document resume ed 256 769 sp 026 185 title exercise and your heart. · 2014-02-24 · document...

DOCUMENT RESUME

ED 256 769 SP 026 185

TITLE Exercise and Your Heart.INSTITUTION National Heart and Lung Inst. (DHMS /NIH), Bethesda,

MD.REPORT NO NIH-81-1677PUB DATE May 81NOTE 49p.PUB TYPE Guides - Non-Classroom Use (055)

EDRS PRICEDESCRIPTORS

M701/PCO2 Plus Postage.Aerobics; *Cardiovascular System; *Exercise; *HeartRata; *Physical Activities

ABSTRACTThis pamphlet presents information on the effects of

physical activity on the heart and practical guidelines for startingand staying on an exercise program. The following topics arediscussed: (1) the benefits of getting sufficient exercise; (2)possible risks in exercising compared to benefits; (3) when to seekdoctor's advice and prevention of heart attacks; (4) common mythsabout exercise; (5) which exercises condition the heart and lungs;(6) how to start, increase, and maintain an exercise program; and (7)ways to avoid injuries. Two sample exercise programs are outlined andadvice is given on becoming more active throughout the day. (JD)

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from the original document.***********************************************************************

U.E. DEPARTMENT OF EDUCATIONNATIONAL INSTITUTE OF EDUCATION

EDUCATIONAL RESOURCES INFORMATIONCENTER !ERIC'

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BEST COPY AVAILABLE

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EXERCISE AND YOUR HEART

Contents

e

2 Foreword4 Do we get enough exercise from our

daily activities?5 What are the benefits of exercise?9 Can e Kercise reduce my chances of

getting a heart attack?13 Are there any risks in exercising?15 Comparing the benefits and the risks16 Should I consult a doctor before I start?18 What if I've had a heart attack?18 Five common myths about exercise20 Which exercises will condition my heart

and lungs?22 The key to success

How do I begin?24 How do I pace myself?

How often should I exercise?How hard?How long?Is there a top limit?

34 Effective ways to avoid injuries37 Two sample exercise programs41 How do I keep going?42 How can I be more active throughout

my day?42 An exercise prescription for your health

I-...111.11.-

2 National Heart, Lung, and Blood Institute

ForewordFor anyone concerned with the health of the American public, one ofthe most visible and encouraging trends in this country is the growinginterest in physical fitness.

Regular and brisk exercise contributes to good health in many ways.It improves the efficiency of the heart and increases the amount ofoxygen the body can process in a given amount of time. Those whoexercise regularly often lose excess weight and improve musclestrength and stamina. Many also de velop an improved self-imagewhich can lead to further adoption of positive health behavior in-cluding that related to smoking and nutrition.

The booklet, Exercise and Your Heart, provides important and helpfulinformation regarding our knowledge about the suggested relationshipbetween exercise and a healthy heart. At the same time, it offers prac-tical and helpful information, including examples of programguidelines that can safely be adopted in order to enhance the prospectfor individual benefit.

In the 1979 report Healthy People, The Surgeon General's Report onHealth Promotion and Disease Prevention, I applauded the growinginterest in exercise but cautioned that there were still far too manyAmericans who have not been persuaded to engage in regular pro-grams of physical activity. It is my hope and expectation that thisbooklet, prepared by the National Heart, Lung, and Blood Institute,will encourage many more people to become active in such a way asto make tneir lives more healthy and enjoyable.

Julius B. Richmond. M.D.Assistant Secretary for Health andSurgeon General

5

EXERCISE AND YOUR HEART 3

Coronary artery disease is the leading cause of death in the UnitedStates. It is responsible for 640,000 deaths each year, including almostone-third of all deaths in people between the ages of 35 and 64. On theaverage, almost three Americans will suffer a heart attack every minuteof the day, adding up to approximately one and a half million each year.It is easy to see why this disease warrants absolute priority amongthose responsible for health policy and programs. Fortunately, duringthe past decade alone, there has been a 25 percent decline in coronaryartery disease mortality.

Among the factors influencing this dramatic decline are the changes oflifestyle which relate to the risk factors associated with coronary arterydisease. During the past several years, we have witnessed a decline insmoking among adult males and adult females, a decrease incholesterol intake, improvements in the control of high blood pressure,and a growing interest and participation in physical activities. While ex-isting data does not enable us to determine the exact role each is play-ing in the decline in the number of deaths caused by coronary arterydisease, there is little doubt that these trends are very positive indeed.

Although. there are many important questions that we still need toanswer regarding sedentary living and coronary artery disease, we doknow enough to advise that regular exercise is a positive pursuit foranyone trying to keep his or her heart healthy.

Thi.i booklet tries to deal with the range of common questions and con-cerns about exercise and health. We have tried to address these in aprudent and practical manner so that an individual will have enough in-tbrrnation to inake an informed decision about exercise and a healthyheart.

