
exercise.
Small bouts of exercise, likesmall habits.
eventually become lifestylechange.
So my first recommendation, doanything that gets your heart
(12:34):
rate up, that makes your musclesfeel like they're worked,
anything is good.
And once that habit has beenestablished, then maybe we can
start branching out and creatingmore prescriptive types of
exercise and intensities.
Okay, so establish just thehabit of doing something, some
sort of exercise.
(12:55):
First, something is alwaysbetter than nothing.
Exactly.
Okay.
And I, yeah, I like to think ofit as like making space in your
life for exercise.
So that it is something you havetime and energy for.
Because if you don't, it's nevergoing to be part of your
lifestyle.
Okay.
So once someone has okay.
done that and they're gung hoabout exercising and they want
(13:16):
to optimize this.
What do you recommend?
Yeah, so you mentioned italready.
Resistance exercise, strengthtraining is one of the most
important methods and modes ofexercise.
By building lean tissue, bydoing strength training,
naturally we improve basalmetabolic rate, we increase lean
(13:37):
tissue, we improve our bonehealth.
And work on preventingosteoporosis, this works to
offset orthopedic limitations,musculoskeletal imbalances, and
we've seen that improvements instrength.
are directly correlated toimprovements and quality of life
(14:00):
because you're able to do thethings you want to do every day
with ease and without pain.
So my first recommendation,strength training.
I love strength training.
It's good for everyone.
Do we need more than strengthtraining?
My second recommendation cardioexercise is deeply beneficial.
(14:21):
That is the modality that onestrengthens our heart and lungs.
But two, burns the mostcalories, which is something
that we do need to focus onsince we have so many K cals.
and calories around us insociety.
There's a lot of foodeverywhere.
My recommendation is higherintensity interval training.
(14:43):
So we call that hit trainingwhere you'll take your heart
rate up higher for a smallperiod of time.
Drop it down until you'rerecovered and then go up and
down that type of exercise Hasproven to increase the amount of
calories that you burn bothduring But also in this magic
(15:04):
window for about 12 hoursafterwards So when you get your
heart rate up, it's a beneficialthen And later.
So that's one of the methods Irecommend.
It also helps keep you engaged.
Sometimes doing steady statecardio or walking or jogging for
(15:26):
periods of time, that can feelboring.
With interval training, oftenit's, wouldn't call it exciting,
but at least keeps your mindengaged in going up and down and
you can listen to some music.
That is a recommendation I havefor a lot of clients is keeping
it moving with the intervaltraining.
(15:46):
I don't know if that makessense.
Yeah, it does.
It does.
Yeah.
And I'm just thinking of hitexercise classes are very
popular now, whether that's orjust basically interval
training, whether that's likespinning, where you're taking
your heart rate up and down, oreven things like orange theory,
which is.
Interval training and, yeah,you're so focused on doing the
next thing that it does helpwith monotony and boredom.
(16:09):
So I've been reading a lotabout, or hearing a lot about
zone 2 training, which I thinkis your more classic study state
cardio.
And so I haven't beenimplementing more of that in my
in my exercise.
Routine I got and what I havefound is that for me, it's just,
it's easier to get it done.
It doesn't feel it's probablybecause mentally, you have to
(16:29):
work yourself up for hit.
You're going to be tired, but dodoes hit in steady state.
Can you or the zone 2 and byzone 2, what they were talking
about is you get your heart rateinto a moderate.
Moderately increased heart ratezone, usually what 60 to 70
percent of your max heart rateand you stay there for a period
(16:51):
of time rather than thatinterval, which you're probably
working more in what, 80 to 90percent of your heart rate max.
Yeah, exactly.
Yeah.
So I guess what are yourthoughts on zone 2?
Yeah.
So zone two, or like you said,60 to 70 percent of heart rate
max, or about 70 percent ofheart rate reserve is what we
would classically call the fatburning zone.
(17:12):
Not only is this the intensitywhere fat becomes the primary
fuel source, but it is also theintensity, like you mentioned,
that is the most pleasant.
That you can sustain for largerperiods of time.
There is nothing wrong with anyof the types of cardio training.
