So many exercise choices, so little time. Where do you begin? Whatever your goal -- cardiovascular, muscle building, or weight loss -- WebMD Weight Loss Clinic's own exercise physiologist, Rich Weil, MEd, CDE, discussed how to get started and make the most of your fitness activities.
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. Do you agree that Americans have made fitness into a "to-do" item, like going to the dentist or paying bills? Everyone I know says they "have to" or "need to" get in shape. Nobody seems to "want to" get fit.
Weil: That's interesting. The research shows that slightly more people are exercising today than they were 10 years ago, but not very many more. In fact, still less than 40% of the people exercise regularly. In terms of "have to" and "supposed to" what the research shows that when people feel they have to, they tend to do it less. So it seems, although exercise and fitness is very popular, we're still not at the place where people have incorporated it into their lives so that it is like brushing their teeth. We'd like to move toward that goal and over time, I suspect that more people will.
It's important to understand that physical activity and exercise is a behavior change, and the best way to change your behavior is to practice changing your behavior. In terms of exercise and a sedentary lifestyle, what we'd like people to do is incorporate physical activity into their lives, and the psychologists will tell you that as you repeat a behavior enough times, it does start to become more second nature.
Moderator: Do you think one key to incorporating fitness into your life is trying things like participation in team sports or even gardening clubs or something like that, instead of buying gym memberships or home gyms, so fitness becomes more like a lifestyle/social thing?
Weil: There is a trend towards more support and activities that people do together. Gardening, for instance is either the second or third most popular physical activity in the country. Some of those people may join garden clubs, and research shows that having a partner or a group does increase adherence to physical activity. It's not true for everyone, but some people will do better with the support of other people.
As far as sports and athletics, we would like people to take some of the focus off of simply formal exercise and go ahead and select activities that they enjoy or that they're good at, or even would like to learn how to do. For instance, some people would really like to learn how to swim. What we do now is encourage them to take lessons to learn how to swim. We have been encouraging people to take ballroom or any type of dancing to help them enjoy the activity, and look forward to it.
In addition, if people do start to participate in more sports-related types of activities, they may decide to do more formal exercise or workouts to enhance their performance in the activity that they have selected. For instance, if you decide to play tennis or racquetball, you may find that working out will improve your performance with that activity. So by combining a physical activity or sport you enjoy or have always had a desire to try, people may find that they can then enhance the performance with more formal workouts.
Member question: What is the best regimen to follow for getting stronger?
Weil: Resistance exercise, where muscles contract against any external resistance or force, will help the muscles get stronger. So you can lift dumbbells or rubber tubing or even your own body weight, like a pushup or other calisthenics, and if the muscles are forced to contract, they will respond by getting stronger.
The guidelines for resistance exercise are written by the American College of Sports Medicine and they are to start with at least two days of any type of resistance exercise doing 8 to 10 different exercises and doing 8 to 12 repetitions. A repetition is how many times you lift the weight or pull the rubber tubing or move your body. So that might be 8 to 10 biceps curls or 8 to 10 pushups.
In 12 weeks of consistent resistance exercise strength can increase by 20% to 23%. Resistance exercise is important because it builds muscle. Muscle is important because it is the engine in your body that burns calories and helps maintain your metabolic rate. I encourage all people to do any type of resistance exercise for those reasons, as well as for the fact that balance will improve and coordination will improve. Resistance exercise also improves self-esteem.
Moderator: So those who are interested in using exercise to aid in weight loss should not just look at calories burned by a certain amount of a particular exercise? Building muscle means weight loss is enhanced across the board?
Weil: When anyone loses weight, up to 25% of the weight lost could be muscle. In other words, if you lose 100 pounds, 25 pounds could be muscle. This can make more weight loss difficult, because of the role of muscle in burning calories. Although weight lifting and other resistance exercise do not necessarily burn lots of calories, it's very important for long-term weight maintenance, because muscle is so metabolically active in your body.
The bottom line is that you want as much muscle as possible. So resistance exercise during weight loss, and once you reach your goal weight, is important.
Member question: What is too much exercise?
Weil: There are symptoms of over training. Those are:
- Loss of strength or speed or performance in general
- An increase in resting heart rate
- More fatigue during the day
- A feeling like you don't want to work out
- Chronic soreness or aches and pains
It's important to remember that the muscles and the body in general, grow during rest periods, not when you're training. If you don't provide down time and rest periods then the muscles never have a chance to recover and grow. Then the symptoms of over training will appear and your results will be greatly compromised.
The trick is to monitor your body and learn how to listen to your body for these symptoms, and when you have the symptoms to take some time off from your workout. Virtually everyone who takes a break from their workout when they are over trained comes back stronger than ever. People are afraid to take time off from working out, but the fact is if you are over trained you will not be able to grow or get more results. So a break is critical.
