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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Has your doctor quizzed you about your level of physical activity? If so, you can thank Exercise is Medicine, a global health initiative managed by the American College of Sports Medicine.

Created in 2007, the initiative encourages health care providers to assess patients’ physical activity during visits, plus include regular exercise when designing care plans. The amount and types of exercise that medical professionals recommend should be based on each person’s current health and ability.

The philosophy behind the initiative is simple: Physical activity promotes optimal health. Regular movement also helps to prevent and even treat various medical conditions. Overwhelming evidence links physical inactivity to poor health and high health care costs, according to a 2020 article in the American Journal of Lifestyle Medicine. The study concluded that health care and fitness programs should be merged.

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In addition, people who were moderately to vigorously active for at least 150 minutes per week had nearly half the health care utilization compared with those who were sedentary, according to a study done by Salt Lake City-based health care system Intermountain Health that was presented at the 2019 annual meeting of the American College of Sports Medicine and accepted for publication.

The study also found the active people had half the total cost of health care compared with the sedentary folks, defined as those who engaged in one minute per week of moderate to vigorous activity, said Dr. Elizabeth Joy, chief medical officer at health technology company Lore Health and chair of the EIM governance board.

Unfortunately, while EIM has expanded and achieved many successes, only 22.9% of adult women and 17.8% of adult men were advised by health care professionals to increase their physical activity levels, according to the 2022 US National Health Interview Survey, Joy noted.

With the average primary care visit lasting less than 20 minutes and with health care providers needing to cover many issues, it’s not surprising that so few are addressing physical activity, Joy said.

“It takes very little time to write a prescription,” Joy said. “It takes a whole lot more time to do evidence-based behavior-change counseling.”

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Despite EIM’s lack of progress in the doctor’s office, it has created numerous programs, initiatives and exercise prescriptions to help people outside of it.

EIM now includes Exercise is Medicine on Campus, for example, a program that helps colleges and universities promote and assess physical activity among students, faculty and staff. To date, more than 200 US schools and over two dozen international education institutions participate.

The EIM-OC program at Grand Valley State University in Grand Rapids, Michigan, has achieved gold status, said Amy Campbell, associate director of recreation and wellness, which means the university routinely assesses and promotes physical activity on campus. The university offers perks such as free personal training via its exercise science majors, plus a wealth of group fitness classes and wellness coaching.

While some of these offerings were in place before GVSU signed on with EIM-OC, Campbell said the university is working more collaboratively to stress the importance of physical activity.

“The CARE team (which connects distressed students to support services) now always asks students, ‘What do you do outside of class? Are you staying physically active? What are activities you enjoy?’” Campbell said. “If they see an opportunity to work with our department, they’ll reach out. For example, if someone can’t afford to participate in an intramural program, we’ll make sure they have access.”

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There’s also Moving Through Cancer, the first disease-specific initiative within EIM. The initiative assists with exercise and rehabilitation programming for those living with cancer and beyond. Most people who are physically active during cancer treatment have less severe side effects, feel better more quickly after treatment and, in some cases, have a lowered risk of their cancer returning, research has shown.

EIM also created the Rx for Health Series, which provides exercise prescriptions for people with a wide variety of common chronic conditions, such as Alzheimer’s, depression and anxiety, osteoarthritis, and heart failure.

“If you’ve had a heart attack, you’re at far greater risk of having another one if you spend most of your time on the couch versus going for a walk,” Joy said. “The couch is more dangerous than your walking shoes.”

While EIM will continue to educate health care providers and students in health care fields about the importance of assessing patients’ activity levels and creating physical activity prescriptions, it’s also looking at other options.

“People don’t respond well to being told to do something,” Joy said. “Rather, people are more likely to engage in and sustain healthy behavior changes when done within their community. If someone’s family, neighborhood, faith-based community or even work environment is supportive of regular physical activity, they’re likely to be more active.”

