 Well welcome everybody. It's nice to see actual people in the community room. We have among us a presenter who was the last presenter here before we shut down, which is Alice Bouvry. I want to welcome her. But my name is Allison Goulder. I'm on the program committee of the Friends of the Robbins Library former board member. But I go to Hawaii to swim with the turtles now, and so I'm not available. Anyway, it's really my pleasure to be able to introduce Judy Foreman. Can you hear me now? Yes. When I was thinking about her, everybody's heard the expression actions speak louder than words. That's not the case with Judy. Judy is a powerhouse with both words and with athletic actions. It's kind of interchangeable. I met Judy a number of years ago. We were both swimmers through Cambridge Masters and listened to her talk about how she was getting ready to write a book on pain. That's one of her earlier books. But she's a remarkable swimmer. She competed in the 2012 Finna World Championships in Italy. She's competed in the backstroke for the USMS Championships. She's an amazing swimmer. I swim next to her and I can't keep up. Unless it's stroke, then I can keep up. I can do the fly. I think she doesn't. Anyway, Judy is a former Boston Globe health columnist and nonfiction author for Oxford University Press. She graduated Phi Beta Kappa from Wellesley College, spent three years in the Peace Corps, volunteering in Brazil, and has a master's from Harvard Graduate School of Education. She was a lecturer on medicine at Harvard Medical School, a fellow in medical ethics also at Harvard Medical School, a night science fellow at MIT. She was a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. She's won more than 50 journalism awards, including a George Foster Peabody Writers. She's an incredible writer. I think if you know her as the health columnist for the Boston Globe for years and years and years, she makes writing science digestible for people who don't understand science. She makes it. She interprets and explains in ways we can understand and appreciate and love. Well, Exercise is Medicine is not her most current book, which she may mention. Her current book is Crispert, but it's an incredibly powerful book, and I recommend everybody reading it. I brought it to Hawaii and gave it to all my Iron Man athlete friends, and they really devoured it. So without further ado, I'd like to introduce Judy. Allison, whoops, is this on? Whoa. Allison is a liar. No, not really, but is this... You have to speak right into it. Okay, there we go. This may or may not stay. Allison, just for the right, is a beautiful swimmer. You should see her do the breaststroke, the underwater part. Her timing is gorgeous, and she told me when I complimented her once, she is the coxswain for some of the outrigger canoes in Hawaii, and they picked her for that because her timing is so perfect. So, whoops, I guess I'll just hold this. Okay. What? Okay, good. All right, let me see. Is Victor still here? All right, here we go. This is... Can I turn it up? I love this part. I don't know if they want to... Whoa. I don't know if they won. You can tell they practiced. All right, so the point is exercise can be fun and it can help you for a long time. And they're just so inspirational. I had to put them at the top of the little program. So I'm going to do my talk and then we can have questions and answers at the end. So if you think of things, just try to remember them. So the book is called Exercise is Medicine. How Physical Activity Boosts Health and Slows Aging, all of which is true. Whoops. Now let's see. Why is this not animating? Oops. Well, I don't know how to do this. This slide was supposed to animate and swirl around. Oh, it did. Oh, it didn't on mine. OK, so if I do this, it does. Ah, OK. So to a biologist, aging is one of the deepest mysteries in the world. Why do some people and some creatures live long, healthy lives and others not? For instance, some sea urchins and sea anemones and by hydra, fresh water hydra, don't age, don't have a set amount of time before they age. Like we sort of think as you get older, your risk of dying gets more, which it does. But for the risk of death, the risk of death for some of these creatures is the same at any point in their life. The chance of dying, say for fresh water hydra, is the same at 10 years or months as a thousand. So there's nothing automatic about this progression that we call aging. This guy is Steve Ousted. I knew him personally when he was at Harvard and I was at the globe. He was actually literally a lion tamer. That's not what Harvard was paying him for. He was a biologist and he is one of the preeminent biologists of aging in the country. And he says, evolution has no reason to favor long life. Evolution favors early copious reproduction at the expense of later survival. So, you know, why do we age? It wasn't meant to happen. Jay Olshansky is another guy I've known for years, very good demographer. And he says, aging is an accidental byproduct of surviving beyond our biological warranty period. He also says, we age