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	James L. Holly, M.D.

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Your Life Your Health - Starting an Exercise Program

James L. Holly,M.D.

January 15, 2009

Your Life Your Health - The Examiner

In starting an exercise program, remember that your main goal is to boost your health by meeting the basic physical activity recommendations: 30 minutes of moderate-intensity physical activity at least five days per week, or vigorous-intensity activity at least three days per week, and strength training at least twice per week.

Guidelines for healthy adults under age 65

STEP 1 - Set aside time each day to exercise. Getting started can often be the most difficult part of any exercise routine. Scheduling exercise into your day and making it a priority will increase the chance of being successful.

STEP 2 - Choose cardiovascular activities you enjoy, such as swimming, biking, or playing basketball with friends to get your daily physical activity. If you need a variety of activities to stay motivated, combine a few that appeal to you. Physical activity can be accumulated through a variety of activities, not just running. Walking is a great way to do moderate-intensity physical activity. Moderate-intensity physical activity means working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation.

STEP 3 - Start with 10 to 15 minutes of cardiovascular exercise daily. Each week, add five minutes to your exercise routine until you reach 30 minutes of moderate-intensity for a minimum of five days per week. Alternately, you may do 20 minutes of vigorous-intensity exercise three days per week. The 30-minute recommendation is for the average healthy adult to maintain health and reduce the risk for chronic disease. It should be noted that to lose weight or maintain weight loss, 60 to 90 minutes of physical activity may be necessary.

STEP 4 - Incorporate strength training into your routine. Do eight to 10 strength-training exercises, eight to 12 repetitions of each exercise twice a week. This can be accomplished by using dumbbells, resistance bands or your own body weight. If you are unsure how to perform the exercises correctly, seek the advice of an exercise professional.

Guidelines for adults over age 65 (or adults 50-64 with chronic conditions, such as arthritis)

STEP 1 -Begin by following the four steps listed above. Both aerobic and muscle-strengthening activity is critical for healthy aging.

STEP 2 - If you are at risk of falling, perform balance exercises. If you are unsure how to perform the exercises correctly, seek the advice of an exercise professional.

STEP 3 - Have a physical activity plan. Older adults or adults with chronic conditions should develop an activity plan with a health professional to manage risks and take therapeutic needs into account.

How much exercise is enough?

Adults need at least:

2 hours and 3-0 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms), or
1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms), or
An equivalent mix of moderate and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms),

10 minutes at a time is fine -Give it a try

We know 150 minutes each week sounds like a lot of time, but you don't have to do it all at once. Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you're doing your activity at a moderate or vigorous effort for at least 10 minutes at a time.

Try going for a 10-minute brisk walk, 3 times a day, 5 days a week. This will give you a total of 150 minutes of moderate-intensity activity.

For ever greater health benefits

Adults should increase their activity to:

5 hours (300 minutes) each week of moderate-intensity aerobic activity and muscle strengthening, or
2 hours and 30 minutes (150 minutes) each week of vigorous-intensity aerobic activity muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms), or
An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Aerobic activity - what counts?

Aerobic activity or "cardio" gets you breathing harder and your heart beating faster. From pushing a lawn mower, to taking a dance class, to biking to the store -all types of activities count. As long as you're doing them at a moderate or vigorous intensity for at least 10 minutes at a time.

Intensity is how hard your body is working during aerobic activity. How do you know if you're doing light, moderate, or vigorous intensity aerobic activities? For most people, light daily activities such as shopping, cooking, or doing the laundry doesn't count toward the guidelines. Why? Your body isn't working hard enough to get your heart rate up.

Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell is that you'll be able to talk, but not sing the words to your favorite song. Here are some examples of activities that require moderate effort:

Walking fast
Doing water aerobics
Riding a bike on level ground or with few hills
Playing doubles tennis
Pushing a lawn mower

Build up over time

If you want to do more vigorous-level activities, slowly replace those that take moderate effort like brisk walking, with more vigorous activities like jogging.

Vigorous-intensity aerobic activity means you're breathing hard and fast, and your heart rate has gone up quite a bit. If you're working at this level, you won't be able to say more than a few words without pausing for a breath. Here are some examples of activities that require vigorous effort:

Jogging or running
Swimming laps
Riding a bike fast or on hills
Playing singles tennis
Playing basketball

You can do moderate- or vigorous-intensity aerobic activity, or a mix of the two each week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity.

Some people like to do vigorous types of activity because it gives them about the same health benefits in half the time. If you haven't been very active lately, increase your activity level slowly. You need to feel comfortable doing moderate-intensity activities before you move on to more vigorous ones. The guidelines are about doing physical activity that is right for you.

Muscle-strengthening activities -what counts?

Besides aerobic activity, you need to do things to strengthen your muscles at least 2 days a week. These activities should work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms).

To gain health benefits, muscle-strengthening activities need to be done to the point where it's hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8-12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-strengthening activities, but to gain even more benefits, do 2 or 3 sets.

You can do activities that strengthen your muscles on the same or different days that you do aerobic activity, whatever works best. Just keep in mind that muscle-strengthening activities don't count toward your aerobic activity total.

There are many ways you can strengthen your muscles, whether it's at home or the gym. You may want to try the following:

Lifting weights
Working with resistance bands
Doing exercises that use your body weight for resistance (i.e., push ups, sit ups)
Heavy gardening (i.e., digging, shoveling)
Yoga

What if you have a disability?

If you are an adult with a disability, regular physical activity can provide you with important health benefits, like a stronger heart, lungs, and muscles, improved mental health, and a better ability to do everyday tasks. It's best to talk with your health care provider before you begin a physical activity routine. Try to get advice from a professional with experience in physical activity and disability. They can tell you more about the amounts and types of physical activity that are appropriate for you and your abilities.

What is brisk walking?

Typically, "brisk walking" is discribed as a 4 mile an hour rate, while "racing walking is defined as 5 miles an hour.

The following descriptions give you a means of measuring the level of your activity.

Level 1 - Very minimal effort. Lying on the couch.
Level 2 - Minimal effort. Quite comfortable. Normal daily activities.
Level 3 - Moderate effort. Light exercise. Warming up or cooling down.
Level 4 - A bit more effort. Might start to sweat. Can sing.
Level 5 - Beginning to sweat. Breathing is a bit labored.
Level 6 - Working hard. Can not sing. Can talk. Breathing heavily.
Level 7 - Intense. Can talk, but not actually carry on much of a conversation.
Level 8 - Huffing and puffing. Cannot keep up the pace for more than a few seconds.
Level 9 - Very, very hard work. Working so hard you throw up.
Level 10 - The absolute maximum you can do.

Your "brisk" walking pace would be a level 5 or 6. Level seven would be if you added intervals or wanted to try power walking or race walking. Typically, fitness walking is between a level three and level 6.

The key is to get started and success depends on sustaining your exercise over a life-time. Remember, if you start and fail to sustain your program, the ONLY healthy choice is to start again.

Related Articles

	Exercise - Getting Started: Part I Exercise - Getting Started: Part II Exercise - Getting Started: Part III Exercise: It's Never Too Late To Start

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