Fitness 337

Fitness

You have probably heard by now that physical activity is good 

for you. It helps you manage your body weight and prevent 

gradual weight gain. This may reduce your risk of certain health 

problems. Yet with all the benefits of being physically active, 

maybe you haven’t quite gotten around to starting a regular 

activity routine.

If you are having trouble becoming physically active, you are not 

alone. In fact, only 48 percent of U.S. adults get the minimum 

recommended level of physical activity each week. What you 

should know is that regular physical activity may help prevent 

heart disease, as well as breast and colon cancers, stroke, type 2 

diabetes, and osteoporosis. All you need to get started is a good 

pair of walking shoes.

What is healthy physical activity?

When some people think of physical 

activity, they think of playing sports or 

working out at a gym. If you don’t like 

doing those sorts of things, then the 

whole idea of being physically active may 

not be appealing. 

But being physically active doesn’t have 

to mean playing basketball, doing pushups, or jogging. Activities that require 

as much or more effort as 10 minutes of 

brisk walking count as healthy physical 

activity. For instance, if you manage a 

household and spend much of your day 

running up and down stairs, vacuuming 

floors, and chasing after toddlers, you 

may be getting plenty of healthy physical 

activity at home. If you work at a job that 

involves a lot of walking or lifting, you 

may be getting plenty of healthy physical 

activity at work.

One type of physical activity is aerobic 

activity, in which you move large muscles 
338 The Healthy Woman: A Complete Guide for All Ages

in your arms, legs, and hips over and be walking on a level surface at a brisk 

over again. During aerobic activity, you pace (about 3 to 4 miles per hour). 

breathe faster and more deeply and your If your breathing increases so much that heart beats faster. it is difficult to carry on a conversation, 

If your breathing and heart rate increase your activity is considered vigorous intento a moderate degree, your activity is sity. Vigorous-intensity activity is any acconsidered moderate intensity. Put an- tivity that burns more than 7 calories per 

other way, moderate-intensity physical minute. An example would be jogging.

activity is any activity that burns 3.5 to 7 Below are some moderate and vigorous calories per minute. An example would physical activities that you might consider.

Moderate and Vigorous Physical Activities

Moderate activities Vigorous activities

Leisure activities Walking, ballroom dancing, leisurely Jogging, bicycling fast or uphill, jumpbicycling, roller skating, canoeing ing rope, swimming continuous laps

Sports Golfing, softball, badminton, downhill Singles tennis, beach volleyball on 

skiing sand, basketball, soccer, cross-country skiing

Home activities Pushing a power lawn mower, gar- Pushing a hand mower, heavy or rapdening, raking the lawn, moderate id shoveling (more than 10 pounds 

housework per minute), carrying items weighing 

25 pounds or more up a flight of 

stairs

Occupational activity Maid service, waiting tables, feeding Teaching an aerobic dance class, 

or grooming farm animals, manually heavy farm work

milking cows, picking fruits or vegetables, walking while carrying a mailbag
Fitness 339

Who should see a doctor 

before becoming physically 

active?

To design a safe, effective physical 

activity program, talk with your doctor 

before becoming physically active if 

you:

• have a chronic, or long-term, disease (such as coronary artery disease or diabetes) or have risk factors for a chronic disease

• are older than 50 and plan to do 

vigorous physical activities

• are pregnant

How much physical activity do I 

need? 

To reduce the risk of chronic disease, 

adults should engage in:

l	 moderate-intensity physical activity 

for 30 minutes or more on 5 or more 

days of the week, OR 

l	 vigorous-intensity physical activity for 

20 minutes or more on 3 or more days 

of the week

This physical activity should be in addition to your routine activities of daily 

living, such as cooking or spending a few 

minutes walking from the parking lot to 

your office.