because mother nature turns her back on us once we're in the post reproductive region of the lifespan. Natural selection didn't build in a program to make us fall apart in later life. So why, then, do some species live so long, including ours, past the age of reproduction? Why not just pass on your genes and then die? One theory is that there's something people call the grandmother effect or the grandfather effect. The idea being that older people, perhaps especially grandmothers, are valuable for keeping the whole species or the whole family alive. And interestingly, interestingly, it's not just humans. Whales do this and elephants do that, do this. I'm sure you've read about matriarch elephants who remember where watering holes are when there's no water that anybody can find. Same with the whales. They remember old food supplies. They really help keep the family and the species alive. In fact, Michael Rose, who is an evolutionary biologist, says that from an evolutionary biology point of view, taking care of a grandchild actually is a reproductive act. It really does help your genes. I mean, from a gene point of view, the whole point is to get your genes to the next generation. That really counts as a reproductive act. Dan Lieberman, who I've also known for a long time, who also has a book out in the last couple of years about exercise and aging. He might know him. The globe used to write about him. He did marathons barefoot. He was not as the barefoot runner. He says, grandmothers and grandfathers are essentially unencumbered. They can produce a surplus and they don't take that much energy out of the system. So that surplus energy time money can go to the kids. Jared Diamond, unfortunately, I do not know personally, but he's he's written guns, germs and steel and a whole bunch of other books. He says that in traditional societies, the knowledge of older people spells the difference between survival and death. For the whole society in a time of crisis. And actually, I got to see this myself first hand in 1993. I was still at the globe then. And there was an epidemic in the southwest of the Hanta virus. You might have heard about it. And unfortunately, it was called for while the Navajo flew. But then finally, the press stopped doing that. And a lot of people were dying of these terrible pneumonias. So the CDC was out there trying to figure things out. And the CDC doctors had the excellent sense to talk to the Navajo elders. And the elders remembered that twice before in the 20th century, there had been a connection that they just observed between increased rainfall and a bumper crop of pine nuts, pinion nuts. And that led to more food for the deer mouse population. The deer mice lived there, pooped all over the place. The poop desiccated, dried up and aerosolized. People breathed the aerosols and got pneumonia. But it was the knowledge of the older Navajos that led CDC onto the right track. So that's a kind of a modern example of this. The two things that are most important for living a long life are the safety or lack of safety in the environment and our genes. So if this goes right, is the animal coming down? Whoops, coming down the tree. It was moving. Did I screw it up? There she goes. That's my own personal leopard. My husband and I went to Botswana a few years ago. Is she out of the tree? Yeah, here she comes. This is twilight and you'll be able to see the, you can see the shadows. She's doing fine and her species is doing fine for her and her kin. This is a relatively safe environment. And you can see the jeep with all the heads of the people in the bottom. She's going off to get her dinner wherever she can. On the right, though, the bottom slide is the same general area. That's me and three rhinos in the back. For them, the environment is not safe because of poaching. In fact, the day we saw these rhinos, the day before we saw these rhinos, there were five rhinos, the day we were there, there were three. They had been poached and they had been poached by two of the rangers who were taking us on to, so it was an inside job. It was the rangers who were left were very, very upset as we were. So basically the bottom line is if you're born into a safe environment, your chances for longer life increase. And over many generations, if you grow up in a safer environment, you can afford to postpone reproduction. You don't have to reproduce quick so while you still have a chance. And interestingly, delayed reproduction helps select for genes that ultimately give you the benefit of longer life. So it's a little bit indirect and convoluted, but it works. J. Olcansky, the demographer, puts it this way. The hostility or friendliness of the environment determines the age of reproduction, which determines the duration of life. So it's kind of a hard concept to get, but it's interesting. And in fact, that's been happening in the modern world with humans over the last century. Life expectancy has gone up dramatically because our environments have gotten safer. We have better refrigeration. We're not preyed upon except by predators like viruses. Viruses