Eating Out & Entertaining

Enjoy delicious dining without sabotaging your diet.

By Kathleen Zelman, MPH, RD/LD

WebMD Weight Loss Clinic – Feature

Reviewed by Louise Chang, MD

Introduction

“Would you like that ‘supersized’?” is a common question at fast-food restaurants. The large portions we’re served when eating out at restaurants and take-out establishments can foil any healthy diet or weight loss program. The good news is that eating out healthfully has never been easier.

Whether you’re on the road, in an airport, or in your neighborhood, you’ll find that nearly all restaurants offer healthy choices for discriminating diners. When eating out, you can almost always find a nutritious salad, grilled chicken sandwich, or cup of soup that will satisfy your hunger without excess calories. (Just watch out for “all you can eat” buffets that tempt you into eating more than you should.)

At restaurants, “have it your way” — ask for the food to be prepared the way you like it. And be picky when scanning the offerings at parties, picnics, or barbeques. When eating with friends at a party or a picnic, your best bet is bring a healthy dish to share. That way, you can be sure there’s something nutritious for you to eat.

Experts offer the following tips to help you make the most nutritious and healthy choices when you’re eating out:

• Have sauces served on the side.
• Choose light salad dressings or vinaigrettes, served on the side.
• Go for foods that are baked, broiled, roasted, grilled — any preparation other than fried is the best choice.
• Select broth-based soups.
• Have tomato or vegetable toppings on pasta.
• Go easy on the cheese.
• Limit bread, chips, or whatever is in the basket while you await your meal.
• Order fresh fruit or fruit sorbet for dessert.
• Choose grilled chicken or lean meat sandwiches.
• Hold the french fries; substitute a side salad (easy on the dressing).
• Skip the casseroles unless you know what they contain.
• Choose simply prepared foods without lots of extra ingredients and calories.
• Enjoy as many simply prepared vegetables as you like.
• Keep portions small.
• Avoid mindless hand-to-mouth eating.
• Enjoy a salad and an appetizer in place of an entree, or take home half your meal for tomorrow’s lunch.

Published February 2006.

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©2006 WebMD Inc. All rights reserved.

Mind & Body Fitness

Use movement to explore the connection between body and mind.

By Shannon James

WebMD Weight Loss Clinic – Feature

Reviewed by Louise Chang, MD

Mind and body fitness? Many people who want to get into shape don’t realize there is more to fitness than well-toned muscles. There’s no shortage of exercise regimes that just promote the perfection of the body, or the idea of fitness as a part of a weight loss plan.

Centuries ago, Western culture lost its focus on the interconnectedness between the body and the mind or spirit, and how each has the power to affect the other. Cultivating a love of movement can help you get beyond the concept of physical fitness as separate from mental fitness – and toward a lifelong program of good health through mind and body fitness.

Whether you choose yoga or another form of movement for exercise, remember that our bodies are made to move to feel good. So when you incorporate regular activity in your life, you’re moving closer to overall mind and body fitness. But if you are overweight, this can be more difficult. You can improve your mind-body connection for better mind and body fitness – it’s just important to choose realistic fitness options.

You might consider redefining exercise as any activity that unites your mind and body and reduces your stress level. In fact, high levels of stress have been linked to weight gain, and certainly can lead to emotional eating. Finding activities that are both enjoyable and easy to do is important when developing any type of exercise plan.

It’s important to be realistic about what we expect from ourselves. Consider your goals. Is 30 to 60 minutes on a treadmill a reasonable time frame at this point in your life? Are you setting yourself up for failure or success when you create this expectation for yourself? Would it be more enjoyable to you to do some stretching and a shorter period of time on the treadmill?

Developing an exercise plan that fits your lifestyle and your desires is critical. Surprisingly, long-term weight loss is linked more closely to whether a person sticks to their fitness routine than to what that routine actually consists of. A routine that is gentle and pleasurable is more likely to lead to the long-term gains you are seeking.

All-or-nothing thinking about exercise leads us to first bite off more than we can chew and then give up all together. Just walk into a gym in the month of January and try to get on a Stairmaster. There’s a good chance you’ll have to wait in line. But by March or April, there are usually plenty of free machines.

It is also important to tailor your fitness goals to your preferences. Some people like the idea of getting out of the house in the evening and going to the gym. Others prefer staying home and doing a quieter exercise routine after the demands of a stressful day. Either approach, or a combination of the two, can result in improved mind and body fitness.

What is critical is for you to come to know yourself and to take yourself seriously. If you like to be home in the evenings, find things to do in your home or consider an occasional walk with friends or family. If you crave the company of others, head for the gym. Think about what would please you most, and follow your inner voice.

