Health and Fitness Information

Nutrition: Pyramid Power

The introduction of the Food Guide Pyramid has simplified the art of eating healthfully. The goal is to eat more servings from foods at the base of the pyramid and fewer servings from those at its peak. Using the pyramid as your guide, you can eat a healthy diet based on a foundation of high-energy, high-fiber carbohydrates like whole-grain breads, cereals, rice and pasta. Add a variety of fruits and vegetables for vitamins and minerals. Keep your body strong and fit with moderate amounts of low-fat dairy products, lean meats, poultry and fish to supply the necessary protein to build and repair lean body mass. The foods at the tip of the pyramid - fats, oils and sweets should be used sparingly to keep your fat intake less than 30% of total calories. How many servings should I eat? The Food Guide Pyramid suggests a range of servings from each of the five food groups shown. The number of servings you need from each group depends on your individual calorie needs. In all cases, be sure to eat at least the lowest number of servings in each of the groups, choosing a variety of different foods. This promotes a balanced diet, and provides the nutrients your body needs every day.

• Bread and Grain Group: 6-11 servings
• Vegetable Group: 3-5 servings
• Fruit Group: 2-4 servings
• Meat and Protein Group: 2-3 servings
• Milk Group: 2-3 servings
• Fats, Oils and Sugars: eat sparingly

What counts as a serving?

Listed below are the serving sizes for many common foods. Remember, if you eat a portion that is much larger than the suggested serving size, count it as more than one serving.

• Bread and Grain Group - 1 slice of bread, 1 ounce ready-to-eat cereal, 1/2 cup cooked cereal, rice or pasta.
• Vegetable Group - 1-cup raw, leafy vegetables, 1/2 cup cooked or chopped, raw vegetables or 3/4 cup vegetable juice.
• Milk, Yogurt and Cheese Group - 1 cup milk or yogurt, 1 1/2 ounces natural cheese or 2 ounces processed cheese.
• Meat, Poultry, Dry Beans, Eggs and Nuts - 2-3 ounces of cooked lean meat, poultry or fish (the size of a deck of cards), 1/2 cup cooked dry beans, 1 egg or 2 tablespoons peanut butter.

How many calories do I need?

To get a rough estimate of how many calories you need in a day to maintain your present weight, multiply your weight by 13, if sedentary, and by 15, if moderately active. You need to add more calories for rigorous exercise. To lose or gain weight, subtract or add 500 calories through diet and exercise. For example, to lose about one pound a week, decrease your calorie intake by 250 calories and increase the calories you burn off through exercise by 250. Walking one mile briskly in 15 minutes burns approximately 100 calories.

If I follow a very low-calorie diet, will I lose weight faster?

You can lose weight quickly by simply not eating. However, after such deprivation, the urge to eat usually wins out, and the lost weight is quickly regained. Also, when you severely restrict your calorie intake, your body learns to conserve calories allowing you to function on fewer calories than before. Consequently, weight loss plateaus and frustration may set in. Pre-diet behaviors may return followed by a faster weight gain than before.

Why do I hear so much about eating less fat?

The message to eat less fat is everywhere, and for good reason. High-fat diets have been linked to many health problems including heart disease and cancer. The major goal of the U.S. Dietary Guidelines is to encourage people to decrease fat consumption to less than 30% of their total daily calories. The average American's diet is about 37-42% fat.

How much fat should I eat?

The ideal dietary balance to strive for consists of 30% or less of fats, 10-15% of proteins and 55-60% of carbohydrates. Most nutrition experts agree that a healthy fat intake should be 20-30% of the total calories consumed in a day. To determine your own fat budget, follow these steps:

1. Estimate your calorie needs based on the guidelines above.
2. Multiply your total calorie needs by .20 and .30. This will give you a range of fat calories between 20-30%.
3. Lastly, divide both numbers of the range by nine to give you the number of fat grams allotted per day (there are nine calories in a fat gram).

If I eat less fat, what should I be eating in its place?

Just as most people eat too much fat in their diets, many don't get enough high-energy, carbohydrate foods. Complex carbohydrates not only provide time-released energy, they are low in fat and high in fiber. Fiber aids in the prevention of digestive problems, and helps regulate blood sugar and cholesterol levels. Good sources of fiber include fruits and vegetables with the peels and seeds, whole-grain breads and cereals, beans, legumes, brown rice, bran, oatmeal, potatoes and corn. Although protein is an essential component of a well-balanced diet, you don't need as much as many people believe. Just 10-15% of your daily calories should come from protein sources such as lean meat, low-fat dairy products, poultry and fish. The serving size guidelines in the Food Guide Pyramid suggest four to six ounces of lean protein per day. To help you estimate your intake, remember that a three-ounce serving is the size of a deck of cards.

How much water should I be drinking?

The average person needs between 8-12 cups of fluids per day with half being water. If you wait until you are thirsty, you have already started to dehydrate. it's best to drink fluids throughout the day. Caffeinated and alcoholic beverages act as diuretics, causing you to lose water through increased urination. Water is the perfect beverage. It has no calories, sodium, caffeine, fat or cholesterol. Choosing between bottled water and tap water is strictly a personal preference. Both types are regulated by the federal government and will provide the hydration your body needs.

Prenatal Nutrition

Maintaining a good, healthy diet is very important when you are expecting a child. Consult your physician regarding any concerns dealing with nutrition (e.g., caloric intake, vitamin and mineral supplements, dieting, etc.)

Weight Gain

Weight gain averages about nine pounds during the first trimester and about one pound per week during the last 20 weeks. Recommended weight gain varies based on the mother's age, pre-pregnant weight, nutritional status, daily energy expenditure and appetite. The average woman should gain about 25 pounds. Pregnancy is not the time to diet unless requested by your physician.

Weight Gain Distribution During Pregnancy

• Baby - 7 to 7 1/2 lbs.
• Breast tissue - 2 lbs.
• Placenta - 1 to 1 1/2 lbs.
• Increased blood volume - 3 to 4 lbs.
• Uterus - 2 lbs.
• Excess water and fat - 6 to 6 1/2 lbs.
• Amniotic fluid - 2 lbs.

Total calorie intake is one of the most important factors affecting infant birth weight. It takes about 80,000 calories, or 300 calories out of your daily caloric intake, to help create a healthy baby (teen pregnancies take 600 calories per day). Weight gains of less than 2.2 pounds during the last trimester are considered insufficient. Pregnant exercisers need more calories, and this need increases as pregnancy progresses. The energy requirements of specific activities are based on kilograms per body weight. Because pregnant women are heavier, this increases energy expenditure.

Nutritional Needs During Pregnancy

Nutrient dense foods should be consumed, and muscle glycogen stores should be replaced with complex carbohydrates. An exercising pregnant woman's physician or caregiver should know the type, frequency and intensity of weekly exercise before addressing caloric needs. The following nutrients and vitamins are of particular concern for the active pregnant woman.

• Protein - needed for fetal growth, increased blood volume and tissue growth. Recommendations for sedentary pregnant women are 75-100 grams per day or 12% of total calories.
• Complex Carbohydrates - provide calories and essential vitamins and minerals for fetal growth. A great source of fiber to aid in constipation. Recommendations for dietary needs are 50-60% of daily caloric intake.
• Iron - needed for fetal storage and maternal blood production. Women athletes do not appear to have an increased need for iron. However, pregnant women need as much as 30 milligrams of additional iron per day in order to maintain adequate hemoglobin levels. Most pregnant women will be put on an iron supplement of 30-60 milligrams per day. It is important to remember dairy products may bind with iron and decrease its absorption. Pregnant women initiating an exercise program may need additional iron to account for the additional blood volume increases associated with training.
• Sodium - needed for expansion of extra cellular fluid volume. Physically active women may be at risk of sodium depletion if the exercise is vigorous and sodium intake is low. Most pregnant women in the United States consume twice as much sodium as they need. The pregnant exerciser may need salty food if she has exercised for a prolonged period. Sodium supplements are not recommended, nor are sodium restriction or diuretics.
• Water - needed for total expansion of body water and maintenance of body temperature. Physically active pregnant women have an increased need for water. The recommendation is at least 8-12 cups per day.

The following vitamins and minerals are important for the pregnant woman. Check with your physician for appropriate amounts.

• Potassium - maintains proper muscle tone and fluid balance.
• Calcium and Phosphorus - needed for fetal skeletal and tooth bud formation and increased maternal calcium and phosphorus metabolism.
• Iodine - needed for increased maternal basal metabolic rate.
• Magnesium - for tissue growth and cell metabolism. Used as a coenzyme in energy and protein metabolism.
• Folic acid - for increased metabolic needs. Used as a coenzyme in energy and protein metabolism. Increases "heme" in hemoglobin and helps prevent megablastic anemia. Decreases the incidence of neural tube defects.
• Vitamin A - needed for cell development, tooth bud formation and bone growth.
• Vitamin D - for absorption of calcium and phosphorous, and for mineralization of bone and tooth buds.
• Vitamin E - needed for tissue growth and cell wall integrity.
• Vitamin C - for tissue formation. Used as a cement substance in connective and vascular tissues and increases iron absorption.
• Riboflavin and Thiamine - used as a coenzyme in energy and protein metabolism.
• Vitamin B6 - used as a coenzyme in energy and protein metabolism.
• Vitamin B12 - used in the formation of red blood cells and as a coenzyme in protein metabolism.

Pregnant women who exercise use carbohydrates at a greater rate than those who are sedentary, and may be prone to low blood sugar (hypoglycemia). Those who have morning sickness, or who have not eaten the day prior to exercise are at risk. A light snack of complex carbohydrates (e.g., fruit, cereal, bread, crackers) should be consumed one to two hours prior to exercise to assure a stable blood sugar level.

Other Considerations

• Due to the decreased space and slowed digestive time, it is best to eat smaller, more frequent meals. Six or more smaller meals per day will keep the blood sugar at a stable level, while decreasing some of the indigestion and heartburn many pregnant women experience after larger meals.
• Avoid dieting, alcohol, cigarettes and drugs during pregnancy unless directed by your physician.
• To lessen nausea and vomiting, eat crackers or dry cereal prior to getting out of bed in the morning. Get up slowly and have small frequent meals rather than large meals. Avoid greasy, spicy or fried foods, and drink beverages between meals rather than with meals.
• For constipation, drink plenty of liquids, approximately eight glasses of water a day, and eat high-fiber foods such as fruits, vegetables, beans, whole-grain breads and cereals. Avoid laxatives unless prescribed by your doctor.

Tips for Breast Feeding

• Drink plenty of liquids, about two quarts daily, including water, milk, and fruit juices.
• Continue taking daily supplements of iron, if your doctor advises.
• Infants who are born premature or breast fed exclusively beyond four to six months of age should receive vitamin D and iron supplements from birth or at least by four to six months, as medical guidance suggests. Consult your physician.
• Continue to maintain a healthy diet to ensure adequate nutritional intake and to meet added requirements.

Weight Loss

How can you be successful in losing weight?

"Diets" typically don't work. The best approach for successful weight loss that allows you to lose fat and maintain energy for daily activities is to eat appropriate portions of healthful, high carbohydrate, low-fat foods. Strict diets based on sheer willpower result in feelings of denial (to say nothing of poorly fueled muscles). Nancy Clark, RD, recommends the following three steps for successful weight loss. A first step toward successful weight reduction is to keep comprehensive food records and become aware of what, when and how much you eat. Typically, weight-conscious individuals "diet" during the day, then "blow it" at night. You are likely to have greater success if you eat the majority of your calories during the day, thereby preventing feelings of fatigue and the ravenous hunger that often results in overeating in the evening. Generally speaking, once you become too hungry, you care less about what and how much you eat and often end up overeating. A second step is to know how many calories per day are appropriate in order to maintain your present weight at rest. Simply multiply your weight by the number of calories (cal) per pound (lb) for your particular age (see below). Age:

• 20-29 multiply wt. by 13-15 cal/lb
• 40-49 multiply wt. by 11 cal/lb
• 30-39 multiply wt. by 12 cal/lb
• 50+ multiply wt. by 10 cal/lb

Note: Most people need 10-15 cal/lb to sustain their normal weight at rest. To determine how many calories are needed to reach your desired weight at rest, substitute the desirable weight for your present weight in the above calculation. If you are active, multiply your desired weight by 12-15 cal/lb for moderate activity and 15-20 cal/lb for higher levels of activity. This number offers a very rough estimate of daily calorie needs; the actual requirements will vary greatly, depending upon individual metabolic differences and intensity of activity. For example, a desired weight of 115 lbs x 12 cal/lb (moderate activity) = 1,380 cal/day to maintain weight. The third step is to determine the number of calories appropriate for weight reduction by subtracting 300-1,000 calories per day (if you are a petite, active athlete, subtract fewer calories). Divide this number by 3, and you'll have a calorie target for each meal. For example, a 120 lb female who is moderately active with daily activities and walks briskly for 3 miles per day may need 120 lbs x 16 cal/lb = 1,920 calories per day to maintain weight. To lose weight, subtract approximately 350-400 calories, bringing the total to 1,570 calories per day divided by 3 = 520 calories per meal. To lose weight you must omit calories, add exercise or do both.

The Vibrant Health and Wellness Foundation recommends conservatively decreasing caloric intake and increasing physical activity for positive weight management. It takes 3,500 calories to produce 1 pound of body weight. To lose 1 pound weekly, omit 500 calories daily. And to lose a 1/2 pound weekly, omit 250 calories daily. You will also lose weight by exercising while maintaining your current caloric intake. For example, if you walk briskly for 1 mile in 15 minutes you will burn approximately 100 calories. If you walk briskly for 2 1/2 miles in 37 minutes you will burn approximately 250 calories. However, this is a very slow way of losing weight. If you combine both a reduction in caloric intake and an increase in physical activity you will be able to achieve maximum results. For example, if you subtract 250 calories from your food intake and add 37 minutes of brisk walking for 2 1/2 miles, the total number of calories subtracted from your total daily intake is 500. If you keep this up on a daily basis you can safely lose 1 pound per week (weight loss should be no more than 1/2-1 pound a week when trying to lose without medical supervision).

Successful weight loss also includes a change in day-to-day habits regarding eating, exercise, moods, physical activity and the way you think about foods. For successful lifestyle changes focus on one to two key habits per week. Remaining aware of your eating patterns, maintaining daily dietary records, and adding only a few dietary changes at a time may change habits. Taking smaller steps in a consistent direction can help you see results, reinforce the action taken, improve self-esteem and maintain a lifelong commitment. 10 guidelines to help create healthy daily habits toward positive eating as well as tips for success and lifetime maintenance. Listed below is a condensed version:

1. Eat 3 meals daily at regular meal times. Feel more energetic, reduce appetite and speed your metabolism by eating every 5-6 hours.
2. Eat slowly, taking at least 20 minutes for meals and 10 minutes for snacks.
3. Choose one specific location to eat; make eating a singular activity. Beware of unconscious eating in front of the TV, at the movies, while reading or studying, driving, cooking or standing. Only eat sitting down. Enjoy eating!
4. Be aware of the social influences that affect your eating behavior. Avoid or be cautious in situations that encourage your overeating.
5. Plan ahead.... this promotes quality food choices and eating strategies for restaurants, parties, weekends, etc.
6. Keep food out of sight. Make problematic foods inconvenient or unavailable. Keep low-calorie foods convenient.
7. Control emotional eating. don't reach for food to make you content or relaxed. Go outside and move!
8. Add pleasure to your life in ways other than with food. Reward yourself, with a new dress, a drive to the beach, a play, etc.
9. Put yourself in situations that support your efforts at controlled eating.
10. Learn to control both the type of food as well as the quantity of food.

• Be committed to a new lifestyle of health and fitness.
• Take charge; assert yourself and your program.
• Be responsible for nutritious meals and regular exercise.
• Develop a plan and stick with it daily.
• Be positive about your new endeavor and expect success.
• Believe in your goals and in yourself.
• Reward yourself.
• Enjoy and savor the results - feeling better, looking better, more vitality.

• Setting your own ground rules for weight loss and maintenance. Design your own eating plan, based on low-fat, high-fiber eating. Include foods you enjoy and know realistically you'll eat.
• Exercising 3-5 times per week. An active life is essential to increase metabolism and keep pounds off.
• Keeping food and exercise logs. They help to boost awareness and make progress.
• Surrounding yourself with support - individuals, groups, places, events that motivate and reinforce good habits and positive lifestyle.
• Staying accountable - joining a group, periodically seeing a qualified nutritionist (registered dietician), regularly weighing yourself in front of your doctor and at home.
• Keeping in mind your personal incentives to lose weight and keep it off.
• Never thinking of yourself as "dieting" but focusing on healthy eating.
• Getting back on track after having an off day.

Remember - weight loss and weight maintenance can best be achieved through positive eating habits, setting realistic goals, regular participation in physical activity and a personal commitment for life.

Facts About Body Fat

Home Measurements

Millions of Americans continue to fight the "battle of the bulge"- increasing body weight and body fat, that is! It is estimated that 37% women and 22% men in the United States are attempting to lose weight. The key to successfully losing weight and keeping it off is through proper exercise and diet. Here are some answers to many popular questions addressing weight and body fat. However, all issues associated with weight, weight loss and diseases associated with such factors should be addressed to health care providers.

