ACSM Issues New Guidelines on Quantity and Quality of Exercise   (6/28/2011) The American College of Sports Medicine (ACSM) has just released new recommendations on the quantity and quality of exercise for adults, definitively answering the age-old question of how much exercise is actually enough. The position stand, titled "Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise," reflects current scientific evidence on physical activity and includes recommendations on aerobic exercise, strength training and flexibility. Consistent with the 2008 Physical Activity Guidelines for Americans, ACSM’s overall recommendation is for most adults to engage in at least 150 minutes of moderate-intensity exercise each week. “The scientific evidence we reviewed is indisputable,” said Carol Ewing Garber, Ph.D., FAHA, FACSM, chair of the writing committee. “When it comes to exercise, the benefits far outweigh the risks. A program of regular exercise – beyond activities of daily living – is essential for most adults.” The basic recommendations – categorized by cardiorespiratory exercise, resistance exercise, flexibility exercise and neuromotor exercise – are as follows: Cardiorespiratory Exercise * Adults should get at least 150 minutes of moderate-intensity exercise per week. * Exercise recommendations can be met through 30-60 minutes of moderate-intensity exercise (five days per week) or 20-60 minutes of vigorous-intensity exercise (three days per week). * One continuous session and multiple shorter sessions (of at least 10 minutes) are both acceptable to accumulate desired amount of daily exercise. * Gradual progression of exercise time, frequency and intensity is recommended for best adherence and least injury risk. * People unable to meet these minimums can still benefit from some activity. Resistance Exercise * Adults should train each major muscle group two or three days each week using a variety of exercises and equipment. * Very light or light intensity is best for older persons or previously sedentary adults starting exercise. * Two to four sets of each exercise will help adults improve strength and power. * For each exercise, 8-12 repetitions improve strength and power, 10-15 repetitions improve strength in middle-age and older persons starting exercise, and 15-20 repetitions improve muscular endurance. * Adults should wait at least 48 hours between resistance training sessions. Flexibility Exercise * Adults should do flexibility exercises at least two or three days each week to improve range of motion. * Each stretch should be held for 10-30 seconds to the point of tightness or slight discomfort. * Repeat each stretch two to four times, accumulating 60 seconds per stretch. * Static, dynamic, ballistic and PNF stretches are all effective. * Flexibility exercise is most effective when the muscle is warm. Try light aerobic activity or a hot bath to warm the muscles before stretching. Neuromotor Exercise * Neuromotor exercise (sometimes called “functional fitness training”) is recommended for two or three days per week. * Exercises should involve motor skills (balance, agility, coordination and gait), proprioceptive exercise training and multifaceted activities (tai ji and yoga) to improve physical function and prevent falls in older adults. * 20-30 minutes per day is appropriate for neuromotor exercise. In addition to outlining basic recommendations and their scientific reasoning, the position stand also clarifies these new points: * Pedometers, step-counting devices used to measure physical activity, are not an accurate measure of exercise quality and should not be used as the sole measure of physical activity. * Though exercise protects against heart disease, it is still possible for active adults to develop heart problems. All adults must be able to recognize the warning signs of heart disease, and all health care providers should ask patients about these symptoms. * Sedentary behavior – sitting for long periods of time – is distinct from physical activity and has been shown to be a health risk in itself. Meeting the guidelines for physical activity does not make up for a sedentary lifestyle. “It is no longer enough to consider whether an individual engages in adequate amounts of weekly exercise,” said Garber, who is an associate professor of movement sciences at the Teachers College of Columbia University. “We also need to determine how much time a person spends in sedentary pursuits, like watching television or working on a computer. Health-and-fitness professionals must be concerned with these activities as well.” The position stand’s purpose is to offer health-and-fitness professionals scientific, evidence-based recommendations that help them customize exercise prescriptions for healthy adults. The position stand is published in the July 2011 issue of Medicine & Science in Sports & Exercise®, the official journal of ACSM. To access this position stand, visit http://www.acsm-msse.org/. ### The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 40,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. Medicine & Science in Sports & Exercise is the official journal of the American College of Sports Medicine and is available from Lippincott Williams & Wilkins at 1-800-638-6423. To speak with a leading sports medicine expert on the topic, contact the department of communications and public information at 317-637-9200, ext. 133 or 127. Visit ACSM online at http://www.acsm.org.