count as predators to epidemiologists. So our environment has gotten safer and life expectancy has gone up. Recently, it's taken a downturn a few years ago because of the opioid epidemic. And I think now also because of COVID. So, you know, these things are not set in stone. One of the things that's been happening, though, as delayed reproduction happens, as you might expect, women are having babies later in life. In fact, on average, the birth of a woman's first child, the woman is 26.3 years old. And it used to be just 24.9. That's a big difference for a whole population. So women are having babies later in life, which makes you wonder, or at least makes the evolutionary biologist, Michael Rose, wonder, could the aging process be kept going forever? Whether we would want that or not is another question, but it might be. You know, it's not totally nuts to think that, you know, there's nothing truly inevitable about aging. What demographers and epidemiologists talk about when they talk about aging is trying to square the curve. Right now, I don't have a pointer, but you can see the sloping blue line that says normative aging. That's what happens normally. We sort of, there's health on the x-axis and whatever it is, y-axis and age on the x-axis. And normally, you know, we sort of start to get more and more health problems and then we die. If we could extend the health span, the number of healthy years, we could square the curve, say, quite healthy until the very end, then drop dead with a minimum of mortality, with a minimum of morbidity, which would not only be nice, it would be cheaper for the whole country. In fact, that kind of squaring of the curve is what happens with a lot of centenarians. These are people who are a hundred or more. And now they're starting to track super centenarians who I think are 110 or more. These people do show the squaring of the curve. They stay quite healthy and then they die with a minimum of disability and disease. I've been following for many years something called the New England Centenarian Study and that found that 90% of over 800 centenarians at study fit into one of about 27 very favorable genetic profiles. So these people have had a safe environment and great genes and they pack most of the sickness and death at the very end of their lives. So the big question actually is, what is aging? And Steve House said, our lion tamer says, aging is a progressive deterioration of virtually every bodily function over time. And I'm sure we can vouch for that. But getting down to the really scientific specifics about what's going on with aging has not been that straightforward. In 2013, which is now quite a while ago, some European scientists laid out what they thought were the major hallmarks of aging. And I will just say their names and you don't have to remember them. But the interesting thing is that all of these can be slowed down by exercise and all of them can be sped up, which is bad, by our Westernized diet and sedentary lifestyle. So they are and I'll just reel them up. Epigenetic alterations, genomic instability, telomere attrition, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellulose in essence, stem cell exhaustion and altered intercellular communication. So just so you know, there's a lot of authenticity to this research. Interestingly, the epigenetic clock is one of the most most important and most interesting features of these hallmarks. Epigenetics, in case you have forgotten, refers to changes to the DNA that tell a gene to turn on or not, like a stimulus to the gene to shut up or be active. That's different from changes in the DNA, which are called mutations. So these are things that act on the DNA to turn a gene on or off. And interestingly, one of the most important things that can act on DNA is a cluster of chemicals called methyl groups. I mean, you don't have to remember this either. They're clusters of hydrocarbons and they land on stretches of DNA and turn genes on or off. And the DNA methylation pattern turns out to be a good marker for aging. And this is going to tell you how it works. So these chemicals just land on various spots randomly or not and turn genes on or off. The interesting part about this is how exercise affects it. In Sweden, scientists took muscle biopsies. You know, they take a little sample of tissue from volunteers who were riding a bike, exercise bike in a lab, only with one leg. They kept one leg on the floor and the other leg cranked the bike. They took biopsies of both legs and the volunteers did this a lot. They did it four times a week for 45 minutes for three months. So that's a reasonable amount of exercise. Then the researchers took biopsies again of both legs and the DNA methylation pattern was strikingly different in the exercise leg versus the non-exercise leg. And this is a really cool experiment because it's a perfect control. The same person, same diet, same sleep, same reading, same everything, except one part of the body gets exercised and one doesn't. So this is like a dream experiment. And the conclusion is that the exercise seems