If you remember one message from this chapter it should be this: It is never too late to reap the health and functional benefits from regular participation in physical activity. The health benefits relate to the reduction in risk factors associated with a number of diseases, including heart disease, diabetes, cancer, and osteoporosis. The functional benefits include improvements in stamina, strength, flexibility, and balance. The risk of falling will also be reduced as you enhance your muscle strength and balance. These adaptations contribute to your ability to maintain an independent lifestyle and a high quality of life in the later years. You will be able to continue to participate in activities associated with daily living such as shopping, gardening, and playing with your grandchildren without limitations. These are just a few of the many benefits that accompany regular involvement in a physical activity program.
Remaining sedentary or physically inactive actually contributes to many well-documented health risk factors that have generally been attributed to the “aging process.” Additionally, other physiological and psychological factors such as a reduction in cardiovascular and skeletal muscle function, as well as declines in cognitive performance, were thought to be a normal part of the aging process. However, recent studies suggest that, while a portion of these changes may be due to growing older, a significant factor is an increase in sedentary behavior associated with older populations (24). Chronic sedentary behavior is associated with increased risk for at least 35 chronic diseases and clinical conditions (6) and increased mortality (death) rates (27). In addition, chronic sedentary behavior contributes to a reduction in aerobic capacity, muscle strength, and overall metabolic function.
Q&A
Can declines in health over the years be attributed to the normal aging process?
The decline in health and functional capacity previously attributed to the aging process is more likely a result of a chronic sedentary lifestyle. Many negative age-related changes can be significantly avoided or delayed by regular physical activity. Getting active is the best choice to make to promote health and fitness.
To achieve these many benefits from regular physical activity, you do not need to exercise as intensely or for as long as competitive athletes. Many older adults resist starting an exercise program for fear of injury, falling, or soreness from an intense bout of exercise. The good news is that you can participate in moderate-intensity exercise such as walking, swimming, and bicycling and still receive both the health and the functional benefits from your time spent being physically active. As you will see throughout this chapter, the rewards from participation in a physical activity program, including the maintenance of an independent lifestyle, lower health risks, and overall improved quality of life, clearly outweigh any risks associated with engaging in regular physical activity. To promote safety when starting to become more physically active or when increasing your exercise program, refer to the screening process outlined in chapter 2.
Focus on Nutrition
Having a healthy diet is important regardless of your age. Eating well contributes to good health and vitality. The recommendations in the Dietary Guidelines for Americans (26), put forth by the U.S. Department of Health and Human Services, provide general guidelines for people of all ages. The core recommendations can be summarized as follows:
· Follow a healthy eating pattern across the lifespan. This includes maintaining energy (caloric) balance to keep your body weight stable. Control caloric intake to match calories burned through daily activities and exercise while ensuring adequate nutrient intake.
· Choose a variety of nutrient-dense foods, including a variety of fruits and vegetables, whole grains, low-fat milk and proteins (fish, lean meat, eggs, nuts, and beans), grains, and oils.
· Decrease consumption of foods and beverages that are higher in trans fats, saturated fats, salt (sodium), and refined sugar.
A diet consisting of a variety of fruits and vegetables is essential for healthy aging.
However, a few dietary modifications may be needed to further promote healthy aging. The reasons for these adjustments range from changes in metabolism and muscle and bone mass to a reduction in activity levels and exposure to sunlight. Older adults may benefit from these particular adjustments (18).
Ensuring Consumption of the Proper Amount of Calcium and Vitamin D on a Daily Basis
Calcium is required for many functions of the body but, importantly for the older adult, is one of the major building blocks for bone. Maintaining healthy bones also requires getting sufficient amounts of vitamin D. Vitamin D assists your body in absorbing calcium and also plays a role in other bodily functions such as the nervous and immune systems. Your skin can use exposure to sunlight to form vitamin D; however, older adults may get less exposure to the sun (to protect against skin cancer), and the process of forming vitamin D is less efficient. Dietary sources of vitamin D include dairy products such as milk, cheese, and yogurt. Vitamin D can also be found in leafy green vegetables and saltwater fish. If you are having difficulty getting the proper amount of vitamin D each day (800-1,000 IU per day), you may consider taking a vitamin D supplement to ensure that you meet the daily requirements. Good food sources for calcium include low-fat and nonfat milk, cheeses, and yogurt. Other food products such as cereals, breads, and bottled water can have calcium added. If you are not getting enough calcium through your diet (1,000-1,200 milligrams per day), calcium supplements are available and may be considered. Consult with your health care provider regarding supplementation of calcium, vitamin D, or both.
