poor nutrition, lack of physical activity and alcohol excess. ‘Of these,’ the report says, ‘the importance of regular exercise is the least well-known. But relatively low levels of increased activity can make a huge difference’. The report concluded that 30 minutes of moderately intense exercise, five times a week, can reduce the risk of developing heart disease, stroke, type 2 diabetes, some cancers and even dementia.2
This needs to be much, much better-known.
If Life Is a Marathon, We Need to Sprint
‘If exercise was a pill, everyone would be taking it,’ says Norman Lazarus, 82, as we walk through a violent downpour outside his office at London Bridge. My feet are drenched even under my umbrella; he only has a jaunty red cap on his head, but he shrugs off the rain. A short, wiry man with a stubby white moustache, Lazarus is a long-distance cyclist who regularly covers distances of 60 miles. He has just come back from cycling 180 miles in Oxfordshire with his daughter at the weekend. ‘Exercise is great,’ he says, in his strong South African accent. ‘For the body, the mind, for muscles – you name it.’
Lazarus is not just a biking fanatic, he is also emeritus professor at King’s College London, where he has co-authored a study into amateur endurance cyclists like himself. The older cyclists in the study – aged between 55 and 79 – were found to have similar immune systems, strength, muscle mass and cholesterol levels as those who were only in their twenties.3 On those criteria, the older cyclists had barely aged at all. The researchers could not tell how old they were by looking at their physiology on paper, only by meeting them and seeing their wrinkles.
The King’s researchers believe that endurance sports, including cycling, swimming and running, may protect the immune system by boosting the number of T-cells in our blood. These protective white blood cells are thought to decline by about 2 per cent a year from our twenties onwards, making us gradually more susceptible to infections and conditions like rheumatoid arthritis. But the older endurance cyclists had almost as many T-cells as 20-year-olds – a protective effect that no medicine yet invented can provide.
To qualify for the study, men had to be able to cycle 62 miles in under 6.5 hours and women had to be able to cycle 37 miles in 5.5 hours. That’s impressive. But all were amateurs, not professionals. Some, like Norman Lazarus, had only taken up cycling in their fifties. And they loved it. When interviewed, they reported not only managing the distances fine, but feeling fabulous as a result and wanting to do more.
Lazarus cycles with an amateur group. He also goes to the gym three times a week and does what he calls ‘anti-gravity exercises’ – lifting weights. Many of his friends cycle, as does his wife, who is 85. ‘We’re all going to die, yes,’ he announces breezily, ‘but none of us are ill at the moment. One day we’ll get to the point where we can no longer fight infection. But then hopefully, it will be quick’ – he pulls his hands towards each other to demonstrate the narrowing period of illness, the mercifully brief end he anticipates when he and his friends eventually move from ‘Young-Old’ to ‘Old-Old’.
Do the cyclists keep going because they are unusually healthy, or are they healthy because they cycle? Lazarus believes it’s the latter. What we see in the cyclists, he insists, ‘is true biological ageing, free from the problems caused by inactivity’.
If you wanted to see what true biological ageing might look like, you could charter a boat. In Ikaria, a beautiful Greek island off the west coast of Turkey, one in three inhabitants live into their nineties and dementia is rare. Ikarian men don’t get cancer or heart disease very often, and when they do, it develops eight to ten years later than in Americans. Ikarians also report considerably less depression.4 Their life is very much an outdoor one – it’s said to be hard to get through a day in Ikaria without walking up 20 hills – and that might just have something to do with it.
Ikaria is one of the Blue Zones (see here), where people live exceptionally long lives in good health. There doesn’t seem to be any genetic singularity; the secret is lifestyle. There has been much talk about the plant-based diets eaten in Blue Zones and far less focus on exercise. But whether in Sardinia, Okinawa or the other Blue Zones, it’s clear that these hearty, long-lived people lead very active outdoor lives.
This is not ‘exercise’ in a gym, pumping iron to music videos. It’s movement built into daily life, to do tasks that the rest of us have replaced with cars, robot-vacuum cleaners and other devices. We have saved ourselves hours by not fetching water, chopping wood or tending our vegetables. But has it lost us our agility? Activity maintains muscle mass, reduces stress by connecting our primitive brain to its old hunter-gathering functions and improves immunity by triggering a cascade of chemical signals in the body. Whenever we take the lift rather than the stairs, or drive rather than walk, we may be losing more than we realise.
Until now I’ve thought of endurance athletes as freakish, as having either a genetic predisposition or a crazy obsession to compete. But now I wonder. Stunning results have been seen in an otherwise normal group of American septuagenarians who started running when it became fashionable during the 1970s, and stayed hooked. Over the next 50 years some went on jogging, others took up cycling or swimming or working out, but they did it regularly – and as a hobby, not to compete.
To the amazement of the researchers, the muscle strength of these seventy-somethings was almost indistinguishable from 25-year-olds, with as many capillaries and enzymes. Their aerobic capacity was 40 per cent higher than people of their age who were not regular exercisers. The researchers at Ball State University, Indiana, concluded this made both the men and the women biologically 30 years younger than their chronological age.5
It’s impossible to overstate the importance of this finding: it suggests there is hope for us all.
Younger Next Year?
In terms of fitness, human beings keep pushing the boundaries of what is thought possible. The ‘Masters’ sporting events are a kind of amateur Olympics for those aged between 35 and 100. These regularly generate headlines about extraordinary feats – like in 2016, when Japanese athlete Hiroo Tanaka ran the 100 metres in 15.19 seconds. Tanaka’s time was nowhere near the Jamaican Usain Bolt’s world record-setting run of 9.58 seconds in the final of the 2009 World Athletics Championships in Berlin. But Bolt was 23, Tanaka was 85.
Masters athletes don’t just sustain performance to advanced ages, they have also been improving constantly over time. Their athletic performance has improved ‘significantly and progressively’ in the past 40 years. And the greatest magnitude of improvements has been made by the oldest swimmers and runners, who are over 75.6 This suggests that we may be only in the foothills of understanding the ‘Young-Old’. One of the Holy Grails for serious sportspeople – the maximal rate of oxygen consumption or VO2 max – declines at half the rate in Masters athletes as it does in their sedentary peers.7 One explanation is that regular aerobic exercise brings more oxygen to the muscles. The more we do, the more our heart and circulation respond, to get oxygen round the body.
Intensive working out doesn’t massively extend life. Olympians gain only 3 extra years over normal folk on average, according to a century of Games records.8 But they do gain a significant health advantage. This is greatest for cyclists and rowers, apparently; but even playing lower-intensity sports like golf can be positive. Commenting on the research, Professors Adrian Bauman of Sydney University and Steven Blair of South Carolina University stressed we don’t all have to be Olympic athletes to reap the benefits of exercise and win a ‘personal gold medal’. They urged governments to do far more to improve physical activity.
We don’t all have to run marathons. Above a certain level of athleticism, you can’t advance your health, only your performance.
