Exercise – A cornerstone of health

This column is written by Stig Bengmark – Professor Emeritus, scientist, lecturer and writer. Read more of Stig Bengmark’s columns here.

Good health has three cornerstones: plenty of exercise, good food, and stress control. Today, I’d like to look into exercise. Exercise gives us:

  • Improved burning of calories and also contributes towards maintaining body weight.
  • Counteracts metabolic syndrome and diabetes, increases the good cholesterol in the body, and counteracts unhealthy fat (triglycerides – long-chain fatty acids)
  • Counteracts a number of diseases such as heart attacks, strokes, mental depression, certain types of cancer, joint inflammation, falls and more.
  • Releases hormones and other factors which improve mood
  • Increases enthusiasm and energy ahead of the day’s work tasks
  • Improves sleep
  • Increases libido

Every age group has its own needs

Under 5 years: It’s enough to play, preferably outdoors, for around 3 hours a day.

5 – 18 years: For this group of quickly-growing people, at least a full hour a day of intense physical activity is recommended, supplemented with some specially organised activities such as cycling, football or dancing three times a week.

Adults (18-64 years): For this group, a bit less exercise than for teenagers is enough. The training can be a little less intense, but at least half an hour five days a week, preferably organised with intervals/tempo changes.

Older ages (65 years and above): The longer that the elderly can continue exercising in the same way as they did in middle age, the better. The more you manage to exercise in old age, the more this contributes to counteracting disease and premature ageing.

Don’t forget everyday exercise – there are lots of opportunities

You can make a lot of progress by walking or cycling to work, instead of driving. Let your employer ‘offer you some exercise for free’ – you can take the stairs instead of the lift. It’s also important that you try to do your household chores yourself; cleaning windows and doing the gardening gives you a lot of exercise. Be a role model for your neighbours – show them that you can do it yourself. Complementary exercise can consist of brisk walking, jogging, cycling, dancing, badminton, tennis, etc. – it’s difficult to point out one specific exercise that’s better than another. It’s important that you enjoy it – happiness in your activities gives good results.

The results of training have a short sell-by date – you need to exercise at least five days a week

The results of training have a short sell-by date – they can’t be stored in the body, you have to repeat your exercise regularly every week. For the exercise to have the desired result, it should contain a significant amount of effort – you should be a bit out of breath and preferably a bit sweaty, at least between your shoulder blades. Taking the dog for a walk hardly counts as exercise and playing golf probably doesn’t involve enough effort – but maybe it can still be good for your health? The basic rule is that, at least during some of your training session, you should be aiming to get your heart rate up properly – to at least 75% of your max. In literal terms, the ultimate ideal is to train not only skeletal muscles but also the body’s most important muscle – the heart – and the respiratory system – the lungs.

Your max heart rate changes over the years. A small child is believed to have a max heart rate of about 225 beats per minute. It decreases over their lifetime by about one beat per year – a seventy year old usually has a max heart rate of no more than 150 and should therefore be aiming for a heartrate of 120 when exercising. There are lots of well-trained senior citizens these days who are displaying higher max rates and can train at higher tempos. There are sophisticated instruments you can attach to your rib cage and you can use apps on your phone to register your speeds. For most of us, however, the basic rule is enough: ‘You should be able to talk to your training partner, if necessary, but if you can sing, you’re going too slow’.

Better to exercise on an empty stomach – ideally in the morning

It is important that you do your exercise a few hours after a meal – preferably in the morning (before breakfast, if you eat breakfast). Studies have shown that if you’ve just eaten and have a lot of antioxidants in your body, it counteracts the exchange in the form of improved health (Ristow M et al. PNAS 2009;106:8665–8670). If, on the other hand, you’re taking part in a competition, this isn’t important – in this situation, a long-term goal is not the most important, and an over-abundance of antioxidants could in fact probably be a significant advantage. It’s generally known that ‘endurance’ sports have short-term disadvantages – shortly after this strenuous exercise, the competitor’s immune system is depleted and the person in question often catches a ‘cold’.

Kids should be playing – not training

It’s quite often the case that 8-10 year olds exercise too intensively – as much as 30 hours a week sometimes. Responsible doctors have given warnings about these developments, as they can have both short- and long-term consequences for children’s health. The general pressure for performance in children’s sports today is reported to be increasing, both from coaches as well as misguided and overambitious parents who dream that their child will become another Zlatan or Kalla. Marita Harringe, who works at the ‘Centre for Sports Injury Research and Education in Stockholm’, specialising in gymnastic injuries, pointed out in an interview in Dagens Nyheter in 2011 the importance of paying the appropriate attention to the unacceptably high frequency of injuries in certain sports. ‘Of course, I think we should be creating a debate around that’, she says, and the well-known Olympic doctor Klas Östberg adds, ‘Children should be playing, not training hard’.

The Female Athlete Triad – an example of exploitation of young girls

The downsides of over-ambitious sports have been highlighted in medical literature, describing a phenomenon that’s becoming more common among young gymnasts and dancers and which has been named the ‘Female Athlete Triad’ (Mallinson RJ, De Souza MJ Int J Women’s Health 201; 6: 451– 467) consisting of eating and menstrual disorders, but also, despite the fact that they train so hard, osteoporosis (reduced bone density, decalcification of the skeleton). There is actually research that shows that it could possibly be a pentad – with five different negative manifestations. Some observations suggest that type 2 diabetes may appear more often and earlier in life (early onset diabetes) among this group, as well as early onset coronary heart disease.

A totally unacceptably high frequency of stress fractures has been reported, among others, in high school students in the United States who play sports too strenuously (Changstrom BG et al. Am J Sports Med 2015;43:26-33). It’s also been claimed that top athletes who quit sports later in life have a higher disease rate when they get older than people who have not played sports as strenuously, but so far the evidence for this claim is weak.

