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What Is It?
Physical fitness has the following components: cardiovascular fitness, muscular strength, muscular endurance, flexibility and body composition.
If a friend told you that delaying the aging process, controlling your weight, feeling happier and less anxious, sleeping better and warding off illnesses like heart disease, some forms of cancer, high blood pressure and diabetes was as easy as walking briskly for 30 minutes each day, would you believe her?
It's true. You can receive all these benefits simply by taking that 30-minute daily walk. According to the Centers for Disease Control and Prevention, inactive nonsmoking women have an estimated 12.7 years of active life expectancy at age 65, compared with 18.4 years for highly active, nonsmoking women. The American Heart Association reports that a sedentary lifestyle is a major risk factor for heart disease and stroke. Studies find that people who start a regular physical exercise program after a heart attack have better rates of survival and an improved quality of life compared with those who remain sedentary. And people who do not exercise have a risk of coronary heart disease double that of people who exercise regularly—an increased risk similar to that caused by high cholesterol, high blood pressure and cigarette smoking.
In addition, being sedentary has several negative health consequences. Your muscles, including your heart and lungs, become weak; your joints become stiff and easily injured; and you can develop high blood pressure, fatigue, obesity and osteoporosis. Lack of physical activity can also contribute to anxiety and depression. Being physically fit, on the other hand, reduces the risk of heart disease, some forms of cancer, high blood pressure, diabetes and other diseases. Exercise may also reduce bone loss after menopause.
What's missing in this age of modern conveniences and desk jobs are reasons to get our bodies up and moving regularly.
That's why the U.S. Department of Health and Human Services' National Center for Health Statistics reports that about 40 percent of American adults report no leisure-time physical activity, and only 31 percent of adults say they engage in regular leisure-time activity (defined as either three sessions per week of vigorous physical activity lasting 20 minutes or more, or five sessions per week of light-to-moderate physical activity lasting 30 minutes or more).
The good news is that it's never too late to take up exercise. At any age, at any level of health, even if you already suffer from a chronic disease, you can improve your level of fitness. Plus, if walking isn't your cup of tea, there are endless options, all with similar results.
What, exactly, is fitness? Physical fitness has the following components:
You should discuss your fitness level with a health care professional before you try to improve it on your own, especially if you haven't been active in awhile, have any chronic health conditions or are over 50 years of age.
During a fitness assessment, your health care professional should ask you about chest pain, faintness or dizziness, bone or joint pain and about any medications you're taking. The health care professional should check the health of your heart and joints, measure your blood pressure and weight and determine if you have a hernia or diabetes. These issues may affect how vigorously you may exercise or the types of exercise you can safely do. If you have heart disease or any risk factors for heart disease, you may need to undergo an electrocardiogram while exercising, commonly called a stress test. During this test, you walk on a treadmill while the health care professional monitors your heart and blood pressure.
Sometimes, your health care professional is the one suggesting a fitness program. This is a good option if you have high blood pressure or high cholesterol, are overweight, have a high percentage of body fat or are losing bone density (a precursor to osteoporosis).
Your health care professional also may recommend a fitness regime if you have or are at risk of developing one of a variety of chronic conditions, such as diabetes.
For example, strong muscles can help those with osteoarthritis protect their joints and bones by improving stability and absorbing shock. Regular exercise also helps women with chronic lung disease improve their endurance and reduce shortness of breath. It is also an important part of controlling blood sugar, strengthening the bones of women with osteoporosis and protecting younger women's bones from becoming thin and fragile. It may even increase life expectancy for women with heart disease.
Your health care professional can give you advice about a program suited to your health needs and fitness goals. He or she may refer you to a fitness professional or a hospital-based fitness class to provide guidance as you begin.
The first and easiest change to make on your journey to fitness is to add "lifestyle physical activity" to your day. This means being more physically active during your usual daily activities. You can:
Making these changes is an easy way to improve mood, heart and respiratory function and muscular fitness, as well as to reduce body fat.
However, for women who need to make more dramatic gains in fitness or need to lose weight, a more formal exercise program, in addition to lifestyle physical activity, may be necessary. Your program should address the five components of fitness by including:
How Much Is Enough?
One of the most common questions is, "How much do I need to exercise?" The Centers for Disease Control and Prevention's 2010 Physical Activity Guidelines for Americans recommend that adults do both aerobic and strength training. Specifically, the guidelines recommend the following:
The guidelines also recommend that adults perform muscle-strengthening activities that involve all major muscle groups at least two days a week.
