I had a chance to work through the free Hacking Exercise for Health online course taught by two entertaining physiologists on Coursera recently. It was recommended by the people behind the Learning How to Learn MOOC. As someone who enjoys moderate exercise, this course supplemented my understanding of its health benefits. It also gave me additional know-how to get the best bang for my exercise buck. While the information gleaned from the course will not be new to professional athletes or dedicated fitness types, it might yet prove insightful and hence useful to those who are already engaged in moderate exercise through sports, gym work, etc. and would like to see improvements in their overall fitness.   

Public health guidelines stipulate 150 minutes of moderate exercise a week, targeting both cardiorespiratory and musculoskeletal fitness (e.g., running and lifting respectively). This is because numerous studies connect these two fitness types with health and longevity. Exercise is the single most essential thing we can do to sustain our health and remain relatively pain-free for our entire lives. It staves away anxiety, depression, and helps with memory too. Cardiorespiratory fitness, which refers to our bodies’ use of oxygen, determines how well our hearts can pump blood and how quickly and long our bodies can stay in motion.

Musculoskeletal fitness refers to muscle strength, endurance, and power. When you lift heavy weights, your muscles are overloaded. When overloaded, those muscles get fatigued. Once fatigued, they then get stronger the next time to adapt. Similarly, powerful moves (e.g., moves with explosive force like boxing, kicking, etc.) can help to develop power in the muscles, as do moves that require endurance, such as long low intensity repetitions (reps) of some movement or isometric type exercises.

When we are not exercising, our heart rate and breathing are constant and slow, but able to provide for the body’s demand for energy. When we start either cardiorespiratory or musculoskeletal fitness activities, our heart rate and breathing increase to make up for the temporary boost in energy requirement. And once we stop or slow down, the body will start to recover from the stress and adapt to prepare for similar stressors it anticipates will occur in the future. This is how we get more fit over time.  

The protein in our muscles breaks down (atrophy) during exercise and new proteins synthesize to replace them. We get stronger and faster when the synthesis occurs at a faster rate than atrophy. This process is most effective when muscles get properly fatigued. In other words, the workout should be rigorous. For musculoskeletal strength training, this might mean lifting weights at 60 percent of your single repetition maximum (1RM). The 1RM is the maximum weight that you can lift only once. So, if you can’t do a 20 kg bicep curl more than once, for optimal effectiveness, you could be lifting 60 percent of that weight, i.e., 12 kg in reps.         

When it comes to sets of musculoskeletal strength training exercises, many people do about three. While it is good to do multiple sets to fatigue, especially if you have certain fitness goals, it has been shown in resistance training studies that one set done once a week for ten weeks has almost the same strength gains as three sets done once a week for ten weeks. Similar findings present themselves for the relationship between cardiovascular type exercises and longevity. People who worked out in this area regularly had a 30 percent lowered chance of dying from all causes compared with people who don’t, based on a study of 50000 adults over 15 years. These health effects can be achieved with minimal effort: running (at a speed at which you can maintain short conversations but cannot sing) for just seven minutes every day was enough for people to reap the health benefits of cardiovascular exercise.   

These figures, if anything, should be encouraging enough to get us off the couch and into the gym/track: even a little bit of exercise – as long as they’re tiring – can offer us proper health benefits, including defense against age related cognitive decline. Walking up hills (but not down stairs for the sake of your knees), swimming, cycling, random sets of push ups and squats in between computer work, all of them add up.

If you do wish to go a little deeper and get a clear snapshot of your fitness level, VO2 max tests are the way to go. These tests measure how much oxygen you are able to remove from the air when you breathe deep. They inform you and your physiologist of the state of your heart, blood vessels, airways in your lungs, and muscle tissue. A good VO2 max score is a great sign. Conversely, a bad VO2 max score is an indicator that you might experience certain health issues down the road, ranging from cardiovascular disease to Type 2 diabetes.   

Let’s go back to the 150-minute exercise guideline public health authorities such as the World Health Organization (WHO) have recommended. Scheduling our weeks ahead of time to accommodate an exercise regimen that adheres to this timeline is good. But what about people who are strapped for time? Fortunately, the 150-minute duration assumes moderate-intensity exercise. So, for those who are time-strapped, it is possible to achieve the same health outcomes at a shorter time frame through high-intensity interval training (HIIT).

Professional athletes have been utilizing HIIT for over a century. HIIT helped Sir Roger Bannister, Paavo Nurmi, and Steven Prefontaine achieve their note-worthy running times. But close to the turn of the millennium, HIIT became a hit among mainstream fitness enthusiasts through the work of Izumi Tabata, an exercise scientist and present dean of the Ritsumeikan University Graduate School of Sport and Health Science. His work helped convince the world that brief intense intervals could significantly improve cardio-respiratory fitness. 

