The Exercise Basics


Cynthia W. was forty-three when she became my patient. At 5 feet 5 inches, she was eighty pounds heavier than she had been at age eighteen. Her body mass index was 38, well over the cutoff point for being considered overweight. The managing editor of a business magazine, she had a high-stress job. She spent every day sleuthing stories, answering phone calls, and making sure that the news got out on time. When deadlines neared, she worked around the clock, living on take-out food. By the time she became my patient, she had had a heart scare that brought her in for an electrocardiogram. She realized it was time to start taking care of herself.


When I tried gently to bring up the matter of her weight, she said, 'Dr. Roizen, don't beat around the bush. I know I need to lose weight. And,' she smiled, 'you're the one who's going to help me do it' After fighting with issues of body image and beauty for a long time, her recent heart scare made Cynthia realize that weight loss wasn't about looking good—it was about being healthy.

She told me, 'All of sudden, I woke up one day, and I was five times the size I always thought I was. I just never made the time to take care of myself. But I don't want to haul all this weight around anymore. Tell me what I can do?

'Eat less and,' I paused, 'exercise.'

'Damn. I thought you'd say that'

'Sorry, but what else can I say? Let's develop a plan you can stick to.'


Cynthia started her first 'workout' that day. She walked from her house to the end of the block and back. That was it: short, sweet and slow. The next day, she did it again. By the end of the next week, she was walking all the way around the block. Within three weeks, she was walking eight city blocks—the equivalent of a mile—each day. Then she began timing herself, increasing her pace a little bit each time. Within three months, she was walking half an hour each day. On weekends she would walk for a full hour. "Mike," she said to me one day, "I never thought I'd say this, but I actually find myself craving my daily walk. Me, the living paperweight actually wanting to exercise! I'll be at the office, the phones will be ringing off the hook, and all I can think is, Gee, I really want to take a walk.''

She had discovered that exercise doesn't have to be painful or exhausting. It can be something to look forward to, a reward. Soon Cynthia set a goal to walk in a five-kilometer walk-run race, just over three miles. And she did it, even jogging part of the way.


Within two years, she has lost more than forty-five pounds. Her blood pressure has dropped, and she feels a whole lot better. "I have more energy, and I actually like the way my body looks and feels," she laughed. Cynthia still hasn't reached her goal of getting back to the weight she was at eighteen, but she's getting closer every day.


Cynthia's doing it the easy way, remembering that health should play an important part of every day. She's working up gradually, aiming to meet her own goal of eight years younger. Cynthia started with the goal of just boosting her overall level of physical activity, aiming to get half an hour a day of moderate activity. Then she moved on to building up stamina, strengthening her heart, lungs, and arteries and to increasing her overall endurance. She has gone from getting less than 500 kcal of activity a week to reaching the ideal goal of 3,500 kcal a week. She still isn't doing lots of vigorous exercise, but she did buy an exercise bike and, on it, she reaches her goal of 65 percent of her maximum heart rate for twenty minutes or so at least three times a week. She is aiming to bring it up to 80 percent of the maximum. She still needs to do some strengthening and flexibility exercises, especially as she builds more stamina, to prevent injuries.


If you want to start exercising, how should you start? 


Like Cynthia, you should start slowly. A behavior change that can last a lifetime takes effort. Don't try to fit a year's worth of workouts into the first week. You'll just get discouraged.


The most common reason for not exercising is "I don't have the time." Yet, exercising doesn't use up time; it makes more of it if you invest a little time each day, you will become younger in the here and now. In just ninety days, the effects will be measurable. You will feel better and more energetic, and your body will be healthier and more efficient. When people say they don't have time to exercise, I remember a clearly out-of-shape comedian who said, "All the time I gain from exercising, I spend exercising." Funny but, thankfully, not true. Just twenty minutes a day of physical activity will make your body younger and more efficient for all the other minutes of the day. In fact, most of my patients who have adopted the three-pronged RealAge physical activity plan tell me that they save more than an hour a day when they exercise. They are more energetic and more efficient in all the other things they do. No wonder. They are 8.1 years younger.