to slow the epigenetic clock. Interestingly, what some of the epigenetics researchers have found is that different parts of the body age at different rates. And I think I can animate. Yeah. So some parts of the body actually age faster than others. For instance, the heart can be 50 and the lungs can be 30. Weird. Why? We don't know. But very interesting. And in the centenarians I've been talking about, the DNA methylation pattern of them shows a very youthful pattern. They are actually chronologically old, but biologically very young. One of the other hallmarks we talked about was telomere attrition. Telomeres you might have heard of, especially my friends who heard me talk about it. Telomeres are the little, they're little caps on the end of our chromosome, sort of like those plastic aglets on the end of shoelaces. And their job is the same as shoelaces, basically. They keep the DNA from unraveling during cell division. So everything is nice and orderly and doesn't get screwed up. Basically, we're born with nice, long, healthy, glowing telomeres. And as we age, they get shorter and shorter and shorter, which helps the cells get messed up when they're dividing. So the rate of telomere attrition, telomeres conking out is considered to be a reasonable marker of aging. The question is, does exercise influence this? And that question is up in the air. There's some data that it does. And other scientists say that's absolutely bogus. So that's up in the air. I like to think it does, but we can't prove it. Another hallmark of aging is called genomic instability. Sometimes some genes jump around like randomly on chromosomes. This was also a woman, Barbara McClintock, got the Nobel Prize a number of years ago for figuring this out. But as we get older, the genes jump around more and that makes your whole genome less stable. And that increases with time. So that instability can also be another measure of aging. I think that's a little complicated to understand, but is important is something called nutrient sensing. When you think of yourself, well, we are animals, think of yourself as a small animal trying to decide whether to have babies. You want to know there's going to be food in your environment so that your babies don't die. So there has to be a way for the body to understand whether it's a safe environment, whether there's food around to have babies. And it turns out that that's regulated by a gene called mTOR. Again, you don't have to remember that. But it turns out to be an important gene. So when food is plentiful, the animal knows by this chemical sensing system that it's safe to reproduce. And when food is not around, if the animal knows it shouldn't reproduce. And this fits in with the whole delayed reproduction thing. When mTOR levels are low, meaning nutrients are not around, the mTOR pathway tells the body not to reproduce because it's not safe, no food. And that means that if you could mimic this with drugs based on mTOR, you could delay reproduction. And also, even without the reproduction part, perhaps postpone or make them make to be more longevity. mitochondrial dysfunction, it goes bad with aging. And we'll go more for that in a minute. But biochemically, when as we get older and our mitochondria poop out, we have less energy. And I'm sure we're all aware of that. One of the other hallmarks is your cells get senescent, which means they're alive, but they don't reproduce. They don't divide and reproduce like young cells. In fact, people call them zombie cells. This wouldn't be so bad, except when then when they're in this zombie like state, they pump out chemicals called cytokines, which can be pro-inflammatory. So these sort of half-dead cells are pumping out these pro-inflammatory chemicals, which create inflammation all over the body. And inflammation is bad and gets worse with aging. It underlies a lot of diseases like diabetes, atherosclerosis, etc. Over the years, there have been a number of theories about aging. One has been caloric restriction that's been shown over and over again since the 30s. If you reduce calories by 30 percent, but still get the right nutrients, you can increase the lifespan. And this might work by that gene we called mTOR. So it all kind of fits together. Also, as we get older, we lose our big supply of stem cells. I'm sure you've all heard of stem cells in terms of treatment for cancer and stuff. Is the guy bouncing the ball? Yeah, stem cells are early, undifferentiated cells that give rise to all the cells in the body. So having a big supply of them is great. As we age, the supply decreases. But scientists are working on ways through drugs to increase the supply of stem cells. There's also a number of specific genes that scientists have found that lead to greater longevity. This is a little worm. There he goes. Or she, I can't tell. This worm, C. elegans, is a subject that scientists study all the time. They're very popular lab animals. And some of these, these, these gene, these worms that have a certain gene called age one live 10 times longer than other worms of the same kind that don't