Central  South  Dakota Medical News
The Clinical View
by P.E. Hoffsten, M.D.
27 March 2002

HOW GOOD AN ATHLETE ARE YOU?

     It’s difficult lately to pick up a newspaper or a magazine without finding some article about the importance of exercise, the horrors of the overweight epidemic in our country, or the latest diet fad.  In my experience as a healthcare provider, one of the lowest yield activities that I do is talking to people about diets.  If you think about it, a diet is an abnormal way to eat.  One of the most common statements in our society is, “You have to go on a diet.”  This means that you have to change the way that you are eating which is normal for you into another way of eating that won’t be normal for you.  The implication is that somehow this is going to improve your life which in most people’s experience is a gross fallacy.  Unfortunately, the scientific inalterable fact is weight loss requires a decrease calorie intact no matter how you do it.  The difference in fat or protein or carbohydrates in a person’s diet may change their appetite but the long and the short is that if you don’t cut the calories you don’t lose the weight.

    Enough said about diets.  This column is about physical exercise and some misconceptions that are unfortunately created at an early age when we are still in grade school.  I remember back in the third grade when our teachers would have us run races at recess. Not that good a runner, I felt lucky to run as far as they wanted but I don’t think I ever was first in any race I ever ran.  The label of “not a runner” was attached to me at that time and has been there ever since.  When high school came, I could play in the line on the football team. I was not an athlete that could run so I never got to carry the football.  I was supposed to get in the way of the fellows trying to tackle our ball carrier and  I was reasonably good at that. Then after high school and college, football isn’t a game for us older fellows, tennis  wasn’t that much fun for someone who couldn’t run, my knees and back hurt too much to play basketball so I played racket ball until my knees and back hurt too much to play that.  Doing calisthenic exercises or an aerobic class was never that much fun so I became more and more of a couch potato either going to work or doing normal daily activity but without a formal exercise program.  I felt that I didn’t need to train since I wasn’t trying out for any team anymore.

    My story isn’t a whole lot different than that of a whole lot of other men and women who are not the swiftest or strongest or the most skilled in their classes in school and therefore they weren’t athletes either so they did not exercise then and they don’t exercise now.  This is a tragedy put upon our society by our competitive athletic mentality.

    There is a second tragedy that results from our competitive athletic mentality.  It’s best exemplified by Mickey Mantle.  You may remember he was one of the greatest baseball players of all times playing for the New York Yankees when they used to win pennant after pennant. Mickey Mantle was every kid’s boyhood hero.  He played baseball until he was in his mid 30’s and then retired.  Since he didn’t need to train anymore he quit exercising too and the thrills that used to come to him from baseball weren’t coming anymore.  So he turned to alcohol becoming a tragic alcoholic and dying of liver disease in spite of a liver transplant.

    Thus our competitive program provides a casualty of inactivity in the less skilled plus the casualty of loss of thrills when the very skilled retire resulting in their starting to overeat, overweight, and used alcohol or other drugs.

    The right answer is that the only person we should be competing with in regard to our health is ourself.  Just because you can’t run fast doesn’t mean that a person shouldn’t run for exercise when they are young and can run.  Just because a person can’t play tennis well or basketball well, doesn’t mean that they shouldn’t play at all.  People should seek companions that provide comfortable stimulation and exercise as they can.

    Those people that keep exercising as they can and maintain their exercise capacity are the ones that live the best and the longest.  An article this past week in the New England Journal of Medicine pointed this out clearly in a study of 6,000 men who underwent exercise testing in relation to their health evaluations.  The study was carried out from 1987 through 2000, a period of 13 years.  During this time, it was found that the very best predictor of survival was their exercise capacity.  This basically meant that the more physically fit the individual was, the more likely they were to remain disease free or survive the disease process that they already had.  Thus individuals with high blood pressure or diabetes or cigarette addiction survived better and longer if they maintained their exercise capacity as compared to those individuals who were otherwise matched but did not maintain their exercise capacity.  The message was very clear.  Just because you are not good at a particular sport, doesn’t mean that you should sit on the couch and watch.

    The exercise prescription for the general population is to walk three miles in an hour on a daily basis.  Many people are not that good an athlete and can’t walk that far that fast.   Then adopt a program that a person can perform and compete with themself to maintain or increase exercise capacity as can  be done.  Whether a person can reach the goal of three miles in an hour daily isn’t the critical question.  The critical question is, “Are you working on a systematic basis to improve or maintain your exercise capacity?”  There is now a sound scientific basis for showing that  exercise capacity maintains overall general health letting the person live longer and better.