The Real Reason To Be Fit

What if, as a young man or woman, you were unable to climb more than one flight of stairs, get on a bike or take an active vacation? Unfortunately, lack of exercise is the case for many American youths age 12-21 years.

Seniors aren't always the most deconditioned segment of our population. For example, contrary to the popular stereotype of the "heart patient" in the Cardiopulmonary Rehab/Wellness class at the Veteran's Administration Medical Center in Dallas, Texas, the largest percentage of clients isn't made up of elderly people. Some have recovered from bypass surgery, a heart attack or angioplasty. Others are in the wellness program to improve their risk profiles and get into shape. Although the oldest patient is an 83-year-old man, the youngest is a girl in the 10th grade, severely obese, who had been having palpitations and dizziness.

According to the latest Surgeon General's report, and the Center for Disease Control and Prevention (CDCP), daily enrollment in P.E. classes declined among high school students from 42% in 1991 to a mere 25% in 1995. Only 19% of all high school students report being physically active more than 20 minutes per day in P.E. classes. Most of us know lack of exercise is a major risk factor for heart disease, but what about it determining someone's need for assisted living? Or when a person may become disabled or frail? The definition of frail does not include an age criteria--frailty is a lack of strength, regardless of age. We discover only when it's too late that to live in this state of being is to have a much poorer quality, and quantity, of life. This is especially important for women to remember. They tend to increase their coronary risks as well as osteoporosis-related injury with a sedentary lifestyle.

The latest Surgeon General's report was the first to address physical activity. (Note: A full report can be obtained at www.cdc.gov). It states that some form of light to moderate exercise should be performed daily. The American College of Sports Medicine (ACSM) and CDCP recently revised the recommendations for physical activity. It now says, "adults should accumulate 30 minutes or more of moderate physical activity over the course of most days of the week."

Note the word "moderate." Exercise does not have to be painful. This attitude causes more harm than good. Although careful heart rate monitoring may be necessary in specific instances, perceived exertion should be used to help guide your intensity. For example, if your pulse is in the right target range, but you perceive yourself to be at a "17" level on the Perceived Exertion Scale of six (very, very light) to 20 (very, very hard), you will be uncomfortable and less likely to continue. Your perceived exertion level for continuous activity should be about a "13," where you can carry on a mild conversation but still feel like your body is working. Exercising at higher intensities can increase your chances of injury and decrease your compliance. A modified version of the Perceived Exertion Scale (0-10) is also used, although with the original scale there is more of a choice, which can be important for lower level exercisers.

Walking is one of the easiest ways to get in shape and stay that way. If you prefer wheels, take a bike or skates to the nearest park (wear a helmet, of course). This is also a great way to meet new people. Choose a variety of activities. After all, your daily life requires all kinds of muscular and cardiovascular capabilities. It's deflating to drive around parking lots because you can't walk too far from your car, or turn down a date's offer for a bike ride because you might collapse, or be afraid to take the stairs when the elevator breaks. All the basic activities we take for granted can potentially be impossible if we are out of shape.

The vanity part of being fit and in shape is all well and good. For example, you jiggle less, wear smaller sizes and can get away with an extra piece of cake. Being thin does not equal being fit, however. It is not enough to squeeze into that dress for a special evening out. Fit means being able to get up if you fall in that great gown. Fit means being able to walk to find assistance if you are stranded somewhere after that night out with friends. Fit means not only maintaining the desire to "just do it," but the ability.

Barbara Belmont Cotten, M.S., is coordinator of the cardiopulmonary rehabilitation program at the Veteran's Administration Medical Center in Dallas, Texas.

COPYRIGHT 1998 Aerobics and Fitness Association of America
COPYRIGHT 2001 Gale Group