Many people who are preoccupied with food and body issues tend to pay too much attention to the needs of others, while paying too little attention to their own needs. While you may intend to benefit your children with their countless activities, the added stress can cause an imbalance within your family. Can you take a look at your schedule (or your family’s) and reschedule some time for yourself? What would it be like to say no?

Long-term weight loss can take time. And we can get demoralized when we don’t see immediate results. But remember that maintaining an exercise routine is associated with physical as well as mental well-being. Where has our focus on the numbers on our scale gotten us? Some would say it has taken us to more harsh thoughts, more bingeing and grazing on food, and, ironically, less fitness rather than more.

It may be that the best exercise you can do right now is to throw your scale into the garbage. Focus on how you’re feeling with your exercise routine. Is it something you enjoy and can maintain? Is it reducing your stress level and allowing a connection between your mind and body? If so, you’ll probably keep it up, and fitness of mind and body and spirit will be yours.

Don’t forget how important it is to see your physician before starting any type of exercise routine, and to following his or her recommendations. So try to be gentle with yourself and realistic about how to proceed.

There is tremendous confusion in our society about how to approach health and fitness. You may have tried losing weight before and failed. But consider the possibility that we as a society have not failed at dieting and weight loss. Rather, dieting has failed us as an effective tool for fitness.

Remember that fitness of mind and body belong together, and that exercise is very narrowly defined in our society. So redefine exercise as any activity that reduces stress and connects your mind and body. You’ll be more likely to continue your exercise plan and achieve the outcome you’re looking for.

Published February 2006.

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SOURCES: WebMD University course “Eating Well: A Start Towards Healthy Living” with Wendy Oliver-Pyatt, MD. WebMD University Course “Fitness Goals” with Wendy Oliver-Pyatt, MD. WebMD University Course “Your Fitness Options” with Wendy Oliver-Pyatt, MD. WebMD Feature “Yoga: Fitness From the Inside Out” by Lynda Liu and William Collinge.

©2006 WebMD Inc. All rights reserved.

Explore your fitness options and nurture a love of movement.

By Wendy Oliver-Pyatt, MD

WebMD Weight Loss Clinic – Feature

Reviewed by Louise Chang, MD

Fitness isn’t just a plan you embark on, along with a diet, to lose weight. It’s a lifelong love of movement that will help you maintain good health and the physique you want. We’ve compiled some workout routines and ideas to help you along your way.

These recommendations will help you evolve your workout routine and activity plan. The theme is picking something you love doing, and nurturing your feelings every step of the way.

After you read through these workout options, consider journaling to explore your fitness habits, desires, and goals.

Level One: Workout Ideas and Recommendations

Begin by expanding your definition of exercise: You don’t need to run, sweat, or grunt — any opportunity to partake in activity counts as exercise!

If you feel uncomfortable going to a gym, a 10-minute walk, twice weekly, is an excellent first step toward better fitness. If you enjoy and can afford it, get a regular massage as well. Consider buying a good beginner’s exercise tape, too. (A tip: rent exercise videos from your local library and try them out to see which you enjoy.) Another great activity is gardening, an underrated form of stress reduction and exercise.

Get in touch with your physicality by using a Jacuzzi or sauna after a cool shower, or just by taking a bubble bath. Afterward, try some gentle stretching, perhaps followed by another cool-down shower and Jacuzzi. A facial is another good way to reconnect your physical and mental being.

If you feel daring, consider karate, a dance class, or bowling. Enjoy the activities you pick, but don’t make yourself continue with them any longer than you want to; for instance, don’t force yourself to bowl three games if you feel like bowling only one. Remember that your goal is to make yourself healthier and fitter by nurturing yourself and reducing stress.

Level Two: Workout Ideas and Recommendations

Think about bowling, softball, or any other type of entry-level team activity. Many people who aren’t natural-born athletes love team sports because of the combination of exercise and social interaction. (Mall-walking groups offer the same benefit if you’re looking for something less strenuous.)

If group activities aren’t for you, start a walking routine, two or three times a week, for 15 to 20 minutes. If you feel like it, jog for a few minutes during each walk. Do a few jumping jacks, sit-ups, or push-ups — along with stretches — in the morning before work. Jump rope with your kids or buy yourself a Hula Hoop. Take an in-line skating class, or start going out dancing occasionally with friends.

Dance, tai chi, and yoga classes are enjoyable, low-stress fitness activities. Also, consider buying several exercise tapes and try out fun activities including biking, swimming, horseback riding, or even a regular game of Frisbee with your dog.

