#229 Just Thinking You Should Exercise More May Cause an Early Death

Just Thinking You Should Exercise More May Cause an Early Death

Do you ever feel like you should exercise more?  If so, you may have just increased your risk of an early death by 71% according to a new Stanford study.  In this article, I’ll review this latest study and offer practical tips to a more mindful approach to physical activity.

Kristen’s Experience

Like most young moms, Kristen had too many things on her plate.  Trying to care for small children while at the same time meeting her employer’s demands and somehow also finding the time to get to the gym was too much.

She knew she should exercise more.  However, there just were not enough hours in the day.

The guilt and shame that came from the feeling that she was slacking off on her exercise worried her.  This worry ultimately led to heart palpitations, an emergency room visit, and then to a consultation with me.

Fortunately, all of Kristen’s tests came back normal.  Knowing that her heart was still strong allowed me to help her develop a more practical and mindful approach to physical activity.

The I Should Exercise More Study

In another brilliant study on the mindfulness component to physical activity, Dr. Alia J. Crum and colleagues from Stanford University tackled the health risks that come from guilt and shame.  To address these health risks, Dr. Crum studied 61,141 Americans over the course of 21 years.

In this study, Dr. Crum asked participants how they felt about the amount of exercise they were doing in comparison to others.  Interestingly, those who felt that they just weren’t exercising enough were 71% more likely to die over the 21 years of the study.

What makes Dr. Crum’s study really interesting is that even if you were exercising, eating right, and maintaining a healthy weight, just thinking you were slacking off on your exercise increased your risk of dying prematurely. This study highlights the importance of a mindful approach to exercising.  It also raises the possible dangers of a nocebo effect.

The Nocebo Effect

While everyone has heard of the placebo effect, many of you may not be aware of the flip side which is the nocebo effect.  With the placebo effect, the mere thought that a food, supplement, medication, or procedure will help you causes it to be a self-fulfilling prophecy.

For example, studies show that a “dummy pill” can actually be curative in up to 62% of cases.  Studies like these highlight the untapped power of the mind to heal us.

However, their is a flip side to the placebo effect.  It is called the nocebo effect.  With the nocebo effect, people who believe that a food, supplement, medication, or procedure will harm them also causes it to be a self-fulfilling prophecy.

I see the nocebo effect everyday in my cardiology practice.  People who are convinced that a treatment won’t work for them are generally right.  Conversely, those people who are convinced that a treatment will work are also generally right.

While the mind can heal us it can also cause disease.  This study from Dr. Crum and her team at Stanford University raises the question that the feeling we just don’t measure up when it comes to exercise may put our hearts and our lives at risk.

Eliminate the Word Exercise

I wish we could eliminate the word exercise from the English language.  The problem is that when many people hear the word they immediately feel guilt and shame from not measuring up.

Too often, when we hear the word exercise we feel like we should be going to the gym more often.  While hitting the gym is a great way to exercise, it is also a huge time commitment.

Most busy people that I know don’t have one to two extra hours to spend at the gym everyday.  Not to mention the fact that many people, myself included, hate going to the gym.

Replace Exercise with Physical Activity

The solution is to replace the word exercise with physical activity.  Physical activity doesn’t carry all of the guilt and shame that exercise does.  It is also something that is much more practical.

For example, if the goal is physical activity then you will probably be much more likely to take the stairs, rather than the elevator.  Also, if the goal is physical activity then you will be much more likely to walk over to a colleague or a neighbor than to use the phone, email, or a text message.

With a mindfulness based approach, we can reengineer physical activity back into our lives.  Exercise is modern day phenomenon.  Historically, our ancestors didn’t exercise. Rather, they were just physically active throughout the day.

Physical Activity in China’s Longevity Village

If you were to ask any of the centenarians in China’s longevity village what they do for exercise, they would look at you like you were crazy.  No one exercised in the village.  It never even occurred to them that they should be exercising.