have that gene. So it's very, you know, there are specific genes that scientists have isolated that really do lead to longevity. In flies, they call it the Methuselah genes or for Methuselah flies. And the scientists isolated this gene by only letting older flies reproduce. So again, that fits in with the whole delayed reproduction, extending mortality. So what you really came for is exercise. And exercise turns out to favorably influence all these processes. I've just talked about it is a key and many people think the key to a healthy and longer life. But this wasn't always obvious. In fact, you know, to us, it seems obvious now, but it really wasn't true. We know now, for instance, this little guy jumping that exercise lowers the risk of heart disease, some cancers prevent, help prevent diabetes, drastically improves, improves brain function in terms of mood and cognition, spurs hormones that damp down this excess inflammation. And most important lowers all cause mortality, including getting hit by a truck. I mean, so basically exercise has a wonderful effect on all this. This wasn't really known explicitly till the 1950s, when the guy on the left, on the left, Jeremy Morris, who was a British epidemiologist, he provided the first compelling evidence of the life extending value of exercise. He compared, it was British, and he compared the drivers of these double decker buses who were sitting all day to the conductors who were running up and downstairs and back and forth along the bus. And he showed that the conductors had far better health, especially cardiac health than the sedentary drivers. And this really set the world onto exploring the role of exercise. In fact, physical fitness is now known to be the leading indicator for reducing all cause mortality. And a lot of that was discovered by, why can't this go forward? I think I skipped a slide. No. Where is my friend? OK, there he is. Steve Blair, I've also talked to for years. He was part of the original Cooper Institute for Exercise in Texas. You might remember that in the eighties, he did a study with 10,000 men and 3,000 women judging their fitness on treadmills. And the ones who were the most fit had the lowest all cause mortality. But the really important thing that he found was that just getting out of the least fit category got you a big benefit in terms of all cause mortality. In other words, you don't have to run marathons. You don't have to swim like Allison and Allison. You just getting off your rear end and moving will really do it. And since then, there's been just a mountain of evidence. As a science writer, often you find things on the one hand on the other hand with exercise, it's all on one hand. It's all pointing in the right direction. There was a big meta analysis where people put together data from a whole bunch of studies. This one involved more than 800,000 adults. It was done by German researchers and they put together 33 studies and they found that physical activity resulted in 35 percent fewer heart disease deaths and 33 percent less all cause mortality. I mean, that's in medicine, that's a huge effect. That's a really huge effect. It doesn't take that much exercise to get this effect. You can run five to ten minutes a day at a six mile per hour pace. I have never in my life done a six mile pace. But you can do a brisk walk of 15 minutes. Just doing 15 minutes of brisk walking a day can add three years to your life. You may spend the whole three years walking, but that's OK. The bare minimum, the government recommendations are 150 minutes a week. That's basically 30 minutes a day for just five days. That's pretty manageable and it doesn't even have to be all at once. You can do it 10 minutes, 10 minutes, 10 minutes. So most people can manage that. What I was surprised about when I started researching this book, I always thought that sitting was kind of the low end of the exercise curve. It's so bad it's a separate variable. In fact, there's separate research groups who just study the bad effects of being sedentary. It's not that it's just not good for you, it's actively bad. The reason is sitting too much allows, as we all know, visceral fat. Visceral fat isn't the stuff you can actually pinch. It's the stuff inside that surrounds your organs. And fat is not just, you know, an ugly blob of tissue. It's an active metabolic organ that secretes these pro-inflammatory molecules, which then lead to diabetes, atherosclerosis, everything. So it's a vicious cycle that sitting basically triggers. Oops, wrong thing. But a new study actually showed in 2020 that 11 minutes, only 11 minutes of moderate exercise a day can help counter the effect of sitting for 10 hours a day. So it's not hopeless. It's definitely not hopeless. But one of my favorite studies that I've written about often on for many years, the study started in 1966. These guys from Texas, from Dallas, it's called the Dallas Bed Rest Study. They put five totally healthy college kids, college guys, men in bed for three weeks. They couldn't get out to go to the bathroom or leave the bed at all. And 30 years