The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Welcome back to WebMD Live, Rich. For those of us who used the hot weather as an excuse to lie around in the air conditioning all summer, how do we get up and get moving after a long period of inactivity?
Weil: The best way to motivate oneself is to go ahead and set a weekly schedule. That means write it down if you're not certain you're going to get to it. Really do this: Write down the activity that you'll do. It might be the stationary bike or the treadmill or going back to the gym. Whatever your activity, write that.
Then write down what day or days of the week you'll do it, and then write down the time of day. That's important, because you need to be very specific when goal setting so that you know exactly what is expected of yourself.
Then write down for how long you will do the activity in minutes, whether it's 10 minutes, 15 minutes, or so on. The reason, again, to write down the amount of time, is that you know and expect what you're going to be doing. If you've been a couch potato all summer, that's no problem; don't worry about if it's only a few minutes; get started realistically and build up gradually. One of the sure ways to not succeed is to set unrealistic goals.
I'd also like to add that in the summer, and particularly this summer, it was very hot and humid, and I noticed, for myself, that as soon as it got cooler, I was able to do more exercise and it felt better. My time in my running improved and overall, it was a better experience. So now is the time to go ahead and get started, when the weather is cooler, and I can guarantee that you'll enjoy the better weather.
Moderator: I know people who go to the gym six days a week and some who swear by those 20-minute fitness places a couple of times a week. For general fitness, just how much time is right for the average adult, if there is such a thing?
Weil: Like most things in science and medicine, there's never always one simple answer. There are two primary guidelines for physical activity in the United States. The first is from the American College of Sports Medicine. They recommend 20 to 60 minutes of moderate to vigorous aerobic exercise at 60% to 85% of your maximum heart rate.
If you don't take your heart rate, simply ask yourself how hard does the work feel? If you feel out of breath and sweaty, that's what counts, and as a result your aerobic fitness and your stamina and your endurance and your energy and your general health will improve.
In addition, the American College of Sports Medicine recommends two days per week of weight lifting. Now, that's new for them to recommend, and it's important that they have recommended it because it speaks to how important building muscle and strength is. The ACSM recommends two days per week lifting, eight to 10 exercises for all the major muscle groups, and you lift 8 to 12 repetitions. The major muscle groups are your chest, back, shoulders, arms, abdominal muscles, and legs.
So the complete guideline from the ACSM is three to five days per week for 20 to 60 minutes of aerobic conditioning, and two days of weight lifting.
That's more formal exercise, but then the Surgeon General has a different guideline: Accumulate 30 minutes of moderate intensity physical activity on five or more days of the week. There are two key words/phrases in the Surgeon General's recommendation. Number one is accumulate, which means you can do 10 minutes in the morning, 10 minutes later on in the afternoon, and 10 minutes in the evening, or you could do two bouts of 15 minutes, or one bout of 30. The second key is moderate intensity, which means that you feel warm and slightly out of breath when you're doing the activity.
The Surgeon General's recommendation is a lifestyle intervention, recognizing that people have time constraints and are frequently resistant to the ACSM guidelines. The Surgeon General's guidelines offer people alternatives to formal exercise and they can still get healthier and improve their fitness.
Lifestyle activities could include:
- Climbing the stairs more
- Raking your own leaves instead of calling the kid down the street to do it for you (use a rake instead of a leaf blower)
- Mowing the lawn with a push mower
- Washing the car by hand (I remember as a kid washing the car by hand with my family and how much fun that was)
We need to start to think about ways in our life that we can be physically active again. The environment is such that labor saving devices do all of the work for us, so get rid of the robo mower and start doing some of these physical activities.
Also, park the car farther from the store or your office and walk more.
How many times do people pull into a parking lot at the mall and drive around for five to ten minutes looking for a space closest to the store? Instead, park as far away and start to work on accumulating those 30 minutes of moderate intensity activity.
The good news is that if you follow the Surgeon General's guideline, which presumably is easier to follow than more vigorous guidelines, you can still get healthy and fit. For people who have either taken the summer off or just need to get started again, this is the perfect way to do it, with lifestyle activities.
Member question: I have just started workouts in the gym a week ago. I find that the total calories burned in treadmill, elliptical, and stationery bicycling does not increase considerably with increase in speed or time. Is that a bad sign?
Weil: The reality is that exercise, by itself, doesn't burn as many calories as people always think. It's possible that the machine is miscalibrated at the gym, but more than likely it's simply that in 30 to 40 minutes of exercise, you may burn anywhere from 250 to 400 calories and not much more. So in terms of strict caloric expenditure and losing weight, exercise is helpful, but it's also important to reduce the number of calories that you eat if you're interested in losing weight.
