The Life Ahead Program, diet, exercise, weight, fitness, health

Abstract: The CFR level of Cardiofitness can be measured in exercise facilities with help of professionals or by individuals themselves using a variety of methods as (1) Three alternative tests on a treadmill at load levels that most people should find acceptable; (2) The Bruce treadmill test (3) Tests on an exercise bicycle; or (4) A measured value of VO2 Max in ml of oxygen per kg-minute. The Life Ahead computer program can compute results from conditions and heart rates or values obtained in any of these tests. The Life Ahead also will compute a usual value of the CFR from amounts and kinds of exercise entered, and will provide an estimate a Cardiofitness genetic factor if an actual fitness measurement is included. An approximate level of Cardiofitness also an be estimated from a carefully measured resting heart rate. Tables are provided for separate identification of Cardiofitness from the 3 proposed treadmill tests.

The Life Ahead method and program provides several ways for you to obtain your Cardiofitness. Many people can obtain a rough approximation from a careful measure of their resting heart rate. Another estimate can be obtained by answering questions about your exercise that are included in the Life Ahead Program. Everyone can and should obtain an estimate from these two methods. Your CFR also can be estimated from a variety of ways that follow, but the most practical and useful CFR value may be obtained by measuring your heart rate when walking on a treadmill.

Various exercise facilities and programs provide a variety of fitness testing programs and ways for estimating what is called 'fitness'. These generally are measures of total physical capability, and may provide information on body fat, flexibility and other very useful data. But these tests probably will not provide the measure of your Heart Efficiency, or your Cardiofitness factor, the CFR. The CFR is today's only measure that will identify a best cardiovascular and overall health risk for adults of each sex and for various ages. Although the CFR usually is determined mostly by exercise, some people are endowed with a genetic advantage or disadvantage in Cardiofitness for a given level of exercise that may be significant.

The Low Resting Heart Rate: Everyone should know their Low Resting Heart Rate. This lowest rate at which the heart usually beats when awake can be a useful indicator not only of CV fitness but of the long term outlook for health and life of many people. The resting heart rate is a key because it can provide an approximate measure of Cardiofitness, and because it is a need in planning a useful exercise program using Pulse Points. Although the CFR estimated from a resting heart rate will not always be accurate, it almost always will show a CHANGE in Cardiofitness as regular exercise is increased or stopped. Higher Cardiofitness usually will result in a lower resting pulse rate. A change in resting rate may take a month or more of new exercise to observe. You will find it fascinating to understand more about the rate at which your heart usually beats. My resting heart rate dropped from more than 70 to 60 beats per minute during a first year of new aerobic exercise. This provided welcome news that my exercise was really accomplishing something significant. Today after good but not extreme exercise for decades my heart usually beats below 50 times per minute early in the morning before breakfast..

In the morning before breakfast, and after sitting quietly for at least 2 or 3 minutes, you probably will measure your lowest heart rate during the day. After each meal your heart rate even when sitting and quiet usually will gradually increase about 10 beats per minute or more higher than this lowest rate, and gradually move down toward the low resting rate during the next three hours. If you are even a bit nervous, upset or ill the rate will move several beats per minute higher. Your resting rate may be elevated appreciably for several hours following a session of strong exercise. It will be elevated after any intake of alcohol or caffeine, or smoking. Modest walking about will increase your heart rate, and some medications will change your resting rate either up or down. A number measured in your doctor's office or in any supervised environment can be 10 beats or more above your true low resting rate. The taking of some medications will raise or lower usual heart rate.

Thus it is important to measure this rate by yourself, at least 3 hours after any meal or intake of the above items, before any session of serious exercise, and at a time when none of these rate-disturbing factors is present. You must observe these precautions not only when taking your resting heart rate, but when performing any of the other fitness tests that are described following.

Please plan to measure your Low Resting Heart Rate tomorrow morning before breakfast. Sit quietly for a full 60 seconds, and then measure it for another 60 seconds. Recheck it for a second 60 seconds. Obtain a first estimate of your CFR from the tables below:

For MEN

Resting Heart Rate	Usual Lifestyle & Exercise	Probable CFR
70+	Mostly Sit or Drive	88 or Lower
65-69	Average sedentary, little exercise	89-103
60-64	Moderately active, some exercise	104-120
55-59	Good regular exercise program	121-135
50-54	Excellent Aerobic Exercise	136-150

Because a CFR from this measurement may be approximate, note how the resting heart rate corresponds at least approximately to the usual lifestyle and exercise descriptions noted above. If as a man, for example, your resting rate is 72 and you still do some reasonable exercise your fitness probably will be higher than noted above. Or as a woman, if your resting rate is 68 and you do no exercise and mostly sit and drive your CFR may really be 90 or lower.

The Life Ahead Program: The free Life Ahead program download provides a detailed questionnaire about how exercise usually produces Cardiofitness. Start up Life Ahead and following your completion of entry screens of sex, age, weight, etc. go directly the "Enter, Edit or Display an Exercise or Fitness Entry". Enter most usual regular exercise and other activity during the past six months and press Continue after completing each display. The third display will show the CFR estimated from entered lifestyle and exercise in a small box at the lower right. As mentioned elsewhere, some people a genetic advantage and others are endowed with a genetic disadvantage in Cardiofitness for a similar level of exercise. If a treadmill or other test of cardiofitness is entered into Life Ahead together with completion of the exercise questionnaire, the program will develop a genetic factor as the ratio of actual to exercise-estimated values. This becomes a new and potentially important health risk factor. A high genetic factor can indicate very favorable genetic risk that heretofore has not been available.

