"Put simply, people who restrict food in hopes of battling obesity will fail, but those who are physically active have a better chance of success.”

James O. Hill, Ph.D., keynote address, American College of Sports Medicine (ACSM), March 29, 2005

Perhaps, before making a recommendation about what exercise you should do, I should make a stab at convincing you of the importance of regular, moderate exercise. If you are already quite sure that exercise will improve your chances for achieving and maintaining a healthier weight, then good for you! If you think you can achieve a healthier weight and keep it off by starving yourself with a "diet" (and, oh, how I hate that word!), then read on. You have some information you need to be made aware of and I have some mind-changing to do.

Now, forget for a moment, that you might need to lose weight. As we have often said on this web site, your goal is to be healthier, not lighter. No, let's briefly outline some of the benefits - aside from changes in weight - that the healthier you will get from exercise. According to the American College of Sports Medicine and the American Heart Association, a person who regularly exercises should expect the following benefits:

• Give your everyday energy level a boost in energy. With regular exercise, you will have new level of energy that will allow you to do the things that you want to do, such as spending quality time with friends and family.
• Improve your mood. There is no better prescription than to exercise away stress, anxiety and depression.
• Better sleep habits. Exercise will improve the quality of your sleep, giving you the rest you need to enjoy your day's requirements - both at work and at home.
• Raise the bar for your peak levels of performance, concentration and creativity.
• Regular exercise will improve your self-esteem by boosting your strength, stamina, flexibility, and sense of self-control.

Need more? Let's change our focus to health benefits of exercise. Again putting aside weight loss, exercise can improve your health in the following ways:

• Reduce your risk of heart disease. If you have already had a heart attack or bypass surgery, sensible, medically-supervised exercise can improve your capabilities and capacity. Exercise, not BMI, was the best predictor of coronary heart disease in this excellent study, and there are others.
• Very importantly, regular exercise is the one factor that can raise the high-density lipoprotein fraction of your cholesterol. As you may know, the HDL is the "good" fraction of your circulating cholesterol and the higher the level of the HDL, the lower your risk of heart disease. It, along with the "bad" fraction (the low-density lipoproteins or LDL) , make up the total cholesterol. The more HDL you have and the lower the LDL (and exercise can do this as well) you have, the less likely, all things else being equal, that you will have a heart attack or stroke.
• Strange as it may sound, at least it does to me, regular exercise will reduce your risk of colon cancer. Go figure!
• If you have high blood pressure, along with reducing dietary salt and other non-drug interventions, exercise will significantly lower your blood pressure and, not surprisingly, your risk of stroke.
• Exercise will improve the efficiency of insulin in your body. It increases both the sensitivity and the number of insulin receptors, required for insulin to work. So, if you have diabetes or simply are at increased risk for developing diabetes (for example, a strong family history), exercise can help control your blood sugar.
• For all the women out there who have heard so much about osteoporosis, all the calcium supplements in the world cannot do as much to prevent this fragility of bone and potential hip fracture than regular, weight-bearing (like walking) exercise.

Ok, I have given you a dozen or so reasons to exercise and we haven't even mentioned its effects on weight or body fat. This article, from the Mayo Clinic, offers even more reasons. But, despite all the evidence that we need to do more, there are still hurdles of perception to overcome. As shown from one survey from September, 2004, 70% of people said they were "completely" or "somewhat satisfied" with their physical health and 66% said the same about their physical appearance, according to the survey, commissioned by the International Health, Racquet and Sportsclub Association (IHRSA), an industry trade group in Boston. From what I see and from what I know as the truth, I can almost guarantee that this survey did not include respondents from my area of the country.