Robert I. Levy, M.D.DirectorNational Heart. Lung. and Blood Institute

6

4 National Heart. Lung. and Blood Institute

Do we get enoughezercise from ourdaily activities?

-A'.11.4,

Most Americans get little vigorous exercise atwork or during leisure hours. Today, only afew jobs such as lumberjacking require vigor-ous, physical activity. People usually ride incars or buses rather than walk, use elevatorsinstead of stairs, and sit at home during theirfree time rather than being physically active.Many people think they are getting enoughexercise from golfing, bowling, or vacuumingthe house. But these activities do not producethe benefits of regular, more vigorousexercise.

There are many ways to get exercise from ac-tivities like swimming, brisk walking, run-ning, or Jumping rope. These kinds of activi-ties are sometimes called "aerobic"meaningthe body uses oxygen to produce the energyneeded for the activity. Nowadays, many peo-ple are rediscovering the benefits of regular,vigorous exercise.

7


What are the benefits These are the benefits often experienced byof exercise? people who exercise regularly.

Feeling Better

Looking Better

Iali- .4Zkik......_

gives you more energyhelps in coping with stressimproves your self-imageincreases resistance to fatiguehelps counter anxiety and depressionhelps you to relax and feel less tenseimproves the ability to fall asleep quicklyand sleep wellprovides an easy way to share an activitywith friends or family and an opportunityto meet new friends

tones your musclesburns off calories to help lose extra poundsor helps you stay at your ideal weighthelps control the appetite

You need to burn off 3,500 calories more thanyou take in to lose 1 pound. If you want tolose weight, regular exercise can help you ineither of two ways.

I


.0 I

First, you can eat your usual amount of calo-ries, but exercise more. For example: A 200 -pound person who keeps on eating the sameamount of calories, but decides to walk brisk-ly each day for 11/2 miles will lose about 14pounds in 1 year. Or second, you can eatfewer calories and exercise more. This is aneven better way to lose weight.


0

A person burns up only a minimal amount ofcalories with daily activities such as sitting.Any physical activity in addition to what younormally do will burn up extra calories.

Below are the average calories spent per hourby a 150-lb person. (A lighter person burnsfewer calories: a heavier person burne more.)Since precise calorie figures are not availablefor most activities, the figures below areaveraged from several sources and show therelative vigor of the activities.

Illicycl0.4 6 mph cals.8147c1thg,12 caipbCroalcO,WittY ?ads..41W0 cals.

cals.cals.

Pala.1:13'r ccaallss.cn 5

.

as

Cab.:400cals.

Walking 21110 cals-17

Walliang 3 mph ads.WalkIng 41/2 mph 440 cals.

3P. The calories spent in a particular activity varyin proportion to one's body weight. For exam-

, ple, for a 100-lb person, reduce the calories by

iTIr 1/3; for a 200-lb person, multiply by 11/2.

Doing Better

Exercising harder or faster for a given activi-ty will only slightly increase the caloriesspent. A better way to burn up calories isexercising longer and/or covering moredistance.

often contributes to more productivity atworkincreases your capacity for physical workbuilds stamina for other physical activitieshelps increase muscle strengthhelps your heart and lungs work moreefficiently

10


Consider the benefits of a well-conditionedheart:

In 1 minute with 45 to 50 beats, the heart ofa well-conditioned person pumps the sameamount of blood as the average person's heartpumps in 70 to 75 beats. Compared to thewell-conditioned heart, the average heartpumps up to 36,000 more times per day,13.1 million more times per year.

Feeling, looking, and doing betterall thesebenefits can help you enjoy your life morefully.

11


Can ezercise reduce Coronary artery disease is the major cause ofmy chances of getting heart disease and heart attack in America. Ita heart attack? develops when fatty deposits build up on the

inner walls of the blood vessels feeding theheart (coronary arteries). Eventually one ofthe major coronary arteries may becomeblockedeither by the buildup of deposits orby a blood clot forming in the artery's nar-rowed passageway. The result is a heartattack.

We now know that there are several factorsthat can increase your risk for developing cor-onary artery diseaseand thus the chancesfor a heart attack. Fortunately, many of theserisk factors can be reduced or eliminated.

as curl Waged

12

10 National Heart. Lung, and Blood Institute

Some other important Diabetes.Having diabetes doubles therisk factors. risk for coronary artery disease.

Exercise can help re-duce or eliminate someof these risk factors.

Overweight.Excess weight increases thelikelihood of getting high blood pressure, highblood cholesterol, and diabetes.

Low Levels of HDL.Cholesterol in the bloodis transported by different types of particles.One of these particles is a protein called highdensity lipoprotein or HDL. Low levels of HDLin the blood are related to an increased risk ofcoronary artery disease.

Physical Inactivity.Being physically inactivealso increases the risk of a heart attack. Mostof the scientific research has found that com-pared to physically active people, inactivepeople have 11/2 to 2 times the risk of havinga heart attack. Chances of dying immediatelyafter a heart attack is also 3 times greater inphysically inactive people than in active peo-ple. Also, no research has shown ..1 increasedrisk for physically active peop)

High Blood Pressure.Regular t..ercise isassociated with lower blood pressure.

