Physical Activity and Sleep. Podcast with Matt Buman | humanOS Radio

I am very happy to announce our new podcast, humanOS Radio. The aim of the show is to host conversations with three general categories of people:

• Researchers whose work informs us about some aspect of how we live.
• Entrepreneurs who are translating science into solutions.
• Investors making bets to predict (and support) the major future influencers on health.

The format will be flexible, but most shows will be 30 minutes or less. I think the best way to get a sense of what the humanOS Radio podcast will deliver is to listen to an episode or two. Without further ado, here is my conversation with Matt Buman, PhD, Assistant Professor in the School of Nutrition and Health Promotion at Arizona State University.

Transcript

Dan Pardi - 00:00: Greetings everyone, this is Dan Pardi. I'm in the middle of writing a blog series on the brain. Over the last 10 years or so it's been shown that exercise is notably good for the health of our brain, the structure of our brain, it increases brain volume. It can also help us think well. There is an acute effect of doing physical activity and getting an immediate boost in thinking ability, but then there's also a longer term effect. If you exercise regularly, that has a beneficial effect on a variety of aspects of the brain. This is a topic that I find really interesting, because with the right information, you can design your day to perform at your peak.

00:00: Today I have with is Matt Buman. Matt and I met a few years ago for a project looking at the effects of vigilance or alertness on eating behaviors. He's now moved on to Arizona State University where he is an assistant professor in the department of exercise science and health promotion. Basically, Matt and I have a very high overlap of interests. A primary emphasis of Matt's research is to look at lifestyle factors to see how they relate. He's also looking at different devices like Fitbits and Jawbones to see how good they are at doing what they say they do. Without any further ado, let's welcome Dr. Matt Buman.

00:00: Matt, it's so good to have you on the show. Thank you so much for being here. Why don't you start off by telling us how you got into what you're doing today. What first interested you in sciences?

Matt Buman - 00:00: Thanks, Dan, for having me on. I appreciate it. I've got an interesting background. Back in undergrad, I was at the University of Utah in exercise and sport science and very interested in motivation. Also interested in sports and athletics. Trying to find a way to connect those two. My path is a little bit not the way that you would expect in that I started off both in undergrad and then in my master's program thinking about actually sports psychology. How do we motivate athletes, how do we have peak performance in athletics using the mind, using motivation. I was doing that for a while and realized I could actually apply some of those concepts. If you can think about an athlete as an ultra [adherer 00:02:24] to exercise, somebody who is relatively disciplined and is out there setting goals and reaching those goals physically. Can we take those skills and principles and actually apply them to the general public for optimal health?

00:00: That helped me make the transition into physical activity promotion, and then from there I really realized that it's not all about physical activity. There's so many other health behaviors that really fit together or are connected together. That helped me make that transition into what I'm doing today in terms of looking at wearable monitors, looking at various technology mediated interventions and strategies to help people be healthier across a range of health behaviors. Yeah, that's what brought me to where I am today.

Dan Pardi - 00:00: That's great. We met doing a project at Stanford. I was introduced to you as somebody who is really knowledgeable on stats. We were doing a project related to sleep together. How did you end up at Stanford, what were you doing there?

Matt Buman - 00:00: I was as at Stanford at the Stanford Prevention Research Center doing a post-doctoral research fellowship. Additional training after my PhD as sort of an apprenticeship almost within academia doing research in physical activity promotion, primarily in older adults. It's funny you bring up the stats issue because I really see myself as a scientist in my areas and domains and disciplines of interest but I am incredibly about research methods and research stats. Not because I'm a math person or not because I think I'm a nerd necessarily, but because I am just fascinated by what we can do when we apply research methods appropriately and we can use statistics to our advantage to test really interesting questions.

00:00: I always tell people, I'm not a mathematician, I'm not a statistician, but I know how to use those tools and because I know how to use those tools, I think that makes me a better scientist because I can think at the beginning of a project as to how would I design this project in a way to sort of maximize its value and be as efficient as possible with this, knowing the game of how you use methods and use statistics.

00:00: I was influenced in this way actually in my PhD program by some really fantastic mentors. When I went to Stanford I was able to use those skills a lot more in a lot of different contexts. One with you, Dan, and others of course. Now as a professor at ASU I'm really able to actually teach that to my graduate students and try to actually make a topic like statistics, which most people are very afraid of and don't want to have anything to do with try to actually show it to them as a tool as opposed to something they have to learn. Try to get them excited about it.

