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Would You Opt for an Exercise Pill?

August 09, 2013

Story at-a-glance

  • Research shows that mice injected with a certain protein underwent physiological changes usually associated with exercise, including increased metabolic rates and weight loss. This may lay the foundation for an “exercise pill”
  • According to recent statistics, 79 percent of American adults aged 18 and over do not meet federal recommendations for physical activity for either aerobic and muscle-strengthening exercise
  • Compelling and ever-mounting research shows that the ideal form of exercise is short bursts of high intensity exercise. This can dramatically cut down the time you spend exercising while reaping greater results
  • For optimal health, you’d also be wise to incorporate aerobic, strength training, core exercises and stretching, for a well-rounded fitness program

By Dr. Mercola

Exercise is a key factor in achieving optimal health; it's particularly important for controlling your blood sugar and normalizing your insulin levels.

I often recommend viewing exercise as a drug that needs to be properly prescribed and "taken" at a proper dosage. When done correctly, exercise can oftentimes act as a substitute for some of the most common drugs used today for things like diabetes, heart disease and depression.

Alas, a side effect of our modern quick fix culture is that many still wish for the benefits of exercise to be delivered in the form of a pill, and researchers are actually hard at work trying to concoct such a thing...

In fact, as reported by the featured article in The Atlantic,1 researchers at the Scripps Institute in Florida suggest2 we are "closer than ever to attaining this goal."

"They found3 that mice injected with a protein called REV-ERB underwent physiological changes usually associated with exercise, including increased metabolic rates and weight loss. Even obese, inactive mice experienced these changes," the featured article states.

Americans Don't Move Enough; Could a Pill Help?

While data from the US Census Bureau's American Time Use Survey4 (cited by the featured article) shows that Americans report exercising about three times more today than 40 years ago, averaging about two hours of exercise per week, Americans still fall far short in terms of getting the physical activity required for weight maintenance and optimal health.

For example, according to recent statistics from the Centers for Disease Control and Prevention5 (CDC), the majority—79 percent—of American adults aged 18 and over do not meet federal recommendations for physical activity for either aerobic and muscle-strengthening exercise, which include getting:

  • At least 2½ hours a week of moderate-intensity aerobic activity or one hour and 15 minutes a week of vigorous-intensity aerobic activity
  • Muscle-strengthening activities that involve all major muscle groups, twice or more per week

Similarly, of the 450,000 respondents participating in the Behavioral Risk Factor Surveillance System, an annual CDC phone survey of adults, only 52 percent said they meet the aerobic activity guideline, and only 29 percent reported meeting the muscle-strengthening activity recommendation. Disturbingly, as reported in a previous article in USA Today,6 other studies suggest Americans are even more sedentary than what these statistics show:

"Scientists with the National Cancer Institute, using actual motion sensors, found that fewer than five percent of adults in the USA get at least 30 minutes a day of moderate-intensity physical activity in bouts of at least 10 minutes." [Emphasis mine]

When severe lack of exercise is combined with an unhealthy high-carb, processed food diet, you're bound to end up with excess body fat... Indeed, as of 2009, nearly 27 percent of the US population fell into the obese category. And in a shocking health report card published in September 2012, the Robert Wood Johnson Foundation and the Trust for America's Health7 predicted that half of all American adults will be obese by 2030 if we keep going the way we are.

Clearly, a great many people struggle with weight issues. But to think that an "exercise pill" will be able to save you from the hassle of having to break a sweat is just as delusional as believing that swallowing a pill will solve your weight loss challenge.

There is simply no way a pill will be able to stimulate your muscle to provide the complex physiology they need to provide you with optimal health. Aside from not being able to achieve its goal, you would have to address the inevitable side effects from seeking to fool your body with a pill.

Don't Fall for Delusional Fantasies...