I think that if our goal is tomake exercise a priority, then
(17:35):
the first step should be pickingwhatever intensity makes us most
likely to continue.
And if, for that, if, if that iszone 2, and steady state where,
we can, Listen to a good book orwatch a television show or go
for a jog outside and seenature, then that's the right
choice.
If the time is limited and it'ssomebody who doesn't want to
(17:58):
think about doing it for a largeduration, then maybe HIIT
training is the option becauseyou can get the workout in and
done pretty fast, but it'll feellike you're working.
Both are beneficial and bothwill create good benefit.
Again, I like HIIT trainingsimply because I think it's a
little bit more effective in ashorter period of time.
(18:22):
But the literature is veryclear.
The higher the intensity ofexercise, the lower the
retention.
So adherence to exercise goesdown with high intensity if
you're at the beginning of thejourney.
So in which case, pick theintensity that makes it more
likely to stick to it.
(18:43):
That makes total sense.
Yeah.
Is there, are there differentbenefits to doing HIT or Zone 2?
Yeah, with zone 2 cardio, thetypical calorie burn is coming
from fat stores as the fuelsource but the calorie burn is
essentially happening whileyou're exercising.
So what is what you get.
(19:04):
With higher intensity cardio,you utilize glucose and glycogen
stores as your fuel source.
because they're faster to burnthan fat.
But that doesn't mean you don'tburn fat.
So the difference is, you'llincrease K Cal expenditure with
HIIT cardio because you'll burnthe calories during.
(19:25):
But then, during a phase calledEPOC, for about 12 hours
following, your body will try toheal itself and replenish energy
stores.
So it will then pull from fatstores later to offset the
carbohydrate use.
So you burn more caloriesoverall with HIIT training and a
(19:46):
lot of literature suggests thatyou increase heart strength and
heart health faster with HIITtraining.
So the effects are morenoticeable.
That being said, it always comesdown to what will make what
you'll most likely do.
And so for some clients, zone 2is the thing that makes them get
(20:08):
out of bed in the morning.
It's the thing they want to do.
That is the right choice forthem.
For others, it might not be.
Yeah, I think that makes sense.
Some people might love to get upand be very motivated to go do
an Orange Theory class wherethat sounds.
Murderous does other people andthey just let her go, for a nice
slow jog outside.
(20:29):
Okay.
Let's talk about so we've talkedabout type of exercise and I
guess one last question, wheredo like yoga maybe Pilates,
those sorts of exercises.
Or that type of workout, wheredo you see that fitting in?
Yeah, I think that those areamazing modalities that
obviously yoga and Pilatesimprove strength more in a
(20:49):
muscular endurance way, andflexibility and obviously range
of motion.
I found that those programs arevery effective at improving
mood, reducing fatigue.
So our psychological measuresclinically are improved.
very heavily by yoga andPilates.
(21:11):
Likewise, of course, flexibilityis improved.
I like to utilize thosemodalities.
As a way to augment resistanceexercise and cardio exercise.
I think of cardio and resistanceas the foundational pillars, and
then yoga and Pilates as amazingsupplements that simply make
(21:31):
everything better.
Okay.
Okay.
Now let's talk about, you hadmentioned earlier we should be
getting 150 minutes of exercisea week.
So talk to me about is that 150minutes?
Does that include.
Everything like your cardio andyour weight lifting and your
yoga and Pilates is that youneed 150.
I've heard 150 minutes ofcardio.
(21:53):
How do you break that up?
And then how hard should we beworking in our exercise
sessions?
Yeah, so the American College ofSports Medicine's recommendation
for the 150 minutes is first inthe moderate range.
So that would be the steadystate zone two that we talked
about.
That's the recommendation.
(22:14):
And that's primarily for cardiobased exercise.
But it is recommended to get atleast two days a week of
resistance exercise that cancount inside of that 150
minutes.
Okay, so I can count my strengthtraining towards the 150
minutes.
Yes, typically most people thinkof it as cardio, but we should
(22:35):
be getting the two days ofresistance inside that.
Okay, so if I work out, I lift 3hours a week, get cardio and on
top of that, I'm trying reallybad.
