BRITISH BROADCASTING CORPORATIONÌýÌý
RADIO SCIENCE UNITÌý
CHECK UP 2. - Exercise for the very unfitÌýÌýÌý
RADIO 4Ìý
THURSDAY 12/08/04 1500-1530Ìý
PRESENTER:
BARBARA MYERSÌý
CONTRIBUTOR:
LEN ALMANDÌý
PRODUCER:
PAULA MCGRATHÌýÌýÌý
NOT CHECKED AS BROADCAST
MYERS
Hello. Getting active doesn't need weights and running machines, it can be as simple as getting up to turn the radio off. But please don't because this afternoon we're talking about the health benefits of getting and staying fit. Whatever your age or physical condition a more active lifestyle can help prevent osteoporosis, lower your blood pressure and protect against heart disease and stroke. And you don't have to be fit to get fit - there are safe and effective ways of building muscle, strength, flexibility and stamina even if you're chair or even bed bound. So what activity would suit you best? How active is active? National guidelines urge us all to do 30 minutes of physical activity at least five times a week. Is that too much, is it enough?Ìý
Well call us now with your questions, the number, as usual, 08700 100 444 or you can e-mail checkup@bbc.co.uk. And joining me on the line today from Loughborough, with the answers I hope, is Len Almand, he's the Director of the British Heart Foundation's National Centre for Physical Activity and Health.Ìý
Len, a quick first question to you: are there real quantifiable benefits from living an active lifestyle?Ìý
ALMAND
There certainly are. If I will take an obese or an overweight person. An obese, an overweight person who is walking every day for about 30 minutes gets substantial health benefits and lowers their risk of many diseases and in fact they're carrying less risk than a thin inactive person. So that's a very, very important message. And the health benefits are normally associated with reducing cholesterol, enhancing insulin sensitivity and lowering blood pressure. Those are the real invisible health benefits that can come from 30 minutes of moderate activity. And so whatever size or weight you are you can benefit substantially.Ìý
MYERS
Very good. So let's see what questions people have about how they might get the benefits then of getting fitter and staying fitter. Barbara Rose joins us first from Exeter in Devon. Hello Barbara.
ROSE
Hello.Ìý
MYERS
And your question please.Ìý
ROSE
I'm 75, I'm reasonably fit - I walk my dog for 30 or 40 minutes each day but wonder if a short regime of sort of stretching, bending would be worthwhile to do in addition to that?Ìý
MYERS
Are you feeling quite fit on the regimen that you're describing with your half hour walks with the dog?Ìý
ROSE
Well reasonably but you know I get sort of the usual aches and pains you get as you get older and my knees are not as good as they should be but other than that - I've got high blood pressure but other than that I'm really very fit.Ìý
MYERS
Len, any suggestions then for Barbara?Ìý
ALMAND
I think Barbara needs to have a look at both her strength and her flexibility or mobility's a better word. And there are quite a number of very good leaflets from the British Heart Foundation to get free. I'll give you the telephone number for that later on. I think you should look at strength, going up and down stairs - if you're in a house of course - most people go up and down stairs four or five times, you should be going up about 10 times because that will help you to build your strength in your legs and that's very, very important.Ìý
MYERS
Go up two at a time for example?Ìý
ALMAND
Oh no, I would walk - no please don't - just walk up normal stairs, any opportunity to walk up stairs walk up the stairs.Ìý
ROSE
Thank you. I must admit I find it quite tiring.Ìý
MYERS
Well that's interesting isn't it because of course if you are going to do a little bit more than you generally do you, I guess, are going to feel it a little bit more challenging - a bit more tiring, as you put it - possibly even a little bit more painful. Len, what do you say to that, I mean does there have to be a sort of a bit of pain before you get the gain?Ìý
ALMAND
No, no, if there's any pain then you should stop and that's absolutely the first priority of safety really. As far as she's concerned just walk as often as you possibly can, do it as often as you can, try to spread activity throughout the day as well - don't see it as just one bout of activity. Any opportunity to move please move. But I would say if you're sitting in a chair you can do simple things like raising your leg - so it's straight out - and both and do that at the same time because that would actually help and build your strength. But you need - you need a list or a photograph or pictures of activities you can do, so you can't [indistinct word] with a radio but I can give you a telephone number to ring and they'll send you free leaflets on exactly what you can do.Ìý
