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Fitness Assessments & Exercise Recommendations
 
Open/Close text What Will Exercise Do for Me?

Physical fitness is an essential component of an overall wellness program.   The benefits of exercise are too numerous to list, but include weight control, cardiovascular disease prevention, control of diabetes, lower blood pressure, enhanced immune response, prevention of osteoporosis and bone loss, improved mental health and well-being, sounder sleep, increased energy and stamina, enhanced self-esteem, longevity and optimum quality of life.

For many individuals, fitness and exercise is a way of life and almost an addiction.  The so-called "runner's high" releases endorphins, or the "pleasure chemicals" in the brain to give a feeling of satisfaction and happiness.  For many others, the thought of exercise is nearly terrifying.  Most people, however, fall between these extremes.  They know exercise is healthy and they usually enjoy some form of recreational activity, but can not seem to make the time or effort to participate in a program of regular exercise.  The priorities assigned to other daily activities pushes fitness to a lower rung on the ladder of life.  The question is: How do I  make time for a regular fitness program of activities that I enjoy?  The answer is much simpler than you would imagine and the effort required for optimizing health is less than you probably guessed.

Open/Close text How Much Exercise Do I Need?

The optimum amount of exercise for any individual depends on personal goals.   The elite athlete training for world class competition obviously needs much more exercise, both in duration and intensity, than an 85 year old grandmother looking to minimize bone loss.  People trying to improve their cardiovascular fitness are intermediate in their exercise needs.  This section will limit its' scope to those people trying to improve their health and optimize their wellness, like most pilots/controllers, without entering into competitive sports.  Competition may be a natural follow-on to those who find a certain talent and enjoyment to a sport, regardless of age.  Many people will find the enjoyment of physical activity with a taste of competition through recreational sports leagues or intramural leagues.  People should enjoy the activities they choose to participate in for exercise so that they will continue to participate.

The amount of exercise required for improved fitness and health is surprising little.  Current recommendations by many organizations scientifically studying this area include approximately 30 minutes of moderate level activity most days of the week.   Exercising 150 minutes divided into four or five days of the week and further divided into several five to ten minutes sessions each day will suffice.  You do not have to work out every day to a level which requires perspiration and breathing hard to achieve and maintain fitness.  Cardiovascular fitness improvement may require some degree of higher exertion, but not much more.

Open/Close text What is the Best Exercise for Me?

Any exercise you enjoy is good for someone interested in fitness.  A balance between aerobic exercise, resistance training and flexibility provides optimum fitness and conditioning.  However, people are not likely to continue an exercise program if it is not enjoyable, convenient and affordable.  Any exercise is better than no exercise.  Conditioning results from any physical activity, not just that performed at a health club or gym, nor that only performed with expensive or bulky equipment.   Pick activities you will enjoy and can participate in on a regular basis and make exercise a regular part of your day.  Several different activities may keep you from getting burned out on one.  Sharing a program with a partner may help you with the motivation you need on difficult days.  Look for exercises you can do at work, many times without anyone realizing you are exercising.  One popular author compares fitness to religion, which benefits from some practice each day, faith to remain a participant and life long rewards.  The bottom line: do what you enjoy and do it every day.
Open/Close text Exercise for Non-Exercisers

Recent articles in the Journal of the American Medical Association point out that casual exercise programs, such as 5-10 minute walks several times per day, is just as beneficial in reducing body fat, lowering blood pressure and maintaining some aerobic fitness as a structured exercise program. Structured exercise programs are those that involve regular fixed amount of activity, typically done at a gym or on a piece of home exercise equipment, riding a bicycle, swimming or jogging.  One study from the Cooper Institute for Aerobics Research demonstrated casual increases in activity during the day gave the same benefits in blood pressure reduction and body fat control within six months and in aerobic fitness after two years.  The second study of overweight women done by Johns Hopkins University showed similar reductions in weight, blood pressure, LDL and total cholesterol in both casual activity groups and structured exercisers.  The bottom line is that any level of activity will improve your fitness.  Simple strategies are to take the stairs rather than the elevator, park at the far side of the parking lot (or tarmac), go personally talk to a coworker rather than using the intercom and walk around your child's soccer field during their games and practices rather than sit on the sidelines.
Open/Close text What Are Low to Moderate Exercise Levels?

