The Amazing No-Sweat Exercise Plan

By Harvy B. Simon, MD
Harvard Medical School

For the past two decades, as "no pain, no gain" has reigned as a fitness mantra, most experts have told us that physical activity won't significantly improve our health unless we perform intense aerobic exercise.

It turns out that this was only half the story. Intense exercise does reduce your risk for heart disease, diabetes, some types of cancer and other serious illnesses. But, until recently, it wasn't clear that moderate and gentle exercise -- everything from sex to yard work -- also can help guard against serious illness.

Researchers Identify Benefits

A study published in the August 2000 American Journal of Medicine followed 110 healthy but sedentary men, ages 48 to 64. One group went about their normal routines without adding any exercise. The second group performed their normal routines but also played 18 holes of golf (and walked the course) two to three times a week. By the end of the 20-week study, the golfers lost weight, reduced their waist sizes and improved their cholesterol levels. The nongolfers experienced no changes.

Since then, more than 22 studies, involving about 320,000 people, have examined how moderate exercise affects cardiovascular health and longevity. The results are stunning. Moderate physical activity can decrease the risks for heart disease (by 18% to 84%)... stroke (by 21% to 34%)... diabetes (by 16% to 50%)... colon malignancies (by 30% to 40%)... and dementia (by 15% to 50%).

How did the experts miss all these benefits? In assessing a fitness program's efficacy, most researchers have traditionally only measured aerobic capacity -- that is, how much oxygen your lungs can hold and how efficiently you use it. To improve that particular measure of fitness, known as "maximum volume of oxygen," or VO2 max, you do need to work out hard.

But when researchers began investigating measures of good health based on everyday activities, they found that even small doses of moderate exercise really do add up. Health benefits can be obtained by climbing 55 flights of stairs per week or even by gardening for one hour per week.

The point is to just get moving. In one classic study, healthy 20-year-old men were asked to spend three weeks in bed. They developed many physiological characteristics of men twice their age. The same group of men then worked out regularly for eight weeks. They experienced an improvement in weight, resting heart rate, blood pressure and VO2 max.

How to Measure Exertion

With all this evidence confirming the benefits of moderate exercise, I felt that a system was needed to measure the value of various everyday physical activities. That's why I created cardiometabolic exercise (CME) points, which assign values to physical activities based on the degree of exertion that is required to perform them.

You can significantly improve your health by accruing a total of 150 CME points per day (or about 1,000 CME points per week). Even if you're a couch potato, you can work up to the target level of about 1,000 points a week over the course of nine weeks. Gradually building up to your target level helps prevent injury. Recommended: Carry a pocket-sized notebook to record your daily activities. Then tally up your CME points at the end of the day.

Important: If weight loss is your goal, you may need to work harder or longer, doubling the target number of CME points to approximately 2,000 per week.

Caution: Before starting a new exercise program, consult your doctor. If you have heart disease or are at risk (due to family history, high blood pressure, etc.), you should have a stress test. For this test, you will likely receive an electrocardiogram (ECG), a painless procedure that measures electrical impulses flowing through the heart, during exercise.

For healthy people, a simple 12-minute self-test devised by Kenneth H. Cooper, MD, MPH, a renowned fitness expert, can help assess your level of fitness. What to do: See how far you can go by walking, jogging or running for 12 minutes. To measure the distance accurately, do this on a track or use a pedometer. If you are out of shape, do not push yourself too hard. Your fitness level is considered poor to fair if you cover less than three-quarters of a mile... good if you can cover three-quarters to one mile... very good for one to one and a quarter miles... and excellent for more than one and a quarter miles. Take your rating into account when choosing activities for your exercise program.

Creating a Program

For people who use everyday physical activity as the core of their exercise program, it's a good idea to add some strength exercise, such as weight training... some flexibility exercises, such as yoga or stretching... and balance exercises, such as tai chi or even standing on one foot while brushing your teeth. Strength training improves muscle mass and bone density. Flexibility exercises help prevent injury and reduce stress. Balance exercises help protect you from falls.

Over the nine-week period, aim to work up to 15 to 20 minutes of strength training two to three times a week... flexibility exercises for 10 to 15 minutes three to four times a week... and balance exercises for five minutes three to four times a week.

Because walking is so convenient, it's an ideal exercise for most people to include in their regimen. The number of CME points for this activity depends on your body weight and speed, but typically a 160-pound man or woman can chalk up about 125 CME points for every 30 minutes of walking.

Each hour of moderate exercise that you perform will extend your life by two hours, according to my analysis of the Harvard Alumni study. This goes to show that exercise may be the best anti-aging medicine we have.