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Exercise
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Like any
other muscle in your body, the heart is also a
muscle and needs exercise to remain in good shape.
Regular exercise provides many benefits to your
heart and your body.
Exercise and Your Heart
A Guide to Physical Activity
Regular, moderate
physical activity can help improve the
way you look, feel and work. These
articles provide up-to-date
information on the effects of physical
activity on your heart, and practical
guidelines for starting and staying on
your own exercise program. We hope
this information will help you
consider the ways physical activity
can help you enjoy life more fully.
Table of Contents
-
Foreword
-
Do we get enough exercise from our
daily activities?
-
What are the benefits of regular
physical activity?
-
Can physical activity reduce my
chances of getting a heart attack?
-
Are there any risks in exercising?
-
Comparing the benefits and the risks
-
Should I consult a doctor before I
start an exercise program?
-
What if I’ve had a heart attack?
-
Five common myths about exercise
-
How do different activities help my
heart and lungs?
-
The key to success
-
How do I pace myself?
-
Effective ways to avoid injuries
-
Two sample activity programs
-
How do I keep going?
-
How can I become more active
throughout my day?
-
Foreword
Coronary heart disease remains the No.
1 single cause of death and disability
in the United States for both men and
women. Over half a million Americans
die of coronary heart disease each
year, and about half of these deaths
are women. Preventing coronary heart
disease remains the leading challenge
to biomedical researchers and public
health workers today. About every 29
seconds an American will suffer a
coronary event, and about every minute
someone will die from one. This year
an estimated 1.1 million Americans
will have a new or recurrent coronary
attack, and over 45 percent of them
will die.
At the National Heart, Lung, and Blood
Institute (NHLBI) and the American
Heart Association (AHA), we are
committed to addressing this challenge
by encouraging fundamental research on
the causes and treatment of coronary
heart disease and by strengthening our
disease prevention and health
promotion programs. We've seen a
dramatic decline in coronary heart
disease mortality during the past two
decades. This has been accompanied by
a growing interest in making lifestyle
changes that can reduce the risks for
coronary heart disease.
With prevention as our ultimate goal,
communicating health information to
the public will continue to be an
important part of our activities.
We've long provided the public with
educational materials to help reduce
three primary risk factors: high blood
pressure, cigarette smoking and high
blood cholesterol. In recent years,
the NHLBI and the AHA have addressed
another major risk factor — sedentary
lifestyle, or physical inactivity. The
results of various studies now show
that regular physical activity can
help reduce the risk of heart disease.
It also can help control other
contributing risk factors, including
obesity and diabetes. We hope that
this information will help to
stimulate a sensible exercise program
as one way of keeping a healthy heart.
We're delighted to join together to
provide this message about physical
activity. We believe that
collaboration is one important way of
performing common public health
missions and furthering this ongoing
partnership.
Do we get enough exercise from our
daily activities?
Most Americans get little vigorous
exercise at work or during leisure
hours. Today, only a few jobs require
vigorous physical activity. People
usually ride in cars or buses, sit at
their computers and watch TV during
their free time rather than be
physically active. Activities like
golf and bowling provide people with
some benefit. But they don't provide
the same benefits as regular, more
vigorous exercise.
Evidence suggests that even
moderate-intensity activities can have
both short- and long-term benefits. If
done daily, they help lower your risk
of heart disease. Such activities
include walking, stair climbing,
gardening, yardwork, moderate to heavy
housework, dancing and home exercise.
More vigorous exercise can help
improve fitness of the heart and
lungs, which can provide even more
consistent benefits for lowering heart
disease risk.
Today, many people are rediscovering
the benefits of regular, vigorous
exercise — activities like swimming,
brisk walking, running, or jumping
rope. These kinds of activities are
sometimes called “aerobic” — meaning
the body uses oxygen to produce the
energy needed for the activity.
Aerobic exercises can condition your
heart and lungs if performed at the
proper intensity for at least 30
minutes, on most days of the week.