Dan Pardi - 00:00: Questions that you have asked and done research on is the intersection between physical activity and sleep. How those two interrelate. Maybe you could tell us a little bit about that research because both of those topics are fundamental to my interests and what I do.

Matt Buman - 00:00: The way I started in this area was primarily looking at how physical activity, in addition to its many other health benefits, could help with people's sleep. People with mild or moderate sleep complaints all the way up to somebody with insomnia or sleep apnea and looking at how physical activity could impact sleep. As I started to do that research, I actually realized that it's probably a two way street in that physical activity can improve sleep, but then sleep can also improve physical activity. We've done some studies that have actually looked at that over a 16 week period where we had people filling out logs and diaries about their physical activity and their sleep each and every day.

00:00: What we found, as we would expect, is that on average people that were more physically active tended to also sleep better. Also on average people that tended to sleep better also tended to be more physically active. What I thought was more interesting was if you looked at it day-to-day, so today's physical activity and how that relates to tonight's sleep, we found that when you exercised more, that very next night you tended to sleep better. Then we slip that around and we said on nights that you sleep better, you tend to be more physically active the next day, and so we were able to show actually this dynamic and reciprocal relationship between these two behaviors that compounds itself over time. That really got me interested in how these behaviors connect.

00:00: What I'm doing today now is looking at how we can nominally spend our time across these behaviors. If you think about it, across a 24 hour period, we're doing one of three things. We're either sleeping, being sedentary, like sitting, or we're being physically active at some level. Light intensity activity all the way up through exercise. How do we optimally spend our 24 hours? We know we need to sleep more. We've been told we need to sit less. Of course we want to move more and be more physically active, but we can't be physically active all day long, right? There has to be this balance and sometimes these behaviors can be at odds. For instance, when somebody is asked to exercise, go run for 30 minutes or take a brisk walk for 30 minutes, many times people choose to do that first thing in the morning and maybe even get actually 30 minutes less of sleep in order to fit that in, or perhaps in the evening they're adding that physical activity before sleep and that might actually impact sleep negatively.

00:00: Trying to understand the time use of these behaviors in optimal fashion for health outcomes is what I'm working on right now.

Dan Pardi - 00:00: I've always thought about sleep and physical activity as opposite sides of the same coin in a way, that they are reinforcing. You sleep well, you feel more vigorous the next day to adhere to any physical activity goals that you might have. I do love the work that's talking about deconveniencing your life. Getting off the bus a couple of stops earlier and walking. Using standing desks. Instead of thinking of physical activity just as something that happens in a gym or on a field, you actually kind of envision your entire day as an opportunity to either get in little exercise snacks or just fit it in. It all adds up and it all matters.

Matt Buman - 00:00: Some of the work that we've done recently is showing that from a time perspective, physical activity is incredibly robust. The 30 minutes a day you spend being physically active is very well worth it from a health perspective. We can only do so much of that, and then it's well, there's the rest of the day. The rest of the 23 1/2 hours of our days, how do we optimize that for health? How do we gain additional benefit? It's absolutely clear now that it seems independent of that physical activity, moving more, doing more light intensity activity, taking the stairs instead of taking the elevator, just getting up and moving throughout the day. Even moving from a sitting to a standing posture like in a standing desk has additional health benefits on top of an independent physical activity.

00:00: That's actually a recent area of my work is looking at, how do we target the rest of the day? Yes, we want to get people physically active, but some people aren't able to, don't want to, it may be difficult for them or they're already doing that and could receive additional benefit from something else. We're looking at strategies, including standing desks and other things, and we're focused in the workplace right now, but there's huge opportunity both in schools and in the home and in many other contexts to work in additional activity throughout the day. It's funny because when you talk to people, you tell them about this is the first thing I always say is don't be scared, I'm not talking about exercise. I'm not going to ask you to exercise. I'm going to ask you to stand up. I'm going to ask you to maybe take a few extra steps throughout your day. Diffusing it that way I think sets people at ease and get's them to think outside the box about how they can integrate activity into what they're already doing without having to plan additional time.

Dan Pardi - 00:00: Your sports psychology background is coming back now to permeate all that you're doing.

