Fitness At Any Age

Energize Your Life! Who ever said physical activity is all work and no play? In fact, it can be just the opposite! There is no need to think of strenuous workouts that are painful and boring. Instead, imagine doing fun physical activities you enjoy and look forward to. Do physical activity for enjoyment and watch the health benefits follow!

The importance of physical activity

The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis.
Regular physical activity substantially reduces the risk of dying of coronary heart disease, the nation's leading cause of death, and decreases the risk for stroke, colon cancer, diabetes, and high blood pressure. It also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among older adults; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. Moreover, physical activity need not be strenuous to be beneficial; people of all ages benefit from participating in regular, moderate-intensity physical activity, such as 30 minutes of brisk walking five or more times a week.
Despite the proven benefits of physical activity, more than 50% of American adults do not get enough physical activity to provide health benefits. 25% of adults are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education.
Insufficient physical activity is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous-intensity physical activity. Daily participation in high school physical education classes dropped from 42% in 1991 to 32% in 2001 (CDC, 2002).
This section explains why you should be active, how inactivity may hurt your health, and how physical activity can benefit everyone.

Why should I be active?

"It's easier to maintain your health than regain it." -Dr. Ken Cooper
Physical activity can bring you many health benefits. People who enjoy participating in moderate-intensity or vigorous-intensity physical activity on a regular basis benefit by lowering their risk of developing coronary heart disease, stroke, non-insulin-dependent (type 2) diabetes mellitus, high blood pressure, and colon cancer by 30-50% (USDHHS, 1996). Additionally, active people have lower premature death rates than people who are the least active.
Regular physical activity can improve health and reduce the risk of premature death in the following ways:

• Reduces the risk of developing coronary heart disease (CHD) and the risk of dying from CHD
• Reduces the risk of stroke
• Reduces the risk of having a second heart attack in people who have already had one heart attack
• Lowers both total blood cholesterol and triglycerides and increases high-density lipoproteins (HDL or the "good" cholesterol)
• Lowers the risk of developing high blood pressure
• Helps reduce blood pressure in people who already have hypertension
• Lowers the risk of developing non-insulin-dependent (type 2) diabetes mellitus
• Reduces the risk of developing colon cancer
• Helps people achieve and maintain a healthy body weight
• Reduces feelings of depression and anxiety
• Promotes psychological well-being and reduces feelings of stress
• Helps build and maintain healthy bones, muscles, and joints
• Helps older adults become stronger and better able to move about without falling or becoming excessively fatigued

Can a lack of physical activity hurt your health? Evidence shows that those who are not physically active are definitely not helping their health, and may likely be hurting it. The closer we look at the health risks associated with a lack of physical activity, the more convincing it is that Americans who are not yet regularly physically active should become active

What are the recommendations for increasing fitness for youth, adults, and seniors?

There is good news for all Americans. Scientific evidence shows that physical activity done at a moderate-intensity level can produce health benefits (USDHHS, 1996). If people have been sedentary, they can improve their health and well-being with regular, moderate levels of activity each day.
Those who participate in moderate- to vigorous-intensity activities regularly should be encouraged and supported in their efforts to continue. While activity at a higher intensity or performed longer offers more health benefits, this level of activity may not be a realistic goal for everyone, at least not to start with. Many Americans, for whom the term "exercise" brings up negative images and emotions, can celebrate the good news by setting a new personal goal-achieving and enjoying the benefits of a regularly active lifestyle that includes a variety of moderate- and/or vigorous-intensity activities.
Adults should strive to meet either of the following physical activity recommendations. See General Physical Activities Defined By Level of Intensity for a chart that lists the intensity levels of many types of activities.

• Adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days of the week.

