Walking, biking, rowing, and swimming are at the top of the list. All are superb exercises because they are considered low-impact exercises and are therefore easy on the joints. Swimming is ideal for those who are overweight, obese, and/or have osteoarthritis. Swimming is also an excellent exercise for pregnant women. Plus, it's never too late to start! Here are just some of the benefits of swimming:- Boosts heart and lung capacity
- Gentle on the joints
- Decreases cholesterol levels
- Increases insulin sensitivity (due to water resistance which exercises the muscles)
- Decreases blood pressure
- Decreases bodyfat
- Decreases waist size
- Tones all of the major muscles (e.g., arms, shoulders, hips, legs)
- Relieves joint stiffness
- Decreases joint pain
- Increases joint flexibility
- Relieves chronic lower back pain (due to water buoyancy which reduces spinal stress)
The health consequences of obesity are astronomical! In fact, clinicians and scientists are discovering more dire risks to mortality regularly due to this disease. This is the one disease that is expected to plague mankind for generations. Interesting how humans have existed for tens of thousands of years and yet only within the last forty years has obesity been a real problem in our society! Could it be the advent of fast food that is prevalent in our culture? Or could it be video games? Or could it be sedentary, cubical occupations which involves sitting in front of a keyboard all day? Or could it be automobiles where we sit in traffic for hours each day? Or could it be a combination of all of the above? Whatever the cause, the problem is deadly serious and the fallout is higher health costs for everyone. The consequences of being obese include:- Hypertension (i.e., blood pressure greater than 140/90 mm Hg)
- High cholesterol (i.e., total cholesterol and LDL greater than 200 mg/dl and 150 mg/dl, respectively
- Diabetes (i.e., increased insulin resistance)
- Heart disease (i.e., arterial plaque buildup)
- Sleep apnea (i.e., interruptive sleep)
- Cancer (esp. colon, breast)
Here are some strategies to help lose bodyweight:- Eat slightly less each week (i.e., caloric reduction should not exceed 500 kcals per day)
- Increase fruit and vegetable intake (i.e., more fiber means less satiety)
- Increase water consumption (i.e., more water means less satiety)
- Eat low-fat food (i.e., lean cuts of meat such as round, loin)
- Increase complex carb intake (e.g., oatmeal, brown rice)
- Avoid "empty" calorie foods (e.g., alcohol, candy, sugary foods)
- Eat small portions (i.e., eat your food on a smaller plate)
- Eat slowly
- Increase physical activity (i.e., at least 60 mins per day)
- Eat more often (i.e., eat 4 to 6 meals per day)
- Increase protein intake (i.e., decreases satiety)
- Reduce salt intake
- EAT BREAKFAST!
Here are the exercise recommendations for overweight or obese persons:- F: resistance training: 2 to 3 days/wk; cardio training: 5 to 7 days/wk
- I: resistance training: less than 75% 1-RM; cardio training: 40 to 70% HRR
- T: resistance training: 15 to 30 mins; cardio training: 40 to 60 mins (intermittent or continuous)
- T: resistance training: free weights, machines, cables; cardio training: walking, swimming, cycling
High cholesterol, or dyslipidemia, can be characterized by any or all of the following:
- Total blood cholesterol level greater than 200 mg/dl
- LDL (low-density lipoprotein) greater than 130 mg/dl
- HDL (high-density lipoprotein) less than 40 mg/dl
- TG (triglycerides) greater than 150 mg/dl
- Total cholesterol to HDL ratio greater than 3.5
Risk factors for high cholesterol include smoking, hypertension and/or a family history of heart disease. Treatment includes avoiding smoking, decreasing bodyweight, increasing exercise (esp. aerobic exercise), and eating a healthier diet. With regard to the latter point, you should eat more:
- garlic
- soy protein (e.g., soybeans, edamame)
- monounsaturated fats (e.g., olive oil, peanut butter)
- polyunsaturated fats (e.g., seafood, sunflower seeds)
- fruits (e.g., avocado)
- vegetables (e.g., chickpeas)
- whole grains (e.g., old-fashioned oatmeal)
- viscous fiber (e.g., oats, barley, psyllium)
- nuts (e.g., almonds, walnuts)
- niacin
and eat less:
- saturated fats (e.g., butter, egg yolks, baked goods)
- trans fats (e.g., margarine, butter, cookies, doughnuts, fried foods)
- sodium
- processed foods (many processed foods contain trans fats)
- sugars
- alcohol
- cholesterol
Here are the exercise recommendations for those having dyslipidemia:- F: resistance training: 2 to 3 days/wk; cardio training: 5 to 7 days/wk
- I: resistance training: less than 75% 1-RM; cardio training: 40 to 70% HRR
- T: resistance training: 15 to 30 mins; cardio training: 40 to 60 mins (intermittent or continuous)
- T: resistance training: free weights, machines, cables; cardio training: walking, swimming, cycling
Asthma is very common in adults and is characterized by shortness of breath, coughing, wheezing, chest tightening, etc. Asthma is exhibited by an inflammatory response in the airway caused by any of an assortment of factors including infection, exercise, allergies, increased mucus production, emotional stress, cold dry air, air pollution, and certain medications. In essence, the bronchioles (lung airways) narrow due to spasms which restrict airflow to the alveoli (lung air sacs), causing difficulty breathing when inhaling air.