Physical Activity: The Antiager


The first goal of any fitness plan is to figure out how to boost your overall level of activity. Most of us lead sedentary lives. We sit at desks all day at work, watch TV when we get home, and drive too much. Future archeologists will label us "The-Sit-Around-and-Get-Round-Society." The decision to get in shape is a big decision, but it's the small steps that really matter. Like deciding to walk to the neighborhood grocery instead of driving. Pedaling an exercise bike while watching the football game. Lifting weights instead of chips during the commercials. Actually walking the dog, instead of just tossing or shoving him out into the backyard. Every movement you make improves your physical fitness level. Housework, gardening, and mowing the lawn—not to mention fun things, like dancing and sex—are all activities that burn extra calories. The point is to get your muscles moving. The more active you are, the younger you are.


At rest, your body burns 1,400 to 1,900 kcal a day. This is your 'resting metabolic rate.' This is the energy your body spends just keeping you alive— the energy it uses to keep your heart beating, to keep your blood flowing, to digest your food, and to breathe. Your resting metabolic rate is approximately 1 kcal per kilogram of body weight per hour. (To get your weight in kilograms, divide your weight in pounds by 2.2.) If you weigh 132 pounds, or 60 kilograms, you will burn 60. kcal an hour. Then multiply this hourly number by 24 hours to get your expenditure per day. A person weighing 60 kilograms would burn 1,440 kcal a day even doing nothing. Likewise, a person weighing 90 kilograms, just about 200 pounds, would burn 90 kcal an hour and 2,160 kcal a day. Ideally, you should expend 3,500 kcal of energy a week in exercise above and beyond your resting metabolic rate. Getting that much physical activity gives you the maximum health benefit with none of the drawbacks of overexercising. Just as examples, brisk walking bums 300 kcal an hour, and jogging bums 400 to 500 kcal an hour.


Think about your daily routine


How and where can you integrate more activity into your routine? At work, take the stairs instead of the elevator (each flight burns 5 kcal). Take a walk at lunchtime, or ride your bike to work instead of driving. In the middle of the afternoon, take a ten-minute break and, instead of having another coffee, walk around the block. It will give you an energy burst without the caffeine. You can even plan a meeting around a walk. I call it the 'walk-and-talk.' Walking a city block bums up 9 kcal. Walk short distances instead of driving. Instead of spending ten minutes looking for the perfect parking spot, park a bit farther and use those ten minutes to walk to your destination. Buy a stationary bicycle, treadmill, or rowing machine and put it in front of your TV. That way, you can catch the evening news, expand your mind, and burn 300 to 600 kcal in an hour.


Getting just thirty minutes of physical activity a day, done in eight-to-ten-minute bursts, not only leads to measurable changes in physical fitness levels but has positive emotional effects. It makes you feel younger and more vigorous. Exercise provides a 'dose-response' relationship. The more exercise you get, the better you feel. The benefit of exercise reaches its maximum at about  3,500 kcal a week. Above that, the benefit is more or less the same until you reach 6,400 kcal a week, at which point you may be overexercising and causing ageing.


Some good news: Every little bit of physical activity matters. Studies have found that people who begin exercise programs doing several small segments in a day are more likely to stay with the program than those who try to do an extensive workout all at once. If you are now relatively sedentary, burning just 750 kcal a week beyond your daily average can make you one year younger.


Although everyone needs exercise, exercise is even more important for those already at elevated risk of cardiovascular disease and other kinds of chronic disease. A famous study done by fitness researcher Steven Blair at the Cooper Center in Dallas showed that people who were physically fit, and even those who achieved physical fitness later in life, had significantly lower death rates no matter what the cause of death and regardless of any other risk factors, such as a family history of cardiovascular disease or previous heart attacks. The Harvard Alumni Study found that people who smoked, had high blood pressure, and didn't exercise had more than seven times the chance of having a heart attack. Having two of these three factors meant that a person's risk was only twice as high as the norm. If you are a smoker, have high blood pressure, or any other major risk factor that ages your arteries, exercise is especially important to retard or reverse ageing.


Family support is an important part of being able to maintain an exercise routine. Talk to your spouse or partner about the need to get in shape and about how important it is for both of you. Each of you should set exercise goals. "When one of you reaches a goal, have the other one cook a special saturated-fat-free celebratory meal or give some other reward. It may be corny, but encouraging someone to stay in shape is the best way to say 'I love you.' It means you want to have that person around for a long time. Use exercise as a way to find time in your busy schedules to get together. You can fill each other in about the day's events just as easily when you're on exercise bikes at the gym as you can in front of the TV at home.


