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GAINING CARDIOFITNESS and HEALTH with EXERCISE

Abstract:  Improving the Cardiofitness that reduces risk of heart disease and cancer requires adequate exercise of the heart and its accompanying cardiovascular (CV) system.  This in turn requires exercise programs that develop elevations in heart rates above low resting rate of at least 30 beats per minute for periods of at least 3 minutes or more.  It is necessary to monitor heart rates during exercise to assure this need is accomplished.   Improvements in Cardiofitness will be related to regular numbers of a measure of heart and CV system exercise called Pulse Points.  Tables are provided that will help guide how much of a wide variety of exercises usually will be needed to obtain identified goals for Cardiofitness.   There probably will be genetic differences in the way the Cardiofitness of some individuals will develop as a function of exercise. 

The Exercise Recommendations:  How much of what kind of exercise do we really need to do?  We have been given advice as:   1.  Get your heart rate up to 65-85% of your maximum heart rate for 30 minutes three times per week. 2.  Walk a mile each day; 3. Walk a brisk mile every day;  4.  Get 2,000 Calories per week of exercise;   The Surgeon General’s report on Physical Activity and Health advised  5. a minimum of 30 minutes of activity such as brisk walking most days of the week, and that "greater benefits are achieved by more exercise;"  6. Some experts recently postulated that "Every US Adult should accumulate 30 minutes or more of moderate-intensity physical activity on most and preferably all days of the week. In this last one, "moderate" activity included walking as slow as 3 mph, fishing, and painting the house;  And 7. another supposedly expert group advised recently that everyone should  "Walk an hour every day." 

Which is correct? 

First, they differ so much. This does not give much confidence in their validity.   Second, some will simply not be acceptable to most people.  Third, they imply that every adult - young and old, men and women, fit and unfit - should do the same thing.  This assuredly is not true.  And finally as will follow, some of these recommendations will waste a lot of people's time for miniscule benefit. 

The Life Ahead Global Biochemical Engineering analysis of all key research found published showed that Cardiofitness was the most probable causative factor that protects against both heart disease and cancer.  The analysis that follows that follows provides a sharper perspective on the kinds and amounts of exercise needed to produce specific goals for Cardiofitness.  Life Ahead identifies what better Cardiofitness can accomplish for health and life. This combination provides health-interested persons a basis for deciding for themselves what kind of and how much exercise they wish to do. 

Cardiofitness requires Exercise of the Heart:  This is the early and still premier theory has now been verified repeatedly by masses of research accumulated during the past half century.  Improving Cardiofitness requires selectively more intense than usual exercise.  Cardiofitness does not develop simply from 'Activity Calories'.  Only certain kinds of more intense than usual Activity Calories contribute usefully.  Six of the above seven recommendations appeared to have lost focus on a very key fundamental need for exercise done to improve health.  It is: 

The exercise that improves Cardiofitness and reduces risk of major disease must effectively exercise the Heart and its accompanying Cardiovascular System

The heart is a muscle.  It does not know or care one iota if the stress on it is from walking, playing tennis, jogging, or anything else.  All it knows is that an external stress makes it beat faster.  And it gets its exercise ONLY by beating faster than usual.  Cardiofitness develops from how much and how long the heart beats faster than usual. And as the heart is exercised more, coronary arteries and all parts of the cardiovascular system are exercised more. 

Recommendation #1 above did recognize this fact. It was astute advice made before any direct verifying research was published.  But unfortunately only about 15% of our population appears oriented to do the high heart rate exercise that can be involved.  Interestingly, the research that extensively verifies how Cardiofitness benefits health risk involved very few people doing this high heart rate exercise.  There must be and there is a way to exercise the heart that will both produce useful benefit and be acceptable to most people.   

How Cardiofitness develops from Exercise:  Think for a moment about how exercise strengthens muscles. If you lift a one pound weight with an arm 10 times each day for a month, that arm will become just a bit stronger.  But after a month or two of this, arm strength will reach a plateau, and  not get any stronger.  If you lift that weight 50 times a day, this will improve strength more than lifting it 10 times a day, and you will become still stronger.  Now if you lift a 10 pound weight ten times a day, that arm will become much stronger than from lifting just one pound. Again, if you lift 10 pounds fifty times per day, that arm will become still stronger.  And what strengthens muscle over time is The stress on that muscle, and the number of times that stress is imposed.  Or STRESS and NUMBER of STRESSES. 