If you are older than 65, you should still 

engage in regular physical activity. Doing 

so will:

l	 help you keep your strength so that 

you can stay independent

l	 improve your balance so that you are 

less likely to fall and break bones

l	 help prevent or delay some of the 

diseases linked with aging, such as 

osteoporosis (OSS-tee-oh-puh-ROHsuhss)

l	 help prevent constipation

l	 help you sleep better at night

If you have not been physically active 

for a long time, you may need to start 

slowly and then work your way up as you 

become more fit. For example, if you do 

not feel up to walking for 30 minutes, try 

walking for 10 minutes. Then increase 

your walking time by 5 minutes each 

week until you reach 30 minutes. 

If walking at a speed of 3 to 4 miles 

per hour is too fast for you, it’s okay to 

walk at a slower pace. As long as you are 

breathing hard, it’s considered moderate 

intensity. A good rule of thumb is to pay 

attention to how hard it is for you to talk 

while being active. If you can talk without any trouble at all, you are not working hard enough. If you can’t talk at all, 

you’re working too hard.

Other ways to be active

As mentioned, one form of physical activity is aerobic activity. There are also 

three other types of physical activity:

l	 strength-training activities

l	 stretching activities

l	 balance activities

To be physically fit, adults should do 

a combination of aerobic, strengthtraining, and stretching activities. In 

addition to these three, older adults 

should also do balance activities.
340 The Healthy Woman: A Complete Guide for All Ages

Strength-training activities

Strength-training activities increase the 

strength and endurance of your muscles. 

Examples of strength-training activities 

include working out with weight machines and free weights.

You do not need to invest in a gym 

membership or buy expensive home gym 

equipment to do strength-training activities. Hand, wrist, and ankle weights 

are less costly options. Also, homemade 

weights, such as plastic soft drink bottles 

filled with sand or water, may work just 

as well. You can also use your own body 

weight, doing activities such as push-ups, 

pull-ups, and sit-ups. You could also buy 

a resistance band at a sporting-goods 

store. It looks like a giant rubber band, 

and stretching it helps build muscle.

In each strength-training session, you 

should do 8 to 10 different activities using the different muscle groups throughout your body, such as the muscles in 

your abdomen, chest, arms, and legs. 

Repeat each activity 8 to 12 times, using 

a weight or resistance that will make you 

feel tired. When you do strength-training activities, slowly increase the amount 

of weight or resistance that you use. 

Also, allow 1 day in between sessions to 

avoid excess strain on your muscles and 

joints.

Don’t hold your breath during strengthtraining activities. That could cause 

changes in your blood pressure. It may 

seem strange at first, but you should 

breathe out as you lift something, and 

breathe in as you relax. 

Below is a strength-training activity that 

you can do at home, and all that you 

need is a chair and some pillows. It’s 

called the “Chair Stand,” and it strengthens muscles in your abdomen and thighs. 

It also helps improve your balance.

1. Place pillows on the back of a chair.

2. Sit toward the front of the chair, knees 

bent, feet flat on the floor.

3. Lean back on the pillows in a halfreclining position. Keep your back 

and shoulders straight throughout the 

activity.

4. Raise your upper body forward until 

sitting upright, using your hands as 

little as possible (or not at all, if you 

can). Your back should no longer lean 

against the pillows.

5. Slowly stand up, using your hands as 

little as possible.

6. Slowly sit back down. Pause.

7. Repeat 8 to 15 times.
Fitness 341

Stretching activities stretches the muscles in the front of your 

Stretching can help you be more flexible, thighs:

allowing more freedom of movement. 1. Lie on your side on the floor. Your Moving more freely will make it easier hips should be lined up so that one is for you to reach down to tie your shoes directly above the other one. or look over your shoulder when you 2. Rest your head on a pillow. back the car out of your driveway. 

3. Bend the knee that is on top. You should do stretching activities after 

your muscles are warmed up—for ex- 4. Reach back and grab the heel of that 

ample, after strength training. Stretching leg. 

your muscles before they are warmed up 5. Gently pull that leg until the front of 

may cause injury. Also, stretching should your thigh stretches. 

never cause pain, especially joint pain. If 6. Hold this position for 10 to 30 seconds. you feel pain when you stretch, you are 

stretching too far. 7. Reverse position and repeat.