Member question: I am taking two different prescription medicines that have affected my weight. One, Adderall, a stimulant medication for narcolepsy and ADD, has made me lose my appetite and a lot of weight. The other is the Pill, which I have just yesterday resumed after a three-year break; this one made me put on 5-10 pounds back then. I hope they'll balance out, but my biggest fear now is that the weight I've lost includes muscle -- how can I tell? Thank you.
Weil: If you belong to a gym, they can measure your body fat with calipers. If you want to spend some money, you can purchase a special type of scale that works with bioelectric impedance. You can purchase one for $50 to $100, and that will tell you what percent of your body is fat compared to muscle. You won't know if you lost muscle, since you don't have a baseline body fat, but if you use it this week in four weeks you do it again, and you can start to see a pattern.
Another way would be to measure your circumferences or even at this moment, determine whether your clothes fit differently. Typically people will lose muscle from their shoulders and upper body first, so if a shirt fits looser through the shoulders it may be you've lost some muscle. Another circumference would be your waist. If you've lost muscle and gained some fat, your slacks might fit a little tighter.
The other thing to keep in mind is that whenever you lose weight, you almost always lose some muscle. In fact, you can lose up to 25% of your weight from muscle. So if you lose 10 pounds, two and a half pounds of that could be muscle.
That's why it's important to lift weights, particularly when you're on a weight-loss program, because muscle is the engine that burns calories and helps maintain metabolism. If you lose muscle, your metabolic rate might slow down and that will make it more difficult to lose more weight.
In your case, whether or not you've gained or lost muscle, it would be very important now to either continue lifting or start if you're not. In addition, any muscle you lost -- if you lost any -- would come back in a very brief time. Now, some medications will cause weight gain, and that's a new problem that doctors and researchers are looking at, but still, the answer is, you want to increase muscle as much as possible and weight lifting is always a good idea.
Member question: I plan to join a 35-and-over indoor soccer league this fall. It's pretty laid back and for fun, so I don't expect it to be too intense, but I haven't exercised regularly in years. Is this taking too big a step? What should I do in the next few weeks to prepare for this so I don't keel over or get injured?
Weil: First thing, always get the okay from your doctor if you're going to do vigorous exercise.
Secondly, start a jogging and stretching program. Start with 10 minutes of jogging. The most that I recommend is 15 minutes, but 10 is usually a good starting place for people who have not been active. There's no way in particular that you can speed up your body's ability to get fitter faster, so over the next few weeks, try to exercise daily with the jogging and stretching of the legs, and increase the time gradually by 10% to 20%.
In three weeks, you could be up to 30 minutes, but I don't recommend rushing it, because even if you can run for 30 minutes once, you don't want to injure yourself or be so sore that you have to take several days off. So the message is, build up slowly and once you get up to 30 minutes of jogging, you will see that your fitness will be significantly enhanced.
The only other way to increase your fitness would be to set aside 30 minutes for jogging and then start out with a five minute brisk walk to warm up and then jog for five to 10 minutes, walk again for three to five minutes, and then you could jog again for 10 minutes. That type of interval work would improve your fitness instead of jogging for 10 minutes and calling it a day.
Don't look at three weeks as the final outcome, because you might end up injured. Instead, look at these next three weeks as your starting point and just continue through soccer season to improve your fitness. It's not realistic to expect to get into the best shape of your life in three weeks. So pace yourself, build up gradually, make sure you stretch before and after, and you'll be ready to go.
Free Weights or Machines?
Member question: Do you recommend free weights or machines, especially for women?
Weil: I recommend both. Body builders always use both. The advantage of free weights is that you can be very creative. They also require more balance and stabilization of the body when you lift. For instance, if you do a standing biceps curl with dumbbells, you have to use your legs and your abdominal muscles to hold your body up. If you do a seated biceps curl on the machine, you won't use all the muscles.
On the other hand, certain machines are terrific. The lat pull down, the cable row machine, the cable crossover machine, and some of the others are all excellent, and you can be creative in terms of the angle and whether you use one arm or two arms.
So both free weights and machine are useful, and furthermore, there has never been a study to show that one is superior to the other. It's a matter of trying them out and seeing which exercises give you the most benefit.
Women tend to like to use the lower body machines like the leg press, adduction and abduction machines, and then you can also use free weight lunges and squats and even side lunges to work the same muscles. So you can get equal workouts with both. A new and popular exercise plan is the Curves program, which, in essence, is circuit training, where you go from one machine to the next. The research shows clearly that this type of training is effective for building strength, improving endurance and stamina, and improving health. You also will get very toned with this type of routine and for the most part, it's all machines, and it is effective.
So the muscles sort of will feel the difference between a machine and free weights, whether you're male or female, but they all will work.