Cigarette Smoking.People who exercisevigorously and regularly are more likely tocut down or stop cigarette smoking.

Diabetes.People at normal weight are muchless likely to develop diabetes. Exercise alsodecreases a diabetic's insulin requirements.

13


Overweight. Exercise can help individualslose extra pounds or stay at ideal weight.

High Levels of HDL.High levels of HDL (oneof the cholesterol carrying proteins in theblood) have been linked to a decreased risk ofcoronary artery disease. Recent studies haveshown that regular exercise significantly in-creases the levels of HDL.

14

12 Nat:mai Heart. Lung. and BIJod Institute

In summary. current evidence suggests that amoderate amount of regular. brisk exercisemay reduce your chances of having a heartattack. But remember that even if you exer-cise, you should not ignore other risk factors.It is important to reduce or eliminate any riskfactors so that you can lower your chances ofhaving a heart attack as much as possible.

For your heart health: exercise regularly; stopor cut down on your smoking: control highblood pressure with proper treatment: cutdown on fats. cholesterol. and salt in yourdiet: and reduce if overweight.

15


Are there any risksin exercising?Muscles and Joints

Heat Exhaustion andHeat Stroke

The most common risk in exercising is injuryto the muscles and joints. This usually hap-pens from exercising too hard or for toolongparticularly if a person has been inac-tive for some time. However, most of theseinjuries can be prevented or easily treated asexplained in "Effective Ways to AvoidInjuries" on page 34.

If precautions are not taken during warm,humid days, heat exhaustion or heat strokecan occuralthough relatively rarely. Thesymptoms of heat exhaustion include a bodytemperature below normal, dizziness, head-ache, nausea, and sometimes confusion. Theother and more serious occurrence is heatstroke. The symptoms are dizziness, head-ache, thirst, nausea, and muscle cramps. Butthere are two important symptoms that occurwith heat stroke: (1) sweating stops and (2)body temperature may become dangerouslyhighwhich can be a serious problem.

Both heat exhaustion and heat stroke can beavoided by drinking enough liquids torethose lost in exercising and by taking otherimportant precautions listed on page 34 inthe section on avoiding injuries.

16


Heart Problems Occasionally, individuals have died whileexercising. Wanst o: these deaths are caused byoverexertion in people who already had heartconditions. In individuals under age 30, theseheart conditions are usually congenital heartdefects (heart defects present at birth). In peo-ple over age 40, the heart condition is usuallycoronary artery disease (the buildup of depos-its of fats in the heart's blood vessels). Manyof these deaths have been preceded by warn-ing signs such as chest pain, sudden dizzi-ness, fainting, and extreme breathlessness.These are symptoms that should not be ig-nored and should be brought to the attentionof a doctor.

Some of the deaths that occur during exerciseare not caused by the physical effort itself.Death can occur at any time and during anykind of activityeating, sleeping, sitting. Thisdoes not necessarily mean that a particularactivity caused the deathonly that the twoevents happened at the same time.

No research studies have shown thatphysically active people are more likely tohave sudden, fatal heart attacks than inactivepeople. In fact, a number of studies haveshown a reduced risk of sudden death for peo-ple who are physically active.

Exercising too hard is not beneficial foranyone, however, and is particularly strenu-ous for out-of-shape, middle-aged and olderindividuals. It is very important for these indi-viduals to follow a gradual and sound exerciseprogram.

If you consider the time your body may havebeen out of shape, it is only natural that itwill take time to get it back into good condi-tion. A gradual approach will help you maxi-mize your benefits and minimize your risks.

17


Comparing thebenefits andthe risks

Potential Benefits

Potential Risks

Should you begin a regular exercise program?Consider the ways exercise can benefit youand weigh them against the possible risks.

More energy and capacity for work andleisure activities

Greater resistance to stress, anxiety, andfatigue and a better outlook on life

Increased stamina and strengthImproved efficiency of the heart and lungsLoss of extra pounds and help in staying at

ideal weightReduced risk of heart attack

Muscle/joint injuriesHeat exhaustion/heat stroke on hot days (rare)Aggravation of existing or hidden heart

problems

18

16 National Heart. Lung. and Blood Inst!.ute

Should I consult a Most people do not need to see a doctor beforedoctor before I start they start since a gradual. sensible exerciseexercising? program will have minimal health risks. How-

ever, there are some people who should seekmedical advice.

Mark those items thatapply to you:

To find out if you should consult a doctorbefore you start, use the following check list.*

Your doctor said you have heart trouble, aheart murmur, or you have had a heartattack.You frequently have pains or pressureinthe left or midchest area, left neck.shoulder, or arm during or right after youexercise.

n You often feel faint or have spells of severedizziness.

ri You experience extreme breathlessnessafter mild exertion.