Matt Buman - 00:00: Yeah, I think so. The idea of finding different ways of motivation and getting people interested, I think absolutely, it does come back full circle I suppose.

Dan Pardi - 00:00: I think re-framing things can be very powerful and one issue that I see is that a lot of the visions of exercise that are permeated throughout our culture are really high intensity where people are sweating, they're exhausted. If you're fit and you get a great workout like that it can feel really good, but it can also, for those that are less fit or that's intimidating, it can, I think, serve as a barrier to do what I call mundane but meaningful things. You think that in order for this to be beneficial, I've got to be killing myself in exercise class.

00:00: I work at home and I've got a little garage base where I've got a standing desk. I've got a treadmill. I call it my lab because I'm always testing out things. One emphasis for my physical activity practice is feeling really good and feeling sharp. I'm writing a series right now on the cognitive aspects of exercise. The first blog is looking at blood flow and it was pretty interesting. Around 60% maximum effort and you get an enhancement of brain blood flow. Then as it gets more intense, because of the pressure of oxygen, the blood flow will actually decrease back to baseline.

Matt Buman - 00:00: Yeah.

Dan Pardi - 00:00: Thinking about that, I actually not just stand at my desk, which feels really good. If you haven't done it before, it can take a couple of weeks before you feel really comfortable doing it for long periods of time.

Matt Buman - 00:00: Absolutely.

Dan Pardi - 00:00: Then you can't go back. You can't go back.

00:00: Also during the day, I'm also moving throughout the day. I'll just run in place, I'll maybe do some jump rope or I try to just mix in some lighter intensity stuff and it actually keeps me in a really positive energetic state. It's funny to think of things that way, like how can I cultivate my own best performance throughout the day.

Matt Buman - 00:00: We're actually just finishing up a lab based study that you might find interesting based upon that. There's a lot of debate in the literature about ... It's this whole idea of sedentary behavior. You've heard this sitting kills. Sitting is the new smoking. We can get back to this, I think that's overblown. I think that there's a real question. It's clear that independent of physical activity how much time we're sitting has a negative impact on our health and our cognitive function and a number of other health outcomes. It's not clear whether this is just an issue of well, when you sit you don't expend a lot of energy or whether it's about something unique about the posture of sitting versus standing. There's the issue, should I get a standing desk or should I get a treadmill desk? Do I need to be moving to get a benefit, or is just standing going to help me?

00:00: We actually designed a study where we had the same group of office workers come in, about 10 of them, and they came in the same day of the week for four weeks. We randomized them to a condition throughout that day in our mock office. One condition was where they sat all day long. This is our control condition. We had them sit basically the whole day except when they needed to take a break for lunch and take restroom breaks, that sort of thing. They did their job throughout the day. We had another condition where we had them stand for about 150 minutes cumulatively across the day. They simply stood, they didn't move, they just stood up at various intervals that we told them when to do that. We had a third condition where they cycled. They stayed seated, they stayed seated, but they had a pedal-er under their chair, so you might have seen some of these, these are out on the market now, where you can stay seated but you've got this pedal-er. The fourth condition was a walking work station, so they stood and then they moved.

00:00: What we were trying to get at, experimentally, was to separate the effect of standing from the other posture changes and the effect of energy expenditure. The walking work station had both increases in energy expenditure and increases in posture, while the cycling only had increases in energy expenditure, which matched the energy expenditure changes for the walking work station. The standing condition matched the posture changes for the walking work station.

00:00: We had some really interesting out comes. One thing we found using continuous glucose monitoring is that on average the postprandial after meal spikes in glucose which were normal were actually dampened in all three groups relative to control. We had significant improvement whether you're just standing, whether you're cycling, or whether you're walking. We had improvements across all three. We also found improvements in blood pressure. Small changes over time in ambulatory blood pressure, so we took continuous measurements of blood pressure every 15 minutes.

00:00: What I'm most interested and excited about, and this is what your comment made me think about, is that we also found improvements in cognition in all three conditions, meaning faster reaction times and a number of other executive functioning decision making types of outcomes, we found improvements in all three conditions relative to the control. Interestingly, our hypothesis was that the walking work station would be best. It combined both posture and expenditure changes, but interestingly I would say, we actually found the best effects were from the cycling.

Dan Pardi - 00:00: Oh, wow.