Low to moderate level activities include those which still allow an individual to talk easily during the exercise.  Examples of  these activities include walking, dancing, golfing, work around the home, walking up stairs, carrying groceries and bicycling.  The target heart rate is 50-75% of the predicted maximum heart rate (PMHR).  To calculate the PMHR, subtract your age in years from 220.  Next, multiply the PMHR by the percentage heart rate desired.  For example, a 50 year old   would have a PMHR = (220-50) = 170.  70% of that PMHR = (170 x 0.70) = 119 beats per minute, which is about 30 beats in a 15 second time interval.  These levels of activity will have most of the benefits exercise can provide for an individual.

Open/Close text Moderate to High Activity Levels

A somewhat higher intensity level of activity is required to achieve athletic training levels of cardiovascular and aerobic conditioning, although cardiovascular benefits occur with almost any level of exercise.  For those people interested in improved sustained maximum performance, exercising at 75-85% of the PMHR for at least 25 minutes per session and 150 minutes or more per week is required.  This level of exertion makes it difficult to speak in complete sentences during exercise and usually results in significant perspiration.  Examples include running, fast swimming or bicycling, full court basketball, aerobics, skiing, soccer, rowing machines and stair climbers.  These activities are known as aerobic since they require ongoing requirements for oxygen at the cellular level, rather than just using stored energy.
Open/Close text Ultra-High Intensity Training for Elite Atheletes

Elite athletes may train for several hours per day at 95-100% of their PMHR.   There is a growing amount of research that this intensity level of exercise may cause physical damage through the excess release of damaging "free radicals" in the body.  These free radicals cause damage to DNA in the cells and may speed the aging process or increase the risk of cancer and other chronic diseases.  Nutrients termed "antioxidants" oppose the effect of free radicals by scavenging these molecules before they do significant harm.  Dr. Kenneth Cooper, the physician who coined the term 'aerobics' in the 1960's and suggested cholesterol could be lowered by changing to a low fat diet in the 1980's, cautions against intense levels of activity in his book, The Antioxidant Revolution.  Unless serious competition is your goal, moderate exercise will provide significant health benefits without the increased risks of free radical damage.

Open/Close text Types of Exercise

Exercise is divided into two major categories, aerobic and anaerobic.  Both provide benefits for your health.  Some activities combine the benefits of both.   Stretching, which contributes to injury protection and flexibility, is another important component of a fitness program.

As noted above, aerobic exercise involves sustained activity at least a moderate level which requires the body to produce and deliver oxygen and nutrients to the cells to maintain this level of output.  Aerobic activity is the best method of improving cardiovascular conditioning, reducing body fat and increasing energy and endurance.   Because the body must use stored fuels, mainly fat, for energy, aerobic activity is excellent for weight reduction and burning calories.  The downside of aerobic activity is that it is very difficult to do in limited amounts of time, as it usually requires 30 minutes of exercise to achieve the 75-85% of PMHR for 25 minutes.

Anaerobic exercise involves "burst" type activity of short duration, often requiring strength.  Examples include weight lifting, jumping, throwing a ball, isometrics, swinging a golf club or a bat, calisthenics and bowling.  Generally, there is a rest period between exertion during which the body can recover.  Heart rates may not be sustained at high levels with anaerobic exercise.  The fuel used by the cell is readily available sugars and carbohydrates in the blood or stored in the liver.  These activities increase lean muscle mass and will also increase basal metabolic rate.   Some can be performed in an office environment or even in the cockpit of an aircraft or tower cab.  Calculation of calories burned during these activities is more difficult and highly variable depending on the level of exertion.