Suppose, that an energy demand requires a heart to beat 30 times per minute higher than at is rate at rest.  This makes it circulate blood at a faster pace. This from chemical engineering places an extra load or stress on the heart that is near directly proportional to the added blood being pumped.  Thus when beating at a 30 higher heart rate the heart is placed under 30 extra units of stress for each beat.  This produces a stress on the heart muscle similar to the way the lifting of 30 units of weight does on the arm muscle.  This 30 added beats per minute above resting rate is called the heart rate elevation due to exercise                                    

But when beating at 30 beats per minute higher that extra stress is also being imposed on the heart 30 more times each minute.  Muscle responds to stress as a multiple of stress times the number of stresses. Thus as for the example of arm exercise we have to multiply the amount the stress by the extra number of times it is imposed.  Thus the extra heart exercise is not just 30 'stress'  units, but 30 stress  units times 30 more times or 900 total exercise units each minute. 

Consider now a heart beating at a rate of 60 beats per minute above its resting rate.  The extra heart stress now is 60 'stress' units. And this 60 stress units is imposed 60 more times per minute.  This now produces 3600 total exercise units each minute.  Twice the heart rate elevation produces four times the effective exercise of the heart.  Effective exercise of the heart thus increases as the SQUARE of the elevation of heart rate above its resting rate.  This now explains why more intense exercise produces Cardiofitness much more effectively.  And this also explains as noted separately why higher intensity Physical Activity Calories can produce ten times the Cardiofitness improvement as will the same number low intensity Calories of usual daily activity.

During a normal day the heart usually beats at rates from the lowest in the morning before breakfast to about 20-25 beats per minute above this rate.  For a low resting rate of 70 this means the heart usually beats between 70 and 90-95 beats per minute.  Even those in very physically active occupations avoid continued exertion wherever possible, and usually maintain heart rates in this range. The heart then is operating similar to a car engine that is idling, and may not fully fill with blood during each beat.  But when an energy demand is placed that requires an average heart to beat about 30 beats per minute or more above its low resting rate, it usually fully fills and starts moving a consistent and useful full amount of blood with each beat.  Only then may the heart begin receiving some really useful added exercise. And the higher the rate at which it beats once this initial 30 beat per minute elevation is obtained, the more exercise it gets.  

There is another important need for useful exercise of the heart that has been seriously overlooked.  The body provides the fuel needed for a short term exercise demand from chemical stores such as glycogen. Only after exercise continues for a significant time does the heart rate move up substantially. An exercise level of 7.5 Activity Calories per minute is considered as intensive and useful in improving Cardiofitness.  Steady exercise at this level will after 3 minutes increase heart rate of a typical man by about 60 beats per minute, or from 70 to 130.  But it takes a full 30 seconds at this level of activity to move the heart rate up to even half of this rate, or even to the 30 beat per minute elevation threshold for useful heart exercise. Thus much of the first half minute of new exercise does not contribute much to real heart exercise.  Except for programmed exercise, most physical exertions of nearly everyone are done for periods much shorter than 30 seconds. These exertions consume many Activity Calories, but produce little useful Cardiofitness.

The Exercise that Is Useful:  The exercise that will effectively exercise the heart and produce Cardiofitness must (1) elevate the heart rate by 30 beats per minute or more, and (2) continue this elevation steadily for 3 minutes or more at each session.  This usually requires exercise such as brisk or fast walking, jogging, running, aerobic dancing, brisk cycling or continuous lap swimming.  Because Cardiofitness can decline rapidly when exercise is stopped, it must be done regularly and year around.  This is by no means a new idea.  Proponents of Cardiofitness have been saying this for decades.  But this also means that Activity Calories of exercise can be an inadequate and misleading concept for identifying a health benefit of exercise.  A vast majority of our population physical Activity Calories are developed either at heart rates that are too low or for periods of exertion that are much too short to produce Cardiofitness benefit.    

Sports can involve much exercise.  But sports can produce Cardiofitness very inefficiently.  The problem is that sports can involve exertions that do not raise heart rates adequately.  As example, an average duration of a professional football play is about 6 seconds. This is far too short a time to raise heart rates adequately for most players.  Similarly unless tennis is performed with high intensity, duration of plays may be too short to produce the needed amounts of steady heart rate elevations needed for cardiofitness.  An analysis made of the possible heart rate profiles obtained in various sports suggested that most sports may produce cardiofitness about a fourth as efficiently per Activity Calorie expended as does continuous aerobic exercise.  Exceptions probably will be hockey and soccer that involve continuous exertions.

