It is inherently social, activates multiple muscle groups, and involves HIIT but does it really add 8 more years to your life compared to working out in a gym?
Family physician here: I actually do think that encouraging people to maintain social connections is helpful for people to hear from their doctor. I include diet, physical activity, social interaction and lifelong learning in my discussions about aging well. Several patients have told me that prompted them to include group activities or otherwise build community in their retirement planning — perhaps they would have done that anyway, but I think it’s useful to hear it from someone they trust.
That sounds like a great idea. As a cardiologist I feel like I am mostly in my lane when I take time to go into diet and physical activity with my patients.
But as time permits I learn more about their families, hobbies, and travel.
Excellent advice:” Do something at a moderate to vigorous intensity, do it consistently, and do it for at least 150 minutes per week.”
Social connections are important, but must now be weighed against the probability of catching a case of Covid, which then becomes a net negative. Thanksgiving superspreader event here, initiated by careless behavior on planes despite our requests that said superspreaders mask.
I’m advising people go back into exercise slowly after COVID, given the proven muscle / mitochondrial damage many experience for the first month or more of vigorously exercising… especially if showing signs of PEM and LC already.
Personally I prefer running and a conversation/reconnection with self… but that’s socially lazy male behavior. Cheers!
Social Connections. Outdoor pickleball which is year-round here in SoCal I deem very low risk for transmission of respiratory pathogens. Indoor slightly higher but if you keep your distance, quite low.
Post-COVID. I think easing back into exercise after any upper respiratory infection or other serious medical illness that has caused deconditioning is wise. Mostly, I tell cardiac patients to be guided by their RPE .
Perhaps reconnection with self is more important than connecting with others! But, personally, I find that being a doctor interacting with patients and family members all day can be a major source of social connection. Sometimes so intense and prolonged that at the end of a long day of patients I may not be interested in socializing.
The risk of catching Covid through social interactions is real, but if activities don’t revolve around food that risk can be mitigated. I am not convinced that social isolation to avoid infectious disease is worth it…but judicious masking and attention to air quality sure is!
For those of us who used to be very physically active but for one reason or another now deal with mobility issues, It’s disheartening to read all the information about how exercise is important in order to have a long life. There are some workarounds available. In my case the amazing Swedish All Terrain Trionic Veloped which allows me to take those daily 1+ mile walks with my dog and go “hiking” up on wide trails in the forests. It was developed to assist all manner of physical issues that impair walking in the great outdoors. And there’s chair yoga and of course PT exercises.
I feel fortunate that things didn’t get bad enough to limit me a lot until my early 70s but after getting to a certain level of acceptance of what I view as my body’s betrayal (probably not the best attitude to take…I’m still working on that), and finding things that I CAN still do, it’s still hard to read these articles. Between that and not being a highly social person and living far from family, but having always been that way, I feel dinged about losing years also because of my introversion and enjoyment of living a quiet life. The friends I made here where we retired were all older than me and eventually moved closer to family in their old, old age, or moved to where living was less expensive. I do have a husband whom I love, and several creative hobbies that I enjoy, keep in touch with family and friends far away thanks to technology, and take online classes in those creative pursuits as well as the occasional local class. So I’m not a recluse but my husband who still hikes and plays tennis, has a far more “in person” active social life than I do.
I’m not looking for advice and I love your articles. I have been following you (and Mandrola) for several years and we even communicated via email once. (I’ve had two discrete Afib episodes in my life, 11.5 years apart, both caused by stress - the last one was 5 years ago I think - we talked about my cardiologist allowing me to not have to take Eliquis daily, but use it as a pill in a pocket kind of thing, for 5 days following any episodes that might follow. Fortunately, I’m still Afib free.)
Living in CA as you do now ( and in my case northern NM) allows one far more opportunities to be outside and to be active. My husband who was a born and bred Michigander and very apprehensive about retiring in the west but did so because of me, fell in love with the West and the beauty of NM and the ability to be active outdoors all year round. The hiking, the snowshoeing, the tennis…he has thanked me several times for dragging him back to the arid west from whence I came (born in Los Angeles, first 40 years in SoCal). Enjoyment of life in general, regardless of all the rest, certainly must count somewhere in the longevity game, eh?
Thanks for your comments, Nanci. I wasn't familiar with the Swedish All Terrain Trionic Veloped but Googled it. Looks amazing for any patients with mobility issues who want to active.
My wife dragged me out to California and like your husband thanks you, I thank her frequently for putting us in a spot where we can enjoy the outdoors all year round.
Joie de vivre is what I live for and counts for quite a lot!
These studies maybe are confusing correlation and causation? If you're playing tennis, you're probably in pretty good health which means you'll likely live a long time, especially for older tennis players. If you start having health problems, you're not able to play tennis, even if you once did. I guess the devil's in the details of these studies.
If pickleball gets your butt off the couch and out the door, then more power to you. Whether or not you will enjoy a bump in life span who knows. However, a friend of mine who enjoys(ed) pickleball with his wife broke his shoulder diving for a shot (65 years old). Not sure how that injury will affect his lifespan. All I know is that as I get older, I cannot recover as quickly from injury and injuries become more life threatening. What the heck…my go to for exercise is mountain biking!!!
I think the injury aspect has to be taken into account. For if one breaks a shoulder or damages a knee this impacts ability to do foundational aspects of our physical activity like walking and lifting.
Any activity that - as we say in Chinese medicine - moves qi and blood and engages joyful human interaction (peaceful shen) can expand quality of life metrics and impact longevity. There are way too many “lazy” fad-like observational studies and RCTs with various statistical forms of bias to create relevance.