Ensuring Consumption of the Proper Amount of Vitamin B12 on a Daily Basis
Vitamin B12 plays an important role in metabolism, red blood cell formation, and nerve function. A vitamin B12 deficiency can result in tingling feelings in legs or hands, memory problems, personality shifts, fatigue, and anemia (shortage of red blood cells). Dietary sources of vitamin B12 include meat, eggs, milk, shellfish, and cereals fortified with vitamin B12. Your ability to digest and absorb vitamin B12 may be impaired as you get older or due to a side effect from certain medications (such as metformin used to treat diabetes). In these cases, supplements may be prescribed by your health care provider.
Ensuring Consumption of the Proper Amount of Fiber
Dietary fiber is important in that it plays a role in stomach or digestive health and may prevent problems such as constipation. Fiber has been shown to lower the “bad” cholesterol levels in your blood as well as blood sugar, thereby reducing your risk for both heart disease and diabetes. There is evidence to suggest that dietary fiber may lower your risk for colon cancer. In addition, fiber adds bulk to your diet, giving you a feeling of fullness that prevents hunger and helps with overall weight control. Sources of fiber can be found in plant foods—fruits, vegetables, whole grains, beans, and nuts. Leaving the skin on the fruits (e.g., peaches) and vegetables (e.g., baked potatoes) will increase the fiber content of your meal. Add fiber slowly to prevent gas and bloating.
Avoiding Excess Salt (Sodium), Certain Fats (Trans and Saturated Fats) and Simple, Refined Sugar
These substances increase your risk for high blood pressure, heart disease, and diabetes. As salt is a component of fresh foods as well as added to many prepared foods, try to avoid adding salt while cooking or at the dinner table. Your goal should be to consume only about 2/3 of a teaspoon of salt per day. Saturated fats found in red meats and trans fats added to products such as microwave popcorn, cookies, margarine, and crackers contribute to your risk of heart disease. You should minimize the intake of these types of fats. Finally, too much sugar can affect your body’s ability to respond to the hormone insulin, which is the initial step leading to the development of type 2 diabetes. Reduce the amount of sweets consumed in candies, cakes, cookies, and so on. Also, carefully read the label on products, as many prepared food items have added sugar (e.g., ketchup).
Understanding the Need for or Lack of Need for Specific Supplements
Advertisements for supplements are abundant and pop up in many venues including television, the Internet, and magazines. Dietary supplements, which come in a variety of forms (pills, powders, extracts, liquids), are substances to be used if your diet is deficient in key nutrients. Supplements may also be taken to improve your health by lowering your risk for a disease (e.g., heart disease, arthritis). These products may contain vitamins, minerals, antioxidants, fiber, proteins, or herbs. The National Institute on Aging recommends that to get the proper amount of needed nutrients, you should eat a variety of healthy foods (18). If you do so, you will not require the use of supplements that can be expensive as well as harmful in some cases. However, some dietary supplements can help older adults who do not meet specific nutrient needs within their daily diet. These special circumstances generally involve calcium, vitamin D, or vitamin B12. Thus, taking supplements containing these nutrients may be recommended by your health care provider, as mentioned earlier.
Eating habits and requirements may change as one ages, but enjoying the foods and beverages consumed is key to making nutritious choices a lifelong habit. Healthy eating can be individualized through consultation with a Registered Dietitian or through resources available from MyPlate tailored specifically for older adults (for more information, see www.choosemyplate.gov/older-adults).
