CHAPTER 1

Defining Exercise

The medical literature is full of studies showing the benefits of working out.But rarely are we told how to do it right. And the media doesn't help—withimages of fast-paced aerobic dance classes, marathoners sprinting to the finishand collapsing, and of course all those pictures that portray "the agony ofdefeat."

Proper exercise has two primary components. One is that it's done in a balancedway; in particular this means that it should comprise a balance between aerobicand anaerobic exercise and the right training equation. This is the educatedapproach. When this path is taken, you can obtain the full benefits of exercise,including increased fat burning and energy and many others discussed in thisbook. The other primary component is fun. This is a very simple andstraightforward concept. Working out is fun when it is properly done. Throughoutthis book I discuss a variety of components of a fitness program that can reduceor eliminate the fun of exercise when they are not done right. This appliesespecially to balance.

In a sense, this is a book on the educational aspects of exercise. It shouldalso inspire you, clear up the many myths you encounter, and help you modify,fine-tune, or start a program based on your needs. Unfortunately, most peopleget caught up in a guessing game when it comes to working out. If you're goingto guess, you're most likely going to get in trouble, in which case you mightactually be better off as a couch potato. In short, don't just do it, do itright.

Before taking the first step, or improving your current program, you shouldunderstand some very important exercise concepts. Not only will they help youunderstand exercise better but they can help you avoid the common regressionperiods that most exercisers encounter. In addition, if you can define thevarious components of exercise, you'll be able to ignore the commercials for abmachines, the lure of overtraining, and the "no pain, no gain" myth, whetherfrom trainers, exercise partners, or family members. In short, once youunderstand the big picture, you'll accomplish your goals and have fun doing it.

A main focus of this book is balance. Therefore, concepts are often paired. Likethe Chinese concept of opposites—yin and yang—these paired conceptshelp set the stage for a more complete understanding. If we don't have balance,we create imbalance, which can lead to various physical, chemical, and mentalsigns and symptoms called injuries.

There's no better teaching tool than experience. We all have experiences, andideally we learn from them. One of my more profound experiences was getting backinto shape after a long period of stress and illness. I was nearing the end ofmy school years and ready to enter private practice. But physical illness due tostress had sidelined me. I was not just inactive and run down: on severaloccasions I had to be hospitalized.

As part of the recovery process I decided to begin walking. At first, even whenI ascended a short flight of stairs I had to stop halfway to rest. A 10-minutewalk was my limit. But soon I was walking 20, 25, and then 30 minutes. As Istarted to feel better, my walk became a bit more brisk, and a year later I waswalking 45 minutes to an hour five days a week.

One day, following my walk, I watched the Boston Marathon on TV. "These peopleare really healthy, if they can run 26 miles," I thought. After more than twoyears of walking, I wondered how healthy I really was, and I thought thatperhaps I should "test" myself. I thought the New York City Marathon, at the endof the year, would be a good test of my health. I was a great runner in highschool and in college, and it would be good to run again. So I began walkingfaster, gradually working some jogging into my workouts, and eventually I beganto run longer. All this training led to my marathon test.

The cannon that announced the start of the marathon was so loud that it shookthe Verrazano Bridge. The crowd of 18,000 runners began to move. All went wellthrough the first 10 miles. Though the excitement made me run a bit quicker thanI had planned, I felt great. By 15 miles I felt as I had expected: tired butable to continue. Within the next couple of miles, however, I began to shiver.Even though I had been drinking plenty of water, I was dehydrated. And I wascraving cotton candy. How odd that seemed.

After about 18 miles I no longer could feel my feet. I stopped to have a look:they were numb but still there. That was when I began talking to myself. "Myhamstrings are cramping," I said out loud. At the same time, I realized that Iwasn't thinking rationally. All I could remember was my goal: to finish therace, proving that I was healthy.

Apparently I looked worse than I felt, for two officials tried to take me offthe course, but I wouldn't stop. Somehow I fought my way through the next fewmiles. I knew the end was near because I was in Central Park—a discovery Imade when I ran into a TV camera in the middle of the road. As the pain becamemore intense, the crowds got louder, and for the first time in quite a while Ihad a clear view. I could see the finish line. I have very little memory ofthose last few miles, but I'll always remember the finale.

Someone hung a medal around my neck, my reward for finishing, and what littlefluid was in me came out as tears. I recall thinking that I had passed the test:I had proved that I was healthy. But something wasn't right.