But you don’t have to train like a
marathon runner to become more
physically fit! Any activity that gets
you moving around, even if it’s done
for just a few minutes each day, is
better than none at all. For inactive
people, the trick is to get started.
One great way is to take a walk for
10-15 minutes during your lunch break.
Other ideas offered here will help you
get moving and living a more active
life.
What are the benefits of regular
physical activity?
These are the benefits often
experienced by people who get regular
physical activity.
Feeling better
Regular physical activity —
-
gives
you more energy
-
helps
in coping with stress
-
improves your self-image
-
increases resistance to fatigue
-
helps
counter anxiety and depression
-
helps
you to relax and feel less tense
-
improves the ability to fall asleep
quickly and sleep well
-
provides an easy way to share an
activity with friends or family and
an opportunity to meet new friends
Looking better
Regular physical activity —
-
tones
your muscles
-
burns
off calories to help lose extra
pounds or helps you stay at your
desirable weight
-
helps
control your appetite
You need to burn off 3,500 calories
more than you take in to lose 1 pound.
If you want to lose weight, regular
physical activity can help you in
either of two ways.
First, you can eat your usual amount
of calories, but be more active. For
example: A 200-pound person who keeps
on eating the same amount of calories,
but decides to walk briskly each day
for 11/2 miles will lose about 14
pounds in 1 year. Or, you can eat
fewer calories and be more active.
This is an even better way to lose
weight.
About three-fourths of the energy you
burn every day comes from what your
body uses for its basic needs, such as
sleeping, breathing, digesting food
and reclining. A person burns up only
a small amount of calories with daily
activities such as sitting. Any
physical activity in addition to what
you normally do will burn up extra
calories.
The average calories spent per hour by
a 150-pound person are listed below.
(A lighter person burns fewer
calories; a heavier person burns
more.) Since exact calorie figures are
not available for most activities, the
figures below are averaged from
several sources and show the relative
vigor of the activities.
| |
Activity |
Calories burned |
| |
Bicycling 6 mph |
240 cals./hr. |
| |
Bicycling 12 mph |
410 cals./hr. |
| |
Cross-country skiing |
700 cals./hr. |
| |
Jogging 5 1/2 mph |
740 cals./hr. |
| |
Jogging 7 mph |
920 cals./hr. |
| |
Jumping rope |
750 cals./hr. |
| |
Running in place |
650 cals./hr. |
| |
Running 10 mph |
1280 cals./hr. |
| |
Swimming 25 yds/min. |
275 cals./hr. |
| |
Swimming 50 yds/min. |
500 cals./hr. |
| |
Tennis-singles |
400 cals./hr. |
| |
Walking 2 mph |
240 cals./hr. |
| |
Walking 3 mph |
320 cals./hr. |
| |
Walking 41/2 mph |
440 cals./hr. |
| |
|
|
The calories spent in a particular
activity vary in proportion to one’s
body weight. For example, a 100-pound
person burns 1/3 fewer calories, so
you would multiply the number of
calories by 0.7. For a 200-pound
person, multiply by 1.3.
Working harder or faster for a given
activity will only slightly increase
the calories spent. A better way to
burn up more calories is to increase
the time spent on your activity.
Working better
Regular physical activity —
-
helps
you to be more productive at work
-
increases your capacity for physical
work
-
builds
stamina for other physical
activities
-
increases muscle strength
-
helps
your heart and lungs work more
efficiently
Consider the benefits of a
well-conditioned heart:
In 1 minute with 45 to 50 beats, the
heart of a well-conditioned person
pumps the same amount of blood as an
inactive person’s heart pumps in 70 to
75 beats. Compared to the
well-conditioned heart, the average
heart pumps up to 36,000 more times
per day, 13 million more times per
year.
Feeling, looking, and working better —
all these benefits from regular
physical activity can help you enjoy
your life more fully.