Body fat consists of millions of tiny fat cells, each a spherical sac, filled with droplets of oil known as triglycerides. Dietary fat intake shows up in the blood as large clumps of triglycerides called chylomicrons. Most of the triglycerides are removed from the blood and deposited in the adipose tissue. Some individuals have more fat cells in their adipose areas causing them to store fat more readily. Fat cells are able to increase in size and number. There are three primary periods of life where the number of fat cells will naturally increase, which is known as hyperplasia. They are:

1. The third trimester of pre-natal life (7-9th months)
2. The first year of life
3. The adolescent growth spurt

Overeating during infancy and puberty is yet another way that fat cells will not only multiply but will become larger as well. The number of fat cells does not seem to change significantly with adults. The onset of obesity with this age group is due primarily to enlargement of the existing fat cells.

What is obesity?

Obesity is defined by the American College of Sports Medicine, as the percent of body fat that increases the risk of disease. It is also defined as a "surplus of adipose tissue containing fat stored in triglyceride form, resulting from excess energy intake relative to energy expenditure." Some experts feel that if you are 20% above desirable weight, or greater than 20% fat for men and 30% fat for women, you are obese.

What is adipose tissue?

Adipose tissue or subcutaneous fat is fat that is stored between our muscles and skin. This is the fat you can pinch. A little is fine, too much can be unkind. Adipose tissue is beneficial in that it serves as:

1. an insulator to help regulate body temperature
2. fuel for the production of energy through metabolism
3. protective padding for various parts of the body

However, too much can lead to heart disease, stroke, high blood pressure, diabetes, and some cancers.

How much is too much?

Although fat, for the most part, is thought to be an evil commodity, it happens to be required for normal physiological function of the various organs. This form of fat is referred to as "essential fat" or essential fatty acids and combines with other nutrients to form important structural compounds such as blood lipids, steroids, cell membranes, bile and hormones. Women should not have less than 12% body fat and men 7% to meet these "essential fat" needs. Experts feel that women should stay below 30% body fat and men below 20%. These percentages represent borderline obesity for women and men respectively. Generally women should try to maintain a body fat percent between 18%-25% and men between 12%-20% (based on Lohman study at University of Arizona, 1989). It gets increasingly difficult as we age since aging brings with it a decrease in activity and a decrease in the amount of calories we need to maintain life.

If I'm overweight am I also overfat and at a higher risk for getting a disease?

Not necessarily. According to a study performed by Dr. Steven Blair at the Cooper Institute for Aerobics Research in 1996, if you are fit and 25 to 75 pounds overweight you can be perfectly healthy. And if you are not fit but slim (underweight) you could be at greater risk of disease. The most important point is that you remain physically active and physically fit no matter what your weight. The more muscle tissue you have the better you are able to use the calories you eat. Other experts feel that if you are 20 pounds overweight you are inviting disease and poor health and decreasing mobility and interest in moving or exercising.

How can I determine if I have too much body fat?

Over the years scientists and fitness professionals have tried to develop many methods to accurately measure and monitor body composition the percentage of body weight that is fat. Many forms of measurement are available today. Some of these methods can be done in the privacy of your own home and some need a professional to administer them.

Is it natural to gain weight as we age?

According to the authors of the May 1994 issue of Physical Activity and Fitness Research Digest the average individual in the United States will gain approximately one pound of additional weight each year after the age of 25 years. Seemingly small gains result in 30 pounds of excess weight by the age of 55 years. Since bone and mineral mass decrease by approximately one-half pound per year due to reduced physical activity, fat is actually increasing by 1.5 pounds each year. This means a 45-pound gain in fat over this 30-year period! It is no wonder that weight loss is a national obsession. These gains can be primarily attributed to environmental and lifestyle choices versus growing older.

Can I lose fat by dieting alone

Yes, but you will also lose valuable muscle. The best way to lose body fat is through a combination of physical activity and a low-fat diet. Keeping fat under control involves regulating the size and growth of our body's fat cells. If an individual exercises regularly, according to Dr. Paul Mole, PhD and author of the article "Exercise and the Fat Balancing Act" in ACSM's Health and Fitness Journal (May/June 1997), the fat in the blood is removed more quickly after we eat because exercise stimulates muscle to take up fat and burn it as fuel. Dr. Paul Mole, couldn't have stated it better, "A person on a balanced, low-fat diet (fat intake less than 30% of daily calorie intake) who engages in regular physical activity is the most likely master of the 'fat balancing act.'" For faster results, regular physical activity should comprise of a combination of aerobic activity such as walking, running, swimming, biking, and resistance training such as lifting weights or working with elastic bands. Aerobic activity, depending on its level of difficulty, can be performed 3 to 5 days or all days of the week. Resistance training should be performed a minimum of 2 days per week with a day of rest in between. In 1996 the US Surgeon General came out with a report addressing physical activity and health. In an attempt to get more of us Americans active and to help lessen our risk of dying prematurely from heart disease, diabetes, and cancer the report recommends the following guidelines for physical activity.

• Everyone aged 2 and above should get at least 30 minutes of endurance-type training, of at least moderate intensity, on most (preferably all) days of the week.
• Additional benefits can be achieved by increasing the time or vigor of the activity
• Previously inactive men over age 40 and women over age 50, and anyone at high risk for cardiovascular disease, should consult a physician before beginning an unaccustomed regimen. This is especially so if they intend to perform strenuous activity.
• Resistance training should be performed at least twice a week. At least 8-10 exercises that use the major muscle groups of the legs, trunk, arms and shoulders should be performed at each session. One or two sets of 8-12 repetitions should be performed.
• Activities should burn approximately 150-200 calories per day (based on an individual who weighs 150 pounds).

Summary

All of us should try to maintain our levels of body fat through participation in physical activity, consuming a low-fat diet and periodically measuring our percent body fat. Some fat is necessary to support life, but excessive amounts increase our risk to heart disease, cancer, diabetes and other health conditions. Low-Fat Eating Out Low-fat eating is "in." Why? Because an increasing percentage of Americans are considered overweight, if not obese, due to an average diet that includes 37% fat. And high-fat eating has been linked to health problems, including heart disease, obesity and some cancers.

The Task at Hand

Once you decide to improve your diet by consuming more well-rounded meals and a lower amount of fat (under 30% of your total calorie intake), you will need to do a little homework on the basics of nutrition (your local bookstore and library have a wealth of information), and also consider the following guidelines. Since the debut of the Food Guide Pyramid, it has become much easier to identify those foods you need to eat more of, and those you'll want to limit. The top of the pyramid, where fats, oils and sugars reside indicates limited servings. Moderate amounts of the dairy and meat/protein groups are appropriate. The multiple servings per day belong to the vegetable and fruit, as well as to the bread and grain, groups. Keep in mind to eat in moderation. If we indulge, we gain excess fat and weight. The first, and perhaps the easiest, task is to prepare your own kitchen and begin cooking and eating healthier meals at home. The tougher task is to continue with your healthy eating habits when you are going out to eat. The difficulty lies in: (1) the choices of foods available, (2) not knowing the exact ingredients in the dishes, and having no food labels to ascertain the content, and (3) not always being the person to select the restaurant. The good news is that a recent study shows that people who eat out one-third of the time actually consume a healthier diet overall than those who eat every meal at home. This is probably because restaurants generally have a greater variety of food choices from which to select, as well as hard-to-prepare items that you may not choose to cook at home. Consumer awareness and demand have resulted in the addition of many healthier, lower fat choices on fast food and family restaurant menus. This certainly makes it easier to stick to a healthy diet, but you will still have to make some informed choices. So, let's get started.

General Tips for Eating Out

Before the Entree

• Eat that wonderful bread or roll without the butter or margarine. Choose an Italian, French or hard roll instead of a croissant, biscuit or muffin.

When Ordering

• Ask questions about the preparation of the items in which you are interested and request that your menu choices be broiled or baked rather than fried or breaded.
• If your entree or dessert is high in fat, share it with your tablemate.
• Ask for salad dressing "on the side" so you can control the amount you consume.
• If there is a low-fat version of your favorite salad dressing, order that instead.
• Practice saying "Hold the mayo."
• Practice saying "Hold the cheese."
• At salad bars, take more of the vegetables, beans and fruit, and less of the cheese, croutons, eggs, meats and creamy dressings.
• If you are ordering a sandwich and it comes with chips, fries or potato salad, ask if you could substitute a salad, fruit, broth-based soup or a baked potato (but don't load it up with butter and sour cream).
• If ordering soup, order broth-based rather than creamy- or cheese-based.
• If you order pasta, look for tomato-based, clam or calamari sauces rather than meat- or cream-based.
• If you order a pizza, choose vegetable, rather than meat, toppings. You can even try the cheese less pizzas that have become popular.
• If anything is typically cooked in oil, say, "Hold the oil."

During and After the Meal

• If your order does not come the way you requested (lower in fat), then send it back.
• If your order comes garnished with something you don't want or with too much of a certain ingredient, scrape it off if you can. Always feel free to leave parts of your meal on the plate.
• If the portion is large, leave some or ask for a doggy bag to take it home.

What to Consider When Dining At:

Ethnic Restaurants

Mexican-before ordering refried beans, ask if lard was used to prepare them (if so, no go). Refrain from the beef and pork dishes, and be sure to hold the guacamole, sour cream, cheese and olives. What's left? You can always enjoy rice and beans with veggies in a burrito, fish and white meat chicken dishes (try a fajita), or a salad in a tostada shell (just don't eat the shell).

Chinese, Japanese, Thai and Indian-simply have the oil omitted during the food preparation, and for starters, try a cucumber salad or steamed vegetable dumplings rather than the fried dumplings or egg rolls. Then order non-breaded white meat chicken, fish and/or vegetables rather than pork and beef, and you'll be served a deliciously seasoned low-fat meal complete with rice or noodles. Italian-skip the cheese, meat and anything breaded, and ask if the tomato sauce and minestrone soup can be made oil-free.

Fast Food Restaurants-Since one-fifth of the American population eats at a fast food restaurant daily, you know that these establishments will continue to increase their offerings of lower fat items to keep up with consumer demand.

• Look for the "light" menu.
• don't assume that a meal with chicken has a lower fat content than one with beef, especially if it is fried or has skin.
• If you choose the salad bar, avoid cheese, nuts and mayonnaise-based prepared salads, and use lemon juice or vinegar-based salad dressings.
• Water, iced tea and soda are better choices than milkshakes or other dairy drinks.
• Breakfast items, such as pancakes and waffles, can be lower in fat if you leave off the butter and top with fruit or syrup.

Family Style Restaurants-Large portions usually reign at family style restaurants. Begin thinking of them as "meals for two," or as "two meals" (a doggy bag is handy). Even here, there are usually "healthy choice" or "heart healthy" selections available to satisfy a lower fat eating clientele. Look for the little hearts next to the menu items, and continue to follow the general guidelines given above.

Expensive Restaurants-One of the nice things about expensive restaurants (certainly not the prices) is that they generally serve smaller portions to create a more attractive and sophisticated presentation. To further enhance the look of the plate, they often add a variety of color, which usually means two or more vegetables. This is indeed good news. However, still keep your general guidelines in mind. Such restaurants are experts in the preparation of creamy and other high-fat sauces and desserts. Now you know that it is possible to maintain your healthy, low-fat eating habits even when you aren't at home. Call the restaurants you frequently visit and ask if they can prepare your favorite dishes without oil, lard or dairy. Eager to please and keep a satisfied customer, they probably will accommodate your new eating habits.

Good luck and healthy eating out!

Nutrition: For The Mature Adult

• Eat sensibly - A well-balanced, healthy diet combined with regular participation in an exercise program is the recommended formula for positive longevity.
• Eat plenty of complex carbohydrates - Complex carbohydrates should account for 60% of your daily caloric intake. Good sources are fresh fruits and vegetables, whole grain breads and cereals, and starches such as rice, potatoes and pasta. Carbohydrates provide quick energy and fiber to help prevent constipation.
• Reduce simple or refined carbohydrates - Cookies, pastries and candies are considered refined carbohydrates (empty calories). With aging, the body is less able to tolerate these sugars. Excess may lead to an increase in body weight and fluctuations of blood sugar levels for some individuals.
• Limit your protein - Protein should account for 10-15% of your daily caloric intake. Proteins are necessary for tissue growth and maintenance, which diminish with aging. Too much protein in an older person1s body can put stress on the kidneys. Proteins are available in meat, fish, poultry, eggs, dairy products, all vegetables, breads and cereals. Animal proteins and dairy products supply all essential amino acids. Plant proteins are deficient in one or more essential amino acids necessary for normal growth and maintenance.
• Reduce fat intake - Fats are the body's primary source of reserve energy, utilized when carbohydrate stores are diminished. However, fats contain twice as many calories as carbohydrates. Therefore, a good way to reduce caloric intake is to reduce fat consumption. A diet high in fat can increase risk of cancer. Fat should not exceed 30% of daily caloric intake, and less than one-third of that should come from saturated fat (no more than 2 grams of fat per 100 calories). Saturated fat is derived from animal sources and increases the risk of cardiovascular disease. Other "healthier" forms of fat are monounsaturated and polyunsaturated fats. Eating fewer fatty types of meat, less butter and less hydrogenated and tropical oils, can reduce saturated fats.
• Fiber - Fiber helps to soften the stool and alleviate constipation. There are two types of fiber, water-soluble and water-insoluble. Water-soluble fiber, found in oat and corn products, fruits, vegetables and legumes (e.g., peas and beans), helps to lower blood cholesterol and normalizes blood sugar. Water-insoluble fiber, found in wheat bran, whole grain breads and cereals helps in digestion and prevention of hemorrhoids, diverticulosis and constipation (common problems for mature adults). Fiber intake recommendation for older adults (65+) is 20-35 grams per day. Be careful not to partake in a high fiber diet if you have had significant surgery in the GI (gastrointestinal) tract. This may cause blockage. Consult your physician for proper dietary fiber intake.
• Water - Adequate water and fluid intake is important in maintaining healthy bodies. Water is necessary to enable the kidneys to function properly. A liter of water per 1,000 calories is recommended for adults. If you are taking any medications (e.g., diuretics) or participating in activities, which promote water loss and urination, you may want to increase water intake. Consuming fruits or fluids high in sodium and potassium helps to maintain electrolyte balance as well as hydration (consult your physician). For potassium sources look for oranges, raisins, apricots, bananas, melons, fruit juices and yogurt. Avoid drinks that contain caffeine and alcoholic beverages since they act as diuretics. Fresh, cool water is highly recommended. Plan a regular schedule of drinking water, whether you are thirsty or not. Regardless of age our body's thirst mechanism is unreliable as an indicator of need to drink water. This may lead to dehydration and a need for medical attention.
• Balance calorie intake with activity level - Generally, the amount of food consumed should be reduced with aging. Between the ages of 55-75, your energy requirements tend to drop by 10%. In order to maintain nutritional balance, food consumption should be reduced according to age and activity levels.

Nutrients for Aging

Many nutrients are important. But for the mature population, there are a few specific nutrients that may be a health concern if proper intake is not achieved. Consult your physician for recommended dietary intake.

Facts On Fiber Fiber

A valuable nutritional component, may be associated with a reduced incidence of heart disease, colon cancer, obesity, diabetes and several types of intestinal disorders. Although not every claim has been validated as fact, new research on dietary fiber is very exciting. Some new studies suggest that fiber may even play a useful role in weight loss, stabilizing blood sugar and lowering blood cholesterol levels. This review contains some of the latest research knowledge on dietary fiber.

Today nutritionists group fiber into two categories. The first is water-insoluble fiber (or insoluble fiber), a sawdust-like fiber that doesn't dissolve in water and is the structural part of plant cell walls. The second is water-soluble fiber (or soluble fiber), which forms a gel in water, is not fibrous in nature, but may have some very important functions in overall health maintenance. Sources of insoluble fiber include whole-wheat products, fruit and vegetable skins, beans and cereal bran. Water-soluble fiber sources include pectin and gums found in many fruits and vegetables, oats, legumes and bean products. The two types of fiber each have a different effect on digestion and absorption. Soluble fibers such as gum and pectin have been shown to slow down gastric emptying, while insoluble fiber from cereal bran speeds up emptying of food from the stomach and intestines, assisting in regularity. Crude fiber, commonly called "roughage," is the indigestible portion of plant food, and may represent only about 1/3 to 1/2 of total dietary fiber. Up to now, traditional methods of measuring fiber content in food have only been able to account for the crude fiber portion.

Currently there is not a Recommended Dietary Allowance for fiber, but an estimate of 20-35 grams of dietary fiber per day has been suggested. The average American diet consists of 7-10 grams of dietary fiber per day.

