FORMULAS FOR FITNESS:

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How Aerobics Can Help Your Heart


Ten years go, Dr. Kenneth Cooper introduced "aerobics" - an exercise program that has improved millions of North Americans' cardiovascular fitness.

The number one health problem in the western hemisphere is heart disease. As costs of medical care increased, it became obvious that the way to reduce the numbers of heart patients in hospitals was not to buy more equipment and hire more doctors, but to teach people preventive care.
It was in this spirit that the aerobics program was developed in the early 1960s. In 1968, my first book, "aerobics," was published to encourage people to use exercise - especially jogging - as preventive medicine. Today, jogging as well as other aerobic exercises such as tennis, swimming and cycling are attracting record attendances. As a result, there has been a marked decrease in death from heart disease since the late 1960s.
Why the good news? Many cardiovascular specialists credit increased preventive action. In fact, famed heart surgeon Michael DeBakey says prevention is the "ultimate goal" for the control of heart disease. Of course, lack of exercise isn't the only factor associated with heart disease. Stress, smoking, high blood pressure, cholesterol and obesity are all risk factors that should be heeded. Increased knowledge about the effects of exercise, however, allows us to prescribe a simple, sensible and positive prescription for health: Improve your physical fitness.
Aerobic exercises, take us back to the basic life process: the use of oxygen and the production of energy. "Aerobic" means with air or oxygen, and its objective is to improve those organs and systems involved in the body's processing of oxygen - the heart, lungs and blood vessels. Better utilization of oxygen brings four effects that strengthen the heart and lighten its work load. Your heart doesn't have to pump as much of your oxygen-enriched blood to each cell as it did before. Your lungs take in more air and get rid of more carbon dioxide. Your blood vessels become more flexible and less prone to accumulation of atherosclerotic deposits. And the network of tiny blood vessels throughout the cells of your body is increased, with the result that when your heart rate rises during a workout, the body's cells get more life-sustaining oxygen than before.
But is it safe for everyone to exercise? Despite claims about the dangers of jogging, the evidence in favor of an aerobics program is overwhelming. Since 1971, we have had more than 5000 people exercising at the Aerobics Activity Center in Dallas. We have logged over one million miles of running and jogging on our tracks, yet we have not had a single fatality. Unsupervised and unaccustomed strenuous exercise may be dangerous, but I can assure you of the safest possible program - provided you follow these guidelines:

  • Have a complete medical checkup no more than a year before you start exercising (three months if you're over 40). Your doctor may say you can go ahead with an aerobics program that builds up to vigorous exercise in any form. He may recommend that you exercise only in a medically supervised program. Or he may even prohibit strenuous exercise altogether and recommend you confine yourself to walking, particularly if obesity, a recent heart attack, high blood pressure or other warning signals are present.
  • Watch your diet, which should be based on a variety of needs, such as weight loss, control of cholesterol and blood-sugar levels. Wait at least two hours after a heavy meal before exercising vigorously. (For at least 90 minutes following a meal, blood is diverted away from the heart and brain.)
  • Warm up. Even a highly conditioned athlete needs a warm up period before any vigorous exercise to help guard against cramps, sprains, strains and heart irregularity. Stretching exercises such as arm circles and toe touches are recommended.
  • Don't over-exert. Some signs of over-exertion are tightness or pain in the chest, severe breathlessness, dizziness, loss of muscle control and nausea. If you experience any of these symptoms, stop exercising immediately and rest.
  • Taper off gradually. A five-minute cool-down period is very important. It helps avoid nausea, cramps and more serious problems.
  • Stick with it. When you're wondering just why you ever started an exercise program, don't throw in the towel. The first ten weeks are the toughest. That's when you'll get blisters sore muscles and become discouraged.