Matt Buman - 00:00: We're not even sure exactly why that is. We think it might have to do with the novelty of that behavior. People aren't as accustomed to cycling as they are to walking, of course, but we need to follow up more on that to understand why that is. The bigger picture is that you can get these kind of benefits simply from standing and perhaps greater benefits if you're moving more in addition to the standing.

Dan Pardi - 00:00: I've never tried one of the cycling desks set ups. I'd have to see how awkward that felt to actually then do work. I have to admit I was surprised. I don't use a treadmill desk now, usually if I have a call I have a treadmill and I walk at like 2 and 1/2 miles an hour, but there was a while where I was working on, and I found that there were some things that I could do pretty well, and I was surprised. I was surprised that it didn't seem like a gimmick, like I could actually get work done on it.

Matt Buman - 00:00: Right.

Dan Pardi - 00:00: Now I think I just prefer to stand, do it this way so I'm standing, walking, sitting, and I listen to my body, too. If I'm tired, I'll take a break and relax. What's your set up like?

Matt Buman - 00:00: I have different set ups at home and at work. At work I have an aftermarket desk unit that goes on top of my desk and I can raise and lower that for standing, so no walking options. At home I have a full desk that goes up and down. You press a button and it comes up and down.

Dan Pardi - 00:00: Yeah.

Matt Buman - 00:00: I don't have options to move at either location, although our workspace has some shared treadmill desks so I can jump on those. Like you, sort of like taking a call, responding to email, doing something relatively mundane. I think the interesting point that you made though about sometimes I just need to listen to my body and sit, I think that's really important. I think sometimes people feel like well, if I get a desk, now I have to stand all the time. The whole point is just to give you options.

Dan Pardi - 00:00: Yeah.

Matt Buman - 00:00: I mean, right now if you go into any workplace, you don't have a lot of options if you want to stand. Pretty much if you walk into a conference room, there's a bunch of chairs in the room and not a lot of places to stand. The idea of having a standing desk or a walking work station is just to give you an additional option so that you don't have to be sitting all day long. That gets to my other point of I think that this idea of sitting is the new smoking and really demonizing sitting, I think is not well advised because I think it makes people feel guilty anytime they sitting, and sitting is a natural behavior. It's a restorative behavior that serves an important role. The fact is that our society, though, has engineered standing and moving completely out of society so we have to reintroduce it so that we give people options. A full range of activity from sitting all the way through vigorous exercise.

Dan Pardi - 00:00: That's really good input. It's not that sitting is bad. We do it too much and there's the absence of other things that are good. [crosstalk 00:17:42]

Matt Buman - 00:00: Exactly.

Dan Pardi - 00:00: Part of what an exercise program that I created is called Intune and it stands for integrated opportunistic training. The idea that you're integrating movements into your day and you're doing it in an opportunistic fashion. You finish an e-mail, and then you do some body weight squats, or you do some push ups, and actually started to do it to try to get more physical activity into my day, but now I do it to actually promote cognitive enhancement. Before a call or whatever. You just get yourself into that zone where you're feeling, you've got good verbal fluidity, good recall. It's like that feeling you get after great exercise where you feel sharp and lucid.

00:00: The other aspect of Intune training that I like is that it's not just this integrating movement into your day in an opportunistic fashion, but you're also in tune with your body. One thing I don't like about training protocols oftentimes it's like hey, go this hard regardless of how you feel. I think it's really good to try to get in touch with your body. What it is telling you? Do you feel like doing something more intense? Do you feel like sitting, taking a nap, and actually developing a relationship with yourself where you trust it. When you're feeling robust, you get some activity, and when you're not, you have other options, and you're always giving your body what it needs.

Matt Buman - 00:00: Yeah.

Dan Pardi - 00:00: I think that's a really good thing for durability of a good physical activity practice because then you're not going to be avoiding it because you're always giving yourself what your body wants. That's been really important for my consistency over the last couple of years.

Matt Buman - 00:00: Right, and it falls right in line with what we know about motivation. It's all about autonomy and enjoyment. It's all about giving people options, helping them to choose, so they don't feel like they have to do this one thing where they have options and then most importantly that they just enjoy it. This whole, as you alluded to, sort of high intensity interval training, people ask what do you think of that, and well, if people like it, then they should do it, and if they don't like it, they shouldn't do it. They should find something else. There's plenty of ways to be active and to move at a huge range of activities and so listening to your body minute to minute and then also just choosing things that you truly enjoy, those are the things. Doing an activity that you don't like, you'll probably get through a month of it maybe if you have really good discipline, but that's not really going to make a lifelong impact.

