Benefits of exercise for your heart and for your health in general:
- Lower your risk of coronary heart disease and stroke: With as little as 30 minutes of cardiovascular activity most days of the week, you can significantly decrease your risk of heart disease! (WHO: Global Strategy of Diet, Physical Activity and Health, 2004)
- Decrease your risk of high blood pressure: As you get older, you are at greater risk of a raised blood pressure. Regular physical activity can help to prevent this increase as well as lower an elevated blood pressure. Six million South Africans suffer from this condition and should take heed.
- Improve your blood lipid profile (cholesterol and triglycerides): Five million South Africans (Norman R, Bradshaw K, Steyn K, Gaziano T. Estimating the burden of High Cholesterol in South Africa, 2000. South African Medical Journal Aug 2007 vol 97 (7)). struggle with a poor lipid profile. According to recent studies, regular exercise has the ability to lower LDL levels ( "bad" cholesterol) and raise HDL cholesterol ("good" cholesterol). In a recently published meta-analysis of 35 studies, exercising subjects had increases in HDL cholesterol averaging about 0.06mmol/l. This increase in HDL cholesterol might appear modest, but considering that cardiac risk is thought to drop by two to three percent for each 0.025mmol/l increase in HDL, this rise in HDL amounts to a substantial reduction in risk (Kodama S, Tanaka S, Saito K, et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol. Arch Intern Med 2007; 167:999-1008). It also decreases LDL- cholesterol and triglycerides (fats in the blood that, if elevated, clog up your arteries and are a health risk). (Katcher HI, Hill AM, Lanford JL, Yoo JS, Kris-Etherton PM. Lifestyle approaches and dietary strategies to lower LDL-cholesterol and triglycerides and raise HDL-cholesterol.
- Lower your risk of breast and colon cancer and possibly various reproductive cancers: Research shows that the incidence of certain cancers could be significantly reduced if we made healthy lifestyle choices, which include not smoking, healthy dietary habits and regular physical inactivity.
- Decrease your risk of Type 2 Diabetes (adult-onset): Excess abdominal fat and inactivity can promote adult-onset diabetes, which plagues approximately 1.5 million South Africans!
- Improve your bone density and decrease risk of osteoporosis: One in two women and one in eight men aged 50 and over will have an osteoporosis-related fracture in their lifetime; related to their low bone density. Fortunately, weight-bearing exercise is a very effective tool in improving bone density and in decreasing loss of bone density with ageing.
- Improve long-term weight control: With 56% of South African women and 29% of men being overweight (Puoane, T. Steyn, K., Bradshaw, D, Laubscher, R. Fourie, S., and Lambert V. 2002. Obesity in South Africa: the South African Demographic and Health Survey. Obes.Res (10):1038-1048) (which has associated health risks), effective weight loss tools are extremely important.
- Exercise raises your metabolic rate (the rate at which food energy is burned), so less of it is stored. The extra muscle mass you gain from regular exercise, further increases your metabolic rate both at rest and during exercise (muscle tissue burns up much more energy than fat).
- Improve your mental alertness: Research shows that exercise improves the "executive control processes" of the brain, for example, your ability to make plans and establish schedules.
- Improve your psychological well-being: Inactivity is a major risk factor for depression. Exercise, on the other hand, improves your sense of well-being, vigour and vitality and decreases stress, anxiety and negative emotions
- Enhance body function in older adults: Research shows that a significant amount of the deterioration in function we experience as we get older, is related to our increasingly sedentary behaviour as we age. Regular activity is one of the best age-defying treatments available and it is for free! It also decreases the risk of falling in the elderly, which could have severe consequences, for example immobilisation due to a hip fracture.
- Lower your medical expenses: Exercise should decrease your need for medications, as well as visits to doctors and hospitals!
- Sadly, about over 60% of South African men and nearly 50% of South African women [(Second Demographic and Health Survey of SA (SADHS)], deny themselves these extraordinary benefits, since we simply don't do enough exercise!
We live in an age of quick fixes, rapid results and instant gratification, where time equals money. So it seems that many people consider that exercise requires too much time, money and grueling workouts with slow results, with other "magic bullets" promising instant results. Although incorrect, these might be barriers to exercise for some.
