Exercise:

A Guide from the National Institute on Aging

Welcome to one of the healthiest things you can do for yourself. Exercise! Regular exercise and physical activity are very important to the health and abilities of older people. In fact, studies suggest that not exercising is risky behavior. That is why we wrote this book. We are the National Institute on Aging, part of the National Institutes of Health, and our research is aimed at improving the health of older people.

For the most part, when older people lose their ability to do things on their own, it doesn't happen just because they have aged. More likely, it is because they have become inactive. Older inactive adults lose ground in four areas that are important for staying healthy and independent: endurance, strength, balance, and flexibility.

Fortunately, research suggests that you can maintain or at least partly restore these four areas through exercise -- or through everyday physical activities (walking briskly or gardening, for example) that accomplish some of the same goals as exercise. What may seem like very small changes resulting from exercise and physical activity can have a big impact.

Getting Past the Barriers

You may be reluctant to start exercising, even though you've heard that it's one of the healthiest things you can do. You may be afraid that physical activity will harm you; or you might think you have to join a gym or buy expensive equipment in order to exercise. Or, you may feel embarrassed to exercise because you think it's for younger people or for people who look great in gym clothes. You may think exercise is only for people who are able to do things like jogging.

In fact, just about every older adult can safely do some form of physical activity at little or no cost. And you don't have to exercise in a public place or use expensive equipment, if you don't want to.

Even household chores can improve your health. The key is to increase your physical activity, by exercising and by using your own muscle power.

Who Can Exercise?

Studies show that, in the long term, older adults in all age groups hurt their health far more by not exercising than by exercising. As a rule, older people should stay as physically active as they can.

What Kinds of Activities Improve Health and Ability?

Four types of exercises help older adults gain health benefits:

Endurance exercises increase your breathing and heart rate. They improve the health of your heart, lungs, and circulatory system. Having more endurance not only helps keep you healthier; it can also improve your stamina for the tasks you need to do to live and do things on your own -- climbing stairs and grocery shopping, for example. Endurance exercises also may delay or prevent many diseases associated with aging, such as diabetes, colon cancer, heart disease, stroke, and others, and reduce overall death and hospitalization rates.

Strength exercises build your muscles, but they do more than just make you stronger. They give you more strength to do things on your own. Even very small increases in muscle can make a big difference in ability, especially for frail people. Strength exercises also increase your metabolism, helping to keep your weight and blood sugar in check. That's important because obesity and diabetes are major health problems for older adults. Studies suggest that strength exercises also may help prevent osteoporosis.

Balance exercises help prevent a common problem in older adults: falls. Falling is a major cause of broken hips and other injuries that often lead to disability and loss of independence. Some balance exercises build up your leg muscles; others require you to do simple activities like briefly standing on one leg.

Flexibility exercises help keep your body limber by stretching your muscles and the tissues that hold your body's structures in place. Physical therapists and other health professionals recommend certain stretching exercises to help patients recover from injuries and to prevent injuries from happening in the first place. Flexibility also may play a part in preventing falls.

If you suffer with a chronic condition, such as diabetes, high blood pressure, congestive heart failure, arthritis, or any other chronic illness, please consult your physician prior to exercise. You also shouldn't exercise until checking with a doctor if you have:

• chest pain
• irregular, rapid, or fluttery heart beat
• severe shortness of breath
• significant, ongoing weight loss that hasn't been diagnosed
• infections, such as pneumonia, accompanied by fever
• fever, which can cause dehydration and a rapid heart beat
• acute deep-vein thrombosis (blood clot)
• a hernia that is causing symptoms
• foot or ankle sores that won't heal
• joint swelling
• persistent pain or a problem walking after you have fallen
• certain eye conditions, such as bleeding in the retina or detached retina.
• Before you exercise after a cataract or lens implant, or after laser treatment or other eye surgery, check with your physician.

How Much Exercise Should I Get Each Week?

When you first start out, you might have trouble keeping up with even the minimum amount of exercise we suggest in the chart at the bottom. Start out with a schedule that your body can tolerate and that you think you really can manage, and build up from there.

Note that the schedules are arranged so that you are never doing strength exercises of the same muscle groups on any two days in a row. If you want to do strength exercises every day, alternate muscle groups. For example, do strength exercises of your upper-body muscles on Monday, Wednesday, and Friday and of your lower-body muscles on Tuesday, Thursday, and Saturday. Or you can do strength exercises of all of your muscle groups up to every other day.

Begin exercising gradually. Once you have worked your way up to a regular schedule...

...get at least this much exercise each week:

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Stretching	Endurance	Strength balance, all muscle groups	Endurance Stretching	Strength balance, all muscle groups	Endurance	Stretching

Stretching: Stretch your wrists, calves, hamstrings, arms, shoulders, and neck.

Endurance: Be aware of how long your are able to perform your stretching exercises.

Balance: Stand on one foot for 3-5 seconds, Stand and sit without using hands, Walk heel-to-toe.

Strengthening: For examples of the Strength and Balance exercises recommended by the National Institute on Aging Click Here.

What Should I Eat?

Your body needs fuel for exercises and physical activities, and that fuel comes from food. Eating the right nutrients from a balanced diet helps build muscle and energy. But just what does "balanced diet" mean? What should you eat, and exactly how much of it should you eat?

This diagram is the U.S. Department of Agriculture (USDA) food pyramid. If you use it as a guideline, you will be following a balanced diet. It tells you how many servings of each kind of food you should eat each day. We have also included a chart that shows you what, exactly, counts as one serving of each kind of food.

If you use the food pyramid as a guideline, you may also be helping to prevent or delay some of the diseases associated with growing older. For example, by cutting down on fats, you will be reducing your risk of getting cardiovascular diseases like high blood pressure. By increasing the amount of fruits and vegetables you eat, you will be lowering your risk of getting some types of cancer.

Looking at the guidelines, you will see that the biggest part of the calories you take in each day should come from grains, and the smallest amount should come from fats, oils, and sweets. The guidelines put heavy emphasis on vegetables and fruits, and less on meat and dairy products.

Some older adults are on restricted diets because of certain health conditions. Kidney disease is just one example of a condition that often requires restrictions of certain foods or fluids. If your doctor or nutritionist has asked you to follow a special diet, please follow his or her advice.