When performing physical exams on new patients, there’s always one question that manages to break the monotony of an otherwise routine checklist of health questions:
How old are you?
“A woman never tells…I’m young at heart…I feel older than I am…how old do I look?… I’ve been 25 for over four decades now…” The variety of responses that I get from that simple question never ceases to amaze me – sometimes it feels like I’m in a singles’ bar rather than an exam room! The other day, one older patient simply replied: “nothin’ you need to worry about Doc. All you need to know is that I’m not dead yet.”
And actually, I couldn’t have put it better myself. I’ve had patients in various forms of poor health and in critical care in their 50s and 60s, and I’ve had patients still playing daily games of tennis well into their 90s. As a doctor, I know firsthand that the number of candles on your birthday cake doesn’t count towards predicting your state of health, your risk of disease, or how many birthdays you’ve got left in front of you.
But if your age can’t predict how healthy you are… can your “fitness age”? According to a growing body of research, your fitness age could, indeed, provide a much more accurate and telling glimpse into your state of health, and perhaps even your ultimate mortality. As more studies continue to confirm the hopeful potential of this measure, the Norwegian University of Science & Technology (NTNU) has just developed an easy online tool to allow people to calculate their very own fitness age, without the need of a doctor or equipment.
While there’s been controversy around the question of whether our fitness level is actually related to how long we will live, most scientific studies continue to confirm that keeping ourselves fit will improve our overall health and our risk factors for disease. And, whether we’ve taken this advice upon ourselves or not, the link between better fitness and better health isn’t new news to most of us either.
However, aside from general guidelines of diet and exercise, what does “being fit” really mean? Is it how much you weigh? Is it the amount of physical activity you do in a day? Is it how long you can last in a race of endurance? Is it how fast your heart beats when you’re resting, or how fast it beats when you’re exercising? Science has been struggling for many years to wrap its mind around this concept as well, in order to determine which measurement of fitness plays the most important role in actually indicating someone’s health, disease risk and chances of early death.
An analysis of thousands of large-scale sports and exercise studies has led scientists to conclude that the key to determining how fit someone truly is is their “maximum oxygen uptake”, also known as their VO2max. A person’s VO2max measures how well his/her body delivers and uses oxygen in all of its cells during exercise, to reflect a person’s physical fitness level. Underpinning all other measures of fitness, VO2max seems to be the single best way to assess someone’s physical condition and cardiac health, even among people who are older, smoke, have diabetes or are overweight.
With this in mind, Professor Ulrik Wisloff and his research team at NTNU’s KG Jebsen Center of Exercise and Medicine set out to create the largest database of healthy men’s and women’s fitness levels in the world. The researchers calculated the average VO2max measurements of almost 5000 healthy Norwegian men and women between the ages of 13 – 90, to determine how fit you should be relative to your actual age – i.e. a scale of “fitness age”. The database was also used to relate fitness level to risk factors for cardiovascular disease, the number 1 cause of death for men and women around the world.
The researchers found that, for about every 10 years of age, the average maximum oxygen uptake of men and women decreases by about 5 percent. So, while an average woman in her 20s has a VO2max of about 45 mL/kg/min, by the time she reaches her 50s, it could drop to about 34 mL/kg/min.
They also discovered that people with a fitness age that is higher than average for their actual age were about 8 times more likely to have many risk factors of cardiovascular disease, versus people with a fitness age that is equal or lower than their average. Moreover, just a 5 mL/kg/min reduction in a person’s VO2max score gives them a 60 percent higher chance of suffering from major risk factors of cardiovascular disease. This study shows that physical fitness is even more important when it comes to heart health than we previously believed.
Even further, other studies are beginning to suggest that fitness might not only play a role in cardiovascular disease and death; it may also be a key indicator of your health risks and mortality risks from all other causes as well. Research has clearly shown that exercise can improve your IQ, help you manage arthritis, fight insomnia, combat depression, build strong bones, decrease weight, ward off viral infections, slow down aging and reduce your risks of cancer. A study published in Medicine and Science in Sports and Exercise concluded that the more time you spend physically inactive, the greater your risk of dying prematurely from all causes. Another group of researchers from Stanford University School of Medicine looked at the predictive power of several different risk factors of early death from all causes. They found that exercise capacity and energy expenditure during exercise were the strongest predictors of mortality – even stronger than other traditional risk factors like smoking, hypertension, obesity and diabetes.
With physical fitness having such a major impact on our over-all health and lifespan, this research will hopefully pave the way towards brand new preventative and treatment approaches for major life-threatening diseases, such as cardiovascular disease, diabetes and obesity. Receiving an “exercise prescription” from your doctor is becoming an increasingly common practice, and studies have shown that patients are starting to take these prescriptions more seriously. Currently in the midst of adding genetic, cellular and molecular aspects to their physical fitness study, the Norwegian scientists are now working on creating a single blood test that could determine the most effective, individualized exercise program for each person, to prevent them from development and dying from cardiovascular disease.
The best way to improve your maximum oxygen uptake is to become more physically active every day, and to exercise more per week. And, according to Wisloff, just adding a little more to your week can already have a major impact on your health and lifespan. “For people who are in poor shape, just one 15 minute workout per week is enough to make a difference. Even parents with children should be able to manage that.”
However, on top of just increasing the amount of low-impact, long-duration physical activity you do throughout your day, research shows that your week should also include at least one workout that involves high-intensity exercise. After about a 10 minute warm-up, increase the intensity of your exercise so that your heart rate reaches up to 90 percent of its capacity for about 4 minutes; then follow this with a 3 minute cool down. Or, if you are ready for a greater challenge, try high-intensity interval training; after a 10 minute warm-up, perform high-intensity exercise for 2 minutes followed by lower intensity exercise for 2 minutes, alternating back and forth for 16 minutes, followed by a 5 minutes cool-down.
While you can’t change your chronological age, it would seem that more frequent and intense exercise is the elixir of youth when it comes to your fitness age. So grab the opportunity to shed years and enjoy better health and longevity. “A youthful fitness age,” says Dr. Wisloff,”is the single best predictor of current and future health.”
Find out your fitness age by clicking here.
For more information on how older adults can safely and effectively improve their fitness level, their health and their longevity, check out these great resources:
Yours in Good Health,
Victor Marchione, M.D.