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Regular exercise can be a hearty prescription for longer life

You don't have to be an athlete to make your heart stronger. Engaging in as little as 15 minutes of exercise per day can benefit your heart and even extend your life span.

In one study, exercising 15 minutes a day for eight years reduced all-cause mortality by 14 percent and increased life expectancy by three years. Every additional 15 minutes of exercise a day lowered mortality during the study period by an additional 4 percent.

"Exercise produces significant benefit by lowering levels of damaging inflammation that affects heart and artery health," says Dr. Daniel Forman, a cardiologist and geriatrician at Harvard-affiliated Brigham and Women's Hospital, Boston, Mass. Dr. Forman has a special interest in how exercise training can improve cardiovascular health and well-being in seniors.

Exercise also helps by improving the body's ability to fight oxidative stress, a chemical byproduct of cellular energy generation. Oxidants damage cells and change the way our bodies function, increasing our vulnerability to illness.

"Exercise lowers your vulnerability to heart attacks, heart failure, peripheral artery disease, and arrhythmias. Not only do you feel better, but also you function better," says Dr. Forman.

PRESCRIPTION FOR EXERCISE

The most well-known path to cardiovascular strength is aerobic exercise. This type of exercise makes your heart stronger and able to use oxygen better. It also improves circulation and lowers blood pressure.

"Exercise doesn't have to be rigorous. Low-intensity exercise can be beneficial. Just start easily and build up gradually," says Dr. Forman. "The important thing is to commit yourself to doing it regularly."

Daily aerobic exercise is recommended. Other types of exercise that complement aerobic exercise and add to its heart-building benefit include strength training and stretching. Each should be done two or three times a week.

"Strength training is especially important, since it builds up strength in muscles and bone, which helps with walking, daily activity, and metabolism. Stretching strengthens joints and improves stability," Dr. Forman explains.

Slow aerobic exercise at the start and end of activity--so-called warm-ups and cool-downs--are particularly important for elderly individuals. Warm-ups provide gradual increases in heart and breathing rates and blood flow in the limbs, which make more vigorous exercise much safer. A cool-down after exercise helps avoid dizziness and falls as the heart slows down.

Dr. Lawrence P. Cahalin, professor of physical therapy at the University of Miami's Miller School of Medicine, conducts research on exercise and heart disease with Dr. Forman. The two experts offer a simple prescription for exercise that almost anyone can follow. The key is to start gently and move gradually.

"If the thought of exercise holds you back, don't call it exercise; call it physical activity," Dr. Forman recommends. "Pick the activity you like doing, because you're more likely to do it."

If you need motivation, join a gym. Many people find the camaraderie good incentive. Many gyms have recumbent bikes that provide an excellent aerobic workout in comfortable position. Gyms also have trainers who will be happy to show you how to use hand weights safely.

There are many alternatives to traditional exercise, too.

"Dancing provides excellent benefits. So does tai chi, which integrates aerobic, strengthening, stretching, and balance," says Dr. Cahalin.

It shouldn't take long before you develop the capacity to exercise comfortably for 15 minutes or longer. When you reach this point, don't stop: longer durations and higher intensities provide even greater cardiovascular and musculoskeletal benefits. Justremember to keep doing it. It also doesn't take long to lose the benefits you've gained.

GOOD CHOICES

1. Aerobic exercise

A low-intensity exercise such as walking is free and can be done any time. For safety, Dr. Forman advises walking with a cell phone or a friend.

"You should be able to talk comfortably while you walk. If you can't talk, or you become short of breath, seek help immediately," he advises. "For maximum heart benefit, walk as fast as you can. Faster is better, but slow, moderate walking still does a lot of good."

Initially, exercise for short periods (five to 10 minutes) at a relaxed pace. "Two 10-minute episodes separated by a rest creates a very substantial heath benefit," says Dr. Forman.

2. Strength training

If you become exhausted after walking for a short time, weak leg muscles may be your problem. Strength training may be just what the doctor ordered.

You don't need fancy weights to accomplish this.

"Put one or two cans of soup in a knee sock and wrap it around your ankle. While seated in a chair or lying in bed, lift your leg slowly and lower it slowly as many times as possible, working up to 10 times," Dr. Cahalin recommends.

Strengthening can improve endurance, as well as strength. Duration of strength is often more valuable than maximum strength. Your ability to carry groceries depends on arm strength. For this exercise, Dr. Cahalin suggests lifting a bottle of laundry detergent 10 times with each arm.

If you'd prefer to exercise with actual hand weights or ankle weights, have at least one introductory session with a trainer. "Weight training is more safely done with supervision in the learning phase," he says.

3. Stretching

Many people don't think of stretching as exercise, but for older adults, stretching provides multiple benefits. When done properly, stretching improves blood flow to joints and muscles, stabilizes joints, increases range of motion, improves balance, and can improve breathing. Full deep breaths improve the function of the heart and cardiovascular system, as well as the muscles being stretched or exercised.

Dr. Cahalin recommends stretching while lying on your back.

"This position causes your heart to contract more forcefully to eject blood. It actually makes your heart stronger than stretching while standing," he explains.

He recommends lying on your back, and with your knees straight, raising one leg to the point of a mild stretch while breathing in and holding the stretch until you have completed a full, deep breath. Then begin lowering the leg and breathing out. Repeat the same procedure with the other leg. -- Harvard Heart Letter

(C) 2014. PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.

Copyright © 2014, The Baltimore Sun
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