Focus on Physical Activity
As already highlighted in this chapter, regular physical activity can favorably affect a broad range of body systems and thus may be a lifestyle factor that discriminates between those who experience successful aging and those who do not. A complete exercise program for older adults includes aerobic exercise, muscle-strengthening exercises, and flexibility exercises. In addition, balance exercises are recommended (11).
Physical Activity and Its Impact on Daily Function
Physical activity has many benefits related to chronic disease, but also can affect two areas that can be a concern with advancing years—a good night’s sleep and cognitive function. Both sleep and brain activity are foundational to one’s ability to fully embrace life experiences. The benefits of physical activity in these areas are discussed in the following sections.
Physical Activity and Sleep for the Older Adult
You may have noticed that the quality of your sleep is not quite what it used to be. Recent scientific studies support this observation and suggest that the “sleep” centers located in the brain are altered with age. As a result, sleep is lighter and more fragmented (less continuous periods of sleep; rather, episodes broken up into shorter blocks, including daytime sleeping) (4, 28). Also, the total sleep time for a given day may be reduced. You may find that you are going to sleep earlier as well as awakening earlier compared to the pattern in your younger days. You may also find yourself falling asleep during the daytime while watching TV or reading. Over time, these types of sleep disruptions can be associated with depression and anxiety disorders, cognitive and memory impairment, fatigue, and an increased risk for falls (12).
However, there is good news regarding the benefits of regular physical activity on overall sleep quality. Regular endurance exercise appears to be an effective treatment to significantly improve sleep quality in older adults who suffer from chronic sleep problems, including insomnia (15, 19). In addition to improving the quality of your sleep, regular exercise can reduce the time it takes you to fall asleep as well as reduce the need for or the dosage of sleep aids you may be currently taking. This is important, as these drugs, frequently used to help with sleep problems (sedative hypnotics), are often associated with side effects such as sleepwalking, daytime drowsiness, and dizziness (21). Other types of exercises, such as tai chi and yoga, have also been shown to be beneficial in reducing sleep problems in older adults (9). These benefits can be realized in as little as one month’s time after the beginning of such an exercise program but are generally observed after three to six months. In order to continue to receive these benefits you will need to stick with your exercise program, as any long-term stoppage will result in a reversal of these sleep benefits. Regular exercise is a simple, nonpharmacologic treatment that can be safely implemented to improve both the quality of sleep and overall quality of life in older adults.
Regular physical activity has been shown to improve sleep quality.
Physical Activity and the Cognitive Function in Older Adults
Advancing age is associated with a decrease in cognitive function as well as an increase in risk for developing some form of dementia. It is estimated that one-third of adults over the age of 65 die with Alzheimer’s disease or some other form of dementia (1), and the risk of developing Alzheimer's doubles every five years after the age of 65. These adverse alterations in brain function clearly have a negative impact on the quality of life. Although concerning, a positive aspect is the impact of regular aerobic exercise on your brain. This holds true for prevention in healthy individuals as well as for treatment in people who already have mild memory impairment, as well as early stages of Alzheimer’s disease (10). Various factors associated with exercise may be involved, including increased blood flow and nerve activity. If you exercise on a regular basis, this chronic stimulation of brain blood flow and activity can reduce the risk of vascular dysfunction (poor blood vessel responsiveness) in the brain as it ages. In addition, recent studies have shown that aerobic exercise lowers the amount of toxic proteins in the brain that are associated with Alzheimer’s disease (3). Thus, the combination of the reduction in these toxic proteins and improved blood vessel function has led experts in the study of Alzheimer’s disease to conclude that no currently available medications can approach the beneficial effects of exercise in the treatment and prevention of this age-associated disease.
There is also accumulating evidence suggesting that regular exercise can help you maintain or even improve your cognitive function and memory as you age (3). These studies indicated that higher levels of cardiovascular fitness were associated with better performance on a variety of tasks testing cognitive function (7). It appears that participation in different modes of exercise (aerobic, strength, balance, flexibility), as described in this chapter, can result in an even better outcome when one examines the role that exercise has in improving cognitive function and memory. Such benefits of exercise have also been reported in people already suffering from mild cognitive impairment (22).
