Sorting through your fitness possibilities
WebMD Weight Loss Clinic - Live Events Transcript
Event Date: May 1, 2003
Starting a fitness routine? What are you trying to achieve: strength, endurance, cardiovascular health, flexibility? We sorted through the possibilities and got our exercise questions answered when fitness expert Richard Weil joined us.
The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Hello Richard. Thank you for joining us today. How are you?
Weil: I'm doing well. I went for my run this morning; I did just three miles because I am coming off of a bout of bronchitis, four weeks of it, but starting to move again feels really good. In addition, I really missed not moving. It's unusual for me to not move. To be laid up for four weeks is difficult. So it feels really good to move again. And one other point is it doesn't take a lot of movement to feel good again. So even when I ran just one mile, the first day back, it all felt really good again. I got the same benefit, really, from one mile that I might get from five.
Moderator: For those who are just starting out with an exercise program (and who are intimidated by the thought of running a mile), can you explain the various types of exercise?
Weil: Yes. There are several types of exercise. I'll describe a couple in detail:
Aerobic, meaning with oxygen, meaning that you do it to the point where you're breathing a little harder than at rest, but not so hard that you're out of breath. If you feel warm and slightly out of breath, and sustain it for any period of time, really beyond 15 minutes, you're going to gain all the benefits of aerobic exercise. The benefits are:
- Improvement in stamina
- Decreased risk of chronic diseases like heart disease and diabetes
- You burn lots of calories
- You strengthen the heart
- It increases well-being, helps control mood, and, overall, people report that they simply feel better.
Furthermore, you don't need lots of aerobic exercise to gain those benefits. In fact, simply going from a sedentary lifestyle where you do very, very little activity to increasing your walking or any other type of aerobic activity, even just three times a week for 20 to 30 minutes, will give you these benefits. Other types of aerobic activity besides walking include:
- Dancing -- any type that feels good and leaves you feeling warm and slightly out of breath.
In addition, any lifestyle type of activity that is aerobic also counts.
- Taking the bus less
- Parking your car as far from the location where you're going and walking across the parking lot
- Climbing stairs instead of taking the elevator
- Mowing your own lawn with a hand mower or a push mower. This is good news. It means that you don't have to do a lot of exercise or formal exercise at the gym to gain benefit from aerobic exercise. The guideline for aerobic exercise is from one of two different sources:
- The American College of Sports Medicine. It recommends exercise three to five times per week for 20 to 60 minutes at approximately 60% to 85% of maximum heart rate. This is a formal exercise guideline. It's similar to going to the gym, working out on the treadmill, the bike, the elliptical machine or any of the other aerobic machines.
- The United States Surgeon General. That guideline states that you can improve your health by accumulating 30 minutes of moderate intensity physical activity on five or more days of the week. The key to this guideline is that you can accumulate the 30 minutes in three bouts of 10 minutes or two bouts of 15 minutes or one bout of 30. The good news is that people who simply cannot or will not adhere to the ACSM guidelines have an alternative. So you can incorporate physical activity into your daily life and your lifestyle and still gain benefit.
The Surgeon General's guideline doesn't replace the ACSM guideline, it is an alternative for people and can complement it. If you already adhere to the ACSM guideline, there's no reason to quit. You should continue with what you're doing. The Surgeon General's guideline simply provides an alternative. So climbing stairs, walking instead of taking the bus, trying to find any way in your daily life to increase physical activity is the way to go for those people who have been unable or unwilling to stick with more formal exercise. So saying there's no time to exercise is not necessarily a problem with the new Surgeon General guideline, because you can incorporate physical activity right into your day.
Another type of exercise is resistance exercise, which is any exercise that causes the muscle to contract against any external resistance. That resistance can be dumbbells, weight lifting machines, rubber bands, or even your own body weight. Calisthenics, like pushups, are a perfect example of body weight as external resistance. But again, any activity that causes the muscles to contract will work. So you don't have to necessarily join the gym to do resistance exercise. You can buy a videotape; you can use the rubber bands at home, or any type of calisthenics program. Sometimes it's useful to have a fitness trainer set up a program for you, whether it's at home or at the gym and then you'll be certain that you're doing the right thing.
