Tag Archive for: exercise

Knowledge Isn’t Enough

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In the study on colon cancer and exercise, there was one more difference: those who were in the structured exercise study had fewer deaths over the follow-up period than those who were given the same materials on exercise and nutrition but no supervision or regular contact with experts. The difference between the two groups was just over 6% fewer people dying of colon or any forms of cancer in the structured group than in the information-only group.

Because they tested all subjects regularly, there were a few things that stood out to me. First, there were more subjects participating in the follow-up testing in the structured group than in the information group. While the difference was small, fewer than 15 subjects each time, it appeared that the structured program kept people involved at a higher rate.

The second observation was that the six-month check-in session was the most well attended at over 80% in the structured group. Both groups declined in participation at about the same rate after that, but the initial difference was maintained better in the structured group. In other words, the subjects maintained their lifestyle changes throughout the entire follow-up period better than the information-only group.

My interpretation is that the initial structure and personalized attention was important in maintaining lifestyle changes, better than just reading material alone. It’s not just about the information; it’s being able to internalize the lifestyle into everyday life. It would appear that the changes last—not perfectly—but better than just reading a book or following a scripted program.

In the Insider Conference Call next Wednesday, October 21, I’m going to address two topics in detail. On Monday I had successful surgery to remove a swollen parathyroid gland, and I’ll explain the importance of the parathyroid gland to your overall health but especially your bones. I’m also going to talk about screening for lung cancer after the Pope’s recent surgery. The Guest Pass is available for this conference call and I’ll also be answering Insider and Guest Pass holder questions.

What are you prepared to do today?

        Dr. Chet

GuestPass

P.S. Get access to the next Insider Conference Call for only $9.95 for a wealth of knowledge. So join me on Wednesday, October 21, 2026, at 9 p.m. Eastern Time to learn live and in person; you’ll also get an opportunity to listen during the following week.

Reference: N Engl J Med 2025;393:13-25. DOI: 10.1056/NEJMoa2502760

Exercise and Colon Cancer

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Most research points to exercise being beneficial to prevent most types of cancer, including colon cancer. Does exercise help reduce the mortality of people who have had severe cases of colon cancer after surgery and chemotherapy? That was the question researchers in Canada asked, and they conducted the Colon Health and Lifelong Exercise Change (CHALLENGE) trial to test their hypothesis.

Researchers recruited subjects who met the criteria from 55 centers, mostly in Canada and Australia, but also included some in the U.K., U.S., and other countries; 889 subjects were selected for the three-year trial. All subjects were provided health education materials on exercise and nutrition. Half of the subjects were randomly assigned to the intervention group that was given exercise support in the form of mandatory exercise sessions and support from a certified exercise specialist. All subjects were tested every six months until the end of the trial.

The primary finding was that all subjects benefitted from the exercise program. The reduction in mortality over three years was about 17% for both groups. But was knowledge about exercise alone enough? I’ll let you know on Saturday.

In the meantime, are you due for a colonoscopy? Paula just had hers, and as always, the prep is worse than the procedure, but it feels so good to get that “all clear” verdict.

What are you prepared to do today?

        Dr. Chet

Reference: N Engl J Med 2025;393:13-25. DOI: 10.1056/NEJMoa2502760

Your Independence Inventory

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I’m breaking this into two separate inventories: your physical inventory, focusing on muscles bones and joints, and your logistics inventory. Let’s begin with your physical inventory. To make this easier, we created a printable checklist that you’ll find in the Basic Health Info section of drchet.com.

Physical Inventory

Let’s start with some of the factors that can impact your ability to exercise, whether that’s getting fitter, stronger, or more flexible:

  • Can you sit and stand without assistance? Do you need assistance whether in the form of a walker or arms on the chair? All of those require basic muscular strength and balance.
  • Can you walk without assistance? How about with assistance? How far can you walk? I know this sounds so basic, but everyone starts somewhere. How fast you can walk also matters.
  • Can you bend over at the waist? Do you lose your balance if you do that? How about squatting? Full squat, half squat, quarter squat, or not at all?
  • Can you get on an exercise bike or an elliptical trainer or a treadmill? In order to use them, you have to be able to balance well enough to get on them first. If you’ve never been on a treadmill, you don’t really know whether that’s possible for your fitness program or not. Some people have balance issues they never knew existed.
  • Can you stand in place with your eyes closed, or do you get dizzy? Can you touch your finger to your nose with your eyes closed while holding your arms horizontal to the floor? This test may be associated with assessing your degree of drunkenness, but you’ve got to be able to do it sober first.
  • Can you raise your arms above your head? Can you bend your arms at the elbow? Can you do a bicep curl with a can of vegetables? Can you lift it above your head?
  • Can you usually grip the lid of a sealed jar well enough to open it? Everyone’s grip strength deteriorates over time, so it’s important to know where you rate.
  • Can you get on the floor on your hands and knees? Can you lie face down on the flood? Can you lie face up? Can you get up off the floor without leaning on any piece of furniture?
  • Can you walk up a flight of stairs? Can you walk up a single stair and step down again?

