'Dr Boyle: Cavemen, Saturday night. Two cavemen were sitting and talking to each other. They said, "It's very strange. We don't drink alcohol and we don't have cigarettes. We don't have any environmental pollution. All the food that we eat is wholesome and there is no contamination. And yet no one lives past the age of 40." So there are big factors out there. The bottom line is that we're not going to live forever. Life is a sexually transmitted disease that is invariably fatal'.

'Dr Boyle:The arguments for alcohol are really quite complicated, particularly when you get down to low levels. For alcoholics and those who consume high levels of alcohol, there is no gain. None at all. But taking one glass of wine per day probably has a benefit in some respects, and at very low levels, probably a null effect in our lives'.

'Dr Kerr: Is there an effect from duration of exposure as well? I guess with alcoholism and chronic liver disease, we see it there. But with the cumulative breast cancer risk, you say that for every 1 unit of alcohol, risk increases by 7%. Is that drinking steadily for 10 years or 20 years?'

'Dr Boyle: It's generally associated with at least medium-term consumption because the studies tend not to have enough cases. The prospective studies tend not to have enough cases of women who drink. Even after 10 or 15 years of follow-up, you don't exactly know what was going on beforehand. But it seems very consistent. There are about 100 studies that are surprisingly consistent, particularly when you're looking for those very low relative risks'.

Excerpt from:

June 08, 2015; Medscape commentary, 'Sherlock Holmes' on the Question of Alcohol and Cancer.

David Kerr, CBE, MD, DSc, FRCP, FMedSci; Peter Boyle, PhD, DSc, FMedSci

http://www.medscape.com/viewarticle/845917?nlid=82555_1842&src=wnl_edit_medp_wir&uac=112845FY&spon=17

I have on occasion observed a prevalent attitude in New Zealand, one which encompasses the succinct idea expressed by the axiom, 'more is better', an axiom equally consistent with the oft expressed heuristic, 'no pain no gain'. As generalisations both are simplistic, often quite wrong and frequently injurious. So, when it comes to considering how much exercise or activity we might consider doing and how hard we should do it, the church of self-flagellation still retains a high value in the culturally instilled belief rankings. Science on the other hand provides us with evidence that advises differently.

It seems a little vigorous physical activity goes a very long way.

Aside from calorie expenditure and 'cardio' or aerobic fitness, activity does excellent things for your metabolic well being, namely your ability to efficiently maintain a healthy blood glucose level, normal blood pressure and eventually normal, stable weight. You are also likely to prevent the new-age sentence for sustained indulgence, the metabolic syndrome (overweight, rising blood pressure, declining insulin sensitivity) potentially leading to type 2, non-insulin dependent diabetes mellitus. Moreover, there is virtually no health or psychological indice that is not usefully influenced by physical activity - in another blog I talk about 'health span'.

A recent large study highlighted that runners achieved on average a 30% reduction in their mortality and a 45% reduction in cardiovascular mortality, with a notional increase in life expectancy of 3 years for mortality and 4.1 years for cardiovascular mortality...all at the cumulative and exceedingly cheap expenditure of only 6 miles (9.66km) a week...let's call it 10km. The running pace was forgivingly sedate - a 40-year-old running 10- to 11-minute miles. This cumulative minimum activity required about 52 minutes per week (just 1 hour!). Running 1-2 times weekly led to maximal prevention in terms of mortality and cardiovascular mortality,

As we age, running may gradually or suddenly become an increasing challenge, a frank cause of irritation, inflammation and pain in the load bearing joints and discs, and the force transmitting tendons and ligaments of our axial and appendicular skeleton. As a result, many people simply cannot run and one common alternative is to walk. In this case, 15 minutes of walking equates to 5 minutes of running (3:1) or 105 minutes of walking equates to 25 minutes of running (4:1). Running is very efficient. Five 10-minute runs a week or two or three 20-minute runs per week is all that is required to produce the benefits.

I have personally found that the gym cross-trainer or elliptical trainer, when set with appropriate resistance can mimic a running activity output that approximates the muscular effort and engagement without the jarring or sudden changes in loads and motion associated with actual running. Consider this gym based activity a real alternative with a factor difference of say, approximately 1.5. It may also come with the huge advantage of being able to watch TV, listen to a Podcast or read while exercising. I have often recommended this exercise tool to patients unable to exercise for fear of compromising the well being of their lower spine. It has enabled many to comprehensively scratch the exercise itch they deeply missed and to exercise long and hard without compromise and in the end, to achieve the restoration of substantial functional capability, lastingly diminished pain and a sense of greater control in their lives.

One more thing, whatever you do you need to savour a measure of enjoyment, or at least enough to develop sufficient post-activity satisfaction, a sense of both reward and achievement that is so vital to carry you through your activity ambivalence to the next round.

After all, isn't life too short not to?

Informed by: www.medscape.com A Prescription to Move: Giving Exercise Its Due. Carl J. Lavie, Jr, MD, Steven N. Blair, PED. January 08, 2015

+ Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces
all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64:472-481.
+ Wen CP, Wai JP Tsai MK, et al. Minimum amount of physical activity for reduced mortality
and extended life expectancy: a prospective cohort study. Lancet. 2011;378:1244-1253.
+ Wen CP, Wai JP, Tsai MK, Chen CH. Minimal amount of exercise to prolong life: to walk, to
run, or just mix it up? J Am Coll Cardiol. 2014;64:482-484.
+ Vuori IM, Lavie CJ, Blair SN. Physical activity promotion in the health care system. Mayo Clin
Proc. 2013;88:1446-1461.