How Health Care Costs Lower With Healthy Diet & Exercise

Overview  

With proper diet and regular exercise you can reduce the costs of health insurance premiums, the amount you spend on medicines and the number of co-pays for doctor visits. Doctors regularly prescribe specific exercise and diet regimens to combat diseases and conditions such as osteoporosis, high cholesterol and blood pressure, diabetes and stroke. You can work with your physician or a dietitian to find ways to lower your out-of-pocket medical costs and improve your long-term health.

Considerations

Health care costs include insurance premiums paid by individuals and employers, payments for medicines and co-pays for physician and hospital visits, including checkups, tests, surgeries and other treatments. Fewer insurance claims may lower your premiums. Fewer bouts of cold and flu, better blood cholesterol levels and lower blood pressure require you to buy less medicine. Less long-term abuse of your body, such as eating a diet high in saturated fat and cholesterol and living a sedentary lifestyle, will result in fewer medical treatments and expenses.

Diet

A poor diet and lack of exercise can lead to metabolic syndrome, which is a combination of high blood pressure, blood fats and blood sugar. Approximately half of adults age 40 to 60 have metabolic syndrome, according to the website of the UCLA Health System. It leads to coronary heart disease and stroke, cancer and type 2 diabetes. You'll have higher out-of-pocket costs to treat these conditions, your health insurance premiums may rise if you get diabetes, and you may have to pay for a portion of surgeries, such as a coronary artery bypass.

Reducing your risk for disease by adding certain foods to your diet and eliminating excess saturated fat, cholesterol and sodium can reduce your need for doctor visits and medicines. Eating more dietary fiber and less cholesterol can reduce the risk for heart disease and stroke. Dietary fiber may also combat the onset of cancer. Adding more calcium to your diet can improve bone density and reduce the effects of osteoporosis. Eating fish rich in omega-3 fatty acids, such as tuna and salmon, can improve cholesterol numbers. You can reduce hypertension by decreasing sodium in your diet. Adding iron-rich foods, such as black beans, spinach or red meat, decreases your risk of anemia.

Exercise

Exercise helps prevent and treat a number of health problems. For example, performing weight-bearing exercise improves bone density and reduces your risk for fractures. Regular aerobic exercise can increase your "good" cholesterol numbers, helping you reduce your risk for heart disease and decrease your need to purchase medicines like statins. 

American workers miss more than 100 million workdays each year because of lower back pain, according to the Wellness Council of America. Lower back pain often results from excess weight and the stress it places on the spine and back muscles. Exercising can decrease your weight and strengthen your lower back muscles and abdominal muscles, which help stabilize your back. 

Treatments for osteoporosis, high cholesterol and lower back pain increase your health care costs if you must pay some or all of the costs of doctor visits and medicines.

Diabetes Prevention

More than half of the diabetes cases caused by obesity are preventable with proper nutrition, according to Dr. David Heber, professor of medicine and director of the UCLA Center for Human Nutrition. Just a 5 percent reduction in your weight can help you reduce your risk for diabetes, the treatment of which requires you to spend money on on insulin, testing equipment and doctor visits.

Wellness Programs

Many companies provide employee wellness programs to help workers stay healthy and decrease health care costs. This results in lower insurance premiums for employers, and less spending on drugs and treatments for employees. Wellness programs include adding a fitness center on company property, giving employees rebates for exercise equipment or gym memberships they purchase, offering nutrition lectures and serving healthy foods in the cafeteria.

References

• UCLA Health System: How Nutrition and Exercise Can Increase Productivity and Lower Health Care Costs
• Wellness Council of America: Building a Well Workplace
• Mercer University School of Medicine: Promote Health Through Diet and Exercise
• MayoClinic.com: HDL Cholesterol: How to Boost Your 'Good' Cholesterol

About this Author

Sam Ellyn has been writing since 1983 for national and regional sports, fitness, business and parenting magazines. He writes and lectures on fitness, nutrition, sports, business, cooking, beauty and home and garden, and works in magazine consulting and association management. He worked in commercial kitchens for more than 20 years, and holds two journalism degrees.

Read more: http://www.livestrong.com/article/302080-how-health-care-costs-lower-with-healthy-diet-exercise/#ixzz1QlMJ1hDL

What’s the Single Best Exercise?

