Fitness At Any Age

Energize Your Life! Who ever said physical activity is all work and no play? In fact, it can be just the opposite! There is no need to think of strenuous workouts that are painful and boring. Instead, imagine doing fun physical activities you enjoy and look forward to. Do physical activity for enjoyment and watch the health benefits follow!

The importance of physical activity

The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis.
Regular physical activity substantially reduces the risk of dying of coronary heart disease, the nation's leading cause of death, and decreases the risk for stroke, colon cancer, diabetes, and high blood pressure. It also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among older adults; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. Moreover, physical activity need not be strenuous to be beneficial; people of all ages benefit from participating in regular, moderate-intensity physical activity, such as 30 minutes of brisk walking five or more times a week.
Despite the proven benefits of physical activity, more than 50% of American adults do not get enough physical activity to provide health benefits. 25% of adults are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education.
Insufficient physical activity is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous-intensity physical activity. Daily participation in high school physical education classes dropped from 42% in 1991 to 32% in 2001 (CDC, 2002).
This section explains why you should be active, how inactivity may hurt your health, and how physical activity can benefit everyone.

Why should I be active?

"It's easier to maintain your health than regain it." -Dr. Ken Cooper
Physical activity can bring you many health benefits. People who enjoy participating in moderate-intensity or vigorous-intensity physical activity on a regular basis benefit by lowering their risk of developing coronary heart disease, stroke, non-insulin-dependent (type 2) diabetes mellitus, high blood pressure, and colon cancer by 30-50% (USDHHS, 1996). Additionally, active people have lower premature death rates than people who are the least active.
Regular physical activity can improve health and reduce the risk of premature death in the following ways:

• Reduces the risk of developing coronary heart disease (CHD) and the risk of dying from CHD
• Reduces the risk of stroke
• Reduces the risk of having a second heart attack in people who have already had one heart attack
• Lowers both total blood cholesterol and triglycerides and increases high-density lipoproteins (HDL or the "good" cholesterol)
• Lowers the risk of developing high blood pressure
• 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 colon cancer
• Helps people achieve and maintain a healthy body weight
• Reduces feelings of depression and anxiety
• Promotes psychological well-being and reduces feelings of stress
• Helps build and maintain healthy bones, muscles, and joints
• Helps older adults become stronger and better able to move about without falling or becoming excessively fatigued

Can a lack of physical activity hurt your health? Evidence shows that those who are not physically active are definitely not helping their health, and may likely be hurting it. The closer we look at the health risks associated with a lack of physical activity, the more convincing it is that Americans who are not yet regularly physically active should become active.

Can everyone benefit from physical activity?

"Do it, move it, make it happen. No one ever sat their way to success." -Unknown
The good news about regular physical activity is that everyone can benefit from it (USDHHS, 1996).

• Older adults: No one is too old to enjoy the benefits of regular physical activity. Evidence indicates that muscle-strengthening exercises can reduce the risk of falling and fracturing bones and can improve the ability to live independently.

• Parents and children: Parents can help their children maintain a physically active lifestyle by providing encouragement and opportunities for physical activity. Families can plan outings and events that allow and encourage everyone in the family to be active.

• Teenagers: Regular physical activity improves strength, builds lean muscle, and decreases body fat. Activity can build stronger bones to last a lifetime.

• People trying to manage their weight: Regular physical activity burns calories while preserving lean muscle mass. Regular physical activity is a key component of any weight-loss or weight-management effort.

• People with high blood pressure: Regular physical activity helps lower blood pressure.

• People with physical disabilities, including arthritis: Regular physical activity can help people with chronic, disabling conditions improve their stamina and muscle strength. It also can improve psychological well-being and quality of life by increasing the ability to perform the activities of daily life.

• Everyone under stress, including persons experiencing anxiety or depression: Regular physical activity improves one's mood, helps relieve depression, and increases feelings of well-being.

What are the recommendations for increasing fitness for youth, adults, and seniors?

There is good news for all Americans. Scientific evidence shows that physical activity done at a moderate-intensity level can produce health benefits (USDHHS, 1996). If people have been sedentary, they can improve their health and well-being with regular, moderate levels of activity each day.
Those who participate in moderate- to vigorous-intensity activities regularly should be encouraged and supported in their efforts to continue. While activity at a higher intensity or performed longer offers more health benefits, this level of activity may not be a realistic goal for everyone, at least not to start with. Many Americans, for whom the term "exercise" brings up negative images and emotions, can celebrate the good news by setting a new personal goal-achieving and enjoying the benefits of a regularly active lifestyle that includes a variety of moderate- and/or vigorous-intensity activities.
Adults should strive to meet either of the following physical activity recommendations. See General Physical Activities Defined By Level of Intensity for a chart that lists the intensity levels of many types of activities.

• Adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days of the week.