- Centers for Disease Control and Prevention/American College of Sports Medicine
OR

• Adults should engage in vigorous-intensity physical activity 3 or more days per week for 20 or more minutes per occasion

- Healthy People 2010

More good news is that it's never too late to start an active lifestyle. No matter how old you are, how unfit you feel, or how long you've been inactive, research shows that starting a more active lifestyle now through regular, moderate-intensity activity can make you healthier and improve your quality of life.
This next section provides guidelines for how active you need to be to gain some benefit and general information on activity levels of Americans.
How active do adults need to be to gain some benefit?
Physical activity does not need to be hard to provide some benefit. Participating in moderate-intensity physical activity is a vital component of a healthy lifestyle for people of all ages and abilities. There is no demographic or social group in America that could not benefit from becoming more active.
The table* below provides recommendations on how to increase your physical activity based on your current activity level. Check it out to see where you are and how you can challenge yourself.

If....	Then...
You do not currently engage in regular physical activity,	you should begin by incorporating a few minutes of physical activity into each day, gradually building up to 30 minutes or more of moderate-intensity activities.
You are now active, but at less than the recommended levels,	you should strive to adopt more consistent activity: moderate-intensity physical activity for 30 minutes or more on 5 or more days of the week, or vigorous-intensity physical activity for 20 minutes or more on 3 or more days of the week.
You currently engage in moderate-intensity activities for at least 30 minutes on 5 or more days of the week,	you may achieve even greater health benefits by increasing the time spent or intensity of those activities.
You currently regularly engage in vigorous-intensity activities 20 minutes or more on 3 or more days of the week,	you should continue to do so

*Scientific evidence to date supports the statements above.
What is "moderate-intensity physical activity?"
Moderate-intensity physical activity refers to any activity that burns 3.5 to 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while walking briskly, mowing the lawn, dancing, swimming for recreation, or bicycling.
What is "vigorous-intensity physical activity?"
Vigorous-intensity physical activity refers to any activity that burns more than 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while jogging, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill.

• On average, regularly participating in one or more moderate-intensity or vigorous-intensity activities is required to burn a minimum of 150 Calories of energy per day, 7 days per week, or total of 1,000 Calories/week (Jones et al., 1998).
• The time needed to burn 150 Calories of energy in a day depends on the intensity of the activities chosen. For example, if someone selects moderate-intensity activities, the time required to meet the minimum recommendation would be generally 30 minutes per day. The more vigorous the activities chosen, the less time needed (22 minutes or less) to burn the minimum of 150 Calories during the day.

Number of Minutes of Activity Required to Burn 150 kcalories

Are there special recommendations for young people?
It is recommended that children and adolescents participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily.¹
Children and adolescents can choose any type of moderate or higher intensity physical activity, such as brisk walking, playing tag, jumping rope, or swimming, as long as it is adds up to at least one hour a day.
For children and adolescents, regular physical activity has beneficial effects on the following aspects of health:

• Weight
• Muscular strength
• Cardiorespiratory (aerobic) fitness
• Bone mass (through weight-bearing physical activities)
• Blood pressure (for hypertensive youth)
• Anxiety and stress
• Self-esteem

Children and adolescents who are just beginning to be physically active should start out slowly and gradually build to higher levels in order to prevent the risk of injury or feel defeated from unrealistic goals. It is important that children and adolescents are encouraged to be physically active by doing things that interest them. This will help them establish an active lifestyle early on.
¹This physical activity recommendation is from the Dietary Guidelines for Americans 2005.
Tips for Parents
As a parent, you have an important role in shaping your children's physical activity attitudes and behaviors. Here are some tips to encourage your children to be more physically active.

• Set a positive example by leading an active lifestyle yourself, and make physical activity part of your family's daily routine such as designating time for family walks or playing active games together.
• Provide opportunities for children to be active by playing with them. Give them active toys and equipment, and take them to places where they can be active.
• Offer positive reinforcement for the physical activities in which your child participates and encourage them as they express interest in new activities.
• Make physical activity fun. Fun activities can be anything the child enjoys, either structured or non-structured. They may range from team sports, individual sports, and/or recreational activities such as walking, running, skating, bicycling, swimming, playground activities, and free-time play.
• Ensure that the activity is age appropriate and, to ensure safety, provide protective equipment such as helmets, wrist pads, and knee pads.
• Find a convenient place to be active regularly.
• Limit the time your children watch television or play video games to no more than two hours per day. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity (walking, playing chase, dancing).