The new guidelines note that adults can achieve additional health benefits, including the promotion of greater weight loss or the prevention of weight regain, by increasing to five hours (300 minutes) a week of moderate-intensity aerobic physical activity or two hours and 30 minutes a week of vigorous-intensity physical activity or an equivalent combination of both.
These minutes can be accumulated in increments of 10. For instance, 10 minutes of an aerobics video in the morning, 10 minutes of brisk walking at lunch and 10 minutes of brisk walking in the evening. Intermittent exercise (intermittently increasing the heart rate) can be part of a good weight-loss strategy because your metabolism is elevated following each bout of exercise.
If you have been inactive, you need to work up slowly to this amount. Start with five or 10 minutes—whatever you're comfortable with—every other day and add one minute every other session. If you do too much too soon, you can become injured, fatigued and discouraged. You can know that you are not pushing yourself too hard if you feel recovered by the next day.
Similarly, don't overdo strength training. Start slowly, with lighter weights, and work up to heavier weights. You don't need to strength train more than a couple times per week. Finally, always wait at least 48 hours before exercising the same muscle group to give those muscles adequate time to recover between sessions.
Ideally, you should warm up the muscles that you plan to use for the activity. This can be done by starting your walk or activity slowly for two to three minutes and then increasing to a brisk walk or increasing the intensity of the activity. It is also helpful to stretch any muscles and joints that you routinely use at work or play a couple of times per week. Hold each stretch for about 30 seconds. Some lighter stretches can even be done at your desk or while you watch TV. Examples of stretching exercises include shoulder or arm circles. There are also a number of stretches specifically targeted to arm, back, chest, thigh and calf muscles.
How Hard Should You Work?
The second question is, "How hard do I need to exercise?"
As you work on increasing the length of your exercise sessions, you also need to work on increasing their intensity. Low-intensity aerobic exercise, like housework, gardening and walking the dog, provide many general health benefits, but to truly enhance fitness, especially if weight loss is one of your goals, you need to up the ante and exercise at a moderate or higher intensity with vigorous activities like brisk walking or jogging, singles tennis, aerobics classes or cycling.
In fact, results from a University of Pittsburgh study published in the Journal of the American Medical Association found that women trying to lose weight can benefit as much from moderate-intensity physical activity as from an intense workout. The exercise duration and intensity trial involved 201 overweight, healthy women ages 21 to 45 years. All received reduced-calorie meals and were assigned to one of four physical activity regimens.
The regimens consisted of either a moderate or vigorous-intensity physical activity performed for either a shorter (2.5 to 3.5 hours per week) or longer (3.5 to 5 hours per week) duration. The physical activity consisted primarily of brisk walking that burned between 1,000 and 2,000 calories a week.
Women in all four groups lost between 13 and 20 pounds, or 8 percent to 10 percent of their body weight, and maintained that weight loss for a year. They also improved their cardiorespiratory fitness. But, most importantly, the amount of weight lost and fitness improvement was essentially the same among the four groups.
The author concluded that an intervention program should initially target the adoption and maintenance of at least 150 minutes a week of moderate-intensity exercise, and, when appropriate, eventually progress to exercise levels of 60 minutes per day, most days of the week. This upper level is consistent with the Centers for Disease Control and Prevention's 2010 Physical Activity Guidelines for Americans' recommendation of a total of 300 minutes per week (60 minutes per day, most days of the week) for greater weight loss and the prevention of weight regain.
Because the goal of aerobic exercise is to work your heart, your exercise needs to increase your heart rate. One way to determine if you are exercising intensely enough is to measure your heart rate. Your heart rate should be about 50 percent to 85 percent of its maximum. Maximum heart rate for one minute is your age subtracted from 220.
After warming up and then sustaining an aerobic activity for about five minutes, take your pulse by placing two fingers on the radial artery on your wrist (it will be toward the thumb side of your wrist). Count the beats for 10 seconds. The number of beats you count should fall between the two numbers listed beside your age in the chart below. The following chart illustrates recommended 10-second heart rate counts.