- Centers for Disease Control and Prevention/American College of Sports Medicine
OR

• Adults should engage in vigorous-intensity physical activity 3 or more days per week for 20 or more minutes per occasion

- Healthy People 2010

More good news is that it's never too late to start an active lifestyle. No matter how old you are, how unfit you feel, or how long you've been inactive, research shows that starting a more active lifestyle now through regular, moderate-intensity activity can make you healthier and improve your quality of life.
This next section provides guidelines for how active you need to be to gain some benefit and general information on activity levels of Americans.
How active do adults need to be to gain some benefit?
Physical activity does not need to be hard to provide some benefit. Participating in moderate-intensity physical activity is a vital component of a healthy lifestyle for people of all ages and abilities. There is no demographic or social group in America that could not benefit from becoming more active.
The table* below provides recommendations on how to increase your physical activity based on your current activity level. Check it out to see where you are and how you can challenge yourself.

If....	Then...
You do not currently engage in regular physical activity,	you should begin by incorporating a few minutes of physical activity into each day, gradually building up to 30 minutes or more of moderate-intensity activities.
You are now active, but at less than the recommended levels,	you should strive to adopt more consistent activity: moderate-intensity physical activity for 30 minutes or more on 5 or more days of the week, or vigorous-intensity physical activity for 20 minutes or more on 3 or more days of the week.
You currently engage in moderate-intensity activities for at least 30 minutes on 5 or more days of the week,	you may achieve even greater health benefits by increasing the time spent or intensity of those activities.
You currently regularly engage in vigorous-intensity activities 20 minutes or more on 3 or more days of the week,	you should continue to do so

*Scientific evidence to date supports the statements above.
What is "moderate-intensity physical activity?"
Moderate-intensity physical activity refers to any activity that burns 3.5 to 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while walking briskly, mowing the lawn, dancing, swimming for recreation, or bicycling.
What is "vigorous-intensity physical activity?"
Vigorous-intensity physical activity refers to any activity that burns more than 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while jogging, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill.

• On average, regularly participating in one or more moderate-intensity or vigorous-intensity activities is required to burn a minimum of 150 Calories of energy per day, 7 days per week, or total of 1,000 Calories/week (Jones et al., 1998).
• The time needed to burn 150 Calories of energy in a day depends on the intensity of the activities chosen. For example, if someone selects moderate-intensity activities, the time required to meet the minimum recommendation would be generally 30 minutes per day. The more vigorous the activities chosen, the less time needed (22 minutes or less) to burn the minimum of 150 Calories during the day.

Number of Minutes of Activity Required to Burn 150 kcalories

Are there special recommendations for young people?
It is recommended that children and adolescents participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily.¹
Children and adolescents can choose any type of moderate or higher intensity physical activity, such as brisk walking, playing tag, jumping rope, or swimming, as long as it is adds up to at least one hour a day.
For children and adolescents, regular physical activity has beneficial effects on the following aspects of health:

• Weight
• Muscular strength
• Cardiorespiratory (aerobic) fitness
• Bone mass (through weight-bearing physical activities)
• Blood pressure (for hypertensive youth)
• Anxiety and stress
• Self-esteem

Children and adolescents who are just beginning to be physically active should start out slowly and gradually build to higher levels in order to prevent the risk of injury or feel defeated from unrealistic goals. It is important that children and adolescents are encouraged to be physically active by doing things that interest them. This will help them establish an active lifestyle early on.
¹This physical activity recommendation is from the Dietary Guidelines for Americans 2005.
Tips for Parents
As a parent, you have an important role in shaping your children's physical activity attitudes and behaviors. Here are some tips to encourage your children to be more physically active.

• Set a positive example by leading an active lifestyle yourself, and make physical activity part of your family's daily routine such as designating time for family walks or playing active games together.
• Provide opportunities for children to be active by playing with them. Give them active toys and equipment, and take them to places where they can be active.
• Offer positive reinforcement for the physical activities in which your child participates and encourage them as they express interest in new activities.
• Make physical activity fun. Fun activities can be anything the child enjoys, either structured or non-structured. They may range from team sports, individual sports, and/or recreational activities such as walking, running, skating, bicycling, swimming, playground activities, and free-time play.
• Ensure that the activity is age appropriate and, to ensure safety, provide protective equipment such as helmets, wrist pads, and knee pads.
• Find a convenient place to be active regularly.
• Limit the time your children watch television or play video games to no more than two hours per day. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity (walking, playing chase, dancing).