Another problem many of us face when beginning an exercise plan is that we're literally fair-weather friends. Many people begin an exercise regimen in the spring, work out in the summer, reach their fitness peak in the fall, and then give up altogether as winter approaches,. Then they start from scratch all over again the next spring. Instead, plan for the cold weather. Join a gym or a club with an indoor pool. Even shopping malls provide indoor walking routes. More than 3 million Americans over calendar age sixty-five now mall-walk.


Starting to Exercise


Here's how I recommend that my patients start Age Reduction exercising:


Start slowly. Don't overdo it. Just go for five or ten minutes at the beginning. Even a walk around the block is a place to begin.


Do a bit more each week. Try to build your workout by a couple of minutes each week. Aim to increase your workout by 10 percent a week.


Warm up first, then stretch, and stretch again afterward. Save your muscles from pulls and tears and notice how good your body feels when your muscles are warm and stretched.


Visualize. Imagine yourself doing your sport. Make a picture in your mind of hitting the perfect shot or running in perfect form. Imagine how your body would move.


Treat yourself right. If it hurts, slow down. If it feels good, do more than you planned.


Cross-train. Try to plan your workout schedule around a number of different activities, such as walking, biking, and, swimming. Rotate your activities on different days.

Reward yourself. Set goals and when you achieve them, treat yourself. Buy a new pair of shoes or get a massage. Celebrate your Age Reduction!


Drink water. Don't let yourself get dehydrated.


Find an accomplice. Exercise with a friend. You'll encourage each other and push yourselves to meet your goals. Get the whole family involved.


Take a lesson. Even if you don't normally work out with a trainer or a pro, treat yourself to an hour with an expert who can show you how to maximize your workout and avoid needless injuries. It's a great way to get started.


Vary your workout pace. Do more on some days and less on others.


Consider whether you need a pre-exercise medical exam. Most adults do not need to talk to a doctor before beginning an exercise plan of moderate intensity. If you have a chronic disease or some other kind of health problem, you should talk to your doctor. Also, if you are a man over forty or a woman over fifty and are planning to start an intensive fitness program, you might also want to ask your physician to help you design a workout routine. If you don't have a regular doctor, ask your clinic or health maintenance organization (HMO) if anyone on its staff specializes in fitness.


If you really like being outdoors but get stopped cold by winter, learn how to dress for the weather. Wearing the proper gear can mean the difference between suffering through your workout and enjoying it. You can keep running right through the winter if you wear a hat and gloves. The advances in exercise wear in the past ten years have produced new fabrics, such as fleece and Lycra, that make exercise clothing both warm and lightweight. To make the most of the cold weather, learn a winter sport. There are few sports that provide the complete body workout of cross-country skiing. Ice skating, downhill skiing, and snowshoeing are all sports that can turn those gray winter months into something you actually look forward to.


Some people find that they miss their exercise routine when they travel or go on vacation. Plan for exercise. For example, I do a lot of traveling for work, and I always try to stay at hotels that offer fitness facilities. I find it's a great way to unwind after a long day of meetings or to start the morning off right. If I can't find a hotel with a gym, I pack a jump rope (some of my friends pack exercise bands). Twenty minutes of jumping rope—done in the right shoes and on a low-impact surface—is a great workout that you can do anywhere with a little bit of room. The ceilings in most hotel rooms are high enough. I often wonder what the person in the room below me thinks, but I know that I am not letting being way from home get in the way of keeping myself young.


(THE  CHARLES  ATLAS  COURSE [STILL OBTAINABLE]  HAS  ALL  KINDS  OF  EXERCISES  YOU  CAN  DO  ANYWHERE,  NOTHING  BUT  YOURSELF  NEEDED  -  Keith Hunt)


Boosting your physical activity levels should be a starting point. It provides the first 40 percent of the Age Reduction benefit attributable to fitness (see Table 9.2). To get the next 40 percent, you have to move to the second phase: stamina exercise.


Building Stamina: Getting Fit for the Long Run


The second element of any exercise routine should be aerobic (stamina-building) exercises. These are exercises that raise your heart rate and make you sweat. Activities like jogging, swimming, biking, and even brisk walking provide a fundamental piece of your Age Reduction exercise plan. Realistically, if you plan to get 3,500 kcal of activity a week, you will need to do something that really gets you moving. 


