InTouch Magazine - Fall/Winter 2000

Exercise - Getting Started
One Step at a Time

For the better part of the last 20 years I have been involved in the testing, training and monitoring of a variety of individuals' exercise programs. I started in the hospital world, moved on to the athletic club environment, then moved into the Sports Medicine arena and finally ended up in the New Age era of the dot.com's.

These environments provided me the opportunity to examine a vast array of fitness levels ranging from the coronary bypass patient to a Tour de France champion. These experiences allowed me to monitor a variety of physiological variables and to observe the human body's phenomenal ability to adapt to any exercise program. However, in spite of these scenarios and the overwhelming evidence as to the benefits of physical activity, I continue to be amazed that we have failed to encourage 75% of America to start an exercise program.

Having said that, you can imagine my dilemma when I received a phone call from four 50+ physicians who wanted training advice so they could ride their bikes all the way across America. My first thought was that they absolutely were in need of guidance - but not from me. However, I also realized that working with them could provide valuable data regarding the effect that aging had on their ability to adapt to an intense training program. More importantly, this data would help determine a better exercise prescription that could be useful in getting a large group of America to start an exercise program. With training, the following changes occurred in the riders:

• The riders were able to significantly improve their maximal aerobic fitness level and ability to train at a higher percentage of their max.
• The riders were able to significantly reduce their percent body fat via underwater measurements. In order for their skinfold measurement to be valid, riders had to subtract 30 years off their age.
• The riders had to consume significantly more calories than expected because the total exercise time was not continuous but split up in 10-15 minute intervals across a 16-18 hour period.

The basic idea behind designing an exercise prescription is to determine the appropriate frequency (days per week), intensity (effort required) and duration (length of time) that is needed to achieve a desired result. These three variables are at the core of every exercise program, whether you are training to ride across America, jog a mile or take your first steps after bypass surgery. Since the desired result for the bike riders was to finish the RAAM in seven days, they were forced to exercise six days per week at 70-95% of their maximal effort for a minimum of 90 minutes. In fact, there were days when they trained four times a day at 70% of their maximal effort for 45 minutes.

If your desired result is to be able to walk a mile, reduce your blood pressure or control your diabetes, you might start at 2-3 days per week at 50% of your max for 12-15 minutes. The most important point to remember is that the adaptation to any exercise program is intrinsic; however the adherence to any exercise program is up to you.

As I look back on the whole RAAM experience, I remember a very insightful comment made by one of the riders. I was riding in the van when he summed up how the group had decided that the only way they would be able to stay focused was to approach the entire race "two miles at a time." With this in mind, the best advice on how to start and progress in an exercise program is "one step at a time."

• Identify the types of exercise that you will find convenient, non-intimidating and fun.
• If possible, find a partner to exercise with you or some type of support system that will help keep you motivated.
• Set realistic and achievable goals including specific days and times for your exercise session.
• Identify a health professional who will help you recognize any of your health risks associated with starting an exercise program and one who can also prescribe the appropriate duration, frequency and intensity level.
• Develop a monitoring system that allows you to record your workout, chart your progress, make any changes to your program, and that can be reviewed easily by others.

For more information on beginning an exercise program, call MHIF at 612/863-3979 or e-mail educ@mplsheart.org.