Are there special recommendations for seniors?
Being physically active can prevent and help treat many of the most common chronic medical conditions associated with old age. Physical activity is one of the most important steps older adults can take to maintain physical and mental health and quality of life. Scientists have proven that being active can help reduce the risk of obesity, high blood pressure, diabetes, osteoporosis, stroke, depression, colon cancer, and premature death. Yet today, more than 60% of older adults are inactive. Older adults face the same obstacles to being more physically active as younger adults but also have special concerns.
The Challenge to Get Moving
Getting older adults to be active is a challenge. The average American lives a long time, but many are sedentary, physically unfit, and experience disability from chronic medical conditions as they age. Physicians and exercise experts hear many reasons from older adults as to why they are not active: It doesn't feel good. It makes my arthritic joints hurt. It takes too much time. It's boring. However, older adults need physical activity like everyone else, at least as much as younger adults. In fact, the loss of strength and stamina often attributed to aging is in part caused by reduced physical activity.
Walking groups and physical activity programs especially designed for older adults can help seniors become-and remain active. For example, senior swim clubs and water aerobic classes are excellent activities for people with arthritis.
The Need for Strength
Strength training is recommended for all adults, but it is a vital link to health for older adults. The reason is that strength training prevents sarcopenia, the muscle deterioration that comes with aging, and also helps maintain bone mass. "Stronger people have better health outcomes," noted Dr. David Buchner, Chief of CDC's Physical Activity and Health Branch and renowned Gerontologist. However, some elderly people avoid physical activity and become sedentary out of fear of falling and fracturing a bone. Dr. Buchner added that emerging data indicate that physical activity can prevent falls by improving strength, balance, and endurance.
Keeping Young at Heart Aerobic activity (also known as cardiorespiratory or cardiovascular endurance activity) is also important. It keeps the heart strong, lowers blood pressure, and relieves anxiety and depression. Older adults can obtain significant health benefits with moderate physical activity, such as walking or gardening.
"We need to make physical activity part of the daily routine for older adults," said Dr. Buchner. Health clubs also provide older adults with a variety of opportunities to improve their aerobic fitness, muscular strength, and flexibility. Dr. Buchner adds, "Traditionally health and fitness facilities have marketed mainly to body-conscious younger adults, who focus on the cosmetic effects. It's great to see that health clubs have developed more programs for older adults, and we hope this trend continues."
*The above information was adapted from: CDC, NCCDPHP. Special focus: healthy aging. Chronic Disease Notes and Reports 1999;12(3):10-11.
Recommendations
The CDC/ACSM recommends that all adults should accumulate at least 30 minutes of moderate-intensity physical activity on five or more days of the week. Cardiorespiratory (aerobic) endurance, strength, balance, and flexibility exercises should all be part of a physical activity program for older adults. No one type of activity will bring about all the benefits of physical activity. It is important to include all of them. Older adults can meet the physical activity recommendation with a combination of these activities using the following sample schedule:

• Cardiorespiratory: Participate in moderate-intensity aerobic activities 3-5 days a week for at least 30 minutes each session.
• Flexibility*: Stretch every day.
• Strength training: Do strength-building activities 2-3 days per week.

*Flexibility refers to how fully one's joints or limbs are able to move. Being flexible allows for easier movements and reduced pain in joints so that it is also easier to perform daily activities of independent living. By adding stretching to your daily physical activity plan, you can help keep your joints flexible which will help you move with more freedom and comfort.

Participating in these types of activities can help you more easily perform many of your day-to-day tasks. For example, being more flexible will help you more easily do things like reaching in your cupboard and tying your shoes. Being stronger and having more balance will help you lift and carry items like sacks of groceries and will make it easier to get in and out of chairs and the bathtub. Improving your cardiorespiratory endurance will allow you to do things like climbing stairs, dancing, or playing with grandchildren without getting out of breath.
The chart below provides ideas of activities in the areas of cardiorespiratory endurance, strength, and flexibility. Many of these activities will also help improve your balance. Most importantly, choose activities that you enjoy. This will make it more likely that you'll keep doing them!

Cardiorespiratory	Strength	Flexibility
Walking	Chair exercises	Stretching
Swimming	Lifting weights or cans	Yoga
Dancing	Carrying laundry or groceries	Tai chi
Skating	Working in the yard
Hiking	Washing the car
Rolling your wheelchair	Scrubbing the floor

The victory is not always to the swift, but to those who keep moving.
So, you already know that regular physical activity can do great things for your health and well-being. And when you pair that with good nutrition, your body is sure to thank you! But isn't getting started the hardest part? Like any change in your life, knowing where you are and where you're going is important.
Have you ever noticed that what works for some people when they make a change in their life may not work for you? Most people move through a series of five stages of readiness as they change behaviors. What helps someone in one stage may not work for someone in another stage. Look at the graphic below to see where you fall in the stages of change.
Stages of Change in Adding Physical Activity Into Your Life-Where Are You?

These stages represent a spiral path to adopting regular physical activity into your life. Each stage takes a period of time to acquaint yourself with new behaviors.
Effort and commitment is needed in all stages. You will move through each stage as you are ready to change. The interesting part of this model is that is recognizes you may not always move forward in a straight line. There will be times when you lapse, going back to an earlier stage. Then the time will come when you are ready to advance forward. This is expected and part of the process of adopting new behaviors. You will progress when you are ready.
Which of the stages below are you at? The ideas and suggestions you'll read are designed just for where you are.

