Northwest Health Summer 2011

Taking Steps for Good Health

Even a little exercise can lower your disease risk, improve your mood, help you lose weight, and more. So what are you waiting for?

Go to: Northwest Health Index

Tami Shumate hasn't always exercised. Only three years ago, the now-svelte 41-year-old weighed more than 300 pounds, found it difficult to turn from one side to the other when lying down, had aching joints, and was worried about future health problems that might develop because of her weight.

With her 40th birthday 15 months away, she considered gastric bypass surgery, but instead decided to try losing weight on her own. Exercise, she knew, had to be part of the weight loss equation.

Today, Shumate, a Group Health member, is a shadow of her former self. Daily exercise has become like breathing, as important as her morning bowl of steel-cut oats. She jogs, she lifts weights, she hikes, and she leads indoor cycling and "boot camp" exercise classes at a local gym. Her blood pressure and pulse are fantastic, she copes with life's stresses more easily, and she has energy to burn. She's even appeared on the "Today" show to discuss her fitness success.

"It got to the point where I love it," Shumate says about exercising.

Along the way to her new size-6 self, Shumate has greatly reduced her risk of developing health scourges such as type 2 diabetes and a number of cancers, as well as heart disease, stroke, and joint problems.

The Exercise/Disease Connection

John Gayman, MD, a personal physician who sees patients at Group Health Medical Centers Capitol Hill Campus, is ardent about the importance of physical activity for improving health and the quality of life. He frequently educates fellow providers and patients about the benefits of movement, and the problems caused by being inactive. And he points to research that links a lack of exercise to a wide variety of chronic diseases including coronary artery disease; diabetes; obesity; hypertension; osteoporosis; colon cancer; cerebrovascular problems; and mental health disorders including anxiety and depression, and cognitive decline such as dementia.

Major research findings have confirmed the following facts about physical activity, Dr. Gayman says:

  • The benefits of physical activity far outweigh the possibility of any problems from exercise.
  • Some physical activity is better than none.
  • The biggest health benefits occur with at least 150 minutes a week of moderate-intensity physical activity, such as brisk walking.
  • Additional benefits accrue with an increase in the amount, intensity, frequency, and duration of physical activity.
  • Both aerobic (endurance) and muscle-strengthening (resistance) activities are beneficial.
  • It doesn't take a lot of exercise or movement to improve health, but it takes a fair amount to help with weight loss.
  • Exercise offers health benefits for all ages, for every racial and ethnic group, and for people with disabilities.
  • Being active slows the aging process.

The people who make the greatest gains in health from exercise are those who start out at the bottom of the fitness spectrum and move up just a bit, says Dr. Gayman.

Finding Motivation to Exercise

If exercise is so good for you, why doesn't everyone do it? There are many contributors to a lifestyle with little exercise: the lure of sedentary activities like TV and the Internet, jobs that require little physical exercise, our dependence on cars to get around rather than our feet, and human nature — which generally follows the path of least resistance. Exercise requires time, effort, and motivation.

Shumate's motivation was her weight loss goal. At her heaviest and least fit, it was all she could do to get through the day, and she was a couch potato at night. Beyond looking better, she wanted to be healthy and fit for her four children. Her son Jake wound up as her fitness buddy, going to the gym with her.

She realized that slimming down would require effort. "I knew that to succeed in my weight loss, I had to exercise," says Shumate, who now weighs 140 pounds, down from 330. "And I knew I couldn't just do 30 minutes a few times a week. I really had to put forth an effort of five times a week for at least an hour at a time. I knew I could do an hour a day because I had that much time to sit on the couch."

Group Health member Teresa Matthews is someone who always loved exercise, but illness reinforced her commitment to it. Matthews developed type 1 diabetes in her late 40s. Her lifelong love affair with water and swimming has helped her manage that disease and also helped her recover from endometrial cancer. "It's just an emotionally healing medium," Matthews says of water exercise. "By exercising I was able to stay positive during my cancer treatments."

Matthews regularly swims in pools and open water, teaches water exercise classes at the Highline Athletic Club in Burien, and coaches swimming. It's an ideal form of exercise for folks just starting a fitness program, she says.