The next thing I knew, I was in the first-aid tent near the finish line. Lyingon the dozens of cots in the tent were finishers who were clearly in pain andwho were being treated by doctors, nurses, and EMTs. But proud finishers theywere. Looking around I asked myself, "Are these people really healthy" I knewthen that I hadn't really proved my health. But I had learned an importantlesson, one that would benefit not only me but also those I would work with fordecades to come: I had made myself fit enough to run 26.2 miles, but thisfitness was different from health. From that point on, I thought about my newgoal. I would improve my health and balance it with fitness.

Health and Fitness

Two words tossed around as casually as a pair of running shoes are health andfitness. But the difference between them forms the foundation of an exercisephilosophy and a workout ethic.

Health is a state in which all the body's parts, including the muscles, nerves,bones, hormones, organs, and glands, are in balance, or what some call"harmony." A perfect state of health may not be attainable, but always improvingour health is something we can all strive for.

Unfortunately, many people assume that health necessarily declines with age.While it is common for health to decline with age, the decline need not besignificant. The more we care for our body, the healthier it will become and thelonger we will be able to withstand the adverse effects of aging. We have thepotential to increase our brain power as we age, get into great physical shape,perhaps the best shape of our lives, and to feel better than ever. This is oneof the benefits of proper exercise.

Fitness is the ability to be physically active. For some, this means workingout; for others, it means playing tennis again after years of disability; andfor some it means being a Master's athlete. If you work out four times a week,you're probably more fit than the person who doesn't exercise. If you win yourclub's tennis tournament, you're the fittest tennis player there.

But your fitness does not necessarily reflect your health. And being healthywon't necessarily make you a fit athlete. Health and fitness are two differentthings. What's important is to balance the two, to become both as healthy and asfit as possible considering your potential, schedule, and desires.

A common imbalance in industrialized societies exists in the person who is fitbut unhealthy. The majority of athletes—the thousands I've seen inpractice—fit this description. They strive to get into better and bettershape through training, but often at the expense of their health. Take, forexample, the injuries. With few exceptions, an injury is due to a decline in thehealth of the person who's injured. (Exceptions include major trauma, such asfrom a fall from a bike or a collision with another player.)

Most injuries arise from a long-standing imbalance in a person's health, such asa muscular imbalance (which can cause an injury to the bone, joint, or muscle),a nutritional problem (e.g., a calcium deficiency, which can in turn result inweak bones, which can lead to a stress fracture), or a nervous-system stresscaused by improper exercise shoes (resulting in a knee problem).

Some individuals are willing to sacrifice their health in order to achieve morefitness, such as by taking performance-enhancing drugs. But more common arethose who want to lose weight or get into shape in an unreasonably short time.These people may exercise excessively, causing an injury. This scenario iscommon in January, after many people abuse themselves over the holidays, andagain in the spring, when they want to be sure they will be able to fit intotheir summer clothes. Others suddenly decide to get into shape fast. This oftenoccurs after seeing an infomercial for some new exercise gadget or reading abouta special rate at the local gym or in anticipation of an upcoming fortiethbirthday. Attempting to make up for lost time is another way to develop animbalance between health and fitness.

Health A state in which all the body's parts, including the muscles, nerves,bones, hormones, organs, and glands, are in balance.

Fitness The ability to be physically active.

Aerobic and Anaerobic

Both aerobic and anaerobic refer to specific systems in the body, much like themany other systems you may be more familiar with, such as the digestive,skeletal, and muscular systems.

Ask most exercisers what the word aerobic means, and you'll hear words likebreathing and oxygen. These definitions came out of academic circles, especiallyin relation to microbes (some need oxygen to survive, others are destroyed byoxygen). There are also complex processes in the body that can be labeledaerobic and anaerobic. But humans are not microbes, and our whole body requiresoxygen to live, so I choose not to use the definition of aerobic associated withoxygen or breathing.

A more important and practical distinction of aerobic function is that it isrelated to the use of body fat for energy. All muscles need energy towork—to carry us through the day and especially through a workout.Although aerobic muscles also burn sugar (glucose) for energy, these muscles canalso burn significant amounts of body fat for energy.

Not only can the aerobic muscles burn fat but they are well endowed with bloodvessels and have many other benefits (see chapter 4). Aerobic muscle fibers aresometimes referred to as "red" because of the numerous blood vessels theycontain and because of the presence of myoglobin, a pigment containing iron.Throughout this book I often refer to the more efficient fat-burning mechanismand other important benefits of proper aerobic exercise.