ROSE
Okay well that would be very interesting. Are you going to put anything on your website?Ìý
ALMAND
Well I'm sure Radio 4 will do that for you.Ìý
MYERS
Well we will indeed and I will certainly give information about how to get on to those websites and there are lots of good resources available. But thanks very much for that Barbara, please stay listening because I know there will be lots more advice coming your way and perhaps some of it on the basis of the question we're getting next, which is from Harry who's on the line from Hemel Hempstead. Harry your question please.Ìý
HARRY
Oh good afternoon. I'm 50 years old, I weigh 16 stone 10, I've put on three stone in weight the last three years and after watching all the programmes on television - food, diets - I'm trying to change my food my daughters and my son are encouraging me to walk - Dad - they said - that's the best exercise going, it's free, you don't have to pay for it. Now I tried walking to the bus stop, which is about quarter of a mile away, and I was completely out of breath, completely out of breath and I sat on the seat by the bus stop and then I came back to my place and I was all aches and pains. Is that the par for the course? They say - my daughters keep saying well you will get aches and pains dad, you will, that's part of it but the more walking you do it'll get better. Will it get better? I mean can I just do a 10 minute walk or ...?Ìý
ALMAND
Harry, you've started on the first day, let's get you walking as often as possible and let's get you building up from a short distance - if it's only 10 minutes - right get 10 minutes that feel comfortable, don't strain ...Ìý
HARRY
Ten minutes is enough is it?Ìý
ALMAND
No, no it's not enough - not enough in the [indistinct word], I really want you to try to do is think of three 10 minute sessions in one day.Ìý
HARRY
Oh in one day okay.Ìý
ALMAND
One day, but make sure that you are building up, in other words you're not rushing or you're not trying to do far too much. Right, you've got to feel comfortable and you've got to feel this is enjoyable - that's very, very important. You will get aches and pains if you have not been exercising for a long time. And we need to get that 16 stone down. So we need to get you walking every single day, we need to build you up to 45 minutes at some stage, that's going to take a long time to do that because you're going to have to find 10 minutes in the morning, 10 minutes at lunchtime, 10 minutes in the afternoon.Ìý
HARRY
Yes I can do that.Ìý
ALMAND
And then start making the 10 into 12, into 13, into 14, into 15 and you'll be up to 45 minutes very quickly and then after that you might even try to move one of the 15 minutes to 30 to 45. But take it slowly and look at it in terms of that weight that you've got on at the moment has taken a long time to put on, it'll take a long time to put it off.Ìý
MYERS
Well can I just ask about that because it does sound as though you've got a bit of a mountain to climb. I mean how much exercise do you have to do - is there a sort of correlation between 10 minutes of exercise equals, I don't know, half a Mars bar or something dreadful? Is there some useful little figure - you think well at least that's offset the fact that I had perhaps a bit too much bread with my breakfast this morning - should you even think like that Len?Ìý
ALMAND
Well I would say Harry needs to get hold of a pedometer.Ìý
MYERS
Oh what's a pedometer?Ìý
ALMAND
A pedometer is a way of measuring the number of steps you take in a day. Now what we would like to get is Harry doing 10,000 steps in a day. And that 10,000 steps can take into account everything he does during one single day and it's amazing when you - once you recognise that I only do 3,000 steps in a day you realise how little a person does and therefore you'll add 10%, so if you've got 3,000 a day it becomes 3,300 this week, 3,600 the following week and so on and so on.Ìý
MYERS
So you really can build up and you can kind of clock what you're doing. And these pedometers are fairly easy, cheap, easy to find?Ìý
ALMAND
There are available all over the place, yes they are.Ìý
MYERS
Okay, you just wear it on your wrist or something do you?Ìý
ALMAND
You wear it on the side of your waist.Ìý
HARRY
A pedometer is it?Ìý
MYERS
P e d ...Ìý
ALMAND
P e d o m e t e r. The walking for health initiative, which is run by the Countryside Agency they call them stepometers. And they are extremely useful for motivating people but also giving you a sense of you know exactly how much you're doing each day.