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Absolutely, said Gerren Liles, a certified personal trainer and owner of Gerren Liles Vision Fitness in New York. Various New York City companies have brought in Liles to teach fitness classes for their employees, and he has seen the benefits.

“It’s always good to unite people into working out,” he said. “That can inspire people to take charge of their fitness. It would be great if companies would invest in fitness, if schools would create programs and events for students and even parents, and if media and movies were all promoting physical activity.”

“Healthy behaviors are contagious,” Joy said. “We also have some personal responsibility around physical activity — to really think about how we influence the people around us.”

So the next time you head out for a walk, Joy said, invite a friend or neighbor along.

Melanie Radzicki McManus is a freelance writer who specializes in hiking, travel and fitness.

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Fitness

How the 3-3-3 Rule Helped Me Stick to an Exercise Routine

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How the 3-3-3 Rule Helped Me Stick to an Exercise Routine

If you’ve ever started a new workout routine with the best intentions only to find yourself skipping sessions by week two, you’re not alone. I’m the type to get trapped in the same cycle of burnout, where I go hard for a couple of weeks, feel exhausted, feel guilty, and repeat. For me, what finally broke that cycle wasn’t a new gym membership or a fancy fitness app, but a simple scheduling hack: the “3-3-3 rule.” I’d seen this rule applied it to general productivity, and all the same principles can apply to your fitness habits, too. Here’s how you can use the 3-3-3 rules to structure your workouts and create a habit that sticks.

What is the 3-3-3 rule?

The 3-3-3 “rule” (or “method,” or “gentle suggestion”) is essentially a weekly workout framework built around three types of movement, each done three times per week:

  • Three strength training sessions. This includes lifting weights, bodyweight circuits, resistance bands, whatever builds muscle and challenges your body.

  • Three cardio sessions. This includes running, cycling, swimming, jump rope, a dance class—what counts as “cardio” is up for debate, but here, I think of it as anything that gets your heart pumping.

  • Three active recovery days. This includes light walking, yoga, stretching, foam rolling, and so on.

And yes, I realize this math adds up to nine intentional days of movement across a seven-day week. Here’s the thing: You do double duty some days, or skip workouts here and there, or adjust to a nine-day cycle, because the point isn’t rigid scheduling. The point is rhythm over a strict structure. For me, the 3-3-3 rule provides a sense of momentum that’s flexible enough to fit into real life, but consistent enough to actually stick to.

Why the 3-3-3 rule works for me

Before I get into how the 3-3-3 rule helped me specifically, let’s talk about why so many workout plans fall apart in the first place. I believe most of them make two classic mistakes. The first is doing too much, too soon. You go from zero to six days a week at the gym, you get burnt out, and the whole thing unravels. The second mistake is having no real structure at all—just vague intentions, like “I’ll work out when I can,” which never materializes into anything real for a lot of people.

For me, the 3-3-3 rule solves both of those problems. It gives me enough structure to build habit and momentum, but not so much intensity that my body and brain feel overwhelmed. I personally adore running, but I struggle to motivate myself to lift weights; the 3-3-3 rhythm here helped me find a middle ground between those two workouts. When I know I have three strength sessions to hit in a week (or nine-ish day cycle), I can look at my calendar and find three slots without too much drama or dread.

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There’s also plenty of breathing room built into the plan, which was the biggest game changer for me. I used to have the (toxic) thought that my rest days were wasted days, which is a mentality that led to either overtraining or complete inactivity with pretty much no middle ground.

Plus, there’s something psychologically satisfying about the number three. I know and love the rule of threes in photography, comedy, survival tips, and all over the place.

How to make a 3-3-3 workout schedule work for you

The 3-3-3 rule has a ton of wiggle room for customization. Here are some ideas for how you can approach it:


What do you think so far?

For strength days, pick a format you actually enjoy. That might be a full-body circuit, a push/pull/legs split, or a class at your gym. (Boxing, anyone?) Your focus on these days should be a progressive challenge—push yourself, yes, but don’t obliterate yourself.

