Life insurance

Because I have 3 children (that I know about) and some time off, I figured there was no time like the present to take care of grown-up stuff that I've been avoiding to this time. So I called our car/rental insurance dude and asked him about life insurance.

After usual formalities, he had only one question for me -- "Do you have an exercise program?" Nothing about smoking, or family history, or smoke detectors in the house, or seat belts while driving, or my hobby of fighting bulls with chainsaws glued to their horns.

Of course with my (normally) 60-80 hr a week job, 3 kids, and aforementioned toreador duties, I don't have an exercise program. I barely have a seeing-the-kids program many months. I walk the stairs at work (I work on the 4th floor and we often have patients on the 8th), I am on my feet most of the day, and of course I try to at least roll around with the kids a little.

The question struck me as a little weird. Not because I completely doubt exercise -- it has proven benefit in preventing prediabetes turning into diabetes, also bunches of stuff on it improving COPD, heart disease, obesity, osteoporosis, yada yada yada. But it got me thinking about the science of exercise in someone like me -- mid 30s, no comorbidities, not overweight, last I checked not hyperlipidemic or hypertensive.

It proves there is not much out there. I spent a few hours flipping through the PubMed results for different searches in which I was specifically looking for outcomes. As you can imagine, most searches bring back several thousand articles, so I narrowed in to review articles. This absence of evidence is unsurprising, as a study to look for adverse outcomes on healthy adults would have to be enormous in order to show any sort of effect (because events are rare). As always, absence of evidence is not evidence of absence. The interesting thing, though, was a number of papers (for example here that I found that support really moderate physical activity (30 minutes of walking a day and it doesn't matter if it's at work, plus a bit of resistance training) in healthy people. More activity, in some studies, is associated with negative outcomes.

This makes physiologic sense. Among the only things that have prolonged lifespan in animal models are reduced caloric intake. The metabolic process itself generates bad things, like the over-hyped "free radicals", which contribute to disease and aging. It doesn't make sense to overeat and then to try to burn it off in the gym because you are just causing metabolism to go into overdrive.

In short, I think I'll have to incorporate some resistive exercise and increase my walking, probably to stave off hypertension, hyperlipidemia, and frailty. Also to keep myself from becoming overweight, which is expected as metabolism normally slows down with age. But it's far from clear that a regular exercise program beyond the very mild recommendations does anything to promote health or survival in a healthy age group, and I don't see why it's the first question from a life insurer.