Age | Number of beats in 10 seconds |
20 | 17 to 28 |
30 | 16 to 30 |
40 | 15 to 26 |
50 | 14 to 24 |
60 | 13 to 23 |
Older adults should exercise as often as others but aim for a lower number of beats per minute. To determine exactly what your heart rate should be during exercise, subtract your age from 220; divide that number by six for a 10-second heart rate count, then multiply that number by 0.5 for the lower end of the range and 0.85 for the higher end. For example, if you're 70 years old:
220 - 70 = 150 (this would be your maximum heart rate for one minute)
150 / 6 = 25 (this would be your maximum heart rate for 10 seconds)
25 x 0.5 = 12.5 (this would be your target heart rate for 10 seconds at the lower end of the range; for one minute, the target would be 75 beats)
25 x 0.85 = 21 (this would be your target heart rate for 10 seconds at the higher end of the range; for one minute, the target would be 126 beats)
An easier way to judge intensity is the talk test. You shouldn't be exercising so hard that you can't talk with a friend or recite a poem. If you can't talk without gasping for breath, slow down.
If you take medications for high blood pressure, your heart rate may be kept artificially low, and intensity should be monitored using the talk test.
The intensity of your strength training exercise will increase over time as well. Again, don't strain to do more, but slowly work your way up to heavier weights or more repetitions. Choose weights that are heavy enough to tire your muscles after about 12 repetitions. The last two reps should be difficult to achieve, because the idea is that the muscle is challenged. When you can comfortably do 12 or more repetitions at a certain weight, increase the weight 5 percent to 10 percent. You will be amazed at how much more you can do after even a few weeks.
What kind of exercise?
The third question is, "What should I do?" The key to sticking with an exercise program is choosing activities you enjoy. There are many to choose from.
Strength training. The best way to start may be to hire a certified personal trainer for three or four sessions to develop a plan and show you how to use the equipment properly. You can use weight machines, free weights or resistance equipment like specially made rubber bands or a weighted vest, and you can strength train at a health club or at home.
Strength training videos that show you how to use common household items such as food cans and water bottles can save you money on weights or other fancy equipment. In any case, if you don't use the proper form, you can injure yourself, so you do need to learn how to use the equipment, whether it's from a personal trainer, a video or a book. Be sure any video or book you use is current, as some once-popular strength-training exercises have been found to be potentially harmful.
Strength training is important for women of all ages. In young women, it can set the stage for a lifetime of stronger bones. Research shows that women start to lose muscle strength as early as age 20. For these women, strength training can help slow or reverse the natural process of muscle degeneration. And studies also find that older women who strength train not only maintain bone density, but have a much lower risk of hip fractures, due in part to the improvement in dynamic balance that often accompanies stronger muscles.
Functional or core strength training. This type of training helps strengthen the muscles of the back, trunk, abdomen and pelvis. The idea is to strengthen these muscles first in the "movement chain" to prevent injury and to provide a solid, stable base so the muscles further down the chain—your legs and arms—have a stable base supporting them and can get stronger and more efficient. So, for instance, rather than strengthening your legs with hamstring curls and leg extensions—which don't have much application in real life—you do squats, step-ups or walking lunges that challenge your entire body and improve dynamic balance while strengthening your legs and thigh muscles.
Aerobic exercise. The options are many and varied. Some of the more popular choices include:
If you're taking an aerobics class, take care of your feet! According to the American Podiatric Medical Association, proper shoes are crucial to successful, injury-free aerobics. Before you start an aerobics program, consider seeing a podiatrist for a biomechanical or gait analysis to estimate your risk of injury. Shoes should provide sufficient cushioning and shock absorption to compensate for pressure on the foot many times greater than found in walking.
Impact forces from aerobics can reach up to six times the force of gravity, which is transmitted to each of the 26 bones in the foot. Because of the many side-to-side motions, shoes need an arch design and upper leather or strap support to provide stability and prevent slippage of the foot.
Make sure shoes have a toe box that is high enough to prevent irritation of toes and nails. Major shoe companies today have designed special shoes for aerobics, which provide the necessary arch and side support; they also have soles that allow for the twisting and turning of an aerobics regimen.
You can buy a video to show you how to do stretching exercises in the privacy of your own home or you can have a personal trainer at a gym show you how to incorporate the exercises after your cool-down period.
Special considerations: exercising when pregnant
Exercising when you're pregnant can help you achieve better posture, less back pain, less stress, better digestion, more energy, an easier delivery and smaller "postpartum belly." It can also help prevent or control gestational diabetes and reduce the risk of complications during delivery. If you've exercised throughout your pregnancy, you will be rewarded with increased strength, flexibility and stamina during labor and delivery, as well as a faster recovery.