later, they tested the same guys again for things like VO2 max, you know, how efficiently your body takes in oxygen and gets it through your circulation to your muscles. Three weeks of bed rest, this is their conclusion. Three weeks of bed rest in 1966 caused greater deterioration in cardiovascular function than 30 years of aging. I mean, that's how bad rest is. In fact, some doctors just say rest is rust, excuse me, rest is rust and it is. The reason exercise has such a big effect is because basically the most important effect it has is on the heart, which is not really a surprise. This is I'm in Lee, who I've also been talking to for years. She says heart disease is the leading killer of Americans, which we know. And exercise is powerful precisely because it can help prevent this biggest killer. That's pretty, pretty clear cut and pretty obvious. This is just a picture, excuse me, of the heart. But exercise has a good effect on blood pressure, heart rate, heart rate variability, which is sort of how easily your heart can change from one rate to another. Glucose, insulin, high and low density lipoproteins, triglycerides, inflammatory markers. Basically, it increases heart output, lets you recover faster from physical work. It helps protect the lining of your blood vessels on and on and on. It does so many good things for the heart that if that were your only goal, that would be worth doing. One of the best fun things I had while doing this book was interviewing a lot of super athletes who were older. This one was my favorite. She was 85 when I interviewed her. So this was a number of years ago, well, three or four, five years ago. And when she was 85 in 2008, 18, she ran the Boston Marathon in seven hours and 50 minutes. She then stayed at a hotel in Boston and took a plane ride the next morning to Europe, met up with a friend and did that walking trail in Spain, the Camino de Santiago the next day. She has an incredible life story, total survivor and interestingly, older runners seem to be the fastest growing part of the running world. So people are taking to it. The best way to get good effects on the heart is high intensity training, HIIT, high intensity interval training. It's very effective for cardiovascular benefits and there's a whole number of protocols for how you want to do it. One was invented in Israel way back in the 70s. You do a 30 second absolute all out effort and then you do a slow effort or just rest for four minutes and you repeat that half a dozen times. And then you do it several days a week. That's hard. I do an easier version myself, but it's very, very effective. And there's some good researchers at McMaster University in Canada who are studying this and they, one of them has a book out called The One Minute Exercise. You can actually, if you don't have time, HIIT is a great way to exercise. And lack of time is one of the main reasons people say they can't exercise. That turns out to be a lie because we spend that time watching TV or, you know, schmoozing or something. The time is there. We all do have 24 hours, but that's people's excuse. Some people wonder if you can ever have too much of a good thing. The answer is very, very, very rarely. I mean, exercise very rarely does harm and almost always does good. There was one study of joggers in Rhode Island that estimated that the risk of death during jogging for every 400,000 hours of jogging was one. That's very low. There was a study of doctors and found one death for every 1.42 million episodes of exercise. Even during rehab for cardiac arrest and heart attacks, there's only one death for 600,000, for 60,000 participant hours. So that's a lot of people doing it and very, very low risk. The real risk is if you've been sedentary and suddenly you get up and run for your life. I mean, that's, that's what is the real problem. Before I finish, I wanted to just talk about mitochondria because they're my favorite thing. We all have mitochondria and they're the little energy factory in all of our cells. And the big thing, aside from protecting your heart and your brain, which I'll get to, exercise has a huge effect, a good effect on mitochondria. Mitochondria, like one and a half billion years ago, there were bacteria, tiny little life form that ended up being engulfed by a bigger cell. The bacteria only had 13 genes and they were round, like the little pink circle. They got swallowed up by a bigger cell. And the trick that this bacterium had was that it could take oxygen from the atmosphere to make energy. Once it got swallowed up by these bigger cells, that trick was available to the bigger cells. So that's why we breathe oxygen and combine it with food and get energy. It's, you know, we wouldn't be here if it weren't for these little bacteria that are in us and they have their own genome, as I said. This is, you don't have to, this again, you're not going to be tested on. But this is how chemicals get transferred along the mitochondrial membrane. And the net result is this molecule called ATP, which is the energy molecule, adenosine triphosphate. That's enough of