Pamela Guggina, MD, MPH

Emergency Medicine, Public Health & General Preventive Medicine, Physician Case Manager, Advance Medical

Nearly everyone has been encouraged, instructed, even “ordered” by the doctor to exercise. Whether it is for cardiac health, weight loss or general well being, the message has been clear, we all need to be exercising on a regular basis. But what does this mean for the individual patient? Knowing exactly where to start and specifically what needs to be done can be challenging. Fortunately, there are clear, research-backed guidelines on the quantity, type and quality of exercise we should be getting.

The American College of Sports Medicine (ACSM), which is the authority on exercise guidelines, routinely reviews all of the scientific research available on exercise and its benefits and publishes guidelines based on this research. The most recent guidelines were updated in 2011 in Medicine and Science in Sports and Exercise, the official scientific journal of the American College of Sports Medicine. This is the best source for detailed information on how much exercise we need, how to get it and what the specific recommendations are.

The ACSM is very clear in their recommendations. Dr. Carol Ewing Garber, who is the chair of committee responsible for the organization’s writing states “the scientific evidence we reviewed is indisputable. When it comes to exercise, the benefits far outweigh the risks. A program of regular exercise – beyond activities of daily living – is essential for most adults.”

Specifically, the ACSM recommends 150 minutes of moderate-intensity exercise a week. This can be met through 30-60 minutes of moderate intensity exercise five days per week or 20-60 minutes of vigorous-intensity exercise three days a week. It is acceptable to do one long and multiple shorter sessions in order to accumulate the recommended number of minutes. In order to avoid injury and to build up fitness, it is recommended that one gradually increase the total time, frequency and intensity. In this way, there will be less risk of injury and a greater chance of adherence to whatever exercise program is being undertaken. Finally, ACSM acknowledges that some individuals will not be able to meet these requirements. Those people will still benefit from some exercise activity. In other words, something is better than nothing.

While intensity clearly means different things to different people a “quick and dirty” way to determine intensity of exercise is the “Sing Test”. If you can still sing, the exercise is low intensity. If you can still talk, the exercise is moderate intensity. During high intensity exercise, you will most likely be able to do neither. Following this reasoning, low intensity exercise would include things like walking, leisurely biking or gentle hiking. Moderate intensity for most people would include things like jogging or running, more strenuous hiking and biking (such as up a steep hill or with a specific challenging time goal in mind) and vigorous swimming. High intensity exercise would then be sprinting, jumping rope, or doing total body exercises like burpees or squat thrusts.

In addition to the cardiovascular exercise, the ACSM also recommends resistance (strength/weight training), flexibility and neuromotor exercise (balance/coordination). While on paper, this may seem overwhelming amount of execise, many of these categories overlap. For example, swimming laps and cycling up a hill are both also strength training, a yoga class will provide both neuromotor training and flexibility and in reality, almost any weight or strength class at your local gym will incorporate most of not all of these components.

The most recent recommendations have differed somewhat from prior recommendations in that they also address the issue of excessive sitting. We’ve all heard phrases like “sitting is the new smoking” and it seems that nearly everyone is counting steps and taking the stairs. It turns out that there is research to back this up. Says, Dr. Garber of the ACSM, “It is no longer enough to consider whether an individual engages in adequate amounts of weekly exercise, we also need to determine how much time a person spends in sedentary pursuits, like watching television or working on a computer. Health-and-fitness professionals must be concerned with these activities as well.”

This position is likely what is behind the growing popularity of standing desks, treadmill desks and large exercise balls replacing conventional desk chairs. These are all excellent ways to keep moving, but there are other practices out there that are becoming increasingly common. These include things such as “walking meetings” and “walking lunches” where instead of sitting around a conference table, participants walk and talk, or eat a light meal after the meeting, but spend the majority of the lunch meeting walking rather than sitting in a restaurant or café.

Exercise can be challenging and often, rounding up the motivation just to get started can be one of the hardest parts. Getting a dog has been shown to increase physical activity in the owner. There are multiple research studies demonstrating that dog owners have higher rates of physical activity and that promoting dog ownership can be a viable means of encouraging an active lifestyle. Whether it is that dog owners feel a sense of obligation to the dog, or the dog needs to walk in order to settle down and be better behaved, dog owners, more than non-dog owners tend to get out and walk more.

Whether it is by more conventional means, such as joining a gym and taking a class, or running, swimming and cycling, or by getting in the miles with a treadmill desk or a dog, the guidelines are clear: an active lifestyle is essential to maintaining good health.

References

  1. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP. Quantity and Quality of exercise for developing and maintaining cardiorespiratory, musckuloskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine and Science in Sports and Exercise. 2011; 43(7):1334-59.
  2. Ham S, Epping J. Dog walking and physical activity in the United States. Prev Chronic Dis. 2006; 3(2): A47.
  3. Westgarth C, Christly RM, Christian HE. Howmight we increase physical activity through dog walking?: A comprehensive review of dog walking correlates. International Journal of Behavioral Nutrition and Physical Activity. 2014;11:83
  4. Thompson DL. Dog walking for activity. American College of Sports Medicine Fitness Journal. 2010;14(3):39-41.

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