Shape Up & Drop 10

Shape Up & Drop 10™

Step 4 — Physical Activity — What's Enough? What's Too Much?

We give you the facts, you make the decisions

We have a lot to tell you in this step about the use of exercise for weight management. Here are the major topics we will be covering in Step 4:

The Role of Exercise in Weight Management
The 2-Step Approach: 1. Reduce sedentary behaviors 2. Increase physical activity.
How Much Exercise is Enough Anyway?
The Role of Strength Training in Weight Management
Protecting Your Joints (knees and hips) for the Long Haul
No Time and other Barriers to Exercise

What exactly is the role of exercise in weight management?

The answer to this question is two-fold:

For WEIGHT LOSS, reducing calories by eating less is the single most important strategy, but COMBINING exercise with calorie reduction yields even better results — that is, more pounds (and more fat) lost.
For WEIGHT MAINTENANCE — keeping the weight off after you have lost it — exercise is absolutely critical.

Most people using Shape Up & Drop 10™ are in the WEIGHT LOSS phase, where cutting calories is the key strategy. The rationale for the delay in discussing exercise is that for now, it is more important for you make the changes in your eating and drinking habits described in Steps 1 and 2, and to start tackling the important factors that will support behavioral change discussed in Step 3. But sooner or later you have to come to grips with exercise, because the data in the scientific literature strongly suggest that you will regain any weight you lose if you don't become more physically active.

The purpose of Step 4 is to explain what type of exercise is needed for successful weight management and how much. We will help you prepare for this important change in your lifestyle so that you won't be overwhelmed. It is important that you be ready to take on this newest challenge. We would like to suggest that you read every word in Step 4 and think carefully about how you want to proceed. If you are getting ready to change your life by becoming more physically active, there are a lot of issues you will need to think about so that you can sustain this change throughout the rest of your life.

Exercise has a beneficial effect on almost every physiological system in your body. If you make one and only one change in your lifestyle, we hope you will choose to increase physical activity. It will offer you the most "bang for your buck" in the sense that it improves your metabolic profile and does more to improve your overall health than any other behavioral change. Here are some of the benefits of regular exercise:

Reduces blood pressure
Reduces "bad" cholesterol levels
Raises "good" cholesterol levels
Reduces overall heart disease risk
Reduces risk for several prominent cancers
Reduces blood glucose levels
Reduces abdominal fat — considered the most dangerous to health
Improves insulin's ability to lower blood glucose levels
Increases bone density
Improves muscle tone and posture
Improves heart (cardiovascular) function
Improves lung (respiratory) function
Reduces stress
Improves mood

The key benefit of exercise for our purposes is improved weight management. There is a large database of information on thousands of people who have taken off 30 pounds or more and kept it off for up to five (or more) years. This database makes it clear that exercise is one of the key factors associated strongly with successful weight management. But for many people, years of sedentary behavior and many pounds of extra weight mean that careful planning and thought must go into making this important lifestyle change.

You may be feeling that increasing your physical activity is too much for you to deal with right now. There is no hurry. The attitude or mindset that will work best is to TAKE THE LONG VIEW — making the changes slowly and gradually with the thought in mind that these are changes you will sustain for the rest of your life.

To Get Started, Take a Two Step Approach — first reduce sedentary behaviors — then increase physical activity

Reduce Sedentary Behaviors
To reduce sedentary behavior you need to think first and foremost about TV viewing. TV viewing is the one sedentary behavior that most Americans indulge in that defeats successful weight management in three ways: it keeps us inactive; we often snack while watching TV; and we are bombarded with advertisements to eat more food. That is why several studies have shown that turning off the TV is highly beneficial. When you turn off the TV, TV viewing is replaced, at least part of the time, with more active pursuits, and those replacement activities are less likely to involve snacking.

So refer to Step 3 and pull out your rewards list. Each time you turn off the TV or avoid turning it on, you need to give yourself a NON-FOOD reward that is meaningful to you. For example, you could drop a dollar into a piggy bank to purchase yourself a new item of clothing, or to spend on a vacation trip next winter.

