Exercised by Lieberman

Exercised by Dan Lieberman: A review

Lieberman, D. (2020). Exercised: The Science of Physical Activity, Rest and Health. Penguin UK. [publisher link]

I’ve been thinking about physical activity, exercise and health for about 25 years now working face to face with several thousand people over that period trying to support health-enhancing physical activity behaviours but also teaching and researching issues around physical activity and health in an educational setting, trying to support and develop the next generation of physical activity advocates.

This wealth of experience gives me many perspectives on the reasons why people tend to be more or less active and the challenges that face us when trying to communicate messages and design interventions to encourage people to limit their sedentary behaviours and increase levels of activity and exercise in a consistent and maintained manner. In two words; it’s hard.

It’s with this perspective that I really enjoyed Dan Lieberman’s recent book, Exercised. Lieberman is a paleoanthropologist at Harvard University, and is well known for his love of running and in particular associated with the phenomenon of barefoot running thanks to his 2004 article in Nature, “Endurance running and the evolution of Homo”. For many years, Lieberman has combined techniques from physiology, biomechanics, anatomy and palaeontology in the lab and most notably in the field to study ancient people but also contemporary hunter-gatherers like the San of the Kalahari, the Aché of the Amazon and the Hadza of Tanzania.

Lieberman uses all of this knowledge and insight to consider how humans have adapted over many thousands of years to ensure that our bodies are fit for their optimal evolutionary purposes. For most of human evolution, calories were precious and exertion unavoidable, so natural selection favoured those that could conserve calories so that we could use them for evolutionarily beneficial activities such as reproduction and cognition.

Throughout the book, Prof Lieberman builds an interesting and persuasive argument that far from being muscle-clad hunter-gatherer warriors our ancient forebears were much lighter and leaner than many would like to think and that when they didn’t need to be active they weren’t. They rested to conserve calories and to be ready for times when they did need to be active. Conversely, they were very active; life was hard. Lot’s of walking, repetitive physical work like harvesting tubers, sitting more actively than we do these days and dancing, lot’s of dancing. Crucially, they never needed to exercise, to consciously choose to stop what they were doing and to put considerable cognitive and physical effort into changing clothes, investing time in going somewhere and even paying for the privilege; that’s what is not natural.

The book is very well written and easy to read combining well chosen scientific literature from a range of fields and intertwining it with personal stories and anthropological insight. For people who are interested in promoting the benefits of physical activity for health yet also have a critical awareness of issues such as the intention-behaviour gap, fat shaming and health inequalities for example, this book is an excellent piece of the jigsaw in understanding what’s “normal” and what the best interventions and change initiatives might be.

As one example, the chapter on sleep is a great perspective on a wealth of recent public conversations on the topic. The idea that it’s to our evolutionary advantage that we all have slightly different sleep patterns and that ancient people would most likely fall asleep more easily with the comforting sound of a crackling fire and the babble of community conversation close-by are examples of insights gleaned from a lost world that can give perspective on more contemporary values and norms. Similarly, the evolutionary benefits of healthy and active aging are discussed and concepts such as the active grandparent and costly repair hypothesis introduced and explained well.

The title of the book, exercised, is a play on the word in that Lieberman refers to those that look down on others who view a lack of regimented, self-motivated fitness training as a moral failure as exercists and the main thesis of the book is that while it is very natural to be quite active, it is unnatural to have to choose this way of life. The stories told in support of this thesis are however well worth reading and a better understanding of this principle has to be a good thing when we are all thinking of ways to reduce sedentary time and ensure people are as active as they were evolutionarily designed to be.

Related Articles by Dan Lieberman

Bramble, D. M., & Lieberman, D. E. (2004). Endurance running and the evolution of Homo. Nature, 432(7015), 345-352. https://doi.org/10.1038/nature03052

Lieberman, D. E. (2015). Is exercise really medicine? An evolutionary perspective. Current sports medicine reports, 14(4), 313-319. https://doi.org/10.1249/jsr.0000000000000168

Lieberman, D. E., Mahaffey, M., Cubesare Quimare, S., Holowka, N. B., Wallace, I. J., Baggish, A. L., ... & Baggish, A. L. (2020). Running in tarahumara (rarámuri) culture: Persistence hunting, footracing, dancing, work, and the fallacy of the athletic savage. Current Anthropology, 61(3), 000-000. https://doi.org/10.1086/708810

Selected Articles referenced in the book

Aggarwal, B. B., Krishnan, S., & Guha, S. (Eds.). (2011). Inflammation, Lifestyle and Chronic Diseases: The Silent Link. CRC Press.

Baggish, A. L., Wang, F., Weiner, R. B., Elinoff, J. M., Tournoux, F., Boland, A., ... & Wood, M. J. (2008). Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes. Journal of applied physiology, 104(4), 1121-1128. https://doi.org/10.1152/japplphysiol.01170.2007

Basso, J. C., & Suzuki, W. A. (2017). The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: a review. Brain Plasticity, 2(2), 127-152. https://content.iospress.com/articles/brain-plasticity/bpl160040

Berenbaum, F., Wallace, I. J., Lieberman, D. E., & Felson, D. T. (2018). Modern-day environmental factors in the pathogenesis of osteoarthritis. Nature Reviews Rheumatology, 14(11), 674-681. https://doi.org/10.1038/s41584-018-0073-x

Chakravarty, E. F., Hubert, H. B., Lingala, V. B., Zatarain, E., & Fries, J. F. (2008). Long distance running and knee osteoarthritis: a prospective study. American journal of preventive medicine, 35(2), 133-138. https://dx.doi.org/10.1016%2Fj.amepre.2008.03.032

Christakis, N. A. (2019). Blueprint: The evolutionary origins of a good society. Hachette UK.