Fiber supplements are available in forms of fiber pills, raw bran, oat bran, capsules and drinks. Fiber supplements may not be necessary if at least 25-35 grams of dietary fiber are taken daily. Humans have digestive tracts that are unable to tolerate extremely high levels of fiber. One crucial point to remember when increasing fiber intake is to drink adequate amounts of liquid at the same time. Fiber without water is unproductive. The National Academy of Sciences has recommended at least eight glasses of water a day for an adult.

Benefits

1. Cholesterol Levels: James Anderson, MD, from the University of Kentucky, found that diets rich in water-soluble plant fibers from oats and beans lowered total serum cholesterol by 16-24% below that of a control group of hypercholesteremic individuals whose diets were not altered. Additional findings by Barbara Schneeman, Ph.D., from the University of California, Davis, found that low-density lipoproteins (LDL), linked with a higher risk for heart disease, can be decreased by water-soluble fiber found in oat bran and beans. On the whole, eating more of some fiber probably slows the absorption of fats and cholesterol.
2. Weight Control: Soluble fiber can make you feel full and slow down the rate at which the stomach empties and the intestines move. High-fiber foods also require more chewing which means ingestion is slower. However, it is not true that all fiber is indigestible and you can eat as much as you want. Many plant fibers are partially digested or fermented in the colon. Pectin, for instance, is almost completely digested. Once fully digested, more calories are added. Dr. David Jenkins, from the University of Toronto, found insoluble dietary fiber could assist in weight control by stabilizing the absorption of carbohydrates. Since the "transit time" is delayed by the presence of fiber in the digestive tract, blood glucose levels are evened out, and fluctuations are reduced.
3. Gastrointestinal Disorders: The incidence of colon cancer and the condition, irritable bowel syndrome, is low in parts of the world in which total dietary fiber intake is high. Only a statistical association has been proven -- not a direct causal effect. Insoluble fiber moves material through the intestines faster and, therefore, may give some carcinogens less time to do damage. This is still inconclusive since other variables are at work -- people on high fiber diets eat more vegetables, some of which are linked with anti-cancer traits.
4. Diabetes: Anderson demonstrated that diets high in fiber and complex carbohydrates could lower blood sugar, and also decrease insulin requirements. This diet would include legumes, whole grains, fruits and vegetables. Diabetics should increase fiber levels only under supervision of a physician because of wide variance in medication needs.
5. Gastrointestinal Clearance: Because most insoluble fiber can absorb several times its weight in water, it increases and softens the bulk waste material, leading to less frequent bouts of constipation, hemorrhoids and diverticulosis.

Processing and Fiber

Canning, freezing and freeze-drying do not seem to alter natural fiber content. Boiling can actually increase the proportion of fiber to food, because the water content is reduced. Peeling decreases fiber content, as does finely grinding bran. Milling can totally remove the bran from the grain, eliminating the fiber content. As more research is done on total dietary fiber and its many benefits, a clearer definition of dietary fiber is evolving. The Food and Drug Administration has recently approved a method of analysis for dietary fiber to standardize the measurement of both soluble and insoluble fiber content in foods. This means that fiber content on food labels will all be measured by the same method in the future.

Precaution: Any individuals who have recently undergone surgery for the stomach, colon, large and small intestines, and/or rectum should consult their physician prior to fiber intake.

Defatting Your Kitchen

Low-fat eating is "in." Why? Because an increasing percentage of Americans are considered overweight, if not obese, due to an average diet that includes 37% fat. And high-fat eating has been linked to health problems, including heart disease, obesity and some cancers.

What to Do

Once you decide to improve your diet, take the practical step of removing the majority of those old, high-in-fat temptations that inhabit your cupboards, refrigerator and freezer. But which ones should you toss and which will pass the muster and be kept to eat as you practice "moderation?" And, is it a good idea to remove all the fat from your diet or is there a healthy balance of some fat with other food groups? According to research published in the New England Journal of Medicine (1998), it is important to focus on eliminating the "bad" fat, such as saturated fat from animal products and trans fats found in most processed foods (referred to as hydrogenated and partially hydrogenated vegetable oils), and select the healthier fats, such as canola oil and olive oil, better known as monounsaturated and polyunsaturated fats. Since the debut of the Food Guide Pyramid, it has become much easier to identify those foods of which you need to eat more, and those whose consumption you'll want to limit. The top of the pyramid, where fats, oils and sugars reside, indicates limited servings. Moderate amounts of the dairy and meat/protein groups are appropriate. The multiple servings per day belong to the vegetable and fruit, as well as to the bread and grain, groups. Some confusion enters when a food contains more than one food group in its preparation. For instance, a donut contains grain (flour), but also a great deal of oil (approximately 60% fat). you'll soon determine the donut's fate as you sweep through your kitchen to lighten your fare.

Are you ready? Let's spring clean. Once the high-fat or junk food items are gone and you've replaced them with lower fat alternatives, it won't be such a task to keep your overall fat intake at or below the recommended 30%.

The Cupboard/Pantry

Let's begin by looking at the peanut butter, and go from there. The pork and beans? Give them all to a friend who is trying to gain weight. What about other items commonly found in American cupboards.

The Freezer

A good place to start looking is the shelf on the freezer door, which usually contains the ice cream. Frozen vegetables are great to have around, as are sherbet and sorbet. Keep all of your low-fat casseroles here for fast meals.

The Refrigerator

First, open the cheese drawer since dairy foods can be full of saturated fat, and toss out the fattiest cheeses and spreads.

By identifying and discarding the highest fat items in your kitchen, and replacing them with lower fat alternatives, you can get started on healthier, low-fat eating. And, for further information and menu suggestions, check out The Vibrant Health and Wellness Foundation nutritional counseling and workshops which are designed to enhance your understanding and appreciation for healthy lifestyle changes.

Exercise Equipment

The Vibrant Health and Wellness Foundation has partnered with organizations such as Taylored 4 Life to establish and develop many military and private fitness equipments and facility requirements, ensuring that appropriate and adequate services are provided. Our knowlege is also applicable to home gyms and corporate wellness.

Many individuals are recognizing the need to get fit, and realizing that one of the most convenient options is through home based programs. This creates a need for consumer education in the field of what, where and why to buy. Within the context of this card we will cover the following areas as they relate to home fitness and exercise equipment.

Types of Equipment Available

This ever growing selection of fitness equipment ranges from items that are bigger than a refrigerator to those smaller than a bread box. Their price can also have a wide range from below ten dollars to several thousand. The best way to explore your options is to categorize the types of equipment according to their purpose. There are three main categories:

1. Equipment that offers cardiovascular benefits and weight control.
2. Equipment that aids in muscle strengthening.
3. Other associated fitness products: equipment that enhances technique, safety or comfort.

Features to Consider

Cardiovascular/Fat Reduction

Movement association: this would indicate the type of joint action or motor skills that the equipment best simulates. This is important when considering impact forces, joint stress and skill or fitness level demands. Equipment may be categorized as:

• Motorized or non-motorized
• Portable and storable
• Adaptable for individual size or physical condition
• Economical or expensive

Muscle strengthening/toning

Target area: muscle group or groups being worked.

Type of resistance force: gravity, body weight, external weight or tension.

Equipment may be categorized as:

• Portable and storable
• Adaptable for individual size or physical condition
• Economical or expensive

Associated Products

Practical, functional or therapeutic need.

Equipment may be categorized as:

• Portable and storable
• Adaptable for individual size or physical condition
• Economical or expensive

Buying Tips

Choosing the Right Equipment For You

Once you have researched your products for quality, design and dealership, you have to evaluate which type of equipment is right for you. Here are a few questions you should ask yourself prior to purchase:

1. According to the fitness goals and features mentioned above, does the equipment meet my needs and fitness objectives?
2. Will this equipment be for me exclusively or will it need to meet the needs of other family members? If so, does it?
3. Is it a movement that suits my body in terms of joint stress, workload and skill level?
4. Will I be able to grow or progress with the equipment?
5. Will this equipment have staying power for maintaining interest and motivation?
6. Do I have space to accommodate and store the equipment?
7. Is it in my price range?

Finding the Right Product

Quality Evaluation

The quality of a piece of equipment will not only determine the longevity of the product but also your satisfaction with its performance or usage. There are several helpful ways to evaluate the quality of any fitness related product:

1. Test market: Go into a store or showroom that has the desired equipment and try it out. When appropriate, look for:
   • proper fit or feel
   • smooth moving parts
   • sturdy, stable construction
   • delivery of what it offers
2. Check the warranties and guarantees: A quality product should come with a long-term warranty. This means that the manufacturer will repair or replace any faulty parts for a reasonable period of usage (usually up to a year after purchase). Even better than this is a money back guarantee that allows the purchaser to test the product out and return it for a refund if it does not meet his/her expectations. This allows you to be assured of liking the activity or equipment and the way it performs.
3. Compare prices: When comparing similar products the price can often, but not always, be an indicator of quality. The more a manufacturer cuts his price, the more he will have to skimp on product materials and production quality. By comparing several price points you can see an average range and try to stay away from the obvious skimpers.
4. Brand awareness: Find out which are the more trusted brands. These companies have more to lose if they produce a low quality product.

Locating What You Need

There are several valuable resources for locating the right product whether you are looking for the best price, features or quality recommendations:

• A personal recommendation from a friend or fitness professional, or equipment dealer you trust
• Consumer reports via magazines and business mail
• Sales representatives in a reputable equipment specialty store or equipment department note: Be leery of products sold on TV infomercials. It is best to try out the equipment prior to purchase whenever possible.

Committing To Exercise Through Goal Setting

It has become quite apparent that regular physical activity is an important component of a healthy lifestyle. The Surgeon General has even jumped on the band wagon with the 1996 Surgeon General's Report addressing physical activity and health, referring to the growing body of evidence implicating physical inactivity as being hazardous to your health. This report, coupled with the statistics which demonstrate that 78% of adult Americans are still choosing to remain sedentary (Pate et al. 1995) is having a huge impact on the way in which physicians and health experts approach fitness. There is a clear shift in focus from the hard core or traditional training measures of yesteryear, to a more gentle and nonthreatening approach that acknowledges physical activity of any kind as beneficial, regardless of its intensity. Modest amounts of activity, such as walking and gardening, have been shown to reduce the overall risk of several chronic diseases (Blair et al. 1989; Paffenbarger et al. 1986; Sandivik et al. 1993), giving us reason to promote activities of all types (functional, recreational or exercise specific), and opening the door for everyone to add physical fitness to their lives, regardless of their age or history of exercise.

Once you recognize the importance of fitness for your own well-being, the challenge is to establish new health and exercise habits that you can commit to over time. It only takes 30 to 60 days to create a new habit, but you will need to set clear goals keep you motivated through this crucial time period. Committing to exercise is rarely easy. You need to find that internal power that can motivate you toward the fitness goals you select, and personal motivation is only possible when your goals are meaningful and attainable. The most common mistake you can make is choosing a goal that does not give you personal gratification in a measurable and timely way. You need to consider both long- and short-term goals when devising your exercise plan. The single long-term goal needs to really excite you when you think about achieving it. It needs to be grand enough to make it worth all your work over the next year or so. It needs to create a sense of want and excitement without seeming unrealistic or overwhelming. To achieve that ultimate goal by year end, you must determine a number of short-term goals, or action steps, that can be met on a daily or weekly basis. To help you stick with your exercise program and gain greater fitness results, follow this four-step plan:

• Step One: Choose and evaluate your long-term fitness goal(s). The Vibrant Health and Wellness Foundation thorough Health/Wellness/fitness assessment will help focus you.

  If dreams could come true_what would you like to do for your body to improve your quality of life-lose a specific amount of weight, or be able to run a 10K race or reduce your stress level in order to regain the energy to enjoy your life's activities? Once you have chosen a long-term fitness goal, evaluate it by listing five benefits to your life that will result from achieving that goal. If these benefits don't excite you, choose a new goal. You can also utilize the SMART system of goal setting. SMART stands for Specific, Measurable, Action-oriented, Realistic and Timed. Defined specific goals are much easier to focus on than vague statements. For example "I want to get in shape" versus "By participating in physical activity 3 times a week and watching the number of calories I eat, I will lose weight and get in shape in 10 weeks."

• Step Two: List three short-term goals to work on over the next month.

  These small goals need to bring you closer to your long-term goal, while being very realistic and achievable. Example of short-term goals plan:

  Long-term goal: Lose 30 pounds
  Month: January
  Short-term goals:

  1. Make an appointment for a physical examination
  2. Lose one to two pounds per week
  3. Contact a friend who can walk with me three to four times per week

• Step Three: Track your plan on a monthly calendar

  Log each short-term goal and its completion date on a special fitness calendar. As you complete each action step, replace it with a new one to work on the following month. (Studies show that people who write down and track their goals are 90% more successful in achieving them.)

• Step Four: Reward yourself on a regular basis

  Always recognize small achievements along the road to lifelong changes. A massage, new outfit, or simple treat can make each step worth the extra effort. The end of the week would be a good time to reward your success and plan for the week to come.

12 Tips to Help You Stick With Your Exercise Program

1. Mix functional exercise with traditional training: use a walk to the mail box or an outdoor activity with the kids as your workout on one day and then go back to your step or sculpt class on the next.
2. Find a friend to work out with; you will help keep each other motivated.
3. Reward yourself, or ask for your next gift from a loved one to be a session with a personal fitness trainer in your area.
4. Have at least one at-home in-door exercise option, that you can use when the weather or your time schedule does not permit you to go out for a workout.
5. Try working out at different times of the day. Write down how you feel emotionally and physically, before you start exercising, during and several hours after the workout. Compare your findings to determine your best time for exercise.
6. Focus on how you feel rather than on what size clothing you wear. Think about how you feel when you go dancing, skiing, or hiking versus always focusing on your physical shape. you'll have fun and the results will be long-lasting.
7. Learn to balance soft and hard workouts-stretch or practice yoga on days between jogging or weight training sessions.
8. If you are intimidated about getting started in public, try private home videos for tips and techniques that will help with your coordination, self-confidence and base fitness level.
9. Reward yourself when you make fitness gains, including simply sticking with your program.
10. Put your exercise routine at the top of your to do list or daily calendar.
11. Look for opportunities to join your fitness quest with that of others-fun runs, round robin tennis tournaments, or fitness fund-raisers.
12. See fitness as a lifelong commitment built on small daily habits.

Now it's time to face the challenge of committing to your fitness goals. As stated above, committing is not necessarily easy, but the results are truly worth the efforts. GOOD LUCK!

Common Exercise Misconceptions

As the fitness industry continues to expand, so does the numbers of opinions regarding the components of the ultimate exercise program. Unfortunately, much of the information supporting these opinions is either completely false or born of half-truths leading to common misperception. The first and best way to judge information is to scrutinize the source. Some of the worst exercise suggestions are based on the testimony of famous, attractive or very fit individuals. While these attributes are certainly desirable, they do not necessarily guarantee individual expertise. Likewise, advertisements are notorious for manipulating facts and rendering them less than true in order to sell a product. Although much of the misinformation that abounds regarding exercise is relatively harmless it can still prevent us from maximizing our wellness potential. Therefore, the following myths, misperceptions and popular notions that often derail and confuse the general population have been rectified to help set you straight on the road to physical fitness:

• Misconception 1: If I weigh the same as I did in high school, ten years ago, I should be considered equally as fit.

  Fact: Not necessarily. The makeup of body weight is primarily the relationship between lean weight (muscle) and fat called body composition. While an indicator of good health, body composition is not a direct measurement of fitness. Time and lack of exercise diminish our muscle tissue and increase our body fat. This sad fact of the sedentary lifestyle has a direct negative effect on our level of fitness, even if the bathroom scale does not change.

• Misconception 2: If I want to lose weight I should just exercise aerobically and not lift weights.

  Fact: Losing weight is primarily a factor of caloric expenditure or burning calories. When it is conditioned, lean muscle tissue is the very organ of the body that prefers fat as the fuel of choice during aerobic activity. To condition muscle tissue perform 20-30 minutes of circuit-style resistance training two to three times per week. This will help the body to burn fat more efficiently when exercising.

• Misconception 3: As an older adult I've been told not to raise my arms above my head during exercise.

  Fact: The reason older adults are instructed not to reach above their head during exercise is that it raises blood pressure. However, it raises blood pressure only if the arms are left in the raised position. Lifting the arms up and down in a rhythmic fashion as in aerobics or resistance training is not only appropriate but is specific to life. Otherwise, older people should remove everything in cabinets and closets that are above their head and store everything at shoulder height and below. Likewise, they should never comb their hair or wave good-bye. You can see how ridiculous some statements are even when there is a foundation of truth involved. If older people are expected to tip-toe through life afraid to move a certain way because they should fear a rise in blood pressure, then to be consistent we must be sure to tell them not to cough, sneeze, or have sex as well.

• Misconception 4: I don't feel I'm really getting a good workout unless I'm sore for several days after exercising.

  Fact: This myth is probably the toughest to eliminate. However, the bottom line is that muscle soreness indicates physiological trauma, and is believed to result from inflammation and microscopic tears in the elastic tissues surrounding muscle fibers. What soreness does give us is sensory feedback. As human beings we want and need knowledge of results. The soreness is th information that convinces us that we have indeed worked hard. Some personal trainers advocate that this trauma is necessary in order to develop muscle more effectively -- "No Pain, No Gain" mentality. In actuality, the continued effort to ensure such soreness induces what is known as overuse syndrome. The best rule of thumb is to increase exercise time or difficulty by 5-10% after every four to six workouts.