Below is an example of an activity that 8. Repeat 3 to 5 times on each side.

Balance activities

As you get older, your risk of falling 

due to losing your balance increases. To 

prevent falling injuries, you should do 

activities to maintain or improve your 

balance. Below are two balance activities 

that you can do almost anytime, anywhere, and as often as you like, as long 

as you have something sturdy nearby to 

hold onto if you become unsteady.

l	 Walk heel-to-toe. Position your heel 

just in front of the toes of the opposite 

foot each time you take a step.

l	 Stand on one foot (for example, while 

waiting in line at the grocery store or 

at the bus stop). Alternate feet. 
342 The Healthy Woman: A Complete Guide for All Ages

Physical activity and health 

problems

More and more, research is suggesting 

that physical activity can help prevent or 

even help treat certain health problems.

Overweight and obesity

Being overweight or obese is a common 

struggle in the United States: Sixty-two 

percent of U.S. women older than 20 are 

overweight or obese. Being overweight 

or obese increases your chances of getting many diseases, including:

l	 coronary artery disease 

l	 type 2 diabetes 

l	 stroke 

l	 cancer of the colon, breast, endometrium, thyroid, esophagus, kidney, gallbladder, and pancreas

When you’re overweight or obese, extra 

fat is deposited in many places in your 

body. The body fat that is most dangerous to your health is visceral (VISS-uruhl) fat, which surrounds your stomach, 

intestines, and other internal organs. 

Having too much visceral fat increases 

your risk of heart disease, diabetes, and 

other diseases. It tends to increase in 

women after menopause. The good news 

is that becoming physically active can 

help overweight postmenopausal women 

reduce the amount of visceral, as well as 

total, fat.

Coronary artery disease (heart disease)

Physical activity can help reduce your 

risk of heart disease. It doesn’t have to 

be vigorous activity. Moderate physical 

activity for at least 30 minutes on 5 or 

more days of the week can help reduce 

your heart disease risk by:

l	 increasing HDL (good) cholesterol 

(koh-LESS-tur-ol)

l	 lowering blood pressure

l	 helping you maintain your weight (in 

addition to eating healthy foods and 

limiting how much you eat)

l	 improving the fitness of your heart

Although your risk of getting heart disease goes up after menopause, you should 

not wait until menopause to start becoming active. Research suggests that women 

who have high LDL (bad) cholesterol 

levels and other heart disease risk factors 

before menopause may be more prone to 

artery problems after menopause. So the 

sooner you get moving, the better.

For more information on coronary 

artery disease, see the Heart Disease 

chapter on page 15.
Fitness 343

Stroke

As is the case with coronary artery 

disease, the risk of stroke increases as 

women age. The most common type of 

stroke results when a blood clot blocks 

an artery carrying blood from the heart 

to the brain. Some research has shown 

that physical activity, including brisk 

walking, can lower women’s chances of 

having this type of stroke. Research has 

also shown that women who had been 

inactive but became active in middle or 

older age had a lower stroke risk than 

those who stayed inactive. So it is never 

too late to start lowering your risk of 

stroke.

For more information on stroke, see 

the Stroke chapter on page 37.

Type 2 diabetes

Physical activity can help people who 

have type 2 diabetes, as well as people 

who have pre-diabetes—higher than 

normal blood sugar levels that often 

lead to type 2 diabetes. In fact, research 

suggests that lifestyle changes—such 

as getting more physical activity, eating a healthier diet, and losing excess 

weight—are at least as effective as drug 

therapy for delaying type 2 diabetes.

If you already have type 2 diabetes, physical activity can help keep your blood sugar levels at a normal level. One research 

study showed that people with type 2 

diabetes were able to lower their blood 

sugar levels with either aerobic activities 

or strength-training activities. People 

who did both activities were able to lower

their blood sugar levels even more.