The people in Longevity Village were physically active throughout the day.  From the moment the sun rose until it set at night, their lives were in a state of continual motion.  This perpetual physical activity helped them to escape most of the medical conditions that plague us in the modern world.

To better understand the people in China’s Longevity Village, as well as to learn the seven principles that may allow you to thrive to age 100 and beyond, please read our new book, The Longevity Plan.

Practical Tips

As the thought I should exercise more may put you at risk of an early death, let me offer a few practical tips.

1. Set realistic expectations.

If you have a young family and a busy job, it will be hard for you to get to the gym.  Likewise, if you are older and have mobility issues, it will also be hard for you to make it to the gym.

Rather than beat yourself up about not exercising enough, set realistic expectations.  Start first with the simple things you can do to reengineer physical activity back into your life.

For example, if you have young children could you push them in a jogger stroller or pull them in a bike trailer?  If your children are older, could you go on family bike rides?

At work, could you commit to never taking the elevator again?  In addition, could you set your smartwatch or smartphone to remind you to get up and walk every 30 minutes?

At home, could you get rid of the TV remote control?  Even better, could you either get rid of your TV or replace your couch with a treadmill?  This would at least force you move your body more.

The key for busy people is to make the world “your gym.”  If you view the world as your gym then it won’t be hard to reengineer physical activity back into your life.

2. Give yourself credit for what you are already doing.

Many people are too hard on themselves.  Just like the 61,000 people in Dr. Crum’s study, many people are always comparing themselves to others.

Just because your friend is always wearing their workout clothes doesn’t mean they are any healthier than you are.  Stop comparing yourself to other people.

Carrying a young child in your arms all day long may be a better work out than lifting weights at the gym.  Likewise, walking up the stairs to the tenth floor may be a much better workout than the stair master or elliptical machines at the gym.  Even the movements of yard work or house work may be as effective as stretching at the gym.

The importance of giving yourself credit for the physical activity you are already doing was brought home in a previous study by Dr. Crum.  In this study, she studied hotel housekeepers.

These hotel housekeepers had a physically demanding job.  Despite all of the physical activity associated with their jobs, they didn’t give themselves credit for this physical activity in their minds.  Thus, they suffered from a myriad of chronic medical conditions.

However, once Dr. Crum educated them about the huge amounts of physical activity they were already doing, everything turned around for them.  Suddenly, many of their chronic medical conditions started going away. This study reminds us that for the full benefit of physical activity, we need to give ourselves credit for what we are already doing.

3. Track yourself.

Tracking brings awareness.  For many of us, life is kind of a blur.

Studies show that the mere act of tracking your steps subconsciously increases your daily step count by 2,491 steps!  When you do the math, 2,491 steps translates into walking more than one extra mile each day.

I can’t think of an easier way to boost your physical activity.  Just tracking yourself increases your daily walking by more than a mile with absolutely zero willpower required.

Long-term, tracking your physical activity could lead to the same scenario of “should exercise more.”  With a more mindful approach to physical activity, you don’t need to track yourself forever.  Just periodically check in to see if you are still on track.

As many people feel they should exercise more, probably an equally high number of people overestimate their physical activity.  In my experience, not giving yourself enough credit and overestimating what you really are doing should both be avoided for optimal health and longevity.

What do you think?

What are your thoughts about this Stanford University study?  Do you agree with their findings?

Please leave your thoughts and questions below.  As always, I will do my very best to answer every question in a timely manner.

Also, if you have not picked up a copy of our new book, The Longevity Plan, or signed up for our free weekly newsletter and podcast, please do so now.

