How to Start a New Year’s Exercise Program

By Dominic McKinley, MD, CAQ and Joe Mullins, M. Ed., ATC

“A new year and a new you” – This is a resolution that is shared by multitudes this time of year. Intentions are high. Motivations abound. Memberships are purchased. One thing is missing – A Plan!

With so many myths and television promises confusing your thought processes, it is very difficult to know how to exercise. Questions regarding how much, or which activities are good or bad hover over you like a black cloud of confusion and discouragement.

To clear away the confusion and discouragement, this article will summarize the Updated Recommendations for [Healthy] Adults from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA).1 Although the recommendations from the American College of Sports Medicine and the American Heart Association state that a physician consult is not necessary for healthy, “asymptomatic men and women who plan to be physically active at the minimum levels of moderate-intensity activity…”, we do recommend a consult with your health care provider prior to beginning an exercise program. Symptomatic persons with medical conditions such as cardiovascular disease, diabetes, or other active chronic disease or persons with any medical concern or question should speak with your health care provider prior to an increase in your physical activity level.

Aerobic Activity – To maintain and promote health the ACSM and AHA recommend a minimum of 30 minutes of moderate-intensity aerobic activity on five days per week or vigorous-intensity aerobic activity for a minimum of 20 minutes on three days each week. Moderate-intensity aerobic activity is characterized by a brisk walk that noticeably accelerates your heart rate. Vigorous-intensity activity causes rapid breathing and a substantial increase in your heart rate. An example of such an activity is jogging. (A list of activities and their respective intensity levels is summarized in Table 1.)

Examples of exercise programs that achieve the above recommendations fall under the category of circuit training programs that combine strength training with aerobic activity. Resources for this type of program can be found at http://www.sportspecificuniversity.com/strength_training_workouts.htm.

Table 1. Intensity Levels Of Common Physical Activities - Reference 1
Light	Moderate	Vigorous
Walking	Walking	Walking, jogging & running
Walking slowly around home, store or office	Walking at a brisk to very brisk pace of 3.0 - 4.0 mph on flat surface	Walking at a very very brisk pace of >4.5 mph on flat surface Walking/hiking at moderate pace and grade w/ <10 lb pack Hiking at steep grades w/ 10-42 lb pack Jogging at 5 - 6 mph Running at 7 mph or >
Household & Occupation	Household & Occupation	Household & Occupation
Sitting - computer work at desk or using light hand tools Standing performing light work such as making bed, washing dishes, ironing, preparing food or store clerk	Heavy cleaning - washing windows or car. Cleaning garage Sweeping floors or carpet, vacuuming, mopping General carpentry Carrying and stacking wood Mowing lawn with push mower	Shoveling sand, coal, snow, etc. Carrying heavy loads such as bricks Heavy farming such as bailing hay Shoveling/digging ditches
Leisure Time and Sports	Leisure Time and Sports	Leisure Time and Sports
Arts & crafts, playing cards Billiards Boating Croquet Darts Fishing - sitting Playing most musical instruments	Badminton - recreational Basketball - shooting around Bicycling - flat land (10-12 mph) Ballroom dancing Fishing - river bank & walking Golf - walking, pulling clubs Sail boating, wind surfing Swimming - leisurely Table tennis Tennis doubles	Basketball game Bicycling - flat land (12-16 mph) Skiing - cross country (2.5 - 5 mph or >) Soccer - competitive Swimming - moderate/hard Tennis singles Volleyball - competitive
Source: Medicine & Science in Sports & Exercise, 2007 Special Communications

Muscle-Strengthening Activity – The ACSM and AHA recommend performing resistance exercises that use the major muscle groups two days each week minimally.  Continued recommendations include 8-10 exercises being performed that allows for 8-12 repetitions of each exercise that ends in “volitional fatigue”.

Benefits outlined by the ACSM and AHA for muscular strength and endurance training include “an increase in bone formation in young adults and slow bone loss in middle age.  Presumably, this can result in a lower risk of osteoporosis, osteopenia and bone fracture.”  Therefore, strength training is of benefit for young adults to baby boomers to senior adults.

Examples of exercise programs that achieve the above recommendations can be accomplished from body weight exercises, dumbbell exercises, or machine type exercises.  Resources for these types of programs can also be found at http://www.sportspecificuniversity.com/strength_training_workouts.htm or at http://www.sportspecificuniversity.com/total_gym_workouts.htm.

Obesity, Gaining, and Losing Weight – The ACSM and AHA attribute the increased obesity rates to “a lack of energy balance” where populations are consistently expending fewer calories than they consume.  Therefore, for healthy adults, weight gain and weight loss is balanced by the number of calories consumed versus the number of calories burned.

The ACSM and AHA recommend weight control strategies as, “adults regardless of body size or shape should be encouraged to meet the moderate-intensity, minimum of 30 minutes/day on five days per week guideline.  For individuals who achieve this level of activity, but remain overweight, an increase in their physical activity is a reasonable component of any strategy to lose weight.”  Recommendations for weight loss are continued by the ACSM and AHA to include a consideration toward “food intake and other factors that affect body weight.”

Weight loss exercise programs are sometimes gender specific.  Resources for gender specific weight loss programs can be found at http://www.sportspecificuniversity.com/weight_loss_programs.htm.

By understanding the guidelines set forth by the American College of Sports Medicine and American Heart Association, you can have confidence that your New Year’s resolution of “A new year and a new you” can be met.

A summary of the guidelines can be found in Table 2.

We wish you health and success.

Table 2. Physical Activity Recommendations For Healthy Adults Aged 18-65 - Reference 1

1. To promote and maintain good health, adults aged 18-65 yr should maintain a physically active lifestyle.

2. They should perform moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic activity for a minimum of 20 min on three days each week.

3. Combinations of moderate- or vigorous-intensity activity can be performed to meet this recommendation. For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days.

4. These moderate- or vigorous-intensity activities are in addition to the light-intensity activities frequently performed during daily life (e.g. self care, washing dishes, using light tools at a desk) or activities of very short duration (e.g. taking out trash, walking to parking lot at store or office).

5. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30 min minimum by performing bouts each lasting 10 or more minutes.

6. Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate.

7. In addition, at least twice each week adults will benefit by performing activities using he major muscles of the body that maintain or increase muscular strength and endurance.

8. Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities, or prevent unhealthy weight gain will likely benefit by exceeding the minimum recommended amount of physical activity.

Reference: 

1) Physical Activity and Public Health:  Updated Recommendation for Adults from the American College of Sports Medicine and the American Heart Association, Medicine & Science in Sports & Exercise, 2007 Special Communications.

Dominic McKinley, MD, CAQ is a primary care sports medicine physician with Guilford Orthopaedic and Sports Medicine Center in Greensboro.  He serves as team physician for N. C. A&T State University and Bishop McGuiness High School.  He enjoys running.  Dr. McKinley can be contacted at 336-275-3325.  More information about Dr. McKinley and the services he provides can be found at www.guilfordortho.com.

Joe Mullins, M. Ed., ATC is Founder and Director of Athletic Training & Conditioning, Inc.  He specializes in functional evaluations and works with athletes from middle school, high school, and college to professional and Olympic athletes.  He can be contacted at joe.mullins@athletictrainingandconditioning.com.  More information about Joe Mullins and the services he provides can be found at www.athletictrainingandconditioning.com.