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Cardio Confusion

<b><I> Seemingly conflicting exercise guidelines have led to some member confusion about the ideal frequency, duration and intensity of workouts.</b></i>

Without proper guidance, getting fit can be daunting for the average, sedentary American. Making it even more challenging are the ever-changing guidelines for staying in good cardiovascular shape, says Mark Roozen, owner and director of the Performance Zone, an 8,000-square-foot facility in Granbury, TX.

In 1996, the U.S. Surgeon General recommended that adults aim for at least 30 minutes of moderate-intensity physical activity most days of the week. In 1998, the American College of Sports Medicine teamed with the Centers for Disease Control and Prevention to recommend moderate to vigorous intensity exercise for 20-60 minutes (continuous or intermittent) three-five days a week. Then in 2002, the Institute of Medicine advised that to maintain cardiovascular health, regardless of weight, adults and children should get at least one hour of moderately intense physical activity each day. In April 2005, the U.S. Department of Agriculture's interactive food guidance system, MyPyramid, further spelled out cardiovascular exercise guidelines including different amounts for children or those looking to prevent weight gain or lose weight. Just a few months ago, the U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt announced plans to develop comprehensive guidelines to help Americans fit physical activity into their lives. HHS will issue the guidelines in late 2008, which will summarize the latest knowledge about activity and health with depth and flexibility targeting specific population subgroups, such as seniors and children (for more on specific organizations' guidelines see page 42).

Couple that with the numerous infomercials, articles and recommendations the average person gets every day through the mass media on how much, how often and how intense to exercise, and you have a recipe for mass confusion.

“We have clients come in all the time who are looking for a quick fix and want results yesterday,” says Roozen. “I tell my trainers that we're not just personal trainers — we need to be teachers and educators. We have to let our clients know what can be expected and the amount of time and effort that will be needed to put in to meet their goals.”

In fact, a recent study published in the March issue of the Canadian Medical Association Journal found that many Americans may not be paying attention to specific exercise guidelines. Of the 2,002 American households surveyed via phone, only 68 percent were aware of specific exercise guidelines, and only 71 percent knew lifestyle physical activities could result in a health benefit. The good news is that 94 percent of respondents were aware of traditional physical activities. Unfortunately, that knowledge was not related to physical activity behavior sufficient for a health benefit.

As director of personal training at the Idaho Athletic Club in Boise, ID, Trisha Sears sees member confusion about cardio training every day, she says.

“We see members come in the club religiously to do their cardio,” Sears says. “They jump on the same machine with either their favorite fitness magazine or watch their favorite shows. Granted, it takes their mind off of exercise and makes that hour go by faster, but weeks, months and even years later, the members still look the same.”

The Guessing Game

As confusing as the various guidelines, amended recommendations and tweaked standards may look to the average person, they're actually quite complimentary, says Cedric Bryant, chief science officer for the American Council on Exercise. While the first Surgeon General's report addressed the minimum threshold of activity to promote health, later guidelines have clarified that threshold and addressed the obesity epidemic by recommending longer exercise durations for weight loss and to prevent weight gain. And although recommendations have become more complex, they've also become more detailed to the individual.

“The other thing that people tend to miss when looking at the recommendations is that they all have one thing in common, which is to accumulate exercise over the day,” Bryant says.

Others agree that the public isn't confused; they just aren't moving enough.

“While fitness professionals are debating the pros and cons of the intensity and this mode and that, the average person isn't following all that,” says David Swain, professor of exercise science and chair of the institutional review board at Old Dominion University in Norfolk, VA. “The big challenge for us is motivation and how do you get people to do these things?”

While being on the elliptical for more than an hour a day may seem out of reach for your sedentary members, it seems much easier to swallow if performed in 10-minute bouts of activity throughout the day.

“The guidelines use activity as opposed to exercise, and it's really any movement,” Bryant says. “It's the old Nike thing. Instead of ‘Just do it,’ it's ‘Just move.’”

The Cardio Conundrum

Another challenge deals with intensity. Although Americans know they should get moving, they don't have a good grasp on how hard they should be working out, especially if they want to see the results promised in consumer fitness magazines.

After a few weeks of low intensity exercise with little invested time, clients won't see the huge improvements that make them want to continue, Roozen says.