Dan Pardi - 00:00: Yeah. I could not agree more. The single most important thing about exercise and physical activity is finding stuff that you enjoy and just doing that. [inaudible 00:20:04] is an author who writes about populations around the world that reach 100 or beyond, that age well. There's a really interesting quote where he says out of the 30 different societies that we've looked at that are centenarians or super centenarians, all of them don't exercise as we think of it, but they do have physical activity integrated throughout their day. They tend to be societies that have this dual combination of access to modern medicine but they live a more rustic lifestyle. They get light exposure, they're carrying things in their day. Interesting perspective.

00:00: What tools do you use? You do assessments with the latest and greatest quantified self trackers. Where do you see the value in those? Have you felt any have augmented your own physical activity practice?

Matt Buman - 00:00: On one side, I use these tools as a consumer to better my own life and then I use them as a researcher. I do a lot of research in terms of validating these types of sensors for their accuracy relative to gold standard measures. As a researcher, I really want to try to find the best tools we can use to most accurately measure behaviors that are occurring in real life. Many of these tools give us that ability to do that in ways that we have never been able to do before. Very wearable. People are willing to wear, 24 hours a day, for weeks and months and years upon end, which is nothing in research that we've been able to do before.

00:00: Unfortunately I think many of these tools are not quite up to the challenge of being able to be of true value to tool, to be able to test interventions and different strategies and various outcomes. I think that right now you have some challenges in terms of the transparency of the tools and that makes it difficult from a research perspective. In the personal perspective, they're fantastic. The whole quantified self movement just shows you just how excited people are to know and gain insights and be able to test and experiment on their own health outcomes and there so much greater awareness.

00:00: The greatest utility that I see for these tools is sort of in the middle in terms of complimenting existing programs and strategies to get people healthy. This might be a program that is already in existence that is not leveraging this to make their program more effective. They're bringing in these tools to make that person more informed and to integrate that information into an existing program. That's very promising.

00:00: On the clinical side, I see huge, huge opportunities in terms of using these tools in a manner to enhance the clinical relationship. Many people are bringing their Fitbits into their doctor's office and saying hey, look how many steps I get. Unfortunately a lot of clinicians don't know what to do with that information yet. We need more knowledge in terms of how can we leverage these tools in clinical environments. How can we make the relationship between the patient and the provider more effective through better communication, more knowledge, knowledge going both ways, using these types of tools. I think that's where we're going to see the most growth in the next few years. I think that's where these tools might have the greatest impact on overall health.

Dan Pardi - 00:00: There was a line that I have from a presentation that I gave on quantified self. I think the question is can it modify behaviors that matter in a meaningful way forever in some populations? I think these tools are best served when they're part of an ecosystem that promotes important behaviors in meaningful ways through a variety of techniques. It's not just tracking and triggering, it's doing other things as well. Giving people very clear ideas of what they can do. Giving people education. All that.

Matt Buman - 00:00: The other side of it, for me is that depending upon the company and the device, they measure huge numbers of things. Some of them matter, some of them don't, some of them are not very transparent of exactly what it is that they're measuring. I think we would benefit greatly if there could be some level of consensus of what is most important that these tools develop and can measure well so that if you buy a Fitbit or a Jawbone or whatever other device that you have some level of confidence that you can track what you want to track and you can track something that's of great meaning and has an actual impact on health. I think right now that there's just no consensus within the field as to what it is we want to measure and so things are relatively diffused at this point.

Dan Pardi - 00:00: We could launch into a whole other conversation [crosstalk 00:24:30], but in terms of time. Maybe we can bring you back and extend the conversation on sleep and more tracking in the future, but thank you so much for coming onto the show. That was really interesting stuff. Clearly a ton of overlap with my own interests. Thanks for the work that you do. I appreciate you coming on.

Matt Buman - 00:00: Dan, my pleasure. It's great to chat with you.

Dan Pardi - 00:00: Yeah, always man. Take care.

Speaker 3 - 00:00: Thanks for listening, and come visit us soon at humanos.me.