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Exercise and heart health: less straightforward than expected?
June 3, 2012 1:44 PM   Subscribe

Some critics have noted that there is no indication that those who had what Dr. Bouchard is calling an adverse response to exercise actually had more heart attacks or other bad health outcomes. But Dr. Bouchard said if people wanted to use changes in risk factors to infer that those who exercise are healthier, they could not then turn around and say there is no evidence of harm when the risk factor changes go in the wrong direction. "You can’t have it both ways," Dr. Bouchard said. (SLNYT)
posted by Nomyte (61 comments total) 4 users marked this as a favorite

 
Ah, those tricky surrogate markers, as I just mentioned in the salt thread.
posted by greatgefilte at 1:56 PM on June 3, 2012


I don't really care if being fit makes me healthy - it makes me happy and that's that.
posted by elwoodwiles at 1:58 PM on June 3, 2012 [6 favorites]


I don't really care if being fit makes me healthy - it makes me happy and that's that.

Exactly my relationship with butterfat and tobacco!
posted by BitterOldPunk at 2:01 PM on June 3, 2012 [50 favorites]


No news here. The advice has always been to get a doctor's okay before beginning an exercise regimen and to maintain regular appointments thereafter.
posted by Ardiril at 2:10 PM on June 3, 2012 [2 favorites]


Isn't the reason most people exercise simply to improve their sex lives?
posted by jeffburdges at 2:13 PM on June 3, 2012 [8 favorites]


I try to improve my sex life so that I get more exercise.
posted by no regrets, coyote at 2:31 PM on June 3, 2012 [9 favorites]


Our culture's promotion of exercise as a panacea to cure all ills is more like a matter of religious practice than science. We engage in exercise as a ritual practice to appease the gods and ward off evil spirits. The practice of exercise signifies moral worth and assures good fortune. Our belief in the efficacy of exercise is supported by the same sort of magical thinking as belief in the efficacy of ritual sacrifice. It confers the illusion of control over our own mortality, which makes being alive a little less terrifying.
posted by Corvid at 2:36 PM on June 3, 2012 [33 favorites]


Anecdotal evidence: My dad had a heart attack in the mid 80s. Around 10 years later he dropped dead one morning while out for his morning run. In fact, he dropped dead so effectively he couldn't be resuscitated despite being literally moments away from the ER.

I don't actually believe that means anything other than that even if you do spend your life eating (what you think is) healthy and exercising you may still kick it sooner than you might like, and we'd all better be OK with there being no guarantees and no magic bullets.
posted by wierdo at 2:45 PM on June 3, 2012 [5 favorites]


Paging Bill Hicks. Obligatory Bill Hicks to thread 116593
posted by hal9k at 2:54 PM on June 3, 2012


BitterOldPunk: "I don't really care if being fit makes me healthy - it makes me happy and that's that.

Exactly my relationship with butterfat and tobacco!
"

You forgot alcohol, Doc.
posted by Splunge at 2:55 PM on June 3, 2012 [1 favorite]


It confers the illusion of control over our own mortality, which makes being alive a little less terrifying.

It really just makes you better than the lower class of folks who eat poorly and don't exercise and lack either the ability or the ambition to do so. Directly opposing the obesity epidemic is the culture of marathoning, Crossfit, and Beach Body videos. All of these being expensive things that cost money, time, and more importantly, willpower, something that's lacking after the grind of unsatisfying, unfulfilling work.

Of course, being fit is great for your self-esteem and if you're mindlessly happy in that way (which I frankly am), then the point isn't the philosophical or social implications of the thing, it's more that you're just doing it because it helps ease your social anxiety, especially during the summer.
posted by dubusadus at 3:12 PM on June 3, 2012 [8 favorites]


Mark Sisson, ex marathoner and triathlete is now evangelical against overdoing endurance training mostly based on his own one data point and perhaps a little selection bias on the available research. Example link.
posted by bukvich at 3:17 PM on June 3, 2012 [1 favorite]


Our culture's promotion of exercise as a panacea to cure all ills is more like a matter of religious practice than science.

Yes indeed, except for all those mountains of evidence. But you know, don't let your guilt about exercising blind you; it's a hopeless waste of time at best, and destructive flim flam at worst.