“We talk to our members about pushing up their intensity levels, adding resistance training, getting into a stretching/yoga/Pilates program, etc., and they are overwhelmed,” he says. “After all, they just read in a magazine that they could lose 10 pounds and drop inches in just 10 minutes a day.”

Educating your clients on the health benefits of higher intensity exercise along with easing them into an exercise routine is the way to do it, says Ron Fioria, personal trainer at The Club @ 800 Squash & Fitness in Rye Brook, NY.

“You have to walk before you run,” he says. “I sit down with them and explain things, so they have a full understanding. People don't know and should be educated.”

Even though researchers say vigorous intensity produces superior health benefits (for more see Research Roundup on our Web site at, pushing a sedentary client to work out at a vigorous pace can be hazardous, says Swain, who has studied different intensities of exercise and their health benefits. He cites muscular-skeletal injuries, adherence issues and even the risk for a heart attack as reasons to take it slow and check with a client's physician before starting a program.

Always take your client's fitness level into consideration, too. For someone at a very low fitness level, a walk might be vigorous, Swain says.

Intensity aside, the best thing you can get any client to do is to establish exercise consistency and regularity, he says. Be sure to give your clients the skills to be healthy and active outside of just the training session or gym.

“I think where many trainers miss the boat is that they don't encourage their clients to just look at being active outside of their routine,” Bryant says. “Given the fact of what we're seeing in regards to obesity and weight gain, that's going to help stem that tide.”

Within the club, fitness professionals should also work to make cardiovascular exercise fun. Roozen teaches a cardio interval class twice a week for an eight-week session a few times a year. For the first few classes, he focuses on low-intensity exercise and works the group for 25 minutes. After building intensity and duration from each week to the next, the final class lasts 65 minutes with 45 minutes of high-intensity exercise and 20 minutes of low-intensity work.

“Training is the key and understanding the key elements that put together a program and working those variables,” Roozen says. “When we do that, our members and clients see results, stay as members and stay happier.”

The President's Council on Physical Fitness and Sports' Recommendations

Warm-up: 5-10 minutes of exercise such as walking, slow jogging, knee lifts, arm circles or trunk rotations. Low intensity movements that simulate movements to be used in the activity can also be included in the warm-up.

Cardiorespiratory endurance: At least three 20-minute bouts of continuous aerobic rhythmic exercise each week. Popular aerobic conditioning activities include brisk walking, jogging, swimming, cycling, rope-jumping, rowing, cross-country skiing, and some continuous action games like racquetball and handball.

Cool Down: A minimum of 5-10 minutes of slow walking or low-level exercise with stretching.

Source: The President's Council on Physical Fitness and Sports

My Pyramid Exercise Guidelines

At a minimum: Moderate intensity activity for 30 minutes most days or preferably every day in addition to usual daily activities. Increasing the intensity or duration of the activity can have additional health benefits and may be needed to control body weight.

To prevent weight gain: About 60 minutes a day of moderate physical activity. For those who have lost weight, at least 60 to 90 minutes a day may be needed to maintain the weight loss. At the same time, calorie needs should not be exceeded. Children and teenagers should be physically active for at least 60 minutes every day or most days.

Greater health benefits: While 30 minutes a day of moderate intensity physical activities provide health benefits, being active for longer or doing more vigorous activities can provide even greater benefits and burn more calories per hour. No matter what activity, exercise can be performed all at once or divided into two or three parts during the day. Even 10-minute bouts of activity count.

Source:, United States Department of Agriculture

ACSM Position Stand: Cardiorespiratory Fitness Guidelines

Frequency of training: Three-five days a week.

Intensity of training: 55/65 percent-90 percent of maximum heart rate or 40/50 percent-85 percent of maximum oxygen uptake reserve.

Duration of training: 20-60 minutes of continuous or intermittent (minimum of 10-minute bouts accumulated throughout the day) aerobic activity. Duration is dependent on the intensity of the activity; thus, lower-intensity activity should be conducted over a period of 30 minutes or more, and, individuals training at higher levels of intensity should train at least 20 minutes or more. Moderate-intensity activity of longer duration is best for adults not training for athletic competition.

Mode of activity: Any activity that uses large muscle groups, can be maintained continuously and is rhythmical and aerobic in nature.

Source: Medicine & Science in Sports & Exercise®, Volume 30, Number 6, June 1998

Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults

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