Additional studies, including a few conducted by the physiologists running the Hacking Exercise for Health online course, have replicated the comparable impact of short high-intensity intervals for fitness relative to long periods of moderate exercise. In one study, they discovered the same fitness gains between one group that did 180 seconds of HIIT once a week for twelve weeks over another group that did 150-minutes of moderate exercise once a week over twelve weeks.

How can 180 seconds and 150 minutes of exercise both lead to the same fitness gains? The answer is in the intensity. The more fuel in the muscle is depleted through strain, the greater the adaptive response during recovery, and the more fitness gains are achieved. So, it does not matter as much how long it takes for the fuel to be depleted, but that it gets depleted. If you train hard for 180 seconds and properly deplete your cardiovascular or musculoskeletal stores, it’ll have a similar effect as a much longer exercise set. Part of the reason for this is also because high-intensity exercises activate both type-one or slow-twitch muscle fibres and type-two or fast-twitch muscle fibres, while slower workouts only activate type-one muscle fibres and are therefore not as efficient at depleting those energy stores. The bottom line is that when it comes to how much time you should devote to working out, quality trumps quantity.

By the time we reach the age of 40, we start to lose muscle mass and corresponding strength at about 1 and 3 percent a year respectively. This is known as sarcopenia. The toll will soon reveal itself when everyday activities are that much harder to perform, sometimes even requiring significant effort or causing unnecessary pain. Any physical movement we perform in the course of our daily lives uses our muscles. So, devoting time and attention to our musculoskeletal health by exercising goes a long way to helping us stave away sarcopenia and care for ourselves and others even up to the point of death from natural causes.

Our muscles – recall that they can be divided into type-one and type-two – are made of fibres and powered by proteins. Stressing these muscles through weights attracts additional proteins to the muscle fibres as they get bigger. This process, called hypertrophy, is what accounts for the size increase of the muscle from exercise. Recalling the concept of the 1RM, what then is the best ratio of 1RM to repetition for strength gains? Do we lift 80% 1RM at 5 reps, 40% 1RM at 20 reps, or something else? The answer is, in fact, anything that requires a high degree of effort from you. Optimization here may be useful for the professional athlete or bodybuilder. For the everyday person, however, as long as we empty the fuel tank, comparable strength gains will follow. A study published by the hosts of the MOOC, which has been replicated in other labs, supports this.

The research […] shows that it doesn’t matter how you fatigue all of the fibers in the muscle, whether you do it with heavier loads or with lighter loads. Whether you conduct three reps at 95 percent of 1RM, or 30 reps of 40 percent of your 1RM. So long as you’re lifting that load until you have a hard time lifting it again, then the same training adaptation happens and your muscles grow

Hacking Exercise for Health MOOC

Because muscles need protein to grow, we need to consume foods that have protein in them, i.e., poultry, tofu, nuts, lentils, etc. Protein consumption at the very least needs to be sufficient to outcompete muscle atrophy. In scientific parlance, you need to be in a state of positive net protein balance. So how much protein do we need to eat? The body cannot store excess protein and the limit of protein synthesis for the average person is 1.6 grams per kilogram per day. So, if you weigh 70 kg, your maximum effective protein intake per day is 1.6 x 70, which equals 112 grams. These 112 grams ingested from natural foods should take place about 24 hours after the workout. You can determine the protein content in foods from their nutrition labels, or with a google search. Supplements are unnecessary.        

Strength training workouts, at their most basic, can be understood with a two by three: push and pull, across the upper body, core, and lower body.

	Upper body	Core/Lower Back	Lower body
Push	e.g., push-ups	e.g., crunches	e.g., lunges
Pull	e.g., pull-ups	e.g., superman hold	e.g., leg raises

A good exercise routine will target all three areas of the body each week, and alternate between push and pull exercises to ensure no muscle imbalances, which may cause injury. Bodyweight exercises like squats, push-ups, pull-ups, planks, and lunges; as well as free weight exercises in all their colourful variations, hit all three areas. These workouts require minimal equipment – usually just a yoga mat, shoes, some assorted dumbbells, a kettlebell, and some exercise bands – and with the advent of video streaming technology, can easily be found on YouTube. I have personally found Fitness Blender and various training for climbing videos helpful. No expensive gym memberships required and no corresponding need to experience judgmental looks from some of the people who can be found in them (which this video game below parodies quite well).

So, it is not necessary to go into more detail here. Do not be discouraged if you are not able to replicate whatever the fitness trainer is doing in the video: adapt the routine to your fitness profile. Break down the workouts in the video by listing them down and making sure that you can perform each of them with proper form. Then bring them together to create your own routine, one that hits the two by three each week and tires you out good and proper.

