Judy Foreman - Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging

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Judy Foreman 2020

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Library of Congress Cataloging-in-Publication Data

Names: Foreman, Judy, author.

Title: Exercise is medicine : how physical activity boosts health and slows aging / Judy Foreman.

Description: New York, NY : Oxford University Press, [2020] |

Includes bibliographical references.

Identifiers: LCCN 2019009496 | ISBN 9780190685461 (hardback) |

ISBN 9780190685478 (updf) | ISBN 9780190685485 (epub)

Subjects: LCSH: Exercise therapy. | ExerciseHealth aspects.

Classification: LCC RM725 .F66 2019 | DDC 615.8/2dc23

LC record available at https://lccn.loc.gov/2019009496

To Mike, Robin, Owen, and Hugo, my dear ones. And to Ken, my beloved husband, with much, much love and many thanks.

The EXERCISE IS MEDICINE trade mark is used with the agreement of the American College of Sports Medicine. The content of this work was developed independently by the author and publisher and is not affiliated with, endorsed, or in any other way sponsored by the American College of Sports Medicine and its EXERCISE IS MEDICINE initiative, which seeks to make physical activity assessment and promotion a standard in clinical care, connecting health care with evidence-based physical activity resources for people everywhere of all abilities. For more information visit www.exerciseismedicine.org.

Thanks first and foremost, to my terrific editor at Oxford University Press, Abby Gross.

Thanks also to Florence Graves, Founding Director of the recently closed Schuster Institute for Investigative Journalism at Brandeis University, not only for welcoming me as a Senior Fellow, but also for supporting this book over the years with a steady supply of fantastic research assistants. They include Yuchen He, Kimberly Milando, and most especially, Stephanie Yan. Many, many thanks to all. Thanks, also, to Lisa Button, managing editor at the Schuster Institute, for finding the perfect assistants for my project from the pool of outstanding Brandeis students. Thanks, too, to my agent, Jim Levine.

In addition, a number of scientists have gone way beyond the call of duty in responding repeatedly to my phone calls and emails to help me understand the thorniest scientific questions. They include Steve Austad, Steve Blair, Claude Bouchard, Carl Cotman, Monika Fleshner, Matt Kaeberlein, I-Min Lee, Benjamin Levine, Barbara McGovern, Martin Gibala, Steve Horvath, Jay Olshansky, Stuart Phillips, David Slovik, Bruce Spiegelman, Mark Tarnopolsky, and Henriette van Praag. Thank you, thank you, thank you.

I am also very grateful to the following scientists and physicians who helped me with specific chapters.

Chapter 1:

Steve Austad

S. Jay Olshansky

Michael Rose

Daniel Lieberman

Matt Kaeberlein

Steve Horvath

Lorenzo Galluzzi

Gary Ruvkun

Chapter 2:

Claude Bouchard

Steve Blair

Trina Hosmer

Jerome Fleg

Jeffrey Metter

Eleanor Simonsick

I-Min Lee

Claudia Kawas

Chapter 3:

Peter T. Katzmarzyk

I-Min Lee

Ken Kaplan

Benjamin Levine

C. Ronald Kahn

Chapter 4:

Katherine Beiers

T. K. Skenderian

I-Min Lee

Benjamin Levine

Arthur Leon

Jonathan Myers

Jay Handy

Timothy Church

Chapter 5:

Mark Tarnopolsky

Christopher Gillen

Martin Gibala

Mark Mattson

Marcia Haigis

Darrell Neufer

Paul McLean

Bruce Spiegelman

David Hood

Chapter 6:

Mark Tarnopolsky

Stuart Phillips

Orly Lacham-Kaplan

Chapter 7:

Lynda Bonewald

Clifford Rosen

Mark Hamrick

David Slovik

Chapter 8:

Carl Cotman

Henrietta van Praag

Mercedes Parades

Shawn Sorrells

Chapter 9:

Carl Cotman

Michael Otto

Ronald Duman

Rod Dishman

Elizabeth Droge-Young

Chapter 10:

Paul Cotter

Lita Proctor

Barbara McGovern

Heather Buschman

Chapter 11:

Monika Fleshner

Connie Rogers

Brandt Pence

Chapter 12:

Marcia Bailey

Karen Mustian

Bradley J. Behnke

Jennifer Ligibel

Chapter 13:

Mary Armanios

Masood Shammas

Steve Horvath

Matt Kaeberlein

Eli Puterman

Elissa Epel

Carol Greider

Jay Olshansky

Chapter 14:

Matt Kaeberlein

Steve Austad

Lorenzo Galluzzi

Todd Manini

C. Ronald Kahn

Irene Mazzoni

David Sinclair

Bruce Spiegelman

Chapter 15:

Benjamin Levine

Frank Hu

Claude Bouchard

I-Min Lee

Mark Tarnopolsky

Bruce Spiegelman

David Becker

Chapter 16:

Thomas Perls

Elizabeth Arias

Aging, to most of us, especially on a bad day, is an appalling prospect, and, all too often, a grim reality. It represents a diminution of much that we have been, a penultimate phase of life, a slow, downward slide into decrepitude, disability, and dependence, a one-way street toward an all-too-literal dead end. As a friend of mine put it, its knowing youre on your next-to-last dog.

To a biologist, though, aging is one of the most exciting mysteries in the universe, a tale told in the chemical language of every cell and repeated in the life span of every organism. What is aging, anyway? Why arent humans like salmon, who die immediately after laying and fertilizing their eggs? Why arent we like mayflies, whose lives consist only of birth, reproduction, and a spectacularly fast death? For that matter, why arent we like some clams, which can live for hundreds of years? Or like 40-year-old bats?

Why does aging even exist, and why is there senescence, this gradual loss of function and vigor? Why do we live so long after our reproductive years are over?

Its possible that we live a long time after reproduction because in social species like oursas with elephants, wolves, and monkeysits advantageous to have postmenopausal females around to act as reservoirs of knowledge about watering holes, food supplies, and child rearing. But while this grandmother effect might explain long life, it doesnt explain senescencewhich makes you wonder, is senescence necessary? Is it part of the evolutionary deal? Are we stuck with it?

Or could things be different? Could we have what scientists call compression of morbidity, that is, long, healthy lives