CHAPTER 1: Exercise and Eating Well

A Sane Approach to Exercise

Regular activity and exercise are important for staying healthy and feeling good. Exercising is like making a deposit in your "health bank". A positive balance helps you recover from injury or illness. It also helps you maintain or regain the ability to do things you want to do.

When it comes to exercise, every little bit helps. Your body responds to the demands you make on it. Muscles shrink or grow; joints become stiffer or more flexible; bones become weaker or stronger; heart, lungs and circulation become less or more efficient. Regular exercise will also help reduce fatigue, depression, constipation, and sleep problems. For all these reasons people who exercise regularly seem to live longer and better.

From thousands of adults who have used Problem Solving the most common suggestion about exercise was to walk regularly each day. Picking a time each day and having friends to join were common methods to make sure that regular walking happened. Regular walking is something most adults can do year after year. Unless you set a plan and have friends to help you, you are much less likely to be successful.

For example:

• Only about four of every ten adults who are of normal weight exercise regularly at least 20 minutes a day.
• Only about two of every ten adults who are are very overweight (obese) exercise regularly at least 20 minutes a day.

When normal weight adults who do not exercise regularly decide to exercise, only three of ten (30%) feel sure they will do it. Even fewer very overweight adults are confident they can change their eating habits or exercise regularly.

How to do it?

Walk without stopping or use a stationary cycle for at least 20 minutes, 3 times a week to make your heart beat a little faster and to make your breathing a little harder. This activity does not need to be all at once; it can be spread throughout the day.

How you feel is may be an easier guide for walking than trying to follow your "target heart rate". If you can sing, you are walking too slowly. If you are too short of breath to talk, you are walking too fast.

Running for some adults is preferred to walking. However, up to four of every ten adults will have an injury to their legs or feet during a year. Good runners make sure they learn from others about how to reduce their chance of injury.

Exercising with slow stretching relaxes muscles and increases flexibility. Gentle movement lubricates joints and reduces pain.

The following is very basic, easy-to-do program that involves the use of weights and a chair. All the listed stretching and lifting movements should be slow and not cause pain.

• Purchase a set of 2 pound (1 kilogram: kg) weights you can put around your ankles or carry in your hands. You can add more weight later, if you wish. You generally do not need more than 5 pounds (2kg) in a weight pack.
• Select a weight that doesn't seem heavy. Strap the weight pack to your wrists, sit as erect as possible in the chair and begin.
• Move weights slowly- take about 6-9 seconds for each weight movement and rest between each for 2-3 seconds.
• Use weights correctly-- don't swing the weights; don't start with too heavy a weight.
• Rest between repetitions (A repetition is a weight movement.) Try to do 8 slow repetitions -- say 1 Mississippi, 2 Miss.., etc.-- and then rest for 1-2 minutes. Skip a day between these work outs because your muscles need a rest.
• Don't forget your abdominal (stomach) muscles. Do 15-30 partial sit-ups with knees bent daily to keep the abdominal muscles in shape. This helps your back!
• Note that these exercises can be used to improve balance, flexibility, and strength.

Record the weight and total repetitions for each limb to see your progress.

Good Eating

Everyone knows that eating only one type of food, eating to the point of being overweight, or not eating to the point of starvation is bad for health. Everyone knows that Eating Well is a good thing -"we are what we eat" - the saying goes. But it is not always easy to Eat Well. And it is not easy to understand all the claims and counterclaims about the benefits of different food, vitamins, minerals, and food supplements.

What everyone needs to understand are "calories" and the percent of calories from fat and protein. When food is used in the body, it produces energy for heat, growth, and life. This energy is measured in calories. Too many calories every day above what are needed makes a person add too much fat. The internet has calculators that change your age, weight, height, and usual activities into needed calories. A typical adult needs about 2000 calories a day.

To understand your needs, for AT LEAST ONE DAY, carefully read food labels. Look at the total calories you get and the percent of calories from fat and protein. Most food labels now tell you the Daily Value (DV) as a percentage. If your total DV of fat, fiber, salt (sodium), and carbohydrates (starches and sugars) each is near 100% and you are a typical "2000" calorie-a-day person, you are doing fine.

Try to keep fat at less than 30% each day. (30% fat in a day is about 2 cheeseburgers or two beef frankfurters). To get the needed fat in your diet, try to have "good vegetable oils" such as olive, canola, peanut, corn and sunflower,safflower, and soybean oils.

