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 Dr. Stephanie Coulter, Center for Women's Heart & Vascular Health
Answering the
Exercise Question
Straight Talk by
Dr. Coulter
from the Center for
Women's Heart &
Vascular Health

 

 

Getting fit in middle age can reduce heart failure risk

American Heart Association
May 2013


Exercise
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Infographic for a healthy heart - Why Exercise and How

Exercise For Life

Exercise Safely All Year

Get tips for cold-weather exercise.

Learn about hydration and hot and humid conditions.

Visit Project Heart, where kids lead the way to heart-healthy exercise.

Exercise can help your body in many ways. Aside from helping you to keep a healthy body weight, exercise increases your mobility, protects against bone loss, reduces your stress levels, and helps you feel better about yourself. And, research has shown that people who exercise are less likely to develop heart disease, high blood pressure, and high cholesterol levels. People of any age or fitness level can benefit from some type of exercise, be it running, walking, ballroom dancing, water aerobics, gardening, or any activity you choose.

Before you start an exercise program

If you have decided to start an exercise program, you are already on your way to a healthier heart and a fitter body. The first step you should take is to see your doctor, especially if you have any of the health risks listed below:

  • You are taking a prescription medicine.
  • You have ever had any kind of heart problem, especially a heart attack.
  • You have diabetes.
  • You have problems with your bones or joints.
  • You have high blood pressure and do not take medicine for it.
  • You have a family history of coronary artery disease.
  • You are a man over 45 or a woman over 50, and you are not used to doing even moderate levels of exercise.
  • You smoke.
  • You are very overweight.

What kind of exercise should I do?

There are 3 categories of exercises: cardiovascular, strength-building, and flexibility.

Cardiovascular exercise is also known as aerobic exercise. Aerobic exercise uses your large muscles and can be continued for long periods. For example, walking, jogging, swimming, and cycling are aerobic activities. These types of exercises drive your body to use oxygen more efficiently and deliver maximum benefits to your heart, lungs, and circulatory system.

Strength-building and flexibility exercises are known as anaerobic exercise. Anaerobic exercise does not have cardiovascular benefits, but it makes your muscles and bones stronger. Strength-building exercises require short, intense effort. Flexibility exercises, which are also anaerobic, tone your muscles through stretching and can prevent muscle and joint problems later in life.

A well-balanced exercise program should include some type of exercise from each category.

In the news . . . April 2013

American Heart Association on the benefits of WalkingWalking can lower risk of heart-related conditions as much as running
"Walking briskly can lower your risk of high blood pressure, high cholesterol and diabetes as much as running can, according to surprising findings reported in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology." Read the full report. [Photo courtesy of AHA]

Cardiovascular Exercise

A simple definition of cardiovascular exercise is any exercise that raises your heart rate to a level where you can still talk, but you start to sweat a little.

At least 20 minutes of cardiovascular exercise 3 or 4 days a week should be enough to maintain a good fitness level. Any movement is good, even house or yard work. But if your goal is to lose weight, you will need to do some form of cardiovascular exercise for 4 or more days a week for 30 to 45 minutes or longer.

The ideal cardiovascular exercise program starts with a 5- to 10-minute warm-up, which includes gentle movements that will slightly increase your heart rate.

Then, slowly move into 20 or more minutes of a cardiovascular exercise of your choice, such as aerobics, jogging on a treadmill, or walking, to reach what is called your target heart rate. (The chart below can help you find your target heart rate zone.) Your target heart rate is a guideline that can help you measure your fitness level before the start of your program and help you keep track of your progress after you begin an exercise program. Target heart rate also lets you know how hard you are exercising. If you are beginning an exercise program, you should aim for the low end of your target heart rate zone. If you exercise regularly, you may want to work out at the high end of the zone.

To stay within your target heart rate zone, you will need to take your pulse every so often as you exercise. You can find your pulse in 2 places: at the base of your thumb on either hand (called the radial pulse), or at the side of your neck (called the carotid pulse). Put your first 2 fingers over your pulse and count the number of beats within a 10-second period. Multiply this number by 6, and you will have the number of heartbeats in a minute. For example, if you counted your pulse to be 20 during the 10-second pulse count, your heart rate would be 120 beats per minute.