Are there special recommendations for seniors?
Being physically active can prevent and help treat many of the most common chronic medical conditions associated with old age. Physical activity is one of the most important steps older adults can take to maintain physical and mental health and quality of life. Scientists have proven that being active can help reduce the risk of obesity, high blood pressure, diabetes, osteoporosis, stroke, depression, colon cancer, and premature death. Yet today, more than 60% of older adults are inactive. Older adults face the same obstacles to being more physically active as younger adults but also have special concerns.
The Challenge to Get Moving
Getting older adults to be active is a challenge. The average American lives a long time, but many are sedentary, physically unfit, and experience disability from chronic medical conditions as they age. Physicians and exercise experts hear many reasons from older adults as to why they are not active: It doesn't feel good. It makes my arthritic joints hurt. It takes too much time. It's boring. However, older adults need physical activity like everyone else, at least as much as younger adults. In fact, the loss of strength and stamina often attributed to aging is in part caused by reduced physical activity.
Walking groups and physical activity programs especially designed for older adults can help seniors become-and remain active. For example, senior swim clubs and water aerobic classes are excellent activities for people with arthritis.
The Need for Strength
Strength training is recommended for all adults, but it is a vital link to health for older adults. The reason is that strength training prevents sarcopenia, the muscle deterioration that comes with aging, and also helps maintain bone mass. "Stronger people have better health outcomes," noted Dr. David Buchner, Chief of CDC's Physical Activity and Health Branch and renowned Gerontologist. However, some elderly people avoid physical activity and become sedentary out of fear of falling and fracturing a bone. Dr. Buchner added that emerging data indicate that physical activity can prevent falls by improving strength, balance, and endurance.
Keeping Young at Heart Aerobic activity (also known as cardiorespiratory or cardiovascular endurance activity) is also important. It keeps the heart strong, lowers blood pressure, and relieves anxiety and depression. Older adults can obtain significant health benefits with moderate physical activity, such as walking or gardening.
"We need to make physical activity part of the daily routine for older adults," said Dr. Buchner. Health clubs also provide older adults with a variety of opportunities to improve their aerobic fitness, muscular strength, and flexibility. Dr. Buchner adds, "Traditionally health and fitness facilities have marketed mainly to body-conscious younger adults, who focus on the cosmetic effects. It's great to see that health clubs have developed more programs for older adults, and we hope this trend continues."
*The above information was adapted from: CDC, NCCDPHP. Special focus: healthy aging. Chronic Disease Notes and Reports 1999;12(3):10-11.
Recommendations
The CDC/ACSM recommends that all adults should accumulate at least 30 minutes of moderate-intensity physical activity on five or more days of the week. Cardiorespiratory (aerobic) endurance, strength, balance, and flexibility exercises should all be part of a physical activity program for older adults. No one type of activity will bring about all the benefits of physical activity. It is important to include all of them. Older adults can meet the physical activity recommendation with a combination of these activities using the following sample schedule:

• Cardiorespiratory: Participate in moderate-intensity aerobic activities 3-5 days a week for at least 30 minutes each session.
• Flexibility*: Stretch every day.
• Strength training: Do strength-building activities 2-3 days per week.

*Flexibility refers to how fully one's joints or limbs are able to move. Being flexible allows for easier movements and reduced pain in joints so that it is also easier to perform daily activities of independent living. By adding stretching to your daily physical activity plan, you can help keep your joints flexible which will help you move with more freedom and comfort.
Participating in these types of activities can help you more easily perform many of your day-to-day tasks. For example, being more flexible will help you more easily do things like reaching in your cupboard and tying your shoes. Being stronger and having more balance will help you lift and carry items like sacks of groceries and will make it easier to get in and out of chairs and the bathtub. Improving your cardiorespiratory endurance will allow you to do things like climbing stairs, dancing, or playing with grandchildren without getting out of breath.
The chart below provides ideas of activities in the areas of cardiorespiratory endurance, strength, and flexibility. Many of these activities will also help improve your balance. Most importantly, choose activities that you enjoy. This will make it more likely that you'll keep doing them!