• Misconception 5: I know I've had a good workout if I sweat a lot.

  Fact: You should not gauge your workout by the amount of sweat you produce. Sweating is the body's cooling mechanism which reacts to ambient conditions, work intensity and individual differences.

• Misconception 6: I know I'm working in my target heart rate zone in aerobics class because we take our pulse in the middle and at the end of each class.

  Fact: Pulse monitoring is actually an inaccurate method of determining heart rate. Heart rates change with the slightest variation in movement effort and rapid arm movement can raise heart rate values without increasing cardiovascular output. In addition minimal movement increases in the leg and hip area can increase both the heart rate and cardiovascular benefit. A heart monitor is the key to truly quantifying an exercise program.

• Misconception 7: As an older adult, I can just garden for exercise.

  Fact: it's true that any movement is better than no movement. That is why gardening, since it involves a variety of movements, can be considered a positive step in the direction of physical wellness. The problem, however, is that the actual workload is unpredictable. The movements are random and the body is often in a vulnerable position, such as stooping to pull weeds, till the soil, or kneeling while planting.On the other hand, raking leaves could provide a more balanced workout.

• Misconception 8: When I feel tightness or slight pain during exercise I just keep trying to stretch the muscle out.

  Fact: Spasm or contraction of muscle fiber can be caused by a variety of conditions from electrolyte imbalance to overuse injury. Cramping is actually the body's own protective mechanism, signaling you to stop and limit further damage. Granted, some muscle cramps are minor and can be stretched out successfully in order to resume activity. However, if the muscle spasm cannot be relieved by one or two simple stretches, then you may be experiencing a precursor to an injury. Discontinue the activity, ice the body part and consult your physician.

• Misconception 9: If I lift weight I'll put too much stress on my joints.

  Fact: Actually the opposite is true. Joints become healthier with resistance training. Obviously, overloading a joint can lead to an injury. However, an appropriate prescription of resistance combined with prudent progression, controlled range of motion, and proper technique can be the best thing for any joint. Simple movement or articulation of a joint provides nourishment by way of increased blood flow to a joint. Furthermore, the resistance strengthens the connective tissue (e.g., ligaments and tendons) which maintains the integrity of the joint and helps to prevent injury. Joints without consistent resistance training are weakened and vulnerable.

• Misconception 10: As a woman, I don't want to lift weights because I don't want big bulky muscles.

  Fact: don't worry, it won't happen. Women do not produce enough of the hormone testosterone for hypertrophy to occur. However, women can expect to achieve tone and definition from resistance training.

• Misconception 11: I always wear a weight belt to protect my lower back when lifting weights.

  Fact: A weight belt does actually help protect the lower back by compressing the abdomen and stabilizing the trunk. However, a weight belt shouldn't be worn for the entire workout because it can become a crutch when used during lighter weight lifting. The body should be trained to stabilize itself during the lesser intensities and the belt used only when additional stabilization is warranted.

• Misconception 12: High protein drinks will maximize my muscle size.

  Fact: Such drinks may add to your size, but it may not be all muscle. The average human body needs approximately 1 gram of protein for every kilogram of body weight. This roughly translates to 70 grams of protein for a person at 154 pounds. Athletes may sometimes require 1.5 to 2.0 grams per kilogram of body weight. The average American diet provides approximately 2.2 grams of protein per kilogram of body weight. The problem with overconsumption is that while the proper amount of consumed protein is used by the body for protein synthesis, the excess is converted to fat and stored. Therefore, the girth of a muscle may increase, yet much of it may be from deposits of intramuscular fat. If a person is inclined to supplement their diet with additional protein, they should at least monitor their body composition regularly. Quantification of the weight lifting program should also be meticulous so as to try to isolate contributing variables.

• Misconception 13: If I stop weight training, the muscles I've developed will turn to fat.

  Fact: Muscle and fat are as different as wood and metal. One cannot become the other. However, curtailing a resistance training program may allow the developed muscle tissue to atrophy (shrink). The decreased muscle tone combined with new fat deposits, due to the lack of exercise, tend to give the appearance of muscle that has turned to fat.

• Misconception 14: I don't really need to lift weight or perform aerobics. I feel great with the flexibility classes I'm taking.

  Fact: Flexibility is truly a positive quality. However, flexibility does absolutely nothing for maintaining lean muscle tissue. You must strike a balance of aerobic work, anaerobic work or resistance training and flexibility.

• Misconception 15:I am really working on my flexibility. My friends even say I'm double-jointed.

  Fact: There is no such thing as actually being double-jointed. Hypermobility is the most accurate term for those who seem to have created such flexibility in the muscles that the joints appear abnormal. Some tension in the connective tissue helps maintain the integrity of the joint. Swimmers and gymnasts, for example, run the risk of serious injury by over-stretching connective tissue beyond its normal state of extensibility.

Postpartum Exercise

New motherhood is both an incredible feat and a remarkable challenge. Following childbirth, every mother has the task of balancing her own physical and emotional needs with those of her newborn. It is normal for the ensuing lifestyle changes to overwhelm her at first and feelings may intensify from lack of a good night's sleep and a regular schedule. While mom and new baby are bonding, the hormones that produced profound effects throughout pregnancy continue to influence her body during this transitional phase. A gentle but consistent exercise program can boost energy and help speed up recovery. However, check with your physician to make sure it is safe to proceed. When permission is granted, try exercising with a positive attitude, patience and caution during the first six months postpartum.

Exercise Benefits During the Postnatal Period

What new mother doesn't long to lose the weight she gained during pregnancy and get back in shape? A regular exercise program, consisting of 3D5 sessions per week, will help burn off some of those extra calories consumed during pregnancy. As a bonus, exercise offers psychological benefits, including an improved sense of well-being, increased energy and motivation, positive feelings about motherhood, and less fatigue and stress. Exercise can also be a time that mom shares with her newborn. During the early postnatal weeks and months, mother and baby share much of their time together. Involving baby in mom's exercise program can create additional opportunities for maternal-infant bonding. It is also an incentive for mom to begin exercising that much sooner. Many postnatal exercise programs encourage moms to bring their babies to class.

Getting Started

How soon can I begin exercising? This depends largely upon your doctor's opinion as well as how quickly you recover from childbirth. Most new moms need the first few weeks to adjust to their new role. Sleep deprivation is often a factor that delays exercise. It is recommended that new mothers rest when the baby naps to gain strength and build energy stores. Typically, doctors prefer that their patients wait to resume exercise until after their postpartum checkup, which is usually six weeks following birth.

How much should I exercise? As with any individual beginning an exercise program, it is important to start off slowly. After clearance by a health care provider, you should consider starting with 2-3 exercise sessions per week, and gradually increase activity to 3-5 times per week. Begin with moderate intensity exercise (70-80% of maximum heart rate) and gradually increase intensity and endurance. Begin with 15-20 minutes of moderate exercise and add one minute to each workout that follows. After one month of consistent exercise, try to perform 30-60 minutes of continuous exercise in your target heart rate zone while maintaining a comfortable pace.

• Always get your doctor or primary caregiver's permission to resume exercise.
• Start off slowly with gentle exercises, such as stretching, walking and light toning, to keep the risk of injury low and motivation high.
• Avoid maximal exertion and activities that can place stress on ligaments and joints, particularly in the pelvic area, until at least six weeks postpartum.
• Include core exercises specific to postpartum and recovery, such as abdominal strengthening and pelvic floor strengthening exercises (Kegels).

Types of Exercise

The pelvic floor muscles support internal organs, including the uterus, and bladder. Kegels, or pelvic floor strengthening exercises, should be performed throughout pregnancy and postpartum simply by contracting the muscles surrounding the vagina and anus upward and inward as if stopping the flow of urine. Hold each contraction for at least 5-10 seconds, then slowly release. As the strength of the pelvic floor muscles improves, you should be able to hold each contraction longer. Do 50-100 per day. In general, a balanced exercise program should consist of strengthening exercises for key areas of the body (e.g., abdominals, back, hips, thighs, and pelvic floor), gentle cardiovascular work (e.g., stationary cycle, treadmill, walking), low-impact aerobics, or swimming once the bleeding stops, and stretching and limbering exercises for the major muscle groups. Walking is one of the best ways to begin physical activity during the first few weeks postpartum, but only when first cleared through your health care provider. During early postpartum, gentle recovery exercises should include pelvic tilts, belly breathing and relaxation exercises, static stretch, supine bridging and Kegels. Cesarean birth usually requires a longer recovery period before resuming a regular exercise program. Be sure to have your doctor's clearance before you begin. However, certain post-cesarean exercises, with your health care provider's approval, may be performed as soon as the anesthesia wears off. Leg slides, ankle circles, wrist circles and head raises promote blood circulation and can be done in your bed. It is also important to get up and walk as soon as you are able to do so following surgery. Once released to recommence exercise by your doctor (usually no sooner than six weeks) begin in moderation. After two weeks of gentle exercise following this period, resume some of the more traditional exercises, including abdominal crunches and curls. Start slowly and take frequent breaks. Do not push beyond what feels comfortable.

Nursing and Exercise

Mothers who nurse use additional calories to produce breast milk and nourish their babies. Nursing moms who exercise must be sure to consume additional calories and water to replace the extra 300-500 calories a day used for nursing and get adequate rest each day. Moderate exercise may not reduce the quality or quantity of your milk.

Special Conditions and Exercise Concerns

The general effects of pregnancy hormones, such as relaxin and elastin, continue to influence the body during the postpartum period.

• Diastasis Recti: A pregnancy-induced condition in which the two halves of the abdominal muscles separate at the midline of the body. During pregnancy, this helps accommodate the growing fetus without overstretching or tearing the abdominals. If the separation is 3 finger widths or greater, heavy abdominal exercises, including oblique twists (torso rotation), should be avoided until the separation decreases. A 2 finger width separation should be supported by splinting (cross hands over lower abdomen to hold seam in place). Torso rotation may be resumed at 1 finger width. Check for diastasis prior to resuming exercise. Questions should be directed to your doctor.
• Back Stress: Throughout pregnancy, the weight of the growing fetus and the enlarged breasts will have placed tremendous stress on the upper and lower back. Moms who did not exercise during pregnancy probably feel more affected during postpartum than moms who continued to strengthen their back muscles throughout pregnancy. The additional stress of lifting and carrying the baby may also contribute to back stress, possible pain, and weakening of these muscles. Exercises should include gentle back strengthening-prone back extensions, supine pelvic tilts and bridges, rows and shoulder shrugs.
• Pelvic Floor Weakening: A common condition that occurs from the constant pressure these muscles experience during pregnancy and finally when they are stretched during delivery. Some women may even experience urinary incontinence. If the pelvic floor muscles are conditioned throughout pregnancy, they will be stronger and better able to function during labor and delivery. Kegel exercises should be continued during the postpartum period to help strengthen and tone these muscles.
• Episiotomy: This incision is made in the perineum between the vagina and rectum during birth to increase the size of the birth canal, allowing more room for the passage of the baby. If you have an episiotomy, it is likely your initial recovery will be somewhat longer. During the first few days postpartum, you will experience the most discomfort from the incision. Kegel exercises should be practiced frequently every day. Although you may experience discomfort during these exercises, Kegels increase muscle strength and promote blood flow to the area, thereby improving the healing of the perineum from stitches or torn vaginal tissue.

Exercise Cautions

Stop exercising and consult your health care provider if you experience any of the following:

• Increased bleeding
• Pain or discomfort around an incision from a cesarean or episiotomy
• Dizziness, disorientation or difficulty breathing

Note: This information was derived from various health and fitness publications related to pregnancy and guidelines established by the American College of Obstetrics and Gynecology.

Have you had difficulty getting started with an exercise program? Have you considered hiring a personal fitness trainer? If so, are you not quite sure how to select the right one? The Vibrant Health and Wellness Foundation advertisement is word of mouth. If you are not in the local area, let The Vibrant Health and Wellness Foundation help you identify the selection criteria. Here are some tips that can help you select a qualified personal fitness trainer.

As with all purchases, the buyer must "beware" concerning the capabilities and qualifications of a chosen personal fitness trainer. Anyone can call himself or herself a personal fitness trainer. Historically, avid exercisers with no experience or training were attracted to offering personal training services because they could do what they like best- exercise and get paid for it. Prospective clients, however, typically over 35 years of age, having special concerns and requiring special exercise program development, were not benefiting from the unqualified trainer. What worked for the personal trainer and perhaps for one client may not be suitable for another client. It became apparent that unless a personal fitness trainer was educated to understand a client's specific need (or methods to ascertain a client's need concerning exercise), the client could be at risk for not achieving the desired results and possibly even be at risk for injury.

Hiring a personal fitness trainer is not an inexpensive endeavor. Personal training fees can range from $30 to $100 per hour or more. Therefore, the same consideration given to another purchase of this magnitude should be given to selecting a personal fitness trainer. Good looks and price should not be the only criteria for your selection. The following is a checklist of what you should consider prior to hiring a personal fitness trainer:

• Ask friends or acquaintances if they are working with a personal fitness trainer. A referral can be a first step towards a positive experience.
• Decide the age and gender you may desire in a trainer.
• Check out the trainer's educational background. A personal fitness trainer should have a minimum of a bachelor's degree in a health and fitness field (e.g., exercise physiology, physical education, exercise science, kinesiology or biomechanics). It is fair to consider years of experience as a trainer in lieu of education. However, passing a nationally recognized certification that evaluates base level competency is essential whether or not a trainer possesses formal academic preparation.
• Make sure your trainer is certified by a nationally recognized organization, such as AFAA. Make sure the certification he/she holds requires passing both a written and practical exam. Ask for a list of credentials.
• Ask the trainer if he/she has maintained current certification in CPR and first aid. Also ask if the trainer has a designated written emergency response plan in case an emergency should arise.
• Ask for the trainer's professional resume and references.
• If you have a specific chronic disease (e.g., arthritis, diabetes, heart disease) or other special needs, make sure the trainer is skilled, experienced, and knowledgeable in that area.
• Ask the trainer if you may contact present or former clients for references. If the answer is no, you may want to look elsewhere.
• Does the trainer carry professional liability insurance?
• A good trainer should give you a personal interview, inquiring about your present health and fitness status, and your goals, as well as explaining the risk of participating in exercise, and discussing any legal documents to be signed prior to beginning any form of fitness training.
• A good trainer properly explains what fitness/exercise is and carefully designs a program to meet your goals not his/hers.
• A trainer should be friendly, caring, motivating.
• A trainer should provide a progressive fitness program within a safe environment.
• A trainer should stay within proper legal practice parameters and make appropriate referrals for you to other fitness and health care providers as deemed necessary.
• Does the trainer offer financial options that suit your budget, such as:
  • An initial set-up fee with periodic evaluations? (A cost-effective approach for some)
  • Weekly meetings for a hands-on approach? (A personal and more expensive approach enjoyed by some)
  • Small group training sessions splitting fees among the participants? (An economic and fun way for a more personal approach)
• Is the trainer willing to trade services? Your professional services for his/hers.

Summary

Hiring a personal fitness trainer is an investment in your health. It can be a very cost effective purchase when the trainer helps you accomplish your fitness and lifestyle goals. But as with all purchases, remember, "Caveat Emptor," "Let the Buyer Beware."

Walking for Fitness

Whether indoors or outdoors, on equipment or a path, walking is the most convenient way to get in shape. Walking is low-impact, non-jarring, does not require practice or experience and can provide a social outlet or solitary relaxing time. Nearly 70 million Americans are currently participating in a regular walking program, making it the number one choice for fitness.

Short-Term Benefits

By walking for 30 minutes each day, you will begin to notice the following benefits within two to three weeks:

• A sense of well-being and uplifted mood
• Improved ability to meet the demands of your daily activities
• Improved motor skills
• Increased vitality and renewed sense of energy
• Improved muscle tone in the shins, calves and thighs

Long-Term Benefits

• Improved agility and coordination
• Improved muscular strength
• Improved muscle tone
• Increased cardiovascular ndurance
• Lower blood pressure
• Lower blood glucose levels
• Reduced risk of coronary heart disease
• Increased bone density.

A regular walking program can help you lose weight and reduce your risk to coronary artery disease, although you shouldn't expect any quick results. Research shows a half-hour walk at your target heart rate range can lead to a slow, steady shedding of 16 to 18 pounds per year. This may not sound like a lot of weight, but think of it this way. If you don't start a fitness walking program or do any other form of exercise, your sedentary lifestyle could very well put an extra 18 pounds on you by next year. You can expect another 18 pounds the next, and the next, as your metabolism slows over the years. This gradual creeping up the scale is the real weight gain culprit for most people. Therefore, a half-hour walk is perhaps the easiest way to ward off creeping obesity and ensure long-lasting weight control.