"You can exercise with no pain in water, even if you're overweight," says Matthews. "There is no joint pressure or strain. Water provides incredible resistance, so you're essentially doing Pilates because you're using your core all the time. And because water is always cooler than body temperature, you're always burning calories."

Exercise has helped her control her diabetes. "I'm insulin dependent, but if I exercise for an hour, I do not have to take insulin after a meal. That's huge."

Just Walking Works

Group Health personal physician L. Raymond Newcombe, MD, applauds people like Shumate and Matthews who have embraced strenuous forms of exercise.

But it's not necessary to jump in a pool or work out for an hour to get the benefits of exercise, he says.

He recommends walking, which doesn't require any special equipment, clothing, or a gym membership. It's something that almost anyone can do, anywhere, any time. By and large, he says, walking will get the job done and it's something folks will stick with.

For some people, especially those who are sedentary and are overweight or have chronic conditions, beginning to exercise may not feel good at first. They may experience joint or muscle pain, and become easily fatigued. It's important not to get discouraged, says Dr. Newcombe. Start slowly and add just a few more minutes of exercise a day — or every few days. Those with chronic pain often find that exercise helps with their pain.

"People who need physical activity the most are those with diabetes or with severe weight issues," says Dr. Newcombe, who practices what he preaches. Despite a very busy schedule, he jogs, bikes, hikes, and skis. "I tell people with diabetes that exercise is more potent than insulin. As a general rule, most of my patients with diabetes are type 2, mostly due to obesity. And most of that obesity is due to both a lack of activity and poor diet choices."

Sometimes, when people have a chronic disease like diabetes, they are worried that exercising will be bad for their health. While they may need to make some accommodations — those with diabetes, for instance, do need to frequently check their blood sugar levels to see how exercise is impacting them — Dr. Newcombe says there is very little downside to exercise.

"Exercise has never been shown to be detrimental to any disease, or to someone's health. Every time a study on some disease comes up, from Alzheimer's on, exercise emerges all the time as a treatment or prevention for it. The immune system is revved up by exercise."

There's no doubt that pills and therapy have their place, but exercise may be the best medicine of all.

How Much Exercise?

Dr. Gayman offers these guidelines.

Kids & Teens Adults
Total exercise time60 minutes daily150 minutes of moderate, or 75 minutes of vigorous intensity, a week
AerobicModerate or vigorous for most of 60 minutes, 3 days a week3 hours a week, which can be spread throughout the week; at least 10 minutes at a time
Muscle and bone strengtheningDifferent muscle groups 3 days a week on non-consecutive daysAll major muscle groups 2 days a week on non-consecutive days
Other tipsEncourage a variety of age-appropriate, fun activitiesIncrease to 300 minutes of moderate or 150 minutes of vigorous aerobic activity a week

Getting Started and Overcoming Barriers

Shumate, Matthews, and Group Health doctors offer these exercise tips.
Squeeze in brief walks throughout the day. Even short spurts of exercise, such as 10 minutes of walking spaced throughout the day, offer benefits.
Schedule it. Write exercise time in your daily calendar.
Make it part of your routine. Then it isn't a "should I, or shouldn't I" decision. You just do it.
Take small steps. If you don't exercise, begin by walking for short periods. Add a few minutes every week to the length of your walks.
Mix it up. For example, if you usually run on a treadmill, run outside occasionally or with a group. Or do some strength training exercises one day, and aerobic activity the next.
Find a fitness buddy. Knowing someone else is depending on you is good motivation.
Get up earlier. If your days are packed and the evening hours hectic, get up 30 minutes earlier a few times a week to exercise.
Park further away. Park in the back row of the parking lot or even a few blocks away and walk to your destination.
Revamp your rituals. Instead of the weekly Saturday matinee with the kids or your best friend, go for a bike ride, take a yoga class, or swim at the local pool.
Make exercise fun. Think of activities that give you joy — maybe it's something like roller skating, or dancing. Catch up with a friend while walking.
Walk the dog. He needs exercise too, and he'll never, ever be too tired.

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