How to Exercise for Longevity: The Aerobic Manual

Your fitness is one of the strongest predictors we have of how long you live. If you feel daunted about exercising, or wanting to understand why it's so crucial to preventing disease, then I think you'll find it useful. I talk about what aerobic fitness actually is, what it does to your body, how much you need, and then more than thirty complete workouts written out minute by minute so you can start this week.

What you get

• 75 pages, written for people who aren't used to cardio and want to understand it before they start

• The full explanation of what fitness is doing inside you

• More than thirty complete workouts, each one laid out minute by minute so you can see exactly what to do

• A full walking manual covering technique, cadence, shoes, weather and the walking workouts

• An entire section on everything that isn't walking, so cycling, swimming, rowing, running, interval training, the gym machines, skipping, bag work, dancing, sport and hiking

• Home tests you can do today and repeat in a month, so you can actually see your fitness moving

• Four weekly plans, including one that starts at ten minutes a day and one built around shift work

• Clear warnings wherever the advice changes for heart disease, diabetes, pregnancy, blood thinners, lung conditions and more

• A twelve week tracker, a one page summary for the fridge, and a full reference list so you can check anything I've said for yourself

You don't need a gym, or any equipment at all

Nearly everything in here needs a pair of shoes and a road outside your door. The plan for somebody starting from nothing begins at ten minutes a day and builds to the full guideline over twelve weeks without a single leap in it, and there's a twenty minute session for the days when you can't get out of the house.

There's also a set of tests at the start that cost nothing and take about half an hour between them. One of them takes ten seconds, needs nothing at all, and tells you something genuinely useful about whether you'll still be independent at eighty. Most people have never been asked to do it.

The number that predicts more than almost anything

There's one measurement that came out worse than smoking, worse than type 2 diabetes and worse than kidney disease when researchers lined the risk factors up against each other in a study of over 120,000 people. It's improvable at any age, from any starting point, and no clinic is going to test it for you.

I explain what it is, what happens to it across the decades if you leave it alone, how to estimate yours at home, and exactly what raises it. The arithmetic on that last part is the section people find most sobering, because it shows you roughly how many good years are on the table.

How hard should you actually be going?

This is where a lot of the popular advice has run ahead of the evidence. When one very large study followed 116,221 adults for thirty years and pulled moderate and vigorous exercise apart, what it found about hard training surprised a lot of people, and it changes how you should build your week.

I set that out properly, along with the one protocol that raises fitness faster than anything else we've tested, how often to do it, and who should leave it well alone for now.

Then everything that isn't walking

Walking is the backbone of the manual because it's free and people keep doing it into old age. It isn't the only option, and for some of you it won't be the right one.

So there's a full section on the alternatives, each with an explanation of which muscles are working, how to do it without hurting yourself, and two or three complete workouts. Cycling, swimming, rowing, running with an eight week build up for people who've never run, interval training and HIIT, the machines in a gym, skipping, bag work, dancing and classes, racquet and team sports, and hiking.

There's also a section on the three things that decide whether any of this is still happening in five years, and the research behind them is more interesting than you'd expect.

Why nobody is going to offer you any of this

The health service I work in is quite brilliant at rescuing people and pretty poor at catching things early. We're extraordinary in a crisis. Give us somebody halfway through a heart attack and we'll do remarkable things for them. Ask us to go and find the twenty years of slow decline that led up to it and the system was never really built for that, because it's funded to react rather than to prevent.

Which means this one sits entirely with you. That sounds like bad news and I'd argue it's the opposite, because there aren't many things in health you get to take that much control over.

It's honest about what it can't do

There's a section at the front on when to speak to a doctor before you start, and what symptoms mean stopping a session rather than pushing through it. Nothing in the manual is ever a reason to change medication you've been prescribed. And there's a full set of adaptations for different bodies, including the one situation where the general advice in the manual would be the wrong advice for you, which I say plainly rather than burying.

Who this is for

If you've never really done any cardio, or you did years ago and stopped, or you walk a bit but nothing that leaves you out of breath, this was written for you. If you're already fit, the sections on dose, intensity and recovery will still be worth your time, but the plans are pitched below where you are.

This covers aerobic exercise. Strength has its own manual, because the two do genuinely different jobs and neither one covers for the other.

What I'd really like you to take from it is that this isn't about adding years to the end of your life, although it does that too. It's about still being able to carry the shopping up two flights of stairs, get down on the floor with a grandchild and get back up again, and walk round a city all day without planning your route around the benches.