• Not ready for change
• Thinking about change
• Preparing for action
• Taking action
• Maintaining a good thing

Not ready for change
As the title suggests, you're not ready for change right now. You're not even thinking about adding physical activity into your daily routine. If you were thinking about it, you'd be planning to do something different than what you're doing today-little or nothing. You may have tried physical activity in the past, and not succeeded in adding it into your life. This is a good time to consider the pros, and then the cons, of becoming more active.
Pros-Wanting to Do This
Check off the benefits (pros) that you want to experience. Maybe you want to...
Maintain a healthy weight.
Feel better in body, mind, and spirit.
Shed extra pounds and abdominal fat.
Live longer by reducing the risk of heart disease and diabetes.
Look your best.
Feel less tired and have more energy to get things done.
Set a good example for your family
Sleep more soundly.
Improve bone density, reducing the risk of osteoporosis and fractures as you get older.
Reduce feelings of tension, stress, anxiety, and/or depression
Become stronger.
Discover enjoyable new activities.
Feel better about your body.
Have fun.
What other reasons do you have for wanting to be more active?
Cons-What's Stopping You
Check off the following barriers (cons) that are holding you back. Maybe you...
Don't know how to find time in the day for physical activity.
Are busy and stressed, and you don't want to take on another challenge.
Want to spend your free time with your family and fear that a physical activity routine will interfere.
Find physical activity boring.
Think that you need to spend money on special equipment or health clubs to become more active.
Have some lingering doubts about becoming more active.
Don't like to sweat and you don't want to shower afterward.
Don't know how to exercise.
Are concerned about how you look while exercising or wearing exercise clothes.
Don't want to check with a doctor to begin an activity program.
Have aches and pains that keep you from physical activity.
Are too old to start or learn how.
Don't know anyone else who can join you.
Had a bad experience with sports or exercise in the past.
What other barriers are holding you back?
Now that you've identified your pros and cons, where do you stand? Which benefits are you most excited about? Which barriers do you feel strongest about? Often when you see what items are most important, you will begin to shift your views about physical activity and decide that finding easy ways to add physical activity into your life is exactly what you want to do.
Do you see those barriers as something you want to explore, or are you satisfied in remaining inactive? If you have no desire to learn more about physical activity or you get upset when people mention it to you, you're not ready to consider easy ways to have more energy throughout the day. However, if you are open to learning more, you will find that working with the barriers you identified will help release you from your defenses.
Thinking about change
So, you are thinking about becoming physically active within the next six months! Imagining yourself involved in physical activity is the first step in adopting a healthier lifestyle. You assessed the benefits of engaging in physical activity, and you determined your barriers to success. Congratulations! You have taken some important steps, and now it is time to continue down the road to becoming more physically active.
Perhaps you're waiting for the magic moment to make some changes. Why not start now? Do you remember a time when you were physically active and felt great? Physical activity does not have to follow the old and incorrect maxim of "no pain, no gain." Physical activity can be fun! Can you imagine taking a 15-minute walk on a beautiful day? Playing touch football with your kids in the backyard? You can do it! Remember, physical activity makes more energy than it takes, and taking just one of the following steps is all you need to get started.
Find the time: Figure out when you could possibly fit physical activity into your already busy schedule. You will find opportunities at home, work, and elsewhere (e.g., walking up and down the stairs for 15 minutes during your lunch break). What is important is discovering that you do have time in your schedule. All it takes is that first step. Remember, accumulating 30 minutes of moderate-intensity physical activity (such as brisk walking) 5 or more days of the week is recommended.
Remember your physical activity successes and interests: Think about physical activities that you have enjoyed or that sound interesting. Were there times in your life when you played a sport on a regular basis? Are you interested in taking a physical activity class such as aerobic kickboxing, tennis, or fly-fishing? Consider activities that you can do alone (e.g., walking) or with a friend (e.g., tennis), and include indoor and outdoor activities. Some possibilities include the following: walking, yoga, low-impact aerobics, gardening/yard work, frisbee, volleyball, swimming, basketball, dancing, skating, biking, tennis, hiking, stair climbing, softball, and jogging. Keep a list by your phone at work or home and jot down new ideas as they come to mind.
Develop a support network: Not yet convinced that you can become more physically active? That's where the people you know can help you out. Discuss your concerns with peers, family, friends, or co-workers who are physically active. Find out how they got started and what keeps them motivated. They might have some great "tips for success" about how to incorporate moderate-intensity physical activity into your daily routine. Turn to them for ideas, motivation, and support. Work together to get started and keep you going. Name two people with whom you will talk to and seek support. Set dates within the month for your discussion with them.
Recall your current level of activity: Nobody knows you better than you do. In this case, knowing your current level of activity will help you decide where there is room for change. Consider the following questions to help you recall your current level of activity.

• How often do you participate in physical activity of at least moderate intensity?
• How active is your job?
• How active are you during lunch or breaks at work?
• What do you tend to do before or after work?
• What kind of activities do you do on a typical weekend or day off work?
• How often do you do active indoor chores such as scrubbing the tub, cleaning out the garage, painting, washing windows, working on the house, or carrying out heavy bags of trash or recyclable goods?
• How often do you do active outdoor chores such as mowing the grass, washing and waxing the car, gardening, heavy yard work, caring for large animals, or doing home repair?

Be honest with yourself. Choose one of the following areas in which you think you can make realistic changes.

