Waiting for Alzheimer's

Factory Reset: Relearning to Run

Fewer than six months ago, my typical exercise regime included 45 minutes of walking/jogging intervals around my favorite local reservoir three to four days a week and usually a yoga session one day a week. I struggled to find time to do more than that, and for the life of me I couldn’t work myself up to jogging more than I was walking in the intervals. I would stare longingly at others who would seemingly glide effortlessly in a steady run around the roughly 3.8-mile perimeter of this body of water. I even one day had a guy pass me – twice.

I often wished I could just go up there and start running, but every time I tried, my breathing got in the way. I gasped for air and sometimes started wheezing. My lungs seared in pain and I often felt like I had a vice around my chest, keeping me from taking a nice deep breath. I concluded that I must have asthma and resolved to discuss my issues with my doctor at my next appointment. She agreed it sounded like asthma and ordered the test. After many long minutes of breathing exercises and tests that left me feeling like I was going to pass out at any given moment, the results were negative. No asthma. Still, my doctor gave me a prescription for an inhaler to see if it helped with my symptoms. Nope. The inhaler did nothing at all. I told myself I just wasn’t meant to be a runner, and I would have to be content with the intervals. I was OK with that. After all, I felt great afterward, feeling like I was getting a solid workout.

My beloved reservoir at sunset: tranquil and quiet with a plethora of birds — from swallows to bald eagles — to keep me company.

I won’t go into too much detail on the importance of regular exercise in maintaining cognitive health – and in maintaining the health of every other cell in the body. Everyone knows this. Everyone knows a well-balanced blend of cardio and strengthening is key to a healthy everything and improves mood, hormone balance, sleep and the list goes on and on. But how much cardio should you do versus how much strengthening? How much is enough; how much is too much? Dr. Dale Bredesen in “The End of Alzheimer’s” says to combine aerobic exercise with weight training at least four to five days a week for about 45-60 minutes each day. He also says to work up to these times slowly and to remember to stretch to prevent injuries. And that’s pretty much the extent of his exercise advice. Other books I’ve read on healthy living were, for the most part, equally vague.

Christiane Northrup, OB-GYN, was the first to offer me a definition of what is too much in her book, “Women’s Bodies, Women’s Wisdom.” I had always believed that with exercise, the harder you pushed yourself the better the benefits. A great workout meant pushing yourself to your limit, stopping just short of complete exhaustion. As a result I had hated exercising and often lacked any motivation to get started. Northrup, however, writes that too much exercise causes stress and can be nearly as bad as not exercising at all. She also offered a somewhat convoluted formula to determine your target heart rate. (Convoluted to me, anyway; math is not my forte.) I didn’t want to bother with something that complicated and decided to instead just go by how I feel. I wanted to believe her about overdoing it, however. So the next time I went out to exercise, I tried to take it easy, trying a comfortable speed walk instead of intervals, but quickly thought, “this is ridiculous, I’m not getting a real workout!” Almost subconsciously, I kept trying to push myself harder and harder. I guess at the end of the day I didn’t believe her. After all, isn’t getting your heart rate and breathing up the very definition of exercise? Wasn’t that the whole point?

A few years passed before I was introduced to Mark Sisson’s “The New Primal Blueprint.” His book is massive, covering pretty much every aspect of a healthy lifestyle, based on following how our primitive ancestors had lived. While he is obviously well-studied in what constitutes a healthy diet and other lifestyle habits, his area of expertise is exercise. He began his career as an elite endurance athlete, competing in marathons and the Iron Man Triathlon and training to compete in the Olympics. As he aged, however, he became burned out and transitioned into personal training and delved into research on why athletes become burned out and worked to develop the ideal workout/training regime. I was very excited to read his book. I believed I was set in all other aspects of my health goals, but I really wanted someone to explain in better detail and help me establish the ideal workout for me (short of spending entirely too much money on a personal trainer).

Sisson’s message is rather simple: Move more each day, including a wider range of motions, but slow down. He says a workout schedule should have a three-pronged approach: moving more in daily life, conducting cardio workouts in aerobic (not extreme) heart rates and performing complementary flexibility/mobility exercises, such as yoga.

“Devoted fitness enthusiasts tend to fixate on the accumulation of impressive and prolonged structured workouts, but the truth is that short-duration activity sessions really do add up and make a significant contribution to your aerobic conditioning and overall health,” he writes. He later continues, “I’m particularly concerned about the vast numbers of fitness enthusiasts in the gyms and on the roads who generally take their pace to slightly uncomfortable in order to get that sensation of ‘getting a good workout’ and experiencing the invigorating pulse of stress hormones – the endorphin high – upon completion.”

He and Northrup both say pushing to the level of achieving a “runner’s high” is actually addictive and not healthy. This rush of endorphins is triggered by stress hormones in a fight-or-fight situation. Triggering this on a regular basis leads to over stress and oxidation, which, as discussed in previous posts, contribute to cognitive decline, heart disease and the rest of the chronic-illness gang. The body creates the runner’s high as a protective mechanism, “by dulling sensations of fatigue and pain when you are immersed in what’s perceived to be a life-or-death effort,” Sisson writes.

You know the stories you hear of people who are elite athletes, absolute pictures of health, who suddenly and inexplicably have a massive heart attack (e.g. celebrity personal trainer from “The Biggest Loser” Bob Harper)? The heart attack, more often than not, was brought on by chronic inflammation and oxidation, caused by too much stress from excessive exercise and burning the candle at both ends. (Not to mention the possibility of a diet high in grains and low on healthy fats.)