It is true that when you turn off the TV, you will sometimes choose to do something else sedentary — like read a book or write a letter. But studies show that at least some of the time, you will choose to go for a walk or do something else that is more active. So think about making a list of TV REPLACEMENT ACTIVITIES that involve physical activity and write that list in your journal. Prepare to give yourself a reward for replacing TV viewing with any activity that involves physical movement.
Start Increasing Physical Activity
Once you are comfortable with the idea of starting to increase your level of physical activity, think first about increasing your ACTIVITIES OF DAILY LIVING. There are small ways in which you can build more physical activity into your day. For example, you can run some errands on foot rather than in the car. You can drive your car to a shopping area, but intentionally park the car far away from the front door so that you will have to do more walking. You can take the stairs instead of the elevator. You can start off by walking downstairs a few flights and then eventually you can start to walk UP a flight or two. Think of your own life and make a list of small changes you can make to add more activity to your daily routine. Write them down in your journal.

The attitude you want to develop is one of LOOKING FOR WAYS TO BE MORE ACTIVE instead of ways to sit more. This is a new way of thinking that you can slowly adopt.

When you are truly ready to embrace physical activity, think about what activities you might enjoy. It is true that the majority of people (both men and women) enjoy walking, but many men do not consider walking serious exercise. The fact is that walking is a legitimate form of exercise in that it can produce every one of the benefits of exercise listed above and it can definitely be used for weight management. But we realize different people have distinctly different preferences for physical activity. So it is up to you to figure out what works for you and what does not. Any activity at all is helpful whether it is dancing, riding a bike, gardening or going to an exercise class or yoga class. If it involves movement, and you are willing to do it, then it is worth doing.

How much exercise is enough anyway?

How much exercise is enough? … "Eight minutes in the morning?" … "30 minutes a week?" … "10 minutes, three times a day? It is all so confusing. We will try to set the record straight about what is recommended and why.

The first recommendation we will consider is the U. S. Surgeon General's recommendation for 30 minutes of moderate physical activity each day, preferably every day of the week. This recommendation was published in 1996 in the Surgeon General's Report on Physical Activity and Health. It is supported by solid scientific evidence that this amount of exercise will yield enhanced fitness, burn a significant number of calories, and improve overall health and reduce your risk of disease.

If you have been inactive for several years and you are carrying around excess weight, this recommendation is an appropriate activity goal for you to achieve over the next six months. But if you have any health concerns, you should discuss them with your health care provider first. If you are given approval to proceed, we suggest that you start out by aiming for 5 minutes a day to start with for the first two weeks. If you feel fine, you can add an additional 5 minutes a day for a total of 10 minutes a day for the next two weeks. You can work in this fashion making small increases in the amount of activity over an extended period of time until you get to the 30-minute mark. Make a plan for yourself in your journal to reach the goal of 30 minutes a day over the next six months. In your plan, make sure you set milestones along the way and indicate the reward you will give yourself for achieving each milestone. [NOTE: Keep in mind that you don't have to exercise continuously. Three 10-minute sessions in a day are just as good as one 30-minute session.]

To make it more fun, many people have benefited from PURCHASING A PEDOMETER and keeping track of their steps in their journal. If you plan to use this approach, keep in mind that 30 minutes of walking a day translates to roughly 5000 STEPS A DAY. So if you plan to track your steps, here is how you proceed:

The Shape Up America! 5000 Steps Program for Better Health™

Clip your pedometer FIRMLY to your waist. DO NOT put it in your pocket or it won't work properly. Your pedometer is designed to be worn above your hip bone and it is sensitive to the motion your hip makes when you take a step. Our advice is to track only the number of steps you take, because your pedometer is most accurate at tracking steps. It is not as accurate at tracking miles walked, or calories burned, both of which are calculated values that involve assumptions that may not hold true.
For weeks 1 and 2, wear your pedometer all day each day and write down the number of steps you took in your journal at the end of each day before you go to bed. At the end of those two weeks, take a look at the number of steps you took each day and select a number somewhere in the middle. That number of steps will be your new minimum goal. To make it easy, let's say your goal is 500 steps.
For weeks 3 and 4, make sure you walk at least the minimum 500 steps each day. Remember you can collect your steps over the course of the entire day. Before you go to bed each night, record in your journal the exact number of steps you took that day because this information will guide you in choosing your goal for weeks 5 and 6.

For weeks 5 and 6, if you feel you can manage it, select a new minimum goal that is about 50% higher than your last minimum goal. If that is too ambitious, choose a goal that is only 25% higher. Proceed in a stepwise fashion, increasing your goal every two weeks until you reach the ultimate goal of 5000 steps a day. The following table does the math for you:

Daily Goal (# steps) 25% Increase 50% Increase

500 625 750
1000 1250 1500
1200 1500 1800
1500 1875 2250
1800 2250 2700
2000 2500 3000
2400 3000 3600
2700 3375 4050
3000 3750 4500
3500 4375 5250 (goal attained)
4000 5000 (goal attained) 6000 (goal exceeded)

At the end of each two week period, reward yourself if you reached your daily goal at least 10 out of 14 days. If you don't reach the goal, or don't reach it as often as you planned, remember how totally useless it is to punish yourself. Rewarding yourself for your positive behavior is associated with lasting weight loss success. Punishing yourself for failing to reach a goal (or for any reason) is counterproductive.

