move (part 1): the data

“Everywhere is within walking distance if you have the time.”

– Steven Wright

There are very few studies of human health in which I believe I’m uniquely qualified to participate. That’s why I’m so surprised that the one that would have been right up my alley I only learned about by reading about it after its completion. I’m convinced I should have been Subject 1 in this brilliant piece of research.

While scientists have long understood that inactivity often correlates with heart disease and Type 2 diabetes, they haven’t been able to pinpoint exactly why that’s the case. Stated differently, the specific role that a sedentary lifestyle – standing apart from any other factors – plays in a person’s health isn’t well understood. That’s because it’s hard to tease out a specific correlation between inactivity and specific health outcomes if the person being studied has other conditions that independently contribute to poor heart health and diabetic onset (e.g., obesity, poor eating habits, other health issues).

So scientists at the University of Missouri – which, after I describe the study, may become your favorite institute of higher learning in the United States just as it has become mine – figured out a way to test the impact of a sedentary lifestyle free from the noise caused by other health factors. They took healthy, active individuals, and cut their activity level – measured in the number of steps they took – by 2/3rds (from roughly 13,000 to 4,000 steps/day).

As an aside, I have to ask why the University of Missouri didn’t cast a wider recruiting net? If someone had only told me that I could contribute to scientific advancement by sitting on my ass for a few days, I would have driven my car from NY to Columbia, arranged for someone to carry me into the building to sign the necessary paperwork, and then hopped into a golf cart that would transport me to my living quarters where I would have spent 3 days in sessile bliss. I find the thought of following a protocol that limits me to walking between my bed, the refrigerator and the bathroom perversely appealing.

But I digress.

The research, just published in Medicine & Science in Sports & Exercise, suggests that even if you’re otherwise healthy, becoming an inactive lump has a verifiable negative impact on you. Key findings include:

  • When subjects’ blood sugar was measured continuously during their regular, high-activity lives, the levels remained constant after eating;
  • In contrast, when they stopped exercising, their’ blood sugar levels spiked after eating by as much as 26%;
  • The post-meal spikes for inactive subjects increased with every passing day of inactivity.

The significance? These kinds of sudden, large increases in blood sugar are linked to both heart disease and Type 2 diabetes.

So the bad news, as I pondered the data Friday morning while trying to muster the will to leave my house to run, is that doing nothing becomes a bad something from a health perspective almost immediately. One might have expected that as soon as I learned this important piece of scientific information, I would at once race out and log some miles, or at a minimum, start pacing nervously around my kitchen. But I remained glued to my chair.

(To provide an appropriate frame of reference, I should point out that scary data doesn’t appear to have any instantaneous  impact on my behavior. For example, when my wife and I went to see the documentary, Super Size Me, we left the theater absolutely revolted by the amount of fat and sugar in a typical McDonald’s Value Meal. We talked about it on the way home. We couldn’t stop discussing all the great points Morgan Spurlock made in the movie, even as we waited for our McDonald’s Value Meals on the drive thru line. (That story is (sadly and disturbingly) 100% true.)

The Missouri results have particularly disturbing implications for those of us who wear a prosthesis. Following limb loss – particularly lower-extremity amputation – walking becomes something you have to do rather than something you want to do. The data bear this out: a University of Washington Study in 2007 of 77 lower-extremity amputees showed that they walked an average of only 3063 steps a day, with some participants walking less than 1200 steps a day. So, to tie this back to the Missouri study, amputees are walking roughly one-third fewer steps than the “sedentary” individuals who presumably got paid by researchers to do nothing. And they’re walking an even smaller percentage of the 10,000 steps per day recommended by the American Heart Association.

The University of Missouri researchers concluded:

These data indicate that daily physical activity is an important mediator of glycemic control, even among healthy individuals, and reinforce the utility of physical activity in preventing pathologies associated with elevated [blood sugar].

In other words, as the study’s author noted last week in an interview with Tara Parker-Pope of the New York Times: “You don’t have to run marathons. … But the evidence is clear that you do need to move.”

Which brings us back to the quandary I alluded to earlier: the limited data available about amputees suggests that we’re even more predisposed towards immobility than the average, immobile American. What to do?

*   *   *

After nearly 6 hours of agonizing last Friday, I walked out my front door and began running. I ran up the hill that leads towards town and then down to the harbor. At the point at which I normally tap the stop sign by the beach and turn around to get back to my house I continued on, climbing a hill that I’ve always avoided because any hill that a truck can’t ascend faster than 20 MPH is a hill that no human being should be summiting without pack mules, crampons, and an ice pick. Running at a ridiculously slow speed, my lungs still felt like they were going to rip through my neck as my right leg became increasingly leaden.