“Slowing down to promote aerobic fitness and protect health requires you use some significant restraint and let go of the instant gratification provided by the endorphin rush,” Sisson continues.

He and Northrup both say cardio exercise should not be difficult, strenuous, painful or exhausting. Instead it should be relaxing and therapeutic with deep breathing. Exercise, Sisson says, is not so much about pushing yourself to the extreme, but instead about maintaining the ideal heart rate. He also offers a formula for determining “maximum aerobic heart rate,” and happily it’s much simpler than Northrup’s. He says multiple formulas exist, but in his research and experience, the best is Dr. Phil Maffetone’s very simple 180 beats per minute minus your age. Now that’s math I can get behind! This formula should not be confused with the maximum total heart rate of 220 beats minus age, which includes aerobic (with oxygen) and anaerobic (without oxygen) rates.

The body shifts into an anaerobic state once the rate increases above 180 minus age — even just a few beats over. The body burns fat while in an aerobic state but switches to burning any stored glucose (sugar) as it switches to anaerobic and produces a stress response due to the higher exertion. Occasional short, intense workouts, taking the heart rate into an anaerobic phase, is healthy, but only if the body first has a strong aerobic foundation, Sisson says.

“Emphasizing aerobically paced exercise not only makes you go faster, it’s healthier,” he writes. “Glucose is the quickest and easiest to burn, but it burns dirty — producing more free radicals and causing oxidative damage in your body. When you burn fat — by exercising at a slower pace and eating the right foods [protein and healthy fats and not sugar and grains] — you utilize oxygen and mitochondria to minimize oxidative damage.”

I was still 40 years old when I took on Sisson’s challenge to slow down, so my target heart rate was 140. I have a Fitbit, so I’m easily able to keep track of my rate and adjust my speed as I go. Easy-peasy, right? Nope. I knew I would be going much more slowly because my heart rate during my previous run intervals would jump into the 160s and 170s. I thought I was in for a relaxing walk, determined this time not to give in and push harder, but I still encountered two problems: One, finding a comfortable stride to maintain the heart rate, and two, feeling like a bit of a buffoon, awkwardly lolloping around the reservoir and truly feeling like I was getting no workout at all. My heart rate, it turned out, just didn’t want to get anywhere near my target rate, no matter how fast I walked. I moved as quickly as I could, pumping my arms like a crazy person, only to have Fitbit tell me my heart rate was 130. So I started a slow jog, and my rate skyrocketed into the 150s. To get my heart rate anywhere near target, I ended up adopting this strange, ridiculously slow, hopping jog that made me feel like an idiot. Sisson did warn me, however, this would happen, noting it was perfectly normal. He assured me this would pass once I found a comfortable and relaxing stride.

“Doing cardio workouts at 180 minus age or below often requires a significant adjustment in mindset to reject the ‘no pain, no gain’ mentality toward workouts,” he writes. “You should feel comfortable at this heart rate and embrace a rhythm of workouts that are not strenuous or stressful. At 180 minus age heart rate, you can easily converse without getting short of breath, and you finish feeling refreshed and energized instead of slightly fatigued and hungry…”

I finally found my stride on my third jog, thanks to the use of a treadmill due to inclement weather. The treadmill did the work at keeping my pace while I worked on my form. From that time on, every time I headed out for my jog, I enjoyed a very comfortable, easy workout, maintaining my target heart rate without ever getting winded. Suddenly I found myself loving to run, looking forward to every workout. Sisson says if you stick with this method, overtime you will be able to go faster and faster while maintaining your heart rate. And he was right. My first few awkward jogs took me about an hour and 15 minutes to get around the reservoir. Within a month or two, I was back down to completing it in 45 minutes. My current record is 42 minutes.

Sisson says he had realized the benefits of slow cardio over intense when he transitioned from training hard-core for marathons and the Iron Man Triathlon to slowing way down to keep pace with his clients as a personal trainer. He had little time to train like he used to, and instead fit in very short, intense sprints or strengthening workouts here and there as time allowed, while spending most of his time participating in slow, easy workouts with his clients. (More on strengthening and sprints soon.)

“When I jumped into the occasional long- or ultra-endourance race, the results shocked me,” he writes. “My ‘by chance’ regimen of very, very slow workouts coupled with occasional very short, intense workouts was effective beyond my wildest dreams. I was able to pace among the top competitors in the world in my age group and very close to the standards set by top professionals of that era. The Primal Blueprint parameters literally took shape in my mind as I blew by my rivals (who were putting in big chronic cardio miles, just like I used to) despite what most experts and prevailing conventional wisdom would have deemed ridiculously inadequate preparation.”

I have no desire to ever enter anything as strenuous as a marathon or triathlon, but as time passed, I found myself thinking, “wow, this is wonderful – and easy! Maybe I should start signing up for 5 and 10K races!” My 3.8-mile jog has turned into a source of great pleasure for me, helping me to de-stress and relax and improving my mood. The truth is, I have fallen in love with running, simply by slowing down and personalizing my workout based on my heart rate. And I’ve never felt better. The best thing I can think of to describe the change is a factory reset of the body. By literally following my heart, I’ve relearned how to breath and how to move, turning me into a true runner, something I never thought I would be.

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