Cardiorespiratory	Strength	Flexibility
Walking	Chair exercises	Stretching
Swimming	Lifting weights or cans	Yoga
Dancing	Carrying laundry or groceries	Tai chi
Skating	Working in the yard
Hiking	Washing the car
Rolling your wheelchair	Scrubbing the floor

When is a medical evaluation necessary?

Experts advise that people with chronic diseases, such as a heart condition, arthritis, diabetes, or high blood pressure, should talk to their doctor about what types and amounts of physical activity are appropriate. If you have a chronic disease and have not already done so, talk to your doctor before beginning a new physical activity program.
If you have symptoms that could be due to a chronic disease, you should have these symptoms evaluated, whether you are active or inactive. If you plan to start a new activity program, take the opportunity to get these symptoms evaluated. Symptoms of particular importance to evaluate include chest pain (especially chest pain that is brought on by exertion), loss of balance (especially loss of balance leading to a fall), dizziness, and passing out (loss of consciousness).

Making physical activity a part of your life

"You can't change where you came from. You can change where you are going." -Anonymous
Just knowing that physical activity is good for us doesn't mean that we'll easily be able to make it part of our daily routines-it's sometimes difficult to adopt new habits. But it's important to remember that you can start out slowly and work your way up to a higher level of activity.
This section provides ideas for how to make physical activity part of your life and how to do it safely.

Components of physical activity

What does it mean to be physically "fit?" Physical fitness is defined as "a set of attributes that people have or achieve that relates to the ability to perform physical activity" (USDHHS, 1996). In other words, it is more than being able to run a long distance or lift a lot of weight at the gym. Being fit is not defined only by what kind of activity you do, how long you do it, or at what level of intensity. While these are important measures of fitness, they only address single areas. Overall fitness is made up of five main components:

1. Cardiorespiratory endurance
2. Muscular strength
3. Muscular endurance
4. Body composition
5. Flexibility

In order to assess your level of fitness, look at all five components together.
What is "cardiorespiratory endurance (cardiorespiratory fitness)?"
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel during sustained physical activity (USDHHS, 1996 as adapted from Corbin & Lindsey, 1994). To improve your cardiorespiratory endurance, try activities that keep your heart rate elevated at a safe level for a sustained length of time such as walking, swimming, or bicycling. The activity you choose does not have to be strenuous to improve your cardiorespiratory endurance. Start slowly with an activity you enjoy, and gradually work up to a more intense pace.
What is "muscular strength?"
Muscular strength is the ability of the muscle to exert force during an activity (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). The key to making your muscles stronger is working them against resistance, whether that be from weights or gravity. If you want to gain muscle strength, try exercises such as lifting weights or rapidly taking the stairs.
What is "muscular endurance?"
Muscular endurance is the ability of the muscle to continue to perform without fatigue (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). To improve your muscle endurance, try cardiorespiratory activities such as walking, jogging, bicycling, or dancing.
What is "body composition?"
Body composition refers to the relative amount of muscle, fat, bone, and other vital parts of the body (USDHHS, 1996 as adapted from Corbin and Lindsey, 1994). A person's total body weight (what you see on the bathroom scale) may not change over time. But the bathroom scale does not assess how much of that body weight is fat and how much is lean mass (muscle, bone, tendons, and ligaments). Body composition is important to consider for health and managing your weight!
What is "flexibility?"
Flexibility is the range of motion around a joint (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). Good flexibility in the joints can help prevent injuries through all stages of life. If you want to improve your flexibility, try activities that lengthen the muscles such as swimming or a basic stretching program.