Logistics Inventory

Logistics for getting healthier requires that you assess your assets and liabilities. You’ve got to know whether you have the time, the equipment, the time, the space, the time, the gym membership, the time… Are you getting the idea that time is important here? That’s the single biggest reason people quit an exercise program, and for most, it’s the reason they never start.

  • Do you have the time in your schedule, while getting reasonable sleep, to exercise? Early in the day? Lunch? Before dinner? In the evening? Every day? Three days per week? Does it depend on your children’s after-school activity schedule?
  • What equipment do you have? Do you like it enough to use it? Do you have exercise tubes or bands? Weights like dumbbells or barbells? Do you have mats for floor routines? Do you like exercising while watching videos or do you prefer music?
  • Are you a member of a gym or club? Can you get there on a regular basis? Is there enough equipment to do what you like to do? Does it have a pool in case swimming is your thing?
  • Do you have the time to prepare meals if eating better is your goal? Do you have a selection of the right tools to cook well? It’s easier if you have the right spices, knives, cookware, and cook wear (might as well have a cute apron). Do you have the budget to buy healthier ingredients?
  • What are you willing to eat on a regular basis? I’ve made it clear I’m not drinking smoothies or eating bars, at least, not very much. That means it takes more time for prep and cooking.
  • If you’re not exercising at home, is your car dependable?
  • Do you live in a safe neighborhood to walk or jog?

Those are just some of the logistical factors to consider before you get to working toward your health goals.

If you’re thinking this is just for old people, nope—I suggest you do this no matter what your age. Mark your calendar to inventory your physical state every year when you get your annual physical. You may find that although you’re only in your 30s, you can’t easily get up off the floor. The time to work on that is now; don’t wait another decade or two to work on your physical independence. You’re building your health future. Take a full inventory before you start your plan; that’s the way to gain the health independence we all want to have.

What are you prepared to do today?

        Dr. Chet

Time to Take Inventory

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After last week’s Memo on Independence, I decided to follow it up with some thoughts on where to begin the quest for independence. Nobody is beginning at absolute zero. Regardless of where you stand (or sit) with your health, it’s time to take an inventory.

I could include everything from lowering cholesterol, sleeping better, or reducing medications, but those are discussions you need to have with your physician first to see if what you’re planning to do is reasonable. They know what health issues you’re facing, from auto-immune diseases to type 2 diabetes, and even more. For example, if you have a genetically determined high blood pressure, you may have to stay on medications no matter how much weight you lose and how fit you become. I would start with a consultation with your physician or healthcare professional.

Once you’ve done that if it applies to you, it’s time to take inventory, both physical and logistical. We’ll do that on Saturday.

What are you prepared to do today?

        Dr. Chet

Adaptation: Exercise

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I can’t think of a better example of positive adaptation than exercise. Whether it’s a sport skill, increasing strength, or improving cardiovascular fitness, exercise uses the adaptation principles; the difference is that it’s an intentional act instead of a response to a physical challenge. As an example, let’s use walking or running to improve the fitness of your heart and cardiovascular system as well as every other system involved—which is just about every other system we have.

Let’s begin with how your cardiovascular system would respond to beginning a walking or jogging program. The first walk with a purpose—faster than window shopping and not so fast that you’re stopping to catch your breath every minute—every system in your body is going, “What the heck is going on here?” Your heart may not be used to speeding up like that. The blood isn’t used to traveling that fast. The 5,000 genes that are typically activated when you start to exercise are awake and alert. Your muscles, ligaments, tendons, and stress hormones are challenged, along with the nervous system that controls how the muscles respond to new movement. It’s a mess, but you manage to get through it.

Depending on how hard you pushed yourself, you may feel it. Maybe fatigue a few hours later or sore muscles. That’s why you begin slowly. Save the fastest you’ve ever walked or ran for another time, and get through this first walk.