    I can't promise that aerobic exercise will give you absolute protection against a heart attack, but I can point to studies showing that exercise will help you survive one. Dr. Charles W. Frank first documented this in 1966 when he examined the exercise habits of 301 men who suffered heart attacks, and found that those who had been active were roughly three times more likely to survive their heart attacks, than those who were totally inactive.
    Our research confirms this finding. For example, a 58-year-old patient of mine who exercised regularly and who had reached a good fitness level went on a safari in Africa in 1974. A day or so after arriving, he felt chest discomfort but attributed it to indigestion. He rested for a day, the symptoms subsided and he continued with the safari, walking great distances. When he returned home and had a checkup, his electrocardiogram showed that he was recovering from a massive heart attack. Apparently he had developed coronary heart disease over the years -but had also built up a network of collateral blood vessels through exercise. When an obstruction finally occurred, he had a backup system to hold the line.
    "I know it's good for my body, but will I feel better?" a patient once asked. I was going to say, "Of course you'll feel better!" Then I realized he wasn't talking about his body, but his mental well-being.
    It's common to separate the two, yet I can assure there is a correlation. In the first place, improved cardiovascular fitness has a direct relation to mental health and a sense of well-being. Improved circulation, giving the brain more oxyen and more glucose, will make a person feel less depressed less hypochondriac; he will also feel more alert and will be more ready to handle streses and challenges.
    When you start an exercise program you soon will find that some of the symptoms you may have associated with tensions of a psychological nature are gone. For example, working with a group of men who had a history of anxiety-tension problems, researchers at the University of Southern California found that a 15-minute walk brought more relief than a mild tranquilizer. Exercise has also been shown to reduce allergy and asthma, long associated with emotional stress.
    In addition, a Florida psychiatrist, Ray Killinger, reports that aerobic fitness improves seven categories of the thinking process: originality of thought, duration of concentration, mental response time, ability to change topics and subjects quickly, depth of thinking, duality of thought - (the ability to entertain a number of ideas at once) and, finally, mental tenacity. Novelist Joseph Heller found his lunchtime run at the YMCA "clears my mind, flushes out the pressures and starts a free flow of ideas."
    Consider, then, the effect on your future. According to longevity projections, if you exercise regularly, you'll gain four years of life. If you don't smoke, you'll gain from three to eight years. If you're moderate in your drinking, you'll gain one year. If you practice weight control, you'll add between two and eight years to your future. That's between 10 to 21 years of added life.
    Another question is, what kind of years are in store. For the quality of the years you have ahead of you is as important as the number. You don't want to spend your future evenings asleep in front of the TV set or your future years afraid to climb the stairs.
    A letter from a 50-year-old woman jogger in Shaker Heights, Ohio, makes the point, "I feel terrific. I have no intention of giving up my running routine. I'll probably live to be 90, but I don't care how long I live, just so I live."
    Throughout the world, aerobics is joining the preventive medicine boom - just as it should, according to Canada's former Health Minister Marc Lalonde: "Good health is the bedrock on which social progress is built. A nation of healthy people can do those things that make life worthwhile, and as the level of health increases, so does the potential for happiness."
    Condensed from The Aerobics Way - Kenneth H. Cooper, M.D., M.P.H.-
    RD/Jy/78/agt01



    EXERCISE IS THE FOUNTAIN OF YOUTH




    Recent studies reveal some pleasant surprises about the benefits to older people.



    Researchers are finding that moderate exercise can not only retard the effects of aging but can actually reverse them. Among the demonstrated benefits are improved heart and respiratory function, lower blood pressure, increased muscle strength, denser bones, greater flexibility, quicker reaction times and reduced susceptibility for depression.