Exercise – running away from diseases

Exercise has been shown to have unique properties for counteracting various chronic diseases – here are some examples:

Alzheimer’s disease: Several publications indicate that a variety of daily activities strongly counteract the development of this disease – it’s important that your day is filled with various social activities. Six different studies have focused on the importance of exercise for Alzheimer’s (summarised by Farina N et al Int Psychogeriatr. 2014;26:9-18.) and they report a significant delay in the disease’s further development. Similar effects are also seen with other neurodegenerative diseases. Exercise is especially important to contribute to calmer and better sleep to Alzheimer’s and Parkinson’s patients who often have sleep disorders, an extremely common occurrence.

ADHD: A recent study of children with ADHD who played sports ‘until they were worn out’ (in this case table tennis) showed significant improvements on many levels, including better sleep and less ‘mischievousness’ (Pan CY et al. J Atten Disord 2015, in publication).

Diabetes: Postprandial hyperglycemia is perhaps the most significant risk factor behind increased morbidity and premature death from diabetes. In several studies, intense exercise has been shown to strongly combat postprandial hyperglycemia (Little JPFrancois ME. Res Quart Exerc Sport. 2014;85:451-456).

Breast cancer: As also, to a certain degree, with Alzheimer’s disease, the appearance of breast cancer is connected, among other things, to inadequate food eaten in childhood, especially dairy products, but also to obesity and lack of exercise. Today, there is no doubt that regular exercise reduces the risk of certain cancers, such as breast cancer (Gonçalves AK et al J Phys Act Health. 2014;11:445-454).  Patients who already have breast cancer have also been shown in studies to achieve significantly better results if their treatment is combined with regular exercise.

Prostate cancer: Studies show that prostate cancer can be halted by a diet that is predominated by raw and fresh ingredients – it’s even been possible to normalise the test that displays the degree of cancer development (see picture).

What’s decisive for the result is the number of times and degree of effort with which the activity takes place. As the picture below shows, the absolute best result was achieved when the activity was practiced more than three hours a week and at speeds above 3 miles/hour (upwards of 5 km / h).

Exercise isn’t enough against obesity – the most important thing is to eat correctly!

One kilo of body fat constitutes no less than 9000 calories. If you’re 20-30 kilos overweight, ‘exercising away’ the excess weight looks like a superhuman task. A significant change to your diet is what you need to achieve success.


Exercise is great but raw food is better – and together they’re the best!

One American study which received a lot of attention compared 21 vegans (eating no meat, dairy products, or eggs) and living on ‘raw food’ for at least two years (4.4 + 2.8 years), with 21 endurance runners (marathons, triathlons, etc.) who have run/been running on average 77 km/week) for at least 5 years, with 21 ‘sedentary subjects’ (unmotivated people who eat western food and don’t exercise). Give yourself plenty of time to study the table next to it – it speaks for itself.

With extreme exercise you might get halfway there, but with ‘raw food’ you get much further. This group showed by far the lowest systolic blood pressure (104+15), the lowest resting blood pressure (62+11), the best fasting blood sugar (85+7), the lowest insulin resistance and the best beta-cell function (HOMO-IR), the highest good cholesterol, and the lowest level of bad cholesterol, as well as the minimum amount of circulating harmful fats – triglycerides. Most striking in my opinion was that in this group it could be confirmed that the width of the carotid artery to the head – was less than half of what was seen in the so-called ‘couch potatoes’ – the group with the western lifestyle.

The differences between the groups’ BMI was also significant: with the ‘raw foods’ it was 21.3+3.1 kg/m, with the ‘endurance runners’ it was 21.1+1.6 kg/m (2)) while the ‘couch potatoes’ were slightly, but significantly, overweight: 26.5 + 2.7 kg/m (p < 0.005).

It’s interesting to note that the vegan group actually consumed significantly less energy – on average actually less than 2000 calories/day while the endurance group consumed on average over 2300 calories and the ‘couch potatoes’ more than 2600 calories. The percentage of carbohydrate intake was actually fairly equal between the groups – the big difference was that the vegans’ carbohydrates were never processed (heated) but always raw. The big difference was that the vegans ate twice as much fibre, 50% more fat (predominantly healthy fat), as well as significantly more ‘healthy’ salt (potassium) and less than half as much protein and ‘harmful’ salt (sodium). In addition, vegans hardly consumed any trans fats, the intake was only a small fraction of what the other groups consumed (0.4 g/day compared to 5.3 and 5.9 g/day).

Unfortunately, you have to be a fundamentalist – otherwise the effects are cancelled out

Numerous studies over the years have shown that there is no middle ground – in the past, vegetarian lifestyles were often, and rightly, questioned, because the diet often consisted of too much bread, cooked vegetables, root vegetables and the like. Studies have seldom shown any particularly dramatic benefits to a vegetarian diet, quite the contrary – the potential benefits that may have been observed have been too small to inspire a more transformative lifestyle change. Maybe it’s a coincidence, but in fact, all the vegetarians I knew when I was young are now long gone. We’re learning all the time and we’re wise to correct ourselves as we go along. Our knowledge is developing all the time. It’s only after one has made a consistent switch to raw food that the greatest benefits have been seen.

It’s about providing the intestinal bacteria with the food they want – in fact, they’re the ones who control inflammation and disease in the body and they require special food in abundance in order to multiply and carry out their mission in the body. We knew very little about that just a few years ago. The colours should be green (like vegetables) and blue (like the sea: sea vegetables and fish).

Welcome to the fundamentalists’ circle. Decide for yourself if you want to stay healthy or be sick!

More from Prof. Bengmark