• Work
• Lunch/break time
• Before/after work
• Weekends
• Active indoor chores
• Active outdoor chores

Set small, specific goals: Okay. You've thought about your favorite physical activities, chosen a support network, and identified one target area that you want to address in the next month. This information can help you set some achievable goals. For example, if you chose physical activity at work as the target area you want to address this month, a specific goal might be to use the stairs instead of the elevator at least twice a week. This is always better than a general approach such as, "I will be more active this month." By starting small and increasing your goals at a pace that feels right for you, all the benefits of physical activity can be yours. And, if you have some setbacks, that's okay. Accept that lapses happen and begin again. You will achieve success.
It is also important to build on your goals. For example, if you are successfully walking once a week as your specific goal, after several weeks add an additional day. Now you'll be walking twice a week. The following month increase the number of days per week and the amount of time you walk. Also, add another activity such as cycling or gardening on the weekends.
Reward yourself: You deserve a medal! Once you've set and achieved some specific goals, celebrate your successes-no matter how small. You might choose a reward that is related to physical activity. How about workout clothing or new athletic shoes? Or reward yourself with a trip to the movies or tickets to your favorite play or sporting event.
Develop long-term vision: Keep in mind that health professionals recommend 30 minutes of moderate-intensity physical activity (e.g., gardening or walking) a day at least five days a week. This can be your long-term goal, but for now just keep building on your successes month by month.
Preparing for action
Whether you've decided to start being physically active now or you would like to be physically active on a more consistent basis, congratulations! You have taken an important step by focusing on future goals. Now, it's time to take action.
Do you remember a time when you were physically active and felt great? You can feel that way again. Simply make a commitment to incorporate moderate-intensity physical activity into your lifestyle, slowly but surely. For instance, this could mean riding your bike to the local market to pick up a few items for dinner. The following steps will provide you with the tools you need to develop a plan of action to meet your goals. You can do it!
Develop support: Share your commitment to becoming physically active with those around you. When seeking the support of others, help them understand your reasons for change so they can help you. Make use of the support networks that exist around you, such as friends or co-workers who are willing to help you remain motivated. Find friends, co-workers or family who will join you for evening walks. Gather a group for a weekend hike and picnic. Name two people who you will rely on for support and motivation.
Getting ready for physical activity can also mean changing your surrounding (e.g., home, work, and car) to support your goals. Keep comfortable walking shoes at work or in the car. Have an exercise bag packed and ready to go. Post motivating messages in your day planner or on your bathroom mirror.
Name two ways you would like to alter your environment to support your goals.
Find the time: With some creative thinking, you'll find ways to squeeze a little more time out of your busy schedule. Adding short bouts of physical activity throughout the day really works. Walk down the hall instead of using the telephone or e-mail. Park farther from the door. Could you get up earlier to take a brisk walk? Climb up and down the stairs for 20 minutes during lunch?
Think about your schedule at work, home, and elsewhere. Find at least three slots that you could devote to physical activity during the next week, and write them down.
Make change a priority: Perhaps you've already made small changes in your level of activity that you can build on, or maybe you will be starting fresh. Either way, adding physical activity into your lifestyle is now at the top of your priority list. You can be confident that you are on the road to success. Choose one area of your life (e.g., work, lunch/break time, before/after work, weekends, active indoor chores, active outdoor chores) that you want to address in the next week.
Create a plan of action: You've developed a strong support network, found three time slots for physical activity, and chosen one area of your life that you want to address in the next week. The next step is to set some achievable goals and create a plan of action. For example, if you chose physical activity after work as the area to work on for the week, a specific goal might be walking the dog after work 4 days a week. Consider the plan developed by John, who makes his living as an aerospace engineer...

"I wanted to look better and was ready to make some changes to allow for physical activity. I did not know where to start, so I started small. My first goal was to be physically active in the workplace three days a week. In the morning, I'd walk to the cafeteria for coffee instead of using the vending machine near my desk. Throughout the workday whenever I wanted more coffee or a bite to eat, I would take the stairs to the basement instead of using the snack shop outside of my office. The changes were fairly simple to make. By the end of six months, I worked up to brisk walking during my lunch break five days a week and taking the stairs to get coffee or snacks. I've been able to maintain a healthier weight and I feel good. Without heroic measures, I have made significant progress."

Now it's your turn! Choose four physical activity goals that you hope to accomplish within the next month.
Monitor your progress: Keep in mind that occasional setbacks do not mean failure. On the contrary, you have set and achieved some specific goals. However, it is important to plan for events that might disrupt your physical activity routine. For example, if you know it will rain all week, rent a physical activity video to use in your home. Right now, make a list of potential setbacks to your routine and how you will overcome them.
It is also important to monitor your progress. Self-monitoring can help you meet your goals by increasing your awareness of the changes you have or have not made. It is also important to build on your goals. For example, if your first weekly goal is to walk to dog 30 minutes twice a week, build on this goal the following week. So, by the end of week 2, your goal will be to walk the dog 30 minutes twice a week plus gardening on Sundays. Try keeping an activity log for your daily activity.
Reward yourself: You deserve a medal! You set and achieved some specific goals. Reward yourself with a gift. Here are some ideas: a health club membership, tickets to a sporting event, a massage, a new CD, or a sitter for the kids.
Use long-term vision: Keep in mind as you are progressing that health professionals recommend at least 30 minutes of moderate-intensity physical activity at least 5 days per week. This can be your long-term goal, but for now, just keep building on your successes week by week.
Taking Action
At this stage, you've been busy the last few months planning and becoming physically active on a regular basis. You have made important decisions and are working to make changes in your life. Way to go! A large part of your plan is in action and you are making physical activity an important part of your life.
By including regular physical activity in your schedule each week, you've shown a commitment to yourself and your health. Are you enjoying the rewards of added energy and a newfound sense of well-being? You've taken old habits and replaced them with healthy actions. The benefits you identified earlier when considering "pros and cons" probably outweigh the barriers. You can be proud of your success-you're making progress! The following steps will support you in reaching your activity goals and will keep you on the right track.
Create balance in your life: Any change is difficult and recently you've added regular physical activity into your life. In doing that, you've taken time away from other things in your busy schedule. Your energy level is increasing but you can't be a super being and do everything. Creating balance in your life is important.
Review the activities in your busy schedule. Protecting your commitment to become physically active is important. Here are some helpful tips.