Can physical activity reduce my
chances of getting a heart attack?
Yes! Various studies have demonstrated
that physical inactivity is a risk
factor for heart disease. Overall, the
results show heart disease is almost
twice as likely to develop in inactive
people than in those who are more
active. Regular physical activity
(even mild to moderate exercise) can
help reduce your risk of heart
disease. In fact, burning calories
through physical activity may help you
lose weight or stay at your desirable
weight — which also helps lower your
risk of heart disease. The best
exercises to strengthen your heart and
lungs are the aerobic ones like brisk
walking, jogging, cycling and
swimming.
Coronary artery disease is the major
cause of heart disease and heart
attack in America. It develops when
fatty deposits build up on the inner
walls of the blood vessels feeding the
heart (coronary arteries). Eventually
one or more of the major coronary
arteries may become blocked — either
by the buildup of deposits or by a
blood clot forming in the artery’s
narrowed passageway. The result is a
heart attack.
We know that there are several factors
that can increase your risk for
developing coronary artery disease —
and thus the chances for a heart
attack. Fortunately, many of these
risk factors can be reduced or
eliminated.
The risk factors for heart disease
that you can do something about are:
Cigarette Smoking, High Blood
Pressure, High Blood Cholesterol,
Physical Inactivity, Obesity and
Diabetes. The more risk factors you
have, the greater your risk for heart
disease and heart attack.
Cigarette Smoking.
Heavy smokers are two to four times
more likely to have a heart attack
than nonsmokers. The heart attack
death rate among all smokers is 70
percent greater than among nonsmokers.
People who are active regularly are
more likely to cut down or stop
cigarette smoking.
High Blood Pressure.
The higher your blood pressure, the
greater your risk of developing heart
disease or stroke. A blood pressure of
140/90 mmHg (millimeters of mercury)
or greater is classified as high blood
pressure. Regular physical activity,
even of moderate intensity, can help
reduce high blood pressure. This type
of activity may also help prevent high
blood pressure.
High Blood Cholesterol.
A blood cholesterol level of 240 mg/dl
(milligrams per deciliter) or above is
high and increases your risk of heart
disease. A total blood cholesterol of
under 200 mg/dl is desirable and
usually puts you at a lower risk of
heart disease. Cholesterol in the
blood is transported by different
types of particles. One of these
particles is a protein called high
density lipoprotein or HDL. HDL has
been called “good” cholesterol because
research has shown that high levels of
HDL are linked with a lower risk of
coronary artery disease. Regular
moderate-to-vigorous physical activity
is linked with increased HDL levels.
An HDL cholesterol level below 40 mg/dL
is considered low.
Physical Inactivity.
The lack of physical activity
increases your risk for developing
heart disease. Even persons who have
had a heart attack can increase their
chances of survival if they change
their habits to include regular
physical activity. It can help control
blood lipids, diabetes and obesity as
well as help to lower blood pressure.
Also, physical activity of the right
intensity, frequency and duration can
increase the fitness of your heart and
lungs — which may help protect you
against heart disease even if you have
other risk factors.
Obesity and Diabetes.
Excess weight may increase your risk
of developing high blood pressure,
high blood cholesterol and diabetes.
Regular physical activity can help you
maintain your desirable body weight.
People at their desirable weight are
less likely to develop diabetes. And,
exercise may also decrease a diabetic
person’s need for insulin.
Remember that even if you are active,
you should not ignore other risk
factors. Reduce or eliminate any risk
factors you can to lower your chances
of having a heart attack.
Tips for your heart’s health:
-
Stay
physically active.
-
Stop
smoking and avoid other people’s
smoke if possible.
-
Control high blood pressure and high
blood cholesterol.
-
Cut
down on total fats, saturated fats,
cholesterol and salt in your diet.
-
Reduce
weight if overweight.
Are there any risks in exercising?
