Do You Really Need a Formal Exercise Program?

HYANNIS – Would you brush your teeth if it took an hour, or even 20 minutes a day? Even though we know that skipping it would result in dental decay, bad breath and stained teeth, most of us would probably be lax about doing it regularly.

That concept goes a long way toward explaining many people’s resistance to adding an exercise regime to their day, said physical therapist Catherine Hoell, lead clinical therapist at Oppenheim Rehabilitation Center in Chatham. Many people simply think it takes too much time out of their day.

The American Heart Association recommends at least 150 minutes of heart pumping physical activity a week, but they estimate that only one in five adults and teens actually meets that goal.

Now, a new approach is emerging that is designed to make exercising more palatable for people.

Medical professionals are encouraging people to focus on the term “exertion of daily living,” rather than the word “exercise.” The idea is that you can do many small activities in bursts throughout the day and expend a respectable amount of energy.

Mayo Clinic obesity experts and endocrinologists James Levine, MD, PhD and Michael Jensen, MD coined the term NEAT (Non-Exercise Activity Thermogenesis) to motivate people to become more active. NEAT focuses on the daily calories a person burns while doing normal activities.

The NEAT program is completely in line with physical therapy mentality, according to Hoell.

“If you don’t use it, you lose it,” she said. “I always tell people if you rest, you rust. The other thing about the NEAT exercises is that every rep is energy stored in your body. You may not see on a calorie counter that you burned 300 calories, but it’s all energy stored in your body and it all adds up. You will build accumulation, kind of like charging a battery.”

Repetition is Key
While exercising for an hour a day only takes up about 4 percent of your day, Hoell understands the many people are resistant to a formal approach. Many of her patients are recovering from surgery or an injury. She tries to figure out what level of activity they were doing before their injury or surgery and then works to improve on that. Repetition is the key.

“I give people a printout of every exercise I give them and I’ll say ‘put this where you’re going to see it every day – on the kitchen refrigerator, on your bathroom mirror, by your bedside where you put your water glass,’” she said. “Repetition is the mother of retention. Keep practicing it and your body will kick in the muscle memory.”

Most of us do brush our teeth at least twice a day, and exercising should be thought of in the same way, she said.

“You just have to make it a healthy habit.”

It helps to find a motivation or a strong “why” for reasons you want to improve your physical strength. For some people, it might be to be able to sit in a beach chair, which are normally lower than regular chairs. Others might want to be able to get down on the floor and play with young grandchildren. One of Hoell’s patients is working to be able to climb the stairs at her favorite beach.

For those who want to sit in a low beach chair or be able to play with grandchildren, one of the easiest repetitions to do is to do 10 sit-stands every time you get up from the dining room table or get out of bed. Building up that stamina will also help older people maintain their independence longer because they will be able to handle their own self-care.

Vacuuming the house, mowing the lawn and mopping floors are all great NEAT activities that can add up. For those without a lot of stamina, Hoell recommends breaking the tasks up into smaller chunks. Maybe mow one section of the lawn one day and move on to the next section the next day. Vacuum one day and mop the next. That way the tasks seem less overwhelming.

Hoell also recommends planning some fun activities that can expend energy. If you are going to one of the local band concerts, park your car farther away and walk to the concert. Park farther in the parking lot at the beach too. Or even better, ride your bike to the beach.

“Doing an activity on the beach is better than just sitting,” she said. “Let’s say you typically go to the beach and just sit there and read your book. Think about other activities you can do like collecting shells or building a sandcastle. Walking on sand is going to burn a lot more calories than walking on a flat surface so that’s a great workout.”

The NEAT Way
To figure out how many calories are burned per minute with your NEAT activities, you can consult the Compendium of Physical Activities. This Compendium reports energy expenditures in metabolic equivalents (METS) and can be converted to calories by multiplying METS times 3.5 times your body weight in kilograms. Then divide by 200.

Ways to live a NEAT life: (figures are for a 140-pound person)

Making beds for 10 minutes: 80 calories
Mopping floor for 10 minutes: 80 calories
Cooking dinner and cleaning kitchen for 45 minutes: 270 calories
Organizing a room and putting things away for 15 minutes: 177 calories
Doing laundry for 10 minutes: 98 calories
Vacuuming for 20 minutes: 160 calories
Grocery shopping for 30 minutes: 168 calories
Pacing while talking on the telephone for 30 minutes: 255 calories
Taking a half-hour walk after dinner: 390 calories
Gardening for 30 minutes: 255 calories
Mowing lawn for 30 minutes: 435 calories
Moderate canoeing for one hour: 1,200 calories
Leisurely swimming for one hour: 882 calories
While exercising will make you healthier, losing weight shouldn’t be the driving reason for making it a daily practice, unless you pair it with healthy eating, according to Hoell.

“You can’t out-exercise a bad diet,” she said. “If someone really has weight to lose, you want to think about nutrition. Abs are shaped in the gym, but made in the kitchen. That’s why it’s really important to think about fun, healthy activities that can become regular habits.”

By LAURIE HIGGINS, Cape Cod Health News

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