By Dr. Swapnali Halder, Ph.D

Regular exercises along with right nutrition keep our body healthy, energetic and help attain or maintain a healthy body weight. In the modern society where most people have a sedentary lifestyle with less physical activities, exercise is vital to stay fit and prevent many serious diseases.

In addition to conventional outdoor sport activities liking running, biking, and swimming, many new exercise or fitness programs have been developed over decades. However it should be understood that every exercise may not the best fit for everybody. Without proper knowledge, it may be hard to choose from the evergrowing and often overwhelming lists of exercise programs that are offered in the market. Also adopting a wrong exercise program would not serve one’s purpose. Though commercial exercise programs come with their own fitness trainers or coaches to guide people, it is always best to first educate ourselves first so that we can contribute better in our own exercise regimen decisions.

Following is a brief discussion on the common exercise programs/regimens, the purposes they claim to fulfill, and the benefits of different exercise programs as reported by scientific studies.

Resistance training:

Resistance training is any exercise that causes the muscles to contract against an external resistance. This type of training is designed to improve muscle fitness such as increase in muscle strength, tone and mass. For the same reason it helps maintain and fight loss of muscle mass. Resistance training involves short lasting high-intensity physical activity and is also termed as anaerobic exercise since body’s oxygen demand exceeds its supply. Resistant training can be performed by weight lifting such as with dumbbell/barbell, bench press, elastic tubing, cable curls, push ups, pull-ups etc.

In addition to muscle building, resistant training has clinical benefits as well. 20 weeks of resistant training enhanced response to growth hormones in young men resulting in larger lean muscle mass, as reported in a clinical study. Findings from another similar study on effects of resistance training on growth hormone release supports this result for young women subjects. Weights placed on bones through weight bearing exercises help slow down deterioration of bones and may prevent osteoporosis in post-menopausal women4. Resistance training improves glucose tolerance in elderly people5, both men and women.

In another clinical study on one hundred female breast cancer patients, the patients practicing resistant training twice a week for 12 weeks exhibited reduced physical fatigue and improved quality of life during chemotherapy compared to the patients not performing this exercise6.

Cardio or aerobics or endurance training:

A cardio exercise involves a large muscle movement for sustained period of time, leads to increased heart rate during this exercise and boosts metabolism. It builds endurance, a physical characteristic that helps one to stay physically active for longer duration without feeling exhausted. Common examples of endurance training include outdoor activities like walking, running, swimming, biking, rowing, or indoor exercises like stair climbing, skipping, power punch, lunge jump, box jump, squat jump etc. It can also be performed using machines like treadmill or elliptical.

Apart from helping healthy human beings maintain their general fitness, aerobic exercise may also assist in medical treatment of type-2 diabetes as a supplementary therapy. Warm up by stretching and walking exercises followed by 30 min walking with maximum intensity, 3 times a week for 8 weeks significantly improved BMI, plasma insulin, insulin resistance in twenty-seven female diabetic patients compared to twenty-six control subjects, as reported by a recent clinical trial7.

Cardio dance workout such as zumba, inspired by a latin American dance style, has gained quiet a bit of popularity in the fitness regimes of modern women. It is scientifically proven that zumba8 dance helps in weight loss and improve BMI in overweight women, improves cardiovascular health, and assist upgrade health related quality of life both in overweight as well as in healthy women.

Endurance, strength and balance exercises—all three are needed to be included in the exercise programs for postmenopausal women. However, to reduce chances of falling, women with osteoporosis should not take high-intensity aerobics.

Balance exercises:

With aging, our body balance becomes weaker resulting in frequent falling and fall-related injuries. National Institutes of Health suggested 5 exercises that are aimed at improving body balance and lower body strength. They include standing on one foot, walking heel to toe, balance walk, back leg raises, side leg raises10. These exercises can be practiced anytime with only one caution that there should be something sturdy to hold on to in case the person becomes unsteady.

T’ai chi is also a common form of balance exercise. The training involves a slow sequence of movements that emphasize a straight spine, relaxed breathing, and a natural range of motion, followed by the different styles of pushing hands for training sensitivity in the reflexes, in concert with a training partner, in order to learn coordination, and positioning.

Yoga:

Ancient oriental cultures have cultivated practice of yoga for thousand of years, for physical and psychological welling. Clinicians and researchers of the modern world have come across with mounting evidence that advocates benefits of yoga in fitness and wellbeing. A recent clinical study on 44 females (age of 18-24 years) has shown that yoga therapy potentially improve the symptoms of presyncope and syncope (i.e., loss of consciousness and muscle strength for a short time) in young female patients with Neurocardiogenic syncope (NCS)11. Despite low energy expenditure compared to many other exercise regimens, regular yoga practices lead to maximum performance and oxygen consumption and score high in some cardiorespiratory fitness parameters12. Yoga exercise for 1 year has been reported to improve the cardiovascular risk factors such as central obesity and blood pressure in patients with metabolic syndrome13.