The most common risk in exercising is
injury to the muscles and joints. This
usually happens from exercising too
hard or for too long — particularly if
a person has been inactive for some
time. However, most of these injuries
can be prevented or easily treated as
explained in “Effective ways to avoid
injuries.”
Heat exhaustion and heat stroke .
If precautions are not taken during
hot, humid days, heat exhaustion or
heat stroke can occur — although they
are fairly rare. Heat stroke is the
more serious of the two. Their
symptoms are similar:
| |
Heat exhaustion |
Heat stroke |
| |
dizziness |
dizziness |
| |
headache |
headache |
| |
nausea |
nausea |
| |
confusion |
thirst |
| |
body temperature below normal |
muscle cramps |
| |
|
sweating stops |
| |
|
high body temperature |
| |
|
|
The last two symptoms of heat stroke
are important to know. If the body
temperature becomes dangerously high,
it can be a serious problem.
Both heat exhaustion and heat stroke
can be avoided if you drink enough
liquids to replace those lost during
exercise. And be sure to take the
other important precautions listed
below in the section on avoiding
injuries.
Heart problems.
In some cases, people have died while
exercising. Most of these deaths are
caused by overexertion in people who
already had heart conditions. In
people under age 30, these heart
conditions are usually congenital
heart defects (heart defects present
at birth). In people over age 40, the
heart condition is usually coronary
artery disease (the buildup of
deposits of fats in the heart’s blood
vessels). Many of these deaths have
been preceded by warning signs such as
chest pain, lightheadedness, fainting
and extreme breathlessness. These are
symptoms that should not be ignored
and should be brought to the attention
of a doctor immediately.
Some of the deaths that occur during
exercise are not caused by the
physical effort itself. Death can
occur at any time and during any kind
of activity — eating, sleeping,
sitting. This does not necessarily
mean that a particular activity caused
the death — only that the two events
happened at the same time.
No research studies have shown that
physically active people are more
likely to have sudden, fatal heart
attacks than inactive people. In fact,
a number of studies have shown a
reduced risk of sudden death for
people who are physically active.
Exercising too hard is not beneficial
for anyone, however, and is especially
strenuous for out-of-shape,
middle-aged and older persons. It is
very important for these people to
follow a gradual and sound exercise
program.
If you consider the time your body may
have been out of shape, it is only
natural that it will take time to get
it back into good condition. A gradual
approach will help you maximize your
benefits and minimize your risks.
Comparing the benefits and the
risks
Should you begin a regular exercise
program? Consider the ways physical
activity can benefit you and weigh
them against the possible risks.
Potential benefits
-
more
energy and capacity for work and
leisure activities
-
greater resistance to stress,
anxiety and fatigue, and a better
outlook on life
-
increased stamina, strength and
flexibility
-
improved efficiency of the heart and
lungs
-
loss
of extra pounds or body fat
-
help
in staying at desirable weight
-
reduced risk of heart attack
Potential risks
-
muscle
or joint injuries
-
heat
exhaustion or heat stroke on hot
days (rare)
-
aggravation of existing or hidden
heart problems
Should I consult a doctor before I
start an exercise program?
Most people do not need to see a
doctor before they start since a
gradual, sensible exercise program
will have minimal health risks.
However, some people should seek
medical advice.
Use the following checklist to find
out if you should consult a doctor
before you start or significantly
increase your physical activity.* Mark
those items that apply to you:
-
Your
doctor said you have a heart
condition and recommended only
medically supervised physical
activity.
-
During
or right after you exercise, you
frequently have pains or pressure in
the left or mid-chest area, left
neck, shoulder or arm.
-
You
have developed chest pain within the
last month.
-
You
tend to lose consciousness or fall
over due to dizziness.
-
You
feel extremely breathless after mild
exertion.
-
Your
doctor recommended you take medicine
for your blood pressure or a heart
condition.
-
Your
doctor said you have bone or joint
problems that could be made worse by
the proposed physical activity.