By GRETCHEN REYNOLDS

Published: April 15, 2011

Let’s consider the butterfly. One of the most taxing movements in sports, the butterfly requires greater energy than bicycling at 14 miles per hour, running a 10-minute mile, playing competitive basketball or carrying furniture upstairs. It burns more calories, demands larger doses of oxygen and elicits more fatigue than those other activities, meaning that over time it should increase a swimmer’s endurance and contribute to weight control.

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Jonathan De Villiers for The New York Time

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ENERGY WELL SPENT In METs (metabolic equivalent to task), a measure of energy exerted for a given activity.

So is the butterfly the best singleexercise that there is? Well, no. The butterfly “would probably get my vote for the worst” exercise, said Greg Whyte, a professor of sport and exercise science at Liverpool John Moores University in England and a past Olympian in the modern pentathlon, known for his swimming. The butterfly, he said, is “miserable, isolating, painful.” It requires a coach, a pool and ideally supplemental weight and flexibility training to reduce the high risk of injury.

Ask a dozen physiologists which exercise is best, and you’ll get a dozen wildly divergent replies. “Trying to choose” a single best exercise is “like trying to condense the entire field” of exercise science, said Martin Gibala, the chairman of the department of kinesiology at McMaster University in Hamilton, Ontario.

But when pressed, he suggested one of the foundations of old-fashioned calisthenics: the burpee, in which you drop to the ground, kick your feet out behind you, pull your feet back in and leap up as high as you can. “It builds muscles. It builds endurance.” He paused. “But it’s hard to imagine most people enjoying” an all-burpees program, “or sticking with it for long.”

And sticking with an exercise is key, even if you don’t spend a lot of time working out. The health benefits of activity follow a breathtakingly steep curve. “The majority of the mortality-related benefits” from exercising are due to the first 30 minutes of exercise, said Timothy Church, M.D., who holds the John S. McIlhenny endowed chair in health wisdom at the Pennington Biomedical Research Center in Baton Rouge, La. A recent meta-analysis of studies about exercise and mortality showed that, in general, a sedentary person’s risk of dying prematurely from any cause plummeted by nearly 20 percent if he or she began brisk walking (or the equivalent) for 30 minutes five times a week. If he or she tripled that amount, for instance, to 90 minutes of exercise four or five times a week, his or her risk of premature death dropped by only another 4 percent. So the one indisputable aspect of the single best exercise is that it be sustainable. From there, though, the debate grows heated.

“I personally think that brisk walking is far and away the single best exercise,” said Michael Joyner, M.D., a professor of anesthesiology at the Mayo Clinic in Rochester, Minn., and a leading researcher in the field of endurance exercise.

As proof, he points to the work of Hiroshi Nose, M.D., Ph.D., a professor of sports medical sciences at Shinshu University Graduate School of Medicine in Japan, who has enrolled thousands of older Japanese citizens in an innovative, five-month-long program of brisk, interval-style walking (three minutes of fast walking, followed by three minutes of slower walking, repeated 10 times). The results have been striking. “Physical fitness — maximal aerobic power and thigh muscle strength — increased by about 20 percent,” Dr. Nose wrote in an e-mail, “which is sure to make you feel about 10 years younger than before training.” The walkers’ “symptoms of lifestyle-related diseases (hypertension, hyperglycemia and obesity) decreased by about 20 percent,” he added, while their depression scores dropped by half.

Walking has also been shown by other researchers to aid materially in weight control. A 15-year study found that middle-aged women who walked for at least an hour a day maintained their weight over the decades. Those who didn’t gained weight. In addition, a recent seminal study found that when older people started a regular program of brisk walking, the volume of their hippocampus, a portion of the brain involved in memory, increased significantly.

But let’s face it, walking holds little appeal — or physiological benefit — for anyone who already exercises. “I nominate the squat,” said Stuart Phillips, Ph.D., a professor of kinesiology at McMaster University and an expert on the effects of resistance training on the human body. The squat “activates the body’s biggest muscles, those in the buttocks, back and legs.” It’s simple. “Just fold your arms across your chest,” he said, “bend your knees and lower your trunk until your thighs are about parallel with the floor. Do that 25 times. It’s a very potent exercise.” Use a barbell once the body-weight squats grow easy.

The squat, and weight training in general, are particularly good at combating sarcopenia, he said, or the inevitable and debilitating loss of muscle mass that accompanies advancing age. “Each of us is experiencing sarcopenia right this minute,” he said. “We just don’t realize it.” Endurance exercise, he added, unlike resistance training, does little to slow the condition.

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