(I mean sheesh, I know it feels great to pretend you're writing a tabloid editorial on on a website, and people might even agree with you! But less hyperbole and more, you know, facts, is a good thing, really)
posted by smoke at 3:19 PM on June 3, 2012 [11 favorites]


It really just makes you better than the lower class of folks who eat poorly and don't exercise and lack either the ability or the ambition to do so.

I don't know, among the poor there are many fine physical specimens who have developed intimidating muscles pumping iron in the prison gym. </Scalia>
posted by Nomyte at 3:20 PM on June 3, 2012 [1 favorite]


There aren't mountains of evidence that exercise "cures all ills." There is a lot of evidence that appropriate programs of exercise can help improve individuals' health and in some cases reduce the impact of certain medical issues. The key word here is "appropriate" and what's appropriate for some people and some issues may be counterproductive for other people and other issues, yes?
posted by Sidhedevil at 3:26 PM on June 3, 2012 [4 favorites]


You can't use risk factors to infer causality, period, no matter how much the result tickles your brain. Risk factors are just an epidemiological phrase that means "partial correlations". Yellow fingers are a risk factor for lung cancer, but no one is going to get cancer by rubbing tobacco on their thumbs. And they aren't going to avoid it by washing their hands, either. Correlations aren't causality, and risk factors have never been intended to communicate that -- though somehow that point is lost a lot in the press.
posted by scunning at 3:28 PM on June 3, 2012 [3 favorites]


Scaliaburger - it's what's for dinner.
posted by symbioid at 3:36 PM on June 3, 2012 [1 favorite]


There aren't mountains of evidence that exercise "cures all ills."

Bit of a strawman, though, isn't it? I didn't see any examples of that furnished, and I don't see a lot of that in real life any more than the many other stripes of popular media nonsense out there.

People certainly seem to hold to the tenet that "exercise is good for you". But, so far as pat, five word phrases go, I would argue that on balance those five words are more correct than incorrect for most people, most of the time.

The study (one study) is couched in so many qualifications, and even it were 100% clear cut, it would still only be relevant for a minority of the population.
posted by smoke at 3:42 PM on June 3, 2012 [1 favorite]


Around 10 years later he dropped dead one morning while out for his morning run. In fact, he dropped dead so effectively he couldn't be resuscitated despite being literally moments away from the ER.

True story: my grandfather dropped dead on a treadmill, having his annual stress test in the hospital's cardiac health unit.
posted by DarlingBri at 3:53 PM on June 3, 2012 [4 favorites]


I do think there's something to the idea that exercise and nutrition serve the role that religious ritual used to fill. Bodily health is everything now, and tending to health is the most culturally sanctioned act of public virtue that exists now. This is not to say that exercise isn't good for your body, or that people don't enjoy it for its own instrinsic value. I am sure that in times past, some people derived great satisfaction from saying the rosary and going to mass at dawn.
posted by yarly at 3:59 PM on June 3, 2012 [4 favorites]


True story: my grandfather dropped dead on a treadmill, having his annual stress test in the hospital's cardiac health unit.

My father dropped dead of a heart attack six month after the executive medical retreat that pronounced him heart-healthy, with the heart of a man twenty years his junior. You really don't know.

I exercise (under the general advice of a physician) because I believe it helps with some specific problems with my health. I've also exercised when I probably shouldn't have--to the point of nearly passing out because I didn't realize my blood pressure was temporarily through the roof--and I can believe there are cases where exercise will do more harm than good. That this extrapolates to include, in some cases, otherwise healthy people isn't entirely surprising. Everything we do has side effects, so why should exercise be any different?
posted by immlass at 3:59 PM on June 3, 2012 [1 favorite]


really just makes you better than the lower class of folks who eat poorly and don't exercise and lack either the ability or the ambition to do so.

What does being poor have to do with anything? I'm about one notch above the poverty line and there's no barrier to me exercising. Go outside. Run if you feel like it. Lift some shit and then put it back down if you want. If you wanna go crazy save money by eating things that are recognizable as food. You'll feel better, look better, be physically capable of more things, and learn to cook.
posted by cmoj at 4:01 PM on June 3, 2012 [4 favorites]


I hate exercise but I like the way it makes me feel. I like being able to run upstairs without turning into a red-faced, wheezing, useless thing. I like the boosted energy levels. I like the way it very demonstrably drops the weight off me.