Specific steps to help alleviate asthma include:
- Inhaled drugs (e.g., bronchodilators, steroids)
- Water consumption
- Cover the mouth and nose with a mask in cold, dry weather and pollution
- Exercise (esp. aerobic in nature such as swimming)
- Perform breathing exercises (i.e., breathe through the nose)
- Have inhaler nearby while exercising
- Restrict intense exercise and be sure to warm-up
- Control your breathing rate
Here are the recommended exercise guidelines:
- F: resistance training: 2 to 3 days/wk; cardio training: 3 to 7 days/wk
- I: resistance training: less than 70% 1-RM; cardio training: 40 to 65% HRR or 8 to 13 RPE
- T: resistance training: 15 to 30 mins; cardio training: 20 to 45 mins (continuous or intermittent)
- T: resistance training: machines and circuit training, avoid valsalva maneuver of holding breath during exertion phase of exercise; cardio training: walking, swimming, cycling, rowing
Contrary to the past, exercise is highly recommended for women who are pregnant as the benefits clearly outweigh the risks. Here are just some of the benefits of exercise that can benefit pregnant women:
- Less back pain
- Better ability to manage bodyweight
- Reduced stress, depression and anxiety
- Improved digestion and less constipation
- Increased energy
- Decreased postpartum belly
Of course there are precautionary measures that should be considered while exercising which include:
- Remain adequately hydrated
- Perform moderate-intensity exercise
- Wear "breathable" clothing
- Avoid exercising in hot, humid environment
- Exercise less than 30 minutes
- Avoid supine exercises
- Consume adequate carbs
- Avoid ballistic stretches
Here are the recommended exercise guidelines for pregnant women:
- F: resistance training: 2 to 3 days/wk; cardio training: 3 to 5 days/wk
- I: resistance training: less than 70% 1-RM; cardio training: 12 to 16 RPE
- T: resistance training: 15 to 30 mins (12 to 20 reps/set); cardio training: 20 to 30 mins (continuous or intermittent)
- T: resistance training: avoid prone/supine exercise (esp. after the first trimester); cartio training: walking, cycling, swimming, stair stepping
Still the most fatal disease in the country, heart disease is caused by excessive plaque within the coronary arteries leading to the heart muscle. The plaque, which consists of mostly cholesterol and fatty deposits, causes an obstruction of the blood supply to the heart. If left untreated, clogged coronary arteries can cause a fatal heart attack. There are primarily seven positive risk factor for coronary heart disease:- Age (i.e., males > 45 yrs; females > 55 yrs)
- Family history
- Smoking
- Hypertension (i.e., blood pressure > 140/90 mm Hg)
- High cholesterol (i.e., > 200 mg/dl)
- Diabetes
- Sedentary lifestyle
Looking at the above list, the modifiable risk factors are smoking, hypertension, high cholesterol, diabetes (type-2), and sedentary lifestyle. The most important factor that should be addressed is smoking. It is the one factor that has the most significance in terms of reducing heart disease risk. Eating a healthier diet (e.g., less trans and saturated fat, less sodium, more potassium, less alcohol) and exercising regularly (esp. aerobic exercise) are the other factors that would significantly reduce heart disease risk. Increasing folate, vit B-6, vit B-12, and niacin in your diet can be beneficial. The reality is that if you exercise regularly, you'll less likely to be smoking and have high blood pressure, high cholesterol and diabetes. Exercise will lessen your body weight which will decrease your blood pressure and cholesterol levels as well as moderate your insulin levels (reducing diabetic symptoms). Here are the recommended exercise guidelines for those having heart disease:- F: resistance training: 2 to 3 days/wk; cardio training: 3 to 7 days/wk
- I: resistance training: less than 75% 1-RM; cardio training: 40 to 80% HRR
- T: resistance training: 15 to 20 mins (16 to 20 reps/set); cardio training: 15 to 60 mins (intermittent or continuous)
- T: resistance training: 8 to 10 exercises of circuit training; cardio training: walking, swimming, cycling
Contrary to recommendations in the past which indicated rest, nowadays exercise is considered better medicine for those suffering from arthritis. Why is this? Because exercise helps to reduce joint stiffness and pain. For those suffering from the debilitating symptoms of arthritis, it's imperative to resist the urge not to exercise! Why? Because being sedentary will only make your symptoms worse such as more stiffness and pain. Exercise serves to strengthen muscles and protect joint integrity. Contrary to popular opinion, exercise will lessen pain, increase mobility, and help control your bodyweight. Here are recommended exercise guidelines for those with arthritis:- Consult with a physician before exercising