Reducing Risk of Osteoporosis

Bone density can be increased and maintained through regular walking. The steady low impact of weight-bearing activities - such as walking - is the action that stimulates mineral content to remain within the bone structure. Studies indicate people who walk at least 30 minutes a day have higher mineral content than those who don't.

Intensity

How hard should you be working? AFAA recommends training at 55-90% of your maximal heart rate. For the most part, this constitutes a vigorous three to four miles per hour (mph) walking pace that allows you to carry on a conversation in brief sentences without undue shortness of breath or fatigue. Most importantly, your workout intensity should be geared to your present fitness capacity. If you do not work out on a regular basis, or you are a novice exerciser, work out at the lower end of the estimated heart rate range. As you become more physically conditioned, gently increase your intensity level by picking up the pace. Hills should be avoided in the beginning. But after a few months, they can provide an extra challenge.

Warm-Up and Cool-Down

Fitness walking requires a simple warm-up - approximately five to ten minutes of striding at an easy pace. A short routine of static stretches (each stretch held for approximately 8-10 seconds) is also recommended before walking for the upper and lower body, especially the back, calves and shins. The easier pace will allow your heart rate and blood pressure to climb gradually to your training level. Likewise, you should end vigorous walking with leisurely-paced strolling for another two to three minutes, allowing time for your cardiovascular system to adjust to a pre-exercise level. Recovery heart rate is generally taken two to five minutes after aerobic exercise. The quicker your heart rate recovers to its pre-exercise level, the better shape you're in.

Stretching

No walking program is complete without some post-exercise stretches. Hold each stretch for at least 20-30 seconds to enhance flexibility. Do not bounce - sustain the stretch in a steady manner, making sure you breathe continuously throughout the stretch. Take the time to stretch the following areas: Achilles tendon, calves, hamstrings, front of shins, hip flexors, quadriceps (front of thigh) and upper and lower back.

Strengthening

Additional Walking Tips

Technique: Always maintain good posture and body alignment. Head should stay in a natural extension of the spine with chin parallel to the ground and eyes focused on the horizon. The chest is lifted with shoulders back and relaxed with arms swinging naturally at your sides. Maintain a natural stride and walk with a rolling heel-to-toe foot action.

Rehydrate: Always replenish your body with fluids depleted by aerobic activity. AFAA recommends drinking 8-10 ounces of water for every 20 minutes of activity. Water is the preferred drink for exercise sessions lasting one hour or less. For activities exceeding one hour, consider rehydrating sports drinks to replenish lost electrolytes.

Clothing: Choose loose fitting garments that allow your body's heat to evaporate. Consider the new sport fibers that whisk away moisture, preventing chafing of the skin. Wear reflective clothing at night.

Shoes: Select a lighter weight walking shoe. Look for extra shock absorption in the heel and ball of the shoe. Shock absorption is crucial to avoid heel pain, plantar fasciitis and burning or tenderness in the ball of the foot (metatarsalgia). A low heel slightly beveled in the rear helps accommodate the heel strike and forward roll of the foot. Make sure you select a good walking shoe that addresses any special needs for your feet or legs. If you have chronic problems seek medical advice. You may need orthotics before engaging in a long-term walking program.

Exercise in healthy environments: If the outdoor temperature is high with excessive humidity (greater than or equal to 75 degrees F with greater than or equal to 60% humidity), exercise inside with air conditioning. If the weather is below 40 degrees F, dress warmly and in layers. To avoid air pollution, exercise in the early morning or late afternoon and away from car exhaust. If you have a respiratory condition, check with your doctor or refrain from exercising during extreme cold and high pollution days unless exercising in a controlled indoor environment. Protect yourself from lightning and storms. Avoid unfamiliar or dangerous places. Walk on sidewalks and safe pathways preferably with a friend. Always carry identification and obey all traffic laws.

Running & Weight Training

Are distance running and weight training compatible? How about short-or mid-distance running and weight training? If I want to add bulk and muscular definition, will running work against me? Is it possible to work out with weights, be a runner and have a muscular body rather than a lean runner's body? Do I have to consume more protein if I'm weight training along with running? And if I do, will this extra protein detract from my running performance? Since I might eat extra carbohydrates to create fuel needed for running, how will this affect body building? This card will address these questions to assist you in designing a fitness program that matches your goals.

• Are running and weight training compatible?
  Distance running and weight training are definitely compatible. When performed correctly, they improve cardiovascular endurance and muscular strength, helping to improve overall fitness. The same holds true for short- and mid-distance running. Experience and research show us that weight training and running are not only compatible, but actually serve to enhance one another.
• What kind of weight training is best if I'm also a runner?
  Weight training that improves muscular endurance (high repetitions and low weight) can be helpful for all runners. This type of program strengthens and improves local muscles that accommodate arm swing and the repetitive leg actions of running.
• Will running improve muscular strength?
  Running will not significantly improve muscular strength just as weight training will not improve the cardiovascular system that supports running. However, put them together and they complement each other creating a perfect exercise program. Weight training can help to strengthen the muscles that support the arms and legs thus minimizing fatigue during long-distance running. And, though leg strength is generally maintained due to the repetitive demand of the lower body during running, upper body strength tends to be lost. Therefore, weight training for the upper body is particularly recommended for total muscular balance.
• How can I maintain a muscular body and include running in my fitness routine?
  Running will not hinder the development of bulk or definition of muscle groups. Each activity is distinct, resulting in different benefits. Weight training for bulk or definition, however, requires different training strategies. In general, to increase muscular definition, weight training exercises should utilize low resistance. This means lifting weights equal to about 50-60% of repetition maximum (RM) (the maximal load that a muscle group can lift over a given number of repetitions before fatiguing). This exercise should be performed with high repetitions (15-20). To build muscle bulk that actually increases the size of the muscle, training should include high resistance and low repetitions. This means at least 80% of RM and between 5-10 repetitions. Additionally, individuals with the goal of developing lean muscular physiques may require an activity such as running that will serve to burn a large quantity of calories, thereby utilizing existing fat stores and enhancing the muscular look of their bodies. However, it is difficult to achieve a defined muscular body without a combination of strength training and aerobic exercises.
• What is a balanced routine for a runner?
  It is important that a runner not develop muscular bulk as it can add body weight and hinder efficient body mechanics for running. Therefore, it is best for runners to primarily incorporate a strength training regimen that includes high repetitions and low resistance (weights). As you train with this technique and begin to find it easy to accomplish the number of repetitions at the current weight, you should gradually increase the weight or number of sets of repetitions. This will not only increase your muscular endurance, but will certainly increase your muscular strength. This type of training will not result in significant mass gains and should not interfere with your running.
• How much protein should I consume if I am combining weight training with running?
  If you eat a normal, balanced diet and are attempting to improve your general fitness, then extra protein may not be necessary. If you elect to increase your protein intake due to a rigorous weight training or body building routine, it will not affect your running capacity either way (average protein intake is .8-1.0 g/Kg of body weight).
• Should I increase my carbohydrates to maximize my ability to run long distances?
  Consuming extra foods in the form of increasing carbohydrate consumption, sometimes referred to as carbo-loading, won't negatively affect your weight training regimen. In fact, carbohydrates will act as an energy fuel. The dietary guidelines suggest approximately 55-60% of your food intake be comprised of carbohydrates. This holds true for all people, regardless of their exercise program.

Exercises for Low Back Pain

The following exercises can be performed daily for healthy back maintenance (consult your physician before performing these or any other exercises).

Stretching

1. Stand and Stretch: In a standing position find your best posture. Place the palms of your hands on your low back and buttocks area. Keeping your neck relaxed, gently lift your chest upward towards the ceiling slightly arching through your back. Hold for 5 seconds as you slowly breathe in and out. Relax and repeat. Try to work up to 5 repetitions.
2. Finding Neutral Spine: Lie on your back with your knees bent and feet flat on the floor or mat. Place arms by your sides. Gently tighten your abdominals and flatten your low back; then arch your back. Now find a position somewhere in between that is comfortable to maintain. That is your neutral spine. Repeat this exercise several times.
3. The Barrel Hug: Lie on your back on a supportive and flat surface, with your knees bent and feet flat on the floor. With your hands, gently bring one knee in towards your chest. Come to a position where you feel the muscles stretching yet it is comfortable and hold for 5-10 seconds. Slowly lower the leg down and bend the other knee in. While holding each position, take several deep breaths in and slowly blow out. When you can perform this stretch easily, try bringing both knees to the chest at the same time. Hold for 10 seconds as you slowly breath in and out.
4. Thigh/Hip Stretch: Lie on your back on a supportive and flat surface, with your knees bent and feet flat on the floor. Gently bring one knee in towards your chest with hands and arms supporting your leg. Slowly extend the bent knee, reaching your foot up towards the ceiling, until you feel a mild tension occurring in the back of your leg. Hold for 5-10 seconds as you breathe in and out. Relax, bending extended leg at knee and bringing it to your chest. Slowly extend your opposite leg so the entire leg rests gently on the floor or mat. Hold 5-10 seconds as you continue to breathe in and out. Repeat on other leg. Gradually work up to holding each stretch 20-30 seconds.

Strengthening

1. Back Strengthener: Lie face down with your feet together. Find neutral spine and hold that position. Place your elbows under your shoulders and gently prop yourself up with your arms staying in contact with the floor or mat. Keep your hips and pelvis on the floor as you gently arch through your back. Hold for 3-5 seconds as you gently breathe in and out. Relax. Work up to repeating 5-10 times.
2. Hands and Knees: In an all-four position, find neutral spine by rounding through the spine like a cat; now reverse position and arch your back. Find the position halfway between and hold it by contracting your abdominals. Extend one leg to the rear and lift no higher than hip height. Now extend the opposite arm out to the front no higher than shoulder height. Hold for 5 seconds as you breathe in and out and maintain neutral spine. Relax down. Repeat on other side. Work up to 5 repetitions.
3. Partial Curl-up: Lie on your back with your knees bent and hands resting on thighs. Tighten your abdominals and begin lifting your shoulders slightly off the floor and hold for two seconds. Try not to strain your neck by letting your neck and head gently flow with the movement. Breathe out on the way up and breathe in on the way down. Work up to 5 then gradually build to 10 and so on.
4. Partial Curl-up with Rotation: Lie on your back with knees bent and left arm extended out to the side with the right hand gently supporting your head. Tighten your abdominal muscles. Slowly raise your right shoulder up as you rotate your torso. Your right shoulder and elbow will aim towards your left knee. Keep your arm open and don’t allow your elbow to squeeze in towards your chest. Slowly perform up to 5 repetitions, breathing out as you come up and breathing in as you lower down. Repeat on other side. As you become stronger, gradually work up to 10 repetitions, 15 and so on.

You can do it and be in control of your low back pain! Just take one step at a time and little by little you will see your low back pain start to disappear. Ease back into your daily routine. Slowly begin moving again and make a commitment to yourself that you will maintain good posture and body mechanics. Perform a simple exercise routine that consists of walking, stretching and strengthening activities.

Cool-Down Exercises

Everyone knows you should warm up before exercising, but what about after you finish your workout? Is it necessary to perform a specific cool-down? How much time should you spend? What kind of movements should you do? Does the type of workout determine the type of cool-down? On which muscles should you focus? And, what are some safety precautions? There are two different kinds of cool-downs: (1) the post-aerobic cool-down and (2) the post-workout stretch. Each one has a specific purpose and proper place. Let's look at them separately, although you should perform both after every workout.

Post-Aerobic Cool-down

A post-aerobic cool-down is the time spent recovering from aerobic activity before you end your workout or move on to different movements. It should last at least three minutes and provide a transition between vigorous aerobic work (the flat top bell curve of intensity) and muscular strengthening exercises or stretches (once the bell curve has been completed by the post-aerobic cool-down).

Most exercisers experience the well-known "high" by the end of their aerobic workout, feeling a surge of energy and interest to immediately move straight to either strengthening work or some other activity. What you actually need and require is a slow decrease in intensity that will allow your body to recover, your heart rate to slowly lower, your muscles to gradually relax, and your breathing to become regulated again, so that your body is then TRULY ready to safely move onto the next activity. Without a gradual cool-down period of three to five minutes, the blood can pool in the extremities immediately after an aerobic workout and not return quickly enough to the heart if movement stops suddenly, resulting in lightheadedness or fainting.

Moderate to slow, rhythmic movements for the upper and lower body enable the muscles of the extremities to pump blood back to the heart and brain, allowing for a safe and gradual decrease in heart rate. Suggested movements include walking, marching, and other low-impact and low-intensity activities similar to those already performed during the aerobic workout, in addition to lower, smaller, less vigorous arm movements, gradually decreasing to no arm movements at all. This is the best way to allow your body to recover from the strenuous aerobic work it just performed. Once the breathing pattern has slowed down and the recovery seems assured, you are ready to proceed to the post-workout stretch.

Post-workout Stretch

You've completed the vigorous, training part of your workout and have cooled down sufficiently; now your muscles are in need of some tender loving care. They want to be relieved of some of the lactic acid buildup they just produced, and to relax after the work they just performed. There is only one correct way to satisfy those requirements-to statically stretch those warm, fatigued muscles. Static stretches also serve another important purpose: to improve the flexibility of the muscles of the body, a key component to overall fitness.

In addition to relieving muscles of lactic acid buildup and improving flexibility, stretching properly and in good alignment after the conclusion of a workout session also relieves muscles of delayed onset muscle soreness (which tends to discourage you from exercising again soon), and allows you to spend a few minutes in a concentrated, relaxed and stress-free environment prior to continuing with the activities of your day.

Before you begin, remember to always stretch statically, without bouncing or pulsing. Hold each position still for a minimum of 20 to 30 seconds, allowing the muscle to relax enough to stretch fully to its longest length. By following these basic tenets of stretching, you will begin the process of improving your flexibility, muscle by muscle. Be sure to stretch each muscle that you have worked. If you worked aerobically, be sure to include stretches for the:

• hamstrings (back of the thighs)
• quadriceps (front of the thighs)
• calf muscles
• hip flexors
• low back

And, if you just completed a strength training session, then focus most heavily on the specific muscles you worked, for instance the:

• arms, chest, shoulders, and back muscles, if you performed an upper body workout
• abdominal and back muscles, if you performed exercises in a standing position in which these muscles were required to maintain torso stability
• the muscles of the hips, thighs and lower legs, if you performed lower body strengthening exercises

Most exercisers begin at the toes and work their way up to the head, in order to remember to include each of the body's muscles. However, you can stretch in any order you prefer. The proper technique for stretching is to slowly move the body into a position that is comfortable, keeping the body in proper alignment. Often, the best position is one in which the muscles can totally relax and not have to hold your body up in a standing position, or in one that is difficult to balance. Experiment with a variety of positions and find the one that best suits your needs and environment. Increase the stretch on the muscle selected to the point of tension only. Never increase the stretch to the point of:

1. pain,
2. discomfort,
3. or involuntary muscle shaking

Maintain a normal breathing pattern, and do not hold your breath. Allow your breathing to slow down as your muscle begins to relax. Once the muscle has relaxed, you might find it necessary to increase the stretch a bit further in order to still maintain that point of tension. Remember, do not bounce or force any stretch, as these movements can cause damage to the muscle and its connective tissues and will not enhance flexibility. As you hold each stretch for a minimum of 20 to 30 seconds, focus on your breathing and allow yourself the time as a reward for a workout well done. You may want to play some soothing music if you are indoors and have a music system available. In conclusion, cooling down is not merely something to do if you happen to have a little extra time at the end of your workout; it is an essential part of your overall fitness program. The cool-down can become the best "feeling" part of your workout and something to look forward to as a bonus at the end of either a cardiovascular/aerobic-type workout, or a strength training program. Either way, stretching and cooling down will prepare your body for the next time you work out, and help enhance your overall fitness level.

Defining Fitness

We have all heard that it is important to "get fit." However, many people are unclear about the meaning of fitness. Over the years, misuse of terminology has caused a great deal of confusion for the consumer. This confusion is one of many reasons why people do not initiate an exercise program, or fail to commit over time to the program they started. By clarifying the differences between health and fitness and their components, you can develop a program that is safe, effective, and feasible. The first step is to understand the following terms.

• Fitness: Your ability to perform daily tasks efficiently, without feeling overly tired. A person who is fit should possess the minimal levels of strength, flexibility and endurance to carry out everyday work, while also having enough energy remaining to participate in additional activities outside the home or work.
• Health: The absence of disease.
• Wellness: The condition of being healthy. It is a process, a way of life, that is based on self-responsibility. When you understand that you have control of your own well-being, you have taken the first step toward being "well." As stated by Halbert Dunn, MD, "Wellness is an active process involving zest for living." It includes not only the physical, but also your emotional, social, intellectual and spiritual aspects. Wellness takes the definitions of fitness and health and broadens them into the concept of a fully balanced lifestyle.
• Exercise: Performing an activity requiring physical or mental exertion in order to maintain or develop physical or mental fitness.
• Activity: Any specific form of action or pursuit, as in recreation or education. Activity can be undertaken for more than just the improvement of physical fitness, but also for the social, spiritual, intellectual and emotional aspects of wellness.
• Intensity: The amount of stress placed on the body to produce physiological results. It can be confusing to determine your appropriate exercise intensity, but experts state that if you work at a moderate intensity (55% to 75% of estimated maximum heart rate) you will see fitness related benefits. You can determine your own moderate intensity level with one of the following methods:
  
  1. Heart Rate:
     
     Step 1: Determine your resting heart rate (the rate at which your heart beats at complete rest). This is best assessed first thing in the morning, before rising, by taking your radial pulse (located at the wrist along the thumb side) for one full minute, finding the average three mornings in a row.
     