Unfortunately, if your body's aerobic system is not well developed, you won't beable to burn much fat. Not only will you store this substance (on your hips,thighs, and maybe even in your blood vessels) but you'll have to rely on theanaerobic system to provide you with energy.

The fat-burning capability of the aerobic system truly sets it apart from thebody's anaerobic function, which is associated with sugar burning. Anaerobicmuscle fibers don't burn fat. They get their energy from glycogen, a form ofsugar stored in muscles and the liver, and from blood sugar. These reserves arerelatively scarce compared with fat stores (even in lean individuals), supplyingenergy only for a short period of time. If we relied only on these sources ofenergy, we'd have only a few minutes worth of energy and then we'd be exhausted.This is the system used in sprinting, whether on the track or when running forthe bus. More important, it's also the system that is stimulated when you'reunder stress. And worse, too much anaerobic stimulation, from exercise orstress, can impair aerobic function. (The important relationship betweenexercise and stress is discussed in chapter 2.)

It's important to note that measuring the body's capacity to burn fat isrelatively easy (although not always convenient). You can determine the amountof fat and sugar your body uses with a gas analyzer, which measures the carbondioxide you breathe out and the oxygen you take in. For example, while riding astationary bike, walking or running on a treadmill, or even at rest, you breatheinto a tube, where your carbon dioxide and oxygen are collected. The amount ofcarbon dioxide and oxygen collected can be used to determine the amount andpercentage of fat and sugar burned at specific levels of intensity, measured byheart rate. For example, during easy exercise your body may obtain 90 percent ofits energy from sugar and only 10 percent from fat. This might indicate thatyour aerobic system is not functioning as efficiently as it might. Properexercise over a three-month period could result in improvements to your aerobicsystem; for example, your body might get 50 percent of its energy from sugar and50 percent from fat. With more aerobic improvements, you might burn even morefat for energy during exercise, which also means you'll burn more fat even whenyou're sleeping!

Aerobic The ability to obtain more energy through increased fat burning.

Anaerobic The increased use of sugar for energy, and diminished fat burning.

Activity and Exercise

Many people place exercise in a neat little box; they treat it as a separateroutine to be set aside for certain days. But exercise can be defined aspurposeful activity, usually done separate and apart from the normal dailychores. In a real sense, it provides us with physical movement no longerprovided for in the course of a normal day. You could say that exercise is anartificial way to induce activity.

Consider that the human body has evolved with very high levels of naturalphysical activity as a primary function. Physical activity has helped us toprotect ourselves, to secure food, and to shelter ourselves for millions ofyears. Unfortunately, only in the past few decades have humans dramaticallyreduced their natural level of physical activity. Enter exercise.

Exercise becomes the separate habit most of us need to employ just to maintain alevel of physical activity closer to normal. In a sense, exercise is artificialactivity. Better to do that than risk falling into a "deficiency" of exercise,resulting in the aerobic deficiency syndrome (see chapter 9).

As our population ages, fewer of us remember the high levels of natural activityperformed by our parents or grandparents. A typical day was a very active one,beginning with morning chores, including making breakfast, bringing in wood forthe fire, feeding the animals, or other activities. Some of us still performthese tasks today, but most of us take the elevator to the first floor at work,spend extra time finding a parking place close to the front door of the store,and use the microwave or the food processor to whip up some fast food or gettakeouts. Through exercise we can make up for the potential deficiencies createdby living in a modern industrialized society.

In addition to finding time for a short period of artificial activity, whetherit's a walk, an aerobics class, or time in front of the TV on a stationary bike,we can make a few changes in our daily life that will bring back some of ourlost natural activity. Here are some ideas:

* When going shopping, park farther from, instead of closer to, the store. Thiswill give your body some more walking to and from the store. It may also keepthose annoying dents off your car.

* If you're going up or down a flight or two in your office building, apartment,or hotel, take the stairs. For most people, even walking three or four flightsdown is not taxing.

* If you take the subway to work, get off a station before or after your normalstop and walk a few extra blocks. It can serve as a time for meditation beforework and mental recovery after.

* At lunchtime, take the long way to the cafeteria. The extra distance canprovide a time to relax, which can be good for digestion. A slow stroll back towork would be great too.

* When waiting for the bus, airplane, train, or people you're meeting, don't juststand there: walk back and forth. So what if others think you're pacing. Theymay eventually follow suit.