The Pay-Off

By: Travis Walker, MD

I listen to a lot of stories on a daily basis…it’s my job. I’m a resident physician in family medicine. On any given day, I can see anyone from a brand new baby to a great grandmother nearing the end of her life and everything in between. Each visit brings a different narrative; some are familiar, some very joyful, and some heartbreaking. All of our stories (probably every life story you have ever heard) represent a ridiculously tiny portion of the 7.6 billion stories out there, but each represents a beautifully unique, complex, and worthwhile person living an exceptional and significant life.

The big question is how do you make your story the best version that it can be. Being in good health is a great start, and you probably didn’t need a doctor to tell you that. Exercise is an essential part of health, and if you are reading this blog, I’ll bet you probably exercise. But how much bang are you getting for your buck?

I recently sent Joel an article from a medical journal put-out by the American Heart Association. In it three decades of research was summarized where they found that cardiorespiratory fitness was directly linked to better health; and the better the fitness, the less likely you would be to die (sounds pretty obvious, but hang in there with me for a minute). Not only that, but your fitness may be a better predictor of your overall risk of dying than smoking, obesity, diabetes, high blood pressure, and high cholesterol. Across the board, your fitness level was also directly related to your risk of dying from a stroke, a heart attack, dementia, Alzheimer disease, type 2 diabetes, CANCER, and even your surgery outcomes.

The study looked at fitness in Metabolic Equivalents (METs). There is a big difficult equation to calculate an individual’s metabolic equivalent, but roughly 1 MET is the equivalent of sitting and doing nothing on the couch. It is roughly your basal metabolic rate. A brisk walk is about 4 METs, or approximately 4 times more energy than doing nothing. 10 METs, for most people, is a 9:00 minute/mile run.

It breaks down like this, if you cannot do more than 5 METs (metabolic equivalents) of work, then you have a higher risk of dying than the average person. For example, if you cannot sustain a light effort bike ride (~5 METs), then you are at a higher risk of dying from a stroke, heart attack, and so on like is listed above. However, for every MET of fitness you gain, there is a 10% – 30% improvement in your likelihood of surviving a major disease or medical emergency. By improving your fitness from the less than 5 METs fitness group to the 5-7 MET (Light effort biking to general jogging) fitness group, you reduced your risk of death by half. And if you were in the fittest group observed (sustaining 8-10 METs, i.e. vigorous calisthenics and running) you had the lowest risk of death at almost a quarter of the least fit group.

So, what is the point? I think we all know that being physically fit meant we would be healthier, and that most of us know we would live longer. But for me I like to know how much it helps. I want to be able to say to some of my patients, “this is how to help yourself and this is the tangible evidence.” To give them knowledge that they will have more time with their children, their grandchildren, more time to travel, and more life.   So when you are exhausted, tired, and sore… when you hit a plateau, or if you think you will never hit your goals; just remember that your work pays off. Your hard work is the tool that gives you a great shot at the best version of your own exceptional, unique, and beautiful story.

(Check out the American Heart Association article by clicking here.)