Note: This article contains general information – always seek your doctor’s advice about starting a new exercise program!

SEE our other posts about exercise:

Exercise: the benefits and How to Start

Exercise – A Great Way to Multitask for Heart Health

Does Running Help Your Heart. . . And your Spouse’s Too?

Exercise News: Delay Dementia, and Never Too Late to Start!

Is Running Risky? Lets check the science. . .  .


Why is activity important?

It has long been known that exercise and increased activity can improve, or sometimes even eliminate, many chronic medical conditions and diseases. The link between activity level and heart disease has been explored for many years and is now based on very firm science.   Most of us know we should be more active, but our modern  lifestyle can be such a challenge to increasing our activity level.   I prefer the term “activity” over “exercise,” because exercise usually means something we have to intentionally perform, while activity is a part of daily life.   The challenge is to increase our activity to a level that minimizes the risk of long-term disease.   For those with established conditions, such as heart disease, diabetes, high blood pressure, and obesity, increased activity can become a therapy which is critical to management of these conditions (but only after consulting with your health care provider).

Thank of your body as having 3 key “systems” that are affected by exercise:

  1. Your heart and lungs, which are your “aerobic” system, whose purpose is to get oxygen into your lungs and blood, and pump the blood to the muscles are needed.
  2. Your muscles themselves which do the actual work of moving your body
  3. Your bones, joints, and ligaments which provide the support to allow your body to move.

Any type of exercise or activity affects all 3 of the systems but some more preferentially. *Interesting fact:  Did you know your muscles have their own way of taking up blood glucose/sugar?  People with high blood sugar and/or diabetes benefit from exercise because their muscles can use blood sugar directly.  To maintain health and ongoing exercise without injury it is important that exercise training involves improving the strength and abilities of each of the three systems above.   Almost all exercise related injuries occur when one system is neglected or (more commonly) overworked.  For example, a long-distance runner who pushes their exercise too hard will invariably develop a muscle strain (e.g. pulled hamstring) or a condition like plantar fasciitis, because those particular systems were overworked.   Likewise, a body builder can develop impressive muscles, but if they do not also add in aerobic exercise, they will neglect the aerobic system (but least they will look good!).

How much activity is needed for good health?

First of all, you should always talk to your  healthcare provider about whether your current medical situation allows you to start a new exercise program or plan.  The so-called experts (national guidelines in the US) recommend about 150 minutes of sustained activity per week. This means sustained walking, biking, jogging, or any other activity that increases your heart rate and uses the large muscle groups in your body.   However, the specific amount of activity or exercise needed to improve your health really depends on your current baseline activity level.  For someone who is completely sedentary, even 15 or 20 minutes of walking per day can have a positive impact. There are some other points to consider regarding exercise:

1. There is no one type of exercise or activity that is better than another.  I once attended a lecture by a fitness “expert” who gave this reply to the question: “What’s the best type of exercise?” – “Any one that propels your rear end through space” . . . . Or as another fitness expert put it, “move your body through space.”  What is important is that you are moving, using your muscles, and increasing your aerobic activity.  Aerobic activity refers to the amount of air you breathe and blood your heart pumps. You know this is increasing when your breathing becomes heavy and your heart rate increases.   For some people, this just means walking at a steady pace while others may want to try, and will benefit more from,  more vigorous exercise.

2. It is perfectly fine to break up activity into small portions.   For example, 2 or 3  10 minute walks is just as good as one long walk.  Dr. Albers talked with Gail Hogan /Daytime Columbus on National Walking Day 4/2/14 about the benefit of walking / staying active.

3.  As your fitness level advances, you  should increase either the duration or the intensity,  for steady improvement.

4. It is important to remember that all activity counts.  What may be more important than a set  exercise “routine” is to increase your total daily activity.   A simple pedometer or one of the newer fitness gadgets can be a great way to promote more daily activity.

5. interval training is an excellent way to increasing intensity of your exercise, and the benefits as well. It also breaks up a monotonous routine.  Interval training refers to short bouts of more intense exercise, for example jogging for 5 minutes and then walking one or 2 minutes. Here is a link to a nice video of some experts discussing a 20 minute interval workout.

6. For overall health (and to balance your 3 exercise “systems”), it can be very helpful to add weight based routines into your personal exercise mix.  Here is a nice video showing the benefits of weight training for all adults (and the best single weight exercise)  Yoga, stretching, etc are also very helpful to improve specific “systems.”

How can I gauge my level of activity?

The amount of overall exercise depends on the total duration (time), and the intensity level of that exercise.  We can all measure time easily, but intensity is a bit more challenging.  Two ways to assess intensity are by measuring your heart rate (pulse rate) or by simply noticing your perceived exertion. Your heart rate, or pulse rate, is a number of time your heart beats per minute. You can learn to measure this yourself, or use a device. A typical resting heart rate is 60-80 beats per minute. The lower your resting heart rate, the more efficient your heart and circulation. Heart rate always increases with exercise, but measuring it allows us to show there we’re in a range which will maximize benefit to our body. Our target range for exercise heart rate is determined by our age and fitness level. One simple formula is to subtract age in years from 220, which is commonly referred to as your maximal heart rate. Target exercise ranges are 70-85% of this. For example, a 50-year-old would have a maximum heart rate of 170 and a “target range” of 119 to 145. The problem with this calculation is that actual peak heart rate varies a lot between individuals. A more accurate way is to have an actual supervised treadmill test which will show your maximum heart rate and allow calculation of your target range. If your doctor has recommended (or has done) a treadmill stress test, ask the doctor or supervising staff member to tell you your maximum heart rate achieved and your target range.  Remember that heart rate can be affected by medications, hydration, illness, and medical conditions.

A second method, which is easier than measuring your heart rate, is a concept called “perceived exertion.” You  simply rate your current effort on a range from one (complete rest) to 10 (absolute maximum exertion).  For routine exercise, you should seek an effort of 6-8, which typically means your breathing is fairly heavy and it is hard to speak a complete sentence without taking a breath.

How do you actually increase activity in today’s world?  Choose stairs, park far from the store, consider biking, dance to music.  Use data tracking devices – options from pedometers to smart phone applications – knowing your step number can be eye opening.  Meet up with fitness partners; if you tell someone you will to walk, chances are better you’ll do it.  Keep variety so you can exercise all 3 systems.  HeartHealth Docs have been proponents of regular exercise for years.  Dr. Albers and her family were featured in this article in the February 2008 Central Ohio Community Health Magazine; The Heart Issue/Your Comprehensive Guide to a Healthy Heart.  For additional advice on starting a exercise program from our colleague, avid runner and sports medicine specialist, Dr. Darrin Bright, see this article at the OhioHealth website.

Here is wonderful video which captures the benefits of exercise:

We will have a future article on the science and physiology of exercise which will explain these concepts in even more detail for those who are interested.  In the meantime, talk to your doctor about how to get moving!

9 thoughts on “Exercise

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