Target Heart Rates by Age
Heartbeats per Minute (% of maximum heart rate)

Age

Low (50%)

High (75%)

20

100

150

25

98

146

30

95

143

35

93

139

40

90

135

45

88

131

50

85

128

55

83

124

60

80

120

65

78

116

70

75

113

Note: If you are taking certain medicines, like beta blockers, you may not be able to reach your target heart rate. Remember, always have your doctor's approval before beginning any exercise program.

You never want to begin exercising by immediately reaching your target heart rate, because your muscles and circulatory system need to warm up slowly. Intensify your activity slowly during exercise until you reach your target heart rate. There is no need to exceed your target heart rate during exercise.

End your exercise program with a 5- to 10-minute cool down, which will help to lower your heart rate and prevent your muscles from tightening up.

It's important to stay hydrated (drink enough water) while exercising because you must replenish water lost through sweating (your body's natural cooling system). Exercising in hot and humid weather can be especially challenging; see hydration tips to lessen the risk of heat-related illness. Hydration is just as important during the winter months; see cold-weather exercise.

Strength-Building Exercise

People who lift weights or who use any type of equipment that requires weights are doing strength-building exercise. Strength-building exercise makes your muscles and bones stronger and increases your metabolism. Strength exercises also make your muscles larger. Your muscles use calories for energy even when your body is at rest. So, by increasing your muscle mass, you are burning more calories all of the time. If you strength train regularly, you will find that your body looks leaner and you will lose fat.

Strength-building exercises should be performed 2 to 3 times a week for best results. Always warm up your muscles for 5 to 10 minutes before you begin lifting any type of weight or before performing any resistance exercises.

Find a weight that you can comfortably lift for between 8 and 12 repetitions (reps). Reps are the number of times the exercise is performed. When you can easily do 12 to 15 reps of an exercise, it is time to increase the amount of weight you are lifting.

You should choose exercises that work your legs, arms, chest, back, and stomach. Make sure that each movement is performed in a slow, controlled way. Do not jerk the weights or use too much force.

Also, do not hold your breath during the movements. Remember to breathe out as you lift the weight and breathe in as you lower the weight.

Flexibility Exercises

Flexibility exercises are the most neglected part of a fitness program. Having flexibility can improve your posture, reduce your risk of injury, give you more freedom of movement, and release muscle tension and soreness.

Before you start the stretching phase of your program, always do 5 to 10 minutes of warm-up to loosen your muscles. Stretching cold muscles can lead to injury. Some examples of a warm-up are walking around, marching in place, slowly riding an exercise bike, or lightly jogging. If stretching is part of a longer program that includes a cardiovascular workout, always stretch after the cool-down section of your program. You want to make sure that your heart rate has slowed before you begin the stretching phase.

You should try to do stretching exercises for each muscle group. Each stretch should be done slowly and held for at least 10 to 30 seconds.

Do not bounce while you stretch, because bouncing can injure your muscles. Also, do not over stretch a muscle, because it can cause strain or even a tear. Try not to hold your breath while you stretch. Instead, take long, deep breaths throughout your stretching program.

Choosing the right program

Whether you decide to join a health club or to exercise on your own, you will make exercise a regular part of your life if you like doing it. So try to find one or more activities that you like to do or that give you satisfaction. Remember that exercise does not have to feel like a strenuous workout. Your body benefits from any type of movement. So if running or weight lifting are not for you, think about an activity like tai chi or yoga.

If you decide to join a group exercise program like an aerobics class or water-fitness class, here are some tips for choosing a program:

  • Choose an instructor whom you like and feel comfortable with. You should be able to ask your instructor about any part of the fitness program.
     
  • Find a program that meets your exercise needs and goals. That sounds simple enough, but a lot of people do not have a clear picture of what they hope to gain from exercise. For example, to help you lose weight, you need to burn calories through aerobic activity. But to build muscle, you will need to work specific muscle groups.
     
