Thursday, November 13, 2008

Getting Back Into Shape

 Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

I am a strong advocate for physical activity.  Any physical activity.  I encourage my patients, friends, family to find something they like to do and DO IT.   For one sister that means running 5K’s, half-marathons, full marathons.  For my mother, it’s the senior citizen dances.  For my husband, it’s running on the treadmill.  For me, it’s walking (walk/jog) my dog and shooting baskets in the back yard.  (Okay—it also includes dancing to the radio and commercials.)
If you haven’t been active in a long time and are seriously de-conditioned, start slow.  There is a program called “The Couch-to-5K Running Plan” which offers some good advice and an easy to follow plan. 
Or you can follow the plan at Shape Up America! 10,000 Step Program which uses a pedometer to keep track of how much (or little) you move each day.
With Halloween just past (all that candy) and Thanksgiving and Christmas coming up, now is a good time to get moving or keep moving.   Here is the post I wrote last November on using a pedometer

I use a pedometer as a reality check. I often go home tired after a day in surgery or in the office. I'm tired so I must have expended a lot of energy and therefore used a lot of calories/done a lot of moving right? Wrong! In the course of a "normal" day most adults take anywhere from 900 to 3000 steps in a day and not much more. That means to truly get "enough" physical activity in daily, I (and you) need to go for that daily walk. Fortunately, I enjoy walking. Most days (barring horrible weather) I enjoy my walks with my dog. Other days--I just do it--rain or cold or heat. This is a picture of my pedometer with my step count on a surgery day. It includes the time from getting dressed to just finishing in the operating room. Notice how few steps have been taken.
JAMA recently had an article (referenced below) that showed "The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure." Overall, the pedometer users increased their physical activity by 26.9% over baseline. The person who gets the most out of the use of a pedometer is the who has a step goal (ie 10,000 steps per day).
The JAMA article also found "Pedometer users also significantly decreased their systolic blood pressure by almost 4 mm Hg from baseline. Reducing systolic blood pressure by 2mmHg is associated with a 10% reduction in stroke mortality and a 7% reduction in mortality from vascular causes in middle-aged populations; thus, it is critical that the effects of pedometer use on blood pressure be examined closely in future studies."
Perhaps you might think about getting a pedometer for someone for Christmas or even one for yourself. It does not need to be an expensive one. I use the Sportline 340 (having lost a few, they cost less to replace). I never bothered to program in my step length. I simply use it to count the steps and aim for that 10,000 mark. Most days I go past it, but there are days I have to "work" at it. Simple adjustments will add up--park the car farther away from the store, take the stairs down two flights or up one rather than using the elevator, walk one extra block, etc.
Some suggestions on getting started with your new pedometer...
  • Start out by wearing the pedometer each day for two weeks and don't do anything to change your normal routine. Keep an exercise log of the daily step count. At the end of the second week, take a look at how many steps you are taking each day in the course of living your life.
  • If you feel comfortable doing so, take the highest number of steps you have walked on any given day during that 2 week period. Use that number of steps (ie 2500 steps) as your first daily step goal. To avoid injury, do not select a higher number. Continue to keep your step log.
  • At the end of that two week period, review all the steps you took each day. If you are ready, add another 500 steps to your daily goal. Your new step goal is now 3000 steps a day for the next two week period.
  • Continue in that manner, working up until you finally reach the goal of 10,000 steps a day.
  • The goal is to keep you active for the rest of your life. So don't go overboard and injury yourself. Take it slow. Take it easy.
  • It takes about six months to "lock in" a new behavior. Aim to do what is necessary to change your exercise behavior permanently. Be prepared to dedicate yourself to your daily goal each day for a minimum of six months. If you do that, you are much more likely to maintain this goal permanently.
  • If you skip a few days due to illness, work or other obligations, the sooner you get back into the exercise groove, the more likely you will be able to get back into your routine.
  • Reaching that walking activity goal of 10,000 steps does not mean that you can increase your food intake. Continue to try to eat a healthy and reasonable portion diet.
  • So the weather's yucky, walk laps at the mall, go to a museum, or walk laps inside your home. Get up and move!
Here's my total at the end of the day.
Using Pedometers to Increase Physical Activity and Improve Health: A Systematic Review; Dena M Bravata, MD and others; JAMA, Nov 21, 2007, Vol 298, No 19, pp2296-2304
Shape Up America! 10,000 Step Program


alex said...

great post! thank you! I have a pedometer that's been languishing in my drawer. I'm inspired to take it out and give it a whirl.

for those looking to track their step goals and activity (and food intake and pretty much everything else) I recommmend it helped me shed 40 lbs so far and run a half marathon.

Carin Diaz said...

Thanks for the reminder. I have 2 pedometers laying around somewhere. I've never thought of it as a tool to reach your goal.

Lisa said...

Good post! :)

What are you, a size 4? Tiny!

swooze said...

I love the article. I had a friend explain it to me once but it wasn't written down. Is there something similar out there for lifting weights do you know?

Love the lobster quilt above. I am sure it will be a hit.

rlbates said...

Swooze, I'm sure there is, but I don't have a link. With weights start slow. Increase reps or lbs once a week. Safer to only do one or the other.

Melissa Gay Art said...

Excellent post, and timely for me, as I've recently begun a conscientious plan to increase my activity level!

5K is about 3 miles, yes? I'm up to two miles of walking per day, but my energy level has not caught up with my activity level yet, and I'm still walking around like a zombie. I expect another week of this until my body catches up with me. The "adding steps" method sounds a lot less traumatic, and I may try that instead of my method (randomly add another mile when it seems like I "ought" to be able to handle it, *lol*).

rlbates said...

Perky Skeptic, yes a 5K is 3.1 miles. Just hang in there, it'll get easier.

Margaret Polaneczky, MD (aka TBTAM) said...

what a doable, easy to follow plan! Thanks for this great post.