Family physician here: I actually do think that encouraging people to maintain social connections is helpful for people to hear from their doctor. I include diet, physical activity, social interaction and lifelong learning in my discussions about aging well. Several patients have told me that prompted them to include group activities or otherwise build community in their retirement planning — perhaps they would have done that anyway, but I think it’s useful to hear it from someone they trust.
That sounds like a great idea. As a cardiologist I feel like I am mostly in my lane when I take time to go into diet and physical activity with my patients.
But as time permits I learn more about their families, hobbies, and travel.
Excellent advice:” Do something at a moderate to vigorous intensity, do it consistently, and do it for at least 150 minutes per week.”
Social connections are important, but must now be weighed against the probability of catching a case of Covid, which then becomes a net negative. Thanksgiving superspreader event here, initiated by careless behavior on planes despite our requests that said superspreaders mask.
I’m advising people go back into exercise slowly after COVID, given the proven muscle / mitochondrial damage many experience for the first month or more of vigorously exercising… especially if showing signs of PEM and LC already.
Personally I prefer running and a conversation/reconnection with self… but that’s socially lazy male behavior. Cheers!
Re
Social Connections. Outdoor pickleball which is year-round here in SoCal I deem very low risk for transmission of respiratory pathogens. Indoor slightly higher but if you keep your distance, quite low.
Post-COVID. I think easing back into exercise after any upper respiratory infection or other serious medical illness that has caused deconditioning is wise. Mostly, I tell cardiac patients to be guided by their RPE .
Perhaps reconnection with self is more important than connecting with others! But, personally, I find that being a doctor interacting with patients and family members all day can be a major source of social connection. Sometimes so intense and prolonged that at the end of a long day of patients I may not be interested in socializing.
The risk of catching Covid through social interactions is real, but if activities don’t revolve around food that risk can be mitigated. I am not convinced that social isolation to avoid infectious disease is worth it…but judicious masking and attention to air quality sure is!
For those of us who used to be very physically active but for one reason or another now deal with mobility issues, It’s disheartening to read all the information about how exercise is important in order to have a long life. There are some workarounds available. In my case the amazing Swedish All Terrain Trionic Veloped which allows me to take those daily 1+ mile walks with my dog and go “hiking” up on wide trails in the forests. It was developed to assist all manner of physical issues that impair walking in the great outdoors. And there’s chair yoga and of course PT exercises.
I feel fortunate that things didn’t get bad enough to limit me a lot until my early 70s but after getting to a certain level of acceptance of what I view as my body’s betrayal (probably not the best attitude to take…I’m still working on that), and finding things that I CAN still do, it’s still hard to read these articles. Between that and not being a highly social person and living far from family, but having always been that way, I feel dinged about losing years also because of my introversion and enjoyment of living a quiet life. The friends I made here where we retired were all older than me and eventually moved closer to family in their old, old age, or moved to where living was less expensive. I do have a husband whom I love, and several creative hobbies that I enjoy, keep in touch with family and friends far away thanks to technology, and take online classes in those creative pursuits as well as the occasional local class. So I’m not a recluse but my husband who still hikes and plays tennis, has a far more “in person” active social life than I do.
I’m not looking for advice and I love your articles. I have been following you (and Mandrola) for several years and we even communicated via email once. (I’ve had two discrete Afib episodes in my life, 11.5 years apart, both caused by stress - the last one was 5 years ago I think - we talked about my cardiologist allowing me to not have to take Eliquis daily, but use it as a pill in a pocket kind of thing, for 5 days following any episodes that might follow. Fortunately, I’m still Afib free.)
Living in CA as you do now ( and in my case northern NM) allows one far more opportunities to be outside and to be active. My husband who was a born and bred Michigander and very apprehensive about retiring in the west but did so because of me, fell in love with the West and the beauty of NM and the ability to be active outdoors all year round. The hiking, the snowshoeing, the tennis…he has thanked me several times for dragging him back to the arid west from whence I came (born in Los Angeles, first 40 years in SoCal). Enjoyment of life in general, regardless of all the rest, certainly must count somewhere in the longevity game, eh?
Thanks for your comments, Nanci. I wasn't familiar with the Swedish All Terrain Trionic Veloped but Googled it. Looks amazing for any patients with mobility issues who want to active.
My wife dragged me out to California and like your husband thanks you, I thank her frequently for putting us in a spot where we can enjoy the outdoors all year round.
Joie de vivre is what I live for and counts for quite a lot!
“Residual confounding” really is all that needs to be said wrt those exercise studies. And as you say, the effect size is absurd.
I think the comparison to diet studies is apropos. Generally speaking, garbage in/ garbage out in both those categories.
These studies maybe are confusing correlation and causation? If you're playing tennis, you're probably in pretty good health which means you'll likely live a long time, especially for older tennis players. If you start having health problems, you're not able to play tennis, even if you once did. I guess the devil's in the details of these studies.
Yes. The observational study shows correlation and does not prove causation. Although causal language often appears in them
If pickleball gets your butt off the couch and out the door, then more power to you. Whether or not you will enjoy a bump in life span who knows. However, a friend of mine who enjoys(ed) pickleball with his wife broke his shoulder diving for a shot (65 years old). Not sure how that injury will affect his lifespan. All I know is that as I get older, I cannot recover as quickly from injury and injuries become more life threatening. What the heck…my go to for exercise is mountain biking!!!
I think the injury aspect has to be taken into account. For if one breaks a shoulder or damages a knee this impacts ability to do foundational aspects of our physical activity like walking and lifting.
Any activity that - as we say in Chinese medicine - moves qi and blood and engages joyful human interaction (peaceful shen) can expand quality of life metrics and impact longevity. There are way too many “lazy” fad-like observational studies and RCTs with various statistical forms of bias to create relevance.
How does one move qi?
More fiber.