Li Your doctor said your blood pressure wastoo high and is not under control. Or youdon't know whether or nat your bloodpressure is normal.

r] Your doctor said you have bone or jointproblems such as arthritis.You are over age 60 and not accustomed tovigorous exercise.You have a family history of premature cor-onary artery disease.

: You have a medical condition not men-tioned here which might need special at-tention in an exercise program. (For exam-ple. insulin-dependent diabetes.)

19


If you've checked one or more items, talk toyour doctor before you start. If you've check-ed no items, you can start on a gradual, sensi-ble exercise program tailored to your needs.

This check list has been developed frum several sourees. particularly thePhysical Activity Readiness Questionnaire. British Columbia Ministry of Health.Department of National Health and Welfare. Canada.

20


What if I've had aheart attack?

Five common mythsabout exercise

We do not know yet if regular, brisk exercisecan reduce the risk of having another heartattack. However, regular exercise can improvethe quality of your lifehow you feel andlook. It can help you do more than beforewithout pain (angina) or shortness of breath.

If you've had a heart attack, you should con-sult your doctor to be sure you are following asafe and effective exercise program. Your doc-tor's guidance is particularly importantbecause it could help prevent heart painand/or further damage from overexertion.

Myth 1. Exercising makes you tired.As their bodies get more in shape, most peo-ple feel exercising gives them even moreenergy than before. Regular, brisk exercisecan also help you resist fatigue and stress.

Myth 2. Exercising takes too much time.Regular exercise does not have to take morethan about 25 to 40 minutes, three times aweek. Once you have established a f_.omfort-able exercise routine. exercising becomes anatural part of your life.

Myth 3. All exercises give you the samebenefits.All physical activities can give you enjoyment.But only regular, brisk, and sustained exer-cises such as brisk walking, jogging, or swim-ming improve the efficiency of your heart andlungs and burn off a lot of calories. Otheractivities do not give yo, t these benefits,although they may give you other benefitssuch as increased flexibility or musclestrength.

21


Myth 4. The older you are, the less exer-cise you need.With age we tend to become less physicallyactive, and therefore need to make sure weare getting enough exercise. In general,middle-aged and older people benefit fromregular exercise just as young people do. Ageneed not be a limitation. What is important,no matter what your age, is tailoring the exer-cise program to your own fitness level.

Myth 5. You have to be athletic toexercise.Most brisk activities do not require anyspecial athletic abilities. In fact, many peoplewho found school sports difficult have dis-covered that these other activities are easy todo and enjoyable.

22

2G National Heart. Lung. and Blood Institute

Which exercises helpcondition my heartand lungs?

Exercises that improve the condition of yourheart and lungs must have three key charac-teristics. These activities must be:

:;,' 4%, '').^

tnA

The columns below describe three types ofactivities and how they affect your heart.

Column A - These exercises are naturallyvery vigorous. They need to be done at least15 minutes, three times a week. Then theywill condition your heart and lungs, burn off alot of calories, and give you many other bene-fits mentioned in the beginning of thisbooklet.

Column B - These activities are moderatelyvigorous but can be excellent conditioners, ifdone briskly for at least 30 minutes, threetimes a week. When done briskly, they givethe same benefits as those activities incolumn A.

Column C - These activities by nature are notvigorous or sustained. They still have certainbenefitsthey can be enjoyable. help improvecoordination and muscle tone, and helprelieve tension. However, they neither condi-tion the heart and lungs nor burn off manycalories.

23


A B CDo Condition Can Condition Do Not ConditionHeart & Lungs

Cross-Country Skiing Bicycling BaseballHiking (uphill) Downhill Siding BowlingIce Hockey Basketball FootballJogging "Valiathenkas Golf (on _foot or by cart)Jumping Rope Field Hockey Soft ballRowing Handball VolleyballRunning in Place RacquetballStationary Cycling Soccer

Squash .

SwimmingTennis (singles)Walking

24


The key to successHow do I begin? The key to a successful exercise program is

choosing an activity (or activities) that youwill enjoy. Here are some questions that canhelp you choose the right kind of exercise foryou:

1. How physically fit are you?If you've been inactive for a while, you maywant to start with brisk walking or swimmingrather than Jogging or jumping rope. Begin-ning with less strenuous activities will allowyou to become more fit without straining yourbody. Once you have gotten into better shape,you can change to a more vigorous activity ifyou wish.

2. How old are you?If you are over 40 and have not been active,avoid particularly strenuous programs suchas jogging when you are first starting out. Forthe first few months, build up the length andintensity of your exercise gradually. If you areover 60, walking and swimming are especiallygood forms of exercise.

3. What benefits do you want fromexercising?If you want the benefits of exercise that condi-tion your heart and lungs. check the activitiesin columns A and B on page 21.

