Doctor’s Note: Exercise Intensity — Does “Work It Harder” Make Us Better?

The best exercise regimen is the one that you actually do.

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Kinesiology researchers at the University of Virginia published a study showing that high intensity aerobic exercise (cycling) may suppress appetite in healthy untrained humans, with a possibly larger effect in women than in men. What does this mean? Is it true, as Daft Punk and Kanye West said, that “work it harder” makes us better?

Well, let’s talk about physical exercise. CDC recommendations state that all adults should have 150 minutes of moderate-intensity aerobic activity a week, or 75 minutes of vigorous-intensity aerobic activity, in addition to muscle-strengthening activities on two or more days a week.

What exactly is the difference between aerobic activity and muscle-strengthening? Aerobic exercise such as jogging or cycling primarily tests your ability to breathe oxygen and deliver it to your muscles. Muscle-strengthening exercise such as weightlifting or using resistance bands tests the strength of an individual muscle or muscle group. Both types of exercise are valuable for overall physical fitness and life expectancy, but aerobic exercise generally has a larger effect on fat loss while resistance exercise improves muscle mass. Activities like jump squats or stair climbing could be both aerobic and muscle-strengthening.

In exercise physiology, low-to-moderate-intensity exercise is defined as exercise below the “critical power” (or critical speed) that induces fatigue. Low to moderate-intensity exercise can be sustained for hours in a healthy individual. High-intensity exercise cannot be sustained beyond seconds-to-minutes, so high-intensity interval training (HIIT) alternates periods of exertion and rest (or lower intensity exercise).

Competitive athletes have used HIIT techniques for many decades, but in recent years HIIT has also gained popularity for general wellness. Compared to moderate-intensity workouts, high-intensity training can achieve similar results in less time. So it’s no surprise that HIIT has become one of the most popular exercise strategies.

Does this mean that higher-intensity exercise regimens are superior to moderate-intensity ones? Not necessarily. One fundamental limitation of clinical trials is that the randomized intervention can only run for a short time, typically no more than three months. Many exercise trials show that less than a quarter of patients continue the prescribed exercise for six months after the end of the trial period, and weight loss trials show only a third of patients are able to maintain their weight loss for two years. That’s far from being a lifelong routine of healthy activity.

If you enjoy high-intensity activities like competitive basketball, tennis, or swimming then you’re much more likely to keep on doing them. If you really don’t enjoy it then you’ll quit. If you enjoy moderate-intensity jogging or cycling then you’re more likely to continue those activities instead.

Both high-intensity and moderate-intensity aerobic training are effective for weight loss and physical fitness. The main obstacle to success, regardless of exercise style, is being able to sustain exercise for the long term. And since every human being has different likes and dislikes, there’s no such thing as one perfect exercise routine that everyone enjoys.

My advice is to find an exercise routine that you enjoy doing, one that you can stick with for the rest of your life. If you like group exercise activities, whether it’s a spin class or a group of runners, the social aspect of not wanting to let down your friends can provide strong motivation. If you don’t like group activities, you can still make exercise a practical part of your life. When I was much younger, I lived on the 15th floor of a high-rise, and stair climbing was my own version of high-intensity interval training. Maybe you could come up with some form of exercise that fits into your unique location and lifestyle.

The best exercise regimen is the one that you actually do. Whether or not you choose to go harder, faster, or stronger, keep in mind that “our work is never over.”

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