-
You
have a medical condition or other
physical reason not mentioned here
which might need special attention
in an exercise program. (For
example, insulin-dependent
diabetes.)
-
You
are middle-aged or older, have not
been physically active, and plan a
relatively vigorous exercise
program.
If
one or more items applies to you, see
your doctor before you start. If
you’ve checked no items, you can start
on a gradual, sensible program of
increased activity tailored to your
needs. If you feel any of the physical
symptoms listed above when you start
your exercise program, contact your
doctor right away.
* This checklist has been developed
from several sources, particularly the
Physical Activity Readiness
Questionnaire, British Columbia
Ministry of Health, Department of
National Health and Welfare, Canada
(revised 1992).
What if I’ve had a heart attack?
Regular, brisk physical activity can
help reduce your risk of having
another heart attack. People who
include regular physical activity in
their lives after a heart attack
improve their chances of survival.
Regular exercise can also improve the
quality of your life — how you feel
and look. It can help you do more than
before without pain (angina) or
shortness of breath.
If you’ve had a heart attack, consult
your doctor to be sure you are
following a safe and effective
exercise program. Your doctor’s
guidance is very important because it
could help prevent heart pain and/or
further damage from overexertion.
Five common myths about exercise
Myth 1. Exercising makes you tired.
As they become more physically fit,
most people feel physical activity
gives them even more energy than
before. Regular, moderate-to-brisk
exercise can also help you reduce
fatigue and manage stress.
Myth 2. Exercising takes too much
time.
It only takes a few minutes a day to
become more physically active. To
condition your heart and lungs,
regular exercise does not take more
than 30 to 60 minutes of your day. If
you don’t have 30 minutes in your
schedule for an exercise break, try to
find two 15-minute periods or even
three 10-minute periods. Once you
discover how much you enjoy these
exercise breaks, you may want to make
them a habit! Then physical activity
becomes a natural part of your life.
Myth 3. All exercises give you the
same benefits.
All physical activities can give you
enjoyment. Low-intensity activities —
if performed daily — also can have
some long-term health benefits and
lower your risk of heart disease. But
only regular, brisk and sustained
exercises such as brisk walking,
jogging or swimming improve the
efficiency of your heart and lungs and
burn off substantial extra calories.
Other activities may give you other
benefits such as increased flexibility
or muscle strength, depending on the
type of activity.
Myth 4. The older you are, the less
exercise you need.
We tend to become less active with
age, and therefore need to make sure
we are getting enough physical
activity. In general, middle-aged and
older people benefit from regular
physical activity just as young people
do. Age need not be a limitation. In
fact, regular physical activity in
older persons increases their capacity
to perform activities of daily living.
What is important, no matter what your
age, is tailoring the activity program
to your own fitness level.
Myth 5. You have to be athletic to
exercise.
Most physical activities do not
require any special athletic skills.
In fact, many people who found school
sports difficult have discovered that
these other activities are easy to do
and enjoy. A perfect example is
walking — an activity that requires no
special talent, athletic ability or
equipment.
How do different activities help my
heart and lungs?
Some types of activity will improve
the condition of your heart and lungs
if they are brisk, sustained and
regular. Low-intensity activities do
not condition the heart and lungs
much. But they can have other
long-term health benefits.
The columns below describe three types
of activities and how they affect your
heart.
Column A — These vigorous exercises
are especially helpful when done
regularly. To condition your heart and
lungs, the AHA recommends that you do
them for at least 30 minutes, on most
days of the week, at 50-80 percent of
your exercise capacity. (See chart
below on target heart rate zone.)
Other health experts suggest a shorter
period for higher-intensity
activities. These exercises can also
burn up more calories than those that
are not so vigorous.
Column B — These activities are
moderately vigorous but still
excellent choices. When done briskly
for 30-60 minutes on most days of the
week, they can also condition your
heart and lungs.
