The Whole Life Routine (Your Health Magazine)

Never mind trying to work your way around the resistance machines at the gym. Think bigger: your life is one big circuit training event

"Those who think they have not time for bodily exercise will sooner or later have to find time for illness."
– Edward Stanley, Earl of Derby, 1873

Grant Knapik sees the benefits of physical activity every day. The certified exercise specialist at the Northern Alberta Cardiac Rehabilitation Program of the Glenrose Rehabilitation Hospital in Edmonton says most of his clients have "had a little medical adventure" prior to meeting with him, but whether they're a seemingly strong 20-something or an ailing octogenarian, the road to recovery from heart trouble always entails an appropriate exercise program.

He's happily devoted his career to helping those who need it, but Knapik would like fewer people to step into his office. A healthy lifestyle, he figures, makes all the difference. "Most of the chronic conditions that society is dealing with – heart disease, obesity, Type 2 diabetes – filter down to two main areas: improper food choices and lack of exercise," says Knapik, admitting that exercise is something that's just too easy for many people to avoid.

Whatever your age or fitness level, the key to maintaining good health is a healthy lifestyle. The activities themselves don't matter – simply being active does. "There are huge health benefits gained, regardless of age and conditioning, just by getting off the couch and moving," Knapik says. "We're not talking about running a marathon. This is not boot camp; we just have to get going."

Kids, teens and tweens
In the 1970s and 80s, children could always be found roaming the neighbourhood streets, playing hide and seek, tag and games like the old playground standard, Red Rover. Packs of teens would organize to meet at local basketball courts or play a marathon game of touch football.

But the natural exercise associated with simply being a kid is on the decline for the computer generation. And getting off the street and online means kids are growing in more ways than up. The Canadian Diabetes Association says that one-third of Canadian kids are overweight. Recent data suggests an American child born in 2000 stands a one in three chance of being diagnosed with Type 2 diabetes in his lifetime. "There's a definite rise in overweight, inactive children," says Kelly Mackenzie, exercise specialist for the Pediatric Centre for Weight and Health at the Stollery Children's Hospital. "All kids, regardless of weight, should be active. Families need to make this a priority."

Health Canada recommends that kids get 90 minutes of activity per day. Pedometers, Mackenzie says, are a good way to track activity: 12,000 steps per day is ideal for girls, 15,000 for boys. For children between ages eight and 12, Mackenzie encourages families to focus on fun. Recreational sports and activities are a great way to build skills, encourage socializing and teamwork while promoting physical activity. Family activities such as games at a park, ice-skating, a hike or a bike ride are ideal to get the whole family moving. "It's important that parents lead by example and provide opportunities for activity as well," Mackenzie says.

Teens, however, want more independence. "By high school, most teens are physically and mentally ready to try more rigorous exercise such as weight training and aerobic conditioning," she says. "Recreational and competitive sports are a fun way to socialize with peers, as well as build skills."

Safety should be the priority at any age but is imperative for children and teens. That means wearing proper safety equipment, which may include helmets, wrist guards, shin pads, and elbow and knee pads. Proper nutrition and hydration is a must, as is dressing for the weather and wearing quality footwear, says MacKenzie.

Resistance training is inappropriate for smaller children. "Most facilities require teenagers to attend a course prior to having access to a gym," says Mackenzie. "This is a great idea as it ensures that they learn proper technique and safety."

Generations X and Y: 20s to 40s
For Kristan McLeod, a lawyer and mother of three, motivation to exercise comes in the form of a 90-pound border collie-retriever cross. Three times a week, McLeod dons her sneakers, Leo his leash, and they go for a run. She says the dog makes a perfect running partner – he always needs exercise, and he doesn't mind if the weather is less than ideal. "I'm not particularly motivated on my own, so I sometimes try to ferret out people who have the same schedules and who want the same motivation of a running partner," McLeod says. she started running about 12 years ago because she was drawn to its simplicity; she didn't want something that required specialized equipment. She tries to run a half marathon once or twice a year, and sometimes she competes in 10-kilometre races, but mostly she runs for the benefits to her health.