Stretching increases flexibility.  Benefits include decreased injury from muscle and ligament strains, improved strength by increasing muscle length and a greater comfort level when exercising and at rest after exercise.  Lower incidences of chronic musculoskeletal pain such as low back and neck pain are seen in people with a regular stretching program.  Most stretching activities can be done anywhere, including the cockpit, terminal or desk.  Even couch potatoes can stretch while watching TV, although this does not burn many calories.  Excellent suggestions for stretching exercises can be found in Shape Up America!'s "Fitting Fitness In" brochure.  We also recommend SUA's "99 Tips for Family Fitness Fun" and "On Your Way to Fitness".

Open/Close text Cautions!

If you are over 35 years of age and have not been exercising regularly before, or if you have heart disease or other chronic diseases requiring medication, consult your doctor before beginning a moderate or higher level exercise program.  Stretching is generally safe, but a new exercise program should start at a low level of intensity.   Increase duration and intensity as each previous level becomes easier.  Don't start off attempting to achieve your ultimate goal in the first sessions.  You risk injury or medical complications.  The American College of Sports Medicine has excellent guidance on exercise prescription and testing.

The Journal of the American Medical Association published an article on "Preparticipation Cardiovascular Screening of U.S. Student - Athletes" in the March 22, 2000 issue.   It provides excellent guidelines for the younger athlete starting an aggressive exercise program.  American Family Physician published an article on The Preparticipation Athletic Evaluation for all ages, used to assess whether a vigorous exercise program is safe to begin.

Open/Close text Fitness Assessments

A common fallacy is that fitness should be assessed by weight.  This is not true!   Just as a person at their ideal body weight can be overfat, they can also be poorly conditioned.  Think of a thin smoker or bulimic individual with almost no lean muscle mass or cardiovascular conditioning.  Remember also that an overweight person may still have very little fat and be in excellent cardiovascular and strength condition due to high muscle mass.  Some collegiate and professional athletes may maintain very heavy weight due to very high muscle mass, yet be extremely aerobically conditioned.  Fitness assessment requires a careful evaluation of several factors.  Excellent fitness also requires optimum nutrition to fuel the body and prevent free radical damage.

At least four elements of fitness should be considered in any fitness evaluation.   These elements include cardiorespiratory conditioning, strength, flexibility and body fat percentage.

Cardiorespiratory fitness describes the body's ability to deliver oxygen to the cells, primarily muscles, when stressed.  Cardiovascular fitness has a direct protective effect on heart attacks, heart failure, strokes, high blood pressure, claudication, diabetes and fat control.  Scientific studies quantify cardiorespiratory fitness in terms of maximum capability of the body to deliver oxygen to cells in a minute.  This is usually referred to as "V O2 max."   Elite cyclists and other endurance athletes may have V O2 maximums of 70-80 ml/mg/min.  The V O2 max decreases with age as does the predicted maximum heart rate.  Good weekend athletes may have values in the 35-50 range while deconditioned people will have values less than 20.

Strength is a reflection of muscle mass.  Good assessments evaluate both upper and lower body strength for an over all picture.  Swimmers may have excellent upper body strength with little lower body strength, while cyclists will have the opposite profile.   Rowers, boxers and weight lifters often have balanced upper and lower body strength.  Back, neck and abdominal muscle conditioning may prevent chronic back and neck pain and poor posture.

Flexibility is described above.  As with strength, both upper and lower body flexibility should be assesses.  Many sports and exercises do not require the muscles to stretch to their full length.  This decreases the maximum power they can generate, but also limits flexibility.  Limited flexibility contributes to injuries, soreness and chronic pain.  Bouncing type stretching exercises, called "ballistic stretching", may cause injuries if not already limber and flexible.   Static (stretch and hold) and proprioceptive (contract/relax) type stretching are excellent methods for novice exercisers to increase flexibility.

Body fat / weight control is the fourth component of a comprehensive fitness assessment.  As mentioned above and in the weight control / body shaping section, weight and body fat are not necessarily related.  An anorectic individual can have a very high body fat percentage while a huge wrestler may have almost no body fat.  Excess body fat is related directly to diabetes, high cholesterol and gall bladder disease.  There may be some relationship to breast and other cancers as well as heart disease.  Optimum body fat percentages in women tend to run about 4-8% more than in men of the same age.  Healthy young men tend to have body fat percentages in the 12-18% range and 16-24% as they age.   Currently, use of the Body Mass Index (BMI) is used as an estimate of healthy weight and fat distribution, but it fails to account for extremes of lean muscle mass.