Your body loses proteins every day. They have to be replaced. Proteins are the building blocks for your body. Proteins come from lean meat, poultry, fish, eggs, beans, nuts, or peanut butter.Try to keep protein more than 15% of DV.

The list below gives a recommended range of servings per day and size of serving. The lowest number is for older, inactive adults; the highest for very active, younger adults.

• Breads, cereals, rice and pasta -- 6-11 servings a day (one serving: a slice of bread, 1/2 cup of pasta)
• Fruits -- 2-4 servings a day (one serving: an apple, 3/4 cup of juice)
• Vegetables -- 3-5 servings a day (one serving: 1/2 cup cooked, 1 cup raw)
• Lean meat, poultry, fish, beans, eggs, and nuts -- 2-3 servings a day (serving: 1 egg, 6 ounces meat, 1/2 cup beans)
• Milk, cheese, yogurt -- 2-3 servings a day ( serving: 1 cup or 1.5 ounces of cheese)

REMEMBER: THERE ARE MANY GOVERNMENT SPONSORED WEBSITES DESIGNED TO HELP YOU EAT WELL. WHEN IN DOUBT, CHECK THEM OUT!

Vitamins, Minerals and Diet Supplements

Many important vitamins, minerals, and "good fatty acids" can be missing if you don't eat a mix of foods as listed above. Since many adults DO NOT eat a portion of fruits and vegetables each day, the sale of vitamins pills, minerals pills, and other supplements is big business. However, no one is sure if the use of these vitamins, minerals, and supplements improves health. For example, studies show that when taken by well-nourished older persons, multivitamins do not reduce the number and severity of "colds". Vitamins E and C supplements do not reduce risks from hardening of the arteries.

Calcium needs increase during the teen years for bone growth. Women past menopause and older men may develop a disorder called osteoporosis which thins out the bones and often leads to painful and disabling fractures. Older people should pay particular attention to their need for calcium (and Vitamin D).

Including foods that are high in calcium in your daily diet is one way to help protect against osteoporosis. These foods include milk, yogurt, cheese and other dairy products, dark green leafy vegetables, canned salmon, and other foods. If you can't drink milk try tofu, sardines, and yogurt for the necessary calcium. The daily recommended calcium intake is 1500 mg; a full glass of milk contains about 300 mg.

Women under the age of 50 require 50% more iron than do men. High iron foods include green vegetables, raisins, and fortified cereals. Iron supplementation beyond what is contained in a regular diet may be harmful for post menopausal women and men.

Another important part of the diet is fiber which is indigestible plant material. The best way to include fiber in the diet is to eat whole grain breads and cereals and plenty of fruits and vegetables. Adding a few tablespoons of unprocessed bran, which is high in fiber, to cereal and other foods is a good way to add additional fiber.

What's the Easiest Way to Shop Well?

Your grocery list may include both fresh and processed foods. Buy enough fresh fruits and vegetables to last only a few days. They will lose their freshness and some nutrients if stored too long. Meats will stay fresh in the refrigerator for varying amounts of time. Ground beef, stew beef, poultry, and fish can be kept safely for only 1 or 2 days and should be frozen if kept longer. Roasts, chops, and steaks can be refrigerated 3 to 5 days before you use them.

Here are some other hints:

• Decide which size item is best for you. A large can or package may be cheaper per unit, but it is not a bargain if most of the contents are thrown away. Consider sharing large packages.
• Frozen vegetables purchased in bags are economical because you can use small amounts at a time.
• If an item at the meat or fresh produce counter is too large, ask an employee to repackage it.
• Read the content labels on packaged and canned foods. The item that is present in the largest amount is listed first. The ones that follow are present in decreasing amounts. The amount of calories, protein, carbohydrates, fat, and sodium per serving is also listed.
• Be careful, some canned foods may be high in salt content. "Reduced" cholesterol and sodium foods means that they have 75% less than the regular food - they often do have some cholesterol or salt.
• Always check packages for freshness dates.

Unit pricing is useful because it lets you know which brand or package size costs less. Plain (generic) label or store brands are usually cheaper than name brands, with little difference in flavor or nutritional value.