"Because my job is sedentary, I recognize that if I stop exercising, I'm going to be in trouble on a number of health levels," McLeod says. When she was on maternity leave, the 37-yearold attended classes that incorporated babies in strollers. When her children were little, she ran with them in a jogging stroller. Now she and her husband, who runs competitively, have a juggling act – they take turns holding down the home front so the other can go for a run. Activity is at the forefront of her family's routine, too. Her children, who range from two and a half to eight, ride bikes, play soccer and dance. With a family history of heart disease, she knows it's never too soon to start thinking about heart health.

According to Grant Knapik, McLeod's thinking is not farfetched. While the demographics at the Northern Alberta Cardiac Rehab Program are all over the board, a disturbing trend has arisen: younger Albertans are experiencing heart problems. "The majority of people in the 20-to-40 range are not patients," he adds. "They're trying to avoid being patients. They recognize they should do something because, hey, they're starting to see things jiggle in places they shouldn't."

People in this age range often experience weight gain – and the dreaded weight redistribution – for the first time. Men may develop the classic beer gut (which usually has little to do with beer) and women may sport larger hips and thighs. But note that it's impossible to spot reduce; you must lose weight overall in order to lose on hips or belly. However, it's possible to tighten up abdominal muscles and work core muscles to improve posture with Pilates, yoga or other strength training.

A strong core, good posture and tightened abdominals will go a long way to making you look and feel better. Throw in some cardio and most people will lose an inch or two around the middle. Activities should incorporate a mix of exercise, including aerobics, strength training and flexibility. Swimming is popular, as is weightlifting and Pilates, but Knapik always encourages an old standard. "Walking is not glamorous," he says. "But there are huge bene- fits. Go for a walk five days a week."

An important component of an exercise program for the time-strapped 20-to-40 set is that participants enjoy the activity. Knapik says there's no benefit to trying something you don't like because it will be impossible to keep up, given the time constraints of busy young people. "You shouldn't join a bowling league if you don't like bowling," he says.

An exercise program for people in this age group typically doesn't require a visit to the doctor first. The key is to do comfortable, moderate amounts of activity that don't result in pain. Pregnant women, obese people or people with underlying health problems should consult a doctor before starting a new regimen. "What we're trying to establish in the 20-to- 40 range is lifelong, healthy lifestyle choices," Knapik says. "Not only for the individual but for their kids."

The golden years: 50s to 70s
There's one thing that Lyne Bourassa can't stand hearing: "I'm too old, I can't do that." She's the director of Capital Health's Active Anytime, Anywhere program. She says that the older a person gets, the more imperative exercise is, to help slow the onset of bigger health problems. "Age doesn't matter if you're physically still able to do it," she says.

The innovative Active Anytime, Anywhere program features one-hour classes twice a week for low-income seniors. "We promote active living not only within the class but also in the community," Bourassa says, noting that fun activities like lawn bowling and mini golf help participants overcome aches and pains.

Exercise for people in their 50s through 70s is just as important as it is for a growing child. Bourassa says it's at this point of life where the body undergoes significant changes and the onset of debilitating conditions, such as osteoporosis and arthritis, becomes a real threat. To reduce the risks, an exercise program focused on strength, balance, endurance and flexibility activities (as outlined by Canada's Physical Activity Guide) typically incorporates the use of resistance bands, light dumbbells and continuous, low-impact aerobics such as toe taps and leg curls. "You can increase muscle," Bourassa says. "Gains can be made in all areas, endurance, strength and flexibility, at any age.

"People in the program are there because they want to maintain their independence and manage any conditions that they have. It's a switch in focus." Bourassa suggests that people in this age group start gradually. Low-impact activity is important for the preservation of joints. Some elderly people, depending on their condition, will progress more slowly than others. In the Active Anytime Anywhere, for example, some participants remain seated for part or all of the workout.

The senior circuit: 70s to 90s
Doreen Carney's dedication to exercise – she walks three days a week in temperatures down to -20°C and attends a yoga class once or twice a week – makes her a good example for people of all ages. Carney is 79, and she also finds the time to volunteer regularly as Commissioner of Marriages. Her weekly exercise routine helps keep her active in all the other facets of her life.