Is 30 minutes a day enough to manage my weight?

Thirty minutes a day is enough to make a big difference in your health and fitness, and of course, it is making a contribution to your weight management. But studies show that 30 minutes will not be enough exercise to prevent weight gain for most people. In the Fall of 2002, the Institute of Medicine (IOM) issued a landmark report that addressed the amount of exercise needed for weight management. The IOM reviewed the scientific literature on weight management and exercise and concluded that 60 minutes of exercise at a moderate intensity would suffice for the majority of people seeking to manage their weight.

Are you saying that to LOSE WEIGHT I have to exercise 60 minutes a day?

NO, that is not what we are saying. We are saying that cutting calories is the single most effective way to lose weight and ANY AMOUNT of exercise you do in addition will help to increase the amount of weight loss. But exercising 60 minutes a day is the amount of exercise needed to prevent WEIGHT GAIN. What this means is that while you are losing weight, it is best to focus on learning about portion control and choosing a healthier diet. Once you have gained mastery over those skills, you can think about aiming at the Surgeon General's recommendation of 30 minutes a day using The Shape Up America! 5000 STEPS Program for Better Health™ described above. Many weeks or months later (depending on how much weight you need to lose), when you are getting close to your goal weight, you need to start preparing for the IOM recommendation of 60 minutes a day of "moderate intensity" exercise to prevent regaining the weight you have worked so hard to lose.

If I start exercising 60 minutes a day, can I go back to my old eating habits?

NO. If your old eating habits are OVEREATING (or over-drinking) habits, then returning to your old habits will only mean regaining the weight.

What does "moderate intensity" exercise mean?

The IOM defines "moderate intensity" as walking at a brisk pace of "4 to 5 miles per hour." That is a pretty fast pace. If you walk a total of 5 miles in 60 minutes, you are walking a distance of one mile in only 12 minutes. Many people find it unpleasant to walk that fast although we know some people who can handle that pace just fine.

I just can't walk that fast, but I could walk the 5 miles if I could take a longer time.

That is perfectly OK. The fact is that if you take extra time to walk the 5 miles, you will accomplish the same thing. We know people who walk a distance of 5 miles in 70 or 80 or even 90 minutes. Some people cover that distance over the course of the entire day. All of those approaches are perfectly OK as long as the result is the same — prevention of weight gain.

What if I want to walk or jog at a faster pace so that I can cover 5 miles in less time?

You can jog or run 5 miles in less than 60 minutes. That is perfectly OK. But it is not necessary to run or jog if you don't want to. In fact, we never recommend exercising at a level that is any harder than "somewhat hard." We don't want you to strain or work too hard for two reasons: First, it is unnecessary to do so to get the health benefits of exercise, and secondly, it may deter you from exercising because you may find it unpleasant.

What if I can prevent weight regain by walking only 4 miles or even 3 miles. Is that OK?

Yes. It is. For good health, you need to meet the Surgeon General's recommendation of at least 30 minutes a day. Beyond that, you need to keep experimenting with yourself to find out how much more exercise YOU need to achieve weight management. That is your own personal goal because that is what works for you. Period.

I can't walk for one hour at a time, but I might be able to break it up into smaller segments.

That is perfectly fine. Studies show that smaller time segments add up to the same health benefits as continuously exercising for the same total length of time. So three ten-minute bouts of exercise are just as beneficial as one continuous bout of 30 minutes.

How many steps does walking 4 to 5 miles equate to?

Walking 5 miles is roughly equivalent to 10,000 steps. When you are ready to tackle this more ambitious goal, you can use a pedometer and The Shape Up America! 5000 Steps Program for Better Health™ described above. Just keep building up your steps (slowly and gradually) until you reach the goal of 10,000 steps a day.