- Begin exercising at a conservative intensity level
- Get adequate rest between exercise sessions
- Consider exercising at least twice daily
- Have a structured exercise plan (e.g., time and place)
- Exercise during the latter portion of the day (i.e., less joint stiffness and pain)
- Exercise using full range of motion at the joints to increase flexibility
- F: resistance training: 2 to 3 days/wk; cardio training: 3 to 5 days/wk
- I: resistance training: less than 90% 1-RM (3 to 10 reps/set); cardio training: 40 to 60% HRR
- T: resistance training: 15 to 30 mins (8 to 10 exercises); cardio training: 5 to 30 mins
- T: resistance training: focus on muscles surrounding affected joints, isometric exercises, yoga, stretches; cardio training: walking, swimming, cycling, rowing, stair stepping
The diagnosis of diabetes is dependent on blood glucose levels (i.e., casual plasma glucose level greater than 200 mg/dl; fasting plasma glucose level greater than 126 mg/dl). One has to be very careful about exercising while having diabetes as blood sugar levels can fluctuate dramatically during periods of intense physical activities. The body of a person with diabetes is not able to readily metabolize sugar because the hormone insulin cannot efficiently transport glucose (blood sugar) into the cells of the body for energy. Either the pancreas cannot produce adequate insulin (Type-1 diabetes) or the cells cannot utilize it properly (Type-2 diabetes). Most people with diabetes have the latter issue in which their pancreas produces enough insulin but due to being overweight or obese, their body's cells have become less insulin sensitive. Resistance (weight) training, which promotes increased muscle mass, can lower the risk of type-2 diabetes. The latest findings recently published in the September issue of the Journal of Clinical Endocrinology and Metabolism discovered a correlation with increased muscle mass and decreased insulin resistance which is a precursor to diabetes. Researchers found that for every 10% increase in skeletal muscle index (ratio of muscle mass to total body weight), there is an 11% reduction in insulin resistance and a 12% reduction in prediabetes. Prediabetes is the beginning stage of diabetes when blood sugar levels are higher than normal but not high enough to be considered diabetes. Even if you already have type-2 diabetes, resistance training may play a role in helping to better use the insulin produced. The reason for this is because muscle is a very insulin-sensitive tissue within the body. The more muscle you have, the more glucose your body can metabolize because of increased insulin sensitivity. Besides increasing your muscle mass, an increase in chromium and fiber intake will also help stabilize blood sugar levels. Diabetes is an insidious disease as the symptoms run the gamut (e.g., blurred vision, excessive thirst, tremors, extremity numbness, frequent urination, confusion, dizziness, fatigue, nausea, extreme hunger, anxiousness, headaches, etc.) but it can be treated or even prevented by proper exercise. Recent research in Neurology has indicated that type-2 diabetes may increase the risk of Alzheimer's disease and other types of dementia. A sedentary lifestyle is certainly a risk factor for diabetes due to the increased fat storage and decreased muscle mass that occurs. Some of the benefits of exercise with regard to diabetes include:- Decreased blood sugar due to increased cellular uptake of glucose (i.e., increased insulin sensitivity)
- Increased heart and skeletal muscle strength
- Increased blood circulation
- Decreased stress
- Decreased bodyweight
Here are recommended exercise guidelines for those having diabetes:- Get medically evaluated for fasting blood glucose (exercise is contraindicated if fasting glucose is less than 80 mg/dl or greater than 250 mg/dl)
- Avoid high-intensity, high-impact exercise (e.g., high box jumping)
- Exercise within three hours after a meal
- Have a relatively high-glycemic index food available while exercising (e.g., orange juice, candy)
- Check glucose levels before, during and after exercise (i.e., normal casual glucose should be between 100 to 200 mg/dl)
- Exercise more than one hour after insulin injection (Type-1 diabetes)
- Avoid exercising in a hot, humid environment (e.g., greater than 90 deg with 60% humidity)
- Inspect your feet regularly for blisters, lesions, etc.