A vast amount of  'Fitness' effort today is spent with exercise machines and in strength training.  This may help reduce weight.  But research has shown that these activities produce rather little gains in measured Cardiofitness. The key to benefit once again is simple.  Any physical effort that produces a heart rate elevation of 30 beats per minute or more steadily for 3 or more minutes contributes efficiently.  If a physical activity does not accomplish both of these needs, it may produce little Cardiofitness. It is possible to design strength improving exercise that does raise heart rate adequately for 3 or more minutes.  But most such exercise done today does not accomplish this.  A wonderfully exercised body may look impressive.  But just as strengthening the arms may not do much to strengthen the legs, there is no assurance that the exercise that strengthened arms and legs produced a truly fit cardiovascular system.

Percent of Maximum Heart Rate does Not Identify Exercise Benefit:  Exercise recommendations long have been dominated by advice to exercise at some percentage of "Maximum Heart Rate".  Some percentage of this Maximum as perhaps 75-85% may be  presumed to define a "Safe" level of exercise for healthy people.  But this measure does not identify amounts of useful heart exercise.  At 75% of maximum heart rate a typical 30 year old will produce three times the heart exercise produced by a person of age 70.   A true amount of actual heart exercise also can vary several fold at maximum heart rate depending on the exact percent selected or the resting heart rate of an individual.  And more important, exercise does not need to be to at anywhere near to a maximum heart rate to be useful.

The two physically fundamental factors that determine cardio-effective exercise are heart rate elevation above resting rate, and the time this elevation is maintained.  You can forget about the kind of exercise being done.  These are the main two things that count.  This is what the heart really knows.  It is stress and how many stresses.  There are secondary factors too. But these two real keys are quantified usefully by PULSE POINTS.

What are PULSE POINTS?   Pulse Points  measure the heart rate elevation above its resting rate during exercise times number of added beats above those at resting rate.  This simply becomes the heart rate elevation times itself or heart rate elevation squared. To make the measure a bit more convenient to use, Pulse Points are based hourly.  And because exercise varies from day to day it is convenient to consider the number of Pulse Points we obtain each week as a measure of our regular cardiovascular exercise. For example if you exercise at say 60 beats per minute above a resting rate of 70, you achieve 3600 Pulse Points per hour of this exercise.  If you exercise at this level for a 1/2 hour session you achieve 3600/2 or 1800 Points each session.  Doing this three times per week produces 1800 x 3 or an excellent 5400 Pulse Points per week.   Pulse Points thus is a simple and  straightforward measure of cardiovascular exercise or exercise of the heart and the cardiovascular system that includes the coronary arteries.  Pulse Points provide a useful approximation of both the amount and intensity of exercise.  And note that Pulse Points is a very specific measure of actual heart exercise.  It does not rely on secondary and potentially inaccurate estimates such as Activity Calories that can have much differing real effects on men and women of differing sizes and physical capability, and that may have much or little effect on the heart rates the really produce cardiofitness.

Pulse Points evolve directly from logical engineering analysis.  Exercise is added stress times number of added stresses.  But their value in forecasting Cardiofitness  has been developed from and verified by what may be a near unique and extensive set of data on about 265 men.   This data and its analysis is on the Web Site and was noted in the referenced 1982 book by this author, the "Pulse Points Plan".  Pulse Points first require a carefully measured low resting heart rate.  With this base, they now can be estimated only from continuing exercise at a fairly constant heart rate.  They are useful for heart rate elevations above 30 beats per minute.  A maximum of 150 heart rate is accepted for computing Pulse Points because the heart may not fill fully at very high rates, and because data is lacking on the value of higher heart rates. 

Designing Exercise Programs to Obtain Cardiofitness:  Pulse Points can provide a useful guide about the amounts of any kind of exercise needed by an average person to achieve specific goals for Cardiofitness.  Table 1 shows the heart rate elevations and time needed to improve Cardiofitness.  As example, assume a man having a 70 level resting heart rate walks 120 minutes or two hours per week with a heart rate of 100 beats per minute, or an elevation of 30 above the resting rate. From a starting Cardiofitness in CFR of 100 or average sedentary, he should obtain an improvement to 105 CFR after 3-6 months and maintain at this level.  If he walks faster and obtains an elevation of 40 beats per minute, his gain will be doubled to an CFR of 110.  If a 50 elevation from walking is possible, the gain will be to 116 CFR, a rather good level of Cardiofitness.  But a 50 beat per minute elevation in heart rate may require some modest jogging for those that are fairly fit.