Damas, F., Libardi, C. A., & Ugrinowitsch, C. (2018). The development of skeletal muscle hypertrophy through resistance training: the role of muscle damage and muscle protein synthesis. European journal of applied physiology, 118(3), 485-500. https://doi.org/10.1007/s00421-017-3792-9

Dybala, M. P., Brady, M. J., & Hara, M. (2019). Disparity in adiposity among adults with normal body mass index and waist-to-height ratio. Iscience, 21, 612-623. https://doi.org/10.1016/j.isci.2019.10.062

Ekkekakis, P. (2009). Let them roam free?. Sports Medicine, 39(10), 857-888. https://doi.org/10.2165/11315210-000000000-00000

Evans, W. J. (2010). Skeletal muscle loss: cachexia, sarcopenia, and inactivity. The American journal of clinical nutrition, 91(4), 1123S-1127S. https://doi.org/10.3945/ajcn.2010.28608A

Foreman, J. (2019). Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging. Oxford University Press.

Green, D. J., Hopman, M. T., Padilla, J., Laughlin, M. H., & Thijssen, D. H. (2017). Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Physiological Reviews, 97(2), 495-528. https://doi.org/10.1152/physrev.00014.2016

Handsfield, G. G., Knaus, K. R., Fiorentino, N. M., Meyer, C. H., Hart, J. M., & Blemker, S. S. (2017). Adding muscle where you need it: non‐uniform hypertrophy patterns in elite sprinters. Scandinavian journal of medicine & science in sports, 27(10), 1050-1060.

Herzog, W., Leonard, T. R., Joumaa, V., & Mehta, A. (2008). Mysteries of muscle contraction. Journal of applied biomechanics, 24(1), 1-13.

Jung, M. E., Bourne, J. E., & Little, J. P. (2014). Where does HIT fit? An examination of the affective response to high-intensity intervals in comparison to continuous moderate-and continuous vigorous-intensity exercise in the exercise intensity-affect continuum. PloS one, 9(12), e114541. https://doi.org/10.1371/journal.pone.0114541

Karlsson, M. K., & Rosengren, B. E. (2012). Physical activity as a strategy to reduce the risk of osteoporosis and fragility fractures. International journal of endocrinology and metabolism, 10(3), 527. https://dx.doi.org/10.5812%2Fijem.3309

Lightfoot, J. T., De Geus, E. J., Booth, F. W., Bray, M. S., Den Hoed, M., Kaprio, J., ... & Bouchard, C. (2018). Biological/genetic regulation of physical activity level: consensus from GenBioPAC. Medicine and science in sports and exercise, 50(4), 863. https://dx.doi.org/10.1249%2FMSS.0000000000001499

Monteiro, A. G., Alveno, D. A., Prado, M., Monteiro, G. D. A., Ugrinowitsch, C., Aoki, M. S., & Piçarro, I. D. C. (2008). Acute physiological responses to different circuit training protocols. Journal of Sports Medicine and Physical Fitness, 48(4), 438.

Nesse, R. M. (2019). Good reasons for bad feelings: insights from the frontier of evolutionary psychiatry. Penguin.

Price, A. (2016) Year of the Dunk: My Search for the History, Science, and Human Potential in Basketball’s Most Dramatic Play

Rana, S. R., Chleboun, G. S., Gilders, R. M., Hagerman, F. C., Herman, J. R., Hikida, R. S., ... & Toma, K. (2008). Comparison of early phase adaptations for traditional strength and endurance, and low velocity resistance training programs in college-aged women. The Journal of Strength & Conditioning Research, 22(1), 119-127.

Rook, G. A. (Ed.). (2009). The hygiene hypothesis and Darwinian medicine. Springer Science & Business Media.

Simpson, R. J., Campbell, J. P., Gleeson, M., Krüger, K., Nieman, D. C., Pyne, D. B., ... & Walsh, N. P. (2020). Can exercise affect immune function to increase susceptibility to infection?. Exercise immunology review, 26, 8-22. https://pubmed.ncbi.nlm.nih.gov/32139352/

Stalsberg, R., & Pedersen, A. V. (2018). Are differences in physical activity across socioeconomic groups associated with choice of physical activity variables to report?. International journal of environmental research and public health, 15(5), 922. https://doi.org/10.3390/ijerph15050922

Stamatakis, E., Lee, I. M., Bennie, J., Freeston, J., Hamer, M., O'Donovan, G., ... & Mavros, Y. (2017). Does strength promoting exercise confer unique health benefits? A pooled analysis of eleven population cohorts with all-cause, cancer, and cardiovascular mortality endpoints. American Journal of Epidemiology. Vol.187, No. 5: 1102–1112, https://doi.org/10.1093/aje/kwx345

Tara, S. (2016). The Secret Life of Fat: The Science Behind the Body's Least Understood Organ and what it Means for You. WW Norton & Company.

Thompson, R. C., Allam, A. H., Lombardi, G. P., Wann, L. S., Sutherland, M. L., Sutherland, J. D., ... & Thomas, G. S. (2013). Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations. The lancet, 381(9873), 1211-1222. https://doi.org/10.1016/S0140-6736(13)60598-X

Vecchio, L. M., Meng, Y., Xhima, K., Lipsman, N., Hamani, C., & Aubert, I. (2018). The neuroprotective effects of exercise: maintaining a healthy brain throughout aging. Brain plasticity, 4(1), 17-52. https://content.iospress.com/articles/brain-plasticity/bpl180069

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