Q&A
What type of activities should be included to promote cognitive function?
A complete exercise program that includes aerobic activity, muscle-strengthening activity, and balance and flexibility exercises appears to provide the most benefits. The good news is that the advantages possible for cognitive function and memory are in addition to the myriad of other health and fitness benefits.
Finally, regular physical activity can improve symptoms of other mental maladies such as anxiety and depression even in individuals already afflicted with Alzheimer’s disease and dementia (10). While the mechanisms responsible for the effect that exercise has on depression and anxiety remain unclear, regular physical activity clearly lessens the symptoms, leading to greater feelings of well-being. Additionally, the psychological and emotional benefits resulting from regular physical activity are worth noting; these include improving your ability to cope with stressful situations, enhanced confidence, empowerment, extended social interaction, improved mood states, and overall relaxation.
Physical Activity Guidelines for Older Adults
Physical activity for older adults should focus on aerobic fitness, muscular fitness, flexibility, and functional fitness (neuromotor exercise training). Including each of these areas in a comprehensive program is discussed in the following sections.
Aerobic Fitness
Endurance or aerobic activities will improve your stamina and allow you to engage in a variety of activities for a longer period of time. For example, you will be able to work in the garden or yard much longer before you feel tired or fatigued. Similarly, improvements in your aerobic fitness will allow you to go on hikes, play with your grandchildren for an extended period of time, or play several sets of tennis. Endurance exercise produces these benefits by enhancing the health and function of your heart, lungs, and circulatory system. Additionally, regular participation in endurance activities greatly improves your health by lowering several risk factors associated with a variety of diseases. This will result in the reduction or prevention of a number of diseases that are common in older adults, including heart disease, type 2 diabetes, and certain types of cancers (11, 23). The health and functional benefits associated with regular participation in an endurance exercise program are numerous.
Key risk factors related to the development of heart disease are significantly improved with endurance exercise (23). These include cardioprotective adaptations such as a reduction in the “bad” cholesterol (low-density lipoprotein [LDL]-cholesterol), an increase in the “good” cholesterol (high-density lipoprotein [HDL]-cholesterol), lower triglycerides (a fat that contributes to coronary heart disease), improvements in resting blood pressure, and a reduction in total body fat.
Importantly, endurance exercise is well documented to improve your sensitivity to insulin. This is critical for several reasons. First, a decrease in insulin sensitivity or an increase in insulin resistance is the primary cause for the development of type 2 diabetes, which is the most common type of diabetes (90-95 percent of people with diabetes are type 2). Second, as you get older, you are at a greater risk of developing type 2 diabetes; thus, regular aerobic exercise is an ideal preventive strategy as well as a treatment for this disease. Regular endurance exercise may be beneficial for certain types of cancers including breast, prostate, and colon cancers. These benefits relate to both lowering the risk for these specific cancers and aiding in the rehabilitation and recovery from cancer treatment. Finally, the weight-bearing component of activities such as walking, running, and tennis helps to maintain bone health (bone mineral density), thereby reducing your risk for bone fractures and breaks. This is particularly important for postmenopausal women, who have a much higher incidence of osteoporosis (weak and brittle bones) than others.
In order to reap the optimal benefits from your exercise program, ACSM recommends paying attention to the frequency, duration, and intensity of your exercise session (11, 13). The exercise session should involve large-muscle groups (such as the legs) in a continuous, rhythmic fashion. Examples include walking, biking, and swimming. Older adults should try to avoid high-impact activities that put excessive strain on joints, muscles, and ligaments.
Ideally, you should engage in endurance exercise three to five days per week. The lower the exercise intensity, the more often the exercise should be done. For example, if you enjoy walking, at least five days per week is recommended for this moderate-intensity exercise. However, if you are doing more strenuous exercise, such as biking or singles tennis, three days per week will be sufficient to provide the desired benefits. The recommended duration, or amount of time you spend in an exercise session, is at least 30 minutes for moderate-intensity exercise and at least 20 minutes for more strenuous activities. If you prefer, you can divide these sessions into 10-minute segments throughout the day. Try to accumulate at least 150 minutes each week.