Member question: So how many days, at most, should you workout?
Weil: Again, it depends on, first of all, symptoms of over training. Some people can work out every day and be fine and others need more rest. It depends also on the type of exercise that you're doing, the frequency with which you do it, and the intensity. For instance, if you do moderate aerobic exercise such as walking or bicycling, and you get just warm and slightly out of breath during the activity, then you probably can do it every day. If, on the other hand, you do hill work or speed work to improve performance for road races, you need to build rest days into the workout.
If you weight lift every day, the chances are that you will burn out and need to take a break. It's really not necessary to weight lift more than three days per week with adequate rest between workouts, as long as the workouts are vigorous and hard. If you lift light weights and do high repetitions, say 15 to 20 repetitions, and perhaps you're doing this in an aerobic-type class, you would be able to perform these activities more than three times per week, but otherwise, heavy resistance training should be limited to two or three days, so that the muscles have time to recover.
Member question: Softball season will be here before you know it. Any tips you have for a 40+ something for getting ready for the season? I've given up on being a softball star; I'd just like to equip myself reasonably and reduce my chances of injury.
Weil: Great question. If you follow all these tips you will probably have a better experience this spring:
- Start to do aerobic exercise to build endurance.
- Begin some resistance exercise to help with performance, like swinging the bat or throwing the ball. The more strength the better, plus more strength may prevent injuries, particularly shoulder injuries caused by throwing.
- Do some type of flexibility program, preferably combined with the aerobic activities. That may be a stretching routine right after an aerobic activity or something like a stretch class or even yoga. One of the more common injuries, particularly in activities such as softball, are pulled hamstring or quadriceps muscles, because people don't stretch, and the nature of the sport of softball is a lot of stop and quick start movements. So stretching in the gym will help limber the muscles.
- Finally, prior to game time treat the game as a workout and warm up properly. That means maybe a 1/2-mile to 1-mile jog, followed by 10 to 15 minutes of stretching, particularly in the legs, and the stretching routine should be as close to game time as possible. One other method is to do an aerobic warm-up such as jogging, and then a few, maybe two to three, faster sprints -- not all-out sprints, but faster sprinting to get the legs prepared for the game.
Member question: What is the best workout for a painful arthritic knee? It seems the more I work it the more stiffness there is in it. I like walking, but it stiffens up a lot after walking. It also has had many operations on it: cartilage, ACL repair, and debridement. Can you suggest anything for me?
Weil: My best suggestion is water classes, water aerobics, or swimming. You can check the arthritis foundation web site for water classes that they sponsor all over the country. There may be one in your area. Otherwise, check your local recreation center or Y to find out if they have water classes. If water classes are not available, then a gentle stretch class and tone class at your gym will help.
You also need to use pain as your guide. If, after a proper warm-up your muscles feel more limber and warm, it will be OK to continue. If the muscles feel stiff and tight, it means you need to spend more time on the warm-up and on stretching.
And finally, a safe routine of weight lifting to strengthen the legs, particularly the muscles around the knees, can be very helpful and alleviate some of the symptoms of arthritis. A fitness trainer at your gym or a physical therapist who you could be referred to by your physician could help design and develop these exercises for you; that would be quite helpful. The Arthritis Foundation may also have information on strengthening the muscles around the joints.
You may want to speak to your physician about the latest treatments, including medication to help you continue your activity.
One point is very clear: people with arthritis do best when they are physically active. So I encourage you to pursue any or all of the options that I've mentioned.
Member question: I need help getting my inner thighs in shape. I currently run for about 40 minutes three to four times a week and do strength training on my legs (adduction machine) two times a week. But my inner thighs still touch!
Weil: Unfortunately, spot reducing does not work. It would be nice if during your run you could tell the fat cells in your thighs to give up the fat so that the muscles could burn the fat away. But this does not work. The way you reduce fat is like you are doing. Running, by the way, is excellent, as is resistance exercise like you're doing.
The adduction machine that you are using will tighten the muscles under any excess fat, but will not reduce the fat. However, if the muscles are tight and toned, they may allow your clothes to fit better.
Also keep in mind that lower extremity fat is very stubborn, particularly so in women, and will not reduce in response to exercise as much as you would like. It doesn't mean that it won't reduce, but you may need to be more patient. Genetically, it may be that you have a predisposition to excess fat in the legs, and although it may be more difficult to lose you can still make some changes with regular exercise.
So hang in there, keep up with your exercise, and try not to be too hard on yourself. Remember that there are many, many other benefits of fitness in addition to the cosmetic benefits; try to enjoy all of those benefits and you will be well served.
Member question: Many people say they do weight before cardio. Can you do cardio before and after weight training?
Weil: Yes. You can do your cardio before weight training. In fact, many people enjoy it that way, because the muscles are warmer and loose and people report that the weight lifting feels better when the muscles are warm.
