Article (a) Fit for Life~the role of Exercise in a Healthy Lifestyle
“Taking the fact that at least 1 in 4 of the deaths in the UK from heart disease are attributed to inactivity … and statistically this could equate to a Lockerbie Jumbo Jet crash or equivalent occurring each and every day, we are looking at a major issue for the nation.”  Physical activity levels need to become a bigger priority for everybody in order to reduce such losses and to impart better quality of life ~ putting years into your life … and life into the years.
Motivations to Exercise
What motivates people to take up exercise … or to continue ?
In 1992 Allied Dunbar undertook a National Fitness Survey (ADNFS-92) which revealed the commonest motivations amongst those who undertook regular exercise.
The top four were :
1st To feel in good shape physically
2nd To improve or maintain health
3rd To feel a sense of achievement
4th To get out of doors
Other factors included ~ weight management/loss; “having fun”; relaxation; and meeting people/socializing.
Addressing the (Poor) PhysicalState of the Nation (relating toADNFS-92)
The human body was designed to be active ~ imagine the level of activity required to live and survive just 150 years ago, let alone in pre-history. In the 21st century we have food in abundance, readily available through vast stores ~ so our days of hunting or gathering are but a gene memory. It is a fact that regular exercise is required in order to stay healthy. Note that exercise “to get fit” is a further dimension beyond that needed for retaining health.
Over the last 30 – 40 years, our homes and workplaces became more mechanised, and with time pressing in, the need for longer range travel presses us to public transport or our cars. Even for short, local journeys, most people take their car rather than walking, cycling or “running an errand”. Of an evening after a day at the computer, we have remote controls so that we do not need to rise from our armchair to change the CD or TV channels! Even with an apparently increased proportion of “spare” time and disposable income directed towards leisure ~ our fitness levels as a nation are falling. Obesity levels reach epidemic proportions, particularly amongst children and young adults. The susceptibility to weight gain is fuelled by an inability by many to take responsibility for levels of food consumption, a preference for high fat and fast, refined and/or processed foods combined with wholesale reductions in routine activity and willingness to exercise.
ADNFS-92 suggested that 80% of our nation consider themselves to be ‘fit’ ~ yet one third of males in the survey’s population of 4,300 adults, and two-thirds of the females, would be unable to continue climbing a 1 in 20 slope, walking at a reasonable pace (3 mph), without getting breathless. It also found :
74% of males and 68% of females fell below the threshold for lowest “acceptable” activity (…missed the bottom rung)
A significant percentage of both sexes & all age groups revealed “no exercise in the last 4 weeks” … not even 20 minutes!
Only 20% of men and 10% of women had occupations which met the survey’s definition of providing vigorous activity.
Unless lifestyle perspectives can be changed considerably, sports and recreation pursuits are the best way of meeting our “vigorous activity” needs ~ especially amongst young adults from 16 to 40 years. However, such pursuits presented substantial barriers to exercise for many people. The reasons why they did not wish to, or could not, participate included : memories of school “Games”; and perceptions of lycra/leotard-infested health and gym clubs!
Activities in and around the home can meet much of our need for “moderate intensity activity”. These are also the activities that are commonly continued into older age by many people. “Active living” places value on all forms of physical activity that can be included in everyday life. Such activity contributes to well being, quality of life and, above all, the many benefits to be gained from exercise which are summarized below.
What are the Exercise Recommendations for Health ?
The following guidelines are purely for maintaining or establishing substantial improvements in health and quality of life ~ not for specific “fitness” or “performance” goals. The guidelines are those proposed by the American College of Sports Medicine , are generally accepted internationally unless noted otherwise and vary little with the age of any adult participant :
Aerobic/endurance activity guidelines ~ the “Moderate Exercise Prescription” : 3 – 5 times per week for 30 minutes (not necessarily all in one go for a single day) to exercise aerobically at between 55 – 69% of maximum heart rate [rate calculated theoretically as (220 – age) b.p.m.]. As the undertaking of five times/week is seen by most individuals as “intimidating” and therefore unlikely to succeed, the Health Education Authority’s March 1996 “Active for Life” physical activity campaign with the Sports Council in the UK promoted that sedentary individuals should start with at least 1 x 30 minutes/week and build this up to three to five times/week at between 50 – 69% of maximum heart rate. However, adopting “Active Living” techniques as suggested below, alongside a realistic exercise programme ~ then the “three times per week” (say) could readily be met in part with an appropriate mix of active living exercise in doses of say 3 x 10 minutes or 2 x 15 minutes in each day. This split session format demonstrates little loss of “for health” gains compared with exercising in single sessions of about 30 minutes. The Moderate Exercise Zone is at a level which most people can maintain output for a long duration of say brisk walking, cycling or gentle running.