Here are some other barriers - tick those that apply to you. Perhaps you:
- Lack time in your day
- Are too busy and stressed to add extra things in your day
- Think physical activity is boring
- Don't know how to exercise
- Think you are too old
- Fear injury and already have some aches and pains
- Think exercise is going to be a costly activity
- Had a bad experience with exercise in your past
- Don't like to sweat and feel breathless
- Don't know who can join you
Although these barriers might appear insurmountable, they can be resolved if you really put your mind to it! So what can we do about it? Let's look at some of the really the positive aspects of being physically active. Wouldn't you like to:
- Live longer and decrease your risk of heart disease and other chronic diseases of lifestyle?
- Lose weight or maintain a healthy weight?
- Improve your bone density and reduce your risk of osteoporosis and fractures?
- Feel more energetic?
- Be fitter and stronger?
- Decrease feelings of stress, anxiety and/or depression?
- Sleep better?
- Feel better about your body and about how you look?
- Be a good role model for your children and family?
- Discover new activities, explore opportunities and have more fun?
Now ask yourself: Are there benefits that you find desirable that inspire you? Are you prepared to tackle the barriers that have prevented you being active in the past? If the answers to these two questions are YES, then you can get out of the rut of inactivity and start benefiting immediately!
Before you get started with your exercise programme - you need to establish a few things:
What is your current health status?
Being physically active is safe for most people, however, it is always best to see whether it is necessary to have a consultation with your doctor before embarking on an exercise programme.
The physical activity readiness questionnaire (PAR-Q) - shown below- is a self-screening tool that can be used by anyone who is planning to start exercising. It was developed by the British Columbia Ministry of Health and the Multidisciplinary Board on Exercise and adopted directly from the American Congress of Sports Medicine (ACSM) Standards and Guidelines.
The Physical Activity Readiness Questionnaire (PARQ)
Answer yes or no to the following questions:
- Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
- Do you feel pain in your chest when you do physical activity?
- In the past month, have you had chest pain when you were not doing physical activity?
- Do you lose your balance because of dizziness or do you ever lose consciousness?
- Do you have a bone or joint problem that could be made worse by a change in your physical activity?
- Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
- Do you know of any other reason why you should not do physical activity?
If you answered yes to one or more questions OR:
- are over 45 (men) or over 55 (women)
- have been inactive or are concerned about your health
- are pregnant
- are a smoker
Consult a physician before taking a fitness test or substantially increasing your physical activity. You should ask for a medical clearance along with information about specific exercise limitations you may have. In most cases, you will still be able to do any type of activity you want as long as you adhere to some guidelines.
Your doctor can give you advice about the type of programme that might meet your health needs and fitness goals. If you suffer from diabetes, high blood pressure, heart problems, seizures, or asthma, you can still gain the health benefits of exercise if you carefully monitor your condition and follow the doctor's/exercise trainer's recommendations. Realise that moderate exercise involves minimal health risks for people in good health or those following a doctor's advice. Far greater risks are presented by inactivity and obesity.
If you answered no to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have low risk of having any medical complications from exercise. (ACSM: For the Exercise Sciences and Clinical Sports Medicine - Physical Activity and Public Health Guidelines - Position Stands www.acsm.org)
However, it is still important to start slowing and to build up gradually. It may also be helpful to have a fitness assessment with a suitably qualified person to determine where to begin.
Note: If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better to begin exercising.
Next, what is your current fitness level - are you doing any physical activity now?
Once you have received medical consent from your doctor, it's also important to get sound advice from a suitably qualified exercise specialist who can prescribe a safe, effective exercise programme. It is vital to start off at a level that is comfortable for you and to proceed carefully. Follow this course and you are far more likely to reach your goal and more importantly - to sustain a physically active lifestyle. The Yes2Life website has a number of exercise suggestions for you.
The only way for an inactive, (or previously active person), to adopt a new behaviour, such as becoming active (again) - is to change. Changing any behaviour requires time and effort and commitment, and generally involves moving through about five different stages. Into which stage do you fit, and what are you doing about moving into the next stage?
