Q.: As I approach the mid-50s, I realise more and more that ageing isn’t equal. Some people are really active in their 60s and 70s while others in the same age brackets really struggle with flexibility, low muscle mass and weight issues. I am a workaholic and I know I need to exercise. The thing is that I am just too tired when I wake up in the morning and also too tired after work. So I do nothing. But this will lead me to age early with inflexibility and low muscle tone. Where do I start? What is the healthiest exercise for someone like me? Maybe I have adrenal fatigue, CFS or burnout? P.B.
IAN CRAIG REPLIES:
A US doctor specialising in functional medicine once told me that in times gone by, the only reason we wouldn’t be able to move was if we were ill or injured. Both of these processes require inflammation in order to clear the infection or repair the injury. Since inflammation has been linked to all known degenerative diseases, by sitting still we are unwittingly switching on a process which, in the long term, makes us ill. This concept is a little scary, so please let it propel you into action.
A regular, moderate exercise programme increases the opportunity for healthy weight management, and reduces the likelihood of diabetes, high cholesterol, hypertension, cardiovascular disease, cancer and auto-immunity problems. Exercise has also been clearly shown to reduce the symptoms of depression and anxiety and to increase the ability to deal with life’s stresses. Also, as you get older, exercise can increase your independence, reduce the chances of osteoporosis and increase levels of psychological empowerment.
So, what is the healthiest kind of exercise for you? All types of exercise have their place in your health, although some individuals will tend to gravitate to certain types of exercise more than others. From the perspective of weight management, the American College of Sports Medicine recommends working up to a level of between three and five hours of cardiovascular exercise (CV) per week. Additionally, resistance training, via its influence on anabolic hormones, is extremely effective at maintaining or increasing muscle mass which, due to its high metabolic nature, supports a healthy body composition.
Exercises such as yoga and tai chi are also contributory as they are anticatabolic and stabilising to our stress hormones and insulin, which in turn can positively influence body composition. These traditional practices can also decrease muscle tension, improve digestive function and support mood.
So, the exact makeup of your exercise pattern will depend on your personal preferences, your genetics and your time commitments; each bout can be as little as a few minutes, or as much as a number of hours. The basic message is to express yourself through movement and not do nothing.
Long-term adherence to an exercise programme is the most important element for success, and is only achieved by enjoyment. Depending on whether you are a social person or not, activities such as dancing, walking, swimming, cycling and exercise classes can be shared with family or friends.
Regular, ‘moderate’ exercise is stabilising to your hormonal and nervous systems, and it is extremely nourishing to all aspects of your physiology. So, don’t be a typical South African and go from nothing to a tough exercise programme overnight – overdoing it, either by high volume, high intensity, or both, will further increase your stress response. For example, you might head to the gym after a stressful day at work to ‘really knock it out of your system’, but you can end up just accumulating stress hormones and, in the long term, negatively impact on your health.
Consequences of long-term raised levels of stress hormones are many:
- Anxiety and/or depression
- Sleep disruption
- Intermittent or chronic fatigue
- Lowered male and female hormones, negatively affecting sexual health, vitality, fertility and muscle- mass
- Weight problems – these are the people with metabolic fatigue, who have become extremely resistant to weight loss efforts, despite sometimes excellent strategies.
Like almost everything in life, exercise is a matter of balance. The harder you train, the harder you must recover. The job of training is to break down certain physiological systems, and the job of recovery is to allow time for these systems to be reinforced to a stronger level than before. In your situation, it is important to get into a regular exercise habit that balances your work and family commitments and isn’t an added stress in your life.
Sleep too is critically important, so if you are tired in the morning, it’s not the time for you to do hard exercise. According to the author of one of the books that I recommend for adrenal fatigue,¹ the last couple of hours of sleep before waking in the morning are the most restorative, especially for somebody with adrenal fatigue. So cranking yourself out of bed with an alarm five or six days a week is not necessarily the healthiest practice.
According to genetic research, there are actually genes for circadian rhythms, so our best waking times will be incredibly individual. Culturally, when compared to other countries around the world, the day starts very early in South Africa, and many exercisers choose to front-load the day with a session before work. Genetically, once you have got over your current state of fatigue, this might work for you as long as you get to bed nice and early, but then again, early rising may simply be defying your physiological comfort zone. So, with regard to sleeping patterns, I think it is immensely important to listen to your body and to respond to what it needs and wants. If you would naturally wake at 07h00 without an alarm clock, don’t force yourself into a gym at 05h30 – rather lie in until 06h30 or 07h00, and fit your exercise in at lunchtime or after work.
In terms of burnout, it is really irrelevant whether we are talking about adrenal fatigue or chronic fatigue – burnout is a fairly loose term used to simply show that the person is finished energy-wise. This would certainly be the case when adrenal fatigue shifts into exhaustion state, but it could also be used to describe somebody suffering with CFS – although if that person was to then obtain a ‘diagnosis’ of CFS, that description would displace that of burnout.
With a healthy lifestyle and a fulfilling exercise routine at stake, the key word is balance, otherwise you will become over-stressed and under-recovered. For you, I would recommend starting by simply getting out of the office for a 30-minute walk daily; once your fitness has improved and your daily energy starts to pick up, also aim to do a more structured gym-type routine after work two to three times per week. Remember, just as you put in great effort to achieve great things such as work successes, you also need to exert some effort towards sustenance of health and performance.
- Wilson J. Adrenal Fatigue: The 21st Century Stress Syndrome. Petaluma, California: Smart Publications, 2002.