MYERS
Does that sound useful?Ìý
HARRY
It sounds very useful, thank you very much.Ìý
MYERS
Thanks very much for calling.Ìý
HARRY
Thanks for your advice, thank you.Ìý
MYERS
You're more than welcome. Let's move along now to Worcester and Mr Duke who's waiting to talk to us, hello?Ìý
DUKE
Hello. This seems to go back one step. Do you recommend a visit to a podiatrist before starting or seriously increasing daily walking?Ìý
MYERS
Ah, so that would be someone who'd look at your feet presumably. Why are you wondering whether you should have your feet checked out?Ìý
DUKE
Oh simply because it's not the sort of thing that one should assume, that one's feet or posture or shoes are necessarily good enough for an increase in that sort of activity.Ìý
MYERS
Oh very interesting point. Would you agree with that Len?Ìý
ALMAND
Yes I think that's right. I mean you really do need to wear good shoes if you're walking regularly. I think that's absolutely right. And also people need to be - if when they're showering to make absolutely sure that they are drying themselves properly. But feet are important in terms of the nails, sometimes people allow infections and fungi to get in and the feet aren't in as good condition as we hope. So yes if anybody feels there's a problem with their feet then go to a podiatrist, absolutely right.Ìý
MYERS
Could it be that you might be increasing your sort of cardiovascular workout by walking for a length but then if you're putting strain through your feet on to your - maybe your knees you could end up with dodgy knees or make them worse or even the hips?Ìý
ALMAND
I don't think that you'll get dodgy knees from walking. It is a relatively low impact activity is walking, so it's highly unlikely you're going to get serious problems with your knees. I mean we've been walking, I don't know how old you are Harry, but people can walk for many, many years and have no problems at all with their knees, it's usually high impact activity that causes problems with people's knees. Walking is absolutely fine.Ìý
MYERS
And so is it worth spending out on decent shoes and what would you say are decent shoes, are we talking about trainers for example, would that be appropriate, would people or hiking boots?Ìý
ALMAND
If you're going to walk in different terrains and if you're going to walk in wet weather then you're likely to need good walking shoes, especially if you're going to be doing more than 30 minutes in a day at one fell stretch. So I think you probably should think about investing in a good pair of shoes. Of course the other thing if you're going to be walking for longer than 30 minutes, especially in different terrain, you should look at water as well, making sure you take water with you, especially this warm weather.Ìý
MYERS
That's very useful, thanks for raising that point. I mean there is quite a lot of interest, is there not, in walking groups and actual preparation for walking, taking it kind of seriously because you can get a lot of benefit but it's worth being well prepared for.Ìý
ALMAND
I think that's absolutely right. I think walking groups are quite important because very often we don't know our local neighbourhood and there may be lots of historical sites, there may be lots of environmental issues - could be a whole range of learning one can get from walking in the local area. So you need to have a look at that and go to your local council and see what leaflets are available promoting walking and also advice about your feet and suitable clothing but they should be available in every local council offices.Ìý
MYERS
Okay, we'll take a walk to Lancashire, at least in cyber space, we'll go to Vernon Thompson who is waiting for us now. Hello Vernon and you've got a question I think about a treadmill.Ìý
THOMPSON
Yes good afternoon. I'm 60 years of age and 14 stone, I recently bought a treadmill and I've been on it for an hour a day, I must admit it's quite a long time I've just realised with that caller called Harry - 15 minutes you reckoned. But it's given me an aching back - not a painful back but an aching back. Plus I've had a heart attack several years ago and I got asthma several years ago and I'm wondering if I'm just doing a bit too much.Ìý
MYERS
Right.Ìý
ALMAND
It depends if you started an hour a day from scratch and you started to walk and that was the first time you'd ever walked for one hour at one fell swoop.Ìý
THOMPSON
That's right.Ìý
ALMAND
