Note: The Figures and/or Tables mentioned in this Sample Chapter do not appear on the web.
Exercise and Fitness
Lack of exercise is a serious public health problem in the United States, contributing to chronic disease and premature death. Regular physical exercise is one of the most important steps you can take to protect your health and live longer. Each year, millions of Americans experience health problems that could have been prevented or relieved through regular physical activity.
The benefits of exercise are numerous and affect virtually every part of your body. One important benefit is that exercise can reduce your risk of developing certain common chronic diseases. For example, regular physical activity has been proven to reduce the risk of premature death from heart disease by preventing its development. Regular daily exercise can make your heart stronger, improve blood flow through the arteries that lead to your heart, and lower the level of cholesterol (see page 89) in your blood.
Exercise also lowers your risk of developing diabetes, high blood pressure, and colon cancer, and helps to reduce blood pressure in people who have high blood pressure. Exercise helps build and maintain healthy bones, muscles, and joints and prevents back pain by increasing your strength and flexibility and improving your posture. Physical activity also helps to decrease your percentage of body fat by preserving muscle mass. Exercise helps you lose weight and maintain your loss; this is another way exercise helps you stay healthy and live longer. It can help curb your appetite, and it burns a large number of calories. Regular exercise also helps you sleep better.
The health benefits you gain from exercise are not only physical, they are also psychological. Exercise promotes your sense of well-being by diminishing feelings of depression and anxiety. A good workout also can help you better manage the stress in your life (see page 118). When you stick to a regular exercise regimen you gain a sense of accomplishment that boosts your self-esteem. Also, because physical activity helps you control your weight and look fit, you will feel better about the way you look.
Regular exercise is extremely important for older men because it can increase the strength of muscles, bones, and joints significantly, which helps to prevent falls (see page 36), a major cause of disability in older adults. Even if you have been inactive for some time, your strength will improve with exercise, especially strength-conditioning exercises (see next page). Maintaining or improving your strength and flexibility will help you to better perform daily tasks so you can continue to live on your own and maintain a high quality of life as you get older.
While a small amount of exercise is better for you than none at all, the more you exercise, the more you will benefit. Once you start exercising regularly, your capacity for exercise will increase. That means that you will be able to exercise longer and more efficiently. If you have been inactive for some time, start with a 30-minute walk each evening before dinner and work gradually up to an hour or longer. If your doctor approves, gradually work your way up to a slow jog, and then a run. The more you work your heart muscle, the more efficiently it will pump, and the more health benefits you will gain-- for both your body and your mind. Work with your doctor to find the best type of exercise regimen for your own personal health profile.
The Different Types of Exercise There are different types of exercise, and each type has different effects on your body. Some types of exercise improve flexibility and muscle strength. Others use the large muscles in your body to build heart strength. Still others increase endurance. Exercises fall into three categories-- aerobic, strength conditioning, and flexibility. Which type is best for you? Ideally, you should include all three types of exercise to achieve a complete fitness program but, if you have time for only one, aerobic exercises provide the most health benefits.
Aerobic Exercises Aerobic exercises are any type of activity that uses oxygen to fuel your muscles. When you engage in aerobic exercises, your muscles and joints send messages to your brain, which stimulates your heart to beat faster and your breathing rate to increase so you take in more oxygen. Because aerobic exercises make your heart work harder, they improve the heart's ability to pump, even when you are at rest.
Any exercise that repetitively uses the large muscles of your arms and legs for a sustained period of time can be aerobic. Aerobic exercises are sometimes called endurance-training exercises because they make your muscles able to sustain the activity for longer and longer periods as they build muscle strength. Examples of aerobic exercises include brisk walking, running, jumping rope, bicycling or stationary cycling, swimming, stair climbing, rowing, and cross-country skiing. Sports that involve continuous running, such as basketball and soccer, also are aerobic exercises.
Regular aerobic exercises are a great way to burn calories and help control your weight. They also lower the proportion of fat on your body and increase the proportion of muscle. Men who maintain a healthy weight are less likely to develop diabetes and other chronic health problems that have been linked to obesity and being overweight.