Mealtime for the Single Person

Your eating schedule can be made to suit your own needs. For example, you may want to eat your main meal at noon. Or you may prefer frequent small meals throughout the day. An attractive table and music can help make mealtime appealing. Here are other ideas:

• Invite a friend or family member for lunch or dinner. (It's more fun to cook for someone else and the invitation may be returned!)
• Eat in a different place, such as the living room or outside on the porch.
• Join or start a "pot-luck" club where everyone brings a prepared dish.
• If you are an older adult, check with a local agency on aging to find out if your neighborhood provides free or low cost meals for older people at a community center, church, school, or in your own home. These meals offer good food and a chance to be with other people.

For Vegetarians, Serious Athletes, and Heavy Exercisers

If you are a strict vegetarian, you should talk to a registered dietician. It is particularly difficult to get all of the needed proteins, vitamins, and minerals if you are a vegetarian and eat no milk products or eggs. Protein intake is the most important concern, and you might also need vitamin B12. In general, a vegetarian has to consume a lot more food to equal the caloric intake of someone who also eats meats, poultry, and fish. Most vegetarians eat milk products which greatly improves the chances for getting necessary calories and vitamins.

The active athlete who engages in 1 hour of heavy exercise needs 400-700 extra calories above the usual recommended levels.

An athlete should increase fluid intake for several days before an event.

Regular, high intensity athletes may also need increase their intake of iron and several micro-nutrients unless they are very good at eating very balanced diets. They may need to discuss their needs with a dietician.

For the Older Adults

The basic guidelines for a nutritious diet are the same for most healthy adults. Older people need to pay special attention to the quality of the foods they eat and the amount of liquids they drink.

Many people are attracted to ads for vitamins and minerals which imply that they will improve your appearance, give your sex life a boost, prevent or cure your diseases, and even lengthen your life. Most of us can get the nutrients we need by eating a wide range of nutritious foods each day.

Some elderly people do not eat enough food, particularly foods that supply the necessary nutrients. As a result, they may not get the vitamins, minerals, and calories they need to stay healthy and active.

If you answer yes to two or more of the statements below, you may be at nutritional risk.

• you weigh less than 100 pounds (45kg)
• you have lost more than 10 pounds (5kg) without trying in the past 6 months
• you have an illness or condition that made you change the kind and/or amount of food you eat
• you eat few fruits, vegetables, or milk products
• you have more than three drinks of wine, beer or liquor almost every day
• you are not always able to shop, cook, or feed yourself
• you do not have enough money to buy the food you need
• you have a mouth or tooth problem that makes it hard to eat

Digestive problems, chewing difficulties, and the use of certain drugs all can interfere with good nutrition. People with these problems may benefit from a dietary supplement.

What About Fluids?

If you are ill, and do not eat food or drink any fluids for 24 hours, you will lose about 5 pounds (2kg) of water from your body. Older persons don't have as strong a thirst drive as younger persons, so you might not even notice how dried out (dehydrated) you are. This water loss can make you at high risk for falls and many other problems.

Many older persons are taking "fluid pills: diuretics" so they may think that not drinking water is good. In almost every case, this is wrong. "Fluid pills: diuretics" are for getting rid of extra salt from your body. Avoiding salt is important if you are taking these pills. Drinking three large glasses of water or salt- free liquids each day is very important.

Increase Your Confidence about Exercise and Eating Well

To change your exercise and eating habits, Go TO Problem Solving

When should you be concerned about your weight? The Table illustrates "pay attention" and "trouble" weights.

Your Height without Shoes	Pay Attention	Trouble
5 feet	over 128	over 148
5 feet 4 inches	over 146	over 169
5 feet 8 inches	over 164	over 190
6 feet	over 184	over 213
6 feet 4 inches	over 205	over 238

Your Height without Shoes	Pay Attention	Trouble
152 cm	over 58kg	over 67kg
163cm	over 62kg	over 77kg
173cm	over 74kg	over 86kg
183cm	over 84kg	over 97kg
193cm	over 93kg	over 108kg

You have probably spent a lot of time worrying about your weight if you are in the "trouble" zone or gained more than 20 pounds (8 kg) since your twentieth birthday, or you now have a lot of fat around your waist. You know that being in the "trouble zone" puts you at a higher risk for heart disease, diabetes, arthritis, and a shorter life.

The trick is figuring out what to do about your weight.

First. Think about your weight problem as a possible indicator of other problems and concerns for which food acts like a medicine for temporary relief. Food is a quick "feel good pill" for many people.

The Table lists problems and concerns that obese people have when compared to people who are not obese. If one of these problems and concerns really matters to you, you should probably think about working on it. The 'Problem Solving'_ tool may be a good way to start.