Just as well, since I also like boozing and scoffing it up like a complete slag.
posted by Decani at 4:06 PM on June 3, 2012 [13 favorites]


Good god, are we back-lashing against EXERCISE now? REALLY??
posted by LordSludge at 4:10 PM on June 3, 2012 [10 favorites]


I do think there's something to the idea that exercise and nutrition serve the role that religious ritual used to fill.

Yep. Nothing but skinny atheists everywhere these days.
posted by ODiV at 4:21 PM on June 3, 2012 [6 favorites]


Yep. Nothing but skinny atheists everywhere these days.

Well, the same percentage of the population are true believers. The rest just mouth platitudes and engage in the rituals just often enough to pass judgement on others. (Hi!)
posted by maxwelton at 4:35 PM on June 3, 2012 [3 favorites]


really just makes you better than the lower class of folks who eat poorly and don't exercise and lack either the ability or the ambition to do so.

What does being poor have to do with anything? I'm about one notch above the poverty line and there's no barrier to me exercising.


I'm not sure this comment was aimed at the "poor" -- I think the implication is that exercising people look down on non-exercising people as "lower class". You know, when one is rich, even the middle class is lower class. Heck--even "new money" is lower class.

In this case, I think the implication is that it's "tasteless" to "let oneself go."

Although, I have to say, working 3 jobs to stay afloat, living in an unsafe neighborhood, and eating convenience store food will, generally, make it less easy to exercise. And, for some reason, these 3 factors are more likely to be present for poor people than rich people. So it's not a complete stretch.
posted by vitabellosi at 4:41 PM on June 3, 2012 [2 favorites]


I run because cookies.
posted by Mooski at 4:54 PM on June 3, 2012 [10 favorites]


Really? People who exercise are closed-minded, poor-hating, anti-science whack-jobs?!

Wow. Just wow.
posted by elwoodwiles at 4:55 PM on June 3, 2012 [5 favorites]


Good god, are we back-lashing against EXERCISE now? REALLY??

Amercia.
posted by XhaustedProphet at 5:15 PM on June 3, 2012 [11 favorites]


It really just makes you better than the lower class of folks who eat poorly and don't exercise and lack either the ability or the ambition to do so...
Of course, being fit is great for your self-esteem and if you're mindlessly happy in that way (which I frankly am), then the point isn't the philosophical or social implications of the thing, it's more that you're just doing it because it helps ease your social anxiety, especially during the summer.


Is this really how you see people who have a lifestyle that is considered unhealthy? That by default they are unhappy and have self esteem problems? Wow. I'm just... wow.

You're trolling, right? Well, no troll food for you, it's probably not healthy anyways. I know that your comment exceeded my daily recommended allowance of (perhaps unintended) condescension already.

Look, I've lived both the extremely fit and extremely unhealthy lifestyles at different points in my life. I was happy and satisfied during both. I have no problem with healthy living, I just have no tolerance for this 'healthier than you = better than you' attitude.
posted by chambers at 5:42 PM on June 3, 2012 [1 favorite]


<Discreetly switches on chambers's critical reading device.>
posted by Nomyte at 5:58 PM on June 3, 2012 [7 favorites]


I, for one, am planning on using this article as an excuse to stop exercising.

Seriously, though. Exercise makes me feel lousy. I get no increased energy, I don't lose weight, I just get tired and hungry. I have never once felt an endorphin rush from working out. I'm at the lower end of the BMI normal range, I'm reasonably strong, and my blood pressure and other bloodwork is fine. Why should I exercise?
posted by snickerdoodle at 6:47 PM on June 3, 2012 [1 favorite]


Our culture's promotion of exercise as a panacea to cure all ills is more like a matter of religious practice than science. We engage in exercise as a ritual practice to appease the gods and ward off evil spirits. The practice of exercise signifies moral worth and assures good fortune. Our belief in the efficacy of exercise is supported by the same sort of magical thinking as belief in the efficacy of ritual sacrifice. It confers the illusion of control over our own mortality, which makes being alive a little less terrifying.
posted by Corvid at 2:36 PM on June 3 [17 favorites +] [!]


You're funny.
posted by docpops at 6:51 PM on June 3, 2012


Life is long, most of the time. Exercise makes the last 2/3 an endeavor where you have a small but real voice in how it turns out, as opposed to paying someone to give you pills that won't help.
posted by docpops at 6:55 PM on June 3, 2012 [4 favorites]


You're trolling, right?

