James Loy:

This is Reframe, The podcast from the College of Education, Health and Society on the campus of Miami university in Oxford, Ohio. 

Everybody knows that exercise is good. But that is not the whole story. It’s not just that exercise is good. It’s also that not exercising is actually so much worse. A general lack of physical activity can lead to many diseases and even cancer. 

So in this episode, we speak with Kyle Timmerman and Kevin Ballard. Two accomplished exercise science researchers who have just been named Fellows in the American College of Sports Medicine (ACSM). Their work explores the mechanisms behind exercise science and how living a much healthier life might not actually be that hard for most people. 

(MUSIC FADE)

James Loy:

Dr. Ballard, Dr. Timmerman. Thanks for speaking with us today. What kinds of thing do you study within the field of exercise science? What is your expertise, and why is it important? Dr. Timmerman can we start with you? 

Kevin Ballard:

Do you want to go first? 

Kyle Timmerman:

Sure. Kevin has heard this a 1000 times. We each have our elevator pitch. But my research has been focused on inflammation and inflammation always gets a bad rap, so I try to put it in context. Inflammation can be both good and bad depending on how you look at it. If you get an infection, you need to generate an inflammatory response to help clear that. But as we age, our baseline levels of inflammation start to slowly creep up and . . . Time Magazine had several years ago “inflammation the silent killer” on it. And it was specifically talking about that gradual increase in our baseline levels of inflammation that predisposes us to developing . . . you name a chronic disease and it appears to have . . . inflammation is kind of an underlying cause in its development and progression.

But we know that people that are more physically . . . or that maintain a healthier body composition, avoid that age-related inflammation. And if we can reduce inflammation, we can reduce the risk of developing cardio vascular disease, type II diabetes, sarcopenia, which is age-related loss of muscle mass and function. I could go on and on about the number of diseases that have that inflammatory link. And the better we can understand what are the pathways that are involved in conferring these anti-inflammatory effects, we understand better how those diseases develop and progress as well. 

James Loy:

Are there practical applications that people can do on their own, start doing right now? Or does it take a specialist or a special intervention to get at those . . . 

Kyle Timmerman:

Oh, it’s . . . well, we all know that exercise is good for us, right? You know, one of the biggest barriers, I think, is that folks don’t know . . . a lot of people don’t know what’s safe for me to do? What do we mean by “exercise?” And so we need to communicate to people, hey, in most studies we are talking about literally walking. We are talking about having them walk. And so, I mean people have evaluated different modes of exercise or different intensities. But in a variety of studies, if we take people that have been relatively physically inactive and just get them to do light to moderate intensity exercise -- and for most folks that could just be walking -- you’re going to see those benefits.

James Loy:

Dr. Ballard. How about you? What’s your background? What’s your expertise and what do you study?

So, similar to Kyle I have a background in both exercise physiology as well as nutrition. So over the past 10 -12 years, my research has focused on the measurement of non-invasive measures of blood vessel function, which are related to the risks for the development of cardio vascular diseases as well as other chronic diseases. And I’ve investigated a number of various lifestyle strategies whether it be exercise or dietary strategies to improve vascular function, and then simultaneously looking at some of the mechanisms that may explain the improvements in vascular function we see with these various lifestyle strategies.

James Loy:

So when you talk about vascular function and how it is related to cardio vascular and heart disease, or other diseases, do you have a sense of how much of a pressing problem these issues are in society today?

Kevin Ballard:

Well, we know now that at least 1/3 of U.S. adults are obese. We talk about those that are overweight or obese, that’s 2/3rds of the population. So there is a large percentage there that are at a higher risk of developing chronic disease.

So one of my first studies that . . . when I got started here and came to Miami in 2015 -- really got interested in what impact sedentary behavior or physical inactivity has on vascular function. So we did a small study in just healthy men showing that 3 hours of prolonged sitting negatively impacts vascular function.

Kyle Timmerman:

And I think that’s such a cool way to look at it. Because most of the studies in exercise science are focused on exercise and physical activity. So some of Kevin’s studies are looking at the flip side of that coin and what about sedentary behavior? And there’s been more research now looking at, hey, comparing and contrasting those two things. You know, which is . . . is physical activity . . . which one of those has the greatest lever to influence your health?

So sedentary behavior is clearly not healthy for you. I always joke to my students that, you know, I sit at my desk 6 hours a day writing about the benefits of physical activity as I am being incredibly sedentary. So I enjoy seeing the literature and participating in the research saying, hey, the fact that I can go get my moderate to vigorous physical activity for 30 minutes per day helps offset a lot of that risk of sedentary behavior.