4. Do you like to exercise alone or withother people?Do you like individual activities such as swim-ming, team sports such as soccer, or two-person activities such as racquetball? Com-panionship can help you get started and keepgoing. If you would like to exercise with some-()Tic rise. can you find a partner easily andquickly? If not. consider choosing anotheractivityat least until you can find a partner.

25


5. Do you prefer to exercise outdoors or inyour home?Outdoor exercise offers variety in scenery andweather. Indoor activities offer shelter fromthe weather and can offer the convenience ofexercising at home as with stationary cycling.Some activities such as running in place orjumping rope can be done indoors or out-doors. If your activity can be seriously af-fected by the weather, consider choosing analternate activity, too. Then you can switchactivities and still stay on your regularschedule.

6. How much money are you willing tospend for sports equipment or facilities?Many activities require little or no equipment.For example, brisk walking only requires acomfortable pair of walking shoes. Also, manycommunities offer free or inexpensive recrea-tion facilities and physical activity classes.

7. When can you best fit the activity intoyour schedule?Do you feel more like exercising in the morn-ing, afternoon, or evening? Consider movingother activities around. Schedule your exer-cise as a regular part of your activities.Remember that exercise sessions are spreadout over the week and needn't take more thanabout 25 to 40 minutes at a time.

By choosing activities you like, you will bemuch more likely to exercise regularly, keepon exercising, and enjoy its many benefits.

26


How do I pacemyself?

How hard should Iexercise?

Build up slowly. If you've been inactive for along while, remember it will take time to getinto shape. But no matter where you begin,you will be able to build up your exercisetime or pace as your body becomes more fit.Just remember that you will feel more fit aftera few weeks than when you first started.

You can find out how hard to exercise bykeeping track of your heart rate. Your maxi-mum heart rate is the fastest your heart canbeat. Exercise above 75 petcent of the maxi-mum heart rate may be too strenuous unlessyou are in excellent physical condition. Exer-cise below 60 percent gives your heart andlungs little conditioning.

Therefore, the best activity level is 60 to 75percent of this maximum rate. This 60.75percent range is called your target zone.

When you begin your exercise program, aimfor the lower part of your target zone (60 per-cent) during the first few months. As you getinto better shape, gradually build up to thehigher part of your target zone (75 percent).After 6 months or more of regular exercise,you can exercise at up to 85 percent of yourmaximum heart rateif you wish. However,you do not have to exercise that hard to stayin good condition.

27

EXERUSE AND YOUR UE'RT 25

2S


To find your target zone, look for the agecategory closest to your age and read the lineacross. For example, if you are 30, your targetzone is 114 to 142 beats per minute. If youare 43, the closest age on the chart is 45: thetarget zone is 105 to 131 beats per minute.

Age .. ..

110104::,

AverageMaximumHeart Rate100%

20 Yeas* 12°451.12,t11 Per min. 200

25 years :-- '4174413,1)eqs; rain. 195

30 Years 14443 *Ws Pei min. 190

35 years 111=135** per min. 185

40 years 108430 bests per inin. 180

45 years 105.-131 beats per min. 175

50 years 10204#:beataper Min. 170

55 wag 00.123.s.beattiper min. 165

60 years 96-120 beittS per min. 160

=tICC 85 years 93-118 beats per min. 155

-WC70 years 90.113 beats per min. 150

CLC)

C/3 Your maximum heart rate is usually 220LaJ03 minus your age. However, the above figures

are averages and should be used as generalguidelines,

29


Note: A few high blood pressure medicineslower the maximum heart rate and thus thetarget zone rate. If you are taking high bloodpressure medications, call your physician tofind out if your exercise program needs to beadjusted.

t

To see if you are within your target zone, takeyour pulse immediately after you stopexercising.

30


1. When you stop exercising, quickly placethe tip of your third finger lightly over one ofthe blood vessels on your neck (carotid arter-ies) located to the left or right of your Adam'sapple.

Another convenient pulse spot is the inside ofyour wrist Just below the base of your thumb.

2. Count your pulse for 30 seconds andmultiply by two.

3. If your pulse is below your target zone.exercise a little harder the next time. If you'reabcve your target zone, exercise a little easier.And if it falls within the target zone, you'redoing fine.

4. Once you're exercising within your targetzone, you should check your pulse at leastonce each week during the first 3 months andperiodically thereafter.

31


A special tip: It is important to exercise at a comfortablepace. For example, when jogging or walkingbriskly you should be able to keep up a con-versation comfortably. If you do not feel nor-mal again within 10 minutes of stopping exer-cise, you are pushing yourself too much.

Also, if you have difficulty breathing, ex-perience faintness or prolonged weakness dur-ing or after exercising, you are exercising toohard. Simply cut back and check your pulseto see if you are still within you target zone.

how long should I Each exercise session should last from aboutexercise? 25 to 40 minutes and include:

Warm up-5 minutes Begin exercising slowly to give your body achance to limber up and get ready for morevigorous exercise. Start at a medium paceand gradually increase it by the end of the5-minute warm-up period.