Status seeking is a thing. Of course, it's not the only thing.
posted by MillMan at 7:24 PM on June 3, 2012


"I'm at the lower end of the BMI normal range, I'm reasonably strong, and my blood pressure and other bloodwork is fine. Why should I exercise?"

To stay that way as you age?
posted by Jacqueline at 7:39 PM on June 3, 2012 [9 favorites]


Seriously, though. Exercise makes me feel lousy. I get no increased energy, I don't lose weight, I just get tired and hungry. I have never once felt an endorphin rush from working out. I'm at the lower end of the BMI normal range, I'm reasonably strong, and my blood pressure and other bloodwork is fine. Why should I exercise?

To stay that way.
posted by ferdinand.bardamu at 8:06 PM on June 3, 2012 [1 favorite]


Life is long, most of the time. Exercise makes the last 2/3 an endeavor where you have a small but real voice in how it turns out, as opposed to paying someone to give you pills that won't help.

Yes, exactly. I used to be a stay-as-skinny-as-possible type, only doing cardio and basic calisthenics. Then one day I was doing some landscaping and had to move some railroad ties, something I once did with ease, and found I could barely make them budge. It was a clarifying moment. I was 27 years old, 5' 10", and weighed 140 lbs. (I am male.) I had visions of my grandmother buying milk in 2 quarts because she couldn't lift a half-gallon. I realized that if I was (potentially) extending my lifespan by staying so small, I was doing so at the expense of being weak and unable for a large portion of it. I immediately hit the weights, started eating, and slowly put on thirty-five pounds of muscle over three years.

I now keep lifting and working hard not to live forever but to be as able as possible for as long as possible.
posted by ferdinand.bardamu at 8:16 PM on June 3, 2012 [2 favorites]


I just have no tolerance for this 'healthier than you = better than you' attitude.

If I value cardiovascular health, and I assume that some substantial part of it is under our conscious control, why shouldn't I make a value judgment on people who neglect it to some excessive degree? I don't know. Is there something morally wrong with respecting people more who exert the effort to take care of themselves? I disagree that there is no linkage between physical health and character.
posted by stroke_count at 8:45 PM on June 3, 2012 [2 favorites]


If I value cardiovascular health, and I assume that some substantial part of it is under our conscious control, why shouldn't I make a value judgment on people who neglect it to some excessive degree?

Out of respect for other people's rights to determine and respect their own values rather than hewing to yours, and out of recognition that not everyone has the resources and abilities that make fulfilling your values possible for you.
posted by decathecting at 9:01 PM on June 3, 2012 [10 favorites]


Metafilter has a hard time with fat/exercise threads, damn.
posted by bardic at 9:37 PM on June 3, 2012 [5 favorites]


Hey chambers, I'm not saying exercising is bad or that people who exercise have self-esteem problems, or even all that poor-hating hoo-hah that's apparently become the gist of my comment. Rather, I'm just saying that exercising can help if you do happen to suffer from a touch of the neurotic because it's one less thing you really have to anxiously over-analyze when you head out into the world.
posted by dubusadus at 10:03 PM on June 3, 2012


I disagree that there is no linkage between physical health and character.

It can be a factor, but it is frequently given far more importance in judging character than it should. Most of it is deeply subconscious wiring reinforced by culture, and is not an active, conscious activity. Often I see it in sweeping assumptions applied far too quickly and easily to far too many people based solely on appearance. I do it too, and I just try to be conscious of it when it happens.

RE: My earlier snarky comment - I misinterpreted and reacted badly. I saw a slight that was not really there a paragraph before a statement that I disagreed with. Apologies, dubusadus.
posted by chambers at 10:16 PM on June 3, 2012


I read the paper and didn't see anywhere in it where they address the idea that regression to the mean would cause exactly this effect in the extremes of the distribution. For example, those at the low end of the insulin distribution would be expected to have increased insulin regardless whether anything was done to them. The researchers used a criterion of 2 technical standard error change, but nowhere do they address how likely regression to the mean would be to cause this degree of change. Until they can address that question, this seems like a pretty unremarkable result.
posted by Mental Wimp at 10:46 PM on June 3, 2012 [2 favorites]


In some people, regular exercise masks the symptoms of heart disease bit does nothing to stop it, and eventually creates the stress that triggers a fatal one and only heart attack. See the deaths of Douglas Adams or James Fixx (who basically created the jogging boom), where the first sign of trouble was sudden death.
posted by w0mbat at 10:55 PM on June 3, 2012 [2 favorites]


All this time I thought I was the only one who exercised solely out of hatred for the poor.
posted by univac at 10:57 PM on June 3, 2012 [8 favorites]


I just have no tolerance for this 'healthier than you = better than you' attitude.