You will be encouraged by your progress in due course. If you do not exercise regularly and/or are on the older side, i.e., above 50, and/or have preexisting health conditions that might affect your ability to work out without injury, consult a physician before starting, and when you do start, start slow. This is particularly important. You don’t want to sustain an exercise injury that sets you back months. Even as a relatively young person, I erred in judgement by doing HIIT jumping lunges before going for a run, and then rock climbing for several hours the next day (things I had never done in succession before). My legs refused to move the day after when I had to get back to work.    

You can use the FITT acronym to plan out the details of your weekly workout schedule. It stands for frequency, intensity, time, and type. As we have learned, frequency and intensity are far more important than time and type. So, if you are just starting out, don’t get stuck in analysis paralysis, just get out there and do something frequently and with passion. As you get into the rhythm and inertia of regular exercise, you can then work on a more detailed FITT plan that incorporates all your big muscle groups with a good dose of cardio.

There are several HIIT ready exercise regimes you can explore, including the 5BX, Tabata style circuit training, the scientific seven-minute workout, and others. Resources abound online. As you get stronger, progressing F/I and varying your workouts become important. Ramping up F/I is recommended because, after a while, exercises that were once taxing for you will no longer take your breath away. And remember that if you are not exerting proper effort to fatigue yourself, the workout is not going to be effective. This is why they should be getting progressively harder. Varying your workouts helps with the fatiguing process also because the body cannot rely on targeted performance adaptations to get through them. So, instead of just doing more standard push-ups, combine them with other kinds of push-ups, e.g., hold at the bottom of your presses, or use explosive force to push yourself up so that you can clap at the apex of your ascent.  

If there were a pill that encapsulated the benefits of exercise, it would be the most powerful pill in existence. Unfortunately, such a pill does not exist. In place of wishful thinking, here are a few tips to help us get on with working out. Find people who can keep you accountable, e.g., a weekly squash gang. Mix it up, variety is the spice of life, and this applies to exercise too. Consider using exercise trackers for motivation. Make it social by working out with other exercise enthusiasts. Some healthy competition can do wonders for motivation: look at all those white (i.e., Caucasian) white-collar marathon runners! Compile your own Get Psyched Mix. Watch the reality show Strong on Netflix (viewed June 2020), a show about elite personal trainers getting people into shape to compete in physical challenges over ten weeks, for inspiration, especially the transformation sequences at the end of each episode. Finally, do what you like to do.

There is no better motivation than to do something that you enjoy. When my friends introduced me to indoor climbing about a year ago, I did not expect to enjoy it as much as I did. But not only do I find it incredibly fun and rewarding, it offers a proper workout too. Lots of popular workouts are skewed toward pushing in the upper body. By contrast, climbing activates pulling muscles (creating that balance between agonist and antagonist muscle movements when combined with more traditional forms of exercise) and requires functional coordination of the entire body, from your fingertips to your arms, your shoulders, your chest, your back, your core, your legs, and your feet. And unlike some gym routines, climbing is not about aesthetics, it’s not about how big or symmetrical your muscles look, it’s about functional strength, i.e., whether you can corral all your physical and mental resources to get to the top of the wall. In this regard, you’ll soon realise that looks can be deceiving.   

In bouldering, i.e., climbing low hanging walls without a harness, there is an added factor of excitement from not knowing whether you’ll be able to complete some route without falling, and a proper sense of accomplishment when you top a boulder problem you didn’t expect you could. In addition, there are endless variations in routes. Route setters will routinely set new routes at these indoor gyms, each of them pegged at different difficulty levels so you can progress as far as you’d like. These variations ensure that your body cannot adapt to a certain set of movements as it might with more traditional forms of exercise, e.g., lifting, running, swimming, cycling, etc. Furthermore, climbing routes, especially bouldering routes, in short succession, are like performing mini HIITs: if you are climbing a route at your max difficulty level, you are exerting a lot of effort for the few minutes you are on the wall. Finally, climbing is mentally stimulating. Other climbers have remarked to me – and I feel this way too – that climbing is like trying to solve a puzzle with your body.

While I’m still relatively new to the sport and have not had the opportunity to climb in the past few months because of Covid-19, I intend to keep indoor climbing as an enduring feature of my weekly physical activity for the long term when the world returns to normal. In the meantime, I’ll just watch world-class climbers do their thing on YouTube             

If there is any takeaway from the Hacking Exercise for Health MOOC, it’s this: even a little exercise is better than nothing, and if you’re willing to work hard, 180 seconds of strength training plus 49 minutes of cardio a week (excluding warm ups and cool downs) is all you need to reap the awesome benefits of physical activity. So, whatever your fitness profile, JUST DO IT!