For optimal health, doctors recommend engaging in aerobic exercises for at least 30 minutes every day. But you don't need to exercise for one 30-minute period. Three 10-minute sessions are just as effective and provide the same health benefits as 30 minutes of sustained exercise. Breaking up your exercise periods may make it easier for you to fit them into your daily activities. When you exercise, you should strive to reach a heart rate that is 50 to 80 percent of the maximum heart rate for your age. This rate is called your target heart rate (see page 12). If your heart rate does not fall within this range, adjust your activity level so it will increase or decrease your heart rate until it falls within the recommended range.
Don't forget to warm up for 5 minutes before every exercise session and to cool down afterward (see page 14). Start by stretching the muscles and joints in your spine, arms, and legs. Then begin moving your body repetitively by walking or slowly jogging or biking to elevate your heart rate slightly in preparation for your more intense activity. Warm-up and cool-down exercises can help prevent injury to muscles and joints.
Be aware that, if you don't keep doing your aerobic exercises, the hard-won health benefits you have worked for will not stay with you for very long. To remain at the healthier level you have attained, you must stick with your exercise program, whether it involves running, stair climbing, swimming, biking, or simply brisk walking.
Strength-Conditioning Exercises Strength-conditioning exercises complement aerobic exercises by building muscular strength. Weight training, using either free weights or weight machines, is an efficient way to strengthen your muscles, but sit-ups, push-ups, and leg lifts accomplish the same goal. Strength-conditioning exercises are sometimes called resistance exercises because they force your muscles to work against, or resist, an object, such as a 5-pound weight.
You don't have to join a health club or buy an expensive weight-training machine to reap the benefits of strength conditioning. For example, simply add some push-ups and sit-ups to your exercise routine, or do some leg lifts on the floor while you are watching television. You can also purchase inexpensive hand weights in various sizes. Take a pair of 3-pound weights with you when you walk or jog to increase your level of exercise intensity. Use 5-or 10-pound weights to exercise the biceps and triceps muscles in your upper arms. Start with the heaviest weight that allows you to perform six to eight repetitions without stopping-- even if it is only a 1-pound weight-- and gradually work your way up to heavier weights. (Lighter weights will increase your endurance but not your strength.) Continue using the weights until you can repeat a set of six to eight lifts two or three times without stopping. Rest between sets of repetitions.
Men who are experienced weight trainers might find it helpful to seek advice from an exercise physiologist or a doctor who specializes in sports medicine when planning a new exercise routine or training for an upcoming athletic event. Remember that anabolic steroids (see page 14) are prescription drugs that may build muscle mass but also lead to serious health problems, including abnormal breast development in men, baldness, shrinking of the testicles, and a reduced sperm count, and therefore should not be used.
Even if you are older-- in your 80s or 90s-- weight training will increase your muscular strength. This type of exercise can help you to perform daily tasks, such as lifting grocery or trash bags, that often become more difficult as you get older. Strength conditioning can mean the difference between leading an independent life and relying on friends, family, or healthcare workers to meet everyday needs.
Flexibility Exercises As you age, your ability to move your muscles and joints through their full range of motion diminishes. ''Use it or lose it'' is the principle that applies here. You may not be able to blame the stiffness you feel after sitting for long periods solely on arthritis. As it becomes more difficult to move about, you will probably want to move even less. Such immobility can threaten your ability to perform everyday tasks. Flexibility exercises such as stretching can help you to maintain the ability to move your muscles and joints easily. Stretching also protects your muscles from the normal wear and tear of both exercise and your daily routine.
Some men are more flexible than other men, and certain joints in your body may have more flexibility than other joints. But whatever your individual differences may be, you can increase your overall flexibility through stretching. Make stretching a regular part of your warm-up and your cool-down routines (see page 14). The muscle cramping or pain that can occur after vigorous exercise, especially when you are just beginning to exercise after having been inactive or have been overexercising, can often be relieved by doing stretching exercises.
The most important muscles to stretch include the hamstring (rear thigh), lower back, and shoulder muscles. When you are stretching, keep the following tips in mind. First, do not stretch to the point at which you feel discomfort or pain. Stay within a comfortable range; any discomfort is a signal that you have stretched too far. Second, stretch slowly and smoothly, and never bounce or make jerking movements. Third, sustain the stretch. Pause for 10 to 20 seconds when you have reached a full stretch, and hold the position so your muscles and joints have enough time to benefit from the stretch.