     Step 2: Using the formula below, determine your training heart rate range.
     220 - age - resting heart rate x 55% + resting heart rate = estimated exercise intensity (lower end of the range). To determine your range repeat formula by using 75% (higher end) instead of 55%.
     
     Step 3: Once you have your range, divide by 6 to get a 10-second count.
     
     Step 4: During exercise, take your radial pulse for 10 seconds. If it falls within that range, you are in a safe, moderate range. (Think of the lower end for beginners, the upper end for those with a higher fitness level.)
     
     Step 5: Periodically check your resting heart rate and recalculate your training range. Your level of fitness can be seen through improvements in your resting heart rate.The more physically fit a person, the lower the resting heart rate.
     
  2. Talk Test: If you can carry on a conversation while exercising, without gasping for air, you are working at a level that is safe.
  3. Perceived Exertion: Listen to your body, and using a rating scale of 1 to 10 (1 being at rest and 10 being heavy exertion), work at a level that feels moderate to somewhat hard (4 to 6 on the scale).

Now that we have defined the above terms, let's put them into the context of understanding fitness.

The Importance of Fitness

Evidence indicates that leading an active versus a sedentary lifestyle is an effective method to improve your overall health. Physical activity, along with a balanced diet, is one of the most important steps for preventing coronary heart disease and non-insulin dependent diabetes, as well as reducing the risk of certain cancers. The Surgeon General reported in 1996 on the hazards of a sedentary lifestyle and has since adopted the following guidelines offered by the Centers for Disease Control and the American College of Sports Medicine: "Individuals should participate in up to 30 minutes of continuous or non-continuous moderate intensity activity most days of the week (preferably every day)."

Examples of moderate activity are walking, gardening, fast dancing, bicycling, and raking leaves. These guidelines have been established for those individuals who lead a sedentary lifestyle and are to help encourage America to become active. Following these guidelines may not produce optimum fitness-related benefits. In order to improve your fitness level (the ability to perform daily tasks satisfactorily), you must include exercise that focuses on cardiorespiratory conditioning, muscular strength and endurance, flexibility and body composition. In order to develop fitness benefits, you should follow the American College of Sports Medicine guidelines listed below:

1. To improve cardiovascular fitness:
   • Mode: activities that utilize large muscle groups, maintained continuously and rhythmic in nature
   • Frequency: 3 to 5 days per week (3 for the beginner)
   • Duration: minimum of 15 minutes, and up to 60 minutes of continuous activity
   • Intensity: 55% to 90% of maximal heart rate (55% to 70% for beginners)
2. To improve strength and endurance:
   • Mode: 8 to 10 exercises for the major muscle groups
   • Frequency: minimum twice per week
   • Sets and Reps: 8 to 12 repetitions/1 set minimum
3. To improve flexibility:
   • Mode: static (held and sustained) stretching for major muscle groups
   • Frequency: to be completed at end of workout when muscles are warm
   • Duration: hold stretches for 20 to 30 seconds each
4. To improve body composition:
   • Mode: follow the exercise programs listed above, together with a balanced diet and try to stay within the healthy body fat percent range
   • Male: 12% to 20% body fat
   • Female: 18% to 25 % body fat

Fitness in 30 Minutes a Day

Despite knowing how beneficial a regular exercise routine would be for them, only 22% of American adults are exercising at sufficient levels to impact health or longevity. We hear countless messages each week extolling the physical and mental virtues of working out regularly. From cereal boxes to shoe ads, everybody is encouraged to just do something! So the question remains - why aren't we exercising if we know it's good for us?

The most common reasons people over age 35 don't follow the recommended exercise guidelines for health benefits (three to five times per week, at least 20-30 minutes per session) are lack of time and energy.

Not Enough Time

Try as we may, we can't really squeeze any more hours into a given day. Time is a finite dimension in a world of unlimited priorities. If we are bent on creating "more time" in order to begin exercising, we'll never start. Shift your priorities. Reclassify exercise from the bottom of the list to somewhere near the top, in order to make fitness a reality.

Not Enough Energy

"Lack of energy" is no excuse. Energy is that intangible vigor you gain as you exercise. Waiting to have more energy to exercise is a backward means to an end. Increase your physical activity and you'll build more stamina for overall lifestyle.

Need Motivation?

Define what would entice you to be more active. Feeling healthier? Having more energy? More strength? Looking slimmer? More enjoyment for the overall quality of life? Disease prevention? Choose your goal and keep it in mind as you position exercise on your daily "to do" list. Be prepared for your priorities to change occasionally, but remember your goal and get back on track.

The top motivators for exercising include a desire to:

1. improve overall feeling of good health;
2. lose weight;
3. increase strength and energy;
4. improve your appearance.

Best Time of Day to Exercise

Most authorities acknowledge that the particular time of day you exercise is not significant, but morning exercisers tend to stick to their regimen better over the long haul. People who schedule exercise later in the day often find it crowded out by other unexpected demands.

How to Find 30 Minutes to Work Out

If you've truly moved exercise up the priority list, and still can't find a half-hour a day, take heart. Experts at the American College of Sports Medicine (ACSM) and the Centers for Disease Control and Prevention (CDC) reviewed the latest research and agree on this basic recommendation, "Every American adult should accumulate 30 minutes or more of moderate-intensity physical activity over the course of most days of the week." Gathering 30 minutes a day does not require a continuous 30-minute workout. It is advisable to aim for at least three 10-minute blocks of exercise time, however, as you accrue your daily half-hour minimum.

Best Type of Quick Workout

You will be pleased to know the activities considered exercise are not all heavy-duty, sweat-producing challenges. You can choose physical activities associated with a high degree of pleasure or gratification, such as gardening, bowling, fishing, hiking, dancing and other recreational pursuits. In addition, incorporate a conscious commitment to actively move throughout the day. Take stairs instead of elevators. Park a few blocks away and walk to the office or store. Ride bikes with your children.

The Occasional Challenge

Once you're pleasantly hooked on a 30-minute-a-day routine, throw your body a curve ball now and then. Exercise continuously for 30 minutes or more every once in a while. Challenge your cardiorespiratory, neuromuscular and skeletal systems to build up your physical capacity. This is a modification of the overload principle in exercise science, which states that the body's systems require a stimulating challenge in order to attain a training effect. it's really common sense. You have to stretch a bit beyond what you normally do in order to improve.

From Maintenance to Improvement

When you're ready to step up to maximum cardiorespiratory fitness, you'll need to sustain 20-60 minutes of vigorous aerobic exercise performed at 55-90% of your maximum heart rate for three to five times per week. If you've been gathering 30 minutes-a-day of moderate-intensity physical activity, you will have a much easier time stepping up to a more rigorous workout. Keep in mind - to properly achieve steady state and maximize calorie burning you should exercise for a minimum of 20 continuous minutes.

Pre-Training Precautions

For any self-regulated exercise program, be aware of the following risk factors and/or medical conditions: diagnosed high blood pressure, arthritis, high cholesterol, cigarette smoking, diabetes mellitus, sedentary lifestyle, pregnancy, heart condition, and/or orthopedic problems. If you fall into any of these categories, consult your physician prior to beginning an exercise program. Stop exercising and obtain medical advice if you observe any of the following exercise danger signs:

• unusual fatigue
• nausea
• dizziness
• tightness in chest or any pain from the jaw to the waist
• lightheadedness
• loss of muscle control
• severe breathlessness
• allergic reactions, e.g., rash or hives
• blurring vision

Importance of Functional Strength

Functional strength is part of a new exercise trend that is based on improving your body's ability to function in normal day-to-day activities. Muscular strength is an important component of physical fitness. Our muscles are responsible for moving and supporting our bodies in space. Without adequate muscular strength and endurance we could not function in life; we would not be able to perform simple tasks, such as standing to brush our teeth, or more demanding work, like lifting heavy boxes. We often base our strength training exercises on what a specific muscle can do in the gym versus what it needs to do during real life activities. Traditional strength training techniques are designed to isolate and overload specific muscle groups, often with the assistance of heavy weight equipment, in order to build strength.

Functional strength training techniques can take this strength one step further by incorporating movements that demand the muscles to work together in a coordinated fashion, the way they need to perform in real life and space, without the assistance of support or machines. Together, these two types of training can meet a wide variety of health and fitness goals, while maintaining focus on correct body alignment, which is the basis of all proper movement. We will discuss two main components of a functional strength training program and how they can be incorporated into your traditional training program to create more useful strength and enhance proper posture and alignment. The benefits of functional strength training include:

1. Development of a more useful strength that applies to real life needs
2. Provision of counterbalances to the stresses that create poor posture and alignment
3. Need for little or no heavy equipment
4. Complimentary to already existing traditional strength training programs
5. Useful to all ages and fitness levels

Key Components of Functional Strength

As previously mentioned, we often approach muscles based on what they can do versus what they need to do. This focus comes from principles in exercise science that entail where a muscle connects on bones, forming a joint, and what happens to the joint when that muscle contracts or shortens. For example, we know that the quadriceps muscle group (on the front of the thigh) can flex the hip and extend the knee when it shortens or contracts. Once we match muscle group to joint action we then try to isolate and fatigue that muscle group within 8 to 12 repetitions of a specific exercise. In the case of the quadriceps, we might use a leg extension machine in the gym (this is a chair-like device that has a bar you hook your ankles under to create resistance as you extend your knees from the seated position). This exercise is great for strengthening the quadriceps group but does not take into consideration that we rarely use this muscle group to extend the knee against resistance in midair or from a seated position. What this muscle group typically does is lift and lower your body by extending and bending the knees when your feet are planted firmly on the ground. This is only one of many examples of independent, isolated strength versus interdependent, coordinated strength. In real life, we need muscles to work together in weight-bearing positions in which more than one joint is working at a time. This takes muscle and joint coordination that cannot be gained from isolated joint strength training exercises. Therefore, it would be wise to include movements, such as lunges and squats, to compliment the leg extension machine exercise, insuring that your quadriceps are not only strong, but functionally prepared for real life movements. Below, you will find a list of widely practiced isolated exercises and complementary multi-joint actions.

Does it Move or Stabilize?

Back to the point of what a muscle needs to do in real life. We tend to think of muscles in relationship to how they may move our bodies without realizing that sometimes a muscle group is really needed to hold a body part stable. Unfortunately, many of our favorite gym exercises actually mask the need for internal muscle support or stabilization by providing benches and backrests that do the stabilizing for us. This often creates a false sense of strength because the external support pad may allow us to perform certain isolation exercises with a much heavier resistance than we could ever handle in real life situations without support. The bench or chest press is an excellent example of this. Without external support, most of us would have trouble pressing even half the amount of weight our chest and shoulder muscles can handle with the support of a seat pad.

If we only perform exercises that offer this type of support, stabilizer groups will not be trained to work in a coordinated fashion. Therefore, without focusing on complementary exercises that engage torso stabilization, gym equipment strength is mainly for looks, rather than useful strength for real life activities. In the case of the chest and shoulders, you would want to incorporate movements like push-ups, where your abdominal and back muscles must contract to hold your torso stable as you move through the pressing motion. This internal support of your posture is another prime focus of functional strength training techniques. Below you will find a list of what to focus on in order to build a strong functional base of strength, as well as exercises to enhance internal stabilization.

For maximum results:

1. Start every exercise with a focus on maintaining proper body alignment
2. Begin each exercise without added external resistance to practice form and technique
3. Concentrate on muscle groups that need to be strengthened to support better standing and seated posture
4. Mix in exercises that include active flexibility (see Flexibility for Functional Fitness card) or specific stretches that are held
5. Perform all functional exercises slowly with control and deep rhythmic breathing

Main Focus Areas for Functional Strength Training

• Strengthening the shoulder girdle retractors: muscles that stabilize or hold the shoulder blades back and down.
  
  Enhancement exercises - e.g., bent over and seated rows leading with the shoulder blades.
  
  
• Maintaining proper pelvic alignment: keep the hip bones level with the shoulders and the tail bone pointed towards the heels or the floor
  
  Enhancement exercises - standing single leg balance exercises, such as side and front leg lifts, while maintaining proper pelvic alignment
  
  
• Bending from the hip versus the back: avoid rounding the spine when bending towards the floor by using more knee and hip flexion and focusing on keeping the chest and sternum lifted as you hold a contraction in the abdominal muscles.
  
  Enhancement exercises - holding a hip-flexed position (torso parallel to floor and knees slightly bent) and performing a triceps kick back, rear deltoid raise or overhead reaching motion, while bending from the hips and not the back.
  
  
• Sustaining abdominal stabilization: think of keeping the ribs pulled in and navel compressed towards the spine.
  
  Enhancement exercises - holding a V-sit (begin with hand support behind the hips and work up to non-supported V-sit position), or push-up position, or performing full push-ups, all while contracting abdominals and maintaining proper spinal alignment.
  
  

Functional Strength Program Example: (functional exercises can be performed alone or in conjunction with isolation exercises)

Isolation Exercise	More Functional Exercise
Seated calf raises	Standing calf raises
Hamstring Curls	Lunges
Leg extensions	Squats
Seated abductor and abductor presses	Standing one leg balance exercises
Lat pull-downs wide grip (palms facing out)	Pull-ups and dips
Bench presses	Push-ups with wide hand placement

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The Do's of Aerobic Exercise

1. Do check the qualifications of your instructor.
2. Do learn to listen to your body and learn how to work within the limits of your fitness level. Be aware of exercise danger signs. A complete physical examination is recommended prior to participating in an aerobic exercise program.
3. Do wear shoes specifically designed for the aerobic activity in which you plan to participate. Exercising without proper footwear greatly increases your chances of injury.
4. Do try to eat at least two hours prior to exercising unless otherwise directed by your physician. Try to limit dietary fat intake to 30% or less.
5. Do include warm-up rhythmic limbering exercises (multi-joint exercises that incorporate large muscle groups and are performed at a smooth and moderate pace, e.g., walking, marching, small kicks, alternating arm reaches) to help ensure a smooth transition into more vigorous exercise.
6. Do include post-aerobic cool-down rhythmic limbering exercises to help provide a safe transition between static stretching and/or floor work.
7. Do include static (sustained and non-bouncing) stretches in your warm-up and at the end of the exercise period.
8. Do maintain a natural rhythmic breathing pattern while exercising and monitor your heart rate (pulse). Aerobic exercise should be maintained for a minimum of 20-30 minutes with heart rate staying within your training heart rate range (THRR). THRR=220 minus your age x 55% to 90% of estimated maximum heart rate. Exercise intensity may also be monitored by rating of perceived exertion (RPE) or how youare feeling during exercise.
9. Do gradually lower your exercise intensity following aerobic exercise. Stopping abruptly may cause fainting due to blood pooling in the extremities of the body which decreases blood and oxygen to the heart and brain.
10. Do strengthen back and abdominal muscles. Proper body alignment and posture decrease risk of injury, improve muscle balance and increase the possible benefit of a specific exercise.
11. Do keep knees slightly bent when exercising in a standing position. This minimizes unnecessary stress on the lower back.
12. Do exercise at least three times each week to maintain physical fitness, and four times to improve. Overtraining may produce negative effects.
13. Do drink plenty of water before, during and after exercise for necessary replacement of body fluids.
14. Do refrain from exercising in extreme weather conditions.

Definitions

• Aerobic Exercise: A variety of exercises creating an increased demand for oxygen over a minimum of 20-30 minutes and maintaining the heart rate at 55-90% of estimated maximum heart rate.
• Anaerobic Exercise: Literally, without oxygen. High-intensity exercises generally requiring short spurts of exertion such as weightlifting, racquetball, and sprinting.
• Charley Horse: (muscle spasm of the lower leg) A painful condition relieved by gentle massage above and below the sore area. It can afflict anyone and often occurs at night in women. Causes may be associated with a torn muscle or tendon in the lower leg, a calcium imbalance, pregnancy, osteoarthritis and/or improper shoes. Contact your physician with questions or concerns.
• Exercise Danger Signs: If you should experience any of the following while exercising, stop immediately. Contact your physician, or obtain immediate medical attention.
  