The Role of Strength (Resistance) Training in Weight Management

For years, the only type of exercise that was considered important for weight management was aerobic exercise like walking, running, jogging, swimming, dancing or any other of dozens of activities involving a lot of movement of the arms and legs. The role of strength training, also known as resistance training, in weight management was not well studied. In the past 5 to 10 years, that has started to change. It is now recognized that strength training has an important contribution to make to weight management. Strength training involves using your muscles to apply force to lift a weight a specific distance, using a specific form, usually 12 to 15 times. The exercise is sometimes repeated a second time after a brief period of rest.

Strength training is designed to target or focus on exercising specific muscle groups. A properly designed strength training program will address all major muscle groups in your trunk (abdomen, chest and back), as well as your arms and legs. The exercise will help to tone and strengthen the muscle and, if the exercise is done correctly, using proper form, it will benefit the entire length of the muscle. Strength training requires proper instruction from a qualified instructor. We recommend evaluating the credentials and training of a personal trainer you may be considering. The American College of Sports Medicine (ACSM) in Indianapolis, IN and the American Council on Exercise (ACE) in San Diego, CA have certification programs. Because you can injure yourself if you do not do strength training correctly, we do not recommend you consider strength training without personal one-on-one guidance on safety procedures and the maintenance of proper form.

Strength training is of benefit to both men and women. Many women are reluctant to get involved in strength training and if this includes you, go to the library and get a copy of Miriam Nelson's book, Strong Women Stay Thin. Dr. Nelson's book will help change your mind and you may find it motivating. Strength training is of benefit to adults of any age. Studies have found it helpful in improving the strength and fitness of people in their ninth decade of life, and improved muscular strength increases the likelihood that you will keep physically active.

Strength training does not always produce weight loss — but if your program is properly designed and conscientiously performed using correct form for an extended period of time (10 to 12 weeks or more), it will reliably cause a reduction in body fat and an increase in muscle mass. In many cases, the waist circumference and hip circumference will decrease so your clothes will fit more comfortably. Complementing your exercise program with resistance training conserves your lean (muscle) tissue, causing more of the weight to be lost as fat. Strength training deserves a permanent place in your exercise plan for life.

CAUTION: Strength training should NOT be done every day. It is recommended that you rest your muscles for at least 24 to 48 hours between training sessions.

Why doesn't strength training always produce weight loss?

Because fat is less dense than muscle. So as you build up your muscle and decrease your body fat, you are replacing less dense fat tissue with denser muscle tissue. Thus, as your muscle mass increases, you can actually gain a little weight even as you lose inches. This is upsetting to many women who write us to find out what is going on. This can usually be avoided by a carefully designed program that involves portion-controlled, healthy eating combined with a balanced program of aerobic exercise and strength training. Make sure the weight used is not too heavy and keep your repetitions to no more than 12-15. Again, you should work with a qualified trainer on designing a program that is right for you. Moderate physical activity usually has no effect on appetite, but if you are exercising and working out a great deal, it may stimulate your appetite and cause compensatory eating — increased eating in response to exercise. If you are not alert to this possibility, compensatory eating may cause weight gain. This can be monitored by using your journal and logging your food intake. Again, this is not usually a problem for people doing moderate exercise, but it is something to keep in mind.

Protecting Your Joints (knees and hips) for the Long Haul

If your BMI is above 25, careful thought must be given to protecting your joints when you exercise. Your goal should be to protect the health of your hips and knees for the long term so that you can exercise throughout your life. Consider exercises that will minimize pounding on the joints and compacting the spine. Even walking (which is appropriate for most people) may be difficult and painful for people carrying around many excess pounds. To begin with, swimming or water exercises or using a recumbent bike may be the right choice. As weight is removed through changes in dietary habits and portion control, the use of an elliptical trainer may be added, if appropriate.

If you are starting out your exercise program with pre-existing joint pain, or if you develop it along the way, we can not emphasize enough how important it is to get appropriate medical help and professional guidance on the choice of exercise that is right for you. An investment in a physical therapist at this stage will help you protect your joints for the long haul. If you are considering strength training, your program can and should be properly designed to strengthen and protect your joints.

Since overweight people are at much higher risk for developing joint problems, an investment in protecting your joints today is truly an investment in successful weight management in the future.

Lack of Time and Other Barriers to Exercise

I just don't have enough time to exercise…

Lack of time is the most commonly cited barrier to exercise. Another important barrier is: "I don't see enough of my kids as it is, I just can't take even more time away from them to exercise." The fact is that all of us are busy to the breaking point. We recognize that your complaints about lack of time are completely legitimate, so here are two suggestions to keep in mind:

Contrary to popular belief, exercise does not have to be continuous to count. If you can grab 10 minutes here and 10 minutes there throughout the day, it all adds up and is equivalent to the same amount of continuous exercise in terms of its beneficial effects on your weight and health.
If you have kids, they need more exercise also. So plan to exercise along with your children so that everyone benefits.