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  1. Just a related aside: From my reading, I gather that medical professionals have wide and varied opinions on several topics: soy products, testosterone supplementation, cholesterol levels, etc. Here’s one I’ve wondered about, and thought I’d get your input as of now: daily aspirin intake. Some doctors STRONGLY recommend taking 81 mg. (or sometimes twice that) for cardiovascular health, cancer prevention, etc. Other doctors (like cardiologist Stephen Sinatra) are far more hesitant, citing internal bleeding issues, etc. Comments? Thanks, jt

  2. Love this article. This is exactly what my Physical therapist says. Interesting though..I have 4 kids. I was physically active. I had unexplained pain according to the doctor. Migraines ,dislocating jaw,dislocated back,neuropathy etc..,idiopathic blood history.I grow a big garden,mow 3 acres with push mower,rack leaves etc..My doctor said I didn’t exercise and needed to do more to improve my heath. Started running and lost more weight ( 80 lbs) My blood pressure was under 90 . Started blacking out really bad. Knees started dislocating. My Doctor said I was over weight. My heart monitors were abnormal. I had PVC’s bradycardia ,tachycardia, Echos showed leaking heart valves but no prolapse. Medical field totally dismissed me . Dislocating hip added to the bunch,shoulder,elbows ,neck. Family history of bicuspid aortic valve mitral valve prolapse,congestive heart failure -disease,heart valve replacement,pace maker,dysautonomia ,POTS. I was finally diagnosed with dysautonomia,POTS by Roy Freeman in Boston and Dr Joel Krier finally diagnosed Ehlers at Bringham in Boston. This all took 30 yrs after being told I was crazy . Since my echo says I am just leaky do I need to worry about anything else. Eye doctor and me are positive that I have a leak from high pressures,leaking out my nose and hydrocephalus. Cardio dismissed me and said this was way too complicated for them. It has taken 7 yrs to get into Boston for Roy Freeman and still waiting for follow up. Knowing this about my family history am I still at any risk ? All 4 of my kids have hypermobility . I took my son to peds cardio and he chewed me out and told me to not come back. My kids do show signs of POTS and I am worried but surrounded by pretty ignorant medical people here in Maine . I met Hal Dietz 2 yrs ago just to throw that in. Connective tissue clinic held here in Bar Harbor Maine. Brilliant doctor to put it mildly. Tons of heart problems in my family and everyone here is telling me I’m ignorant. Should I have any concerns ,since I’m stupid according to the doctors in Maine.

    • Hi Gina,

      I’m so sorry to hear about your health struggles over the years. Dysautonomia can be very difficult to diagnose and treat as I’m not sure anyone in the world fully understands these conditions.

      It is impossible for me to say if you should have any concerns or not via the Internet. It sounds like you have found some good doctors to treat you. My suggestion would be to keep working with your physicians and live the healthiest lifestyle possible.

      Hope this helps!


  3. I’m wondering if the same thing applies to having the recurring thought that I should be eating more vegetables or start eating fish, yet not doing anything about it. What do you think?

    For what it’s worth, I do get regular exercise by attending fitness classes, so I worry more about my diet than about physical activity (although I wish I could afford to live in the city and walk/take public transit to get around rather than going everywhere by car).

    • Hi Diane,

      You bring up an excellent question. My guess is that you might see the same results…perhaps this explains why a mindfulness approach to everything that we do seems to protect the heart.

      Thanks for reading!


  4. Hi Dr. John,

    I am wondering if your book will be available in kindle format to download?
    I went to purchase the hard copy from Amazon but the shipping cost make it quite costly.
    Shipping cost about 2/3rds of book price.


  5. It seem that it is not as simple as “thinking” about getting more exercise, but surely “obsessing” about getting more exercise. I am very active, and I think about doing more regularly. I hate to think that I am shortening my life by thinking about it!

    • Hi Becky,

      You bring up an excellent point. The key is a mindfulness approach to everything in life.

      Thanks for reading!


  6. After reading your book, I was challenged to buy a Fitbit Zip. Great idea. The daily tracking has shown me I was getting more paces than I thought…but also challenged me to meet a daily goal. By standing up (and pacing) during 1/2 my work day (every half-hour on the hour) and walking around the barn once an hour, I’m now up to 8 miles a day on average!

    • Hi John,

      Congratulations on your purchase! These tracking devices can be great tools. Personally, I use the Apple Watch, as well as the Pacer app on my iPhone, to track activity.

      All the best,