For more information on type 2 diabetes and pre-diabetes, see the Type 2 

Diabetes chapter on page 69.

Cancer

Research suggests that physical activity 

may reduce your risk of breast and colon 

cancers. Some experts think that one 

of the ways that physical activity may 

reduce your cancer risk is by reducing 

body fat. Fat may help cause cancer by 

releasing substances, including hormones 

such as estrogen and insulin, that may 

promote cancer cell growth.

Research also suggests that physical activity can help if you already have cancer. 

Although chemotherapy or radiation 

treatment can make you feel too tired for 

much physical activity, even some physical activity may:

l	 help you feel less tired, anxious, and 

depressed

l	 reduce pain

l	 help your immune system recover 

from chemotherapy
344 The Healthy Woman: A Complete Guide for All Ages

For patients with breast cancer receiving 

chemotherapy, physical activity may also:

l	 reduce hot flashes and sweats

l	 prevent muscle loss and inappropriate 

weight gain

For patients with cancer in general, once 

treatment is finished and the cancer is 

gone, staying active may help:

l	 prevent your cancer from returning

l	 reduce your chances of dying of cancer

If you are being treated for cancer or 

have recovered from an attack of cancer, 

be sure to talk with your doctor before 

starting any physical activity routine.

For more information on cancer, see 

the Cancer chapter on page 51.

Osteoporosis

Research suggests that physical activity 

may help prevent osteoporosis, a disease 

that weakens bones. To help prevent 

osteoporosis, you should do weightbearing activities. These are activities in 

which your body works against gravity. 

Jogging, walking, stair climbing, and 

dancing are all weight-bearing activities 

because you are holding up your body 

against the force of gravity. Weight lifting, or strength training, is another type 

of weight-bearing activity. In contrast, 

swimming is an example of an activity 

that is not weight bearing because the 

water is helping to hold up your body.

Engaging in weight-bearing activities 

helps reduce your risk of osteoporosis by:

l	 helping you grow healthy bones during your teenage years

l	 helping you maintain healthy bones in 

adulthood 

l	 reducing your rate of bone loss during 

aging

For more information on osteoporosis, see page 225 of the Healthy Aging

chapter.

Arthritis

Research suggests that physical activity 

can reduce your chances of getting osteoarthritis (OSS-tee-oh-ar-THREYEtuhss). More common in women after 55 

years of age, this type of arthritis causes 

pain most often in the hip, knee, spine, 

and finger joints.

For more information on osteoarthritis, see page 229 of the Healthy Aging chapter and page 360 of the Pain

chapter.
Fitness 345

Does physical activity have 

positive effects on the mind?

Depression and anxiety

Research suggests that regular physical 

activity:

l	 reduces feelings of mild to moderate 

depression and anxiety

l	 improves mood

l	 increases feelings of well-being

Physical activity is not a cure for depression or anxiety. But it may help you 

manage your symptoms by:

l	 giving you a sense of success, which 

can boost your confidence

l	 helping you meet other people

l	 taking your mind off your problems 

Also, physical activity may help you feel 

better by:

l	 increasing the level of substances in 

the brain that improve your mood

l	 reducing levels of stress hormones

Research suggests that, for some people, 

physical activity can work as well as an 

antidepressant in treating major depression. But if you are now taking an antidepressant, do not stop taking it on your 

own. You should discuss with your doctor how physical activity might fit into 

your overall treatment plan before making any changes.

For more information on major depression and anxiety disorders, see the 

Mental Health chapter on page 207.

Quitting smoking

As every smoker knows, quitting smoking can be hard to do. Every year, many 

smokers try to quit but only a few succeed. One research study suggests that 

vigorous physical activity can help 

women quit smoking, even women who 

have been heavy smokers for many years. 

As an added bonus, vigorous physical activity can also help you gain less weight 

after you quit.

It is not known for sure how vigorous 

physical activity might help you quit 

smoking. One way it might help is by 

reducing stress, which might reduce your 

urge to smoke.