The featured article gets you to spin thoughts about "what you could do with two extra hours per week," were you able to just pop a pill instead of hitting the gym:

"Moreover, we would not need to shoulder the burden of guilt that many of us experience due to insufficient exercise levels. No longer would we feel compelled to avoid looking in the mirror in the morning or avert our eyes as we drive past a health club teeming with fit and trim exercise enthusiasts. Such guilt cannot be good for us, likely elevating the levels of stress hormones in our bloodstreams and undermining the self-confidence we depend on in so many other spheres of life," The Atlantic writes.

To make good use of a modern acronym: LOL! The article paints an even more utopian picture (or perhaps dystopian, depending how you look at it), completely void of biological reality, when it states:

"Despite No Child Left Behind and other federal legislation that sought to focus school curricula on reading, writing, and arithmetic, school children all over the country are still spending precious hours exercising during recess and gym, instead of hunkered down over their textbooks augmenting their vocabularies. Thanks to the exercise pill, our children will be able to devote all their time and attention to the part of the body that matters most, above the shoulders."

At this point, you would be excused for thinking that I must be quoting something out of the satirical paper The Onion... Yet many probably do think this way, and only need a tiny bit of encouragement to fall for the fantasy, hook, line, and sinker. But believe me; you simply cannot fool your body in the long term. Even if you were to overlook the potential for side effects (and they will surely exist), would an exercise pill really work?

Taking a Pill Is Not Exercise

A pill may mimic a specific biological effect that exercise produces, such as increasing your metabolic rate, but it will never provide you with ALL the health effects exercise provides, which go far beyond any one effect. Exercise has countless effects on your body -- not only on your muscle fibers but also on your brain, your immune system, your ability to fight cancer, depression and much more. To "mimic" all of these benefits you would literally need handfuls of different pills -- and even then they could never reproduce the synergistic benefits that exercise has on your body and mind.

For example, research published in the journal Cell Metabolism8 shows that when healthy but inactive people exercise intensely, even if the exercise is brief, it produces an immediate change in their DNA. While the underlying genetic code in the muscle remains unchanged, exercise causes important structural and chemical changes to the DNA molecules within the muscles, and this contraction-induced gene activation appears to be early events leading to the genetic reprogramming of muscle for strength, and to the structural and metabolic benefits of exercise.

Several of the genes affected by an acute bout of exercise are genes involved in fat metabolism. Specifically, the study suggests that when you exercise, your body almost immediately experiences genetic activation that increases the production of fat-busting proteins. Previous studies have identified and measured a wide variety of biochemical changes that occur during exercise. More than 20 different metabolites9 are affected by exercise, including compounds that help you burn calories and fat, and compounds that help stabilize your blood sugar. These biochemical changes create a positive feedback loop.

Will an exercise pill be able to affect all those metabolites?

Furthermore, one of the key health benefits of exercise is that it helps normalize your glucose and insulin levels by optimizing insulin receptor sensitivity. This is perhaps the most important factor for optimizing your overall health and preventing chronic disease. But that doesn't mean you need to spend multiple hours in the gym each week. The most recent research shows that relatively short bursts of intense exercise—even if done only a total of a few minutes each week—can deliver many of the health and fitness benefits you get from doing hours of conventional exercise.

How to Optimize Results from Your Exercise

High intensity interval training (HIIT), which is a core component of my Peak Fitness program, is key for reaping optimal results from exercise. There are many versions of HIIT, but the core premise involves maximum exertion followed by a quick rest period for a set of intervals. My Peak Fitness routine uses a set of eight 30-second sprints, each followed by 90 seconds of recovery, as taught by Phil Campbell who is a pioneer in this field. Also, while I typically recommend using an elliptical machine or recumbent bike, it can be performed with virtually any type of exercise; with or without equipment.

Ideally, you'll want to perform these exercises two or three times a week for a total of four minutes of intense exertion, especially if you are not doing strength training. You do not need to do them more often than that however. In fact, doing it more frequently than two or three times a week can be counterproductive, as your body needs to recover between sessions. If you want to do more, focus on making sure you're really pushing yourself as hard as you can during those two or three weekly sessions, rather than increasing the frequency.