Member question: I have started doing abdominal and back crunches in order to reduce my tummy. I find that every other morning my upper abdomen feels tight for some time and then the feeling goes away. Does this mean any improvement? (I am doing 50 forward crunches and 25 backward)
Weil: Yes. The muscle tightness means that the muscle is responding; it is getting stronger, and if you continue, you will probably notice that your clothes will fit looser as your torso tightens up. This tightening may occur even if you don't lose weight or fat. The reason the clothes fit tighter is that the muscles have tightened and pulled in the abdomen, even if there was no weight loss.
Unfortunately, you cannot spot reduce, so even if you did 1,000 sit-ups per day, the fat on top of the muscle is not going to disappear. Basically, our abdominal muscles look no different than pieces of steak from the butcher. The meat is the muscle and the fat around the meat is the fat. The only thing missing is the skin. You can work that muscle all you like, but it won't eliminate the fat.
The way to reduce the fat is to do aerobic exercise, which stimulates the fat to release into the body, into the bloodstream, so that it can be burned during exercise, and to do resistance or weight lifting exercise to build that muscle. Remember the muscle is the engine that burns all the calories. The aerobic exercise will stimulate the fat to release into the bloodstream, so that it can get to the muscle. Once the fat is in the muscle, it gets burned and then you have a smaller fat cell, and that's how you lose fat.
Keep up with the abdominal exercises, because they will tone you, tighten you and strengthen you, and then as you do more aerobic activity, you'll get those fat cells to reduce.
Then finally, of course, attention to how many calories you eat is critical for losing the fat, because no matter how much exercise you do, you will never lose weight if you eat more than you burn.
Member question: Can you recommend any free weight exercises to replace lunges and squats for bad knees?
Weil: Start with straight leg raises:
- Lie down on the floor, one knee bent and the other leg straight.
- Lift the straight leg to the height of the other knee.
- Pause one to two seconds and then lower the straight leg to the floor.
- Repeat 10 times.
- If that's easy, strap an ankle weight -- two pounds to start -- on your ankle and do the exercise with that.
That will start to strengthen the quadriceps and the knee with no stress on the knee.
Once you can do three sets of 10 repetitions with five to eight pounds ankle weights, you may be able to do some standing squats or lunges, but if not, you can start with seated leg extensions and seated leg curls. If those bother your knee, you can shorten the range of motion so the knee doesn't bend all the way to 90 degrees. And, of course, if the knee continues to hurt, you should see your doctor.
Once you can do straight leg raises, leg curls seated, and seated leg extensions without pain, you should be able to do squats and possibly lunges.
Member question: I have tons of exercise equipment at home but not sure which ones to use and should they be used in a specific order?
Weil: Lots of exercise equipment is a good thing. Number one, it serves as a cue to exercise, and number two, it's very convenient.
Here is a potential order to do your exercise program:
- Start with a three to five-minute brief aerobic warm-up.
- If you have a treadmill or bike or any other aerobic device, use that first. Do anywhere from 15 to 30 minutes of aerobic activity on the machine.
- Then spend time with your resistance exercise equipment. If you have dumbbells, lift those. If you have a therapy ball or Physioball, use that as well, in conjunction with the dumbbells.
So the basic order can be basic aerobic and then resistance exercise. Most people prefer that order because the muscles are warmer after aerobic activity and then the weight lifting or calisthenics feel better. But your body doesn't really care all that much, and if you prefer the resistance machines first, try it and see what feels most comfortable.
The most important thing is that you do something. Don't get locked into rules about what to do and in what order when those questions aren't as important as simply using the machines. So set a schedule, try it one way or another, and see what feels most comfortable for you, and I can assure you that you will get benefit, whether you do the treadmill first or the dumbbells or whatever equipment you have. Listen to your body, feel how it responds, and you will soon know what's the best for you.
Moderator: Before we wrap up for today, Rich, do you have any final comments for us?
Weil: The most important element of all of fitness is if you're not doing anything to get started slowly and realistically. The evidence is very clear that going from a couch potato to someone who walks three to five days per week for 30 minutes or does even less activity, is going to benefit tremendously. In fact, being a marathon runner and adding another type of exercise won't give that person as much benefit as the couch potato who simply gets started.
For people who are already going to the gym five, six, seven days per week, of course I encourage them to remain active, but try other activities, like hiking or a sport that maybe they've thought about but for whatever reason, didn't want to try, or long bike rides or walks with the family on the weekend. Get the family involved for an overall fitter lifestyle.
Finally, physical activity is a real key to health and well-being and I encourage everyone to do whatever they can to lead an active lifestyle.
Moderator: Thanks to Richard Weil, MEd, CDE, for sharing his fitness expertise with us. And thank you members for joining in the discussion. For more information, please visit Rich at his Exercise & Fitness message board.