Cognitive decline during aging

As we age, we sometimes forget things. 

Maybe we no longer think as quickly 

as we used to. Experts call this “cognitive decline,” where “cognitive” refers to 

thinking, learning, and memory, as opposed to emotions. 

It was once thought that cognitive decline was a normal part of aging. But 
346 The Healthy Woman: A Complete Guide for All Ages

research now suggests that staying physically active as you get older may slow 

cognitive decline, at least for a while. 

Some experts think that physical activity may slow cognitive decline in part 

by increasing blood flow to the brain. In 

addition, physical activity may even help 

new brain cells grow.

Physical activity during and after 

pregnancy

Health experts say that most pregnant 

women should get 30 minutes or more 

of moderate physical activity each day. 

Such activity offers many benefits. It can:

l	 lessen some of the discomforts of 

pregnancy

l	 give you more energy and make you 

feel better

l	 improve your posture

l	 increase your chances of an early recovery after delivery

Moderate activity during pregnancy may 

also reduce your risk of:

l	 preeclampsia (pree-ee-KLAMP-seeuh), a condition that involves high 

blood pressure and other problems 

during pregnancy

l	 depression

Physical activity during and after pregnancy can also help keep you from gaining too much weight. Women who gain 

too much weight during pregnancy and 

do not take it off afterward are more 

likely to be obese 8 to 10 years later.

When you are being active during pregnancy, do not push yourself to the point 

of exhaustion. If you cannot talk easily 

while you’re active, you may be overdoing it. Also, avoid being physically active 

during very hot weather. And be sure to 

drink plenty of water so that you do not 

become dehydrated.

Pregnancy

Check with your doctor before becoming active to ensure the safety of you 

and your baby. Your doctor may ask 

you to avoid some or all physical activity if you have certain medical conditions or complications involving your 

pregnancy.

For information on preeclampsia, see 

page 179 of the Pregnancy chapter.

Physical activity and menopausal 

symptoms

Menopause affects every woman differently. Common symptoms of menopause 

include:

l	 hot flashes (feelings of warmth)

l	 trouble sleeping through the night 

l	 mood swings, feeling crabby, crying 

spells 
Fitness 347

If you have hot flashes, physical activity 

is probably not going to reduce them. 

But research suggests that being physically active may offer other benefits, such 

as:

l	 improved sleep quality

l	 fewer feelings of nervousness, anxiety, 

and depression

Physical activity tips

With all the things that you have to do 

each day, finding the time and motivation to get moving can be challenging. 

Here are some suggestions for ways to 

get started:

l	 If you do not have 30 minutes in one 

stretch to set aside for moderate physical activities, try being active in three 

10-minute periods throughout the day.

l	 Join a sports team. For example, you 

may work for a company that has a 

baseball team that you could join.

l	 Join a hiking or running club.

l	 Use stairs instead of the elevator.

l	 Walk or bike to work or to the store.

l	 Be physically active at lunch with coworkers, family, or friends.

l	 Take a break at work to stretch or take 

a quick walk.

l	 Go dancing with your partner or 

friends.

l	 Plan active vacations rather than only 

driving trips.

l	 Wear a pedometer (a small tool worn 

on your belt that counts the number 

of steps you take). Try to walk 10,000 

steps each day.

l	 While watching TV, use a stationary 

bicycle or treadmill. Another idea is to 

work out with hand weights.

l	 Spend time in active play with your 

kids. While you’re at it, you could also 

teach your kids about the health benefits of physical activity. Children and 

adolescents should be engaging in at 

least 60 minutes of moderate-intensity 

physical activity on most, and preferably all, days of the week.

l	 If you are having trouble finding the 

time or motivation to be physically 

active, figure out what is holding you 

back and then brainstorm with family 

and friends about ways to overcome 

these barriers.

