Fit enough to do your thing

couple-2765327_960_720Some of you might know my superhero alter identity.  Nights and weekends I am Scoutmaster and Adventure Dude, but weekdays I am a mild-mannered Exercise Physiologist at a Cardiac Rehab program at a Regional Hospital.

Yesterday I had the pleasure of speaking with a group of the lovely ladies of the Four Seasons civic group about fitness and becoming fit and maintaining your fitness as you age.  I thought I’d clean up my talking notes and leave them here because someone else might get something out of them.

What do you want to be fit for?

First of all, “fit” is a slippery idea thing to get hold of.

  • You do not have to be a marathon-running fanatic to be fit (unless marathoning is your thing)
  • Being “fit” is no guarantee that you will not ever suffer negative health events – Jim Fixx (the guy that started the jogging craze of the 1970s) died of a heart attack.

What do you want to be fit for?

  • I’m not asking “Why would you want to be fit” but “Fit for what?”  What do you want to do with your fitness?
  • Some people say they want to be “normally fit”, but fit as a “normal” person is setting the bar too low – especially around here.  It is “normal” these days to suffer and die of obesity and diabetes and heart attack.
  • Fitness as a way to avoid negative health events is also hard to figure out because it is hard to measure things that do not happen.  For instance, if you do not suffer a heart attack in the next few years, can you be certain it was because of your fitness routine?
  • The best objective target for fitness is to find a recreational activity that you love (bonus points if it is outdoors and involves nature or community service), whether it is walking or golf or dancing or whatever, and do enough deliberate extra exercise to be fit enough to enjoy that recreational activity.  Get fit enough that you can do your thing – whatever that thing is.

Modality, Intensity, Duration, and Frequency

The things you do for exercise – that is what Physiologists call modality.  It turns out that you need about 3 different modalities of exercise to stay healthy – Resistance exercise, aerobic activity, and stretching.

  • Resistance exercise is anything that makes your muscles work against gravity or weight, whether it is lifting weights or doing calisthenics against body weight.
  • Aerobic exercise is anything that makes you sweat and breathe hard continuously for several minutes at a time. Jazzercize, spinning, walking, aerobic dance, etc…
  • Stretching is any sort of routine that makes your muscles longer – yoga, Pilates, etc…

Intensity – How hard do I have to exercise?

  • Regular physical exercise that is greater than about 50% of your maximum capacity will maintain and perhaps even improve your capacity.
  • The problem with that is it’s hard and unpleasant to figure out what is your maximum capacity (who here wants to volunteer for a maximal treadmill stress test or a 1-rep-max weight lifting test) – so in turn, it is hard to figure out what is 50% of you max
  • Some folks use heart rate guidelines but that is also tricky too for 2 reasons
    • They estimate your max heart rate using a mathematical formula that is not all that good.
    • Most everyone at our age – especially if they’ve already had heart problems – is on medicine to keep their heart rate low.
  • The best guideline for intensity is perceived exertion and symptom limitation.
    • We use a 4-point exertion scale – basically light, medium, hard, and too hard.  It’s pretty easy for most folks to describe how they’re feeling on that scale.  You want to aim for medium to hard but not so hard you have to stop right now.
    • If you have symptoms (chest pain, etc) take a break till it subsides then go again but slightly easier.

Duration and Frequency

  • Regularity of exercise is much more important than modality or intensity.
  • fitness experts used to tell people 30 minutes per day 3 days per week – but they found that folks think it is acceptable to almost reach that goal.  A few minutes of exercise 1-2 days per week seemed to most folks like it should be okay.
  • Now the recommendation is 45-60 minutes per day most days of the week (that’s 4-6 days per week)!  That way, even if you miss that recommendation you’re likely to hit the 30 minute-three day goal 😉

Dwight Eisenhower story

The example of the day was Ike Eisenhower.  He had a heart attack during his first term.  Back then a heart attack was a death sentence.  There was no cardiac rehab.   It either killed you right then or the doctors told you to lie in bed until you died.

Ike Eisenhower had a young, forward-thinking Harvard doctor who basically told him, “Since you’re a goner anyway, let’s try some things out on you.”

He prescribed for the President to walk outside and play with his grandkids and go fishing – all at a light-to-moderate exertion level and all symptom limited.  And Ike’s fitness improved until he was able to return to the highest stress job in the world!

One look at this photo of Ike fishing should be enough to convince you of the restorative properties of fishing 😉

ike fishing

Eisenhower would go on to have an aneurysm, a stroke, and something like 13 more heart attacks but they didn’t stop him from walking and fishing and playing and Presidenting – because he used moderate, sensible exercise to keep himself fit enough to do his thing!

The usual disclaimers

This is not medical advice.  It is just an anecdote.

It would not be prudent for you to begin an exercise program without consulting your physician.  Talk to your doctor!  They almost never say, “No, you can’t exercise.”  Instead they’ll usually give you good advice and resources for starting an exercise program geared to your needs and geared toward keeping you fit enough to do your thing!

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