It was yeah. And walking on a treadmill could actually as well - just the positioning of the treadmill - because you will probably walk differently from what you would in a normal street. And especially over an hour you might be putting undue strain on certain muscles. I would say a treadmill will come in useful, especially useful when it's bad weather, but try and walk as often as possible outside. If you want to pace yourself and record exactly how long you're doing and at what level, so you know what the walking pace is, that's absolutely fine. So check that the walking pace you're walking at on the treadmill is appropriate and not too much for you and be able to walk and talk at the same time, that will also give you an indication of you're not doing too much. Also always walk tall - think about walking tall all the time, that would help your back as well and you'll feel better. So walk tall.Ìý
MYERS
It's interesting Vernon you said I think that you have had a heart attack, so have you been advised to do more exercise and have you had any concerns about what effect that might have on your heart?Ìý
THOMPSON
Well I was advised to take exercise recently after I had the heart attack but I hadn't really taken all that much until recently. So I am a bit worried about that.Ìý
MYERS
I mean what should Vernon or anyone else be looking out for if they know they have a problem with the heart - should that make them a little cautious in undertaking this kind of exercise, as well as the aches and pains that might accrue, is there any danger to the heart Len?Ìý
ALMAND
If a person's had a heart attack then exercise will help to strengthen the heart and strengthen the circulation. So long as people start slowly and build up. They first and foremost need to restore their capacity and then can build on that capacity and they will find exercise much more easy, they will be able to do far more and they'll feel much more alive, they'll feel better and everything around them will feel - I can do this, I can do that.Ìý
MYERS
And on the other side of the coin, Len, you'll know this from your research at the National Centre there, does exercise prevent heart disease and indeed strokes too?
ALMAND
It can help to reduce the risk of heart attack and it can help to reduce the risk of further heart attacks by engaging in regular exercise that helps you - it's not too strenuous, it's not overbearing and you need some safety factors - like, for example, before exercise if you have a temperature or infection or a sore throat then you simply forget the exercise for that day and you leave it alone until you're feeling better. If you're exercising and you feel dizzy or you're feeling faint or you're getting very hot or very unsteady and your heart rate's going up very rapidly then I would say stop any exercise.Ìý
MYERS
Does that mean you have to have a heart monitor if you're going to do exercise?Ìý
ALMAND
No I don't think so. I think if people are going out walking every single day - I don't want to medicalise it - what I want them to do is to see exercise, in terms of walking, as something normal that's going to help me feel better and help me reduce the risk of any further heart attacks. And that means ensuring you're getting 30 minutes of regular activity.Ìý
MYERS
And does it matter what time of day you take your exercise?Ìý
ALMAND
I would prefer - I would prefer Vernon to be walking mid morning and afternoon, I would not like you to be thinking about very early in the morning, I would much rather it was much later in the day.Ìý
MYERS
And why do you say that?Ìý
ALMAND
Well there is some evidence that a cardiac event can occur in the night and very early morning, so what's the point of putting yourself at risk? Because anybody who exercises they're going to increase the heart rate, their breathing is going to increase, it's going to be more frequent, it's going to be more deep and they're not putting a strain on themselves so long as they are comfortable with exercise and doing more of it they'll condition themselves and the body will adapt. And it becomes easier and easier. Once it becomes easier you can actually do more. And the thing I would want to work on, especially if you had a heart attack, is ensuring you're doing a minimum of 30 minutes every single day of the week, and you are comfortable with that 30 minutes and I'll be very happy with that.Ìý
MYERS
All that useful to you Vernon?Ìý
THOMPSON
Very useful, yes, I'll cut down the time and I'll cut down the speed.