Not Feeling Confident to Manage and Control Health Problems and Concerns	70 of 100 people
Bothersome Sleep	20 of 100 people
Bothersome Pain Problems	20 of 100 people
Medications May Be Causing Problems	15 of 100 people
Poor Social Support	15 of 100 people
Bothersome Emotional Problems	15 of 100 people

Second, understand that we gain weight because we eat more calories each day than we need... BUT calorie counting diets alone, do not work well. If counting calories is the method we chose, highly manufactured food calories are the ones that we must focus on for a better result.

For example, vegetables, fruits, grains, beans, and nuts are "good" even when they have been roasted, boiled, or pasteurized to increase shelf life or make them safe to eat. In comparison "bad" foods contain little, if any, of the "good" foods and are meant to be convenient, hyper-palatable, and low cost "Bad foods" are typically high in sugars, refined grains, fats, preservatives, salt and substances you wouldn’t use in food preparation at home such as hydrolyzed proteins, modified starches, hydrogenated oils, high fructose corn syrup... usually a list you can barely read and never understand.

KEEPING TRACK OF CALORIES HELPS BUT IT IS THE BAD CALORIES THAT MATTER MOST

Keep a diary record of what you eat. After a week select the high/BAD calorie food you often eat that you can do without. Then don't eat it. For example if you switch to low fat milk instead of whole milk (1 cup a day) you could loose 5 pounds (2 kg) a year. Eliminate toast, jam, and butter in the morning, and you'll lose 16 pounds (7kg).

If you have not lost weight, continue tracking what you eat in the diary, and after several more weeks, pick another food to eliminate. Expect to lose only a few pounds/kg a month if you want to really keep weight off. (No more than 10% of your weight in six months).

Play it smart with your appetite. Slow your chewing of regular meals and munch on water-filled, high bulk food (like apple slices or a carrot). These foods make you feel full without giving you a lot of calories.

Broil or bake foods rather than frying them. Chicken may have less fat than beef but when deep fried, chicken has twice as much fat as a hamburger. Select lean cuts of meat. Eat fish and poultry instead of red meats. Use low-fat or non-fat milk products. Cut down on hidden fat in fried foods, foods served with heavy sauces or gravies, pastries, and even chocolates. Reduce milk to 2% fat or less. You won't notice much difference in taste.

Third. What about "diet pills" and the newer glucagon-like peptide-1 (GLP-1) anti-obesity agonists?

Persons who use diet pills may have some weight loss early but often find they are overweight again later. Because these pills have risks - some have been taken off the market in the last 10 years - you should talk to a doctor before you take them. Few will recommend older diet pills or special diets (herbal, carbohydrate, protein, etc.)

Instead, the GLP-1 medicines have taken over.

GLP-1 medicines are booming in numbers and names. They all seem to work for a while, but weight loss seems to be sustained best by those who are able to exercise regularly.

Exercise and Weight Control

The Table below shows you how many minutes you would have to do certain types of activities to "burn off" the calories from certain foods.

Food	Activity Needed to Burn Off Extra Calories
	Calories	Walk	Bike	Run	Rest
		(min)	(min)	(min)	(min)
Bread and butter	78	15	10	4	60
Cake, 1/12, 2-layer	356	68	43	18	274
Carbonated beverage, 1 glass	106	20	13	5	82
Chicken, "TV" dinner	542	104	66	28	417
Cookie, chocolate chip	51	10	6	3	39
Doughnut	152	29	18	8	116
Ice cream, 1/6 qt.	193	37	24	10	148
Pancake with syrup	124	24	15	6	95
Pizza, cheese, 1/8	180	35	22	9	138
Hamburger	350	67	43	18	200
Roast beef with gravy	430	83	52	22	331
Spaghetti, 1 serving	396	76	48	20	305

On pound (or a half of kilogram) of fat is about 3500 calories or 10 hamburgers worth of calories (from the Table). To "burn off" 10 hamburgers of fat one has to run 3 hours or bike 36 hours! Many people think that exercise is a good way to control weight. As you can see, unless you have a lot of time to exercise and you are very young so you can keep exercising a long time, exercise is usually not the best way to lose weight. Watching what we eat is the best way to keep our weight where it needs to be.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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Last reviewed: January 2024 © 1997-2024 FNX Corporation and Trustees of Dartmouth College. All Rights Reserved.