Note: With especially vigorous activities suchas jumping rope, jogging, or stationary cycl-ing, begin your warm-up period with gmtlestretching exercises. Then begin jumping ropeor jogging slowly, warming up to your targetzone. Many of these stretching exercises canbe found in books on sports medicine andrunning. Below are three exercises you canuse in your warm-up period. Each of these ex-ercises help stretch different parts of yourbody. Do stretching exercises slowly and in asteady, rhythmical way.

32


Wall push: Stand about 11/2 feet away fromthe wall. Then lean forward pushing againstthe wall, keeping heels flat. Count to 10 thenrest. Repeat one to two times.

Palm touch: Stand with your knees slightlybent. Then bend from the waist and try totouch your palms to the floor. Do not bounce.Count to 10 then rest. Repeat one to twotimes. If you have lower back problems, dothis exercise with your legs crossed.

Toe touch: Place your right leg level on astair, chair, or other object. Keeping yourother leg straight, lean forward and slowly tryto touch your right toewith right hand 10times, with left hand 10 times. Do notbounce. Then switch legs and repeat witheach hand. Repeat entire exercise one to twotimes.

33


Exercising withinyour target zone-15-30 minutes

IL i-_. ____

Your goal is a minimum of 15-30 minutes.Build up your exercising time gradually overthe weeks ahead until you reach ;our goal of15-30 minutes. Once you get in shape, yourexercising will last from 15-30 minutesdepending on the type of exercise you are do-ing and how briskly you do it. For examplefor a given amount of time, jogging requiresmore energy than a brisk walk. Jogging willthus take less time than walking to achievethe same conditioning effect. Generally, theguidelines are: the very brisk exercises ofcolumn A on page 21 should be done aminimum of 15 minutes. The mildly briskexercises of column B should be done aminimum of 30 minutes. For two examples ofhow to build up to the goal of 15 to 30minutes. see "Two Sample Exercise Pro-grams" on page 37.

Cool down-5 minutes After exercising within your target zone, slowdown gradually. For example, swim moreslowly or change to a more leisurely stroke.You can also cool down by changing to a lessvigorous exercise, such as changing fromjumping rope to walking. This allows yourbody to relax gradually. Abrupt stoppiag cancause dizziness. If you have been running.walking briskly, or jumping rope. repeat yourstretching and limbering exercises to loosenup your muscles.

34

32 National Heart. Lung, and Blood Institute

How often should I Exercise at least three times per week.exercise?

What if I miss a fewsessions?

Exercising regularly is one of the most impor-tant aspects of your exercise program. If youdon't exercise at least three times a week, youwon't experience as many of the benefits ofregular, vigorous physical activity as youcould or make as much progress. Try tospread your exercise sessions throughout theweek to maximize the benefits.

Whenever you miss a few sessions (more thana week), you will need to resume exercising ata lower level than before.

If you miss a few sessions because of a tem-porary, minor illness such as a cold, wait un-til you feel normal before you resume exercis-ing. If you have a minor injury, wait until thepain disappears. When you resume exercis-ing, start at one-half to two-thirds your nor-mal level, depending on the number of daysyou missed and how you feel while exercising.

Whatever the reasons for missing sessions,don't worry about the missed days. Just getback into your routine and think about theprogress you will be making toward your ex-ercise goal.

Is there a top limit to That depends on the benefits you are seeking.exercising?

Anything beyond 30 minutes daily of a veryvigorous activitysuch as those listed in col-umn A on page 21 or 60 minutes daily of amoderately vigorous activitysuch as thosein column B will result in little added condi-tioning of your heart and lungs.

If you want to lose extra pounds or controlyour present weight. there is no upper limit inthat the longer you exercise. the more caloriesyou burn off. But remember that the most ef-fective weight loss program includes cuttingdown on calories in addition to exercise.

35


Remember: How you exercise is just as im-portant as the kind of activity you do. Youractivity should be brisk, sustained, andregularbut you can do it in gradual steps.Common sense and your body will tell youwhen you are exercising too long or too hard.Don't push yourself to the point where exer-cise stops being enjoyable.

36


Effective ways toavoid injuries

The most powerful medicine for injuries isprevention. Here are some effective ways toavoid injuries:

1. Build up your level of activitygradually over the weeks to come.

Try not to set your goals too highother-wise you will be tempted to push yourselftoo far top quickly.For activities such as jogging. walkingbriskly, and jumping rope, limber up gent-ly and slowly before and after exercising.For other activities, build up slowly to yourtarget zone, and cool down slowly after-wards.

2. Listen to your body for early warningpains.

Exercising too much can cause injuries tojoints, feet. ankles, and legs. So don't makethe mistake of exercising beyond earlywarning pains in these areas or more seri-ous injuries may result. Fortunately, minormuscle and joint injuries can be readilytreated by rest and aspirin.