Be sure to consult with your doctor about your exercise routine. If you were active before becoming pregnant, you should be able to continue, within reason. If you are new to exercise, be sure to start slowly and do not overdo. Low-intensity or low-impact cardiovascular exercise like walking, swimming, low-impact aerobics classes or special exercise classes for pregnant women are best. You can engage in these activities most days or every day of the week for about 30 minutes per session. Ask your health care professional about specific exercise recommendations. It's critical that you keep your body cool and well-hydrated (drink lots of water) during exercise. Don't forget to warm up and cool down.
Strength training during pregnancy can also help build your stamina and strengthen your muscles and bones. Use lighter weights or resistance because heavier weights increase your chances of injury. Remember to breathe normally and follow these pointers:
Special considerations: women with chronic conditions
Today, exercise is often recommended as a management strategy for many chronic medical conditions. Of course, a thorough discussion of exercise with your health care professional is imperative prior to beginning any kind of program.
For example, exercise is highly recommended for women with osteoporosis, a bone disease that causes bones to thin and weaken. A carefully designed exercise program can help protect your bones and retard development of the disease. Weight training, in particular, helps counter the effects of osteoporosis by stimulating bone formation.
Choose weights heavy enough to tire your muscles after about 12 repetitions. The last two reps should be difficult to achieve, because the idea is that your muscles are challenged. When you can comfortably do 12 or more repetitions of a certain exercise, increase the resistance by 5 percent to 10 percent. Walking, jogging and aerobics classes also help build bone. Bicycling and swimming, however, don't stimulate bone formation in the hips because you do not bear your full body weight on your feet. Flexibility exercises enhance your posture and increase your balance, making you less susceptible to dangerous falls.
Exercise is also extremely helpful if you have diabetes. Studies find that people with diabetes who are physically active have fewer complications. Exercise can reduce blood sugar levels and enable your muscles to use glucose more efficiently, reducing or eliminating the need for insulin.
The American Diabetes Association recommends aerobic activity at least five days a week for about 30 minutes, as well as strength training and stretching exercises several times a week. Your health care professional should oversee the design of your fitness program.
And always check your blood sugar level prior to exercise and make sure it's not low. Exercise increases the ability of glucose to get into cells, reducing the need for insulin. Always have a fast-acting sugar source with you in case you do have a reaction, and wear a medical alert identification bracelet or necklace.
For women at risk of developing heart disease, exercise is crucial. In fact, according to the American Heart Association, lack of physical activity is now clearly shown to be a risk factor for cardiovascular disease, the number one killer in America.
Studies find that people who are physically inactive are about twice as likely to develop heart disease—a risk factor as significant as high cholesterol, high blood pressure and cigarette smoking. Even low-to-moderate-intensity activities such as pleasure walking, climbing stairs, gardening, yard work, moderate-to-heavy housework or dancing can bring some benefits when performed for as little as 30 minutes a day. More vigorous aerobic activities such as brisk walking, running, group fitness classes, swimming, bicycling, roller skating and jumping rope done for a total of at least 150 minutes a week are best for improving the fitness of the heart and lungs.
If you already have heart disease, you can exercise safely as long as you work out under medical supervision and carefully monitor warning symptoms. Check with your local hospital or university for monitored cardiac rehabilitation exercise programs.
Strenuous physical exertion, however, is never recommended for people who suffer from congestive heart failure, unstable angina, chest pain, significant aortic valve disease or aortic aneurysm, although some may benefit from mild or moderate exercise under controlled situations.
Exercise also is beneficial for and can help control obesity, high cholesterol, high blood pressure and back pain and may improve the symptoms of some neurological and emotional disorders. It also has been shown to help prevent certain types of cancer.
Unfortunately, more than half the people who start an exercise program quit within six months.
Overdoing it early on, getting injured or not seeing quick results can all lead to quitting a new fitness regime. To help combat these off-ramps on your highway to fitness, there are some simple rules you should remember.
Review the following Questions to Ask about fitness so you're prepared to discuss this important health issue with your health care professional.
Getting fitter and being more physically active can actually slow the onset of disease or improve symptoms if you already suffer from a chronic condition. It can slow the aging process, ward off symptoms of depression or anxiety, help you sleep better and improve feelings of well-being.
Being sedentary leads to a weak cardiovascular system, weak muscles and stiff joints, which are easily injured. Without regular physical activity, you are at a much higher risk of developing heart disease, high blood pressure, osteoporosis, fatigue and obesity.
If you are healthy and under age 65, you should work your way up to being able to exercise at an intensity that causes your heart rate to rise to between 50 percent and 85 percent of your maximum. Your maximum heart rate is 220 minus your age.