- F: resistance training: 2 to 3 days/wk: cardio training: 4 to 7 days/wk
- I: resistance training: less than 75% 1-RM (12-20 reps/set); cardio training: 40 to 70% HRR
- T: resistance training: 15 to 30 mins; cardio training: 20 to 30 mins (Type-1) and 40 to 60 mins (Type-2) while periodically monitoring glucose level
- T: resistance training: 8 to 10 exercises; cardio training: walking, swimming, cycling, rowing
Optimal blood pressure is 115/75 and should be the goal for all people. If your blood pressure is at or above 140/90, you are in the hypertensive range and need to make some lifestyle changes if you want to live long enough to enjoy your grandchildren. Harsh? Perhaps, but so is dying needlessly due to poor lifestyle choices (e.g., eating high-fat sugary foods regularly, being sedentary). Here are my recommendations to get you on the right path to living a healthy life:- Lose bodyweight (e.g., bodyfat)
- Limit alcohol intake (e.g., less than 3 drinks daily)
- Avoid smoking
- Reduce sodium intake (e.g., less than 1500mg daily)
- Consume more calcium, magnesium and potassium
- Exercise regularly (esp. aerobic exercise) Be sure to allow at least 5 minutes of warm-up/cool-down
- F: resistance training = 2 to 3 days per week; aerobic training = 3 to 7 days per week
- I: resistance training = less than 70% 1-RM (16-20 reps/set for 1-3 sets/exercise); aerobic training = 40 to 70% HRR (RPE = 10 to 13 if on anti-hypertensive medication)
- T: resistance training = 30 to 60 minutes; aerobic training = 15 to 30 minutes
- T: resistance training = circuit training (8 to 10 exercises); aerobic training = walking, swimming, cycling
Absolutely! In very rare instances would it be contraindicated to exercise when of advanced age (e.g., severe coronary heart disease, arrhythmia, uncontrolled hypertension, acute myocarditis, and/or thrombosis). The benefits of exercise far outweigh the risks. As we get older, such things as agility, balance, cardiovascular endurance, flexibility, muscular strength and endurance, motor coordination, power, speed, and mobility become much more important. Not surprisingly, most if not all of these things can be maintained via regular physical activity (esp. resistance exercise). Many of the physiological changes that occur as a result of both aging and inactivity (e.g., muscle atrophy, decreased bone density, high cholesterol and blood pressure, diabetes, obesity, insomnia, incontinence, etc.) can be ameliorated by exercise. The majority of major lifestyle-related diseases (e.g., type-2 diabetes, obesity, heart disease, colon cancer, etc.) can be prevented by regular exercise. Exercise can provide the strength, vigor, endurance, and flexibility in older adults comparable to those who are thirty years younger. In addition, and probably most importantly for most seniors, regular exercise decreases one's dependence on others for everyday activities (e.g., shopping, cooking, etc.). Just last month a study was published in Medicine and Science in Sports and Exercise (July 6th, 2011) regarding how much resistance training exercise is needed for older adults compared to younger people. The study found that older adults (60-75 years of age) need to exercise more than younger people (20-35 years of age) in order to maintain muscle mass. If you haven't exercised for quite some time, here are the exercise guidelines:- F: resistance training: 2 to 3 non-consecutive days per week; cardio training: 3 to 5 days/week
- I: resistance training: less than 80% 1-RM; cardio training: 40-75% HRR
- T: resistance training: 10 to 30 mins (8-15 reps/set); cardio training: 10 to 60 minutes (intermittent or continuous)
- T: resistance training: resistance machines, flex bands, cables, and free weights as needed incorporating high repetitions in general, increase reps before loads; cardio training: walking, swimming, cycling, stair stepping
- STRETCHING: stretch everyday to slight discomfort 2 to 4 times per stretch and holding each stretch for up to 30 seconds
Be sure to increase your protein intake (e.g., 20-30g per meal) to help maintain your lean body mass (i.e., muscles) and assist in tissue remodeling. Emphasis should be on obtaining all of the essential amino acids (esp. leucine) from complete protein foods (e.g., eggs, dairy products, lean meats, poultry, and fish). Protein shakes containing milk fortified with calcium and vitamin D should be consumed post-workout and is recommended for maintaining muscle mass and strong bones. Consider getting at least 20g of protein as soon as possible after your resistance training. In addition, a daily calcium and vitamin D supplement containing at least 500mg and 1200 IUs, respectively, is also recommended.
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