  • Unusual fatigue
  • Nausea
  • Dizziness
  • Blurred vision
  • Lightheadedness
  • loss of muscle control
  • Tightness in chest control, severe breathlessness or any pain from jaw to waist
  • Allergic reaction, e.g., rash or hives
• Final Cool-down: This final stage includes static stretches (each stretch held for 20-30 seconds) to hasten lactic acid removal and minimize muscle soreness. Follow with a final heart rate check.
• Heart Rate (HR)/Pulse Rate: Monitoring HR serves as a guideline indicating your level of exertion or exercise intensity. Pulse should be taken at the thumb side of the wrist or at the carotid artery, touching lightly at the neck. Count every beat for 10 seconds, starting with the number one and multiply by six to find the number of beats per minute. Your HR should be taken five minutes after beginning active aerobic work, at completion of most intense aerobic work and at completion of post-aerobic cool-down. If this is not feasible, check HR at the completion of the most intense aerobic work rather than not at all.
• Post-aerobic Cool-down: A post-aerobic cool-down (minimum of three minutes) provides a transition between vigorous aerobic work and muscular strengthening exercises or stretches. Without a gradual cool-down, blood can pool in the extremities immediately after an aerobic workout and does not return to the heart quickly or efficiently. If movement stops suddenly, lightheadedness and/or fainting may occur. Moderate to slow rhythmic movements (walking, marching, etc.) for the upper and lower body enable the muscles of the extremities to pump blood back to the heart and brain.
• Rating of Perceived Exertion (RPE): This is a measure of exercise intensity based on the way you feel. The RPE chart ranges from 0-10 (0 represents feeling nothing, 10 represents feeling extreme exertion) with appropriate exercise intensity falling between 4 and 6 on the scale. This method helps individuals to listen to their bodies and may be used in conjunction with THRR.
• Shinsplints: Shinsplints is a catch-all term for any pain between the knee and ankle occurring in individuals who engage in running, walking, jumping-type repetitions or other aerobic activities. Specifically, it is a pain along the inner or outer front surface of the tibial shaft (shinbone) and should not be used to describe all lower leg pain.
• Side Stitch: A side stitch is a sharp pain localized in the lower front side of the torso thought to be caused by a spasm in the diaphragm due to insufficient oxygen supply and/or improper breathing. May be relieved by leaning forward while applying pressure at the painful site.
• Static Stretches: Static stretches are sustained in a supported position which allows the muscle being stretched to relax and elongate. Stretching is most effective when performed slowly and gently without bouncing or pulsing.
• Training Heart Rate Range (THRR): This range provides an easily identifiable gauge of an individual's level of aerobic work, and indicates whether or not the intensity of aerobic activity should be increased or decreased.
• Warm-up: A warm-up should include 8-12 minutes of a balanced combination of rhythmic limbering exercises and static stretches to prepare the entire body for more vigorous exercise.

Warming Up

Anyone who has ever participated in a sport, some form of exercise or just physical education class in high school, has heard the phrase, "You've got to warm up before you exercise." But what does "warming up" mean? What types of warm-ups are best? How can I tailor my warm-up to best suit my choice of physical activity? How long should a warm-up last? Is warming up really that important? Is stretching the same as warming up? This card will address these questions to enable you to incorporate the best warm-up routine for your form of physical exercise.

What is "warming up?"

Warming up is exactly that -- it's the process of increasing blood flow and muscle temperature. it's possible to warm up your whole body or parts of your body. Studies have shown, however, that warming up the whole body, as opposed to specific parts, is the only beneficial method. There are two ways to warm up -- actively and passively. Active warm-ups are accomplished by any physical activity involving the large muscles of the body -- mainly the arms, legs and back. Passive warm-ups can be accomplished with hot baths or showers, steam rooms or saunas.

What is the purpose of warming up?

Warming up your body before exercising produces many benefits that can help a person achieve maximum value from physical activity, including:

1. Warming up with rhythmic limbering exercises, movement rehearsal and mild preparatory static stretches stimulates joint lubricants so muscles and joints are more pliable, lessening the risk of injury to muscles, tendons and ligaments.
2. Promotes nerve impulse conduction. In athletic skills and sports in which efficient speed is required, warming up will actually increase performance.
3. Gradually warms up the heart and muscles, safely preparing them for more vigorous activity.
4. There's an increased rate of chemical reactions in the body. These reactions, in conjunction with the increased oxygen levels, further speed up the quick production of energy.
5. Raises blood flow to the muscles. Increased blood volume supplies muscles with needed oxygen and nutrients for maximum performance.

Exercises to Include in Your Warm Up

• Rhythmic Limbering Exercises: Multi-joint exercises that incorporate large muscle groups and are performed at a smooth and moderate pace.
• Movement Rehearsal: Light and less intense versions of movements or patterns that will be used in the workout to follow. Both rhythmic limbering and movement rehearsal exercises help prepare your body for more vigorous exercise by increasing the range of motion of the joint and its attachments, raising muscle and body temperature, increasing circulation to the tissues surrounding the joints, and maximizing neuromuscular function.
• Preparatory Stretching: Correctly performed mild static stretching will increase the capacity for performing full range of movement. This allows one to exercise more efficiently with less risk of injury to muscles, ligaments, and tendons. Begin a slow and easy stretch without bouncing. Stretch to the point of mild tension and hold the position. As the muscle relaxes, increase the stretch slightly until the point of tension is reached again. If tension is painful, ease off slightly. Breathing should be slow, rhythmic and controlled. The length of time that a stretch is held will vary according to whether or not one is stretching at the beginning of exercise, when the muscles are not thoroughly prepared, or at the end of exercise, when the muscles are warm. For warm-up, hold each stretch for less than 20 seconds (typically 8 to 16 beats of music). Avoid stretching muscles that are cold prior to performing preliminary rhythmic limbering exercises.

Customizing Warm-Ups

Active warm-ups can be in a general or specific form or a combination of the two. Rhythmic limbering exercises may be categorized as either general or specific depending on the activity.

General warm-ups are exercises that incorporate large muscles of the upper and lower body and require working at a light pace for 5-10 minutes. Such activities are walking, jogging, marching in place, riding a stationary bike, etc. These help to gradually warm up the cardiovascular system and lessen the risk for abnormal functioning of the heart. A general warm-up should always be performed prior to stretching and resistance training.

Specific warm-ups, also known as Movement Rehearsal, involve the same muscles you are planning to train in your exercise program. Some examples are tossing a baseball prior to playing, or using rhythmic limbering exercises prior to aerobic dance exercise. Research has shown there may be a difference in performance for those people who practice movement rehearsal vs. general warm-up. According to the Journal of Strength and Conditioning Research, those who warmed up specifically for a movement performed better than those who did not. Therefore, if possible, it would be better to participate in a specific warm up when skill is required.

Summary

Warming up is necessary for increased physiological function, preparing the body for optimal performance and lowering the risk of injury. Warming up should be an essential part of your overall fitness routine.

• Warm up first, regardless of the duration of the athletic activity.
• Warm up 8-12 minutes for aerobic dance exercise and 5-10 minutes for recreational and sport activities.
• Warm up rhythmically prior to static stretching.
• Include a balanced combination of rhythmic limbering exercises and static stretches for the entire body.
• Exercises included in the warm-up may be of lower intensity and mimic movements that may be performed later in your exercise session.

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Water Exercise

As people start to turn their attention to exercise and health, the traditional exercises of walking, jogging, cycling, stair climbing and strength training as well as other dry land activities come to mind. Many of these activities, however, are traumatic to the skeletal system and can result in joint pain or other injuries. Some people who already experience orthopedic pain or joint discomfort while performing the above traditional exercises, should not believe that all exercises are beyond their physical limitations. It is imperative that these individuals find an exercise that is free of orthopedic shock and trauma.

Many sports clubs, recreation centers and YMCAs now offer water exercise classes. Exercising in water offers an excellent, trauma-free alternative to traditional dry land exercise. Exercises in water include traditional swimming, water aerobics, and jogging or running in water using a specially designed vest that keeps you upright and buoyant. Exercises may be performed in shallow or deep water.

Benefits of Water Exercise

1. Water exercise offers an opportunity for people of all ages to be physically active. This is especially true for mature adults (over the age of 50) who may suffer from joint pain or arthritis.
2. In water, you weigh 50-90% less than you do on land (depending on water depth), thereby easing the burden during physical exercise on weight bearing joints such as your hips, knees and back.
3. Water exercise provides an excellent medium for all ages and fitness levels to move in ways that may be difficult at times on land, yet still enables individuals to improve muscle tone and cardiovascular conditioning.
4. The same rules concerning training heart rate and exercise intensity apply to both aquatic and dry land exercise. (However, some experts recommend lower heart rates for the water since heart rate doesn't rise as readily due to the ability of water to keep one cooler while exercising.) In addition, sessions of 20-60 minutes, three to five days per week are recommended.
5. Water exercises provide an excellent environment to regulate body temperature and avoid overheating.
6. Water aerobics provides the ultimate in low-impact exercise.
7. Water (as a medium in which to exercise) offers resistance to limb and body movement, providing an isokinetic form of strength training and muscular development. The faster you move your limbs in the water, the harder the water pushes back, providing a resistance stimulus for muscular strength development.
8. Water jogging, using a vest that keeps you vertical in water, and swimming are excellent cross-training activities for endurance development. Walkers, runners and joggers should consider including water jogging in their training regimen to decrease the wear and tear on their joints. This can help them extend their land jogging and running careers.

Other Considerations

1. To perform water jogging, the pool depth should be greater than your height. To perform water aerobics, three-and-a-half to four foot deep pools are best.
2. The water temperature should be approximately 83-86 degrees F in order to maintain comfort and optimize conditioning.
3. If you participate in water exercise, you should know how to swim.
4. Never exercise in water alone; always bring a training partner, or be sure the pool has a lifeguard.
5. Be certain to work at an intensity that is right for you. Measure your exercise intensity through the "talk test." If you can maintain a conversation while exercising, then the intensity is fine. You can also monitor exercise intensity through the rating of perceived exertion or how hard you feel you are working while exercising.
6. If you use an outdoor pool in the winter, be sure to cover yourself when leaving the pool to avoid excessive loss of body heat.
7. It could be useful to take classes in CPR and basic first aid, including what to do for a drowning victim.
8. If you are participating in group water exercise, be certain the instructor is certified by a reputable organization.

Considerations for Pre-Natal Participants

Water is a wonderful choice for the expectant mother because the water supports the mother and the the weight of the fetus, taking stress off the mother's lower back and allowing for better posture alignment. Some tips for prenatal participants are:

1. Wear supportive swimwear and jog bra for protection from chafing.
2. Avoid cold water and/or airflow which may stimulate nipple erection and hormone changes.
3. Concentrate on muscle strengthening.
4. Limit the range of motion during hip extension/flexion moves to avoid stress on the broad and/or round ligaments.
5. Limit rebound moves and quick changes in direction.
6. Maintain proper body alignment.
7. Vary the muscle groups worked to balance blood shunting and avoid fatigue.
8. Hydrate before, during and after exercise.

Special Medical Considerations

1. Avoid crossing legs midline of the body if there has been a hip replacement.
2. Avoid full leg extensions after ACL knee surgery.
3. Decrease forward speed and stabilize the spine during travel moves if individuals are suffering from back problems as well as avoid using arms overhead and hand held weights.
4. For individuals with a history of shoulder dislocation, limit shoulder external rotation to 20 degrees back behind the body.

Saunas and Hot Tubs

Saunas, hot tubs and hot showers may be appropriate after water exercise when the body has chilled. However, limit such heat exposure after exercise to avoid overheating the body. Saunas, steam rooms and hot tubs are not recommended for individuals with high blood pressure, those on medications, or pregnant women.

Hydration

The principles of hydration apply in water as they do on land. People often erroneously think if they exercise in water, they don't need to drink water. Also, since heat stress is not as much a factor in water, thirst may not be stimulated in the same way it is during land classes. Moisture is lost through sweat and respiration; and as these factors increase during water exercise, the body must be hydrated to avoid fatigue. Bring a water bottle when you exercise and drink periodically.

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Getting Started

For many of us, our participation in exercise has been limited to gym class in high school with no further activity in adulthood. Others may have participated in a sport or physical activity at one time in life and then decreased their intensity, duration and time of involvement to nothing at all. Perhaps it was due to an illness, accident, being too busy, or simply being so caught up in the circumstances and stresses of life, that participation in a physical activity just could not be squeezed in. We are living longer lives now that science has eradicated many infectious diseases or created vaccinations against them. Increased longevity brings higher health risk and costs.

it's up to us to incorporate exercise, good nutrition, stress reduction techniques and other health practices for fitness into our lives for further prevention and cost reduction. The fastest growing population today is comprised of persons over age 65. Whatever your age, health condition, or relationship to exercise, it's never too late to begin. The physiological and psychological benefits derived from a well-balanced exercise program will far outweigh the difficulty in getting started. Whether a person is beginning an exercise program for the first time, starting all over after a layoff, or is young or old, there are basic tips and guidelines to be followed.

1. Always consult your physician before starting an exercise program. Your doctor should determine if there are any health conditions that will exclude certain types of exercises. Often, hidden health problems, such as hypertension, aren't discovered until you have a physical examination.
2. Look at your schedule realistically. How many days are you willing to commit to an exercise program? How long per workout? Then write those workout times into your schedule. People often make the mistake of thinking they're going to exercise every day, only to be discouraged and disappointed when they miss a day. More is not necessarily better. The keys to developing a lifetime habit of regular exercise are slow progression, consistency and regularity.
3. Identify any other obstacles which may prevent you from exercising and find ways in which you might work around them.
4. Select an activity that you enjoy. One that you feel you will participate in on a regular basis throughout your life. Selecting a variety of activities helps to prevent boredom and can give added health benefits for mind and body.
5. Develop an exercise contract with yourself. Sign it, date it and have it witnessed.
6. Keep a complete exercise log. Include activity performed, date, time of day, duration of activity and how you felt upon completion.
7. Be sure to include these five components in your physical fitness routine:
   • Warm-up
   • Cardiovascular conditioning
   • Cool-down
   • Strength training
   • Flexibility and range of motion exercises

   Often in a person's excitement to begin a particular form of exercise, one or more of these areas may be neglected. In order to achieve maximum value from an exercise program all five of these components must be included.

8. Set realistic goals. If you select walking as your activity, start out with 10 minutes per day, three times a week. Gradually add five more minutes each week. If you choose to lose weight, create a 500 calorie deficit per day, decreasing your caloric intake by 250 calories and increasing your activity level. This will allow you to safely lose 1/2 to one pound per week. don't expect to lose 35 lbs. in two weeks. Safe weight loss takes time.
9. Exercise with a friend. Friends help to motivate each other and maintain regularity in exercise participation.
10. If you like to exercise on your own, use music, or books on tape for motivation by wearing a portable stereo unit.
11. Reward yourself after participating in an activity for a certain number of days. This could be a trip, movie, new outfit, etc.
12. Learn the benefits of exercise by:
    • Talking to fitness instructors, personal trainers, or fitness practitioners.
    • Joining a health club.
    • Consulting with a certified dietician.
    • Reading health and fitness magazines and books.
    • Watching fitness videos and exercise programs on TV. Be aware of who is writing the article or book or leading the taped program. Make sure they have a background and credentials in health and fitness.
13. Once an exercise routine is established, talk with a trained fitness professional to make sure that you are:
    • Warming up properly.
    • Properly executing each exercise for positive effect and injury prevention.
    • Using proper breathing techniques during exercise.
    • Using the equipment correctly.
    • Cooling down properly after exercising.

To avoid injuries and reduce the symptoms of overtraining (e.g., illness, tendinitis, severe muscle soreness) include rest days in your workout schedule. After a hard workout the body needs a period of time to recuperate and grow stronger. Scheduling rest days will not take anything away from your progress. Rather, rest days allow your body to function and make more efficient and rapid progress. You might feel stiff or sore when first starting out but you should never feel pain. Pain signals the body that something is wrong. If you feel pain or become overexhausted while training consult with your physician.

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Exercise While Traveling

Traveling can be demanding on the muscles of your body. When sitting or standing for prolonged periods of time it is important to perform simple exercises in order to increase circulation and maintain flexibility. The following is a list of exercises that can be performed while maintaining proper posture and breathing techniques. It is strongly recommended to check with your physician prior to participating in any form of exercise.

Tension and Stress Reducers for the Neck and Upper Back

Maintain good posture and alignment by sitting tall, ribcage lifted, shoulders back but relaxed, pelvis in neutral alignment and the head in a natural extension of the spine. Breathe naturally, inhaling and exhaling through the nose and the mouth.

1. When sitting or standing, slowly tilt head towards the right shoulder leading with the right ear. The action will be as if you are placing your right ear close to your right shoulder. Hold this position for 3-5 seconds, then slowly tilt head toward the left shoulder and hold. Repeat a few times to both sides.
2. Lift shoulders to ears (shoulder shrug) and lower to starting position. Perform 5 repetitions. Repeat each repetition slowly and with control.
3. Sitting or standing tall, turn head slowly to right side, looking over right shoulder. Turn head and neck as far as it feels comfortable. Hold 3-5 seconds, then slowly turn head to left side, looking as far over left shoulder as possible. Repeat a few times to each side, moving slowly and with control.
4. Round shoulders forward then press them back squeezing your shoulder blades together. Repeat, moving slowly and with control. Exhale your air when you round your shoulders forward and inhale when you press your shoulders back, lifting the chest, and sitting tall at the same time. Repeat at a slow to moderate pace 5 times. Then gently rotate shoulders front, up, back and down; repeat 5 times.
5. Give yourself a big hug; hold; then slowly open your arms out to the side; hold. Repeat 5 times, exhaling on the hug and inhaling as your arms open to the side. While performing this exercise tell yourself to relax your shoulders and upper back, and focus on deep breathing.
6. Reach both arms to the front of your body and interlace the fingers. With arms reaching to the front, relax your shoulders, let the head lower naturally downward as your eyes focus between your arms. Relax into this upper back stretch and maintain steady rhythmic breathing.