Open/Close text American College of Sports Medicine Fitness Guidelines

The American College of Sports Medicine has recently revised its "Guidelines for Exercise to Maintain Fitness."  The previous guidelines included recommendations for cardiorespiratory and muscular fitness.  The revised guidelines now include recommendations for flexibility training as a component of a comprehensive physical conditioning program.
Open/Close text Fitness Age

One product available commercially provides a very user-friendly comprehensive fitness assessment in each of the four areas listed above, as well as in overall fitness. Fitness levels are given in terms of the relative age of the average US population able to perform at the same level of the testee.  Fitness test performances from over 100,000 people from age 18 to 80 years old were used to develop average scores in each of the four categories for each age and sex.  A person may have a chronological age of 43 with a cardiorespiratory fitness equivalent to a 28 year old, a strength age of 49 years, a flexibility age of 33 years and a body fat age of 24 years based on individual testing.  The overall fitness is expressed in terms of years also, weighting the cardiorespiratory score heavier since it is the most significant health determinant.   In the example above, the overall fitness score may be 30 years, meaning the 43 year old testee has a fitness level of the average 30 year old of the same sex.  The test can be repeated an infinite number of times, previous results shown graphically and trends plotted.  Three subjects can use each CD-ROM.  The assessment, called FitnessAge, was developed by Dr. Robert Voy, former Chief Medical Officer of the US Olympic Committee, and Dr. Lawrence Golding, editor of the American College of Sports Medicine Health and Fitness Journal.
Open/Close text How Fitness Affects Your Health

The benefits of regular exercise and a fitness program are almost too numerous to describe.  Below is a list of some of the benefits well studied in medical research.

Weight Control - regular exercise consumes calories that are converted into fat if not used.  It also helps build lean muscle mass which burns calories faster than an equal amount of fat.

Cardiac Health - aerobic exercise in particular increases blood supply to the heart, increases the pumping efficiency of the heart and decreases the risk of both fatal and non-fatal heart attacks.

Blood Pressure - blood pressure is reduced by regular exercise combined with proper diet and weight control.  Heavy weight lifting may cause temporary blood pressure rises during exercise which returns to normal with rest.

Stroke - exercise decreases the risk of stroke, the third leading cause of death in the United States.

Cholesterol - aerobic exercise decreases total cholesterol and triglyceride levels while raising HDL (good) cholesterol levels.

Cancer - colon cancer incidence is reduced in exercisers.   Other cancers may also be reduced by exercise and fat reduction, such as breast and prostate cancer.

Blood Sugar / Diabetes - exercise burns calories and helps control blood sugar, possibly reducing the need for diabetic medications and reducing the complications of diabetes.

Osteoporosis / Bone Loss - weight bearing exercise reduces the rate of bone loss in older Americans, adds bone mass to younger people and reduces the risk of fractures and collapse of bones of the spine.

Mood and Depression - exercise increases endorphins and other "pleasure chemicals" of the brain, reduces effects of stress and anxiety, improves mood.

Sleep - sleep studies indicate exercise improves quality of sleep and aids in falling asleep.

Back Pain - stretching and abdominal exercises reduce the risk of chronic low back pain and improve posture.

Physical Appearance and Energy- through weight loss and muscle toning, exercise firms up the body, while blood count improves giving more daily energy and stamina.

Mental Function - exercise improves mental activities, particularly when taking breaks during busy days.

Open/Close text VFS Aeromedical Assistance

For a more specific personal explanation to your questions or those concerning aeromedical certification, contact VFS for a private consultation.   For help in reporting treatment for and obtaining clearance from the FAA to fly or control with a medical condition, refer to the VFS FAA Confidential Questionnaire. If you are a VFS Corporate Member, these services are FREE to you.
 
 
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