The final component of your endurance exercise program is the exercise intensity. The greater the exercise intensity, the shorter the exercise duration required. Strenuous or vigorous exercise will cause you to breathe heavily, perhaps to the point where it is difficult to talk. On a scale of 0 to 10, with 0 equal to sitting at rest and 10 representing your maximal possible exertion, a strenuous exercise bout would be in the range of 7 or 8. A moderate exercise intensity session would be in the range of 5 or 6. You may want to track your daily movements with a commercial activity tracker or with a smartphone app.
Muscular Fitness
Muscular fitness training has many rewards beyond stronger muscles. These rewards range from making it easier for you to get into and out of your car, climb stairs, and carry objects to improving your balance and reducing the risk of falls and broken bones.
Enjoy outdoor activities to promote fitness.
Strength training should be performed at least two times per week focused on the major muscle groups (legs, arms, shoulders, chest, abdominal muscles, and back). For a given muscle group, find a weight that you can lift ~8 to 12 times (repetitions) before fatiguing (if you are just starting with resistance training, a range of 10 to 15 repetitions might be preferable). For example, when doing an arm curl to strengthen your biceps, you may find that you can lift a 5-pound (2.3-kg) dumbbell 10 times but not 11. Thus this would be a good weight for this exercise. After resting for a few minutes, repeat the same exercise. Do the same routine for the other major muscle groups. Do not hold your breath while performing your strength exercises. Lift the weight slowly (about 2 seconds) and return the weight slowly (about 3 seconds). Over time, as you become stronger, you should increase the weight you are using to continue to challenge your muscles and remain in the 8- to 12-repetition range. If you do not have access to handheld weights, you can use common kitchen items such as soup cans or water bottles. Also, the use of resistance bands may make certain exercises easier for you to perform.
Resistance training options include the use of resistance bands.
In addition to increasing your strength, a resistance training program will help you maintain and possibly increase your muscle mass. This is critical for enhancing your quality of life at many levels. A common problem among older adults in the United States today is a significant loss in muscle mass (known as sarcopenia). Connected with this loss in muscle mass is a loss in strength, which has direct implications for your ability to go about activities associated with daily living. Maintaining your muscle mass and strength will enhance your quality of life by improving your mobility, balance, and overall independence. Finally, strength training is extremely valuable in promoting healthy bones. The mechanical stress placed upon your bones while you are doing resistance exercises stimulates the bone to become stronger, thereby lowering the risk of age-associated osteoporosis (a disease that makes bones brittle). This is especially important for the bones in your upper body, as they receive little stimulation and benefit from endurance exercises that rely primarily on the legs.
Flexibility
Flexibility, or limberness, is defined as the ability to move joints and muscles through their full range of motion. Unfortunately, an individual’s flexibility generally declines with age. However, with regular and proper stretching exercises, your flexibility can be well maintained throughout life. The significance of achieving proper flexibility will translate into an enhanced quality of life and safety by maintaining a good range of motion in all joints.
Ideally, stretching should occur when your muscles are warm and your body temperature is raised. Many people combine their stretching program with their endurance exercise session. A good time for stretching is after an endurance workout, while the muscles and joints are still warm. For best results, you should stretch at least two days per week for a minimum of 10 minutes. Each stretch should be accomplished to a degree of mild tightness in the muscles. Do not stretch to the point of pain or discomfort. Try to do each particular stretch three or four times per session. Static stretches, in which you hold the stretched position, should be done for 30 to 60 seconds (13). Remember to keep breathing while the stretch is being held. Also, it is important to slowly initiate the stretched position, avoiding any bouncing or jerking motions.
Key areas to focus on, where flexibility generally decreases with age, include the neck, shoulders, back, and legs. Chapter 7 includes a number of activities that can be included in your stretching program. The benefits of maintaining and improving your flexibility are many. As a result of the loss of flexibility in the neck and back associated with aging, some older individuals have difficulty turning around to look behind them (e.g., when backing out of a parking space). This, of course, can be dangerous as it limits full visibility. Other benefits associated with improved flexibility include bending over to tie your shoes or to pick objects up off the floor, reaching objects located a little bit higher, as in kitchen cabinets or closets, and twisting or achieving range of motion when executing a golf or tennis swing.