    As one investigator put it, disuse accounts for about half the functional decline that usually occurs between the ages of 30 and 70. Exercise by middle-aged and elderly people can set the clock back by as much as 10 to 25 years.
    Furthermore, findings show that no matter when in life a person starts to exercise, improvements in functioning can occur.
    Dr. Roy J. Shephard, an expert on exercise and aging at the University of Toronto, concludes: "You'd have to go a long way to find something as good as exercise as a fountain of youth. And you don't have to run marathons to reap the benefits. For the average older person who does little more than rapid walking for 30 minutes three or four times a week, it can provide ten years of rejuvenation."
    The more recent studies contradict the widespread belief that the elderly cannot improve physiologically and at best may only slow their decline. One of the early studies was by Herbert A. de Vries, a pioneer in the use of exercise physiology to explore gerontology. In his study, more than 200 men and women aged 56 to 87 who lived in a California retirement community participated in a fitness program that included a walk-jog routine, calisthenics and stretching for one hour a day, three to five times a week. After just six weeks, de Vries began to see dramatic changes. Blood pressure dropped, percentage of body fat decreased, maximum oxygen transport increased, arm strength improved and muscular signs of nervous tension diminished. Peak fitness occurred after 18 to 42 weeks.
    "Men and women of 60 and 70 became as fit and energetic as those 20 to 30 years younger," de Vries noted in his book Fitness After 50. "The ones who improved the most were those who had been least active and most out of shape."
    "Eventually we all decline," concedes Everett L. Smith, director of the Biogerontology Laboratory at the University of Wisconsin. "But the quality of life is so much higher for the elderly who are physically active than for people who sit in a rocking chair waiting for the Grim Reaper."
    Smith has shown that among once-sedentary women in their 50s who participated in an aerobic dance program for six years, fitness improved by 23 percent - and they experienced none of the functional declines typically seen with increasing age.
    Of course, exercise by the elderly is not without risk. Dr. Charles Godfrey, Director of the Department of Rehabilitation at the Wellesley in Toronto, has seen more than his share of the fallout from overambitious exercise programs. He advises against pounding and jumping exercises for people over 50 because "they have produced an epidemic of self-inflicted injuries." Nonetheless, he insists that "exercise is the only way to go, so long as it's done properly."
    What kinds of exercise and how much should you do? There are three major types of exercise. All are important in maintaining the highest possible quality of life. Endurance activities condition the cardiovascular and respiratory systems. Strengthening exercises increase the power of muscles, and help protect the joints against injuries. Flexibility or stretching exercises keep aging joints from stiffening. (Researchers have shown that much of the joint stiffness and aches and pains that accompany aging are the result of disuse, not of arthritis.)
    The basic recommendation for endurance exercise is to pursue one or more activities for 30 continuous minutes at least three times, and at most five times, a week.
    The ideal activity for most older people is brisk walking at a pace at which one becomes a little short of breath but can still talk. Swimming laps can also be excellent if done continuously. So is using a stationary bicycle or rowing machine. But to prevent injury to the knees and ankles, most experts advise that the elderly avoid excessive jogging, rope jumping and other activities that involve jumping or pounding motions.
    Strengthening exercises need to be done only three or four times a week to increase muscle strength by 40 to 75 percent over several months. You can use lightweight hand and leg weights, building gradually from perhaps 280-gram weights (such as a 284-millilitre can of soup), or work out on weight machines. Exercises such as leg lifts, finger presses and bent-leg curl-ups can also help.
    Flexibility exercises are best done daily, but significant benefits can be achieved with just three sessions a week. The single most important rule in stretching the body's soft tissues (muscles, ligaments and tendons) is to hold the stretched position for at least a count of ten. Then relax for a moment and repeat. Bouncing when stretching is counterproductive, it tightens, not stretches, soft tissues.
    How to exercise safely? De Vries gives these six tips for older adults:

