Most people are less physically active than they should be. So, when you get the chance to take a flight of stairs, do it. Think of the escalator as your enemy and the stairs as your friend. A new analysis reinforces the message that climbing a few flights is well worth the effort.
Researchers combined the results of nine studies involving almost half a million people. The participants were followed for about 14 years. Those who regularly climbed stairs had a 39 per cent lower risk of cardiovascular death and a 24 per cent lower risk of death from any cause than those who did not regularly climb stairs. Those are impressive numbers. Climb the stairs!
Here is a lesson in understanding these kinds of studies. They were observational, meaning there was no random assignment of half a million people to climb stairs and the other half to take elevators. Instead, researchers arrived at their conclusion by watching what people were already doing and then looking at what happened to them over many years.
This opens the door to a problem called reverse causation. Think about two people standing in the lobby of an office building. One walks toward the staircase. The other presses the elevator button. It is tempting to conclude that the person taking the stairs is healthier because stair climbing is making that person healthier.
Healthier people like to take the stairs as a matter of course. These people already have stronger legs, better balance, better lungs and healthier hearts. They are lighter, more active and less likely to have arthritis. Those waiting for the elevator may already have heart disease, shortness of breath, bad knees or some other condition that makes climbing stairs difficult.
In that case, the stairs are not necessarily the cause of the difference. They are instead a marker of the difference. This is what scientists mean by reverse causation. The apparent cause and effect can run in the opposite direction from what we assume. It is an important caution because headlines are particularly good at turning associations into prescriptions.
Benjamin Franklin would have understood the argument. In 1772, when he was 66, Franklin wrote to his son about the virtues of exercise and observed that walking a mile up and down stairs provided more exercise than walking five miles on level ground. He also pointed out the convenience: stair climbing could be done indoors when bad weather discouraged going outside, or when a person was short of time. More than 250 years later, the inventor in Franklin would surely have admired the innovation of elevators, escalators, and all sorts of other conveniences. As an astute observer of the world, would he have recognized that in making life easier, we have also made ourselves less active?
Unlike walking on level ground, climbing requires lifting our body weight against gravity. The large muscles of the legs have more work to do. Heart rate and breathing rise quickly as they demand more oxygen and energy. Stair climbing can therefore deliver a vigorous cardiovascular workout in a short time.
Take the stairs at work. Walk to the store. If you drive, park further away. Get a dog and walk it. Do these things with happiness. Do not let modern conveniences lull you into poor health.
Remember, stairs demand our respect, especially as we age. Balance, vision, muscle strength, and reaction time change. Medications add to the risk of falling. A staircase is an excellent piece of exercise equipment when using it deliberately. Use the handrail! Mind your footwear. Remove any obstacles. Stay safe while being healthy.
This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more.
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Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!