So that would be 180 minutes,and then how much cardio do I
need on top of that?
The American College of SportsMedicine is more cardio based,
so their foundation is generallycardio specific.
(23:00):
What they're trying to do isensure that we're strengthening
our heart and our lungs.
So I think the question wouldbe, it depends on what type of
resistance exercise.
So if we're, there's lots ofresistance programs.
that are maybe faster or morecircuit based where we're
lifting and our heart ratesgetting staying up the whole
time.
I think that's the best of bothworlds.
(23:21):
Your heart rates up, you'relifting weights.
Otherwise, if it's traditionalstrength training, sitting down,
lifting three sets of 12 or 10and you're resting in between, I
think then you do need to addcardio on top of that to ensure
that you're hitting heart,lungs.
And muscles.
Okay.
So if you're doing a circuitbased weightlifting program, 3
(23:44):
times a week and keeping yourheart rate at least in the zone
2 or above range you may notneed extra cardio.
Yes, but if it's not doing that,then add in some cardio to round
things out.
Okay.
Yep.
What about walking?
Where do you think that fits inwhen your heart rate like.
So I, and we usually try to giveour clients a step goal because
(24:08):
to my mind the steps equate togeneral activity.
And again, they're very doable.
You don't have to do it all atonce.
Pretty much anyone can walk.
All you really need is.
A decent pair of shoes, maybe acoat.
Yeah, how do you view walking tofit in all of this regimen?
Yeah, walking, I consider formost people physical activity as
(24:30):
opposed to exercise.
Now, I think that for certainability levels and training
levels, walking, especially at agood pace, with good arm
movement, Can be exercised aslong as the heart rates up.
I think the perfect program orthe perfect lifestyle is a
combination of physicalactivity, like walking or
(24:53):
playing with kids and structuredexercise.
I think physical activity iswonderful, but the way I look at
it is, if all we do is physicalactivity, we may not be
overloading our systems enoughto create the change necessary
to either combat disease.
or prevent disease.
(25:14):
So I think of it as my mantra issimilar to the idea of no pain,
no gain, which kind of has anegative connotation.
But really, if it doesn'tchallenge you, it doesn't change
you.
So if every time we're doingphysical activity or exercise,
we don't feel ever challenged,Whether it's our muscles or our
(25:37):
lungs and heart, it may not bethe most effective, but walking
is great.
I just think it should probablybe paired with other things.
Yeah, I think the way I bestunderstand this, or people have
explained that makes sense to meis that we want to be sent.
We want our the way thatexercise is helpful as it causes
(25:58):
adaptations in our bodies thatare beneficial.
I suppose that.
The way that non exercisingcould cause adaptations in our
bodies that are not very helpfulto us.
And so if you're not doingenough to stimulate your body to
adapt to something new, thenyou're probably not getting the
benefit of it.
So exactly.
Yeah.
So walking is.
(26:18):
We want to get be generallyactive and walking is a good
proxy for that.
But we also need the structuredresistance training and
cardiovascular training toreally stimulate those
adaptations that are going toprevent the disease or cure the
disease.
Exactly.
And that's where I thinkprescribing exercise more in a
fine tuned way is also helpfulbecause you'll see that
(26:41):
different chronic conditions,different cancer types,
different cancer treatments willimpact the body in different
ways.
And so what we're able to do isfind the type.
of exercise and the intensitythat best offsets those specific
problems.
And then almost like a mirrorimage, you find the toxicity or
(27:04):
the side effect, you find thebenefit of exercise and you
marry the two together.
And that's how you make aprescriptive exercise program
for each person dependent ontheir medical history.
Yeah, that makes a lot of senseto me.
Okay let's now talk aboutexercise as a medicine during
the treatment of disease.
The best example I can give is,someone going through treatment
(27:27):
of cancer.
Yeah, so what does that looklike?
Yeah, when you start, whenyou're diagnosed with cancer,
you'll, most likely there'sseveral treatments, surgery,
radiation, and chemotherapy, andthese treatments, whether done
separately or concurrently, Allhave pretty drastic side
effects.
We see that with fatigue, withdecreased immune function, but
(27:52):
many of the side effects alsohappen systemically.