The benefits of resistance exercise are:
- Increased muscle tone
- Increased strength
- Increase in well-being
- Increase in metabolic rate
For people who are trying to lose weight or maintain their weight, particularly once they've lost weight, resistance exercise is a good choice. It's a good choice because when you lose weight you can lose up to 25% of your weight from muscle. If you lose muscle while losing weight it may become harder to lose more weight. The loss of muscle may account for the plateau that people often experience when they lose weight. So resistance exercise can slow down the loss of muscle and metabolic rate. In fact, there have been several studies to show that resistance exercise can decrease the loss of metabolic rate and muscle by more than 15% to 20%. It's good news all around to do resistance exercise. In addition, we tend to lose about 5%, and maybe even more, of our muscle per decade after age 30. In a classic study of resistance exercise, researchers had 90- to 96-year-old folks living in a nursing home lift weights for 10 weeks. After 10 weeks their strength increased 110%. And they were able to walk down the hall 30% to 50% faster after the 10 weeks of lifting. So it's never too late to start, and it's always a good idea to maintain strength.
The guideline for resistance exercise is a minimum of two days per week eight to ten exercises, 10 to 12 repetitions, one set minimum. As you advance, you may need more sets than one to gain further improvement, but for beginners, one set will yield results.
Moderator: People exercise for a variety of reasons: weight loss, strength, endurance, body sculpting, flexibility, and/or cardiovascular health. How does your goal affect your choice of exercise? And if you want to do several things, how do you combine different exercises to efficiently reach your goals?
Weil: The minimum guidelines for general health and fitness are modest. They include some aerobic activity, as I mentioned earlier, either the ACSM or Surgeon General guidelines, and some amount of resistance work, even if it's just at home doing basic activities, like presses, pushups, those sorts of things. Those activities will cover a broad range of benefit: health, aerobic fitness and stamina, and general strength. If you do just those, you can assume that you will have a healthier and fitter life. If you want to be more specific with your goals, then you can be more specific with your training. For instance, if you play tennis and you want to improve your game, then you break down the game of tennis into the components. There's strength and speed and agility. And so you train specifically. For instance, you would spend a little more time, perhaps two or three days in the gym lifting weights, working the muscles that are involved in swinging the tennis racket. And that applies to any sport. If you wanted to run a 10-kilometer race or ride a bike-a-thon, then you would train for that activity more specifically with those activities.
If you want bigger muscles or more tone, then you might train differently. If you want big muscles then you lift heavy weight in a range of six to 10 repetitions, the 10th repetition being fatigue, meaning you can't do another repetition with good form. If you want more toned muscles and not more mass, then you increase the repetitions 10 to 15 repetitions, multiple sets, will give you more tone. If you look at the arms of a house painter, the arm that paints will have more tone than the other arm, simply because the house painter uses the arm all day. So you would simulate that in the gym. If you want weight loss, you need to understand that exercise does help with weight loss, however you lose a lot more weight with reducing calories. The real role of exercise, as far as weight loss is concerned, is more towards maintaining the weight loss for the long term.
So overall, go ahead and identify what you want from the activity and then you can fine tune how you will train. You may need assistance from a fitness professional to do that, but for those of us who want general fitness, stamina, conditioning, and improved health, the modest guidelines from the Surgeon General are an excellent place to start.
Member: Working out with weights sure makes my heart rate go. But I'm doing exercise to build muscles. Am I getting a good cardio workout at the same time?
Weil: Traditional weightlifting, where you train to increase mass or strength, may raise your heart rate at the moment that you do the exercise, and if you move quickly to the next exercise the heart rate may stay elevated. If you rest up to three minutes, as someone who is training for pure strength, then the heart rate will recover.
There is a training technique called circuit-training, where you move from one weightlifting station to another quickly. You spend 45 seconds at one station lifting as many repetitions as you can in that 45 seconds, then take 15 seconds to get to the next station. This may go on for 30 minutes. The stations would include weight lifting, activity like jumping jacks, sit-ups, pushups, weightlifting machines, and sometimes even an aerobic machine like a bike. But if the circuit involves or includes all weightlifting apparatus, but you move quickly from one station to the next, you will get an aerobic or cardio workout, as well as a strength and toning workout. Circuit-training is an efficient and fun way to increase aerobic stamina as well as strength and tone. It won't work quite as well as if you dedicate all of your time to training on just one or the other. However, it is an excellent way to train.
Member: How about running up and down my stairs a few times? No equipment to buy!
