"Everyone should be exercising," says Mona M. Shangold, MD, director of the Center for Women's Health and Sports Gynecology in Philadelphia.

"It's better to develop the exercise habit while you're young because it's harder to develop it when you're older. But it's never too late to start."

Dr. Shangold is a former marathon runner whose specialties include the somewhat unusual combination of gynecology and sports medicine. She points out that all adults are increasingly susceptible to medical problems as they age such as heart disease, diabetes, obesity and osteoporosis (thin, fragile bones).

Regular exercise greatly reduces the likelihood that you'll suffer from any of these. Looking at Pennsylvania's high rates of these life-style related diseases, you have to believe that the old saying is true: we northerners really do hibernate for the winter. Come springtime, it's not always easy to bust out of that sedentary lifestyle.

Ideally, you'll want to develop and maintain three kinds of fitness:

Stamina
First, you need stamina or endurance, promoted by aerobic exercises like running, swimming, or riding a bike. But any exercise that makes you breathe hard will do—a brisk walk, climbing stairs, or yard work that keeps you moving.

Some fitness experts offer this rule of thumb:

• If you can talk with no trouble at all during exercise, it's probably not hard enough.
• If you're gasping and can't talk at all, it's too hard.

Strength
Second, there's strength, developed most efficiently with weight training—either with light dumbbells, machines in gyms and health clubs, or free weights. You can also gain strength by exercises done without equipment, like push-ups and abdominal crunches, but it's harder to work all muscle groups that way.

Stretching
Third, you'd like to maintain flexibility and balance, promoted by stretching and activities like yoga and tai chi. Ideally, stretches should be done slowly and held for up to 30 seconds.

For more information see the Mayo Clinic's "Adjust to your workout: Why warming up and cooling down help keep you on the go."

Dr. Shangold notes that women, who tend to have less bone density than men to begin with, are particularly susceptible to accelerated bone loss after menopause. This puts them at greater risk for bone fractures and other problems later in life.

Regular exercise helps to prevent bone loss. Walking, running, or weight training are excellent—anything that causes bones to support weight; swimming, a wonderful aerobic exercise, is less useful in this respect.

"Regular exercise is the best way to prevent the accumulation of fat," Dr. Shangold continues. "Fat increases our susceptibility to diabetes, heart disease, and several cancers as well. As we get older our metabolism slows down, and we tend to add fat. Exercise not only strengthens our muscles and bones but also speeds up our metabolic rate, so that we have less of a tendency to get fatter."

In fact, she adds, dieting without exercise is more often than not a losing battle. Simply taking in fewer calories tends to slow down the body's metabolism, making weight loss more difficult. Conversely, adding lean muscle helps your body burn calories faster.

If you've really been a couch potato, Dr. Shangold advises checking with your doctor before taking up anything more strenuous than walking. Your physician will ask whether you've experienced dizziness, chest pains, or other problems during mild exertion. He or she may want to do some tests.

Most people, however, can safely follow a familiar advertising slogan: "Just do it." As Dr. Shangold says, "Probably there's greater risk from not exercising. And if people begin early in life, they can usually prevent problems that become obstacles to exercise later."

If you prefer to exercise at home, opt for something that gives you aerobic training like a stationary bike or treadmill, perhaps supplemented by light dumbbells. But you may find sticking to a program easier if you do it with friends.

Try:

• Cycling clubs
• Working out with a partner at a gym
• Walking with one or more people you like

"Exercise needs to be convenient," Dr. Shangold says. "And it needs to be fun." If you're seriously out of shape, the idea of regular exercise may not sound like fun at first. But it grows on you.

Dr. Shangold says that one of her patients, a woman in her 30s, weighed over 300 pounds at the time she first appeared for a physical. Her previous attempts at dieting hadn't helped. Now, a year later, she's lost over 100 pounds and continues to slim down.

The major reason for her success is simple: "She's become an exerciser," Dr. Shangold says, "and she's loving it. She's also loving the weight loss."

From the Mayo Clinic: "Fitness on a budget: Low-cost ideas for getting in shape."

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Compared to motivating adults to exercise, getting today's children—raised on cartoons, MTV, and computer games—to exercise regularly may be the most difficult challenge of all.

Carl Davis, a health teacher at a Carlisle, PA, middle school not only practices what Dr. Shangold preaches, but passes it on to the teenagers he teaches. Davis himself is a lean, active 58-year-old who stays fit by hiking, walking, and gardening. In winter he swims, does cross-country skiing when he can, and works in a moderate amount of weight training.

Five years ago, Davis was looking for a fun way to promote fitness for students in his classes. He came up with the idea for an obstacle course.

"There was this Channel 8 guy on television doing challenges," Davis recalls, so he invited the television announcer to participate in a competition against the middle-school kids. He asked the school shop class to build a wall, the arts department to make a sign, and got the band out.

This was the beginning of an annual event now billed as The Ultimate Challenge.

The obstacle course, which involves rope-climbing, wall-climbing, walking a balance beam, and other activities designed to test fitness and agility, remains in the school gym for a week. All students do it, and about a hundred choose to do it in a public assembly.

Boys and girls (and teachers) who complete the course with fast times later compete against teams of adult "challengers" from outside the school. Davis asks outside competitors to include women on their teams "so the girls know that it's not just guys who need to be fit."

In addition to the TV personality, organizations sending challengers have included:

• The local police department
• The Pennsylvania State Police
• The Carlisle YMCA
• The US Army War College in Carlisle
• The Cumberland County Medical Society

"You've got to keep showing that fitness is part of good health," says Dan Hely, MD, a Carlisle surgeon who began helping with the Ultimate Challenge when his own children were in Davis's classes and who decided to enlist his fellow doctors in support of the effort. "The program is excellent because it gets a bunch of kids who aren't the mainstream athletes to participate. It's less like traditional competitive sports and more a matter of self-accomplishment."

In fact, the students have consistently won the "ultimate" competition with adults, but Davis emphasizes that neither winning a race nor setting a record time is as important as setting personal fitness goals.

"We get kids in the Ultimate Challenge who don't have a lot of physical ability," he says. "Sometimes they're overweight. It may take them five tries to get over the wall, and four minutes to complete a course which most of the kids do in a minute. But even though they don't do it fast, they do it. What I think makes it special is that they're determined, and they stick with it. And everybody always applauds when they're done."

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Copyright 2002—Fred D. Baldwin, PhD, used by permission.

Baldwin is a freelance writer who lives in Carlisle, PA. He's a member of the Author's Guild, National Writers Union, and National Association of Science Writers and is the co-author of Infomedicine, A Consumer's Guide to the Latest Medical Research.  

From MayoClinic.com:

Walking for fitness: Taking steps in the right direction
This article tells you how to begin a fitness-walking routine and includes tips for tracking your progress and sticking to your workout.

Your fitness program: Tips for staying motivated
Suggests choosing a workout that fits your lifestyle so you have fun and don't get bored with your fitness routine. Also includes several links to relevant information.