I continued on past the street where my son’s elementary school is and onward to the town police station. My chances of getting back home on foot dimming with every step forward, I hung a right at the police station and commenced a climb that continues largely unabated for close to a mile. This is the stretch of road that broke me in a road race seven years ago, reducing me to a slow walk and gutting me for the balance of my leg of a team relay. I completed it this time and continued down winding roads to my daughter’s school. And past it.

At the end of that road, I commenced my next climb, close to a half-mile steep uphill that left me again gasping for air and wondering why the town hadn’t installed a rope tow for easier ascent. As I stumbled into town, I realized that I had gone roughly 7 miles and had (a) no phone, (b) no wallet, and (c) no chance of taking the straight route all the way home, which was close to another 6 miles. My run ended somewhat ignominiously at the local pizza place, where I borrowed a cell phone to have my wife collect me. (They also generously gave me some slices and a soda despite my lack of money. Apparently, a good sweat and a highly visible running leg have some currency in the local barter market. God bless DiRaimo’s Pizzeria and Dean, who lent me his phone.)

The point of recounting this little venture isn’t to pat myself on the back and say, “Isn’t it great that I did that?” I want to strongly emphasize this: from my micro-level perspective, the run was a failure, as my goal was to go round trip – to town and back home. By that measure, I didn’t even come close. But looked at from a macro level – i.e., in the context of the Missouri study – it was a success in the following way.

I had put on my running leg at 6:20 AM, planning on hitting the pavement shortly after dropping my son at school an hour later. But I had skipped the 7:20 slot. And the 8:20. And the 9:20, 10:20 and 11:20 slots as well. My wife asked if I had run late in the morning, and I responded in the negative. She commented that she’d love to say something supportive that would get me out the door, but doubted she could be of much help. I corroborated her opinion, saying, “There’s nothing you can do. I just don’t want to go. I have zero desire to run.”

Finally, after noon, I reluctantly walked out of my house and broke into a jog halfway down my driveway. Less than a mile into my run, going at an intentionally slow pace, I was suddenly committing myself to a goal that I’d fail to reach but that led me on a route that I’d never tackled before and that, in retrospect, left me satisfied despite a lower mileage total than I had originally targeted.

Given my morning do-nothing mental state, the accomplishment was simply doing something. I was dangerously close to just taking off my running leg and coasting through the rest of the day when I forced myself to walk out of the house. The moment my door closed behind me, I had already won. If I had run 400 yards up the street and then turned around and come home, that was still better than pulling the plug on the entire venture.

This victory reminded me of an important lesson I learned between seventh and eighth grade. During the summer, I attended a soccer camp run by Joe Morrone. Morrone was the coach of UConn’s soccer team, which had recently won the NCAA Division I Championship. I remember 3 things very clearly about that camp: (1) kids who misbehaved were woken up early to clean garbage, which filled me with terror and gave the camp a vaguely chain-gang’ish vibe; (2) I was desperately homesick and wrote long screeds to my parents detailing the permanent psychological damage that they were inflicting on me by forcing me to stick out the full week on the mean streets of The Taft School; and (3) a coach saying, “if you can juggle a soccer ball once, you can do it twice. If you can do it twice, you can do it 4 times. If you can do it 4 times, you can do it 8,” and so on.

At the time, I couldn’t juggle a soccer ball all that well. But applying the coach’s logic and with a little practice, I soon found myself juggling a soccer ball upwards of 50 times without a hitch.

Forget how many steps a day you walk today. It doesn’t matter. You don’t need to document your activity with scientific precision to be “successful”. In fact, scrap the ideas of success and failure while you’re at it. Instead, think only of doing one thing today physically that goes beyond what you did yesterday.

When you go into town tomorrow to pick up the groceries, instead of taking the handicapped spot right in front of the store, park 15 yards farther away. If you normally sit in a chair for 3 hours at a stretch, set an alarm and get up every half hour. If you’re watching TV, get up at every commercial break. Stretch and take a quick walk around your house. If you can’t walk comfortably because you’re having prosthetic problems, schedule an appointment to get your socket adjusted so that you can try to add one short walk – even if it’s only 10 yards – to your daily activities next week.

I speak from experience: a 1.2 mile walk became two miles, became 3 miles, became 5 miles, became a 1.2 mile jog, became a 2 mile jog, became a 4+ mile run on the Atlantic City Boardwalk, became regular 6 mile runs, became a 13.5 mile shot out of the blue last November. Similarly, a 10 yard walk will become 20, will become 40, and so on.

We don’t need to become the next Oscar Pistorius, Sarah Reinertsen or Scout Bassett, much as we might want to. Spring is coming, so now’s the perfect time to get started. Just put one prosthetic leg in front of the other a little more today than you did yesterday. Keep on doing it and all of a sudden everything really will be within walking distance. And your heart and pancreas will thank you.

3 thoughts on “move (part 1): the data

  1. Pingback: move (part 2): goal setting « less is more

  2. Pingback: post 100 « less is more

  3. Pingback: the domino effect « less is more

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