The Life Plan (26 page)

Cardio

A critical element in my physical fitness program is improving balance, or neuromuscular stabilization—which is the body’s ability to slow down external resistance and stabilize the kinetic chain in all three planes of motion (that is, not falling down). The kinetic chain is the muscular, nervous, and joint systems all working together to create a fluid movement.

Improving balance through stretching and enhancing flexibility prevents injury. Your muscles can get to the most efficient level of strength if they are 1.2 times their resting length. Creating slightly elongated muscle means having a bigger range of motion. The longer your muscle is when it’s resting, the more efficient it will be in the wider motion range. Better training plus more efficiency equals better body composition, more muscle mass, more strength, higher metabolism, more youthful appearance, better health, and more enjoyment out of your workout. Flexibility is also crucial for maintaining muscular strength, proper posture, full-range motion, and a spry, youthful gait.

My balance and flexibility program includes exercises tailored for men. You’ll find that not only will they enhance your flexibility and balance, they will help reduce stress, alleviate low back pain, and diminish injury risks from your other physical activities. You’ll learn more about all aspects of balance and flexibility in Chapter 5.

“Just get moving” is traditional medicine’s generic exercise prescription. While moving (I’m guessing they mean aerobic exercise) is important, you also have to start pushing yourself to new limits for muscle growth and adaptation. It’s the only way to experience real health benefits. Your muscles are living entities, which are constantly using energy. That’s where building muscle mass comes into play. It causes you to have a higher metabolism, so you are burning more calories even when you’re not exercising.

Muscle and strength loss can be stopped and reversed only with resistance exercise. As our muscle mass increases, so does our strength. Having increased muscle mass and strength is the first step toward reversing physical frailty. Balance and coordination also improve with weight lifting, which reduces our chance of falling—a major source of injury, fractures, and debilitation leading to death for men as they age.

I believe that frailty is so important to prevent because most doctors are not addressing it correctly. When you go to see your primary care doctor, will a bone scan be part of your annual checkup? Probably not. Even if you ask for one, most insurance companies typically won’t pay for a DEXA scan, even if risk factors are present. As a result, many men are walking around with serious bone issues and don’t know it. According to the National Osteoporosis Foundation, 2 million men have osteoporosis and another 12 million are at risk, yet osteoporosis in men remains “underdiagnosed and underreported.” The disease causes 1.5 million fractures every year: 300,000 hip fractures, 250,000 wrist fractures, 700,000 vertebral fractures, and 300,000 other site fractures. The CDC states “approximately 20 percent of individuals with hip fractures will die the year after the fracture from surgery complications, such as pneumonia or blood clots in the lung.”

In my practice, there isn’t a week that goes by that I don’t see a male patient who is osteopenic or osteoporotic. The good news is that things can be turned around with comprehensive diagnostics, correcting hormone deficiencies, the right nutrients (calcium, vitamin D3, and so on), and weight-bearing exercise.

Improves emotional state

Improves mental clarity

Enables us to have a more powerful presence

Enhances self-confidence

Extends to all areas of our personal and professional lives

Promotes increased production of our own hormones

A significant study published in January 2008 found that men who were “highly fit” had a 50 to 70 percent lower mortality risk than their “low-fit” counterparts. According to the study, a regular exercise program can slow or reverse the loss of aerobic fitness, reducing the individual’s biological age and prolonging independence. Progressive aerobic training can delay loss of independence by 10 to 12 years. The last thing any of us want is to have to depend on others to take care of us.

Aerobic exercise is particularly important for prevention of heart disease and for treatment after a heart attack, angioplasty, or bypass surgery. Just one session of aerobic activity can reduce blood pressure for up to 24 hours. When aerobic exercise is performed regularly, this effect—called postexercise hypotension—can decrease blood pressure by 5 to 7 mm Hg.

A study published in 2000 in the
New England Journal of Medicine
showed that in sedentary men, the endothelium (the lining of the blood vessels and heart) becomes more impaired as they get older. However, regular aerobic exercise can prevent age-related loss of endothelial function. And it can “restore damaged endothelium to healthy levels in previously sedentary middle-aged and older healthy men.”

Doctors used to believe that it took weeks or months of regular exercise to gain any degree of protection for the heart. Yet new studies show that each exercise session stimulates the heart to increase its synthesis of protective proteins—stress proteins. Within 24 hours after exercising, these proteins increase enough to protect the heart against a variety of physical stresses. Moderate exercise can up your protection greatly. In fact, exercise intensity above that improves the protection gain by only a modest amount.

The most important lesson for cardio work is that you have to stay with it: Research shows that exercise-induced cardiac protection is lost once regular exercise is stopped. If you stop exercising, the synthesis of those protective proteins comes to a halt. In under a week, you’ll be back to your pre-exercise level. No matter how long or how intensely you’ve been training, you’ll be back to where you started in less than seven days, and you’ll put your heart at risk.

On my Life Plan you will be doing some form of aerobic activity three to seven days a week. Aerobic exercise should involve continuous movement of your large muscle groups for 30 to 60 minutes or more in the range of “somewhat hard” to “hard.” High-intensity interval training can dramatically shorten this time. You’ll learn more about the specifics of this plan in Chapter 7.

Aerobic exercise and resistance training clearly work hand in hand to prevent, reduce, or even eliminate heart disease as they prevent or control diabetes, high cholesterol, and high blood pressure. Aerobic exercise does a great job lowering systolic blood pressure, and both aerobic and resistance exercise help reduce diastolic blood pressure. This makes it much easier for the heart to do its job of pumping blood throughout the body. Both forms of exercise also strengthen the heart muscle, making it work much more efficiently.

Dr. Kenneth Cooper now believes a mix of aerobic conditioning and strength training is the best exercise program for aging adults, because he recognizes, as I do, that as we age, we need more strength training. His exercise ratio protocol is as follows:

Age 40 or younger: 80 percent aerobics and 20 percent strength training

41 to 50: 70/30