Stage 1: Not ready for change
These individuals have no desire to change their inactive ways. Hopefully, this no longer describes you; you are ready to make a change in the next few months, which means you have progressed to stage 2.
Stage 2: Contemplation
Whilst the idea of becoming fit and healthy is very exciting, there will be challenges along the way. So be prepared and optimise your chances of long-term success by implementing these 3 tips:
- Prepare a comprehensive list of reasons reinforcing why you want to be active; keep them handy in case you start doubting your motives.
- Write down disruptions or barriers that could arise (e.g. holidays, visitors, low energy levels, bad weather).
- Prepare a list of solutions for each barrier/disruption listed (e.g. alternative physical activities which include family/friends, home exercise videos, rainy weather gear etc).
Stage 3: Preparing for Action
You're now ready for action, but perhaps you'll need your doctor's consent if you. Do the Physical Activity Readiness Questionnaire (PARQ) to assess whether you need medical consent.
Realise that moderate exercise involves minimal health risks for people in good health or those following a doctor's advice. Far greater risks are presented by inactivity and obesity
Here are a few more tips at this stage:
- Prioritise exercise in your life; see it as something that you simply can't do without.
- Choose physical activity that suits your personality, you're more likely to enjoy it and stick to it (outdoor person - walking/hiking).
- Make sure your exercise option is accessible and affordable.
- Decide what is the best time of day to exercise (morning, lunch-time or evening).
- Get support from at least 2 people close to you - perhaps get a partner with whom to train.
- Get the necessary garb (sports shoes etc) and sort out the logistics of your sessions.
Stage 4: Taking action - the first 6 months
Fifty percent of people who start an exercise programme drop out in the first 6 months, so this is the crucial testing time. However, the positive benefits you are deriving from exercise should keep you focused and on track and here are a few tips.
- Double your chances of success by joining a group or programme.
- Be disciplined and patient, especially in the first few weeks, until good habits are well established and you start seeing results.
- Put "exercise appointments" in your diary.
- Set small, achievable and measurable goals every month.
- Keep track of your progress. Start a logbook where you record each session's activity as well as a weekly/monthly record of for example your waist and hip measurements, blood pressure and weight.
- Reward yourself when you reach a goal (a massage, some time out etc.).
Stage 5: Maintenance Stage
By this time, regular exercise is integrated into your lifestyle. Research shows that people who have exercised for longer than 6 months, are much more likely to succeed long-term, but just make sure that you stay aware and don't become over-confident about your success, or otherwise you might slip-up.
- Add variety to your exercise programme to avoid boredom.
- Develop a long-term plan- what is your exercise mission (health, fitness, an event)?
- Keep seeing exercise as a major priority in your life and keep rewarding yourself when you realise new goals.
- Remember that ANY exercise is better than none at all, so use those 10 spare minutes, climb that flight of stairs - every step counts.
- HAVE FUN with activity - it is well worth the investment!
"More on WALKING as a WAY to WELLNESS"
Walking is how we humans get around and perhaps for this reason, many disregard it as a "real" form of exercise. But this is not the case! Research on walking shows that it improves your circulation and cardiovascular function, strengthens your bones, helps to build and maintain muscle mass, eases stress and anxiety, improves your sense of well-being and done correctly, is a nifty way to shed extra kilos.
Assuming you have followed us advice regarding buying the right walking shoes - here are some more tips on:
- Walking technique
- Maximising your energy expenditure when walking
- Some final tips to ensure success on your walking programme
Part of Body
TORSO AND PELVIS
ANKLES AND FEET
Position whilst walking:
- Don't look down - look ahead focused on a point 30m or so ahead of you. Make sure that you don't crane your neck forward, a posture we often adopt when we are in a hurry Keep your head up with your eyes
- Relax your shoulders by shrugging them out before you start walking. Holding your shoulders and arms tense 'disconnects' the arms from the walking action, which is not what you want to do.