• Be realistic. Gradually adding moderate-intensity physical activity to your life will give you added energy. Don't overdo. You put yourself at risk for injury if you increase too much, too fast.
• Select a menu approach to adding additional activities. Think about activities that you have wanted to do in the past and include them in future plans. Vary your routine to help keep boredom away. Have fun.
• Replace bad thoughts with good ones. When you hear yourself saying, "I should be better (or faster) at this by now," counter back by saying, "I have made some real improvements and am right where I need to be."

Support yourself in thoughts and action: Surround yourself with people who support your new, active lifestyle. Not all of your family members, friends, or co-workers may want you to succeed in becoming more active. You will develop new habits that might not include them and that may be a problem. Remember the stages of change. Your path will be different from theirs. Visualize your response to a non-supportive friend who discourages you from wanting to be something different-more energetic and healthy. Be assertive in your response.
Some people find supportive messages surrounding them very helpful. Leave encouraging notes to yourself or "to-do lists" at home, in the car or at the office. A message in the car that reminds you to part farther away from the grocery store will give you an opportunity to walk a few extra minutes.
Can you find ways to make it easier to add activity into your day? Leaving an extra pair of walking shoes at the office or in your car would be one way. Your dog only has to walk around the block once to believe you will walk him every day at that same time. How can you say no to your favorite pet, even if you grumble the entire time? You'll soon find yourself looking forward to the time...you really will. What are two supportive actions you can take to maintain or enhance your current level of physical activity?
Pat on the back: Give yourself a big pat on the back for becoming physically active. You are making great strides in adding health benefits and strength to your life. Build in rewards to maintain your motivation. These can be setting goals for yourself or something you can get your hands on, such as a new pair of walking shoes. What would motivate you?
Review long-term vision: You may want to contract with yourself to reach certain goals. What are your long-range (one year or longer) goals for physical activity? List three short-term (three to six months) goals that will help you reach your long-range goal. Be specific.
Utilize your support network: Maintain a buddy system. Knowing you can ask a co-worker or family member for support is helpful. Mentors are important in the work setting. They help you make the right decisions and show you the ropes.
Do you know someone who would make a good mentor or buddy in maintaining or increasing your current activity patterns? What type of support and feedback do you need from your friends or mentor to be successful?
Plan for setbacks: Think about times when you will be tempted not to be active (e.g., added demands of work and family, the flu, a blizzard, or out-of-town visitors). List for yourself any events that have gotten in the way so far.
Accept that these lapses will happen. It does not mean that you have failed or will not get back into your regular habit. Be aware that during the first six months of any behavior change, you are at risk of reverting to old habits. Lapses are a normal part of the change process. If you plan and prepare for events that are likely to happen, you can prepare to hurdle over them as well. You've heard the term, "jump back in the saddle again." If you do lapse, just start right back where you left off. You'll thank yourself afterwards.
Maintaining a good thing
Regular physical activity has become a part of who you are. You have kept the commitment to include activity in your everyday life and are a source of encouragement to others. The benefits of good health are important to you. The steps you've taken have been major and now you are physically active on 5 or more days of the week. Congratulations!
Look back to when you first started to become physically active. Do you remember some of your early struggles? You made the decision to overcome the barriers and succeeded in finding ways to increase your energy level and physical skills. One of the most important steps in maintaining your current success is anticipating minor slips.
Threats to success: It may be difficult for you to imagine a time when you will not want to continue regular physical activity. Repeat this next sentence three times (out loud and with feeling). "Minor slips will happen."
The greatest threat for relapse is overconfidence or believing it won't happen to you. It will happen and you have to plan for it. List two situations where you may be tempted to stop your regular activity, if only for a few days (e.g., vacation, a bout of flu, demands of work and family).
It's important to plan how you will handle these interruptions in your daily routine. If you know they will happen, you can plan around them. What can you do to reschedule physical activity during one of the situations you listed?
You have special friends and co-workers who have been encouraging you. Often as your activity level increases and becomes routine, this support stops. Because you're doing so well and exercise now is part of who you are, your friends may not believe you need the extra encouragement. Re-examine what you need from them and ask them to help you again. They can be the first ones to see old behaviors coming back. Ask them for continued feedback.
Tell-tale signs of danger
"I've got nothing to worry about."
"I'll never be a couch potato again."
"Nothing will stop me from including physical activity into my day."
"I'm safe. My friends or family won't let me quit."
"I've only missed a few days and will start back soon."
Have you heard yourself say any of the above sentences? These are signs that you may be in danger of overconfidence. Old habits die hard. Watch for times when temporary lapses lead to disappointment or giving up. That old couch will be calling you and reminding you of its comfort and support for your weary bones. What will you say back? Remember how hard it was in the beginning. Keeping up your commitment to physical activity today is as important as it was when you started.
Keep your balance: Just as you planned how to remove your barriers to physical activity months or years ago, it's time for you to do so again. Review the benefits and barriers from when you assessed the "pros and cons" earlier. How have your barriers changed from when you started becoming physically active? What are some of the things you can put around your home or office to reinforce your efforts? What are some of the things you can remove that contribute any threat to your activity? List two plans of action you can take to support your continued goals.
Maintain self-confidence: You have a sense of confidence that regular physical activity brings into your life. You have more energy and are also adding health benefits such as reducing the risk of developing or dying from some of the leading causes of illness and death. Maintaining this sense of well-being is important. When you are confident that you will continue to remain physically active, your success rate goes up.
How confident are you of participating in regular physical activity under the following conditions:

• When you are tired?
• When you are in a bad mood?
• When you feel you don't have time?
• When you are on vacation?
• When it is raining or snowing?

Mentor others: Look back at how others helped you adopt new behaviors. Their support and encouragement may have made a difference in your efforts. Did someone offer to show you the ropes or share a new technique that worked for you? It's time you become part of the buddy system but on the other end. You have made progress through the transition of adding regular physical activity into your life. It's been both hard and rewarding, even fun on most days. Share your skills with someone else. Having others depend on you will increase your likelihood of continued success. Being a role model will bring good feelings from helping others and will reinforce your motivation to stay with your active

When is a medical evaluation necessary?

Experts advise that people with chronic diseases, such as a heart condition, arthritis, diabetes, or high blood pressure, should talk to their doctor about what types and amounts of physical activity are appropriate. If you have a chronic disease and have not already done so, talk to your doctor before beginning a new physical activity program.
If you have symptoms that could be due to a chronic disease, you should have these symptoms evaluated, whether you are active or inactive. If you plan to start a new activity program, take the opportunity to get these symptoms evaluated. Symptoms of particular importance to evaluate include chest pain (especially chest pain that is brought on by exertion), loss of balance (especially loss of balance leading to a fall), dizziness, and passing out (loss of consciousness).

Making physical activity a part of your life

"You can't change where you came from. You can change where you are going." -Anonymous
Just knowing that physical activity is good for us doesn't mean that we'll easily be able to make it part of our daily routines-it's sometimes difficult to adopt new habits. But it's important to remember that you can start out slowly and work your way up to a higher level of activity.
This section provides ideas for how to make physical activity part of your life and how to do it safely.

Components of physical activity

What does it mean to be physically "fit?" Physical fitness is defined as "a set of attributes that people have or achieve that relates to the ability to perform physical activity" (USDHHS, 1996). In other words, it is more than being able to run a long distance or lift a lot of weight at the gym. Being fit is not defined only by what kind of activity you do, how long you do it, or at what level of intensity. While these are important measures of fitness, they only address single areas. Overall fitness is made up of five main components:

1. Cardiorespiratory endurance
2. Muscular strength
3. Muscular endurance
4. Body composition
5. Flexibility

In order to assess your level of fitness, look at all five components together.
What is "cardiorespiratory endurance (cardiorespiratory fitness)?"
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel during sustained physical activity (USDHHS, 1996 as adapted from Corbin & Lindsey, 1994). To improve your cardiorespiratory endurance, try activities that keep your heart rate elevated at a safe level for a sustained length of time such as walking, swimming, or bicycling. The activity you choose does not have to be strenuous to improve your cardiorespiratory endurance. Start slowly with an activity you enjoy, and gradually work up to a more intense pace.
What is "muscular strength?"
Muscular strength is the ability of the muscle to exert force during an activity (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). The key to making your muscles stronger is working them against resistance, whether that be from weights or gravity. If you want to gain muscle strength, try exercises such as lifting weights or rapidly taking the stairs.
What is "muscular endurance?"
Muscular endurance is the ability of the muscle to continue to perform without fatigue (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). To improve your muscle endurance, try cardiorespiratory activities such as walking, jogging, bicycling, or dancing.
What is "body composition?"
Body composition refers to the relative amount of muscle, fat, bone, and other vital parts of the body (USDHHS, 1996 as adapted from Corbin and Lindsey, 1994). A person's total body weight (what you see on the bathroom scale) may not change over time. But the bathroom scale does not assess how much of that body weight is fat and how much is lean mass (muscle, bone, tendons, and ligaments). Body composition is important to consider for health and managing your weight!
What is "flexibility?"
Flexibility is the range of motion around a joint (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). Good flexibility in the joints can help prevent injuries through all stages of life. If you want to improve your flexibility, try activities that lengthen the muscles such as swimming or a basic stretching program.