that. All right, so exercise revs up the mitochondria, mass produces the mitochondria. But again, only in the muscles you use. So if you did that one leg experiment, the exercise leg would have a lot more mitochondria in its cells than in the non-exercise leg. Exercise is good for bones, but not in the way we used to think. Turns out that weight bearing doesn't have as much of an effect as we all hoped 20 or 30 years ago. I can slow the rate of bone loss, but it doesn't really rebuild very well. But what exercise does is help with your muscle strength and your balance so that you don't fall and falls are the real problem. And they're a big problem and falls can lead to, you know, you're lying in bed with a broken hip and that can lead to blood clots and death. And there's a lot of bad things that happen with falls. My two favorite chapters in the book are about the brain. There is a ton of evidence that exercise is good for cognition and mood. I think this might animate. That's because exercise triggers this chemical. If there's one thing I would love for you to remember from this talk and or the book, it's a chemical called BDNF, which stands for Brain Derived Neurotrophic Factor, which is BDNF. When you exercise, the brain produces this this factor that some people call miracle grow for the brain. That's a little easier to remember. It lands on the hippocampus, which is one of the main memory centers and makes the cells replicate. So you end up with more neurons in your hippocampus. And so over time, that really does improve your memory. And there's one study that I love that if everyone who is currently inactive suddenly became active at this low government level, 150 minutes a week. One in seven cases of Alzheimer's could be prevented. It has a huge effect on cognition. And it also has a big effect, see what slide I'm on, on mood and depression. I can't tell you how many studies there are showing this. There was one study in 2016 of a million men and women. Those who were the least fit were the most likely to develop depression. And there's just so many studies with this. And in a lot of the studies, exercise is as good as antidepressant medication. And it also has a synergistic effect. So it's good at preventing mood problems and also at treating them. I can't quite see where I am. All right. Exercise is also great for inflammation control. There are a number of pills on the market. I would say don't go near them, but the reason exercise is so powerful. It acts on so many different molecules around the body. The pills are usually aimed at one or two. And that could screw things up if you overdo one and not the others. Exercise gets the whole thing, so that's why it's better. So the message is buy or beware. But the science behind some of these pills is very interesting. Some of them are also marketed as anti-aging pills. And there's good science behind those, too. But again, I think it's safer to just exercise. These are the names of the pills. I won't even read them off. So the take home message is exercise at least 150 minutes a week. More is better. Strength training is important, too. Moderate exercise means you can talk, but you can't sing. Vigorous exercise, you can't talk. And you start sweating very early in the in the bout of exercise. How fast do we lose fitness? Depressingly fast aerobic condition, aerobic conditioning declines about 25 percent after just three or four weeks of detraining. Even after two weeks, there's a significant decline. It does come back. It does come back, but it's depressingly fast to lose it. Basically, there's not really a harmful level of exercise if your heart is healthy and your doctor gives you OK. There was one study of more than 600,000 people even at 10 times the recommended dose of exercise. There was no evidence of harm. So you're really the harm benefit ratio is very much in favor of exercise. Exercise alone probably won't help you lose that weight that much because if you're 160 pound person and you walk at a 20 minute mile pace, you will burn 255 calories in an hour. And that is about one small muffin. So basically, if you reward yourself with a muffin after every exercise, you're not going to lose weight. You do have to diet for that. And if you exercise forever, are you going to live forever? No, but you will die buff, which is very important. And my last slide is I spend some parts of the summer out in Truro, which is near Provincetown, Massachusetts. And one night we went to hear music. There's a lot of music on the beach. And I bumped into this lady who was in a wheelchair a couple of years ago, was told she would never walk again. And here she goes. So I love to see all the people jumping around. So that's it. I can take a few questions. And if you have questions about my other book, you can ask those two. Thank you. Yeah. Shall I do this? OK. You can repeat it. So sitting is bad. So what have there been any studies on standing guests? When using standing guests in classrooms, is that considered exercise? So the question was, sitting is bad, are standing desks good? Have there