You will want to start slowly and work your way up. Stamina building is a RealAge 'two-for-one' special: Stamina exercises give you double RealAge credit  benefits for boosting your overall physical activity—burning kcalories— plus additional Age Reduction benefits for building stamina and aerobic capacity. In the Harvard Alumni Study of ten thousand subjects, those who expended 3,500 kcal a week had half the rate of ageing for the period studied as the least active people. In RealAge terms, individuals who were fit— those who reached overall activity levels of 3,500 kcal a week and included stamina-building exercises in their weekly routines—were 6.4 years younger than those who were completely unfit.


Aerobic exercise increases the body's uptake of oxygen and boosts your overall metabolic rate, meaning that the more you exercise, the more calories you burn, even when you're sitting still. Elevating your heart rate to 60-90 percent of its maximum for twenty minutes or more three times a week will give you a stronger heart, arterial system, and lungs and will help your body attain a higher resting metabolic rate. You also will reach your 3,500-kcal-a-week goal in half the time.


In contrast to your overall fitness level, the goal of stamina exercises is not the expenditure of kilocalories, but an increase in 'metabolic equivalent units,' or METs—-that is, a change in your metabolic rate, or the amount of oxygen that your muscles consume during exercise. One MET represents your metabolic rate at rest; 10 or 11 METs is the goal you should strive for when doing a vigorous workout. You will want to boost your metabolic rate to ten times its normal rate. Whereas kilocalories measure the total amount of energy burned, METs measure the intensity, or rate, at which you burn that energy. That is, the higher your metabolic rate (the higher your METs), the more kilocalories you burn in a shorter period. The goal of the second prong of your exercise plan-—-the stamina-building prong—should be to reach 10 METs for sixty minutes a week if you are a woman and 11 METs for sixty minutes a week if you are a man.


Now that you know what you're aiming for, how can you measure METs? Unfortunately, you can't, or at least not easily. METs can be measured accurately only at a sports medicine clinic or some other place equipped to monitor METs. There are three good substitute guidelines for measuring your metabolic rate: estimating the kilocalories burned per hour, estimating 'sweat time,' and determining your heart rate. Use these guidelines for measuring the intensity of your workouts. Look at 'calories-per-hour rates' to get a rough guideline for your MET level. If you walk briskly (300 kcal per hour), you will reach a metabolic rate of six to seven METs. If you do something that burns more than 600 kcal an hour, then you are somewhere close to 10 METs. You should try to exercise at this rate for at least twenty minutes three times a week. Another good way to estimate METs is by sweat time—try to sweat for twenty minutes or more three times a week. The amount of time you actually spend sweating is a relatively reliable indication you have reached 70 percent of your maximum heart rate and metabolic rate. The third way to estimate METs is by measuring your heart rate—the number of times your heart beats per minute. During bouts of vigorous exercise, your heart rate should get within 65-80 percent of the maximum.


How many beats per minute is that? First you need to calculate your maximum heart rate (the number of times your heart beats per minute when pushed to the limit). Calculate this by subtracting your calendar age from the number 220. If you are forty, your maximum heart rate should be about 180 beats per minute. If you are sixty, your ideal should be about 160 beats per minute. As I've gotten more fit, I challenge myself by subtracting my RealAge from 220. When you first start on your exercise program, the goal is to raise your heart rate to at least 65 percent of the maximum for twenty consecutive minutes at least three times a week. As you get in better shape, you should try to reach 80 percent of that number. For example, if you are forty, you should try to raise your heart rate to 117 beats a minute for twenty consecutive minutes each time you do a stamina-building exercise. As you progress, try to increase that number to 144 beats a minute. If you are sixty and just beginning to exercise, you should raise your heart rate to 104 beats a minute and subsequently aim for 128 beats a minute.


These are general guidelines that describe ideal heart rates for the average person in a particular age range. Remember, however, that there are individual variations in heart rate.


How do you measure your heart rate? When you are well into your workout, stop your exercise for a few seconds. Place the finger of one hand on your opposite wrist and search for the pulse point. It lies on the spot of your wrist just below the base of your thumb. Feel around for it. Make sure to use a finger, not your thumb, to feel for the pulse, as the thumb itself has a pulse point that can distort your reading. Then count the number of heartbeats in fifteen seconds, subtract one, and multiply by four to get your heart rate for a minute. Remember, a heartbeat has two parts to it—an 'in' and an 'out.' You should feel both. If you find it difficult to get this down, or if you want a more exact measure of your heart rate, buy a heart-rate monitor. These monitors are easily found at sporting goods stores but can be expensive. You can even get watches that have a heart-rate monitor in them.