3. Be aware of possible signs of heartproblems such as:

Pain or pressure in the left or midchestarea. left neck. shoulder, or arm during orjust after exercising. (Vigorous exercisemay cause a side stitch while exercisingapain below your bottom ribswhich is notthe result of a heart problem.)Sudden dizziness, cold sweat, pallor, orfainting.

Ignoring these signals and continuing to exer-cise may lead to serious heart problems.Should any of these signs occur, stop exercis-ing and call your doctor.

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4. For outdoor activities, take ap-propriate precautions under specialweather conditions.

On hot, humid days:Exercise during cooler parts of the daysuch as early morning or early eveningafter the sun has gone down.Exercise less than normal for a week untilyou become adapted to the heat.Drink lots of fluids, particularly water. Youdo not need extra salt because you getenough salt in your diet. Also, a well-conditioned body learns to conserve salt sothat most of the sweat is water.Watch out for signs of heat strokefeelingdizzy, weak, light headed, and/or excessive-ly tired; sweating stops; or body tempera-ture becomes dangerously high.Wear a minimum of light, loose-fittingclothing.Avoid rubberized or plastic suits, sweat-shirts, and sweat pants. Such clothing willnot actually help you lose weight any fasterby making you sweat more. The weightyou lose in fluids by sweating will be quick-ly replaced as soon as you begin drinkingfluids again. T his type of clothing can alsocause dangerously high temperatures,possibly resulting in heat stroke.

On cold days:Wear one layer less of clothing than youwould wear if you were outside but notexercising. It's also better to wear severallayers of clothing rather than one heavylayer.Use old mittens, gloves, or cotton scA.Ks toprotect your hands.Wear a hat, since up to 40 percent of yourbody's heat is lost through your neck andhead.

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On rainy, icy, or snowy days:Be aware of reduced visibility (for yourseland for drivers) and reduced traction onpathways.

5. Other handy tips are:If you've eaten a meal, avoid strenuousexercise for at least 2 hours. If you exercisevigorously first, wait about 20 minutesbefore eating.Use proper equipment such as goggles toprotect your eyes for handball or racquet-ball, or good running shoes with adequatecushioning in the soles.Hard or uneven surfaces such as cement orrough fields are more likely to cause inju-ries. Soft, even surfaces such as a levelgrass field, a dirt path, or a track for run-ning are better for your feet and joints.If you run or jog, land on your heels ratherthan the balls of your feet. This will mini-mize the strain on your feet and lower legs.Joggers or walkers should also watch forcars and wear light-colored clothes or areflecting band during darkness so thatdrivers can see you. Face oncoming trafficand do not assume that drivers will noticeyou on the roadway.If you bicycle, you can help prevent inju-ries by wearing a helmet and using a lightand reflectors on the wheels at night. Also,ride in the direction of traffic and try toavoid busy streets.

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Two sample exerciseprograms

There are many ways to begin an exerciseprogram. Below are two examplesa walkingand a jogging program. These activities areeasy ways for most people to get regular exer-Cis° because they do not require special facil-ities or equipment other than good, comfort-able shoes. If walking or jogging does notmcet your needs, look for other exercise pro-grams in pamphlets and books on aerobicexercise and sports medicine.

If you find a particular week's pattern tiring,repeat it before going on to the next pattern.You do not have to complete the walking pro-gram in 12 weeks or the jogging program in15 weeks.

A sample walking programa

Warm up Target sane exercising Cool down Total time

Week 1Session Walk slowly Then walk briskly 5 min. Then walk 15 min.A 5 min. slowly 5 min.Session Repeat above

pattern.Session Repeat aboveC pattern.

Continue with at least three exercise sessions during each week of the program.

Week 2 Walk slowly5 min.

Walk briskly 7 min. Walk slowly5 min.

17 min.



19 min.


Walk briskly 11 min. Welk slowly5 min.

21 min.



23 min.

Week 8 Welk slowly5 min.


25 min.

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28 min.

Week a Walk slowly5 min.


30 min.

Week 9 Walk slowlymin.


33 min.



36 min.

Week U Walk slowly5 min.


38 min.



40 min.

Week 19 on:Check your pulse periodically to see If you are exercising within your target zone. As youget more in shape. try exercising within the upper range of your heart zone. Rememberthat your goal is to continue getting the benefits you are seeking and enjoying youractivity.


A Sample Jogging ProgramIf you are over 40 and have not been active, you should not beginwith a program as strenuous as jogging. Begin with the walking pro-gram instead. After completing the walking program. you can startwith week 3 of the jogging program below.

Warm up Target zone exercising Cool down Total time

Week 1Session Stretch and Then walk 10 min. Then walkA limber up for Try not to stop. slowly 3 min.

5 min. and stretch2 min.Session Repeat above

B pattern.Session Repeat aboveC pattern.

20 min.

Continue with at least three exercise sessions during each week of the program.Week Stretch and

limber 5 min.Walk 5 min.. jog 1 min..walk 5 min.. jog 1 min.