Editorial Follows: As I was taking a new patient back last week (March, 2005), she left her 3 beautiful girls - about 4,6 and 8 years old - sitting in the waiting room, eating. I will not comment on what she had brought for their Spring Vacation "day out with Mom" (suffice it to say, it was fast food with a kids toy in the meal), I did notice something during the visit that made me do a lot of thinking. As the mom was watching our patient introduction video and I left the room to gather her patient materials, I noticed that the children had stopped eating. In our clinic, we have set up the large room that faces the waiting room to constantly run various exercise videos to show our patients just what is available for them to use at home when they can't get out of the house to walk or for a visit to the local gym. On this particular occassion, it was a walking video. The little girls, fortunately none already overweight, were all standing in front of the video, walking along gleefully with Leslie Sansone. They were smiling as they marched along with the video and did the walking, laughing all the time. When mom had finished her visit with me and was ready to go, she gathered up the little girls and left. It was clear, to anyone who had watched, that these children were having fun. Fun! They weren't doing exercise - they were playing! I have thought a lot about that visit since then and with my thoughts drifted to my beliefs that God intended us to enjoy our bodies and take care of them and nurture them. I had, long ago, decided that the natural state of humans is to be active and in motion. Children do it spontaneously because they have fun doing it. We dread it because we have been conditioned by society to believe that acitivity should be reserved for work or home chores. Adults believe exercise = work. A child knows exercise = fun. Wouldn't it be great if we could start thinking again like our inner child? As God intended us to be? Reveling in the wonderous body we have been given? It's a shame that basic truth gets beaten out of us by society but we can all try and get back our inner child again. We would all be much healthier and happier if we did. [End of editorial]

Now, back to the original question: What is the best exercise for improving your health and, coincidentally, losing some weight? Very simple question to answer. The absolute best exercise for achieving a healthier weight is the exercise that fits all, or at least most, of the following criteria:

• It is an exercise, first and foremost, that you enjoy doing. Walking, when done briskly and at a reasonable speed, is an excellent exercise. But, if it bores you to death, as it does me, you will not stay with for very long. Soon enough, you will become very adept at inventing excuses not to go for your walk. It's raining. It's too cold. It's too hot. You'll do it tomorrow. But you never get back on track.
• It is an activity that you have the time - or can, with a little organization, find the time - to do on a regular basis. If you decide to start working out at a gym, what will you do when the gym changes their hours or, worst of all, goes out of business? What about when your kids are on summer or holiday vacation? What will you do with the children?
• If there is an expense involved in the activity, you can afford it. If you want to take up karate or kickboxing, where will you find the monthly dues from your budget? If you decide that a stationary bicycle would be just perfect for you, where will you get the money to buy one?
• If the exercise involves using equipment, you have easy access to this equipment. If your next door neighbor has a treadmill and would allow you to use it, what if you can only find time to exercise at 5:30 in the morning? Will the neighbor be willing to let you in her house and tolerate the noise of a treadmill at that hour?
• It is an activity you can do year round. If you live near a lake or a swimming pool, beach, or a lake and swimming is your favorite exercise, what will you do in January?

In summary, the "ideal" exercise for you, as an individual, is one that you enjoy doing on a regular basis, you can afford any costs involved and you have easy, year-round access to doing it. The point of all this is that you should give a significant amount of thought before rushing out to start any exercise program.

Alright, we have gotten a few of the details out of the way. Here's something very important to think about. It's one of the biggest changes in your thinking I am going to ask you to make. If you think you are exercising solely to burn up calories so you will lose weight faster you are absolutely, positively wrong. The amount of calories you are probably going to "burn up" during a typical exercise session is less than the calories found in 2 slices of bread. The body is way too efficient as a machine to burn up huge amounts of energy during any exercise, regardless of how strenuous that exercise may be. You are not exercising for the "calorie burn." If you have the misconception that exercising is done to simply burn up calories you are incorrect. To prove my point, in the following table, from the Center for Disease Control, these are some activities and the times required to burn up a mere 150 calories. For those of you who might not know this already, this is less than the number of calories in two slices of bread. For comparison, a Big Mac™ has over 550 calories (without drink or fries). The listing might be an eye-opener for those of you who think your are exercising in order to burn up calories.

Just to point out some highlights, it would take more than an hour to bicycle away the calories in one 20-ounce Coke. It would take nearly an hour and a half of gymnastics or volleyball to burn off the calories in one Mrs. Fields’ Chocolate Chip Cookie! You have to walk 2 miles at 4 miles per hour (30 minutes of fairly brisk walking) just to burn up 150 calories. You have to ride a bicycle for 5 miles to do the same. Thirty to forty minutes of volleyball for 150 calories? You have to jump rope for about 15 minutes for 150 calories burned. To burn up the calories in a single Big Mac you have to walk at 4 miles per hour for about 2 hours - about 8 miles distance. So, just because you stroll around the block with your neighbor for 30 minutes, don't think you will be able to knock down a Supersize Meal at the local fast food restaurant. Get the picture? For an excellent calculator for almost any type of activity you can think of, click here.

If you are not exercising for the "calorie burn" - which helps but our bodies are just too darned efficient for our own good for this purpose - just why are you exercising? Read on!

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Albright Bariatric Clinic