And I think that’s really important because I think in general that we are a fairly sedentary society. And so, as Kevin’s research would suggest, that’s unhealthy. But if we can get people to do the recommended amounts of physical activity, that really helps offset these negative impacts of our largely sedentary lifestyle.

James Loy:

Also, I think a lot of people probably think of sedentary behavior in terms of extreme examples, but not realize how sedentary our modern life encourages us to be. Like, our jobs that have us sitting at computers all day. I mean, I don’t exercise consciously as much as I should, but I try to take the stairs and things like that, but I imagine that’s offset by all the computer work I do, and all the commutes that we do, and also all the different streaming services that encourage us to watch even more TV. 

Kyle Timmerman:

Yeah.

James Loy:

So I think maybe even people who consider themselves to be healthy might not realize how sedentary they actually are. 

Kyle Timmerman:

Yeah. The whole idea of Netflix binging. Now Netflix even has a prompt that pops up that says, do you want to get up and go outside? 

Kevin Ballard:

I haven’t seen that.

Kyle Timmerman:

I was like, oh man, how many episodes of The Office did I watch!?

But yeah. It . . . you hit on it a lot. You know, what . . .  people think of . . .  I teach a class on exercise testing and prescription. And so this whole idea of how do we test somebody’s fitness and how do we recommend physical activity to them? And kind of what you mentioned, you said, “I don’t get up and do dedicated exercise, but I take the steps and things.” And that’s an important concept to communicate to folks. That’s beneficial.

The New York Times just had an article based on a research study saying that, hey, even 5 minute chunks of activity, if that can add up to roughly 30 minutes or so per day, you’re going to meet the recommendations for physical activity. And I guess we should throw that in, that the American College of Sports Medicine, the American Heart Association recommend about 150 minutes per week of moderate to vigorous physical activity. And until 5 years ago, they said, hey, we need that to be in 30 minute chunks. And that can be daunting to some folks. But now people have started to parcel that out.

Research has found, hey, you know what? People can still get the same benefit if they are accruing that 30 minutes in smaller chunks throughout the day. And to somebody who has been relatively sedentary though their life, that helps them, right? Because, hey, if I could just do a 5-minute walk before lunch, a 5-minute walk after lunch, you know, walk with the kids or the dog or a friend after work . . . It doesn’t take too much to get to that recommended amount of physical activity.

Versus if you tell somebody, “You have to go out and walk for 30 minutes in one bout.” Where it is much easier to say, hey, can you get in, you know, a handful of 5 or 10-minute bouts during the day? And it doesn’t have to be on a treadmill. It doesn’t have to be on an exercise bike. It can be . . .  Kevin does a better job than I do escaping the building and just going for a walk on campus. That can add up.

James Loy:

Yeah, I think you are 100% right. I feel like people get daunted by how much of a change people think they need to make right away, and then get frustrated and quit if they can’t make this huge transformation . . .

Kyle Timmerman:

Yeah. 

James Loy:

. . . right away. So I think, yeah, that seems very important to communicate that incrementally building toward these good habits is super important.

Kyle Timmerman:
I mean, eventually I think we hope our research translates to somebody who is going to use it. They are going to see what we are doing, you know, the public or clinicians, will use it. And so, we need to help people start to overcome those barriers and the biggest barrier to exercise are time . . . And so the research coming out and saying, hey, I can get these in chunks and I don’t have to get a gym membership. I can do smaller bouts. And then . . . lot of people look at exercise as a 4 letter word, right? You picture like The Valley’s Gym commercials were people are sweating and looking like they are exercising real hard and people see that and it’s like that just looks so hard. And then, so, overcoming that idea that . . .  again, you can meet the recommendations with walking. It doesn’t have to be lifting massive amounts of weight or sprinting on a treadmill or sprinting on a bike. And . . .

Kevin Ballard:

No, it should be something that is enjoyable to the person. But also something that they can consistently do. That’s going to be the key there. Exercise is not the same for everyone. Some people enjoy running outside. Others enjoy going to the gym, kind of doing their own thing. The key is just to find something that you enjoy doing and stick with it.

Kyle Timmerman:

Kevin’s point is great. I always ask students, what’s the best exercise? And they will say it’s swimming. It’s biking. And then . . . to Kevin’s point . . . it’s the one that you will do. It’s the one that you will do that is the best exercise.

James Loy:

So how dangerous is sedentary behavior? Is it even more dangerous than we realize?

Kevin Ballard:

Well, some people consider it . . .  have called it actually the new smoking.

James Loy:

Wow, really.