Another study on seventy-five subjects in their 40s or 50s, with rheumatoid arthritis (RA) or knee osteoarthritis, revealed that 8 weeks of yoga (two 60-min classes and 1 home practice/wk) practice may help increase physical activity, improve physical and psychological health, and health related quality of life (HRQOL)14 in arthritis patients.

Yoga combined with meditation is an effective complementary measure for managing menopausal symptoms in breast cancer survivors15. Yoga can also serve as a supplementary intervention to memory training in older individuals suffering from dementia16.

There are various yoga styles like hatha yoga, bikram yoga, vinyasa yoga, which are modified versions of basic yoga poses, leading to different experiences. Hatha yoga is an old school system that includes the practice of yoga postures (called asanas) and breathing exercises (called pranayama). Bikram yoga involves twenty-six postures and two breathing techniques for ninety minutes, in a room with 105°F (40.6°C) temperature, and 40% humidity. Principle of vinyasa yoga involves synchronizing breathing with a series of movements or poses. Power yoga is basically a more vigorous performance of vinyasa yoga.

Meditation exercises for physical and mental health:

Stress has become an integrative part of modern society. Excessive stress affects both body and mind, and often acts as a silent killer. Chronic stress may be underlying cause of many diseases including depression, cardiovascular diseases, stroke, etc. Depression leads to overeating, carb craving, and weight gain in many instances. Benefits of mindfulness meditation for mental relaxation and overall physical and mental health are immense. Meditation often goes hand in hand with yoga exercises. It is scientifically proven that meditation is effective for stress release. More people are adopting meditation training day by day for stress management.

Mindfulness Based Stress Reduction (MBSR) program is a program that was created by Dr. Jon Kabat-Jinn at the University of Massachusetts Medical Center in 1979. This program offers an 8-week training, which puts together yoga and mindfulness meditation. Duke integrative medicine department also developed a similar MBSR program, which offers 9 weekly 2.5 hours sessions, total 10 sessions. Clinical studies have reported beneficial impact of MBSR or other mindfulness based cognitive therapy or meditation to improve posttraumatic stress disorder (PTSD)17, depression 18,19, and sleep disturbance20.

Commercial exercise programs:

Some popular commercial exercise programs for physical fitness are as follows.

Cross-fit exercises-– this is high intensity workout program that requires full-body routine. Earlier it was formally used to train soldiers, policemen, martial artists and professional athletes, and includes extensive cardio, gymnastics and weight lifting, which suggests that it may not be suitable for everybody.

Insanity workout– It is a 60 days workout program, 45 minutes a day, guided by a DVD that costs about $120. It incorporates rigorous full body exercise routine including push-ups, squat, lunges, kickboxing etc. This program involves high intensity bursts that can last from a few seconds to more than a minute, followed by short rest times or lower intensity exercises. However, it may be hard to catch your breath in this short period of time interval. This is cardio-based routine that burns fat faster than any other “conventional cardio workout”, however gives minimum focus on muscle growth.

P90X— P90X is a 55 min per day, 90-day home fitness system that guides the trainee by DVD that costs about $140 and provides a three-phase nutritional plan along with the exercise instructions. P90X program focuses on the principle of muscle confusion and involves switching of workouts consistently so that muscles are “shocked” and grow. The program includes 12 intense workouts that use resistance and body-weight training, cardio, plyometrics, ab work, martial arts and yoga. This program is not for beginners, rather mostly for established bodybuilder or athletes or people who are already acquainted with high-intensity training.

Soulcycle– It is a stationary bike workout program for 45 minutes a day to burn calories. It is also combined with music soundtrack and choreography, mini push-ups and chrunches. Cost of regular classes is $34 per class.

Squat challenge: This program plan instructs to squats, starting from 50 squats up to 250 squats a day for a month, in order to get leaner legs.

Plank exercise: It is a repeating exercise of getting up into a push up position and stand still which is claimed to improve core muscles, waistline and postures, if practiced regularly. This program does not require any equipment.

Conclusion:

Just like most of the exercise programs are designed to meet different needs, similarly, their suitability may also vary according to age groups (for example, how many times to repeat or how long to do an exercise), physical condition or certain medical conditions. If a person has chronic health problem such as cardiovascular disease, arthritis, osteoporosis, suffering from stiffer muscle, or did not exercise for long time, one must consult his or her healthcare provider to determine risks and benefits before taking up an exercise program. Same suggestion applies for a pregnant woman who is seeking a suitable fitness program. In conclusion, with mindful selection of exercise programs and regular practice of those exercises in appropriate methods, it is possible for everyone to achieve and maintain physical and mental fitness.

