My 56 year-old brother calls me.

“I have to get a heart scan, the Doc’s not happy about my stress test and wants to check a few things out,” he says. “My cholesterol’s a bit high…and I’m a few pounds on the wrong side of normal,” he adds worryingly. And then the inevitable question, “Why is that…”? he asks.

When someone asks me a question like that, I’m always confused as to whether I need to answer it like a Trivial Pursuit question (Like, what is the capital of Mexico?). How is it that he thinks I know the answer when it’s his problem? I wouldn’t have a clue as to why he’s overweight. Although he would. I pepper him…

”Are you eating clean, eating too much, sleeping properly? What about sugar intake etc?”, I ask.  And then the bombshell…”What exercise have you done in the last week, month, year…?” Silence. “Are you still there…”? I ask. Still silence.

“Smartarse”, he says smugly.  I thought it was a pretty straight forward question.

In my experience, people will go to the ends of the Earth to hack their way to ‘better’ health, whether it be restricting their calories (unsustainable), drinking ‘heath’ shakes to lose weight quickly (still unsustainable and a dumb idea) or buying the latest ‘muscle vibration machine’ (seriously?)…anything which will break the circuit and do the job quickly. As humans we’ll err on the side of easy in preference to what’s necessary.

My brother had to face the reality that exercise was his sticking point. Like most of us he’s confusing his busy lifestyle with physical activity. The two are not interchangeable. Being ‘busy’ does not mean you’re physically active. It’s just gives the illusion that you are. At middle-age, my brother needs to change his thinking. He needs to understand what is about to happen (or indeed what has been happening) in his body to get a greater appreciation of his future health. Let’s take closer look at the two main eventualities which we all face approaching middle-age.

1. From age 30, your body begins to lose 1% of its muscle mass each year. This means the 40-50% (men) or 30 – 40% (women) of muscle mass you had will reduce to the mid 20% (men) and under 20% (women) by the time we reach 70. This process (called sarcopenia) is a built-in metabolic disaster. Imagine slicing your car engine in half yet driving it under the same conditions you do now. You see, muscles are our metabolic ‘powerhouses’ which burn energy as we move. More importantly, they also burn energy ‘at rest’ i.e. when sleeping or lying on the couch. The more muscle mass you have the more energy you burn. Period. So, as we age and our muscle mass decreases not only does our strength decline but also the ability to burn ‘maintenance’ calories – hence the gradual body weight gain over time.  No doubt this is what my brother was experiencing.  His weight had climbed by the stairs and of course, he wants it lose it now via the elevator.

2. Your body contains 650 skeletal muscles which attach to 206 bones. Again, these bones begin to lose density, in other words, become more fragile and therefore likely to break from age 30. This is due to bones losing calcium over time, leading to a condition known as Osteoporosis. Your muscles and bones are designed for movement to navigate the infinite pulling, pushing, bending, squatting, twisting, stepping, running and gripping required daily to survive. In a classic tale of ‘lose it if you don’t use it’ your body will adapt specifically to what you bestow upon it. Sitting in the office chair all day will result in weak core and postural muscles. If your physical lifting capacity is walking the washing basket to the clothes line each week, your shoulder, arm and lower back muscles will be no stronger than what it takes to carry out this activity. The decline of muscle and bone strength is directly related to the amount of ‘movement stress’ we place on it as we age. These factors – the natural decline of muscle mass, the loss of muscle strength and bone density can have enormous repercussions as we age.

Why is all this so important? Well, it all has to do with our health span. Quite simply, this is the term given to describe the quality of our lives as we age. Life span, on the other hand, is the amount of years between life and death. If we don’t intervene (I’ll get to that in a moment), health span will decrease rapidly with life span. In fact, the quality of our days will decrease BY HALF in the last 10 years of life (say between 70-80 years) when compared to the first 70 YEARS! Think of the health span of the 75-year-old who breaks their hip due to Osteoporosis. They spend most their remaining months (or if they survive, years) in high care with loss of movement and the ever-dangerous threat of infection or blood clotting. At that age there is no coming back from this. By a lesser extreme, heart attack patients can have a severely affected lives for years with drug medications or follow-up surgery.

This rapid and inevitable decline in the quality of our lives can take hold if we don’t prepare for it. The good news is that researchers have discovered a naturally recurring ‘drug’ which can stop health span decline in its tracks. It’s free, available every day and costs nothing. Surprisingly, 100% of doctors know about it but only 2% prescribe it. It’s called exercise. Every major study about exercise and aging always concludes with the basic premise: Exercise is the single most powerful method to increase both our health span and life span. It increases muscle strength, bone density and muscle mass even into our 90’s. It’s more potent than any laboratory or naturally occurring prescribed drug in existence and without the side effects. Exercise works. It’s the only ‘wonder drug’ you’ll ever need.

At middle-age my brother has a choice. Does he continue down the health span decline path, or does he intervene? I guess it comes down to what he sees as a priority. For me, exercise is an investment towards my approaching retirement years to be enjoyed with burly bones and strong muscles that can lift and push my frame around, pain-free. I know my habits now will reap huge rewards in years to come.

Which will you choose?