Focus, above all, on giving yourself permission to enjoy your physicality. If you can, start getting regular massages. If you belong to a gym, don’t feel you must do a strenuous workout every time you’re there. Try going occasionally just for the enjoyment of stretching for several minutes and then taking a Jacuzzi, steam, or sauna bath. You’ll learn to reconnect with your physicality and rediscover your body as a source of pleasure.

Level Three: Workout Ideas and Recommendations

By choosing the right exercise program, you can make your natural athleticism work for you. Avoid heavy-duty exercise programs that trim off inches for a little while but may not work in the long run because they can cause burnout.

For long-term results, find activities that you enjoy, instead of merely choosing those that burn calories. You probably already know some of the activities you do and don’t like, so select those you prefer and drop the ones that bore or stress you.

For instance, are you starting to dread your usual five-mile run? If so, give yourself permission to take a leisurely bike ride or swim. Too tired for a 30-minute workout? Exercise for 15 minutes, and see if you feel like continuing. And if you find yourself setting harder and harder goals (“I need to run an eight-minute mile”), reconsider your priorities. Remember that getting regular, moderate exercise is smarter and more effective than forcing yourself to do grueling workouts that can lead to injury or burnout.

You might enjoy the challenge of participating in a run or bike race for charity — a great way to get exercise while meeting new people and helping your community. You might even want to train for a half-marathon, if running is your favorite activity. Just be sure to make fun and stress reduction — not calorie-burning — your top priorities!

Level Four: Workout Ideas and Recommendations

Keep up the good work! Your goal is to establish a healthy, pleasant exercise routine, intermingling challenging activities with peaceful and relaxing mind/body experiences. If you find yourself getting bored, vary your exercise routine with creative new activities. For instance, if you’re tired of jogging every morning, try taking up kickboxing, spin cycling, in-line skating, even a jazz dance class. Spicing up your exercise routine will motivate you to stick with it.

No matter what level of activity is right for you, concentrate on nurturing yourself through exercise. When you do, you’ll feel good — and when you feel good, you’ll stick with your fitness plan.

Some days, that plan might lead you to be the first person at the gym or to sign up for a challenging fitness run. Other days, you’ll be found at the spa, getting a massage or stretching for a few minutes before you take a leisurely walk. It may seem hard to believe, but all of these activities are active ways of achieving true and lasting fitness.

So forget “no pain, no gain,” and focus on the joy of swimming, walking, skating, belly dancing, or even Jacuzzi-ing your way to better health and a trimmer body. Expand your definition of exercise to include any activities that help you relieve stress and “connect” your mind and body — and make a commitment, based on self-love and self-affirmation, to make exercise a priority in your life. When you do, you’ll see your excess pounds and inches come off more quickly and effortlessly.

Most of all, remember that combining a variety of workout routines and ideas can help keep your exercise program interesting so that you’ll be more likely to stay on the road to lifelong better health and fitness.

For additional information on starting an exercise program and choosing a workout routine read Fitness 101: The Absolute Beginner’s Guide to Exercise and What’s Your Workout Personality?.

Published February 2006.

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SOURCES: WebMD University Course “Your Fitness Options” with Wendy Oliver-Pyatt, MD. Portions of this page copyright 2003 by The McGraw-Hill Companies, Inc. All rights reserved.

©2006 WebMD Inc. All rights reserved.

The most common nutrition mistakes — and how to avoid them.

By Colette Bouchez

WebMD Weight Loss Clinic – Feature

Reviewed By Kathleen Zelman, MPH, RD/LD

You read all the books; buy all the right vitamins; you know the buzzwords to look for on food labels. By all standards, you’re certain your nutrition report card should be filled with straight A’s.

But before you start pasting gold stars onto your refrigerator door, take heed: Nutrition experts say most of us think we are eating a lot better than we actually are.

“It’s easy to buy into some pretty popular nutrition misconceptions — myths and half-truths that ultimately find us making far fewer healthier food choices than we realize,” says New York University nutritionist Samantha Heller, MS, RD.

To set the record straight, Heller and two colleagues from the American Dietetic Association gave us the dish on seven nutrition mistakes you probably don’t know you’re making — along with sure-fire ways to avoid them.

Mistake No. 1: Assuming your choices are better than they actually are.

From fruit juices to canned vegetable soup, breakfast muffins to seven-grain bread, it’s easier to think your food choices are healthier than they really are, experts tell WebMD.

“If a label says ‘Seven-Grain Bread,’ it sounds pretty healthy, right? But unless that label also says ‘whole grains’ it’s not necessarily going to be the healthiest bread choice you could make,” Heller says.