Kevin Ballard:

Yeah. So physical inactivity or sedentary behavior, prolonged sitting, some people call it prolonged sitting. So people are really considering that a risk factor for chronic disease. Whether that be cardio vascular disease, diabetes and so on. There is a number of other . . . I’ve seen some other papers showing that the more sedentary behavior . . . that’s even associated with even the increased development of certain cancers. 

Kyle Timmerman:

Yeah.

James Loy:

Do you think this might even actually get worse from here? I mean, a lot of the people who are working these jobs now and living these lifestyles full of technology . . . most of us are probably relatively young, so maybe most of these effects haven’t even yet come to fruition yet. They haven’t yet become even as pronounced as they may be even down the road a bit.

Kevin Ballard:

Yeah, I mean, I would expect that. Just because everyone has a cell phone now. Everyone has some sort of, maybe, gaming system where they . . . or a TV where they are sitting for hours on end, and they are not as physically active as even a generation ago, I would say. So I think over the course of the next several decades, it is likely that the health problems associated with sedentary behavior are going to increase dramatically.

Kyle Timmerman:

There’s studies that just look at screen time per day.

Kevin Ballard:

Yep.

Kyle Timmerman:

So whether that’s computer, TV, or iPad. And then risk of chronic disease. And again, I think screen time is just a reflection of . . . the more screen time you have the more sedentary we are. 

Kevin Ballard:

Right. You are likely sitting then.

Kyle Timmerman:

So, to the diseases, I think the reason we focus on cardio vascular disease risk factors or diabetes risk factors is those are two of the biggies for chronic diseases. But you go down a laundry list of chronic diseases or conditions. You know, osteoporosis, I mentioned sarcopenia before. Kevin mentioned cancer. You name it. Then being sedentary appears to increase your risk of many of these and being more physically active can decrease your risk of developing them, or -- for folks that have those conditions -- can help reduce their symptoms.

And I’ve seen at ACSM conferences and in publications that talk about, you know, there’s no medicine that has the breadth of benefit that exercise itself does, or any type of intervention. A really cool study I present in the class is . . . this was less than a decade ago, where they had people that had some level of heart disease and something needed to change. So they had some level of blockage in the coronary artery. They needed to have someone go in where they could open up that blockage and often times they use a stent.

And so for this population of people, they randomized them to receive that procedure or to start doing exercise. And the exercise was walking. And they found that, hey, the percentage of these 2 groups who had survived 10 years later, and had the greatest level of function, were the exercisers. Versus the people who had that very specific problem fixed with the treatment, versus the people that actually were incentivized to exercise, that had the better outcomes even a decade later.

And that goes to the fact that that stent fixed one very specific thing that was their underlying problem. Where exercise helped with that, but then had all these other benefits that contributed to their improvements in their clinical outcomes.

James Loy:

The reverent effects that . . .

Kyle Timmerman:

Yeah, so I think that’s where this whole, you know, the ACSM is big on, you know, and has this whole focus on the exercise is medicine.

Kevin Ballard:

Right. 

Kyle Timmerman:

And I think we are seeing how true . . . 

Kevin Ballard:

Right.

Kyle Timmerman:

. . . how true that is, from these research studies that keep coming out.

Kevin Ballard:
Because drugs just affect one pathway. They target one pathway, target one disease. But exercise itself beneficially affects the whole body. All the systems of the body. 

James Loy:

That’s a great way to look at it. I mean, again, you hear how exercise is good all the time. And it’s healthy. But I don’t know that I’ve heard it literally equated to some of the best medicine there is.

Kyle Timmerman and Kevin Ballard:

Yeah. 

Kyle Timmerman:

Yeah, it’s hard to argue with that point. Students always say . . . I always ask students which one has more side effects. And they’re like, the medicine. Well, it’s actually exercise. But they are good. 

Kevin Ballard:
Right.

Kevin Ballard:

Whereas many of those medications, they do have side effects. But the majority of those are . . . I mean we all watch the TV commercials. And it’s like, oh, that’s a great medicine and then they start talking about all the side effects. And I’m like, wow! So it’s . . . it’s really an interesting area.

Kevin Ballard:

The ACSM has really been at the forefront of this. About 10 years ago they came out with the exercise medicine initiative. And their target was really physicians and trying to get them . . . trying to educate them and get them to promote physical activity to their patients. 

James Loy:

Alright. So move more. Be healthier. Live longer. It seems like it could really be that simple. Dr. Keven Ballard and Dr. Keven Ballard thank you so much for talking with me today.

And you can find more episodes of our podcast available now on SoundCloud and on iTunes. And if you have any questions you can also email us at: reframe@MiamiOH.edu