Abdominal and Buttock Exercises

1. Sitting tall, contract abdominals with a slow 4-count contraction and a 4-count release phase. When the abdominals are contracted your lower back has a tendency to flatten or slightly round into the lower back of the chair (if standing, your lower back will feel as if it is flat with no lumbar arch). Repeat at least 5 times.
2. Sitting or standing tall, contract your buttocks slowly to a 4-count contraction. Then slowly release on 4 counts. Repeat at least 5 times.
3. When sitting, roll and transfer weight to right hip and buttock as you lift the left hip off the seat. Roll to left hip transferring your weight as you lift your right hip off the seat. Perform slowly and with control in a easy rolling side-to-side fashion. don't perform this exercise if you have a spinal injury! Consult with your physician.

Lower Body Exercises

1. While sitting or standing tall, with abdominals held in for good postural support, march in place 8 counts, then march your legs and feet apart 8 counts and march them together 8 counts. Let arms swing freely at sides. Repeat 2-4 times.
2. While sitting tall, tap right foot 4 times, tap left foot 4 times. Then tap right foot 2 times, switch, tap left foot 2 times. Alternate toe taps right and left 8 counts. Repeat. Tap right heel 4 times, tap left heel 4 times, tap right 2 times, tap left 2 times. Alternate heel taps right and left 8 counts.
3. While sitting, lift right foot. Slowly point and then flex right foot to stretch shin and calf. Repeat on left foot. Slowly rotate right ankle in a clockwise direction then slowly reverse direction. Repeat on left ankle. Helps to relieve fluid retention and stiffness in joint.
4. Bring right knee into chest, stretching buttock and lower back. Hold. Release, then repeat stretch by bringing left knee to chest.

Hand and Wrist Exercises

1. Open and close your hands, stretching fingers as far as they can comfortably open, then close, forming a fist. Perform with slow-to-moderate speed. Repeat as often as you wish. This exercise helps to relieve fluid build-up and stiffness within the joint of the fingers.
2. Rotate wrists, circling inward, then outward. Flex and extend at the wrist by stretching fingers up to the ceiling then down to the floor. Repeat as often as you wish.

These are a few exercises to get you started on a safe and healthy trip. Have fun!

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Circuit Training

Circuit training has been practiced for many years in the weight training room to maximize equipment usage and minimize workout time. Traditionally this method allowed participants to move from one piece of weight equipment to the next, performing one set of 8 to 12 repetitions at each station. It served as an excellent way to accommodate a large number of people in the gym for an efficient strength training session. This original concept has now been expanded to include workout formats that can also be done in the aerobic room and, in addition, can include cardiovascular and flexibility activities.

Today, circuit training involves a series of work segments or stations followed in a consecutive sequence. Participants perform exercises for a predetermined length of time, moving from segment to segment or station to station until all exercises have been completed at least once. Popular in-home circuit training equipment includes hand-held weights, elastic tubing, step platforms, jump ropes and stationary cardiovascular machines and equipment. There are also many videos available on the market that demonstrate a circuit training style of workout. For the time conscious exerciser (and who isn’t) a strength and cardiovascular circuit program can provide a way to maintain a fit body in a minimal amount of workout time. Circuit training is also a great way for the novice exerciser to train in shorter bouts of aerobic activities, which may be less threatening than trying to complete 20 to 45 minutes nonstop. And, in order to keep exercise stimulating, circuit training allows you to vary what you do from segment to segment every few workouts.

Research has shown that circuit training can provide significant improvements in muscular strength and cardiovascular endurance as well as positive effects on body composition. Investigators have found up to a 22% increase in muscular strength, 17% improvement in aerobic capacity and as much as 3.2% decrease in body fat (Blair, S., Kohl, H., et al. 1989. "Physical fitness and all-cause mortality: a prospective study of healthy men and women." JAMA, 262:2395-2401.)

Circuit Formats and Sequence Design

Today’s circuits can be designed to meet individual training goals and fitness levels. There are three main circuit formats, each of which should include appropriate pre-and post-training flexibility work.

1. All Strength Circuit: This type of circuit focuses on increasing muscular strength and endurance and improving your ratio of lean body tissue to fat tissue, thus aiding in long-term weight control.

   It should include at least one exercise for each major body part and corresponding muscle group: back (latissimus dorsi, trapezius, and spinal erectors), chest (pectoral group), shoulders (deltoids), arms (biceps and triceps), abdominals (rectus abdominus and obliques), hips and buttocks (gluteus, abductors and adductors), legs (quadriceps, hamstring and gastrocnemius). You will need some form of resistance that can be increased for stronger muscle groups and progress with your developing strength gains. This circuit is best suited for the weight room.

   Sequence Design: 5 to 15 segments or stations with one minute per exercise and 15 to 30 seconds rest between stations (stretching of exercised muscles during rest is recommended).

2. All Cardio Circuit: This type of circuit focuses on cardiovascular conditioning and maximum calorie usage (aerobic activity utilizes the highest amount of calories during a given workout period).

   It should involve at least two different types of aerobic activity utilizing large muscle groups over an extended period of time, elevating the heart rate to a training level of between 55% to 85% of your maximum heart rate (220 minus your age). All cardio circuit training allows participants to exercise longer with less stress to the joints due to the variety in activities. Research shows that cross-training of aerobic activities greatly reduces overuse injuries.

   Sequence Design: 5 to 15 segments or stations with two to five minutes per activity; no rest between segments.

3. Strength and Cardio Circuit: This type of circuit focuses on both strength increases and cardiovascular conditioning, helping to improve your overall fitness level.

   It can be performed in an alternating fashion with every cardio segment followed by a strength segment (or vice versa); or you can complete all of the cardio segments followed by all of the strength segments (or vice versa). You may also choose to focus more on cardiovascular conditioning by lengthening the time spent during the cardio segments, or focus more on strength by completing two to three sets of each strength segment prior to performing a cardio segment. It is this change in sequence design that can create tremendous variety within each workout, helping you to avoid training plateaus as well as to keep your interest and motivation levels high.

   Sequence Design: 6 strength and 6 cardio segments or stations with 2 minutes per strength and 2 minutes per cardio activity; alternate between strength and cardio segments; no rest period between segments.

For Maximum Results

• Before beginning a program, check with your physician for medical clearance
• Use a strength training resistance that fatigues the muscle group between 8 and 12 repetitions
• Select at least one strength exercise for each major body part
• Perform your aerobic conditioning between 55% and 85% of your estimated maximum heart rate intensity (220 minus your age).
• Learn proper weight training and aerobic techniques from a fitness professional

Circuit Training Program Example

Exercise	Duration
Warm Up	10 - 15 minutes
6 Cardio Segments	2 minutes
6 Strength Segments	2 minutes
Total Circuit Time	24 minutes
Cool-down Stretches	10 minutes

Segment or Station Activity Suggestions

Strength: Most of the exercises below can be performed with elastic tubing or hand-held weights.

Body Segment	Exercises
Chest	push-ups, chest press, dumbbell flys, cable flys*
Back	rows, chin-ups*, lat pull-downs*, prone back extension
Shoulders	arm raises, upright rows, overhead press, front press
Arms	biceps curl, triceps extension
Abdominal	abdominal curl, oblique curl, stabilization exercises
Hip & Buttocks	lunges, squats, side leg lifts, rear leg extension
Legs	leg press*, hamstring curl, knee extension, calf raises

*needs weight room equipment

Cardio

High or low-impact aerobics, jogging in place, step aerobics, slide aerobics, jump rope, stationary cycle, stair climber, treadmill, riders and gliders.

Sample Circuit Set-up: This circuit plan includes six cardiovascular (CV) and six muscle strengthening stations. These could include equipment such as steps, mini-tramps, jump-ropes, slides, weights, tubes and mats.

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Deep Water Exercise for Health and Fitness

Deep water provides a unique resistive environment in which you can improve fitness while completely "suspended," eliminating joint impact. Your abdominal muscles work constantly to balance your body as you exercise with complete freedom of movement, working through full range of motion. Water currents provide a cool, relaxing body massage. To train your muscles, it's easy to capture the resistance "on demand" by simply adding effort and pushing harder through the water. The harder you push, the harder the water pushes back. And, by slowing down or stopping, you can immediately rest. You're in control!

Benefits of Deep Water Training

• It's a private workout because only your head is exposed.
• Speed is used to regulate resistance, so go at your own pace.
• Your arms and legs work constantly through a giant liquid weight machine.
• Rest is easy - simply slow down, float through the moves or stop to take a break.
• Water pressure decreases swelling and blood pooling in arms and legs.
• Muscles that control inhalation become stronger as you inflate the lungs against water pressure.
• During water exercise, cardiac volume increases 27%-30%, stretching the myocardium (heart muscle) which can then contract with greater strength.
• Stroke volume (amount of blood pumped with each contraction) increases about 35%, making your heart more efficient.
• Circulation and blood supply to muscles increase, improving oxygen delivery to muscles.
• You'll feel less muscle soreness after water exercise, compared to land exercise.
• Water exercise constantly trains your stabilizers (abdominals, obliques and the lower back) by adding resistance against your postural muscles. Your abs get to work all the time!

Deep Water Training Results

Research indicates that regular participants:

• Improve cardiorespiratory and muscular endurance
• Increase range of motion
• Lose body fat and gain muscle

A study by Michaud, et al. (1996) showed deep water runners improved their running time when measured on land. Without the pounding stress, you can train in the water to be a better runner or walker on land.

Deep Water Precautions

To participate in a deep water program, you should feel safe in deep water and be able to perform basic personal recovery skills. Work with a swim instructor to brush up on, or learn, deep water safety. Always train under the supervision of a qualified lifeguard or in the company of an experienced swimmer who can provide assistance if necessary.

Equipment for Buoyancy, Balance, Resistance and Travel

Proper buoyancy in deep water is a must. A buoyancy belt, worn around the waist for support, can help you to achieve this state. The amount and type of buoyancy needed by each person in deep water depends on bone density and body fat.

To check your buoyancy belt, relax and "hang in the water vertically." Your shoulders should be above the surface of the water so you don't submerge when you exhale.

• If you struggle to stay afloat, add more buoyancy by using a thicker belt.
• If you float too much, decrease the buoyancy by using a smaller or thinner belt.

Always check the belt's manufacturer instructions for safe tips on using the equipment. You will also need webbed gloves for balance, resistance and travel. Webbed gloves make your hands more efficient and effective for balance and make it easier to move through the water faster. The intensity for upper body resistance can be adjusted by opening or closing the webbed gloves.

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Sample Exercises for Fun

Take the plunge and start slowly to build your strength. Then increase the intensity and time you perform the exercises. The Vibrant Health and Wellness Foundation develop individual and group programs.

Interval Training

If you are familiar with interval training, you probably picture athletes training at a grueling pace. However, conditioned as well deconditioned individuals have used interval training to enhance their physical conditioning and performance. It remains an important part of an athlete’s overall conditioning programs well as an individual going through cardio rehabilitation. Interval training involves the alternation of high and low intensity cardiovascular exercise, in specific timed ratios to improve your cardiovascular system and athletic abilities. Think of it as adding peaks and valleys to a workout.

Some may question the relevance of adding interval training to the program of the general fitness enthusiast or less fit individual. However, it is well documented that the body responds to interval training in a different way than it does to continuous training. This is not to say that one type of training is "better" or should be used instead of the other. Both protocols can make important contributions to your aerobic fitness. The effects of an interval program are similar to many experiences in everyday life. Natural intervals occur when ever we encounter a hill during a walk or run. If you play recreational sports you probably experience the need for these bursts of intensity. If you have ever been late for a flight and had to rush through an airport while carrying luggage, you have probably felt the peaks and valleys of life’s "interval" demands.

As you can see, all active people can benefit from interval training. Today interval training is successfully improving the fitness level of a broader range of participants. If used properly, it can be an excellent way to maximize and increase the benefits of aerobic training.

Interval training benefits include:

1. Improved cardiorespiratory fitness
2. Increased caloric expenditure per exercise session
3. Increased ability to work harder and longer during aerobic activities
4. A new challenge for the exerciser who has been participating in continuous aerobic training
5. An effective way for new exercisers to increase their abilities to perform continuous training by challenging the anaerobic process.
6. Adds variety to cardiovascular training
7. Decrease in workout time

Interval training increases your ability to work harder and longer during cardiovascular activities (aerobic capacity). The ultimate goal of interval training is to challenge both the aerobic and anaerobic systems. It is important to understand that the aerobic system is what we use when performing continuous or steady state training. In this type of training, sufficient oxygen can be supplied to meet the demand of the working muscles so you can keep the activity going for extended periods of time; when you are working at these intensities you are training aerobically. However, as the exercise intensity is increased to the point that oxygen demands can no longer be met by the aerobic system, your anaerobic system contributes to the energy requirements of the activity (this is only possible for a short period of time from 30 to 90 seconds).

To be considered true interval training, it must include a work effort of high intensity followed by a recovery period of low intensity or complete rest. Both bouts combine to make up what is called an interval cycle. The high intensity work effort should be performed above 85% of your estimated maximum heart rate (220 minus your age), while the low intensity recovery period needs to bring your heart rate to below 60% maximum or lower than typical continuous training levels (continuous training refers to aerobic work that you can comfortably perform for at least five minutes).

An interval workout will focus exclusively on aerobic and anaerobic cardiovascular training, not to be confused with circuit training, which involves a variety of exercise bouts that may include cardiovascular, strength training and flexibility work. Interval training ratios of work to recovery will vary depending on the fitness level and conditioning goal of the participant. More recent programs have also included a broader range of intensity options in order to accommodate less fit participants. Keep in mind that it is recommended to obtain a physician’s medical clearance when entering a program that includes higher than previously performed intensities.

Traditional Interval Training

In traditional interval training, the work to recovery bouts can be performed in a 1 to 3, 1 to 2 or 1 to 1 ratio. Based on the fact that we can only perform truly high intensity anaerobic work for 30 to 90 seconds, a 1 to 3 ratio would be 30 to 90 seconds of work followed by 90 to 270 (4 1/2 minutes) of recovery; 1 to 2 ratio would be 30 to 90 seconds of work followed by 60 to 180 seconds (2 minutes) of recovery; and 1 to 1 ratio would be 30 to 90 seconds of work followed by 30 to 90 seconds of recovery.

The less the ratio difference the more challenging the workout will be. It is suggested that the work effort be performed at or above 85% of your estimated maximum heart rate. This should make you feel breathless by the end of the 30 to 90 seconds. Conversely you need to make sure that the recovery period is long enough and of a low enough intensity to allow you to be at or below 60% max. This should make you feel comfortable enough to talk while moving continuously. The ratio you choose will often depend on your ability to recover to comfort prior to the next cycle. You can also modify these recommendations by beginning with a less structured form of speed play or shorter bursts of high intensity work, maintained for the duration that feels right. This is a great way to introduce high intensity training into a new exercise program.

Fitness Interval Conditioning

In order to accommodate a wider base of participants a less demanding aerobic fitness interval program is suggested. During such an aerobic interval, you a.) work slightly harder than you would normally during your continuous aerobic training, maintaining this level for 3 to 5 minutes; and then, b.) work at a slightly less than normal continuous aerobic training level for the same duration of 3 to 5 minutes. By conditioning with these moderate bouts of intensity, the less fit individual would feel less overwhelmed and progress sensibly to training in the higher energy system.

For maximum results:

• Use electronic heart rate monitor (or check carotid pulse frequently)
• Start by adding 1 or 2 cycles within your continuous training program, progressively performing more
• Make sure you fully recover before repeating a work effort
• Vary the activities or movements you use during high intensity work, to reduce over stress injuries
• Check with physician before starting an interval training program
• Be sure to engage in a resistance training program
• The use of distance or time may be helpful in measuring short work intervals

Interval Training Program Example

Rythmic warm-up and stretch	10 minutes
Intervals	5 cycles
Ratio	1 to 3
Duration	1 minute work / 3 minutes recovery
Total Interval Workout Time	20 minutes
Cool-down Stretches	10 minutes

Activities that lend themselves to interval work

• fitness walking
• running*
• high-impact aerobics*
• stair climbing
• stationary cycling
• step aerobics*
• lap swimming
• rope jumping*
• slide aerobics

*Involves high-impact forces that increase risk of injury for some participants.

Copyright 2009, Vibrant Health and Wellness Foundation (VHWF). The Vibrant Health and Wellness Foundation is a project of Congressional District Programs, a 501(c)(3) public charity.
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