Intensity is indeed KEY for reaping all the benefits interval training can offer. To perform it correctly, you'll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 seconds. Here's a summary of what a typical interval routine might look like using an elliptical:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should be gasping for breath and feel like you couldn't possibly go on another few seconds. It is better to use lower resistance and higher repetitions to increase your heart rate
  • Recover for 90 seconds, still moving, but at slower pace and decreased resistance
  • Repeat the high intensity exercise and recovery seven more times

When you're first starting out, depending on your level of fitness, you may only be able to do two or three repetitions. As you get fitter, just keep adding repetitions until you're doing eight. For a visual demonstration, please see the following video.

Aim for a Well-Rounded Fitness Program

While high intensity interval exercises accomplish greater benefits in a fraction of the time compared to slow, endurance-type exercises like jogging, I do not recommend limiting yourself to a few minutes of exercise per week. If that's all you have for now, then by all means, do what you can. But ideally, to truly optimize your health, you'll want to strive for a varied and well-rounded fitness program that incorporates other types of exercise as well. Without variety, your body will quickly adapt. As a general rule, as soon as an exercise becomes easy to complete, you need to increase the intensity and/or try another exercise to keep challenging your body.

I recommend incorporating the following types of exercise into your program:

  1. Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods.
  2. Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you're really optimizing the possible health benefits of a regular exercise program. You can also "up" the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
  3. Avoid Sitting for More Than 10 Minutes. This is not intuitively obvious but emerging evidence clearly shows that even highly fit people who exceed the expert exercise recommendations are headed for premature death if they sit for long periods of time. My interview with NASA scientist Dr. Joan Vernikos goes into great detail why this is so, and what you can do about it. Personally, I usually set my timer for 10 minutes while sitting, and then stand up and do one legged squats, jump squats or lunges when the timer goes off. The key is that you need to be moving all day long, even in non-exercise activities.
  4. Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.
  5. Foundation Training, created by Dr. Eric Goodman, is an integral first step of a larger program he calls "Modern Moveology," which consists of a catalog of exercises. Postural exercises such as those taught in Foundation Training are critical not just for properly supporting your frame during daily activities, they also retrain your body so you can safely perform high-intensity exercises without risking injury.

    Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.

  6. Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching, you hold each stretch for only two seconds, which works with your body's natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.

Are You Stuck with Stubborn Pounds Despite Exercising?

As mentioned earlier, one of the key health benefits of exercise is that it helps normalize your glucose and insulin levels by optimizing insulin receptor sensitivity. This is perhaps the most important factor for optimizing your overall health and preventing chronic disease. A pill might be able to mimic a specific biological effect that exercise produces, such as increasing your metabolic rate, but it will never provide you with ALL the health effects exercise provides, as the sum is greater than the individual parts.

So, while I often recommend viewing exercise as a drug that needs to be properly prescribed and "taken" at a proper dosage, I stand firmly against any notion that you might be able to forgo physical exercise by taking a pill.

If you're in the minority of people who exercise regularly yet are still struggling with your weight, it's probably due to your diet. Diet actually accounts for 80 percent of the health benefits you reap from a healthy lifestyle, so along with exercising, make sure to address your diet as well. My Optimized Nutritional Plan can take you through each step in an orderly fashion, free of charge, starting from the beginner's level, through intermediate and advanced.

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Sources and References

  • 1 The Atlantic July 18, 2013
  • 2 Nature Medicine July 14, 2013 [Epub ahead of print]
  • 3 Nature Medicine July 14, 2013 [Epub ahead of print]
  • 4 American Time Use Survey User’s Guide, June 2013 (PDF)
  • 5 USA Today May 2, 2013
  • 6 See ref 2
  • 7 Trust for America's Health, September 2012, “F as in Fat”
  • 8 Cell Metabolism March 7, 2012: 15(3);405-411
  • 9 Science Translational Medicine May 26, 2010; 2(33):33ra37
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