Ask the Doctor
Q. I'm disabled and confined to a wheelchair. Are there any activities I can do to get the benefits of aerobic exercise?
A. Men with a disability are less likely to engage in physical activity than men who are not physically challenged, but they have the same need for exercise. Remember that physical activity doesn't have to be strenuous to achieve health benefits. You can attain significant benefits with moderate, daily activity. First, you should consult your doctor before beginning an exercise program. Ask him or her if it would be safe for you to spend 30 to 40 minutes each day wheeling yourself in your wheelchair through a shopping mall. Wheelchair basketball is another option that would provide excellent exercise and would vary your routine. You can also lift hand weights and do stretching exercises with your arms to build upper-body strength and flexibility. Check with a local YMCA or community center to see what exercise programs may be available for people who are physically challenged.
Your Personal Exercise Program You will be more successful if you develop a complete, personal exercise program, rather than just becoming more active in general. If you are over age 40, remember to check with your doctor before starting any exercise program, especially if you have been inactive, or if you already have a health problem. Start slowly with an easy activity that you enjoy, such as walking. Walk for as long as you feel comfortable. Gradually increase the distance you walk, and walk at a faster pace as you get used to exercising. Try to exercise for at least 30 minutes every day. Other good aerobic activities are swimming, stair climbing, jogging, biking, and cross-country skiing. The best way to make sure you will stick with your exercise program is to choose an activity you enjoy.
Varying your weekly exercise program by including two or three different aerobic activities-- for example, walking or jogging 3 days a week, swimming 2 days a week, and biking 1 day a week-- will help to keep your routine interesting. This concept is called cross-training, and it is a good way to prevent boredom. Cross-training also helps give your entire body a workout.
In addition to aerobic exercises, work some weight training into your routine to build muscle strength. Do push-ups and sit-ups or use hand weights to perform repetitive sets of lifting exercises. Increase your flexibility by stretching your arms, legs, and lower back before and after your aerobic workout (see page 58).
The time of day you choose to exercise can be important. There is some evidence that exercise workouts are more productive when your body temperature is highest, which is usually in the late afternoon. At this time, your muscles are more flexible and your resting heart rate and blood pressure are both low. Of course, if your schedule does not allow you to exercise late in the day, or if you already have an established exercise time and are happy with it, do not switch to an afternoon workout. Exercising at any time of the day is better than being inactive.
Some men may think of exercise as something to do only when they need to lose a few pounds. But regular physical activity should be a permanent part of every man's lifestyle. The health benefits you gain (see page 55) won't last unless you exercise regularly. Here are some easy ways to incorporate physical activity into your daily routine:
- Make time for exercise every day. Get up half an hour earlier in the morning to work out. Better yet, watch television half an hour less each day and spend the time exercising.
- Work exercise into your usual routine. Stop using the elevator at work; take the stairs instead. Park a few blocks away from work or from the store and walk the extra distance. Take the dog for a nightly walk. Push the baby in a stroller or pull your children in a wagon or on a sled for half an hour every day.
- Exercise with a friend or family member. Working out with someone is a good strategy because you can motivate each other.
- Exercise while doing other things. Lift hand weights while you are talking on the phone. Do some sit-ups or leg lifts or ride a stationary bicycle while you are watching television.
- Break up your exercise time. Exercise for three 10-minute periods throughout the day instead of one long session. The exercise benefits will remain the same.
- Draw up an exercise contract. Write down weekly fitness goals and sign the contract. Then have a friend or family member witness it.
Don't forget to warm up before exercising and to cool down afterward (see page 14). And remember, you are making a change for the long term. Once exercise becomes a permanent part of your daily routine, it will cease being an effort. And you will feel better and look better-- two of the best motivators you can find.
Choosing and Using Athletic Equipment A wide variety of exercise equipment is available for home use, but how do you determine which equipment is best for your needs? Experts say to choose equipment that you are familiar with and comfortable using and to make sure that you will use it regularly before making your purchase. In other words, you have to try it before you buy it. Let's begin with the basics. The most important athletic equipment you can own is appropriate shoes.