Strength training guidelines for general muscle tone : minimum 2 training sessions per week to exercise all major muscle groups ~ say 8 exercises for 2 sets of 8 – 12 repetitions undertaken at slow to moderate speed (and unable to push loading for say 14 repetitions). Time to carry out ~ typically approx 20 minutes for health gains only.
Flexibility guidelines for suppleness and mobility : 3 times per week : static stretches for each major muscle group, held for 10 to 30 seconds and 3 – 5 repetitions for each stretch
Rest : suggested at least one day, and preferably 2, per week of complete rest for the body to repair and rebuild structures changed or damaged during the exercise (“super-compensation” ~ usually rebuilds stronger over time). The rest part of the work : rest cycle through the week is of at least equal importance to the exercise dose.
The Benefits of Exercise and of Adopting “Active Living”
Physical activity undertaken by an individual confers many benefits in terms of health, fitness and psychologically. Health benefits that have been recorded in a variety of studies include :
Reduces risk of coronary heart disease by about one half ~ improved circulation through better capillary structure. Bearing in mind that in 1999 CHD, stroke and related disease were jointly responsible for 41% of deaths in the UK ~ this is a very significant reason ON ITS OWN! The risk of a stroke can be reduced by about one third
Reductions in high blood pressure amongst people with hypertension have been shown in studies, based on frequent moderate intensity activity; and lowering of overall cholesterol levels with improvement in blood lipid profiles and increased HDL (the “good” guys)
Reduction in resting heart rate and general recovery after exercise
Including an exercise prescription during cardiac rehabilitation can reduce mortality by 20-25% over a three year period
Reduced risks of developing colon cancer (by about 40%) and breast cancers in particular have been shown in many studies. The typical risk reduction for other cancers was in the range 20 to 30%, although some studies were unclear as to the nature and extent of the links. Greatest benefits were gained with highest activity levels
Reduces risk of type II diabetes by typically 33-50% (no evidence in respect of type I diabetes) and of obesity. For diabetics, regular exercise improves glucose-insulin responses, improves control in type II (no evidence in type I) and improves lipids and blood pressure both in type I and type II. It should be noted that regular exercise does not seem to worsen any of the circulatory complications associated with diabetes ~ but more research is needed in this area (Retinopathy ~ eye problems ~ Physical activity not associated with increased or decreased risk of retinopathy in a single trial; Neuropathy ~ extremities at risk, i.e. problems with feet and toes in particular ~ exercise improved balance in a single trial; Nephropathy ~ kidney complications ~ exercise seemed to prevent the progress of renal disease in a single trial)
Improved posture & weight regulation; the latter achieved through an increase in metabolic rate from toned muscle in particular. This helps to bur n up fat stores at a faster rate whether active or at rest, and also retain youthful looks
Improved exercise tolerance through super-compensation ~ giving better aerobic endurance & resistance to injury
Better flexibility and range of movement : specifically shown to help control joint swelling and arthritic pain
Better bone development through youth (up to age of about 25 when the body’s Peak Bone Density is achieved) and potential reduction in Osteoporosis with ageing (loss of calcium from the “spongy” or trebecular bone in the core of skeletal structures) providing that the participants’ diet includes adequate calcium, vitamin D and magnesium. For bone density benefits to be conferred, the exercise or activity does need to be weight-bearing. Swimming does not meet this particular criterion, therefore ~ although in other respects as a part of an all-round programme swimming is excellent aerobic activity and uses all major muscle groups. It is true that for some people, swimming tires their muscles before substantial aerobic gains have been achieved. There is some debate as to whether even brisk walking is sufficiently load-bearing or “impact” related. There are studies that show benefits when the participants were involved in