Likewise, she says many folks think that eating a can of vegetable soup is as nutritious as downing a plateful of veggies — not realizing how few vegetables are inside, and how much of the nutrients are lost in processing.

Another common mistake: Substituting fruit juices for whole fruits.

“Are fruit juices healthier than soda? Yes. But they are also concentrated sources of sugar that don’t give you anywhere near the same level of nutrients you get from whole fruits,” says Bonnie Taub-Dix, MA, RD. What’s more, says Taub-Dix, if you’re trying to lose weight, you won’t get the same sense of fullness from a glass of juice that you will from a piece of fruit.

“Instead, you’ll just take in a whole lot of calories — and still feel hungry,” Taub-Dix says.

The solution: Whenever possible, eat whole, fresh, and unprocessed foods. Even when you eat them in smaller amounts, you’re likely to get a well-rounded group of nutrients. When buying packaged foods, put in at least as much time into reading labels and selecting products as you do when choosing a shower gel or shampoo.

“Don’t just assume a product is healthy — even if it’s in the health food section of the supermarket,” says Heller. “You’ve got to read the labels.”

Mistake No. 2: Being confused about carbs.

A national fascination with low-carb diets has many Americans eliminating carbohydrates from their eating plans in record “grams.” But before you reconstruct your personal nutrition pyramid, there’s something you should know.

“There are carbs that are very, very good, and some that are less good, but your brain and body must have some carbohydrates every day,” says Heller.

Moreover, because complex carbohydrates (those rich in whole grains and fiber) keep you feeling full longer, they also help you to eat less — and lose more!

But eliminating this important food group isn’t our only carb-related mistake. According to dietician Rachel Brandeis, MS, RD, just as troublesome is the belief that all no-carb or low-carb foods are healthy, or that you can eat them in any amount.

“Much like the low-fat diet craze, where everyone thought that if a meal had no fat, it had no calories, similarly people have come to believe that if it has low carbs you can eat as much as you want and not gain weight,” says Brandeis. “And that is simply not true.” Eat enough of anything, she says, and you’ll gain weight.

The solution: Experts say you should never cut any food group out of your diet — including carbohydrates. Equally important, says Heller, is to learn which carbohydrates give you the biggest bang for your nutritional buck.

“It’s a lot harder to run amuck when you are including carbohydrates like fresh fruits and vegetables and whole grains in your diet,” says Heller.

Mistake No. 3: Eating too much.

Whether you’re filling your plate with low-fat, low-carb, or even healthy, nutritionally balanced foods, overestimating how much food your body needs is among the most common mistakes, experts say.

“Many people believe they should feel not just satisfied after a meal, but stuffed,” says Heller. “I think many of us have lost touch with the sensation of having had enough food.”

Adds Taub-Dix: “People also tend to believe that they can eat larger portions if all the food on their plate meets the guidelines of their current diet — such as low-carb or low-fat — and that, of course, is also not true.”

The solution: Remain conscious of portion sizes. Weigh and measure standard portions, at least at first, so you’ll know what the amounts should look like. And, says Brandeis, “never use restaurant portions as your guide — they super-size everything.”

Mistake No. 4: Not eating enough — or often enough.

While overeating and undereating may seem like contradictory nutrition mistakes, they are related.

“If you don’t eat at regular intervals throughout the day, you risk disrupting your blood sugar and insulin levels, which in the end can promote fat storage and lower your metabolism — both of which lead to weight gain,” Brandeis says.

The solution: Eat something every four hours and never let yourself “starve” from one meal to the next, Brandeis says.

Mistake No. 5: Taking too many supplements.

“People tend to forget that a vitamin pill is a supplement — it’s meant to complement your diet, not act as a stand-in for the foods you don’t eat,” says Heller. What’s more, she says, taking too many vitamins can end up sabotaging your good health.

“Every vitamin and mineral and phytochemical in our body works in concert with one another, and it’s easy to knock that balance off if you are taking concentrated doses of single nutrients, or even groups of nutrients,” says Heller.

Bradeis cautions that any diet plan that claims you must take a high-potency supplement to meet your nutritional needs should send up a red flag.

“It means that eating plan is not healthy,” says Brandeis, “and it also means you are going to miss out on the synergistic health effects that can only come from whole foods — including not only helping you to feel fuller longer, but also preventing cellular breakdowns important to preventing disease.”

The solution: Both experts recommend taking no more than one all-purpose multivitamin daily. Don’t supplement your diet with individual nutrients without the guidance of your doctor, nutritionist, or other health expert. Keep in mind that the sales clerk in the health food store is usually not a health expert.