There are many different types of shoes for various athletic activities-- run-ning shoes differ from walking shoes, which differ from basketball shoes. Cross-training shoes can be used for more than one activity, such as running and walking. First you need to decide which activity you will most often perform and then shop for an appropriate shoe. Wearing the proper shoe for a particular activity can prevent blisters or injuries such as shin splints and stress fractures (see page 63). When trying on shoes, wear the kind of socks you will be wearing when you exercise to ensure the proper fit. A stable shoe is one that prevents excessive movement of your foot inside the shoe. The insole should be cushioned, and the sole should provide traction while retaining flexibility. Athletic shoes usually have a midsole, which absorbs shock when the foot strikes the ground during walking or running.
The midsole is the layer that will wear out first on any athletic shoe. That is why fitness experts recommend replacing your athletic shoe every 350 to 500 miles of use. If you are heavy, buy new shoes closer to the 350-mile mark. If you walk 15 miles per week, you will have to replace your shoes in 6 to 8 months. Your shoes may not look worn and you may be reluctant to replace your shoes so often, but the price of a good shoe is a small investment when it comes to injury prevention.
Your athletic socks are also important. Appropriate socks can reduce the like-lihood of blisters, toenail injuries, infections, and bone problems. The right socks can also enhance performance. Cotton socks effectively absorb perspiration from your feet, but if you perspire excessively or exercise in the rain, your cotton socks may reach the saturation point. If that happens, your socks will stretch and lose their shape, and your feet will begin to slide around inside your shoes, leading to friction blisters and skin irritation. Socks made of acrylic or other synthetic materials may perform better under ''wet'' conditions. Try wearing different types of socks when you exercise to determine which type of sock works best for each type of activity.
When considering the many different types of exercise machines you can purchase for home use, choose carefully. Remember that exercise equipment does not have to be expensive to be effective; you can use a length of rope to skip rope, and walking requires little more than sturdy shoes. If you are interested in purchasing strength-training machines or equipment that delivers an aerobic workout, here is a short equipment guide:
Treadmill Americans buy more treadmills for home use than any other piece of fitness equipment. The motorized track of a treadmill allows you to walk, jog, or run at a pace you choose. Many treadmills have programmed inclines to simulate the intensity of jogging uphill. Others include resistance levers that give your arms and upper body a workout. If you hold the handrails, you can lower the intensity of your workout.
Stationary Bicycle Stationary bicycles are good for exercising when the weather is bad and, unlike running, have only moderate impact on your knees. You can increase the intensity of your workout by pedaling faster or adjusting the resistance on the wheel. Some models offer movable handlebars for an upper-body workout. To avoid injuring your knees, you should adjust the seat so that your knees are still slightly bent when the pedals are at the lowest point of their cycle.
Stair-Climbing Machine Stair climbing is one of the most intense forms of aerobic exercise you can perform. Stair-climbing machines give you a rhythmic workout that does not put a lot of stress on your knees. You can adjust the resistance for a more intense workout. Be sure to place your entire foot flat on the step to protect your Achilles tendon, which runs from the back of your calf to your heel, from injury. Do not climb using only your toes.
Cross-country Ski Machine Because this type of equipment uses the muscles in both your upper body and lower body, it is an excellent form of exercise that burns plenty of calories. Cross-country ski machines place little stress from impact upon your joints. Some models allow you to raise the front of the machine so that you can simulate uphill skiing for a more intense workout.
Rowing Machine Rowing machines simulate the effort exerted when rowing a boat. Rowing machines work the upper body and the legs. Some rowing machines are electric, while others are manual. You can adjust the resistance to vary the intensity of your workout. Sitting upright as you row will help prevent back strain.
Exercise Rider This type of exercise machine combines the motions of rowing with those of leg presses to provide a total-body workout. You can adjust the resistance to alter the intensity of your workout. Exercise riders provide a more intense workout for men of average fitness than for very fit men.
It is important that before you purchase a piece of exercise equipment for your home, you try it out for 5 to 10 minutes in the store to make sure your lower back and joints feel comfortable. Do you like the ''feel'' of the machine? Does it seem sturdy? Is it noisy? Does it operate smoothly? Are all of the handrails and bars padded? Are the controls easy to use? Ask the salesperson how long it takes to assemble the machine and how much extra features cost. Think about your home and determine whether you have enough room to set up and store the machine. And consider honestly whether you will actually use it.
To purchase good-quality, dependable equipment, be prepared to spend at least a few hundred dollars on each piece. Once you have the equipment, be sure to follow the manufacturer's instructions carefully and use it properly to avoid injury.