say 30 minutes a day of regular walking, whereas others revealed no significant density gains. Most of the studies agree that walking in youth can confer more bone density gains to push the skeleton towards a higher Peak Bone Density level reached in middle twenties, and so encouraging such exercise in youth suggests greater active lifestyle gains. With load bearing or resistance-based exercise, the risk of hip fractures from osteoporosis in later years can be reduced by about one half. The key sites for attention in this respect are the hips, the spine and the wrists. There are specific exercises which should be undertaken regularly to encourage calcium deposits especially around these high risk fracture areas
Avoiding muscle and joint deteriorations, especially those due to ageing ~ the Use it or Lose it philosophy is certainly not a myth. These deteriorations start for most people at about the age of 40 if they are inactive. This does vary from individual to individual depending on what general activity is being done, state of nutritional health and so on. It is this mid-life onset of deterioration that is the key reason why everybody should undertake SOME resistance training as well as their moderate intensity aerobic exercise. Resistance training to tone and protect muscles will give more retained abilities in later life. Specific muscle fibre types and the motor nerve systems that “fire” them are the most vulnerable to lack of use. Once the deterioration of muscle fibres advances, with increased connective tissue interlinking sliding filaments, it can be very difficult to recover. A smaller number of active motor nerve units to activate muscles means less strength and lowered endurance. This seems to happen particularly quickly in the legs of inactive individuals, and is one of the main reason why so many end up restricted to chairs due to weakness and loss of balance … and perhaps bedridden in later years
Improved self image and reduced levels of stress, anxiety and depression; plus overall psychological advantages from release of endorphins, enhanced brain neural networks and neurotransmitters
Improved immune functions with moderate intensity levels, although more extreme exercise levels and overtraining are usually linked with the risk of compromised immune defences. However, exercise is commonly associated with improved recovery from illness and injury
Helps to retain the ability to live independently and reduces the risk of falling and fracturing bones as a result of improved balance ability (assessed to be a 25% lower risk of falls amongst elderly populations : source Department of Health)
Can help reduce blood pressure in some people with hypertension
Reduced levels of spent hormones (endogenous) circulating within the body
Greater DNA repair abilities
And last but not least, there’s “lifespan”. Several studies have showed that an increased weekly energy expenditure in physical activity as an ongoing habit can extend your expected lifespan. One study estimated that the risk of death amongst a sample of nearly 12,000 Harvard College alumni between 1977 and 1985 may have been reduced by 7% if all the target groups had simply walked at least 5 kilometres every week. In terms of physical activity, the risk of death might have been reduced by 20% if each person in the study had expended 2000 kilocalories or more per week in walking, recreational activities or climbing stairs ~ and moreover their quality of life would have been improved.
So, What Sort of Activity can You Fit in and How Often ?
The traditional view had been that to achieve these benefits one needed to perform “vigorous exercise” at least three times a week, and probably four to five times ~ where heart rate levels in excess of 70% of maximum are achieved. That may be OK for a seriously competitive individual, but more recent research has proven that regular participation in activity at moderate levels can confer substantially the same physiological benefits for health. It is such research behind the formulation of the ACSM Guidelines referred to above.
Living in the 21st century, one can easily be distracted from taking exercise to undertake the chores of daily life. Active living principles suggest reversing sedentary habits that you may have unconsciously developed. In most cases the more physically active path takes no more time, is no less enjoyable and may even save money (some fares for example).