But by the third walk, your body will start to adapt; your heart rate might not get as high. By the 10th walk, you most likely will be able to maintain a faster pace, but your heart rate may not be as high as the first walk you took at a slower pace. You’re adapting—in fact every system in your body is adapting to the new stress. It will take less effort to do the same work.

You’re not ready for a marathon or maybe even a 5K yet, but exercise is a positive utilization of the adapting ability of your body. You just have to approach it in a systematic way to improve your cardiovascular health.

If you’re the kind of person who needs to see progress to keep going, track your distance, time, heart rate, and so on, but don’t let a few down days discourage you. Sometimes your body needs a bit of time to catch up; stay the course and you’ll soon see improvement again. On the other hand, if you’re the kind of person who hates record-keeping, you’ll still notice improvement—maybe you’ll walk your usual 30 minutes and feel like going another five, or you’ll realize you’re not breathing as hard as you were a month ago. Do what works for you.

I intentionally sent this Memo one day sooner because this is Memorial Day weekend in the U.S. While we celebrate and cherish those who’ve fallen in defense of our country with quiet moments, parades, and fireworks, use the three days to start your fitness program by going for a walk every morning, as long as your physician has no objections to your exercising. By the time you read Tuesday’s memo, you could be on that path to adaptation and a better healthspan than you are right now.

What are you prepared to do today?

        Dr. Chet

You’ve Got Another Chance

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Did you assess your time spent investing in your health as I outlined in Tuesday’s Memo, counting up the time per day, week, or month you spend in the activities that will benefit your long-term health? How did you do? Did you think of more than the short list I provided? Did you come away disappointed with your efforts? I know that I did in some areas.

Life is giving you another chance—in fact, it’s giving you more than one. As long as you draw breath, you can always start. You don’t even have to wait until the new year; pick one thing and begin working on it today. Then, when that change becomes a habit, start on another one. You don’t have to begin everything all at once; in fact, it’s better if you try one change at a time and see how that works before adding more.

If you fail, start again. As Seth Godin said in a recent post, everyone needs more chances. But whether this is the time you actually lose the weight, lower your HbA1c, add that muscle, or whatever is important to your long-term health, taking that next chance is determined by only one thing:

What are you going to do with that chance this time?

It doesn’t matter what you haven’t done—you need to succeed only once at changing a poor health habit into a good one that you will maintain. Take that chance and do something with it this time. Next year, we all could be having completely different conversations. So, really:

What are you prepared to do today?

        Dr. Chet

How Much Time Did You Invest?

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As the new year approaches, it’s a good time for reflection. Regardless of your age, taking care of your body should always be a top priority, so let’s assess 2024. Here’s a series of questions—not a complete list by any means, just a place to begin. The overall question is this:

How much time do you spend each day taking care of your body?

How many minutes do you spend on aerobic exercise?

How much time in resistance exercise to maintain or gain muscle?

How much time stretching to maintain flexibility?

How much time massaging your aching muscles?

How much time do you spend cooking foods with natural nutrients?

How much time recording the foods that you eat?

How much time flossing and taking care of your teeth?

How much time caring for your skin?

How much sleep are you getting?

These are not just rhetorical questions. Spend some time thinking about it. Add other questions related to how you take care of your body or issues you’ve been having. Write down the minutes per day you spend in each one of those areas. Do it for the next three days, and you’ll see where you stand now and where you can improve.

You get out of your body what you put into it. You need to think and assess so you can identify what you need to work on in 2025.

This year’s final Insider Conference Call is tomorrow night. The main topic is going to be why research on science should never stop or slow down. This is the time to become an Insider to help you achieve your health goals in 2025. Join by 8 p.m. ET tomorrow night and you’ll be a part of the call.

What are you prepared to do today?

        Dr. Chet

Do Weekend Warriors Improve Their Health?

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Let’s finish the week with a question no one asked but was the topic of a recent study: what’s better for your health—being a weekend warrior or working out according to established guidelines? The major component of the guidelines is more than 150 minutes of moderate to intense exercise a week spread out over most days of the week. Turns out, they are both effective, but let’s take a closer look.

The Study

The UK Biobank data are connected to the medical records of all people in the UK, making it an excellent source for studies. This observational study used data collected on close to 90,000 subjects who wore an accelerometer for a week sometime between 2013 and 2015; they were tracked for at least six years. Researchers tracked the diagnosis of over 678 conditions and compared those who exceeded the minimum of 150 minutes of moderate to intense exercise, either over a weekend or stretched over a week, with those who exercised fewer minutes.