Table 2 provides a more direct way for estimating how different kinds of exercise can produce Pulse points over time, and Table 3 provides the method for estimating how added Pulse Points will produce different Cardiofitness levels from various starting levels of Cardiofitness.

A first need in designing an exercise program is to determine an actual Cardiofitness level now.  This can be done by taking the suggested Life Ahead treadmill tests and using the accompanying tables or the Life Ahead Program options. This will provide perspective about how much of a gain in Well-Days can result from further improvements in Cardiofitness, and how much time and effort the individual is will to expend on this.  A first modest objective for improvement as for example 10 CFR can be most appropriate for initial planning.  If a Cardiofitness level is not known, assume a value of 100 CFR for the estimate if no significant exercise program is now being done.  Alternatively a rough estimate of likely Cardiofitness can be derived from estimating possible Pulse Points from Table 2 and then using Table 3.  An estimate of present Cardiofitness also can be obtained from entering the needed exercise entries into Life Ahead.

Suppose for example an objective is to improve CFR by 10 units, and present Cardiofitness is 100.  This as per Life Ahead should reduce risk of cardiovascular disease by nearly half, reduce risk of cancer by more than a third, and if done regularly should add 4 years to the Well-Days of life for an average man or woman of age 50.  Table 3 suggests this gain will take a bit less than 2000 or about 1800 Pulse Points per week.  Table 2 suggests this will take abut 90 minutes of walking brisk enough to raise heart rate 30 beats per minute above resting rate.  Or perhaps 55 minutes per week if heart rate can be comfortably increased by 40 beats per minute above resting rate.  This Cardiofitness gain should be obtained from maintaining the heart rate elevation of 60 noted in Table 2 from only 30 minutes per week of jogging or moderate running by those medically approved for this.  These should be very acceptable programs for most people. And a gain of 10 units in CFR should be measurable by the suggested treadmill tests after 3 to 6 months of this exercise.

Many people and especially those younger will wish to improve Cardiofitness by at least 20 units or 20%.  This as per Life Ahead provides a very substantial improvement in the outlook for life and is a usual recommendation for good habits.  Sixty minutes per week of good aerobic exercise or about two hours of brisk to fast heart rate monitored walking should accomplish this.

The Pulse Point method and its confirming data reveal the large importance of exercise intensity in improving Cardiofitness. This importance of exercise intensity as been well verified by population research on heart disease.  Running at a 70 elevation in heart rate that is practical and acceptable for many at middle age produces Cardiofitness in one third of the time needed for brisk walking.  Thus any younger person and many older that are in good physical condition and medically approved should not be wasting valuable time walking when they can get far more benefit from more vigorous exercise.  But walking remains a best alternative for those older and for those finding other exercise less acceptable.  The real key is this:  Walking must be brisk enough to be useful.  A full hour a day of walking at an inadequate heart  rate may be of little benefit to health.   The word brisk that can mean different things to different people is not sufficiently meaningful. 

Obtaining Cardiofitness Efficiently requires a Monitoring of Exercise Heart Rates:  Exercise recommendations 2 through 7 cited above all are seriously deficient because they provide inadequate recognition of the fact that the key to health is exercise of the heart.  There is only one way to insure that the heart gets its exercise.  This is to insure that a useful elevation of heart rate above its usual low resting rate is obtained during exercise. Doing this is very simple. First measure your own resting heart rate in the morning before breakfast.  Then check your heart rate after walking for at least 3 minutes.  Just stop and take it yourself.  It the heart rate is less than 30 per minute above resting rate and you are in good health, walk faster until your heart rate reaches at least this level.  This is how fast you need to walk.  If you are in good health, try to gradually move that heart rate higher during exercise.