I'm just too tired to exercise.

Many people complain that they are too tired to exercise. It is indeed exhausting just to think about the hectic lives that most of us lead. All that we can say in response is that exercise is actually energizing. It adds to your sense of vitality and brightens your outlook. It reduces stress and helps you focus. It will also improve your mood since exercise has been shown to have an anti-depressant effect. Using exercise to elevate your mood will help you avoid all of the side effects and expense of anti-depressant medications, many of which cause weight gain.

Summary

Increased physical activity can make losing weight easier and can increase the amount of weight lost as fat
Exercise is critical for weight maintenance because it prevents weight re-gain after a weight loss program
Exercising 30 minutes a day is essential for good health, but more may be needed to prevent weight re-gain
Start out by rewarding yourself for turning off the TV (with non-food rewards)
When you are ready to increase your physical activity, The Shape Up America! 5000 Steps Program for Better Health™ can help you slowly work up to achieving 30 minutes a day
Learning how to reward yourself (using non-food rewards) for increasing your physical activity is associated with long term weight loss success and prevention of weight re-gain
Strength training can make a positive contribution to weight management in men and women of all ages
Protecting your knees and hips is very important for maintaining an active lifestyle for life
Exercising for short periods that add up over the entire day is just as beneficial as one continuous exercise bout
Rather than making you more tired, increasing your physical activity will energize you and is a natural anti-depressant

Homework Assignments

Make a list of the types of physical activity that you are interested in and think you would enjoy. If some forms of physical activity require joining a class or a gym, look up the necessary contact information for each one in your community. Start making phone calls to inquire about the costs of each and the times of each class. Find out which classes fit with your schedule. Be aware that studies show that a gym or health club should be CONVENIENT to either your home or place of work, otherwise you are unlikely to use it. This is a sizable investment so make sure you maximize your chances of benefiting from it.
Can you afford to purchase a piece of exercise equipment for use in your home? Many pieces of equipment end up as expensive clothes racks because they are not used. Studies show that a treadmill is one piece of equipment that is more likely to be used over time. If you are contemplating purchasing a treadmill, think about what would make you more likely to use it on a regular basis. For example, is there a radio show or a TV program you could enjoy while exercising on the treadmill? Think about ways you might make it more pleasant and more likely for you to use this piece of equipment each day. Can you locate your treadmill in a room with a view outside? A view of the TV? Do you need to purchase a headset so you can exercise and listen to a program without disturbing others in your home?
Make a list of TV REPLACEMENT ACTIVITIES that you would enjoy doing as an alternative to watching television and write the list down in your journal.
Make a list of REWARDS that you would enjoy giving yourself each time you turn off the TV and write them in your journal.
Make a list of Special Rewards that you would give yourself for exercising 30 minutes a day for five days a week. Think of a reward you would give yourself for doing that every week for 6 weeks or even 6 months. Make your rewards as special (but as affordable) as you can manage.
Consider forming your own walking group. This might be a group of 5 or 6 people who meet every day at a certain time of the day, rain or shine. This is a strategy that is especially helpful if neighborhood safety is a barrier to exercise. Walking in a group can offer increased safety.

If You Have Children

If you have a child in school, inquire about the number of times each week that your child is given instruction in physical education (PE). Does your child actually enjoy PE? If not, find out why. Find out what types of activities are included in the PE curriculum. It is important that children are actually physically active during PE class. PE should be offered each day of the week. Is your child's PE class taught by a bona fide PE teacher with appropriate training and credentials? You might want to observe PE class, especially if your child is not enjoying it. The goal is for children to have fun while they are physically active.
Does your child walk to school? If not, why not? Think about what it would take to make it possible for your child to get more physical activity and to have more of your company at the same time. Are there activities you can do together? Make a list and write them in your journal. Discuss each one with your child.
If possible, walk a child to school and notice safety issues along the way. Are there sidewalks? Are there traffic lights at busy corners? Does the walk light stay green long enough to allow even a senior citizen to cross the street safely? Is there anything that needs to be done to make the walk safer and more pleasant? This is the sort of perspective that will make your neighborhood safer and more attractive to walk in for people of all ages. Write a letter to your mayor or town leaders to let them know if changes need to be made.

Proceed to Step 5 of Shape Up & Drop 10™