The Fitness Doctor: It’s Never Too Late to Get Active

The Fitness Doctor: It’s Never Too Late to Get Active
Dr. Fredrick Peters

A study of more than 30,000 patients with cardiovascular disease shows that becoming active later in life can be nearly as beneficial to survival as continued activity. These encouraging findings highlight how patients with coronary heart disease may benefit by preserving or adopting a physically active lifestyle.

Regular physical activity is advised for patients with heart disease, but recommendations are largely based on studies that used either a single assessment or an average of activity levels assessed over time. However, patients may modify the amount of exercise they do, and it remains unclear whether these changes are related to survival.

This study investigated activity levels over time and their relationship to the risk of death in patients with heart disease. The researchers examined the risks of all-cause death and death from cardiovascular disease according to the four groups.

Compared to patients who were inactive over time, the risk of all-cause death was 50% lower in those who were active over time, 45% lower in those who were inactive but became active, and 20% lower in those who had been active but became inactive.

Similar results were observed for death due to cardiovascular disease. Compared to those who remained inactive, the risk for cardiovascular mortality was 51% lower among those who remained active and 27% lower for those whose activity increased. Cardiovascular mortality was not statistically different for those whose activity decreased over time, compared to those who remained inactive.

These results show that continuing an active lifestyle over the years is associated with the greatest longevity. However, patients with heart disease can overcome prior years of inactivity and obtain survival benefits by taking up exercise later in life.

On the other hand, the benefits of activity can be weakened or even lost if activity is not maintained. The findings illustrate the benefits to heart patients of being physically active, regardless of their previous habits.

Improving Fitness
Moderate-vigorous physical activity is the most efficient at improving fitness. In the largest study performed to date to understand the relationship between habitual physical activity and physical fitness, researchers from Boston University School of Medicine (BUSM) have found that higher amount of time spent performing exercise (moderate-vigorous physical activity) and low-moderate level activity (steps) and less time spent sedentary, translated to greater physical fitness.

“By establishing the relationship between different forms of habitual physical activity and detailed fitness measures, we hope that our study will provide important information that can ultimately be used to improve physical fitness and overall health across the life course,” explained corresponding author Matthew Nayor, MD, MPH, assistant professor of medicine at BUSM.

He and his team studied approximately 2,000 participants from the community-based Framingham Heart Study who underwent comprehensive cardiopulmonary exercise tests (CPET) for the “gold standard” measurement of physical fitness. Physical fitness measurements were associated with physical activity data obtained through accelerometers (device that measures frequency and intensity of human movement) that were worn for one week around the time of CPET and approximately eight years earlier.

They found dedicated exercise (moderate-vigorous physical activity) was the most efficient at improving fitness. Specifically, exercise was three times more efficient than walking alone and more than fourteen times more efficient than reducing the time spent sedentary. Additionally, they found that the greater time spent exercising and higher steps/day could partially offset the negative effects of being sedentary in terms of physical fitness.

According to the researchers, while the study was focused on the relationship of physical activity and fitness specifically (rather than any health-related outcomes), fitness has a powerful influence on health and is associated with lower risk of cardiovascular disease, diabetes, cancer, and premature death.

Before you get started with a new exercise plan and diet, you’ll need the following:

  • A clean bill of health from your doctor if you’ve had an injury, illness or medical condition
  • 30-60 minutes of time, 4-5 days a week (splitting it up if necessary)
  • A commitment to follow a healthy diet most days of the week
  • Access to free weights, resistance bands or machines

Cardiovascular Program

The foundation of any good weight loss or fitness program is cardiovascular exercise. This is your foundation for burning calories and conditioning your heart and lungs. Use these tips and guidelines for setting up your cardio program:

  • Start where you are. Assess your fitness level and start with what’s comfortable for you. If you haven’t worked out in ages, you might start with 15-20 minutes 3-4 days a week and gradually add time and frequency.
  • Split your workouts. If you don’t have time for long workouts, try doing short bouts of exercise throughout the day (this is just as effective as continuous workouts).
  • Choose activities you enjoy. You’ll be more motivated to stick with your workouts when you like what you’re doing.
  • Vary the intensity, duration, and type of activity. Try short, intense workouts mixed with longer, slower workouts for variety. You can also try interval training once or twice a week to burn extra calories and boost your endurance.

Strength Training Program
The second part of your program will be strength training to build lean muscle and increase your metabolism. To burn the most calories, stick with compound movements (i.e., movements that target more than one muscle group). Examples would be squats, lunges, pushups, and pull-ups.

A few guidelines:

  • Target all your muscle groups at least twice a week, with a day or two of rest in between workouts.
  • Keep your reps between 8-12 to build muscle, 12-16 for endurance and 4-8 to build strength. Use different rep ranges regularly to challenge your body in new ways.
  • Don’t be afraid to lift heavy (women included)
  • Choose 1-2 exercises for each body part.

*Dr. Peters is the founder of “The Fitness Doctor” ( He has a Ph.D. in Physiology from Kent State University and is a certified member of the American College of Sports Medicine. Dr. Peters was born and raised in the Cleveland area and is a graduate of St. Ignatius High School and John Carroll University. He can be reached at [email protected].

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