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Mistake No. 6: Excluding exercise.

While most folks believe nutrition is all about food, Brandeis says it’s also about how your body uses food — and that’s where regular exercise comes in.

“Without adequate exercise, you cannot maintain a high enough metabolic rate to burn your food efficiently,” says Brandeis. “A pill can’t do that for you; foods alone can’t do that for you. Exercise is the only way to achieve it.”

The solution: Make exercise a regular part of your life. And don’t get hung up if you can’t do it at the same time every day. If you miss your routine in the morning, don’t wait until the next day and try to do twice as much. Instead, try to fit in some exercise — even if it’s just a little bit — every day, says Taub-Dix.

Mistake No. 7: Believing everything you read about nutrition and weight loss.

“Just because someone writes a diet book or a nutrition guide does not mean they are an expert,” cautions Brandeis.

If you’re turning to a book for guidance, she says, “look to the author’s credentials and ask yourself: Is this person a dietician; do they have an advanced degree in nutrition? Or are you buying this book because it’s written by a celebrity who you think looks good?”

Even if an “expert” is behind your nutrition or diet plan, Brandeis says, it’s important to make sure the plan is based on solid research.

“Has the plan been tried on 20 people or 200 people? Have the results been published in a peer-reviewed medical journal — or is it based solely on anecdotal reports? These are things that I fear many people don’t pay attention to before paying attention to what is being said — and that is a huge mistake,” says Brandeis.

Perhaps even more important: Experts say there is no one diet or nutrition plan that is right for every person.

Brandeis tells WebMD that dieters need to stop blaming themselves when a plan doesn’t work for them. It’s not them, she says. It may not even be the plan. “It’s just not the correct match,” she says.

The solution: Before following a particular diet or nutrition plan, check the credentials of the author or creator. Look for plans that are backed up by published medical data, and supported by the opinions of many experts in the field.

Exercise & Fitness Tips

Get answers to your questions about exercise, and tips for getting the most from your workouts.

By Richard Weil, MEd, CDE

WebMD Weight Loss Clinic Exercise Physiologist

Reviewed by Louise Chang, MD

High Blood Pressure and Exercise

Medical Author: Dwight
Makoff, MDand Melissa Conrad Stöppler, MD
Medical Editor: Leslie
J. Schoenfield, MD, PhD

A sedentary lifestyle is a major risk factorfor heart and blood
vessel (cardiovascular) disease. For example, people who are less active and
less physically fit have a 30%-50% greater frequency (incidence) of
hypertension (high blood pressure) than their more active peers. Furthermore, clinical trialshave shown that
physical activity may reduce blood pressure in hypertensiveand normotensive(having normal blood pressure) individuals, independent of changes in weight.

Medications have proven to be effective in lowering blood pressure and
protecting against the risk of cardiovascular and kidney(renal) diseases.
However, because of the side effectsand cost of medications, many individuals would prefer to undertake lifestyle modifications to help improve blood pressure as a first-line treatment. In numerous clinical studies, it has been well documented that aerobic exerciseis a suitable
treatment and can even play a roll in the prevention of hypertension. (Aerobic
exercise is vigorous and sustained exercise, such as jogging, swimming,
and cycling.)

Even without changes in body weight, those individuals who participate in aerobic exercise regularly tend to have reductions in resting blood pressure. The blood-pressure reduction does not seem to depend on the frequency or intensity of aerobic exercise or on the type of exercise. That is, the studies have indicated that all forms of exercise seem to be effective in reducing blood pressure. Aerobic exercise appears to have a slightly greater effect on blood pressure in hypertensive individuals than in individuals without hypertension.

Read more about the benefits of exercise »

Are you getting started with an exercise program? Hoping to improve your existing routines or find new workout options? Did you know that a complete plan consists of three basic elements: aerobic fitness, muscle strength/endurance and flexibility? How do you assess your current fitness level before you begin? How do you know how much exercise you should do, or whether you should see a doctor before you start?

Our Healthy Living channel provides in-depth answers to these questions, along with guidelines to help you develop a fitness program that’s right for you. With these exercise and fitness tips, you can learn to gauge how hard and how often you should exercise, and get yourself started on the road to better fitness today.

Q. Why do you use the BMI, and is it useful for weight lifters?

The Body Mass Index (BMI) is a simple way for men and women to estimate body fat based on their height and weight. From the BMI, it is possible to determine your healthy weight range.