Weil: Stair-climbing is intense and vigorous exercise. If you do this, you should pace yourself, stretch your legs and your calves really well and build up slowly. So maybe five minutes, if that's all you can do the first week, and then increase by a few minutes every third or fourth workout, or every week.
A researcher by the name of Boreham did a wonderful study in England a few years ago with women who were in their early 20s who worked in an office. What he had them do over seven weeks was walk up and down the stairs in their office once a day for the first week, and then over the seven weeks, had them increase the number of times they climbed the stairs each day. So by the end of seven weeks, they were climbing the stairs seven times per day. However, they did not climb the stairs all at once. They climbed seven different times throughout the day. Each time they climbed it took two minutes, roughly. So by week seven they were climbing seven different times per day for two minutes each time. At the end of seven weeks, they were about 15% to 20% more fit than they were at the beginning of the study. So stair-climbing is good exercise, but it's hard, and you need to pace yourself.
Member: Any advice for someone who is very busy and wants to lose 10 pounds or so and do some body sculpting?
Weil: The first thing that I recommend to someone with a busy schedule who wants to lose weight is to evaluate two things: one is their diet and caloric intake, and two, their daily physical activity. Virtually everyone will lose weight with or without exercise if they reduce their caloric intake. People lose weight all the time without any exercise at all.
Now, as far as the exercise, this is good news, because it means that you do not have to do lots of exercise to lose weight. If you reduce your caloric intake, you will lose weight. As you lose more weight, it will be easier to move and if you continue to increase your physical activity as you continue to lose more weight, then by the time you reach your target weight, you should be moving enough to maintain the weight loss. As for body sculpting, as you lose weight and reduce body fat, you will start to see the muscles that were hiding under the excess fat, and if you engage in simple toning exercises like the rubber bands or simple calisthenics, the muscles will respond and along with any increase in walking and other daily activity, you will start to see a significant change in your physique.
So it can be done with attention to your caloric intake and a modest amount of physical activity, like walking, and some type of toning or conditioning exercises like the rubber bands or calisthenics. Even five to 10 minutes of an exercise video designed to improve muscularity and tone will help.
Member: Will any kind of exercise help fight mild depression?
Weil: It is very clear that exercise will alleviate the symptoms of mild to moderate depression, but not major depression. If there is major depression, it needs to be treated with medication or other therapy. One of the issues with depression and exercise is that people frequently ask, "Well, I know that exercise can help with depression, but I'm too depressed to do it, I don't have the energy." And the answer is that sometimes you do have to wait for the depression to pass, but other times the simple act of making a decision to take a walk around your block as a way to get started will help alleviate some of the symptoms. So the simple act of taking care of yourself will help.
I remember a woman I knew who went through a period of two weeks of depression, which isn't that long, and she had a treadmill at home, and what she did was once she felt even a little better, she just stood on the treadmill, and once she stood on the treadmill she was able to turn it on and start to work. And once she was able to walk for five to ten minutes, she felt like it really helped the depression. There have also been some studies to show that exercise, compared with medication, has a similar effect in the brain. And so exercise truly can help with treatment of depression.
Member: Does exercising close to bedtime make it easier or harder to fall asleep? Sometimes after the kids are in bed is the only time I have to stick in an aerobics tape.
Weil: This is a myth of sorts. The research shows that deconditioned, out-of-shape people may experience some loss of sleep if they exercise close to bedtime. But people who are more conditioned don't experience this. And then, of course, if you start as a deconditioned person at night, within just a few weeks you will become more conditioned and loss of sleep won't be an issue. In addition, it's very important to be physically active and we all do have busy schedules, and so the best time to exercise is the time that you can squeeze it in.
Moderator: Rich, we are almost out of time. Before we wrap up for today, do you have any final comments for us?
Weil: Exercise and physical activity are all about taking care of yourself. That's what it is. We owe it to ourselves to be physically active people. Whether it's weightlifting, running, jogging, going to the gym, walking tours with your family on the weekend, it's critical that we become a physically active population. Currently less than 25 percent of the population is physically active enough to gain any benefit from physical activity. It's expensive medically to be sedentary, and a sedentary lifestyle is a major preventable cause of death in the United States. We don't need to get bogged down in whether we do one type or the other; all physical activity is good for us, and we just need to make the commitment to ourselves to become physically active people at whatever pace we're comfortable. If we do, we will experience all the joy that movement and good health can offer.