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For cardio days, variety helps. Mix a longer, easier effort with a shorter, more intense session (like a 20-minute interval run). I know I’m biased, but cardio really shouldn’t feel like punishment.

For recovery days, resist the urge to “make them count” by sneaking in extra work. The whole point is to let your body consolidate the gains from your harder days. Walk, stretch, breathe, and trust the process.

Another practical tip: Pick a night to map out your 3-3-3 week ahead of time. You’ll probably find that the week arranges itself pretty naturally once you’re looking for those nine windows.

The bottom line

As always, consistency should always be your priority in fitness. If you’ve been struggling to find a rhythm, if your past workout plans have always fizzled out around week three, give the 3-3-3 rule an honest four-week try. Maybe start with a 1-1-1 month! After all, the 3-3-3 rule isn’t a hack to totally transform your physique, but I do think it can provide something way more valuable. Finding a routine that works for you—like the 3-3-3 rule works for me—is the first step to make exercise a reliable, sustainable part of your life.

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I’m a running coach — I’ve just tested shoes actually designed for women’s feet, and they’re a total game changer

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I’m a running coach — I’ve just tested shoes actually designed for women’s feet, and they’re a total game changer

Why you can trust TechRadar


We spend hours testing every product or service we review, so you can be sure you’re buying the best. Find out more about how we test.

QLVR ENDVR: Two minute review

Most running shoes feel familiar for a reason: the formula has barely changed in millennia. We have archaeological evidence of shoes being fastened with “shoelaces” as far back as around 3,500 BC, yet the basic lace-up running trainer remains the default.

QLVR (pronounced “clever”) set out to challenge that. Its debut shoe, the ENDVR, is a laceless “running slipper” built around a women-specific mechanical structure, with a slip-on Wing Fit system inspired by the way a bird’s wing opens and closes around movement.

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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

Move more. Sit less. For many years, that’s been accepted guidance for people wanting to get healthier.

Now that message is getting refined, with a growing body of research suggesting that certain types of movements may be more beneficial than others when it comes to health benefits.

The intensity of your exercise may matter as well. A new study published in the European Heart Journal found that a small amount of vigorous activity may be linked to lower risk of eight different chronic diseases.

The findings raise questions about why intensity matters and how people can incorporate more intense exercise routines into everyday life. To better understand the study’s implications, I spoke with CNN wellness expert Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.

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CNN: What did this study examine about exercise and its relationship to chronic disease?

Dr. Leana Wen: This investigation looked at how the intensity of physical activity is related to the risk of developing a range of chronic diseases. Researchers analyzed data from two very large groups in the UK Biobank, which is a long-term health study in the United Kingdom that tracks medical and lifestyle information from hundreds of thousands of participants. One group included about 96,000 people who wore wrist activity trackers that objectively measured their movement, and the other included more than 375,000 people who self-reported their activity.

The researchers followed participants over an average of about nine years and examined the development of eight conditions: major cardiovascular events, atrial fibrillation, type 2 diabetes, immune-related inflammatory diseases, fatty liver disease, chronic respiratory disease, chronic kidney disease and dementia, as well as overall mortality.

The key finding was that the proportion of activity done at vigorous intensity mattered. People who had more than about 4% of their total activity classified as vigorous had substantially lower risks of developing these conditions compared with people who had no vigorous activity at all. The numbers were stunning, with the participants having the following results:


  • 63% lower risk of dementia,

  • 60% lower risk of type 2 diabetes,

  • 48% lower risk of fatty liver disease,

  • 44% lower risk of chronic respiratory disease,

  • 41% lower risk of chronic kidney disease,

  • 39% lower risk of immune-mediated inflammatory diseases,

  • 31% lower risk of major cardiovascular events,

  • 29% lower risk of atrial fibrillation, and

  • 46% lower risk of death from any cause.