- Your back should be straight as you walk, allowing for its natural curves - so you shouldn't be leaning backwards or forwards. But, a slight forward lean on hill climbs is acceptable
- Your torso should be erect. Be careful of leaning either backwards or forwards, since this will place enormous strain on the back. Strong abdominal muscles will help you to keep erect and minimise back strain. Imagine that your pelvis is a bucket of water, and you are aiming not to spill any but avoiding tipping it forward or back
- Keep your navel gently contracted to your spine - imagine you have done up a zip from your pubic bone to your bellybutton, holding in the whole area between.
- Using your arms properly during walking can increase your energy expenditure. If walking at a leisurely pace, your arms should be relaxed and slightly bent. As you speed up, your arms should be bent close to 90 degrees, and they should move forward and back in a straight plane, rather than crossing the body. This will help you to go faster.
- Keep your hips square and level with no sideways movement. Strengthening your core muscles will help you to maintain stability of the hip region.
- Try to keep leg action relaxed with only a moderate knee lift. Imagine your legs start at your waist, not your groin, and really extend them with each step
- Try to walk with 'loose' ankles. Imagine your foot is dangling rather than rigid between foot strikes - rigid ankles have a detrimental effect on the knees. After you land on the outer side of your heel, your foot rolls inwards, which is essential for adequate shock absorption and the final phase is a push off with your toes. Your feet should point forwards and should land directly under your hips.
- Finally, smile - this is all about getting fit and healthy and having fun!
MAXIMISING YOUR ENERGY EXPENDITURE WHEN WALKING
With summer in full swing, one is especially conscious of the extra kilos that have crept on during winter. Even if aesthetics don't bother us - extra weight means extra health risks.
Regular exercise and a healthy, balanced eating plan can help to shed extra kilos, improve your bone density, decrease health risks for chronic diseases of lifestyle and should improve your cholesterol profile too.
Basically to lose weight, you need to create an imbalance between the calories you take in and your energy expenditure (calories burned). To achieve this, combine a healthy, low-fat, calorie-controlled diet with a regular moderate-to-vigorous intensity exercise programme. Walking offers a wide range of wonderful opportunities to shape up and here are 4 ways to achieve a fit and healthy body.
- Accumulate more steps in a day
- Speed up
- Interval training (bursts of high intensity)
- Find hilly routes
- Walk on trails or go hiking
The easiest and safest way for beginner walkers to lose more weight through walking, is to walk further, more often. One burns approximately 50 calories for every kilometer walked, so a few extra kilometres walked here and there, can quickly increase your energy expenditure. Why not invest in a simple pedometer and monitor the number of steps you walk each day. Challenge yourself to increase this number each week.
Walking faster means burning more calories, recruiting more muscles and giving your heart a better workout! This translates into a fitter and better toned person. It should also improve your body composition as you burn more fat and build a little muscle. Muscle weighs more than fat, so don't be despondent if your weight doesn't drop much in the first few weeks of walking. Only increase the speed of your walking when you have a solid base of at least 3 weeks of walking.
How fast should you walk? On your fast walks, aim for 140 steps or so per minute. If you prefer to work on actual speed, a brisk walk would be about 6km/hour, whereas a fast walk would be about 7km/hour upwards. Not all your walks need to be fast. Alternate an easier day (5- 6km/hour) with a high intensity day.
This is best done on a sports field or in a traffic-free zone! It involves alternating short bursts of high intensity walking with a slow recovery walk as described in the programme. It's an excellent method for getting fitter and boosting your metabolism. To start out - after a 10 minute warm-up walk - walk very fast for 2 minutes - then walk slower for 3 minutes. Repeat this five times. As you get fitter - so you can increase the number of repetitions as well as the "fast-walking" interval.
For anyone trying to get fit - hills are your best friend! Training on hills provides you with benefits that far outweigh many other workouts. Start off, by choosing a route that incorporates about three to four, 300m hills and try to walk this once a week. Once you are fitter - you can actually do a session a week - where you do hill repeats. After a 10 minute warm-up walk - walk up a 300m hill briskly. Recover o the downhill and catch your breath. Repeat four times before doing a cool-down. As you get fitter - so you can increase the number of hill- repeats you do - until you reach about 10 repetitions.