Common physical activity and fitness terms

Calorie: A measure of energy from food. (3,500 kilocalories of food energy = 1 pound of body weight). Also the amount of heat required to raise the temperature of 1 gram of water 1° C (1000 calories = 1 kilocalorie). An interesting fact: When we see "Calories" on a food label it is actually measuring kilocalories
Cardiorespiratory fitness: (also called aerobic endurance or aerobic fitness)
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel and oxygen during sustained physical activity.
Exercise: Exercise is physical activity that is planned or structured. It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness-cardiorespiratory endurance (aerobic fitness), muscular strength, muscular endurance, flexibility, and body composition.
Household physical activity: Household physical activity includes (but is not limited to) activities such as sweeping floors, scrubbing, washing windows, and raking the lawn.
Inactivity
Inactivity is not engaging in any regular pattern of physical activity beyond daily functioning.
Kilocalorie: The amount of heat required to raise the temperature of 1 kg of water 1° C. Kilocalorie is the ordinary calorie discussed in food or exercise energy-expenditure tables and food labels.
Leisure-time physical activity: Leisure-time physical activity is exercise, sports, recreation, or hobbies that are not associated with activities as part of one's regular job duties, household, or transportation.
MET: The standard metabolic equivalent, or MET, level. This unit is used to estimate the amount of oxygen used by the body during physical activity.

1 MET = the energy (oxygen) used by the body as you sit quietly, perhaps while talking on the phone or reading a book.
The harder your body works during the activity, the higher the MET.

• Any activity that burns 3 to 6 METs is considered moderate-intensity physical activity.
• Any activity that burns > 6 METs is considered vigorous-intensity physical activity.

Moderate-intensity physical activity: Moderate-intensity physical activity refers to a level of effort in which a person should experience:

• Some increase in breathing or heart rate
• a "perceived exertion" of 11 to 14 on the Borg scale
  • the effort a healthy individual might expend while walking briskly, mowing the lawn, dancing, swimming, or bicycling on level terrain, for example.
• 3 to 6 metabolic equivalents (METs); or
• any activity that burns 3.5 to 7 Calories per minute (kcal/min)

Occupational physical activity: Occupational physical activity is completed regularly as part of one's job. It includes activities such as walking, hauling, lifting, pushing, carpentry, shoveling, and packing boxes.
Physical activity: Physical activity is any bodily movement produced by skeletal muscles that result in an expenditure of energy.
Physical fitness: Physical fitness is a set of attributes a person has in regards to a person's ability to perform physical activities that require aerobic fitness, endurance, strength, or flexibility and is determined by a combination of regular activity and genetically inherited ability.
Regular physical activity: A pattern of physical activity is regular if activities are performed:

• most days of the week, preferably daily;
• 5 or more days of the week if moderate-intensity activities (in bouts of at least 10 minutes for a total of at least 30 minutes per day); or
• 3 or more days of the week if vigorous-intensity activities (for at least 20-60 minutes per session).

Note: These are minimum recommendations, greater health outcomes can be achieved by doing additional types activities and/or increasing time spent doing activities.
Transportation physical activity: Transportation physical activity is walking, biking or wheeling (for wheelchair users), or similar activities to and from places such as: work, school, place of worship, and stores.
Vigorous-intensity physical activity: Vigorous-intensity physical activity may be intense enough to represent a substantial challenge to an individual and refers to a level of effort in which a person should experience:

• large increase in breathing or heart rate (conversation is difficult or "broken")
• a "perceived exertion" of 15 or greater on the Borg scale;
  • the effort a healthy individual might expend while jogging, mowing the lawn with a nonmotorized pushmower, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill, carrying more than 25 lbs up a flight of stairs, standing or walking with more than 50 lbs for example.
• greater than 6 metabolic equivalents (METs); or
• any activity that burns more than 7 kcal/ min

Weight-bearing physical activity: Any physical activity that imparts a load or impact (such as jumping or skipping) on the skeleton
source:medicinenet.com