Active living approaches to a part of one’s exercise needs for a week do have the benefit of naturally overcoming most of the barriers to exercise identified in the National Fitness Survey (ADNS-92), the following being the major barriers :
Insufficient time (driven by work, wish to spend time with family etc)
Dislike of sport and/or going to the gym
Fear of injury
Active living is geared towards the promotion of better health, “fitness”, positive well-being and quality of life through undertaking everyday activities in such a way that your body is tested either to develop endurance (aerobic activity), strength or flexibility. It is a way of living which values all forms of physical activity in everyday life ~ for their contribution to individual well being and quality of life. People of all ages should make such activity an integral part of their daily routine and leisure pursuits. Active living is measured not just in terms of exertion levels, resistance, heart rate zones; but also in terms of enjoyment, personal satisfaction and Calories expended. This is a very different to the traditional approach to exercise, where time has to be set aside (usually 3 to 4 times a week) to get to a venue, prepare, carry out the exercise, change afterwards and get home again. Active living measures can take place in the home, the office or place of work, in the countryside or away on holiday ~ thereby covering usually a major part of one’s physical activity needs.
Rethinking your daily activities is unlikely to meet all your exercise needs, but efforts on the lifestyle front add up to a worthwhile contribution. The added benefit is that regular, moderate intensity exercise will give you a livelier attitude to life.
Ideas for moderate intensity, active living exercise:
Walk (or run) up the stairs instead of taking the lift or escalator (aerobic exercise) In a break during the working day, take a brisk walk (fresh oxygenated blood to defog the brain / aerobic exercise)
Leave the bus a stop or two earlier, or park your car a further from your destination ~ then walk the rest (ditto).
Cycle to work, at least part of the way (ditto)
Carry a hand basket instead of pushing a supermarket trolley for part of the walk around the supermarket (resistance training for arms, shoulders and postural muscles)
Switch the television off and get on with that garden project (aerobic and resistance exercise)
Hand wash the car(s) rather than sitting and driving them through the roller carwash
In fact, any activity which requires physical exertion can be approached in a more upbeat manner and considered as a part of Active Lifestyle Exercise ~ even doing the hoovering!
1. Do not expect results overnight.
2. Start slowly and build up gently to avoid overstrain or injury.
3. Within 4 to 8 weeks you should become aware of a gradual, but noticeable, increase in your level of fitness and your sense of wellbeing.
4. Note your progress at each session and try to build some progression into what you achieve (not always doing the same old things … avoid boredom)
5. Exercise must become a habit and a pleasure if it is tobe regular and give you any real benefit.
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REFERENCES for Article (a) :
Bob Laventure : British Heart Foundation National Centre for Activity and Health at Loughborough University ~ keynote speaker at a London seminar entitled “Someone Like ME!” 21st January 2003
ACSM Position Stand on the Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness and Flexibility in Adults : 1998 : Med Science Sports Exercise : Vol 30 Number 6 pp 975 – 997
Dr Imogen Sharp, Head, CVD and Cancer Prevention, Department of Health : Sept 2002 : Presentation to the “Physical Activity and Medical Conditions Conference” at the British Heart Foundation National Centre for Activity and Health at Loughborough University “Making the Case for Physical Activity”
Paffenbarger, Hyde, Wing & Hsieh (1986) : Chronic disease in former college students ~ physical activity and all causes mortality, and longevity of college alumni : New England Journal of Medicine, 314, pp 605 – 613
Article (b) ACTIVE LIFESTYLES ~ Walking Burns The Fat
The General Household Survey of 1990 found that the most popular aerobic activity for recreation in the UK was … walking.
It is a very acceptable and accessible pastime for a substantial proportion of our population. Fitness walking is therefore an excellent way of approaching the problem of improving the health and fitness of those people who do not wish to run, cycle, swim or attend a local gym or specific exercise classes.
The results of the survey were as follows, assessed over a 12 month period :
¨ Running and jogging 10%
¨ Cycling 14%
¨ Yoga and other “keep fit” activity 18%
¨ Swimming 42%
¨ Walking 66%
Walking also gains substantial support amongst those seeking an activity to continue through their older years, in retirement, aged 70 and beyond.
Addressing the State of the Nation
(The Allied Dunbar National Fitness Survey 1992)
Our homes and workplaces are more mechanised, and travel needs now seem to direct us to public transport or our cars. Our dependence on the machine is at such a level, that even for short, local distances too many people take to the family car rather than walking, running or cycling. Of an evening after a hard day sitting behind a hot computer we have remote controls so that we do not need to rise from our armchair to change CD tracks or TV channels. Even with an apparently increased amount of “spare” time and disposable income directed towards the leisure sector ~ our fitness levels as a nation are lamentably dropping.