Many chemotherapy drugs directlydamage the heart, directly
damage the lungs, cause musclewasting.
And what's special aboutexercise is that it is able to
directly offset and attenuatealmost all of the treatment
(28:13):
related side effects.
of cancer and chemotherapy andradiation.
So patients who do exerciseduring and immediately following
cancer and its treatments willsee improvements in
cardiovascular health, muscularstrength, muscular endurance,
(28:33):
their functional ability, andtheir flexibility and range of
motion, which are all negativelyaffected from the cancer
treatments and surgery.
Okay and then does it also, doesexercise while being treated for
cancer directly impact outcomes?
So aside from helping manage theside effects of medicine, does
it also impact, the overalloutcome?
(28:56):
Yeah what's really special isthere are certain chemotherapy
agents that directly damage theheart.
And over the years, oncologistshave learned that they actually
have to temper the amount ofthese chemotherapy drugs given
to patients.
because they'll cause heartfailure.
What we've found is thatexercise, specifically cardio,
(29:19):
during the administration ofthese chemotherapeutic agents
directly stops and blocks any ofthe damage to the heart.
So what that means now is thatoncologists can work directly
with an exercise physiologist tohave the physiologist prescribe
cardio exercise Duringchemotherapy administration, so
(29:41):
that the patient can toleratemore of the drug with no side
effects and thus increases theefficacy of the cancer
treatment.
So we're able to actually takemore cancer treatment drugs
while exercising, which means wehave a greater chance of
healing.
killing all of the cancer cells.
(30:01):
Yeah, I guess intuitively thatkind of makes sense to me
because you're probablymetabolizing more of it, right?
Through exercise.
And yeah, it seems like youwould be able to tolerate more
of it.
I guess my question on this isthat probably most people when
they're having chemo orradiation or undergoing cancer
treatment, probably don't feellike exercising.
Yep.
And it may not feel like it'sgood for them if you feel pretty
(30:25):
rotten.
So How do you deal with that?
Yeah, fatigue is the number oneside effect of cancer and its
treatments.
followed closely byimmunosuppression.
What's really unique aboutexercise is that once you start
exercising, when you are goingthrough treatment and when you
(30:45):
are that fatigued is it's almostlike a like a fog has lifted the
way I've been, I've heard itdescribed.
And all of a sudden you can seea little bit clearer, you feel a
little bit better and you feelbetter at the end of the
exercise.
Then you did when you startedand every day it makes it a
little bit easier to want toexercise and the literature is
(31:09):
pretty clear.
Exercise is probably the mostpowerful stimulus for reducing
cancer related fatigue, so it'smore of that first step taking
that first step to try toexercise when you're that
fatigued is the hard part, but Ipromise that once you do, you
will feel better.
So how does this work for say wehave a listener who's actively
(31:32):
undergoing cancer treatment andthey're not currently exercising
or they think they can't ordon't feel good enough.
Is this just something theyshould talk to their oncologist
about?
And are there clinics that youmight go to, like a PT clinic or
something that helps, peoplebeing treated for cancer,
understand what exercise isgoing to be best for them and
how to work it into their, totheir life while they're getting
(31:53):
treatment.
Yeah programming and that'sactually my entire goal of my
career and my mission is to makeexercise based cancer rehab more
available for patients.
The idea is that an oncologistwould directly refer a patient.
To an exercise physiologist orcertified exercise professional
(32:14):
with an expertise in cancer tothen help create an
individualized exercise planbecause the time point during
treatment.
Is, a critical point.
And so working with aprofessional is pretty important
in that moment, because we wantto make sure that the exercise
dosage is appropriate so that wedo not cause harm as well.
(32:38):
Yeah, it seems like it could bea real like Goldilocks formula
and a little too much could betoo much.
Yeah, but you want to be doingenough to for it to be
effective.
So that is exactly correct.
Okay, so something to talk toyour oncologist about it, if you
are undergoing cancer treatmentand want to explore this as a
(32:59):
way to, boost the effects ofyour cancer treatment.
Okay.
How does exercise does itaffect.
remission rates?