These results are amazing. Imagine if someone invented a medication that could reduce the risks of all these diseases at once — it would be very popular! Crucially, even people who exercised a lot still benefited if the proportion of time they spent doing vigorous physical activity was increased. Conversely, people who were relatively inactive also benefited from adding just a little bit of higher-intensity exercise to their daily routines.

CNN: What counts as “vigorous” physical activity?

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Wen: Vigorous activity is generally defined as exercise that substantially raises your heart rate and breathing. A simple way to gauge it is the “talk test.” If you can speak comfortably in full sentences while exercising, you are likely in the low to moderate range. If you are so out of breath that you can only say a few words at a time, that is vigorous.

Running, cycling, lap swimming or climbing stairs quickly could count. But this also depends on people’s baseline fitness. For some individuals, taking longer strides with walking can be vigorous exercise. Others who are already fairly fit would need to do more. It’s also important to remember that vigorous activity doesn’t have to be in the context of a structured exercise plan. Short bursts of effort in daily life, such as rushing to catch a bus or carrying heavy groceries upstairs, can also qualify if they raise your heart rate and make you breathless.

CNN: Why might higher intensity exercise provide additional health benefits?

Wen: Higher intensity activity places greater demands on the body in a shorter period. This type of movement can improve cardiovascular fitness, increase insulin sensitivity and support metabolic health more efficiently than lower-intensity activity alone. Some studies have also linked vigorous activity with cognitive benefits.

Greater intensity may have distinct benefits across different organ systems. The researchers found that some conditions, such as immune-mediated inflammatory diseases, appeared to be more strongly linked to the intensity of activity than to the total amount. On the other hand, type 2 diabetes and kidney disease were influenced by both how much activity people did and how intense it was. Why this is the case is not yet known, but intensity appears to have a significant impact across diseases affecting multiple organs.

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CNN: How much vigorous activity do people need?

Wen: The threshold for people seeing a benefit appears to be relatively low. The researchers found that once people reached more than about 4% of their total activity as vigorous, their risk of developing chronic diseases dropped substantially.

To put that into practical terms, we are not talking about professional athletes dedicating their lives to hours of high-intensity training. Everyday people may see benefits from just doing a few minutes of vigorous effort daily.

CNN: How can people realistically incorporate vigorous activity into their daily routines?

Wen: One helpful way to think practically is that vigorous activity does not have to happen all at once. It can be accumulated in short bursts throughout the day.

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People can take the stairs instead of the elevator and do so at a faster pace than usual. When they are heading to work, they can add some speed walking. They can park farther away when grocery shopping and walk briskly while carrying groceries.

Structured exercise also can incorporate intervals where people alternate between moderate and more intense effort. If you’re swimming laps, you can warm up at a more leisurely pace, then do a few laps at a faster pace, then again at a leisurely pace and repeat. This suggestion applies to any other aerobic exercise: Aim for multiple intervals of at least 30 seconds to a minute each where your body is working hard enough that you feel noticeably out of breath.

CNN: What about someone who is older or has mobility issues?

Wen: Not everyone can or should engage in high-intensity activity in the same way. Vigorous activity is relative to that person’s baseline. For someone who is not used to exercise, even a short period of slightly faster walking or standing up repeatedly from a chair could be considered high intensity. And not everyone may be able to walk. In that case, some exercises from the chair can have aerobic benefits.

Individuals who have specific medical conditions should consult with their primary care clinicians before embarking on a new exercise routine. People with mobility issues also may benefit from working with a physical therapist who can help to tailor exercises appropriate to their specific situation.

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CNN: What is the key takeaway for people trying to improve their health?

Wen: To me, the main takeaway from this study is that it’s not only how much total exercise you get but also how hard you push yourself that matters. And you don’t have to have a lot of high-intensity exercise: Adding just a little has substantial health benefits across a wide range of chronic health conditions.

At the same time, exercise needs be practical. People should look for opportunities to safely increase intensity in ways that fit their daily lives. The most effective approach to physical activity is a balanced one: Exercise regularly, incorporate more challenging activities when you can and build habits that are sustainable over time.

Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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