The Allied Dunbar Survey suggested that 80% of our nation consider themselves to be ‘fit’ ~ yet one third of males in the population for the survey (surveyed over 4,300 adults) and two-thirds of the females would be unable to continue climbing a 1 in 20 slope, walking at a reasonable pace (3 mph), without getting breathless.
It also found :
¨ 74% of males and 68% of females fell below an optimum target activity threshold (missed the bottom rung)
¨ A significant percentage from both sexes and all age groups fell into the category “no exercise in the last 4 weeks” … not even 20 minutes!
¨ Only 20% of men and 10% of women had occupations which met the definition of providing of vigorous activity (see below).
¨ Sports and recreation pursuits therefore offered the best potential for meeting vigorous activity needs ~ especially amongst the young adults of ages 16 to 34 years.
¨ Activities in and around the home can supply much of the “moderate” activity needs ~ and these are the ones that are regularly continued on into older age by many people.
The following Activities could be defined as Moderate :
¨ Mixing cement
¨ Digging the garden
¨ Heavy housework
¨ Postal deliveries
¨ Long walks at a brisk or fast pace (2 miles distance or more)
¨ Football, swimming, tennis, aerobics or cycling (if not getting out of breath or sweaty).
… And these come into the VIGOROUS Activity category :
¨ Occupations that require frequent climbing, lifting or carrying heavy loads
¨ Hill walking at a brisk pace (distances of 5 to 10 miles or more)
¨ Squash, football, tennis, cycling (out of breath and/or sweaty) and running
The aim is to get more individuals meeting the goal of 12 exercise or activity “sessions” of 20 minutes duration each in a four week period. Level 3 activity would be 12 x 20 session of moderate activity in 4 weeks; Level 4 activity would be 12 x 20 session of a mix of moderate and vigorous activity in 4 weeks; and Level 5 activity would be 12 x 20 session of vigorous activity in 4 weeks. That is to be active just three times a week on average ~ for HEALTH benefits to accrue. For real fitness gains that should be increased to 4 or 5 times per week and the duration of activity would also rise.
Incorporating more walking into your daily routine will help you get into shape. Research shows that regular "lifestyle" activity, such as walking, will improve health and help weight management.
Walking for Life ~ a Practical Approach
This research is supported by changes my clients have enjoyed.
Sam had hitherto managed time to get to her gym for training about twice weekly, but recently added in usually 30 minutes of vigorous downland walking each day with her dogs. Another, Jim, started getting off his commuting bus one stop earlier (and catching back from the same stop in late afternoon) which gave him a total extra 20 minutes of vigorous walking on 4 to 5 weekdays. Neither increased the amount of actual "fitness training" they were doing ~ but both changed their approach to one area of their lives and thereby boosted their metabolism. They have both lost weight or changed their body composition (reflected in waistline circumference particularly) over a three month period without making substantial changes in other areas.
Why were these small lifestyle changes so effective?
Twenty minutes or so of brisk walking each day would typically burn an extra 125 Calories. Not much on its own, but if you multiply that by say 5 days per week and then look at it over a quarter ~ it adds up to a significant contribution to Calorie expenditure. Furthermore, after the completion of exercise, their energy consumption remains higher for a time … and their muscles, better toned by that extra walking, also burn energy throughout the day at an enhanced rate ~ rewarding them with the loss of some excess fat and their getting into better shape.
So, by adding that small amount of regular physical activity to your existing routine, yourmetabolism is given a little boost each day … it’s THAT SIMPLE.
or more information about WALKING the Way to Health (an initiative of the British Heart Foundation and the Countryside Agency) we suggest that you visit their website on (this link will open in a new window)
Suggestion for further reading :Walking for Health : Dr William Bird and Veronica Reynolds : CARROLL & BROWN PUBLISHERS Ltd 2002 : Amazon price currently £10.39 (marketplace sellers prices new from £11.24)
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