One of the limitations of BMI is that it can overpredict overweight or obesity in people who are lean and muscular. For instance, someone who is 5 feet 10 inches tall and weighs 220 pounds, with 12% body fat, would be considered obese based on BMI standards. Obviously, someone with 12% body fat is not obese.

The scientists who developed the BMI guidelines readily admit to this limitation. But their rationale is that most Americans are not lean and muscular and so for most people, the BMI is an accurate assessment of body fat and increased health risk.

It is important to know that people who are classified as overweight or obese can still be healthy as long as they are fit. In one well-known study, fit people with BMIs that classified them as overweight or obese were healthier and lived longer than unfit people who were at normal weight.

The BMI, for the majority of Americans, is the most up-to-date and scientifically sound method available for determining healthy weight.

Q. Does aerobic exercise interfere with muscle gains from weightlifting?

If you’re training for an endurance event like a marathon, when you might run 60 miles or more per week, you’ll almost always see a decrease in your muscle mass. For most of us, who do more moderate amounts of physical activity, there will be minimal, if any, loss in muscle mass — so there’s nothing to worry about.

If you do plan on lots of aerobic exercise and are concerned about losing muscle, try starting with 20-30 minutes of moderate aerobic exercise (at 50% to 70% of your maximum heart rate) two to three days per week, and see how it goes.

QUESTION

Muscle weighs more than fat.
See Answer

Q. Should I hold off on weight training until I lose weight?

Absolutely not. Lifting weights will not only help you lose weight, but maintain the loss. Here’s why:

• Muscle keeps your metabolism revved up, burning calories, fat, and glucose (sugar).
• When you lose weight, up to 25% of the loss may come from muscle, resulting in a slower metabolism. Weight lifting will help preserve or rebuild any muscle you lose by dieting.
• Muscle helps you with aerobic exercise. The stronger you are, the better you will be at any aerobic activity.
• Weight training improves your body’s muscle-to-fat ratio (you end up with less body fat and more muscle), which improves both your health and your fitness level.
• Gaining muscle will help you look better as you define and tone your physique.
• Building strength helps you feel good about yourself. Although the scale may show a slight weight gain when you start lifting weights (usually five pounds or less), you probably won’t look heavier because the gain is in muscle, and your clothes may even fit more loosely.

Q. How much exercise should I do?

In addition to the National Academies’ Institute of Medicine’s recommendation of 60 minutes of daily exercise to prevent weight gain, there are two other major U.S. guidelines for how much physical activity you need:

• The American College of Sports Medicine recommends a five- to 10-minute warm-up and then 30 to 45 minutes of continuous aerobic activity (such as swimming, biking, walking, dancing, or jogging) three to five times a week, with a stretch and cool down period in the last five to 10 minutes. The ACSM also recommends weight training: at least one set (eight to 12 repetitions) each of eight to 10 different exercises, targeting the body’s major muscle groups.
• The surgeon general recommends accumulating 30 minutes of moderate-intensity activity (hard enough to leave you feeling “warm and slightly out of breath”) on most, if not all, days of the week. You can do it in two bouts of 15 minutes, three bouts of 10 minutes, or one bout of 30 minutes. This recommendation emphasizes incorporating activity into your daily life — walking instead of taking the bus, parking your car farther from the mall and walking across the parking lot, taking stairs instead of the elevator, and washing your car by hand.

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Q. I don’t have time to exercise. I hate exercise. 60 minutes a day?

The 60-minute suggestion is based on the National Academy of Science’s recommendation for people who are trying to prevent weight gain, or keep themselves from regaining after weight loss — not for people who are trying to increase or maintain their cardio-respiratory fitness or health. There’s plenty of research to show that 30 minutes of physical activity a day will help you gain lots of health and fitness benefits.

Both guidelines will help improve your health and fitness. Following the more vigorous ACSM recommendation will make you more aerobically fit, and its strength-training component will make you stronger and more toned. The Surgeon General guideline, meanwhile, may be easier to fit into your lifestyle — not replacing the ACSM guideline, but complementing it.

If you already exercise vigorously at the gym several times a week, there’s no reason to quit. But if the ACSM recommendation is too much for you, the Surgeon General’s report offers you an alternative.

The most important thing is that you do something.

Q. Where do I start if I have never exercised?

If you’re new to exercise, or have struggled with it in the past, talk with your doctor about your exercise plans. After that, start by incorporating more activity into your daily life. For instance:

• If you always take the elevator, try the stairs.
• If you try to park next to the door of wherever you’re going, park farther away and walk.
• If your habit is to eat at your desk, take a 10- to 20-minute walk first, then have your lunch (or take a walk after you eat).
• Instead of watching TV all day Saturday and Sunday, plan active weekends. Go to the park, take a walking tour, ride your bike, or row a boat.

