Q&A: Improving Health with the Right Dose of Exercise

As an undergraduate psychology major at UVA, Damon Swift was browsing the course catalogue one day when an exercise physiology course caught his eye. The course, taught by professor Art Weltman, combined two of Swift’s major interests: physical fitness (Swift is a former athlete and sports fan) and the biology of the human body.

“It was honestly one of the most interesting classes that I’ve ever taken,” he said.

He was hooked. After graduation, Swift enrolled in UVA’s exercise physiology master’s program and began a career studying how exercise can improve health. It all came full circle in 2021 when Swift returned to Charlottesville – this time with his wife and young son – to join the UVA faculty alongside Weltman.

Swift is still into sports, cheering for his hometown New York teams, and of course, the Cavaliers. But while a fascination with the inner workings of arteries originally drew him to the field, these days Swift is motivated more by working directly with people. Whether mentoring students or helping participants in an exercise trial get healthier, his work is driven by a desire to improve people’s lives.

One year into his time at UVA, we caught up with Swift to talk about exercise as medicine, mobile health technology, and his advice for how to develop a healthy exercise routine.

Q: When did you decide to pursue a research career in exercise physiology?

A: When I came into the master's program, I didn't really know what I wanted to do. I just knew I really liked exercise and sports. In the beginning, I was really interested in the performance aspect – because I was a track runner when I was in high school, so I was all about how to enhance performance. But when I got involved in the research and started working on a thesis, I started to see how exercise can be used as a modality to improve health. That's where it started to become really interesting to me.

Everybody knows that exercise is healthy. But I didn't realize how many different areas of the body exercise impacts. We have a phrase in ACSM [the American College of Sports Medicine] that “exercise is medicine.” From mental health, all the way down to genes and metabolism, there are so many ways exercise can be used to make people healthier.

Q: What are some of the things that have shaped your career and research since?

A: During my postdoc, I trained at a place in Louisiana called Pennington Biomedical Research Center, under a physician by the name of Timothy Church. We did large scale exercise training trials on health.

Working with Dr. Church expanded my thinking about how exercise can be viewed to improve public health. How do different levels of exercise relate to fitness or risk factors for health? How does it impact weight loss, or weight maintenance, or diabetes?

It put me into more of a clinical space. I started thinking about how to translate exercise guidelines so that when a doctor is speaking to you one on one, they can give you individual guidance on how much you should exercise, the type of exercise you should do, and why.

Q: How would you characterize your research focus?

A: My major research focus is exercise and lifestyle interventions. What I hope to do at UVA is to create a multidisciplinary approach to improve health.

Exercise is an important component of health, and certainly a primary thing that we're interested in, but we also want to bring in folks that are interested in nutrition, as well as clinicians that are interested in health impacts – always trying to keep it public health related and clinically relevant, meaning that it impacts health risk factors and has relevance to people's lives. For example, if you have somebody that lost weight, how much did they exercise? What is the benefit of that in general? And how does that help us prescribe exercise better for different individuals?

Q: What are you working on now that you’re excited about?

A: One thing we're trying to look at is how exercise level interacts with bariatric surgery. We know that bariatric surgery causes great weight loss, but one thing that's not commonly known is that it can resolve diabetes in a lot of patients. So figuring out the extent of the cardio and health benefit of different exercise levels in bariatric patients.

We’re also really interested in utilizing mHealth, or mobile health technology. After weight loss, can we use mobile health technology as a mechanism of improving weight maintenance? For example, using a remote blood pressure cuff, can we look at blood pressure changes during the weight maintenance period? If your blood pressure is starting to go up, we can then change our lifestyle therapy based on this information. Or if you're using an accelerometer, a Fitbit or another similar device, maybe we see that physical activity levels are going down and we need to figure out physical activity. These technologies have the possibility of opening up a lot of new avenues in treatment.

Q: What do you enjoy about doing work that is focused on public health and lifestyle interventions?

A: In these large exercise training trials, participants just felt so much better, and their risk factors for heart disease and diabetes also improve. I think that's the most gratifying part of my research studies. Some people had been sedentary for 20 years, and they're able to exercise to public health recommendations and feel a lot more energy, and we have the data to back up the fact that they've gotten healthier. That part's really cool.

From the student perspective, it’s just watching them grow through the scientific process, seeing them understand exercise data, and gratification that they get after feeling like they're helping participants. Seeing them develop scientifically and as people is really motivating.

Q: What is it like being back in Charlottesville?

A: It's been really, really cool. The Charlottesville community has always been special to me and my family. We love the nature, we love the opportunities for physical activity, and the mountains. We definitely missed the area and are excited to be back. And it’s a lot easier to see Cavalier games from here!

Q: What advice would you give to the average person struggling to implement a good exercise or fitness routine in their life?

A: The biggest, most important thing you can do is get off the couch. Sometimes the perception is that you have to do a lot of exercise in order to be healthy. But you get the largest bang for your buck, in terms of lowering heart disease risk, from going from inactive to somewhat active.

The physical activity guidelines are 150 minutes of moderate physical activity per week, 75 minutes of vigorous activity or a combination of both. But even if you're getting half of that exercise, you're doing better than somebody who is completely sedentary. So number one, some activity is better than nothing. Even walking has been shown to be effective to improve health and cardiorespiratory fitness and other risk factors for disease.

The other piece of advice is to do something that you like. You're way more likely to adhere to an exercise program if it's something that you actually enjoy doing, as opposed to something that you're just doing because you know it’s good for you.