Review: The First 20 Minutes, by Gretchen Reynolds

Reynolds is the author of The New York TimesPhys Ed Well Blog. She’s written for The New York Times Magazine, O: The Oprah Magazine, AARP Magazine, Popular Science, and Outside. Click here for buy links.

I purchased The First 20 Minutes for my Kindle on whim. At $13.64 it was an expensive whim (price now is $12.99). Published in April of this year in hardcover and digital by Hudson Street Press (a division of Penguin), The First 20 Minutes provides more in depth chapters on many of the exercise related topics Reynolds covers in her blogs for the NYT and writing for magazines like Outside. Subjects include the value (or lack thereof) of stretching, sports nutrition, weight loss and exercise, endurance, strength training, burnout and injury, the relationship of exercise to the brain, genetics and fitness, and longevity.

Each chapter begins with an anecdote, usually results of a study that fly in the face of common sense or conventional wisdom, then proceeds to take the reader through several other studies on the subject, with comments — often wry or ironic — from researchers, and some comic aside or an autobiographical comment from Reynolds. Here’s an example of Reynolds’ subtle humor:

In a study that might well have gone viral if more teenage girls subscribed to the British Medical Journal, scientists in Denmark discovered that those of us with sturdy, muscular thighs, typically conferred by strength training, live longer than those with stick figure slender thighs. Contrary to popular belief, thunder thighs are desirable and healthy.

The First 20 Minutes is well-written and readable, exactly like Reynolds’ magazine and blog writing. Indeed, as is typical of books by journalists, many of these chapters are expanded and/or updated versions of previously published articles. The book is marketed as as a “how to”:

Reynolds tackles the questions we all have and (sometimes) ask about exercise. Consulting experts in physiology, biology, psychology, neurology, and sports, she uncovers how often we should exercise, how long workouts should be, how to avoid injury, and how to find the right form, routine and equipment for our goals.

That’s not exactly misleading, but readers should be prepared for meandering chapters which report on study after study, many of which contradict each other, are tentative and provisional, or are limited in applicability to the average reader. Each chapter concludes with concrete suggestions (“take-aways”) for the reader. Reynolds has a flair for science writing for the lay reader, and makes a big effort to connect the science reporting with the how-to aspect of the book, but a reader who doesn’t care about the “why” and just wants exercise and fitness tips should borrow this title from the library and read the last two pages of each chapter.

Here’s an excerpt (from NPR) which gives a good sense of how the book is written:

Recently researchers in Scotland trawled through a vast database of survey data about the health and habits of men and women in that fair land, similar to the BRFSS survey here. In this case, the scientists were looking to see how much exercise was needed to keep the average Scotsman or — woman from feeling dour (or in technical terms, experiencing “psychological distress”). Scots are not famed for being blithe-hearted, and many of us might have expected that firm measures and lots of sweat would be required. But as it turned out, researchers found that a mere twenty minutes a week — a week! — of any physical activity, whether vigorous or easy, improved the respondents’ dispositions. The activities in question ranged from organized sports to walking, gardening, and even housecleaning, the last not usually associated with bliss. The researchers found that, in general, more activity did confer more mental health benefits and that “participation in vigorous sports activities” tended to be the “most beneficial for mental health.” But overall their conclusion was that being active for as little as twenty minutes a week was sufficient, if your specific goal happened to be a sanguine temper.

The question of just how little activity people can get away with has preoccupied exercise scientists in recent years, in part because so many of us have proven so resistant to any exercise. There was a time, in the 1970s and 1980s, when most exercise guidelines, including those from the American College of Sports Medicine (ACSM) and other groups, aimed at athleticism; they recommended that people engage in prolonged, uninterrupted, vigorous activity for an hour or more, multiple times a week. Basically, people should run, swim, or bicycle, the recommendations suggested, and they should do so hard, and the more the better.

Some people responded. That was the height of the 1970s running boom. Then in 1984, Jim Fixx, the author of The Complete Book of Running, died at age fifty-two of a “fulminant heart attack” while marathon training. Running didn’t kill him. He’d been afflicted, an autopsy showed, with intractable heart disease, probably congenital. But some people gleefully and ghoulishly pointed to his death as a reason to remain couch-bound. Even more Americans, though, hadn’t needed such an excuse. They had not been inspired to exercise in the first place, at least not hard, and resolutely continued not to.

By the 1990s, formal exercise recommendations, bowing to human nature, had softened, and experts were suggesting that less-vigorous exercise might be sufficient. In 1995, the ACSM and the CDC jointly announced that “Every U.S. adult should accumulate thirty minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.”

But there still was little science behind any exercise guidelines, including that one. So in the mid-2000s, the U.S. Department of Health and Human Services convened an advisory committee of scientists, including physiologists, cardiologists, epidemiologists, nutritionists, and others, and asked them to scrutinize decades of studies about the benefits— and risks— of exercise and to formulate new, evidence-based guidelines. The result was the massive 2008 Physical Activity Guidelines for Americans, which began on a cautionary note. The “amount of physical activity necessary to produce health benefits cannot yet be identified with a high degree of precision,” the authors wrote.

The First 20 Minutes has all of the limitations than any science reporting does. Reynolds says in the genetics chapter: “This chapter is out of date. It would have been out of date if you’d read it the week I finished it.” But that is true for the entire book, really. In chapter after chapter Reynolds reminds us of once widely held but now discarded beliefs (like that stretching cold muscles is a good way to prevent injury, or that straight legged sit-ups are the best route to abdominal strength, or that you can keep doing the exact same exercise routine and expect to keep improving fitness). Those discarded beliefs of yesteryear hang like ghosts around The First Twenty Minutes.

Reynolds has reported on masculine bias in subject selection, so I was glad to see that she was usually careful to state the genders of the study participants. And she goes to some lengths to talk about the way gender specific factors, like estrogen, impact (often positively) fitness and health. She was also good about signaling the fitness levels and ages of study participants. Many studies are done on super lean, super fit, super young male college athletes, and those results aren’t always directly applicable to the average person, especially if they have different goals. For example, stretching doesn’t improve (it actually hurts) performance, and flexibility doesn’t seem correlated at all with athletic ability or reduction in rates of injury. But stretching might still help some people meet some goals (reach a soup can in a bottom drawer?).

The overall take-home message is clear. Here’s how one doctor put it:

“Do you want to live to be a hundred? … being active is the best, easiest, and cheapest way to decrease all-cause mortality and increase functional life span. People who don’t exercise are at greatly increased risk of dying earlier than they need to.”

The First Twenty Minutes is a quick, interesting, and informative read. I’m not sure how much of it will stay with me, but if you are interested in this topic, I recommend checking it out.

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