Whichever plan you decide on, it’s a good idea to set weekly goals:

• Write down what activity you plan to do, on what day of the week, for how long, and at what time of day. Be as specific and realistic as possible. For instance, write down “Tuesday: Walk for 20 minutes at 7 p.m., to the park and back.”
• At the end of each week, review your goals and set new ones for the upcoming week.

Research shows that setting goals will help you stick to your program. It will clarify what you’re supposed to do and let you track your progress. If you hit a roadblock later on, you can refer back to what has worked in the past, or use your accomplishments to re-energize yourself.

Q. What should my heart rate be during exercise?

Richard Weil, MEd, CDE, recommends calculating your target heart rate with a
formula called the “heart rate reserve” method. Use a watch with a second hand
to keep track of how many times your heart beats per minute. You can feel your
heartbeat at the underside of your wrist or along the side of your neck.

Here’s how to use the formula:

• Determine your Maximum Heart Rate (MHR) by subtracting your age from 220.
• Then, subtract your resting heart rate (it’s best to take this when you first wake up in the morning) from your Maximum Heart Rate to find your Heart Rate Reserve (HRR).
• Multiply your HRR by the percentage of your MHR at which you wish to train (60% to 85% is the usual range for people looking to increase fitness and health).
• Add your resting heart rate back to that result to get your target rate.

So, assuming an age of 27, a resting heart rate of 70 beats per minute, and a desired training range of 70%, the calculation would look like this:

220 – 27 = 193
193 – 70 = 123
123 x .70% = 86
86 + 70 = 156

Remember, this is an estimate, not an absolute. Also keep in mind that athletes may exceed the training zone, and even the maximum heart rate, during high-intensity training.

Q. My weight has hit a plateau. What do I do?

There are several reasons why your weight can hit a plateau, including:

• Losing weight too quickly. When this happens, your metabolism (the rate at which your body burns calories) can slow down because your body senses it is starving. Rapid or large amounts of weight loss can slow your metabolism by as much as 40% in six months.
• Losing muscle. When you lose weight, up to 25% can come from muscle tissue. And since muscle is the engine in your body that burns calories and helps maintain your metabolism, losing it can hinder weight loss. Weightlifting can help preserve and build muscle.
• Reaching your body’s particular set point — the weight and metabolic rate your body is genetically programmed to be. Once you reach that point, it’s much harder to lose weight and even if you do, you’re likely to regain it. If you’re at a weight at which you’ve hit a plateau in the past, if your body generally seems to gravitate toward that weight, and you’re within a BMI (body-mass index) range of 20 to 25, then you may be at your set point.
• Decreasing your physical activity and/or increasing your caloric intake. People lose weight all the time by reducing their caloric intake without doing any exercise, but it’s almost impossible to keep weight off without exercising. Many scientists agree that physical activity is the single best predictor of whether a person will maintain a weight loss.
• Other health factors, including thyroid or adrenal gland problems; medications like antidepressants; quitting smoking; menopause; and pregnancy.

Even with any of the above factors, the bottom line to losing weight is eating fewer calories than you burn. Studies show that people almost always underestimate how many calories they’re eating. So if you’re struggling with weight loss, you’re still exercising, and you’ve ruled out any of the above reasons for weight plateaus, look at your calorie intake.

As for exercise and weight plateaus, sometimes a change in routine can help. Instead of the treadmill, try the bike, or the stepper. Instead of a dance class, try a stretch and tone class. If you’re not weight lifting, this would be a good time to start. If you already do aerobic exercise, try adding intervals (short bursts of higher-intensity exercise) to your aerobic workouts. And keep reminding yourself that if you maintain an active lifestyle and continue with healthy eating, you will reach your goals.

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Q. What’s the bottom line to weight loss?

The bottom line to weight loss is to burn more calories than you consume all day. (The behavior isn’t simple, but the equation is.) For example, if you eat 2,500 calories a day and only burn 2,000, you gain weight; if you eat 1,500 calories and burn 2,000, you lose weight; if you eat 2,000 and burn 2,000 you maintain weight.

It’s true that there are several medical conditions, and medications, that can make weight loss difficult (see below). But even if one of those factors applies to you, you still need to burn more calories than you consume to lose weight.

The good news is this: You can lose weight with a very modest amount of exercise.

People lose weight all the time without exercise by reducing their caloric intake. But keeping the weight off without exercise is another matter. Many experts agree that exercise is the single best predictor of long-term weight control. If you lose weight and don’t start exercising, there’s a very good chance you will regain it.