How does it work after you'vebeen treated for cancer?
Does continuing to exercise helpprevent the cancer from coming
back?
Yeah, not only does exerciseimprove the efficacy and
(33:20):
outcomes of cancer and itstreatments, but the data is very
clear that exercising followinga cancer diagnosis reduces
recurrence and hospitaladmittance rates.
Okay, that sounds Prettypersuasive to me.
And again, is this still I thinkstill people like, we'll get in
(33:40):
this mindset but if I'moverweight, or even if I'm
exercise, if I'm not losing theweight, there's no point in the
exercise, like that it's doingsomething beyond helping manage
your weight.
Yeah, honestly, I think, I thinkyou and I have touched on this.
I think body weight is probablyone of the worst metrics to
determine health.
There are so many other ways.
Even resting heart rate, ifyou're resting heart rate starts
(34:03):
to go down, that directly meansyour heart got stronger.
There are so many ways tomeasure our success that has
nothing to do with the scale.
Okay I'm so glad that you saidthat, because I think we get so
stuck on that.
And if we don't see that scalegoing down, we don't think
anything that we're doing ishaving any effect.
And, it's probably a little bitmore nuanced than that.
(34:25):
And our day to day habits areprobably a little more.
Just more nuanced and how theyaffect our health than just
looking at the scale and seeingif it's going down and then
translating that into betterhealth.
Okay.
In terms of impacting remissionrates.
Is there a type of exercisethat's better than another?
Or is it just depend on thecancer diagnosis and your
treatment and that sort ofthing?
(34:47):
Yeah, really depend on the typeof cancer.
But really that well roundedkind of multimodal approach with
resistance, exercise, cardio,and then some form of
flexibility or functional worklike the yoga and Pilates.
I think if we're looking for theperfect program, the perfect one
is a mix of everything with afoundation and strength and
(35:10):
cardio.
Okay.
And I guess one thing that wehaven't talked about at all, but
I know for me, It's veryimportant or exercise is very
important as mental healththoughts on the impacts of
exercise and mental healthagain, putting what the scale
says aside, what does exercisedo for people's mental health?
What doesn't it do right toimprove our mood exercise makes
(35:32):
us feel better in the moment.
It improves confidence, othersdemonstrated evidence of reduced
depression, improved quality oflife.
Strangely, exercise improvesfatigue across the board,
whether it's cancer relatedfatigue or just you had a rough
day.
Really, exercise is the fountainof youth.
(35:53):
It is.
It is medicine.
Exercise is probably the onething we should do every single
day to feel better.
And when we were talking aboutways to gauge success.
The scale is not a great method,but how you feel every day.
When you get done with theworkout, when we all get done
with an exercise session, wealways feel better.
(36:14):
And then it translates to therest of our day.
When you get up the nextmorning, you feel better.
And so I feel the only badworkout is the one that you
don't do.
Exercise improves all of thosefeatures.
Yeah, I agree.
And I think if you went to thedoctor and said, give me
something that improves my mood,helps me feel more productive,
helps me sleep better at nightregulates my appetite.
(36:37):
And the doctor said, Oh, I havethis pill.
Everyone would sign up for it.
No, that is a perfect way.
If we had an infomercial ofexercise, sign up here, if you
did this, or if you want this,and this, all you have to do is.
Exercise like that's it.
It's miracle.
I think it's just it's work.
So it's not as convenient asmaybe popping a pill every day.
(36:58):
But but I know for me, it'sgotten to the point.
I probably started, was mostlymotivated by vanity.
And now I just it's such anintegral part of my.
Energy management, having goodenergy, managing mental health
that I would never not do it.
Okay this has been sointeresting.
Can you give us any partingthoughts or practical tips that
you have about exercise asmedicine in our day to day
(37:20):
lives?
Yeah.
Sorry, you're waiting for thatreally nice mic drop, Joe.
I'm trying to think.
We said so many great thingsalready.
We did.
Yes, you did.
Yeah.
I think we know exercise ismedicine, but I think that we
all know that it is so good forus.
It improves all of ourpsychological functioning.
(37:40):
It improves physicalfunctioning.