  • Choose an instructor who can show you how to exercise safely and properly. Your instructor should be able to tell you what muscle groups each exercise works. The instructor should also show the class the different levels in which each exercise can be done, so each person in your class can modify the activity to meet his or her fitness level.
     
  • Choose an instructor who is certified by a nationally recognized certification program.

If you decide that you would like a personal trainer to help you with your exercise program, here are some tips to help you get started:

  • Ask the trainer to give you a list of references. Other clients are one of the best ways to find out if this is the trainer for you.
     
  • Make sure that the trainer has a schedule that works with yours. It is easier to fit exercise into your life if you set aside the same time each day or week for training and for exercise.
     
  • Choose a trainer who is certified by a nationally recognized certification program.

Instructors or personal trainers who are certified by a nationally recognized certification program have special training that helps them meet your needs. To prepare for the certification exam, instructors must learn the fundamentals of anatomy and physiology and know all types of safe and effective exercise. Certified instructors and personal trainers know how to develop an exercise program and can specialize in developing programs for elderly people, pregnant women, and those with disabilities. Certified instructors also know how to perform CPR in an emergency.

Preventing exercise injuries

One of the most important parts of an exercise program is the warm-up, but most people do not take the time to warm up properly.

A warm up increases your body temperature and makes your muscles loose and ready to exercise. Marching in place, walking for a few minutes, doing some jumping jacks, or jogging in place are all ways to get the blood flowing to the muscles and to prepare them for exercise.

These same exercises can and should be done to cool down after you exercise.

Buying good shoes before you begin an exercise program is one of the most important ways to make sure that you do not get hurt. Your shoes not only protect your feet but also give you a cushion for the weight of your whole body. That is why it is so important that your shoes fit properly.

You should go shoe shopping at the end of the day, when your foot is at its largest size. When you try on a shoe, there should be one-half inch between the end of your toe and the end of the shoe, and your foot should not slip or slide around inside.

Your shoes should feel good when you buy them, and they should not need a "breaking-in" period. If you are exercising regularly, you will most likely need to buy new shoes about every 3 to 6 months. Shoes that are used regularly lose the ability to absorb your weight during exercise and may cause injury to your knees and ankles.

If you are new to an exercise program, and you are exercising at a health club or fitness facility, ask for help before you try something new. The staff should be able to show you how to work any exercise equipment that you do not know how to use. Asking for help will stop you from lifting too much weight or from using the wrong posture when you use the machine. This, in turn, leads to fewer injuries.

No matter what exercise you choose, remember to drink enough water before, during, and after to prevent dehydration (see Hydration Tips).

Finally, use your good judgment and stay within your exercise limits. Light exercise performed regularly is always better than one gut-wrenching workout session a week. Your body will tell you if you are pushing it too hard. Pain, dizziness, fainting, a cold sweat, or pale skin are signs to stop. Even professional athletes and coaches will tell you that physical fitness is gained a little at a time.

Remember that exercise is not limited to working out in a health club or jogging around a track. Pushing a lawn mower, putting up storm windows, and vacuuming a rug are all forms of exercise, although they are not cardiovascular exercise. If you do not have a job that requires physical activity, taking the stairs instead of the elevator, parking farther away from your office, or taking a brief walk at lunch are all ways to find fitness during your day.

See also on this site:

Exercise lesson plans in Project HeartProject Heart–Activities for the Classroom has exercise lesson plans and activities for each grade level.

Ask a Texas Heart Institute Doctor

 



See on other sites:

MedlinePlus
www.nlm.nih.gov/medlineplus/fitnessandexercise.html
Fitness and Exercise

American Heart Association 
http://startwalkingnow.org/
Start! "It's more than a program. It's a movement."

Centers for Disease Control and Prevention
www.cdc.gov/nccdphp/dnpa/physical/everyone/index.htm 
Physical Activity for Everyone
 


Updated May 2013
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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