MYERS
Very good.Ìý
THOMPSON
Three or four times a day for 10 or 15 minutes he said.Ìý
ALMAND
That would be absolutely fine.Ìý
MYERS
Thank you very much for the call. We'll go on - we have a caller in Weston Super Mare, Diana is waiting, hello Diana.Ìý
DIANA
Hello.Ìý
MYERS
And what's your question please?Ìý
DIANA
Well I'm in my late 50s, I'm diabetic and two and a half years ago I had a triple by-pass and I was told eventually I should be walking three miles a day. Unfortunately I started with ulcers on my feet.Ìý
MYERS
Is that from the diabetes?Ìý
DIANA
From the diabetes. So [indistinct words] throughout the last couple of years, plus some pretty nasty infections and so on. The cardiac people are saying yes but you should be walking to get your heart strong, podiatry - the doctor said to me the other day you said have 90% rest. So what do I do - I want to get fit, I used to love walking my dogs but sometimes the pain in my feet I can hardly walk a few steps?Ìý
MYERS
Oh you're between a rock and a hard place here aren't you.Ìý
DIANA
Exactly.Ìý
MYERS
Len, any ideas?Ìý
ALMAND
Well Diana have you - have you tried stopping any walking for a few days and then seeing if there are any improvements at all to your feet?Ìý
DIANA
Oh yes, well when I've been in hospital I've been sitting down with my feet up and hardly taking any steps even around the room, it hasn't made much difference at all.Ìý
ALMAND
It hasn't made much difference.Ìý
DIANA
No, I've got one ulcer on my heel that just will not heal up. I've had other ulcers that have come and gone but this one on my heel just - well we don't know what to do with it.Ìý
ALMAND
Right.Ìý
DIANA
Rest seems to make no difference.Ìý
ALMAND
Well in that case if resting doesn't seem to make any difference then I would be more inclined to say carry on with the walking. Now you're doing three miles a day?Ìý
DIANA
No this is what I've been told by the cardiac people I should be doing.Ìý
MYERS
I imagine you can't even contemplate three miles a day.Ìý
DIANA
No, just walking around the house sometimes is excruciatingly painful.Ìý
ALMAND
I would go for either three 10 minute sessions or two 15 minute sessions and that might actually help. And when you've finished why don't you put your feet up, so you've actually put them on the surface, so you're actually there and taking the weight off your feet when you've done the exercise.Ìý
MYERS
It's interesting isn't it that the cardiovascular team have spoken about walking three miles a day, obviously to improve the heart, but presumably any exercise - there are other exercises that would improve the heart that wouldn't necessarily have to be done on the feet Len?Ìý
ALMAND
No, no swimming would be absolutely ideal. If you could afford to go swimming, swimming will be brilliant.