Neuromotor Training
Balance is defined as your ability to move or to remain in a stable position without losing control or falling. It is essential to maintain your balance as you age. Millions of older Americans are rushed to emergency rooms each year as a result of fall-related injuries. Consequences of these falls can be severe, resulting in fractures of the arms, legs, and hips as well as serious head traumas. These injuries may result in permanent disability and in some cases are life threatening. Hip fractures alone account for about 260,000 hospital visits per year among individuals 65 years and older (8). Approximately 95 percent of these hip fractures are caused by falling, frequently leading to long-term functional impairment, nursing home admission, and increased mortality (5). Physical limitations may result in a lack of ability to perform activities of daily living (16). Women, who are more prone to age-related osteoporosis, have up to 75 percent of all hip fractures (25). A number of people who fall develop a fear of falling. This frequently causes them to limit their activities, contributing to reduced mobility, loss in leg strength, and poor balance, which in turn actually increases their risk of falling (17).
The best results for balance and stability are seen when coupled with improvements in strength (as discussed previously) and, in particular, leg strength. Stronger leg muscles provide superior support for both forward–backward motions and lateral or side-to-side movement and balance. The motions are common components of activities associated with daily living such as shopping, gardening, and playing with small children. To help promote balance, various exercises can be performed two to three days per week, each exercise lasting 10 to 30 seconds. Examples of balance (neuromotor) exercises are included in chapter 8. The benefits in maintaining and improving your balance are well worth the time spent. The most important benefits are the reduction in the rate of falls and subsequent injuries related to such falls.
Optimal Program Progression to Promote Safety
The majority of older adults can safely participate in the activities described in this chapter, which focuses on a moderate-intensity level. If you are starting an exercise program for the first time or if you have not engaged in regular physical activity for a number of years, begin slowly at the lower recommended exercise intensities. This will give you the opportunity to determine your exercise tolerance, limitations, and any potential orthopedic problems that may affect your ability to exercise. Over time, as you progress and improve your fitness, you can gradually increase exercise intensity or duration, or both, so that you can optimize the benefits from your training. If you have any existing medical conditions, such as high blood pressure, diabetes, or hip and knee pain, you should have a discussion with a health care provider regarding what types of exercise you should avoid and which activities are best suited for your condition. Actually, regular physical activity is often prescribed, as it is known to be beneficial, when done properly, in individuals with existing conditions such as heart disease and diabetes—but you must be aware of your limitations.
Engaging in a 5- to 10-minute warm-up before your exercise session is important to help prevent injury and the consequences of an abrupt start. The warm-up will increase muscle temperature as well as gradually prepare your heart and lungs for the more intense exercise to come. While exercising, particularly when you are outside on a warm day, be sure to drink fluids to keep your body hydrated. You may not feel thirsty even if your body is low on fluids. If it is extremely hot outside, you should find an indoor location (such as a gym, shopping mall, or swimming pool) that has climate control where you can exercise safely.
Once you have completed your exercise session, a 5- to 10-minute cool-down is recommended to gradually lower your heart rate, blood pressure, body temperature, and breathing rate. As with the warm-up phase, the cool-down should be performed at very low exercise intensities. The cool-down prevents any negative effects on the heart and on blood pressure that may be associated with abruptly stopping the physical activity. After the cool-down, while your muscles are still somewhat warm, is a good time to do stretching exercises to improve your flexibility.
Generally, it is not a good idea to exercise when you are sick or suffering from an infection. This is particularly true if you have a fever and muscle aches. A small amount of light exercise can be tolerated if you are suffering from a head cold or an upper respiratory tract infection, but ideally, you should rest and give your immune system a chance to fight the infection. Finally, reasons to stop exercising and seek medical attention include chest pain or pressure, feelings of nausea or dizziness, or pain in your joints and extremities.