Walk slowly3 min.,stretch 2 min.

22 min.

Week $ Stretch and Walk 5 min.. jog 3 min.. Walk slowly 26 min.limber 5 min. walk 5 min.. jog 3 min. 3 min..stretch 2 min.

Week 4 Stretch and Walk 4 min.. jog 5 min..limber 5 min. walk 4 min.. jog 5 min.

Walk slowly3 min..stretch 2 min.

28 min.

Week 5 Stretch and Walk 4 min... jog 5 min.. Walk slowlylimber 5 min. walk 4 min.. jog 5 min. 3 min..

stretch 2 min.

28 min.

Week 6 Stretch and Walk 4 min.. jog 6 min.. Walk slowly 30 min.limber 5 mirb. walk 4 mm., jog 6 mm. 3 min..stretch 2 min.

Week 7 Stretch and Walk 4 min., jog 7 min..limber 5 min. walk 4 min.. jog 7 min.

'1 )


32 min.

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Week a Stretch and Walk 4 min.. jog 8 min.. Walk slowlylimber 5 min. walk 4 min.. jog 8 min. 3 min..

stretch 2 min.

34 min.

Week 9 Stretch and Walk 4 min.. jog 9 min..limber 5 min. walk 4 min., jog 9 min.


36 min.

Week 10 Stretch and Walk 4 min., jog 13 min.limber 5 min.


27 min.

Week 11 Stretch and Walk 4 min.. jog 15 min.limber 5 min.


29 min.

Week 12 Stretch and Walk 4 min.. jog 17 min.limber 5 min.


31 min.

Week 19 Stretch and Walk 2 min., jog slowlylimber 5 min. 2 min., jog 17 min.


31 min.

Week 14 Stretch and Walk 1 mm., jog slowlylimber 5 min. 3 mM.. Jog 17 min.


31 min.

Week 15 Stretch and Jog slowly 3 min..limber 5 min. jog 17 min.


30 min.

Week 18 oasCheck your pulse periodically to see if you are exercising within your target zone. As youbecome more flt, try exercising within the upper range of your target zone. Remember thatyour goal is to continue getting the benefits you are seeking and enjoying your activity.

The exercise patterns for both of the sample exercise programs are sug-gested guidelines. Listen to your body and build up less quickly. if need-ed.

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How do I keep going? Here are some tips to help you keep on yourexercise program:

Set your sights on short-term as well as long.term goals. For example, if your long-termgoal is to walk 1 mile, then your short-termgoal can be to walk the first quarter mile. Orif your long-term goal is to lose 10 pounds.then focus on the immediate goal of losing thefirst 2 or 3 pounds. With short-term goals youwill be less likely to push yourself too hard ortoo long. Also, think back to where youstarted. When you compare it to where youare now, you will see the progress you'vemade.

Discuss your ex.:I-else program and goals withyour family or friends. Their encouragementand understanding are important sources ofsupport that can help you keep going. Yourfriends and family might even join in.

If you're having trouble sticking to yourregular exercise program, use the check liston pages 22 and 23 to think through thekinds of things that can affect your exerciseenjoyment.

What were your original reasons for startingan exercise program? Do these reasons stillapply or are others more important? If youare feeling bored or aren't enjoying a particu-lar activity, consider another conditioningexercise.

By continuing to exercise regularly, you'll bebuilding a good health habit with benefitsyou can enjoy throughout your life.

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How can I becomemore active through-out my day?

To become more physically active throughoutyour day, take advantage of any opportunityto get up and move around. Here are someexamples:

Use the stairsup and downinstead ofthe elevator. Start with one flight of stairsand gradually build up to more.Park a few blocks from the office or storeand walk the rest of the way. Or if you rideon public transportation, get off a stop ortwo before and walk a few blocks.Take an exercise breakget up andstretch, walk around and give yourmuscles and mind a chance to relax.Instead of eating that extra snack take abrisk stroll around the neighborhood.

If you have a family, encourage them to takepart in an exercise program and recreationalactivities they can either share with you or doon their own. It is best to build healthy habitswhen children are young. When parents areactive, children are more likely to be activeand stay active after they become adults.

Whatever your agemoderate physical activitycan become a good health habitwith lifelong benefits.

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46

Acknowledgement

'I he National Heart Lung. and Moral Inca mite wnuld to acknowledge the talents and dedication of the many pro.vie who participated in the development of this exercise handbook. While the numbers of those who made significantcontnhutions arr ton great to list here special recognition must be given to two members of our Office of Prevention.Education and control who were primarily responsible for taking this booklet from concept to finished product. Theyare Stephen Havas. M 1.) and Sheila Ninomiya Pohl, health communication specialist.

Nlow htel Bureau of Health Promotion and Disease Prevention.Department of Health Services. State of Connecticut.

U S GOVERNMENT PRINTING OFFICE 1981 - 725.':48 47

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