Moving Forward

Moving Forward

From Chicken Soup for the Soul: Say Hello to a Better Body!

Moving Forward

Why Exercise?

When I first read the stories submitted by Chicken Soup for the Soul contributors for this book, I noticed something interesting. Most of the women who lost weight and became fit started out by exercising — often, simply by walking. I have a theory about why this is so. In contrast to dieting, with which so many middle-aged women have a long record of repeated disappointment, exercise has fewer negative associations. Many of us enjoyed playing kickball or jumping rope as girls and, though we may have “sweated to the oldies” with Richard Simmons or “gone for the burn” with Jane Fonda, we are much more likely to have dieted than exercised over the years. This isn’t a good thing, of course, but we can use it to our advantage, in that we can now approach exercise and fitness with a fresh point of view.

First, what is fitness? It has nothing to do, you’ll be relieved to know, with Lycra, spandex, or bulked up muscles. The American College of Sports Medicine (ACSM) defines fitness as follows:

The ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy to enjoy leisure pursuits and to meet unforeseen emergencies.

The ACSM further specifies the different elements of physical fitness, including: fitness of the heart and lungs, muscular strength and endurance, total body fat, flexibility, balance, agility, and reaction time.

In other words, when you’re fit, as the women in the stories here describe, you feel more alive. You can do more of the things you want and need to do: run around with your grandchildren, plant flowers, hike the Grand Canyon, make love, volunteer in a soup kitchen, change a flat tire, and offer a hand when someone falls. Over fifty, I think most of us find more value (and more motivation) in these things than in “buns of steel.”

In addition to feeling better — and, steel buns or not, looking better — the health benefits of exercise are incomparable. There is no doctor you can consult, no pill you can take, no surgery you can undergo that can improve your overall physical and mental health more than walking briskly for 30 minutes, five times a week. Does that seem hard to believe? It’s not, when you consider the wide range of proven health benefits of regular exercise, summarized here in a 2008 report from the U.S. Department of Health and Human Services:

Strong evidence

• Lower risk of early death

• Lower risk of coronary heart disease

• Lower risk of stroke

• Lower risk of high blood pressure

• Lower risk of adverse blood lipid profile

• Lower risk of type 2 diabetes

• Lower risk of metabolic syndrome

• Lower risk of colon cancer

• Lower risk of breast cancer

• Prevention of weight gain

• Weight loss, particularly when combined with reduced calorie intake

• Improved cardiorespiratory and muscular fitness

• Prevention of falls

• Reduced depression

• Better cognitive function (for older adults)

Moderate to strong evidence

• Better functional health (for older adults)

• Reduced abdominal obesity

Moderate evidence

• Lower risk of hip fracture

• Lower risk of lung cancer

• Lower risk of endometrial cancer

• Weight maintenance after weight loss

• Increased bone density

• Improved sleep quality

So, to re-cap: exercise makes you look and feel better, makes you live longer, makes you less likely to get cancer, a hip fracture, heart disease, depression, diabetes and dementia… and, did I mention, it’s fun?

What Kind? How Long? How Strenuous?

If we all still did agricultural work, as many of our ancestors did, we wouldn’t have to worry about exercise. We would spend all day walking, bending, reaching, and lifting heavy loads. One study, in which Amish people (who don’t use many labor-saving devices) were given pedometers to wear, offered an eye-opening perspective on this. Amish women, just in the course of a day on the farm, walked five times the amount currently recommended by the ACSM. What’s more, the Amish women didn’t decrease the amount they walked as they aged.

Most of us don’t work on farms. But we can use various kinds of exercise to achieve all the different types of fitness. In 2011, the ACSM updated its guidelines for adults, summarized here:

Cardiorespiratory Exercise (“Cardio”)

Engage in moderate intensity exercise 30 minutes per day, on five days per week, for a total of 150 minutes per week. Moderate intensity activities include walking briskly (>3.0 mph), mowing the lawn, dancing, performing yard work, recreational swimming, light rowing, and cycling. Moderate-intensity activity typically causes a light sweat and makes you breathe hard enough so that you are still able to talk, but not sing.

OR

Engage in vigorous intensity cardiorespiratory exercise training for 20 minutes per day on three days per week, for a total of 60 minutes per week. Vigorous-intensity activities include race walking, jogging, running, heavy rowing, cycling uphill, swimming laps, and singles tennis. You work up a good sweat and cannot easily carry on a conversation while doing these activities.

You can mix and match these activities, and you don’t need to do the recommended time all at once. For example, at the gym you might choose to do 10 minutes each on the treadmill, elliptical, and stationary bike. Or, you can walk for 10 minutes in the morning, 10 minutes after lunch, and 10 minutes after dinner. Or, wear a pedometer and try to walk 3000 steps in 30 minutes, or 1000 steps in 10 minutes three times throughout the day, five days per week. And remember, these are goals to strive for: when you start, you may not be able to walk more than a block or two — that’s okay! Little by little, day by day, much sooner than you’d think, you’ll reach the recommended targets.