  • See your doctor. A medical checkup is extremely important before beginning or increasing the intensity of an exercise program.
  • Take it slowly. Start at a low, comfortable level of exertion and increase its intensity very gradually.
  • Know your limit. If you have excessive fatigue, sleep problems or persistent muscle soreness, you are probably trying to do too much.
  • Exercise regularly. It takes many weeks, even months, to reach a peak level of conditioning, but it can be lost in a week or two of inactivity. Try to maintain an exercise schedule of at least three workouts a week. But discontinue your program if you become ill, even if it is only a cold.
  • Warm up first. The older you are, the more important it is to prepare the body for intense exercise. A proper warm-up (stretching and slow walking) of about ten minutes protects the heart, muscles and joints from injury.
  • Cool down afterwards. Never stop vigorous exercise abruptly. Walk for at least two minutes after a walk-jog and, waiting at least five minutes after a vigorous workout, take a warm rather than hot shower.

    Today millions of people are running, cycling, swimming and walking their way to a healthier, more fulfilling life. Even if you are over 50, you can join in the fun - and benefit!

    Condensed from the New York Times - Jane Brody -



    II

    CHOOSING THE RIGHT EXERCISE


    There are as many myths and mistruths about exercise as there are miles in a marathoner's diary. For the people who already have succumbed (or eventually will) to admonitions to get moving for the sake of their bodies and souls, these myths can induce confusion, anxiety and inappropriate decisions as to when and how to move. A few examples: "You can achieve total fitness in four minutes a day." "Jogging isn't enough; you have to run if you want to be really fit." "If you can't exercise every day, you'd better not do it at all." "Swimming is the best exercise."
    Exercise serves not one but many purposes. It can enhance skills, improve flexibility, build muscle strength and tone, relieve tension, help in weightloss and imporve the body's general physiological condition. Particular types of exercise may serve some of these functions, but not others For example, bowling and golf can help you strengthen certain muscles and eaxpend some energy (calories), but they rarely involve enough continuous activity to condition your cardiovacular system.
    Isometric exercises - weight lifting, water-skiing and arm wrestling - will promote strong muscles but are useless as cardiovascular conditioners and may actually be harmful to persons with heart disease or high blood pressure. On the other hand, brisk walking may do little for your athletic skills or muscle strength, but can be highly beneficial to your heart and figure.
    Most people start exercising because they wan to look and feel better. Often the chosen activity spurs a change or expansion of goals. For example, those people who take up tennis to reduce tension or flab may find themselves huffing and puffing on the court, and to get back into condition they may start running or cycling to improve their bodies' ability to deliver oxygen to their muscles.
    In choosing an exercise, it's important to know what you hope to get out of it and whether that choice will help you achieve your goals. Any type of exercise - from hanging laundry and scrubbing floors to badminton, skating, football or long-distance running - can help you control your weight. Weight gain represents an excess number of calories consumed over the number your body burns up. The more you move, the more calories you burn. And the heavier you are to start with, the more calories it takes to move ourself a given distance.
    Moreover, you don't ave to sweat or exercise strenuously to use energy. Walking a mile burns about half the same number of calories as running a mile. The difference, as far as calories are concerned, is that running involves lifting the body as well as moving it forward faster. You may have time to run a second mile and use up four times as many calories. In addition, your body cotinues to burn calories at a higher rate for up to four hours after you stop exercising.
    Some activities are intense energy guzzlers, using eight or more times the amoutn of calories ayour body burns at rest. These include running more than 5.5 m.p.h., cycling 13 or more m.p.h., playing squash and handball (if you keep moving) and skipping rope. But you can burn as many calories playing a challenging game of Ping-Pong or volleyball for an hour as you would running for half an hour.
    this is not to say that Ping-Pong in any amount can be equivalent to running in total all-around exercise value. To achieve fitness, the activity should use the large muscles in a rhythmic, repetitive, continuous motion - so called isotonic exercises. While the amount of calories used depends only on the amount of work your body does, conditioning is a functin of both the amount of work and the vigor with which it is done.
    A cardiovascular-conditioning exercise must also be aerobic - that is, it must promote the use of oxygen and be capable of being sustained for at least two minutes. Walking, running, cycling and swimming are aerobic exercises, but sprinting is not.
    To condition the cardiovascular system, the aerobic exercise should be performed at least three times a week for 20 to 30 minutes at a time during which the heart rate is within the individual's "target zone" - between 70 and 85 percent of the maximum rate your heart can achieve. The maximum heart rate or pulse rate, counted as beats per minute, can be estimated for the average healthy adult as 220 minus your age in years. Take 70 percent and 85 percent of that number and you will have the pulse rate range that is your target zone. (To determine your heart rate while exercising, stop and immediately take your pulse, count the beats in ten seconds and multiply by six.)
    As you become conditioned to a certain level of exercise, you may have to increase the rigor of your workout to keep your heart rate within the target zone. A conditioning exercise should be done regularly or the benefits will be lost rapidly. If you must stop for a week or more, resume at a lower level and gradually build up again.
    Time available. Running or indoor stationary cycling can be done at any time for 30 minutes or more. Rope jumping for ten minutes is equivalent to 30 minutes of jogging. Organized sports tend to be more time-cosuming and restrictive.
    Cost and convenience. Tennis may involve driving miles to a court, paying high fees, searching for a partner and arranging schedules. The cost of a bicycle may be prohibitive, but a good jump rope can be purchased for $5. For most people, sex is convenient, inexpensive and can burn a lot of calories, but to achieve a conditioning effect, a vigorous level of activity would have to be maintained for eight or more minutes.
    Your body's capabilities. If you're uncoordinated, ball games or rope jumping may prove very frustrating. If you're tight-jointed, you may need flexibility-enhancing exercise (calisthenics) before you try running or tennis.
    Age, health status and present physical condition. The older and more sedentary the person, the less rigorous the activity he needs to bring his heart rate into the target zone. At any age, and especially if you are beyond 35, check with your doctor before starting a rigorous exercise program. Beyond 50, condition yourself first through a walking program. Beyond 60, most people would be wise to avoid the more taxing exercises, and stick to walking, swimming and cycling. At any age, if you are out of condition, start slowly. Anyone with a chronic illness should consult his physician before exercising.
    Personal taste. You're more likely to stick with an exercise that you enjoy but you should give a new activity a trial of a month or two before deciding you don't like it. Dr. Lenore R. Zohman, a New York exercise cardiologist, advises that you think back to the activities you enjoyed as a youngster for clues to what you might like today. She says that if you have an aversion to organized sports or strenuous activity, brisk walking for 20 minutes to 30 minutes or climbing up 25 flights of stairs, not all at once but at a comfortable pace throughout the day, can help you achieve physical fitness.
    Dr. Zohman points out that, contrary to popular belief, "there is no best exercise for everyone." Dr. John Marshall, physician for the New York Giants, recommends that the exerciser hone his skills at more than one activity. This helps to develop muscle strength throughout the body, diminishes the chances of injury that can result when some muscles are developed at the expense of others, and provides alternative exercise if the main activity can't be done at a particular time. In other words, when it rains, the jogger or tennis player can jump rope or ride a stationary bicycle.



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