Column C — These activities are not
vigorous or sustained. They still have
benefits — they can be enjoyable,
improve coordination and muscle tone,
relieve tension, and also help burn up
some calories.
These and other low-intensity
activities — like gardening, yardwork,
housework, dancing and home exercise —
can help lower your risk of heart
disease if done daily.
| |
A |
B |
C |
| |
Do condition
heart and lungs |
Do condition
heart and lungs |
Do not
condition much |
| |
Aerobic Dancing |
Downhill Skiing |
Badminton |
| |
Bicycling |
Basketball |
Baseball |
| |
Cross-Country Skiing |
Field Hockey |
Bowling |
| |
Hiking (uphill) |
Calisthenics |
Croquet |
| |
Ice Hockey |
Handball |
Football |
| |
Jogging |
Racquetball |
Gardening |
| |
Jumping Rope |
Soccer |
Golf (on foot or by cart) |
| |
Rowing |
Squash |
Housework |
| |
Running in Place |
Tennis (singles) |
Ping-pong |
| |
Stair-climbing |
Volleyball |
Shuffleboard |
| |
Stationary Cycling |
Walking Moderately |
Social Dancing |
| |
Swimming |
|
Softball |
| |
Walking Briskly |
|
Walking Leisurely |
| |
|
|
|
The key to success
How do I begin?
The key to a successful program is
choosing an activity (or activities)
that you will enjoy. Even moderate
levels of activity have important
health benefits. Here are some
questions that can help you choose the
right kind of activity for you:
-
How
physically fit are you?
If you’ve been inactive for a while,
you may want to start with walking
or swimming at a comfortable pace.
Beginning with less strenuous
activities will allow you to become
more fit without straining your
body. Once you are in better shape,
you can gradually change to a more
vigorous activity if you wish.
-
How
old are you?
If you are over 40 and have not been
active, avoid very strenuous
programs such as jogging when you’re
first starting out. For the first
few months, build up the length and
intensity of your activity
gradually. Walking and swimming are
especially good forms of exercise
for all ages.
-
What
benefits do you want from
exercising?
If you want the benefits of exercise
that condition your heart and lungs,
check the activities in columns A
and B in the chart above. These
activities — as well as those listed
in column C — also give you other
benefits as described in this Web
site.
-
Do you
like to exercise alone or with other
people?
Do you like individual activities
such as swimming, team sports such
as soccer, or two-person activities
such as racquetball? How about an
aerobics class or ballroom dancing?
Companionship can help you get
started and keep going. If you would
like to exercise with someone else,
can you find a partner easily and
quickly? If not, choose another
activity until you can find a
partner.
-
Do you
prefer to exercise outdoors or in
your home?
Outdoor activities offer variety in
scenery and weather. Indoor
activities offer shelter from the
weather and can offer the
convenience of exercising at home as
with stationary cycling. Some
activities such as bench stepping,
running in place or jumping rope can
be done indoors or outdoors. If your
activity can be seriously affected
by weather, consider choosing a
second, alternate activity. Then you
can switch activities and still stay
on your regular schedule.
-
How
much money are you willing to spend
for sports equipment or facilities?
Many activities require little or no
equipment. For example, brisk
walking only requires a comfortable
pair of walking shoes. Also, many
communities offer free or
inexpensive recreation facilities
and physical activity classes.
-
When
can you best fit the activity into
your schedule?
Do you feel more like being active
in the morning, afternoon, or
evening? Consider moving other
activities around. Schedule your
activity as a regular part of your
routine. Remember that exercise
sessions are spread out over the
week and needn’t take more than
about 10 to 15 minutes at a time.
By
choosing activities you like, you will
be more likely to keep doing them
regularly and enjoying the many
benefits of physical activity.
How do I pace myself?
Build up slowly. If you’ve been
inactive for a long while, remember it
will take time to get into shape.
Start with low- to moderate-level
activities for at least several
minutes each day. See the sample
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