The concern about cardio before weight lifting is that the cardio will wear you out and you will not get the same resistance exercise workout because you're tired. That would be true for people who do vigorous or hard cardio workouts and are concerned more about their weight lifting benefits than their cardio. In that case, then they should do just a brief and light aerobic warm-up, maybe 10 minutes of light cardio and then weights. But if you're not just focused on weight lifting results then cardio before is fine.
The bottom line is how your body responds and how you feel during the workout. There are no hard and fast rules. Experiment with cardio before and after and see how you feel and what results you get. That will ultimately determine which way you work out. Either way is acceptable.
Member question: Does a teenager's body metabolize faster than the average adult? How long on average would it take for a 17-year-old teenage boy, 140 pounds, to lose 20 pounds of fat doing regular exercise of running 3 miles every other day mixed in with about two hours of recreational tennis with a diet of an average teenager (cereal for breakfast, sandwich lunch, not so heavy dinner)?
Weil: Average safe and healthy weight loss is 1 to 2 pounds per week and not more. Your doctor can help you decide how much weight if any, you need to lose. For instance, if you're 6 feet tall and 140 pounds, you do not need to lose any weight. These are issues you should discuss with your doctor before going on any weight loss plan.
In general, three to five days of aerobic exercise and two to three days of resistance exercise is desirable, and then paying attention to your diet and calorie intake. You can also discuss your diet with your doctor or even check in with one of the dieticians on the WebMD web site if you have more diet-related questions.
Member question: We are thinking of a family bike trip during spring break. I like to ride and feel that it is the best way to prepare for this trip. However, some days it is too wet to ride. What training can you recommend for those days? I hate riding stationary bikes (too boring).
Weil: Any other aerobic activity will keep your heart and lungs in condition for biking. In fact, doing other activities may help with biking because the muscles will have a chance to rest, and the next time you get on the bike you may be fresher and stronger.
If you want more leg work and cardio together, and want to keep your legs strong for biking, you could jump rope or even climb stairs for your workout. Climbing stairs would be as close as you could come to the biking movement, either in your home or wherever you could find stairs. I don't recommend stair climbing more than once or twice a week because it is so vigorous, but a combination of the jump rope, which you could do indoors on a rainy day, and climbing stairs would help you stay bike fit.
Member question: I have an 11-year-old son who lives with his mother. My son is a bit on the heavy side. It happened once before, too, when his mother fed him too many apple juice bottles when he was 2 or 3. He slimmed down for a few years, but in the last three or so his weight has shot up and he has a larger tummy than I'd like to see. When I approach him about his weight and his eating habits, I feel bad because he cries and says, "You think I'm fat." When I approach his mother, she berates me or hangs up the phone. Any suggestions?
Weil: Family weight issues can be complex. Research shows that the best approach for children who have weight problems is not to make the focus on the weight or specifically isolate the child. Any child who feels all of the attention is on him will have a very difficult time losing weight. Instead, the family should all be involved in regular exercise and healthy eating. That means family bike rides on the weekends, a family walk after dinner, maybe the family all preparing meals so that everyone is involved and no one feels like they are being singled out.
In fact, some studies show that intervening just with the parents helps children lose more weight than intervening with the child or the parents and child together. So it's clear that the entire family needs to make the changes together and that's the best way to go about it.
Member question: How many times a week should I do resistance training for my arms to be able to see definition?
Weil: Two to three days per week of resistance exercise is more than adequate for definition. The repetitions should be in the eight to 12 range, and the final repetition should be to fatigue. After eight to 12 weeks there should be some noticeable difference, provided that you do not have a lot of excess fat on your arms, because spot reducing won't work; but otherwise, eight to 12 weeks at two to three times per week is more than enough.
Member question: I want to increase my weight as I am 26 and weigh just 50 kilograms at 5 feet 6 inches. Could you tell me what I should do?
Weil: There are two things that you can do. First, start resistance exercise, using the guidelines we mentioned earlier. The second thing is to meet with a registered dietician who can make suggestions for safe, healthy, and effective weight gain. Unless your calories increase it will be very difficult to gain weight. Your doctor can refer you to a registered dietician.
Moderator: Do you have any final comments for us, Rich?
Weil: Physical activity and exercise have been proven, without any doubt, to improve health, fitness, and quality of life. We still have a long way to go before all Americans enjoy the benefits of regular activity, but if we can all make even the smallest steps towards increasing our physical activity, we will go a long way towards better health, more fitness, and feeling better about ourselves.
Spring is around the corner and there's no better time to start thinking about and taking those steps towards an active lifestyle.
Moderator: Thanks to Rich Weil for sharing his expertise with us. For more information on everything he discussed today, be sure to visit him at his WebMD Weight Loss Clinic message board, where you can post questions for Rich and get advice and support from fellow Weight Loss Clinic members.