Trail-walking is an excellent training session - and not only does it burn up lots of energy, it's also a great way of doing strength-training. Once you have done some trail walks - why not do a few day-hikes. South Africa boasts some beautiful hiking trails - so when you are fit enough - why not get a group together to tackle a three to four day hike., A 68kg person, carrying a 12kg backpack will expend well over 600 calories per hour of walking- so this is certainly an excellent way of whipping that body into shape. Even better, you will have the added advantage of returning home with a renewed spirit, fully inspired to continue on your health and fitness journey.
SOME TIPS TO ENSURE SUCCESS ON YOUR WALKING PROGRAMME
- VARY YOUR ROUTES. Incorporate some off-road walks (forest, cross-country, beach) but always walk with a group for safety.
- FIND AN EVENT FOR WHICH TO TRAIN: Having a goal is motivating and keeps you focused and disciplined.
- STRETCH REGULARLY - ideally daily. Stretch after walking when your muscles are warm.
- FIND A FRIEND OR GROUP WITH WHOM TO TRAIN: It helps to be accountable to someone else or to a group leader.
- MONITOR YOUR PROGRESS (distance, time taken, mood, body measurements etc). Measuring positive changes is truly motivating!
12 snippets of top scientific evidence that are enough to get you walking
You know in your heart that moderate intensity exercise, such as walking is great for you- but sometimes hard facts are much more convincing! Here are 12 of the top scientific reasons to put on those shoes and get walking.
- General Health and Wellness
- Improved immune system
- Boost your brain power
- Reduces the risk of developing or dying from coronary heart disease (CHD)
- Reduces the risk of stroke
- Lowers both total blood cholesterol and triglycerides and increases high-density lipoproteins (HDL)
- Lowers the risk of developing high blood pressure and helps reduce blood pressure in people who already have hypertension
- Lowers the risk of developing non-insulin-dependent (type 2) diabetes mellitus
- Reduces the risk of developing breast cancer
- Reduces the risk of developing colon cancer
- Reduced risk of needing gall stone removal surgery
- Psychological benefits
A full analysis of the results of 18 studies related to walking was published in the British Journal of Sports Medicine, 2008. They showed that there is an inverse dose-response relationship between walking, health and disease prevention. That means that up to a point - the more you walk - the healthier you are! The minimal amount of exercise that imparts benefits is unclear, but moderate activity, such as brisk walking for 30 to 60 minutes a day most days of the week, is associated with big reductions in the incidence of cardiovascular disease as well as death from this disease. A gratifying take home message is that physical activity need not be vigorous to benefit your health.
Many studies suggest that regular walking can decrease the incidence of colds. One study of 50 women divided them into a group who walked briskly for 45 minutes a day, 5 days a week, and a control group that did not exercise. The walkers experienced half as many colds as the control group. The walkers also showed an increase in natural killer cells, immune system cells that attack bacteria and viruses.
Research published in the Journal of the American Medical Association in 2004 suggests that regular cardiovascular exercise might enhance your brain power! In a study of more than 18000 female nurses, those who walked at least 1.5 hours per week, scored higher on tests of general thinking ability, verbal memory, and attention than did women who walked less than 40 minutes per week. Similarly, a study of more than 2000 men showed that regular walking reduced the development of dementia (including Alzheimer's disease). Exercise improves blood flow to the heart and brain, promotes the preservation of brain cells and increases the connections between them.
Cardiovascular disease includes heart attack, stroke, hypertension and congestive heart failure. Getting regular exercise is one of the pillars of prevention. Brisk walking three hours a week, or just half an hour a day, is associated with a 30% to 40% lower risk of heart disease in women, according to a 20-year study on 72000 female nurses (Nurses' Health Study). Even short periods of exercise like walking one hour a week can greatly reduce the risk of heart disease, according to a study published in the Journal of the American Medical Association.
Regular, moderate exercise equivalent to brisk walking for an hour a day, five days a week, can cut the risk of stroke in half, according to a Harvard study of more than 11000 men. One of the ways exercise helps, is that it can inhibit clot formation by making the platelets "less sticky". It also promotes the release of enzymes that break down clots. This is important, since clots can either partially or completely block of blood supply to the brain, which can result in a stroke
An exercise, such as walking, helps to combat atherosclerosis (the progressive thickening and hardening of the walls of arteries as a result of fat deposits on their inner lining) in several ways.