It prevents disease.
It cures disease.
But I think the hardest part ofexercise is making it a habit
and doing it.
And I think that that lifestylechange is actually probably the
hardest component of all ofthis.
And so one of the ideas I alwaysimpart to my clients and
(38:01):
patients is this idea that itjust takes small steps.
Every day we make a small stepto create a habit and these
small habits over time lead tolarger habits and eventually
that becomes our lifestyle.
And I think you said finding away to fit it into our day to
fit it into our life that thereal secret isn't necessarily
(38:25):
the type of exercise, the modeor the intensity.
I think the real secret isfinding a way to make this part
of everything that we do andevery day.
And that is how we preventdisease is simply by having any
exercise.
Yeah.
Yeah.
And, as I think about it, Ithink about myself or other
(38:45):
people that that I know who arevery fit or have a very strong
exercise habits.
It's a process.
And so I know, I started outrunning and then I did aerobics
and then I went back to runningand then I didn't get into
weightlifting until I was in my40s.
And so no one ever starts outlike with a perfect regimen.
(39:07):
It builds on itself.
And I think everyone, no, thatmight.
Mean that it starts out fordoing yoga three times a week
and you just get in the habit ofdoing that and then that makes
you feel better.
And then you wanna add in somecardio or some strength training
until you get to a place whereyou have a well-rounded exercise
program.
Exactly.
Also.
I also think if, and this ismost people we talk a lot about
(39:28):
this in our, the coaching partof our program is I don't know
if you've heard of GretchenRuben and the 4 tendencies and
how we're motivated.
Most people are.
Motivated by externalaccountability and so if you are
someone that isn't going to dothis, unless you hire a coach,
or you have a trainer that youshow up for, or you pay for a
(39:48):
class, because, you don't wantto waste the money and, you will
show up to the class.
To me, health is your bestinvestment.
And so it's okay to expend thatmoney or make that investment.
Because it's just ultimately aninvestment in your longevity and
your quality of life.
And your health.
As you age.
That's perfectly fine.
And you should do that.
(40:09):
If it will help you form thehabit.
No, you're really right.
And honestly, most habits startwith those extrinsic external
forces getting us there and youhave to build a series of those
external facets until it becomessomething more internal.
That makes perfect sense.
Yeah.
Yeah.
And it, I don't think anyonealso ever just starts out loving
(40:31):
it.
It does feel like a chore atfirst Yes, that is true.
Sometimes it still feels a chorelike a chore, even if we've been
doing it for a long time.
And that's why I like the hitexercise.
I, instead of thinking about thefact that I'm doing exercise,
I'm just thinking that I'm gonnadie the whole time and then it's
over.
Yeah, I can relate to that.
Okay.
I I think that's all we have fortoday.
I really appreciate you comingon and discussing this topic.
(40:53):
It's a really valuable messageagain.
I think my big takeaway fromthis, and I hope all of our
listeners will understand that.
Exercise, regardless of whatit's making the scale do, is
going to be good for you.
Don't throw the baby out withthe bath water, and just
because, the scale isn't goingin the way that you think, or
you don't think it's making youlose weight, or making you look
(41:14):
the way that you want, it'sstill very good for you, and you
should continue doing it.
That's my public serviceannouncement for today.
But thank you for coming on.
Is there, are you on socialmedia or if people want to learn
more about what you discussed ormore about you, where can they
find you?
Yeah.
We have a website on the Carrolluniversity website and I can
(41:34):
leave that information with you,Joe.
Most of my information is onthere as well as information on
the Carroll universityrehabilitative exercise clinic,
which is a Cancer and ChronicDisease Rehabilitation Clinic
and Program designed to exactlydo this, use exercise as
medicine to be that change thatwe need to see.
(41:55):
Awesome, and I will put a plugin for our very own coach
Leanne.
She trained under you, Ibelieve, or was 1 of your
students.
If you like this approach, andyou like what you're hearing our
very own coach Leanne definitelyknows all these principles and
is really how she thinks about,structuring programs for our
clients.
Okay thank you for your time.
And it was great talking to youand thanks everyone for tuning
(42:16):
in.
Thank you.
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