References:

1. American College of Sports Medicine. Resistant training for health and fitness. https://www.acsm.org/docs/brochures/resistance-training.pdf. Accessed August 6, 2015.

2. Walker S, Santolamazza F, Kraemer W, Häkkinen K. Effects of prolonged hypertrophic resistance training on acute endocrine responses in young and older men.

J Aging Phys Act. 2015;23(2):230-6. doi: 10.1123/japa.2013-0029.

3. Gordon SE, Kraemer WJ, Looney DP, Flanagan SD, Comstock BA, Hymer WC. The influence of age and exercise modality on growth hormone bioactivity in women. Growth Horm IGF Res. 2014;24(2-3):95-103. doi: 10.1016/j.ghir.2014.03.005.

4.Watson SL, Weeks BK, Weis LJ, Horan SA, Beck BR. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporos Int. 2015. [Epub ahead of print]

5. Frank P, Andersson E, Pontén M, Ekblom B, Ekblom M, Sahlin K. Strength training improves muscle aerobic capacity and glucose tolerance in elderly. Scand J Med Sci Sports. 2015. doi: 10.1111/sms.12537. [Epub ahead of print]

6. Schmidt, ME, Wiskemann J, Armbrust P, et al. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. International Journal of Cancer. 2015; 137(2): 471-480. doi: 10.1002/ijc.29383

7. Motahari-Tabari N, Ahmad Shirvani M, Shirzad-E-Ahoodashty M, Yousefi-Abdolmaleki E, Teimourzadeh M. The effect of 8 weeks aerobic exercise on insulin resistance in type 2 diabetes: a randomized clinical trial. Glob J Health Sci. 2014;7(1):115-21. doi: 10.5539/gjhs.v7n1p115.

8. Cugusi L, Wilson B, Serpe R, Medda A, Deidda M, Gabba S, Satta G, Chiappori P, Mercuro G. Cardiovascular effects, body composition, quality of life and pain after a zumba® fitness program in italian overweight women.J Sports Med Phys Fitness. 2015. [Epub ahead of print]

9. Delextrat AA, Warner S, Graham S, Neupert E. An 8-week Exercise Intervention Based on Zumba® Improves Aerobic Fitness and Psychological Well-Being in Healthy Women. J Phys Act Health. 2015. [Epub ahead of print]

10. NIH Senior exercises. Built with you in mind. Balance exercises.

http://nihseniorhealth.gov/exerciseandphysicalactivityexercisestotry/balanceexercises/01.html. Accessed August 13, 2015

11. Gunda S., et al. Role of yoga as an adjunctive therapy in patients with neurocardiogenic syncope: a pilot study. Journal of Interventional Cardiac Electrophysiology (2015); 43(2): 105-110. doi: 10.1007/s10840-015-9996-1

12. Sovová E, Čajka V, Pastucha D, Malinčíková J, Radová L, Sovová M.

Positive effect of yoga on cardiorespiratory fitness: A pilot study. Int J Yoga. 2015;8(2):134-8. doi: 10.4103/0973-6131.158482.

13. Siu PM, Yu AP, Benzie IF, Woo J. Effects of 1-year yoga on cardiovascular risk factors in middle-aged and older adults with metabolic syndrome: a randomized trial. Diabetol Metab Syndr. 2015;7:40. doi: 10.1186/s13098-015-0034-3.

14. Moonaz SH, Bingham CO III, Wissow L, et al. Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial. Journal of Rheumatology. 2015; 42(7): 1194-1202. doi: 10.3899/jrheum.141129

15.Cramer H, Rabsilber S, Lauche R, et al. Yoga and meditation for menopausal symptoms in breast cancer survivors. A randomized controlled trial. Cancer. 2015;121(13): 2175-2184.

16.16. McDougall GJ Jr, Vance DE, Wayde E, et al. Memory Training Plus Yoga for Older Adults. Journal of Neuroscience Nursing. 2015;47(3): 178-188. doi:10.1097/JNN.0000000000000133

17. Polusny MA, Erbes CR, Thuras P, Moran A, Lamberty GJ, Collins RC, Rodman JL, Lim KO. Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial. JAMA. 2015;314(5):456-65. doi: 10.1001/jama.2015.8361.

18. Kumar S, Adiga KR, George A. Impact of Mindfulness-based Stress Reduction (MBSR) on Depression among Elderly Residing in Residential Homes. Nurs J India. 2014;105(6):248-51.

19.19. van Son J, Nyklíček I, Pop VJ, Blonk MC3, Erdtsieck RJ, Pouwer F.

Mindfulness-based cognitive therapy for people with diabetes and emotional problems: long-term follow-up findings from the DiaMind randomized controlled trial. J Psychosom Res. 2014;77(1):81-4. doi: 10.1016/j.jpsychores.2014.03.013.

20. Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015;175(4):494-501. doi: 10.1001/jamainternmed.2014.8081.