Common physical activity and fitness terms

Calorie: A measure of energy from food. (3,500 kilocalories of food energy = 1 pound of body weight). Also the amount of heat required to raise the temperature of 1 gram of water 1° C (1000 calories = 1 kilocalorie). An interesting fact: When we see "Calories" on a food label it is actually measuring kilocalories
Cardiorespiratory fitness: (also called aerobic endurance or aerobic fitness)
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel and oxygen during sustained physical activity.
Exercise: Exercise is physical activity that is planned or structured. It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness-cardiorespiratory endurance (aerobic fitness), muscular strength, muscular endurance, flexibility, and body composition.
Household physical activity: Household physical activity includes (but is not limited to) activities such as sweeping floors, scrubbing, washing windows, and raking the lawn.
Inactivity
Inactivity is not engaging in any regular pattern of physical activity beyond daily functioning.
Kilocalorie: The amount of heat required to raise the temperature of 1 kg of water 1° C. Kilocalorie is the ordinary calorie discussed in food or exercise energy-expenditure tables and food labels.
Leisure-time physical activity: Leisure-time physical activity is exercise, sports, recreation, or hobbies that are not associated with activities as part of one's regular job duties, household, or transportation.
MET: The standard metabolic equivalent, or MET, level. This unit is used to estimate the amount of oxygen used by the body during physical activity.

1 MET = the energy (oxygen) used by the body as you sit quietly, perhaps while talking on the phone or reading a book.
The harder your body works during the activity, the higher the MET.

• Any activity that burns 3 to 6 METs is considered moderate-intensity physical activity.
• Any activity that burns > 6 METs is considered vigorous-intensity physical activity.

Moderate-intensity physical activity: Moderate-intensity physical activity refers to a level of effort in which a person should experience:

• Some increase in breathing or heart rate
• a "perceived exertion" of 11 to 14 on the Borg scale
  
  • the effort a healthy individual might expend while walking briskly, mowing the lawn, dancing, swimming, or bicycling on level terrain, for example.
• 3 to 6 metabolic equivalents (METs); or
• any activity that burns 3.5 to 7 Calories per minute (kcal/min)

Occupational physical activity: Occupational physical activity is completed regularly as part of one's job. It includes activities such as walking, hauling, lifting, pushing, carpentry, shoveling, and packing boxes.
Physical activity: Physical activity is any bodily movement produced by skeletal muscles that result in an expenditure of energy.
Physical fitness: Physical fitness is a set of attributes a person has in regards to a person's ability to perform physical activities that require aerobic fitness, endurance, strength, or flexibility and is determined by a combination of regular activity and genetically inherited ability.
Regular physical activity: A pattern of physical activity is regular if activities are performed:

• most days of the week, preferably daily;
• 5 or more days of the week if moderate-intensity activities (in bouts of at least 10 minutes for a total of at least 30 minutes per day); or
• 3 or more days of the week if vigorous-intensity activities (for at least 20-60 minutes per session).

Note: These are minimum recommendations, greater health outcomes can be achieved by doing additional types activities and/or increasing time spent doing activities.
Transportation physical activity: Transportation physical activity is walking, biking or wheeling (for wheelchair users), or similar activities to and from places such as: work, school, place of worship, and stores.
Vigorous-intensity physical activity: Vigorous-intensity physical activity may be intense enough to represent a substantial challenge to an individual and refers to a level of effort in which a person should experience:

• large increase in breathing or heart rate (conversation is difficult or "broken")
• a "perceived exertion" of 15 or greater on the Borg scale;
  
  • the effort a healthy individual might expend while jogging, mowing the lawn with a nonmotorized pushmower, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill, carrying more than 25 lbs up a flight of stairs, standing or walking with more than 50 lbs for example.
• greater than 6 metabolic equivalents (METs); or
• any activity that burns more than 7 kcal/ min

Weight-bearing physical activity: Any physical activity that imparts a load or impact (such as jumping or skipping) on the skeleton.

Source: Centers for Disease Control

References listed:

Centers for Disease Control and Prevention. 2000 Behavioral Risk Factor Surveillance System Prevalence Data, 2002. Available at http://apps.nccd.cdc.gov/brfss/ Accessed December 19, 2002.

Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2001. Morbidity and Mortality Weekly Report 2002;51(SS-4):1-64.

Jones DA, Ainsworth BE, Croft JB, et al. Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study. Archives of Family Medicine 1998;7(May/June):285-289.

Pate RR, Pratt M, Blair, SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association 1995;273(5):402-407.

Pratt M, Macera CA, Blanton C. Levels of physical activity and inactivity in children and adults in the United States: current evidence and research issues. Medicine & Science in Sports & Exercise 1999;31(11):S526-S533.

U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.

U.S. Department of Health and Human Services. Healthy people 2010: understanding and improving health. (2nd ed.). Behavioral Risk Factor Surveillance System (BRFSS) 1996 & 1998. Active Community Environments. Washington, DC: U.S. Government Printing Office, 2000.

Information in the "Getting Started" section was adapted from: Centers for Disease Control and Prevention & Cooper Institute for Aerobics Research. Personal energy plan-physical activity: steps for adding PEP to your life. Dallas: Cooper Institute; 1999. To order a printed copy, contact 800-635-7050, x-3230 or E-mail: bshp@cooperinst.org.

U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.