Most of the people I know who engage in "healthy living" don't have tolerance for that attitude either. We really don't exercise to feel better than you, we exercise for ourselves.

But do you know what I also have no tolerance for? This escalating war on exercise by the FA community. You don't want to work out? Fine, you really don't need an excuse. It's nobodies business.

Seriously, though. Exercise makes me feel lousy. I get no increased energy, I don't lose weight, I just get tired and hungry.

Also, cocaine makes me feel like a GOD. I get tons of increased energy, I lose tons of weight, and I never feel hungry!

What do you guys think, should I increase my weekly "workout" to three times a week?

It sounds like a snarky response, and it is. But it's also an honest response. What you do with your own body is entirely your own choice (or should be), but A) evaluating long-term health benefits by whether it feels good in the moment is a bad idea, and B) everything good for you doesn't always feel great.
posted by formless at 11:38 PM on June 3, 2012 [5 favorites]


I do think there's something to the idea that exercise and nutrition serve the role that religious ritual used to fill.

Hmmm.
posted by dhartung at 11:59 PM on June 3, 2012 [1 favorite]


I think there might be a problem operationalizing 'exercise.'

Are we talking about:

Lifting weights
Jogging
Running
Something else

For a particular weight/distance/length of time/speed?

Because the suggestions I'm currently seeing in medical literature are walk for about 20-40 mintuees a day. Just stroll a little more quickly than what I'd think of as 'leisurely,' and so much the better if your walk has the purpose of taki g you to buy a newspaper or commute to work.

Medicine pretty much seems to agree that Marathon training is not only unnecessary for most people, but dangerous for some. Dangerous particularly for individuals who cannot afford regular medical care from a primary care physician (as opposed to incredibly expensive emergency room visits.)
posted by bilabial at 1:47 AM on June 4, 2012 [3 favorites]


I was a blob that ate a lot and smoked a lot. And then I got some pains in my neck, and then they found blocked arteries in my heart. Easily fixed. Amazing change.

Then I started exercising and lost weight. OMG! Looking great, feeling great. Until I wrecked my knee (again), last week. Now I can't even reliably walk. I stretched out in bed lastnight and had my knee lock. It came unlocked in it's own time.

The really annoying and frightening part: My resting pulse is now 50. I can bike 20 kph and comfortably carry on a conversation. Yea, I quit smoking when they fixed my heart. Problem now is, I won't get the warning that smoking provided. Smoking contracts the arteries. So any artery that's getting too narrow has the chance to advertise it's distress when you smoke.

It's extremely likely, probably even inevitable, I'll have more clogged arteries. I got them in my legs, too. I'll have them in my heart. Maybe next time I won't know until my heart is ripping itself apart with the charlie horse that ends all charlie horses, literally...perhaps on the tread mill at the cardiologist's.

But I've felt far better since I dropped that weight. It's very frightening to realize how far gone I had become, just looking at what I can do today that I could not do 2 years ago. And yet, I still can't do as I did in my far-of youth (even though my lungs are WAY better).
posted by Goofyy at 4:19 AM on June 4, 2012


Nothing I hate more than seeing the hoity-toity rich snobs at work who walk the stairs instead of using the elevator. It takes them an extra minute to climb seven floors but god-DAMN do they have to rub it in my face with their slightly flushed cheeks and their quick sips at the drinking fountain? It is an assault and an affront on my sedentarism, an excessive display of alarming anti-technology fervor. Just take the elevator, you pretentious, smug bastards, or I'm going to shove a Double Whopper down your ever-loving throat until you choke and die.
posted by (Arsenio) Hall and (Warren) Oates at 4:52 AM on June 4, 2012 [5 favorites]


The point of diminishing returns for exercise if rapidly met, which makes it ripe for conflict and misunderstanding among those who do it and those who don't. Exercise is been a way of life for me as long as I can remember but to characterize it as strictly physical misses the point. I ride my bike for mental release. My attention span is on loan to an employer and my family for many hours of the week. When I ride I have the rare moment of bliss to just think about riding. That it generally keeps me healthy is nice too.