There is another important need for monitoring heart rates during exercise.  As one becomes more cardiofit, resting heart rate usually declines.  An improvement of 10 in CFR probably will reduce a resting heart rate by 7 or from 70 to perhaps 63 beats per minute.   If you just walk at the same rate your walking heart rate probably also will also drop by this same 7 beats per minutes. But as you become more cardiofit you can comfortably walk faster and keep your heart rate at the previous level.  If that previous level had been 100, and you keep it at 100, your heart rate elevation will be 37 and you now will be getting 1370 Pulse Points per hour vs. the 900 Pulse Points you obtained initially.  You can get the same Cardiofitness benefit now from walking only about 2/3rds as long as you did initially.  Pulse Points reveal that those cardiofit can obtain much more benefit that average from their exercise at a given exercise heart rate because they achieve lower resting heart rates.  This author's heart rate moved down from 70 to below 60 after a first 6 months of exercise.  After years of more intensive but by no means extreme exercise it moved down to about 48.

About Genetics:  Research now confirms that genetics and family relationships are important factors that related to Cardiofitness.  First, some individuals are genetically more Cardiofit than others for a probable given amount of exercise.  Also research shows that the Cardiofitness of individuals can respond differently to the same amount of heart exercise.  All tables in Life Ahead are for population averages, and keep in mind the the Cardiofitness of individuals may respond differently to exercise and Pulse Points than average.  The most important result is the Actually Measured Cardiofitness.  This appears to be the factor that determines future health.  Try to develop enough exercise to improve those actually measured values of Cardiofitness. 

Use Life Ahead to Obtain some very Valuable Information:  You can use the tables following for estimating how much exercise you need to do to reach a given improvement in CFR above the so-called sedentary level of 100.  It does not matter what kind of exercise is done as long as it is done for a minimum of 3 minutes and preferably for at least 10 minutes.  But the Life Ahead computer program provides some very simple alternate and now unique ways for estimating how cardiovascular fitness usually will develop from a wide variety of both individual popular exercises and combinations of different exercise done at different intensities and for different times. Download and install the free program from Download Life Ahead. It is best to enter all of your own habits and factors into the program.  But to value exercise usefully you do not even need to do this.  Simply use the Demo Program provided that produces results for a typical middle age man or women. Click on Demo, highlight man or woman, and then click the 4th option down at the right, 'Compute Results from Data now Entered'. The program will complete its thousands of computations in a second and near immediately display the health outlook for the typical US person. The Demo assumes 5 miles per week of usual walking at average rate, a few daily stair climbs, and a usual lifestyle of mostly sitting or driving that usually produces a sedentary 98.5 level of cardiofitness in CFR, or a value close the usual level of 100 for sedentary. 

Now access the option 'Change Exercise/Fitness'.  The first display will permit entering amounts and intensity of walking, jogging/running, aerobic exercise and  weight training.  A second display provides for entry of sports and golf.  An important entry is about physical activity of lifestyle other than that of specific exercise. Make any entries of these exercises you wish.  After completing exercise display #2, press Continue again to bring up the 3rd exercise display that at the bottom will show a probable value of  CFR for this revised exercise entry. Click Continue again and the 4th exercise display will show your Cardiofitness Pulse Points per week and your Exercise calories per day from each of these exercises and in total.  Now click 'Compute Outlook Now' and the program will display your change in risk of heart disease and overall cancer, and any change in Well-Days of potential life if this revised exercise is carried out continually henceforth.  You now can ask again to 'Change Exercise' and try any other single or combination of the included exercises to view its potential. Be sure to delete previous entries if you do not want them include in a new valuation.

You will note that the 3rd exercise entry screen provides for entering results of specific treadmill tests and of various popular methods for actually measuring cardiofitness. Results obtained in any of these tests can be converted to more useful levels of cardiofitness in CFR, which simply approximates a percent of usual sedentary.  Much more about these tests is described elsewhere on this site. Because cardiofitness is partly genetically endowed, it is desirable to obtain an actual measurement wherever this is possible. Some people will have genetically higher or lower levels of cardiofitness than the averages assumed for these tables.

    Table 1:  Typical Pulse Points obtained for Times of Different Types of Exercise per Week

                                              ---------------------------------------------------Time of Exercise in Minutes----------------------------------------------------------------------

  Table 2:  Gains in Cardiofitness in CFR from Exercise Pulse Points from Various Starting Levels of the CFR

Gains in Cardiofitness from 10,000 or fewer Pulse Points per week probably can be achieved with 6 months to 1 year of continued exercise.  Gains from Pulse Points above 20,000 per week may require 2 years of more of dedicated exercise.  Assumes that 160 CFR is maximum obtainable for an average person doing an ultimate competitive training program.  Note that gains from higher fitness levels require far more Pulse Points than do gains from lower levels.