The weekend warriors had reduced Hazard Ratios for 264 conditions and regular weekday activity had reduced Hazard Ratios for 205. Most of the benefits were associated with cardiometabolic metrics such as hypertension, resting heart rate, and type 2 diabetes. When compared head-to-head, there were no conditions where the weekend warriors and the regular exercisers differed.

What Should I Do?

I wouldn’t change anything you’re currently doing as long as you’re getting more than 150 minutes of moderate to intense exercise every week. We don’t know the activities involved in either—just that the accelerometer showed they were moving.

What it can mean is that for those who are playing basketball or soccer for a couple of hours a day on the weekends, you’re getting some benefit. It also means if you have a two-hour trail walk you like to do on weekends, it can help reduce your risk of cardiometabolic diseases.

The Bottom Line

What I really think it illustrates is that any movement is good movement, and if you can’t work in as much exercise as you’d like during the week, you can make up for it on the weekend. I would have liked to have seen the different activities involved and any orthopedic injuries associated with the activities, but let’s take the win. Just get moving and stay moving during the week or packed into a weekend. Or—maybe—both! Go get ’em, you warriors!

What are you prepared to do today?

        Dr. Chet

Reference: https://doi.org/10.1161/CIRCULATIONAHA.124.068669

I’m Alive: V2.55

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When I opened my eyes this morning, I knew I had another year to do what I was created to do: teach people how to be healthy and fit. For those of you who are new readers or those who need a refresher, here’s the story: when I wake on May 10th every year, my superstitious belief is that I have at least one more year to live. My dad died on May 10, 1969. In case you’re wondering, I’m version 2.0 (my father was the first Chester John Zelasko), and it’s been 55 years since my father died. It makes no sense in the real world, especially for a guy who’s a scientist, but every May 10 is a milestone for me.

Last weekend as I pulled into the parking lot where I work out, there was an SUV with a number of plastic bags on the roof arranged in no particular order. As I walked past it, I couldn’t help but notice the car was packed to the ceiling, including the passenger’s seat. In fact, it encroached on the driver’s seat. I don’t know how anyone drives without being able to see the rearview or sideview mirrors, but I guess that person somehow managed. I could speculate whether they were moving or living in their car, but here’s how I saw it.

We all carry the baggage with us—memories of every time we didn’t complete a goal we set, especially health goals. We know the foods we should eat and the ones to avoid. We know that exercise will make us fitter, stronger, and more flexible. We know we have supplements and/or medications we should take for our health or to deal with conditions we may have. In retrospect, we ask ourselves why? Why don’t we do that?

It may not be the only reason or reasons, but I think we carry the baggage of past failures with us. And we continue to lose fitness, strength, and on and on. You know the worst sentence I can think of? “What difference will it make now?” It will make a huge difference. Can you walk your daughter down the aisle, or will you need a walker? Will you need a wheelchair in five years, or can you postpone that? Will you still have the flexibility 15 years from now to take care of your own personal needs, or will you need someone else to bathe you and clip your toenails? In 20 years, will you still be chugging along, or will you be so heavy you can’t stand up without help? I can think of hundreds of examples, but insert your own. It matters.

The important point is that you can change your trajectory. Joining a workout group or taking charge of your diet can make a world of difference in your future, so stop putting it off till next month.

I have my own baggage to deal with, so this version is going to overcome as much of it as I can this year. I’m going to spend the year encouraging you to do the same. We have things to do, and we just have to find a way to drop the baggage and get out of our own way to be the next version of ourselves. All the people who need you will be glad you’re making the effort.

What are you prepared to do today?

        Dr. Chet

Your Last Resort

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Did you ever have one of those days where you just didn’t have it?

  • Maybe you wake up just a little later than expected.
  • Maybe your energy got up and went before you had a chance to get up and go.
  • Maybe everyone in the world seemed to want a piece of you today—and they succeeded.
  • Maybe nothing you wanted to do got done.

What do you do? Here are some ideas:

  • Put on some weather-appropriate clothes and go for a walk.
  • Get on the exercise bike and move those legs.
  • Grab the dumbbells and work those biceps and triceps.
  • Or just get up and sit down 25 times to work those quads.

It doesn’t matter what type of exercise you do, but get that one thing done and you’ve done something positive you can feel good about. It may do wonders for you mentally and make the day a success, or at least not a total loss. Use exercise as the last resort to rescue your day.

What are you prepared to do today?

        Dr. Chet