Carney says the key to making exercise a way of life is establishing a routine and sticking to it. "Exercise gives me good health and makes my muscles stronger," Carney says. "I commit myself to certain activities and try hard not to miss them. Yoga is excellent for balance, and walking keeps you fit."

She walks with the West Edmonton Self Starters, a seniors group which carpools to various parks across the city, and participants also do yoga and other exercise classes. "One benefit is the fellowship. You just feel so good when you're out walking in the parks with the birds singing, and we walk in the winter. It's so easy to say, 'I won't go this time,' but it's important that you do it on a regular basis."

Carney recommends finding a group of people to exercise with, as it offers the additional social aspect to serve as motivation while making the activity itself more enjoyable. Plus, for people who are new to a city or don't have a broad social network, a walking group is a great way to meet new people. "I can't express enough how important it is to keep fit, and walking is one of the easiest activities you can do. With the camaraderie, it keeps your mind thinking," Carney says.

And research supports Carney's assertion that activity for seniors has benefits for both physical and mental wellbeing. "In the elderly, exercise improves their functioning and how they manage at home," says Dr. Lesley Charles, a geriatrician at the Glenrose Rehabilitation Hospital. "It improves mood and decreases stress levels. We are encouraging the elderly to be as active as they can."

Dr. Charles says that the type of exercises for this age depends on an individual's capabilities. There's a spectrum of people in their 80s and 90s, she explains, some of whom are very functional and attending fitness centres as younger adults might, while on the other end, there are people who are very frail. An appropriate exercise regimen depends on abilities.

She agrees with Carney Knapik that walking will pay major dividends. "For somebody who is very sedentary, just getting out there and walking is going to be a great benefit," she says.

To minimize the risk of falls, it's important to work on gait and balance. Drills to strengthen hip flexors can improve balance and can be conveniently done wherever the individual is. "People can do that in their own kitchen, lifting up their legs to strengthen their thigh muscles," Dr. Chares says. "The other big thing you can do for balance is get a person to walk through a series of cones, weaving in and out to work on that higher balance functioning."

Individuals in this age group have to be aware of their own limitations and heart function. Chest pains and shortness of breath are signs to slow down. Skeletal disorders such as arthritis can also be very limiting, so Dr. Charles simply encourages members of this age group to do as much as they're able.

She has seen some amazing results in seniors who have undertaken an exercise program. Dr. Charles recalls one elderly patient at the Glenrose who was totally reliant on her husband. A nursing home was the next step but after doing some work on her gait and balance at a rehab day program, there were noticeable improvements in her health and state of mind. "These people can become or remain very independent," she says.

Stick to it
Anyone can start an exercise program. The hard part is keeping it up. "We face barriers that interfere with our good intentions," says Grant Knapik. "If you polled most people, they would say, 'Yeah, I should exercise more and I understand why.' But do they?"

Several factors will determine an individual's ability to stick with an activity regimen. Knapik suggests that those who incorporate the following aspects into their exercise routine will have a much better chance of adhering to it:

Make sure the activities are fun. If you don't enjoy what you're doing, it's easy to stop.

• Make it a social event. Being involved in group activities with other individuals gives you more incentive and encouragement when it comes to sticking with the routine.
• Affordability is important. Beneficial activities shouldn't require you to spend exorbitant amounts of money.
• Involve family and pets. Family outings, be it tossing the Frisbee around at the beach or a group run (with animals included), provide health benefits and establish good examples for children.
• Try something new. A fresh activity, like rock climbing or Pilates, might help you find your niche.

Resources

• Capital Health's Active Anytime Anywhere program promotes active living programs for older adults with low incomes. For information call Lyne Bourassa 488-4900.
• Capital Health's Fit to Play program introduces tweens (ages 9 to 13) with weight management issues to the world of physical activity. Participants and their families will learn how to adopt a healthy, active lifestyle. For information call Capital Health Link at 408-LINK (5465).
• Be sure to set time aside every day for activity. If you establish that a certain period of the day is devoted to exercise, you will be less likely to make an excuse for missing it.

-David DiCenzo

Your Health Magazine - July/August 2007 Issue

Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)