Here are some factors that can keep you from losing weight and/or cause weight gain:

• Thyroid or adrenal gland problems.
• Medications like antidepressants.
• Stopping smoking.
• Rapid weight loss. This can lower metabolism because the body senses it is starving and make it harder to lose weight. The decrease in metabolic rate is often due to loss in muscle (when you lose weight, approximately 25% of the loss comes from muscle), so lifting weights is a good idea.
• Menopause (and premenopause).

If you think any of these things are factors for you, your doctor may be able to help.

Otherwise, patience, determination, regular physical activity, and attention to your diet are the keys to long-term weight control. Doing these things will give you your best shot at reaching your weight loss goals and keeping the weight off.

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Q. What if I am physically unable to exercise due to a medical condition?

There is virtually no medical condition that will keep you from doing any type of exercise. Even people with congestive heart failure — who were long told not to exercise at all — can benefit from moderate amounts of activity.

And people with limited mobility can often do water exercises, or do yoga or other exercises while seated in a chair (some “chair exercise” videos are now on the market). Of course, if you have any medical condition, check with your doctor before starting an exercise program.

If you have questions about your condition or are still not sure what exercise you can safely do, please consult your physician.

Q. What is interval training?

In interval training, you alternate between bursts of higher-intensity exercise and periods of less-intense exercise (or “active rest”). As you get more fit, you decrease the “rest” time and increase the high-intensity periods. You’ll see big fitness gains if you train this way regularly.

For example, if you now run for 30 minutes at 6 mph, try this routine: Jog for five minutes to warm up. Then, increase your speed to 6.5 mph for one to two minutes (less if you can’t go that long). Then, jog for a few minutes at your normal speed, then again at the faster speed, and so on until you reach your time limit. Your ratio of work to active rest would be 2:3 if you ran for two minutes at 6.5 mph, then jogged for three minutes at 6 mph.

You can also use your heart rate to set intervals. For example, if your heart rate hits 70% of your maximum when you jog at 6 mph, start at that speed. Then increase either your speed or elevation (if you’re on a treadmill) to get your heart rate to 85% or 90% of maximum for one to three minutes. Then, go back to jogging at the 70% heart rate, and continue alternating.

As your fitness improves, your heart rate will be lower at the higher speeds, and then you can spend more time at those speeds. A good starting ratio of work to active rest is 1:3; you can always vary the ratios if they turn out to be too hard or too easy.

I recommend interval training just once a week to start, as it is more intense than you may be used to. Once you get a feel for it, you can do it more often.

Q. What’s the difference between the fat-burning mode and the cardio mode on the machines at the gym?

There are problems with the fat burning option on the cardio machines, and it really ought to be eliminated.

The idea behind the fat burning option is this: Because fat is denser than carbohydrate, it requires more oxygen to burn. So, to maximize the percentage of fat you burn, compared to carbohydrate, the fat-burning mode would have you work out at a pace at which your body can deliver lots of oxygen to your muscles. That generally means a slow pace, to keep you from getting breathless.

The problem is that when you exercise at a slower speed, you burn fewer total calories — from both carbohydrate and fat — because you simply don’t do as much work. Further, the way to get aerobically fit is to get your heart rate into the training range (usually 60% to 85% of your maximum heart rate), which is hard to do at slower speeds. And fitness is ultimately what you’re after, whether your goals are better health, burning calories, or improving heart and lung capacity.

The bottom line is that the fat burning mode probably won’t be intense enough to maximize total calorie- or fat-burning, or to help you increase or maintain optimum fitness levels. Use the cardio mode to maximize your exercise benefits.

Q. What is basal metabolic rate?

Basal metabolic rate (BMR) is the rate at which your body burns calories just to sustain life. For most people, that’s roughly 50 to 80 calories per hour, or 1,200 to 1,920 calories per day. Exactly what your BMR is depends on genetics, your muscle mass, and other factors.

Of course, you burn more calories when you exercise — or just go about the activities of daily life. For example, if you work out at the gym for 60 minutes and burn 400 calories, that comes in addition to whatever your BMR burns up. (If you walk home from the gym instead of driving, you’ll burn even more!) At the end of the day, if your total energy expenditure is greater than the number of calories you’ve eaten, you’ll lose weight.

Originally Published May 1, 2003.
Medically updated February 2006.

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SOURCE: WebMD Weight Loss Clinic Expert Column WebMD Weight Loss Clinic: Exercise and Fitness by Richard Weil, MEd, CDE, published May 1, 2003. American College of Sports Medicine web site: “Guidelines for Healthy Aerobic Activity.”