been any studies on them? There weren't too many when I wrote the book, but I think since then there have been and I got one myself. And I don't know. I have one of those Apple watches that tells how many hours I or how long I've stood as well as gotten steps. And, you know, you get a lot of you got a lot of steps and credit for standing. So, yes, that's a good thing. And even just getting up in front of, you know, when you're watching TV, getting up for go to the bathroom, go get something to eat. Just get up a little bit and move around. That has been shown to help. Some people set a timer on their watch to get up every hour. So when they're working at their desk so that they just move around, that has a huge beneficial effect. So was there some more questions? Yeah, you mentioned something that was disappointing that weight-bearing exercise now was not thought in physical density. Is that right or could you elaborate? And also, are other things or is there other things that could be in physical and mineral density, like jogging and in-house teleportation? Yeah, that has been disappointing because everybody thought for a long time that it was the pounding and that people who landed hard and, you know, to some extent that may still be true, but it isn't as true. It doesn't replace lost bone. For women, estrogen is a huge bone builder. And if you take estrogen after menopause, as I did for a long time, you end up with these great bone density scans. But I think the thinking now is that exercise is still important for bones, but not for the reasons we used to think. More because if you're strong and exercises like Tai Chi that work on balance, then you won't fall. I mean, nobody's recommending against weight-bearing exercise. It's just not as powerful a bone protector as used to be thought, which is disappointing. I remember Gina Colotta, one of the New York Times science writers, had a wonderful column that was just totally depressing when this came out. It was a good column, but bad news. Some other questions? OK. You didn't mention biking. There's been a lot of literature that's been here to talk to us about the effects of biking. Yeah, so a lot of studies on it. It's a very good thing to do if you're careful and wear a helmet and don't get hit by cars. Yeah, no, that's there's a lot of studies on the on the huge conditioning effect you get from riding bikes. Thank you that. Yeah, a lot. There's there's a lot of studies on that. Interestingly, I was surprised to learn in some of these studies, the control group compare, you know, like cardiovascular stuff. Sometimes they control it to an education only group or a yoga group. Yoga does not do as much. It doesn't do much cardiovascularly. It does help with balance and strength, which are also important. And flexibility, flexibility is huge, very huge. Yes. And that certainly goes down with age as well. Yeah. Any other question? Yeah, if I can ask a general question, sure. Science, writing, the appetite for who buys me? Not enough people. Is it on an upswing? Is it on a downswing? I think people really do have an appetite for health books, certainly diet books. And there's a lot of misinformation out there, not just on the web, but on the web, but in some books. I think I mean, the exercise book did pretty well. My other book, which I don't have to talk that much about, this is a fiction book. It's a medical thriller. So it's my first attempt at fiction. This is about the gene editing technique called CRISPR. And there's a bad guy and a good savior of the world. But there's an appetite for science-based fiction, too. Whether it's going up or down, I don't know. I don't know. That's a good question. Are you a science writer? I work as a scientist. What kind of science did you do? The what? Physical chemists working as an analytical chemist. Oh, OK. Vertex. Yes, I've heard of it. Yeah, when I was back at the Globe, I mean, I had a lot of, not a lot, but a number of doctors called and said they wanted to be writers. Some were fabulous writers, like Jerry Groupon, Jerome Groupon, you may know, the hematologists. Most of them were not. But the ones who are good are just, you know, priceless because you don't have to. I have to interview people like you. You don't. You could just go for it. So there is a group called the National Association of Science Writers and there's a New England Association of Science Writers. I can give you my email and you could email me and I could put you in touch with them if you want. OK, did you all hear that? Probably not. You can. He's a physical chemist, just retired, wants to work on essentially like STEM education for kids to, for their own development and maturation and for being the United States, being competitive scientifically. I'm sure there's groups that would hire you. Anyway, are we supposed to stop? I see. Oh. Well, why don't we stop? And I can, if you want to, I'm going to sell the all the books at whatever price there, but half of it, if you want to buy one, I will sign it. And I'll give some to the library and that's it. So thank you very much.