MYERS
How does that strike you?Ìý
DIANA
Well not with ulcers on my feet no.Ìý
ALMAND
No that was the only thing I was thinking of. There are certain socks, I think, you can wear.Ìý
DIANA
I need something absolutely waterproof or watertight ...Ìý
ALMAND
Yeah you would and that's the problem.Ìý
DIANA
... because of infections.Ìý
ALMAND
The only other possibility then is cycling - a stationary bike.Ìý
DIANA
I have an exercise bike and I told the podiatry people I'd got that and they threw up their hands in horror and said - oh but the pressure on your feet, you shouldn't be on that.Ìý
ALMAND
Then I think you've got - I think we've got a difficult problem here Diana. I mean I want you to exercise as much as you can and I would say instead of long periods of exercise then two 15 minute sessions and three 10 minute sessions could be a good compromise, so you're getting at least 30 minutes of activity during the day and you are keeping a very strong watching brief on those ulcers.Ìý
MYERS
Can I throw in another - well it's an e-mail from Eddie and I wonder if it will help us on at all because this is - well he writes that he's about to start a new job as a radio operator, that means he can't go for walks or even have lunchtime exercise because he has to maintain a listening watch, so he's looking for exercises that he can do in front of his operating position - in other words he's sedentary, possibly a little bit as Diana is finding she's having to keep her feet up. So are there any upper body exercises or stretching exercises that you can do without having to get out of the chair.Ìý
ALMAND
Well there is a whole range of chair based exercises, if you go on the computer and put into one of the search engines you actually will find a lot of chair based exercise you can actually do. But also the British Heart Foundation booklet would help you with that. You can also use elastic bands - they will help you to put some, if you like, resistance there so you can actually build up strength. But it's really identifying a range of exercise that you can do while you're in the chair over a period of time.Ìý
MYERS
I mean what's good to know is that both Eddie and Diana certainly want to try because they know that it's going to be good for them, so I hope something of what's been said is going to be helpful, again more details about how to follow the trail through to some of those websites that might have more information, we've also got a helpline number which will have some details of booklets and so on. But thanks Diana, we will have to move on, if I may. I'll go to a call from Martin in Middlesex. Martin, it's your turn.Ìý
MARTIN
Yes good afternoon. Some years ago I had quite a serious weight problem and by adopting a fairly rigid routine at the local gym and combining it with sensible eating I managed to lose five stone.
MYERS
Good for you.Ìý
MARTIN
But I have to say what I found in the process that unfortunately there are parts of the fitness industry which appear to be flagrantly and shamelessly ageist.Ìý
MYERS
What do you mean by that?Ìý
MARTIN
Well I'm actually quite a determined and self-motivated individual, which is how I managed to shift most of the weight, but I can only speak from experience and my experience was that some of the younger club members and even some members of staff on occasions could actually be downright abusive. There appears to be discrimination against anybody who doesn't fit the fashionable stereotype of the user of a health club I'm afraid.
MYERS
Anyone who's not in Lycra.
MARTIN
Well that's pretty well it and there does seem to be something of a legwarmer culture to the extent that I know a significant number of the other older members feel intimidated about using, for example, the aerobics studios.
MYERS
Well that's very disappointing isn't it to hear that because people need encouragement not to be dispirited by that sort of attitude. I mean Len do you think there is something in what - well clearly Martin has found that - how would you advise people to find the right sort of places where they'll get the particular attention that they need at whatever age?Ìý
ALMAND
Yes Martin has identified a real serious problem with some people in the fitness industry and I think you should have asked very serious questions and made formal complaints about that to the people there. And I think you really ought to ask of any leisure or fitness facility you got to - just ask them what kind of sound advice will I receive that will help me progress and keep me into exercise? Because you're the sort of people who want to be encouraged to exercise more. Now there is a programme called Moving More Often, which is a motivating programme, to get older adults helping other older adults get into activity. And there are a number of facilities now, gym facilities, who will cater just for the older adult. Anybody over 45 they will cater for them and provide specific times during the day where they can get sound advice. And I'm afraid you need to find out where those are.Ìý
MYERS
And in the 10 seconds we've got left Len, can you just reaffirm that point that of course you don't have to go to the gym to keep fit.Ìý
ALMAND
No you don't have to go to the gym, I would say, Martin, if you're walking every single day and you're going up and down steps and you're walking up slopes you'll get plenty of exercise with that sort of activity and that won't cost you a penny.Ìý
MYERS
Thank you very much. I'm going to stop it there. Thanks to Len Almand, who joined us from the British Heart Foundation's National Centre for Physical Activity and Health in Loughborough. Thanks indeed to all of those who phoned and e-mailed. More information on our website - go to bbc.co.uk follow the links to Check up - or the helpline - 0800 044 044. Next week join us for questions on breast disease.Ìý
ENDS
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