I used to race bicycles and that is definitely beyond the bounds of good health, but if you want to talk about conflict and snobbery I submit bike racing as probably the stupidest group mindset available. Inside that community you are easily convinced that there are possibly several thousand people in the nation who aren't lazy oafs. Exercise is easily the domain of "us vs them" whether you do it or not.
posted by dgran at 6:55 AM on June 4, 2012 [2 favorites]


marathoning, Crossfit, and Beach Body videos. All of these being expensive things that cost money, time, and more importantly, willpower

I don't know about Beach Body videos (because I'm unfamiliar with them) but neither marathoning nor Crossfit need be particularly expensive.
posted by Kurichina at 7:30 AM on June 4, 2012 [1 favorite]


Exercise tightens up your jiggly bits. Isn't that enough?
posted by Kokopuff at 9:03 AM on June 4, 2012 [2 favorites]


Our culture's promotion of exercise as a panacea to cure all ills is more like a matter of religious practice than science.

If you think epidemiology is a real science, the top three most consistent findings of epidemiology related to chronic disease (as opposed to infectious disease or accidents):

1. Poor people get sick more than rich people.

2. Smoking increases your risk of lots and lots of health problems.

3. Exercise decreases your risk of lots and lots of health problems.

Quitting smoking and escaping poverty are pretty hard. Increasing how much you exercise can be difficult (for some people nigh-impossible), but even very modest increases in exercise can dramatically lower your risk for some diseases. Unless you think epidemiology is a complete pseudo-science, exercise really is about the closest thing we know of to a universal silver bullet, the one recommendation that makes sense for almost everyone.
posted by straight at 9:46 AM on June 4, 2012 [1 favorite]


I thought it was well known that exercise isn't good for some people, and you should check with your doctor first. What is the significance of this study? That there weren't any distinguishing markers other than the decline in health after exercising? I guess that is significant because that would mean "check with your doctor" may not work, as the doctor has no way of knowing if you're in the 10% who may have an adverse reaction. (I'm not a physician or a healthy person -- can someone translate the article?)
posted by bluefly at 11:03 AM on June 4, 2012


I thought it was well known that exercise isn't good for some people, and you should check with your doctor first.

This caveat has historically pertained to people with heart or joint ailments that can be exacerbated by stressful exercise. This finding, were it real, would indicate a new group of individuals for whom exercise is harmful. However, it is probably not real, but a function of regression to the mean. This is a phenomenon wherein individuals whose measurements on first reading are extreme have readings closer to the mean on subsequent readings. This happens when readings have inherent reading-to-reading variability or error. This is why the researchers only considered readings truly worsening when they got worse by more than two technical standard errors. This would be adequate for readings around the mean, but for extreme readings, movements of more than this might be possible simply due to regression to the mean. The researchers did not address this issue in their paper at all.
posted by Mental Wimp at 11:51 AM on June 4, 2012 [1 favorite]


There's a good summary of what these studies may mean over at one of my favourite blogs, Sweat Science.
posted by smoke at 6:01 PM on June 4, 2012


In some people, regular exercise masks the symptoms of heart disease bit does nothing to stop it, and eventually creates the stress that triggers a fatal one and only heart attack. See the deaths of Douglas Adams or James Fixx (who basically created the jogging boom), where the first sign of trouble was sudden death.
posted by w0mbat at 6:55 AM on June 4


My granddad smoked sixty a day and lived to be 90!
posted by Decani at 2:36 PM on June 5, 2012


A) evaluating long-term health benefits by whether it feels good in the moment is a bad idea, and B) everything good for you doesn't always feel great.

Oh, absolutely. But my family is full of people who live to a ripe old age, I've gained maybe 5 lbs since college (mostly due to pregnancy), and I have better things to do with my time. So when people talk about exercising in a way that implies that it makes them more virtuous, it reminds that there are a ton of people who simply don't have the time or money to prioritize exercise, and raises my hackles. Discipline, stretching your limits, and taking care of yourself are all good things, but you can accomplish them in other ways. You can make stuff, learn new ideas, or devote time to service. For a lot of people, there's only room for a one or two things after work and family obligations are met, and exercise is not the only valid option.
posted by snickerdoodle at 5:34 AM on June 6, 2012


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