Perhaps the most important tip, though, 

is to find physical activities that you 

enjoy. You are more likely to keep physically active if you are having fun. n

Safety Tips

While you are being physically active, 

be sure to keep safety in mind. We 

have already mentioned some safety 

tips, such as starting slow if you have 

not been physically active for a long 

time. Below are a few more safety tips:

• Use safety equipment. For example, 

wear a helmet for bike riding or the 

right shoes for walking or jogging. 

• Drink plenty of fluids when you are 

physically active, even if you are not 

thirsty. 

• Always bend forward from the hips, 

not the waist. If you keep your back 

straight, you’re probably bending 

the right way. If your back “humps,” 

that’s probably wrong.
348 The Healthy Woman: A Complete Guide for All Ages

One Woman’s Story

After turning 40, I realized that I was at my highest weight ever and my blood pressure was borderline high. Since I have a strong family history of heart disease, I knew that 

I needed to take action. 

I started by walking on the treadmill. 

After losing the first few pounds, I really 

liked the feeling of getting healthy, so 

I started to add to my home gym. The For many people, 

first addition was a set of dumbbells 

and a bench purchased at a yard sale. having that helping 

I had absolutely no clue how to use 

them, so I read countless books and 

researched on the Internet. I wanted to hand can make the 

learn everything I could about physical 

activity and fitness. difference between 

I’ll admit that there were days when I 

wanted to give up. I was working out on 

my own, but it would have been very success and failure.

helpful to have someone to keep me 

motivated. However, I didn’t quit, and 

after 24 weeks I managed to lose 48 

pounds! I loved physical activity and challenging myself, and I also loved the fact that I 

felt better at 40 than I did when I was 20.

For Christmas, my husband gave me a gift certificate for time with a personal trainer. 

Working out with a trainer helped me realize how important it could be to have someone 

there to count on for inspiration and support. For many people, having that helping hand 

can make the difference between success and failure. 

I knew then that I wanted to be a trainer myself. I began by training family and friends; after great success, I became certified through the American Council on Exercise. I wanted 

to help people take control of their health and maybe learn something about themselves 

along the way. I truly want all my clients to succeed. I want them to have the feeling I had 

when I reached my goal—a feeling of accomplishment and well-being that comes from 

making healthy choices.

I eventually opened a private studio. I want to help the people who might not want to go 

to a conventional gym for one reason or another, but want the guidance and structure 

needed to be successful with their specific goals. I have improved my quality of life and 

want to help others do the same.

Colleen

Oakdale, Pennsylvania
Fitness 349

For More Information...

Office on Women’s Health, HHS

200 Independence Ave SW, Room 712E

Washington, DC 20201

Web site: www.womenshealth.gov/ 

FitnessNutrition

Phone number: (800) 994-9662, 

(888) 220-5446 TDD

U.S. Department of Health and Human 

Services

200 Independence Ave, SW

Washington, DC 20201

Web site: www.healthierus.gov

www.smallstep.gov 

Division of Nutrition, Physical Activity 

and Obesity, CDC

4770 Buford Highway NE, MS K-24

Atlanta, GA 30341-3717

Web site: www.cdc.gov/nccdphp/dnpa

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

The President’s Challenge

501 N Morton, Suite 203

Bloomington, IN 47404

Web site: www.presidentschallenge.org

Phone number: (800) 258-8146

The President’s Council on Physical 

Fitness and Sports

Department W

200 Independence Ave SW, Room 738-H

Washington, DC 20201-0004

Web site: www.fitness.gov

Phone number: (202) 690-9000

Weight-Control Information Network, NIH

1 WIN Way

Bethesda, MD 20892-3665

Web site: www.win.niddk.nih.gov

Phone number: (877) 946-4627 

National Center on Physical Activity and 

Disability

1640 W Roosevelt Rd

Chicago, IL 60608-6904

Web site: www.ncpad.org

Phone number: (800) 900-8086 voice and 

TTY

Women’s Sports Foundation

1899 Hempstead Turnpike, Suite 400

East Meadow, NY 11554

Web site: 

www.womenssportsfoundation.org