Get creative about sneaking some extra exercise into your day. Park farther than you need to, get off the bus or train a stop early, offer to meet a friend or colleague for a walk instead of coffee. Also, consider using your cardio as a form of meditation. As you walk on the street, track, or treadmill, be aware of your breathing, the swing of your arms, the strike of each footstep. You’ll be amazed at how mentally refreshing this is — though it works better if you aren’t watching CNN or Real Housewives or blasting music through your earphones while you’re exercising.

A final note about cardio: the guidelines are for health, not weight loss or maintenance. Participants in the National Weight Control Registry who’ve maintained at least a 30-pound weight loss for a year or more walk an average of 11,000-12,000 steps a day — that’s about five or six miles, four times the ACSM recommendation. If you’re serious about losing weight and keeping the weight off, the truth is you’ll have to get serious about moving more.

Strength Training

Two to three days a week, perform resistance exercises for each of the major muscle groups. Resistance training can be done with free weights, weight or resistance machines, elastic bands (such as Thera-bands) or with floor exercises such as pushups, sit-ups, and Pilates. Increasing muscle strength boosts metabolism, helps prevent osteoporosis, and reduces back and joint pain. A personal trainer can help you develop a strength-training program (sometimes in just a couple of sessions) or you can use one of the many excellent videos and “on demand” TV exercise programs. “Strong Women Stay Young” (book, video, or class) is a simple and popular 20-minute strength training routine using inexpensive wrist and leg weights.

Flexibility and Balance

Two to three days a week, engage in activities such as yoga, ballet, t’ai chi, or qi qong that improve flexibility and balance. These activities reduce the likelihood of falling — a major health risk as women get older — and are particularly good for reducing stress.

These recommendations may seem time-consuming, but remember, they are targets. Some weeks you may not be able to do everything. Also, some activities can be combined. At the gym, use the cardio equipment before and after lifting weights. Map out a half-hour walk near the yoga studio. With a little planning, you can devise a manageable and enjoyable exercise program that includes most of these activities.

In addition to increasing exercise, studies show it’s also important to reduce the time you spend being sedentary. Most people are horrified to learn that the average American child now spends at least seven hours a day in front of TV, computer, and video games. Would you believe that the average baby boomer spends nine and a half hours daily in front of a screen? Get into the habit of taking a break from your desk, reading in the evenings instead of watching TV, and limiting your Internet surfing. Even if you’re not exercising, almost anything you do will burn more calories than staring at a screen.

Staying Injury-Free

Don’t get hurt while getting fit! Injuries are painful and disabling, and they also interrupt your fitness program. Here are a few tips to avoid injury:

• Have the proper equipment: High quality athletic shoes made for your sport (tennis, running, and walking sneakers are all made differently), a bike helmet, and reflective clothing are crucial for injury prevention. Thousands of walkers, joggers, and cyclists are hit by cars every year, many because motorists can’t see them.

• Stretch: It used to be thought that stretching before exercise was important. Newer research suggests that it’s better to stretch after you’re warmed up, during or following your exercise routine. Stretching improves flexibility, which, along with improved balance, prevents falls, twisted ankles, and muscle pulls.

• Stay hydrated: Exercise causes you to lose much more body fluid than you think, especially in hot weather. Drink plenty of water and, if it’s very hot or you’re exercising for an extended period, add some salty and sugary food (like trail mix), a sports drink, or an energy bar.

• Don’t ignore pain and fatigue: Your workout should be challenging, not painful or exhausting. If exercise leaves you hurting or wiped out, you may be doing too much too soon (especially after an injury or hiatus) or using improper form (especially when lifting weights). Slow down, ease up, get advice from a trainer or instructor. Dizziness, significant shortness of breath, and chest pain are symptoms for which you should seek immediate medical help.

Making Time for Exercise

The number one reason people give for not exercising is lack of time. And yet, when I ask my patients if they could find the time to take a family member to a daily 30-minute medical appointment, they say “sure!” (In fact, they also admit they’d find the time to take the family dog to a daily 30-minute appointment!)

Some tips for making time to exercise include:

• Mark down your weekly exercise plan — noting specific times — in your calendar. Make an unbreakable appointment with yourself.

• Meet a buddy — human or canine — for your daily walk. Or have a regular meeting time with a buddy or trainer at the gym. You’re more likely to show up when someone is expecting you. Several stories in this book, including “My Walking Buddy,” “Running Like Sixty,” and “The Silver Streakers,” attest to this.

• Exercise early in the day. This isn’t for everyone but, frankly, it works for most people. I tell my patients that working out in the morning is like having savings taken automatically out of your paycheck, rather than waiting until later to see “what’s left over.” A morning workout primes your metabolism and makes you more energized and alert all day.

Consider this: There are three phases to each exercise session: before, during, and after. Everyone likes the “after” — you feel good after you exercise. And most people would say that once they’re warmed up, they enjoy the “during” — the exercise itself. What nobody likes is the “before” — the thinking about exercise. So don’t think about it too much. Have a plan, and “just do it” — there’s nothing better for your waistline, heart, lungs, bones, brain, mood, and mind.

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