Remember that it is always smart to take the proper safety precautions when exercising, and that the health benefits from a program of regular physical activity greatly outweigh the risks. Many older adults are reluctant to begin an exercise program at this stage of their life for fear of negative consequences (falling, joint pain, cardiac events). However, remaining sedentary or physically inactive is a much greater health risk than participation in regular physical activity (2, 14).
Programs to Meet and Exceed the Physical Activity Guidelines for Older Adults
If you are beginning an exercise program for the first time or have been physically inactive for an extended period of time, here are a few guidelines to get you started. First, complete the health screening described in chapter 2. Maintaining good communication with your health care provider is recommended, especially if you have any current health limitations. Second, it is important to know your starting point or initial level of fitness. Chapters 5, 6, 7, and 8 address a number of techniques and exercises to assess your aerobic fitness, muscular fitness, flexibility, and neuromotor fitness. For a number of areas, specific assessments are available for older adults, including the 6-minute walk test for aerobic capacity, the chair stand and the arm curl test for muscular fitness, the chair version of the sit-and-reach for flexibility, and the 8-foot up and go test for neuromotor fitness (20). Regular and accurate performance feedback can assist you in developing realistic expectations of your own progress.
Knowing your current level of fitness in the areas of endurance, strength, and flexibility will better allow you to more accurately determine the optimal intensity, duration, and frequency at which to begin or advance your exercise program. A sample tracking form is shown in figure 11.1. This can serve as a motivational tool as well as a way to monitor your progress. Repeating the assessments periodically can ensure you are staying on track with your exercise program.
Once you have established your initial fitness level, it is recommended that you set both short- and long-term goals. A sample of a beginner exercise program is shown in figure 11.2, and a sample for a regular exerciser is in figure 11.3. Your goals should be realistic such that they can be accomplished in the time frame you have set. Setting unrealistic goals that cannot be met will lead to disappointment and a lower desire to continue with your exercise program. Examples of short-term goals might include being able to walk around the block without feeling fatigued or being able to lift your grandchild without discomfort and strain. Long-term goals might include regaining control of your blood sugar levels to within a normal range by your next doctor’s appointment or being able to ride your bike to a friend’s house.
Tracking Your Progress
In order to reap the many benefits from physical activity, you must be active on a regular basis. Here are a few tips to help incorporate exercise into your daily routine and lifestyle. Choose activities that you enjoy and find appealing. Also, adding some variety to your activities will keep things fun and interesting. For example, if you like to walk or hike, try exploring new neighborhoods or trails. Also, consider new activities, such as joining a bowling league or signing up for a yoga class. Activities that have a social component can promote regular participation. If you prefer tennis or golf, find a regular group of like-minded individuals for weekly matches. When exercising in your home, listen to music or watch your favorite TV show when you are doing your balance and flexibility exercises.
Importantly, do not get discouraged during the first few weeks of starting your physical activity program. Initially, your muscles may feel sore or may ache. This is natural, and these sensations will disappear as you continue with your activity level. In sticking with your program you will see some rewards relatively soon (weeks to months) and others that may not be as obvious. For example, any benefits relating to your blood sugar levels or blood pressure will not be recognized until your next checkup with your doctor. Keeping track of your progress can be a useful motivational tool. Figure 11.4 provides a simple chart whereby you can track your fitness progress over the course of 10 weeks.
Finally, life can get busy. Unfortunately, it seems that being physically active is the agenda item frequently put on the back burner. Please remember how important being active is to your health and well-being. Make it a high priority in your daily routine.
Healthy aging involves making a number of sound decisions and commitments on lifestyle factors. The scientific evidence is very clear on the role of nutrition and exercise in promoting healthy aging. The benefits for both body and mind go a long way toward maintaining independence and quality of life in your later years. The scientific evidence is just as clear as to the deleterious effects of remaining sedentary or physically inactive. An inactive lifestyle contributes to an elevated risk for the development of many chronic, life-threatening diseases that become more common and prevalent with advancing years. The choice to be active or not seems obvious.