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Ep. 68 – Reducing risk of dying of cardiovascular disease

How would you like an easy way to reduce your risk of dying of cardiovascular disease? Two new studies show that stretching decreases the risk. Dr. Chet Zelasko takes a look at the research on this episode

Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the world of health. Nutrition. Exercise. Diet. Supplementation. If there’s something new, I look at the science behind them, and let you know whether it’s real or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.

Quick! If I were to ask you which form of exercise would decrease your chance of dying AKA mortality rate, and especially your chance of dying from cardiovascular disease (CVD), what would your answer be? Don’t think about it. What popped into your mind first? Three seconds.

You probably picked some form of aerobic exercise such as running, elliptical training, walking, and cycling—any type of exercise that works the heart and the entire body to improve your cardiovascular fitness. No question about it - that’s on the list for sure, but it’s not the form of exercise that seems to decrease your risk of dying the most. Data from two large observational studies show this form of exercise decreases your risk of dying the most: stretching.

Stretching? Stretching is that toe-touching and heel-to-butt type of stretching we were all taught in high school or some other fitness class. Stretching is putting your foot on a rock or a fire hydrant and trying to touch your toe when you're out for a jog. It's that deep breathing and arm shaking in circles that you do before you start lifting weights. Those are all part of it but that’s not all.

What also counts as stretching would be activities such as yoga, tai chi, and qigong. Those types of stretching feature slow, elaborate movements that control the body in ways that result in stretching the muscles and other connective tissue. Those all count as stretching.

The question is, how much does it reduce mortality? Let's take a look at the research results from those studies about exercise and longevity. In one study, over 26,000 American adults took the National Health Interview Survey and reported their exercise types back in 1998. They were followed to observe all-cause mortality through the end of 2015. When you do this kind of study you have to use a variety of wats to statistically account for age at the beginning of the study, overall risk of cardiovascular disease, and several other things. What they found, is that after 17 years of following those adults, there were close to 5000 deaths. After adjusting for all the things I had mentioned and more, they found that walking, aerobics, stretching, weightlifting, and stair climbing were all related to lower risks of mortality. When each exercise was examined individually, stretching reduced the mortality risk the most at 10%. Of course, combining the different types of exercise such as stretching with aerobic exercise and weight lifting could potentially decrease the risk by 22%. Still, it was surprising that stretching was highest on the list.

In another study published in 2023, researchers followed close to 35,000 people who had taken the Korea National Health and Nutrition Examination Survey between 2007 2013. Data were collected through December 2019. What they found was that five days of flexibility training when compared to no days, reduced the all-cause mortality hazard ratio by 20% and the cardiovascular mortality by 25%. Aerobic physical activity at the amounts recommended here in the United States as well as in Korea were also associated with lower all-cause mortality of 18% and cardiovascular mortality by 45%.

But stretching? How or why? Why would stretching decrease mortality? There are no definitive answers, but here are a few possibilities.

It may be that stretching strengthens the blood vessels as well as the connective tissue; that may decrease the potential for blockages or building up plaque in the arteries. Or it may be that the deep breathing that’s associated with most forms of stretching also contributes to the health of the heart and lungs.

One of the other benefits of stretching is a resultant increase in strength. Stretching makes you stronger? It won’t make you a body builder but yes, it does. Stretching could help keep the muscles more pliable, and that’s important at any age. I’ve already mentioned that there may be an improvement in arterial function when undertaking stretching, but associated with stretching is a reduction in resting heart rate and an increase in vasodilation. Together, the net impact could lower blood pressure, which would reduce mortality.

I think that one of the most important benefits is going to be related to mobility and balance. We often only think of the flexibility of the muscles of our hips and our knees, but something as simple as raising your hands above your head can benefit stretching those lower joints as well. And all that contributes to your ability to move in space as you get older; maybe you move more if you stretch regularly. By regularly, that means five days a week, the criterion in one of the studies I mentioned.

Finding out the why stretching helps may take a while, but the fact is that there are benefits to what we would consider the easiest forms of exercise. Let me give you an example. A young man I know just celebrated his 90th birthday, I've known him for probably 20 years but only see him occasionally. I write e-mail messages that are a very condensed version of some of the Straight Talk On Health podcasts. When he read the one on stretching, he e-mailed me with his story. He sent me a photograph of he and his wife on his 90th birthday in the gym. When he turned 62 years of age and retired, he decided that he was going to exercise regularly. In his case, he and his wife go to the gym three days a week and according to him, he hasn't missed more than a day or two over the years. Stretching is part of his routine as well as a focus on weight training. Do I need to say again that he's celebrating his 90th birthday? I hope you get the point. Motion is lotion for your joints, for your muscles, and for your mortality. Reducing mortality that is.

As you move forward through this year, when you have a few minutes in every day, whether it’s waiting for the microwave to finish heating a cup of coffee, washing your hands after using the bathroom, or standing alone on an elevator, taking the time to do purposeful stretching may provide a benefit that you don’t envision. You could take three deep breaths while raising your hands above your head and standing up on your tip toes. You could rock back and forth, going toe to heel and back again 5 times. I’m sure you can figure what to do.

To take it one step further, put together a short routine of three to ten minutes that you do every day; if you have old injuries or joint issues, an appointment with a physical therapist can help you devise a routine you can do safely. And now that spring has sprung and you can get out of the house a little easier, try a class in yoga, tai chi, or qigong. That’s what I’m doing. You can also check out one of the video channels to see what’s available. Be sure to look for one that’s within your abilities; Paula and I tried a class a few years ago and were embarrassed that we couldn’t get up and down as easily as the 20-somethings.

The net effect should be that your muscles and your connective tissue will be more pliable. Who knows, you just may end up living a little while longer as well! Sounds like a good investment of time to me. Speaking of time, I’m all out of time. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.


1. Med Sci Sports Exerc. 2020 Dec;52(12):2554-2562

2. BMC Public Health. 2023; 23:1148.

Dr. Chet Zelasko is a scientist, speaker, and author. Dr. Chet has a Ph.D. and MA in Exercise Physiology and Health Education from Michigan State University and a BS in Physical Education from Canisius College. He’s certified by the American College of Sports Medicine as a Health and Fitness Specialist, belongs to the American Society of Nutrition, and has conducted research and been published in peer-reviewed journals. You can find him online at drchet.com.
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