In a study published in the Medicine Science Sports Exercise journal in 2008, a programme of 8 weeks of walking 10 000 steps, three times a week, was shown to lower total cholesterol by as much as 7%. High-density lipoproteins (HDL), also known as "good" cholesterol, increased by up to 6%. This is an impressive effect. HDL transports fats to the liver, preventing them from accumulating on artery walls. Exercise also helps reduce low-density lipoproteins (LDL or "bad" cholesterol) in the blood, which can cause plaque buildup along the artery walls — a major cause of heart attacks, as well as triglycerides (another fat linked with cardiovascular disease). Exercise also protects one's arteries. Artery walls are lined with endothelium and injuries to the endothelium caused by high blood pressure, high cholesterol, diabetes, smoking and the wear and tear of aging, are often the starting points for the growth of plaques. Researchers believe that the regular expansion and contraction of arteries during exercise, keeps the vessels "in shape" and maintains endothelial function. This was illustrated in a study published in Circulation (2000) and one in the Journal of Applied Physiology (2000).
Physical activity can decrease both systolic and diastolic blood pressure by 6 - 7 points as reviewed in articles published in the Journal of Clinical Epidemiology (1992) and American Journal of Hypertension (1994). To achieve these benefits, participants in the study did moderate exercise (e.g. walking) to high intensity exercise (e.g. running), for 30 - 60 minutes, three to four times a week. Furthermore, these effects were found both in those with normal blood pressure as well as those with hypertension. Being regularly physically active is just as effective as some medications in keeping down blood pressure levels.
Note: Type 2 Diabetes is often adult-onset and is frequently related to lifestyle
Regular exercise has long been considered a cornerstone in the treatment of diabetes. The joint position statement of the American Diabetes Association and the American College of Sports Medicine concludes that exercise regimens at an intensity of 50 to 60% VO2 max (60 to 70% of maximum heart rate) three to four times a week for 30 to 60 minutes are consistently associated with improvements in carbohydrate metabolism and insulin sensitivity.
It is well established that a single exercise session improves glucose metabolism in type 2 diabetics by as much as 30% and that the improvement in peripheral (muscle) insulin sensitivity may last for 36 hours post exercise.
In study on 70 102 female nurses over an 8-year period, the risk of type 2 diabetes was about 20% less in those women who reported walking about 1 hour per week and 25% less for those walking 3 or more hours per week. Independent of the number of hours they walked, their walking pace was also inversely related to risk of type 2 diabetes. In women who walked at a pace of 3.2 km and 4.4km/h, the risk of type 2 diabetes was lowered by 15%. The women who stepped up the pace and walked at a pace faster than 4.8 km/h, the decrease in risk was a hefty 40%.
In the Nurses' Health Study II, involving 64 777 premenopausal women, the researchers found a 39% lower breast cancer risk when considering total lifetime physical activity, in the most active women compared with the least active women. Whilst the results in different studies are varied, the emerging consensus is that if you do 3 - 4 hours of exercise a week, you can reduce your risk by 20 - 30%. Brisk walking can fulfill these criteria.
A comprehensive study published in the Journal of Oncology in 2006, involved 832 patients with stage III colorectal cancer (5 stages in this disease). It compared patients who reported less than an hour of moderate -paced walking a week, with those who did about six hours of walking a week. The study showed that those who totaled about six or more hours a week of moderate-paced walking decreased their risk of death from colorectal cancer by 45%.
Regular walking or other physical activity, lowers the risk of needing gallstone surgery by up to 31% according to a Harvard study of more than 60 000 women, aged 40 to 65 (Nurses Health Study).
Aside from all these vital physiological benefits of walking - the psychological benefits are equally if not more important. In a Scottish study involving 19842 men and women, it was shown that different types of activities including walking, were all independently associated with lower odds of psychological distress. Mental health benefits were apparent at a minimal level of at least 20 minutes per week of any physical activity. Again there was a dose-response pattern - with greater mental health benefits with more physical activity.
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