It's never too late to start. First, consult your health care professional for a thorough assessment. Then, start slowly. Some people start with as little as two minutes of cardiovascular exercise a day. You will be amazed at how your body responds, allowing you to add a little time each week until you work your way up to the level of exercise recommended for you.
The key to sticking with an exercise program is choosing activities you enjoy. For strength training, you can choose to work out on weight machines in a gym or health club, or you can work out with hand weights or resistance equipment like rubber bands and a weighted vest either in a class or at home, using a video or book for guidance. Walking, jogging, cycling, swimming, aerobics and other types of classes—from dancing to boxing—are all good cardiovascular exercise choices. Again, you can choose to exercise in group settings or in the privacy of your own home. Cross-training, which is doing different activities on different days, is often recommended to combat boredom.
Many health care professionals recommend exercise for a wide variety of chronic conditions. In these cases, your exercise program needs to be tailored by a professional to your needs. Strong muscles can help women with arthritis protect their joints by improving stability and absorbing shock. Regular exercise also helps women with chronic lung disease improve endurance and reduce shortness of breath; is an important part of controlling blood sugar for women with diabetes; strengthens the bones of women suffering from osteoporosis; helps protect your bones as you age; and may even increase life expectancy for women with heart disease.
Exercising when you're pregnant can help you achieve better posture, less back pain, less stress, better digestion, more energy, fewer complications and an easier delivery and a smaller "postpartum belly." It can also prevent or control gestational diabetes. Be sure to consult with your OB/GYN about what exercises are appropriate and at what intensity, as the rules do change somewhat for pregnant women. If you were already active before becoming pregnant, you should be able to continue, within reason. If you are new to exercise, be sure to start slowly and do not overdo.
For information and support on Fitness, please see the recommended organizations, books and Spanish-language resources listed below.
Aerobics and Fitness Association of America
Website: https://www.afaa.com
Address: 15250 Ventura Blvd., Ste 200
Sherman Oaks, CA 91403
Hotline: 877-YOUR BODY (968-7263)
American College of Sports Medicine
Website: https://www.acsm.org
Address: 401 W. Michigan St.
Indianapolis, IN 46202
Phone: 317-637-9200
American Council on Exercise
Website: https://www.acefitness.org
Address: 4851 Paramount Drive
San Diego, CA 92123
Hotline: 1-888-825-3636
Phone: 858-279-8227
Email: support@acefitness.org
Lifelong Fitness Alliance
Website: https://www.lifelongfitnessalliance.org
Address: 658 Bair Island Road, Suite 200
Redwood City, CA 94063
Phone: 650-361-8282
Email: info@lifelongfitnessalliance.org
National Academy of Sports Medicine
Website: https://www.nasm.org/
Hotline: 800-460-NASM (6276)
National Strength and Conditioning Association
Website: https://www.nsca-lift.org
Address: 1885 Bob Johnson Dr.
Colorado Springs, CO 80906
Hotline: 1-800-815-6826
Phone: 719-632-6722
Email: nsca@nsca-lift.org
President's Council on Physical Fitness and Sports
Website: https://www.fitness.gov
Address: Department W
200 Independence Ave., SW, Room 738-H
Washington, DC 20201
Phone: 202-690-9000
Email: fitness@hhs.gov
Books
Active Wellness: Feel Good for Life
by Gayle Reichler
Aging Beyond Belief: 69 Tips for REAL Wellness
by Don Ardell
Exercise Rx: The Lifetime Prescription for Reducing Your Medical Risks and Sports Injuries
by Gary Yanker
Strong Women Stay Slim
by Miriam Nelson, Sarah Wernick, Steven Raichlen
Strong Women Stay Young
by Miriam Nelson, Sarah Wernick Ph.D.
Walk with Ease: Your Guide to Walking for Better Health, Improved Fitness and Less Pain
by Arthritis Foundation
Yoga for Dummies
by Georg Feuerstein, Larry Payne
You: The Owner's Manual: An Insider's Guide to the Body that Will Make You Healthier and Younger
by Mehmet C. Oz, Michael F. Roizen
Spanish-language resources
American Heart Association: Healthy Living
Website: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/healthy-living-spanish-infographics
Address: American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
Hotline: 1-800-AHA-USA1
Email: Review.personal.info@heart.org
MedlinePlus: Exercise and Physical Fitness
Website: https://www.nlm.nih.gov/medlineplus/spanish/exerciseandphysicalfitness.html
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: custserv@nlm.nih.gov
HealthyWomen content is for informational purposes only. Please consult your healthcare provider for medical advice, diagnosis or treatment.
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