As you start your new exercise program, begin slowly and build. Do as Cynthia did: Start with slow walks and gradually increase your workout each week by 10 percent. Soon you will start to sweat. When you begin a sport, it is more important to build stamina than intensity. Run farther but at a slower pace. Bike farther, rather than go all out for a short distance. Quantity matters most. Space your workouts during the week. Exercise every other day or switch between sports.


Forget the statement 'No pain, no gain.' Exercise shouldn't be painful. True pain is your body's way of telling you to back off. If you hurt, slow down or try a different regimen. The most common kind of pain you feel when you first start exercising is a slow, burning ache in the muscles and being out of breath. This feeling is normal because you are reaching your anaerobic threshold and are at the limit of your endurance. The pain is caused by the buildup of lactic acid in your muscles, which occurs when your muscles are not getting enough oxygen. This is not an indication of an injury but of reaching your fitness limit. The more you work out, the higher your anaerobic threshold will go, and soon you will be able to work out for longer periods and at a more vigorous rate.


If you feel sore after a workout, especially the next day, don't worry. Unless something really hurts, it will probably go away within a day or two—eventually producing lean muscle where there used to be flab. That's why you should space your workouts and rotate between activities-—-so that different muscle groups are worked on different days, getting a day off in between.


As you do more of your workout, set new goals and try to meet them. Try to increase the length and intensity of your workouts. Start small but be consistent, and you will do wonders. Stamina-building exercise can give you 6.4 years of youth.

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TO  BE  CONTINUED


SOUNDS  SOMEWHAT  COMPLICATED.  WELL  IF  YOU  ARE  IN  THE  UN-FIT  SITUATION,  YES  START  OUT  SLOW  FOR  SURE.  IF  IN  THE  FIT  CATEGORY,  THEN  DIFFERENT  VARIETIES  WITHIN  YOUR  FITNESS  PROGRAM  IS  A  MAJOR  KEY  TO  BEING  ABLE  TO  STICK  WITH  YOUR  OVERALL  PROGRAM.  HAVE  A  VARIETY  OF  THINGS  YOU  DO  TO  KEEP  YOU  FIT.  

ONE  IMPORTANT  RECENTLY  NEW  DISCOVERY  IS  THAT  "HARD  AND  FAST"  TRAINING  WITH  RESTS  IN-BETWEEN  FOR  FOR  1/2  AN  HOUR  DOES  WONDERS  FOR  YOUR  BODY.

MY  EXAMPLE  IS  WHEN  I'M  SWIMMING…..I  DO  A  FAST  AS  POSSIBLE  LAP  SWIM,  REST,  RELAX,  30-60  SECONDS,  THEN  ANOTHER  FAST AS  POSSIBLE  LAP,  AND  SO  ON.  THIS  NOT  ONLY  GETS  YOUR  MUSCLES  WORKING  HARDER  BUT  ALSO  YOUR  HEART,  LUNGS  AND  ETC.


YES  PARK  AT  THE  FAR  END  OF  THE  SUPER-MALL  PARKING,  WHEN  GOING  SHOPPING  AND  BRISKLY  WALK  TO  THE  SUPER-MALL  OR  GROCERY  STORE.


IF  YOU  GET  THE  CHARLES  ATLAS  HEALTH  AND  STRENGTH  COURSE,  YOU'LL  BE  GIVEN  ALL  KINDS  OF  STRENGTH  AND  STRETCHING  EXERCISES,  THAT  DO  WONDERS  FOR  YOUR  BODY,  NO  GADGETS  REQUIRE.


I  ALSO  HAVE  DUMB-BELL  WEIGHTS,  ONES  THAT  ADJUST  REAL  EASY  FROM  5  POUNDS  TO  50  POUNDS.


I  HAVE  A   BIKE.  AND  I  AM  A  HORSEMAN  WITH  MY  OWN  HORSE.


SO  THERE  IS  MY  VARIETY  OF  EXERCISING  ROUTINES  IN  ANY  GIVEN  WEEK.


AND  I  WORK  PART  TIME  AS  CARETAKER  FOR  A  COMMUNITY  CENTER…..MANY  THINGS  REQUIRE  EXTENDING  ENERGY  AND  MUSCLES.


I  DO  ALL  OF  THIS  AT  A  BIRTH  CERTIFICATE  AGE  OF  71  -  72  SEPTEMBER  11TH  2014.  PEOPLE  THINK  AND  GUESS  MY  AGE  AT  ABOUT  50.


Keith Hunt [June  2014]

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