The Treadmill Tests of Cardiofitness: Three new alternative treadmill tests are suggested as methods for estimating Cardiofitness. Each test requires measuring a heart rate obtained after walking on the treadmill for three minutes and when observing all of the precautions about eating, taking medications, etc. noted above for taking a resting heart rate. The treadmill test should be taken at least 3 hours after food, alcohol, or caffeine intake. And the heart rate must be measured accurately. If you have access to a professionally managed exercise facility, get the help of an expert in doing your first tests. The treadmill tests are simple and can be taken every day when you exercise.. Thus it can be worthwhile to check this heart rate carefully and average results of 2 or more rates. Machine measured heart rates can be accurate if they appear steady and move up steadily. But they can be very inaccurate if they fluctuate. If in doubt, check your heart rate yourself to verify if the machine rate looks OK. If machine rates are wrong, they can be far wrong.

Heart rate must be increased at least 30 beats per minute above Low Resting rate in any of these tests for results to be useful. If the Treadmill speed and load say in Test A does not produce this, go to Test B or Test C. It is desirable to use heart rates no higher than about 50 beats per minute above Low Resting rate. Generally, most men will need Test B. Most women should start with Test A.

Test A uses the treadmill at zero grade and 3.5 miles per hour. Test B uses the treadmill at 2% grade and 3.5 miles per hour. Test C uses the treadmill at 5% grade and 3.3 miles per hour. These speeds and grade must be set accurately.

Test C is the reference basis. This test simulates the 5 minute level of the Balke Type Treadmill exercise test result taken by more that 20,000 men and women in the Cooper Institute, and average population heart rates at this test level were related to actually measured CFR and VO2 Max values at 99% correlation accuracy. (See more on the CFR). Further, the the risks of heart disease, cancer, and all causes of death were directly measured vs. results of this test in this premier study of Cardiofitness and health that comprises some of the key research data used in Life Ahead. No other sub-maximal fitness test available today duplicates the direct correspondence of results of both widely varying Cardiofitness levels, the CFR, and actual health risks for men and women of differing ages. And no other test results have been found published on such very large sample of individuals. But some professionals may prefer to use a heart rate for Test C as that from a more direct simulation of the actual Balke Test at the 5 minute time rather than the 3 minute Test C proposed herein. See Note A following.

Test C is a fairly demanding test for most women and for men that are in less that good condition. It should be taken in a monitored facility by those not accustomed to regular aerobic exercise, and a doctor's exam should be involved for anyone that is not accustomed to exercise that is more intense than walking. Because any exercise test can expose the heart of a person to a higher than usual load, some people - although very rarely - can experience a heart problem or attack when taking such a test. Anyone taking such a test should recognize this - and use suitable medical approval and care. Those with high resting heart rates probably will be at increased risk. With this caution, Life Ahead disclaims any responsibility for any health problem encountered by anyone from taking one of its proposed exercise tests. But these are types of tests commonly used on millions of people.

Tests A and Test B are less demanding tests that should be suitable for most people that are accustomed to brisk walking. But results now are computed from energy equations and the values of CFR although reasonably approximate may be biased somewhat and need more testing. Researchers are encouraged to refine results on Tests A and B from actual research using Test C or the more basic Balke test at 5 minutes time as a reference and send us the results.

The Bruce Treadmill Method: The Bruce test is used in medical facilities and involves stepwise increasing levels of speed and incline, each done for three minutes. You will be supervised closely when doing this test because this test may proceed up to your maximum heart rate. The supervisor will record your heart rate, the test level, and minutes into this test level when you finally give up and stop the testing. An estimate of VO2 Max probably also will be recorded by the supervisor. Before leaving the test area, write down the level number, minutes into this level, and the VO2 Max number recorded. Life Ahead will compute your CFR result from your minutes into this test. But if you have to give up early on this test and are diagnosed with any kind of a heart problem, the result of the Bruce or other VO2 Max test will not provide a useful measure of your exercise related CFR.

From the VO2 Max: Although few people usually will have this value measured, the CFR can be computed directly from an entered value of VO2 Max from the option provided in Life Ahead. The value must be measured when exercising at full maximum heart rate.

From Tests on a Exercise Bicycle: A measurement of the CFR also can be obtained via tests on a calibrated exercise bicycle if the treadmill is not available. For the bicycle test you need a professional one with a load calibrated in kpm or watts. Most people can start with a load of 100 watts or 600 kpm, but if you are in poor shape it is best to start at 50 watts or 300 kpm. Pedal at 60 rpm, and try to get a target rate of at least 35 to 40 beats per minute above your resting rate. Do not exhaust yourself. If your heart rate goes much higher than this, reduce the bicycle load. Then record the bicycle load and your heart rate after three minutes of this exercise. Life Ahead Fitness will compute your CFR from the load and heart rates from this test. As for the treadmill test you can do this test by yourself if you are adequately fit and have been approved by a doctor but is always is well to obtain professional help in a monitored facility. CFR values from the bicycle test may differ somewhat from those from a treadmill test because as before each measures a somewhat different aspect of Cardiofitness. For example, the bicycle test will not involve your body weight in its basic evaluation as much as does the treadmill. Observe the above precautions about machine measured heart rates.

From Pulse Points: If your key aerobic exercise is carried out at a fairly similar heart rate, you can enter your Pulse Points as alternate to the more approximate entries into Life Ahead. For example, if you run, jog, or swim at a fairly usual pulse rate, the Pulse Point method will provide a more accurate estimate of true aerobic exercise than will the alternate of time and intensity entry options provided. But if you enter Pulse Points from running, as example, be sure NOT to duplicate this entry with the alternate entry for time spent running.

Estimating Cardiofitness in CFR from Multiple Methods: These options provide for a variety of different methods for estimating Cardiofitness. Do not expect every method to produce the same value. Different methods will measure different aspects of the human body. Life Ahead displays the results from different test methods separately. If a treadmill test A, B, or C is entered this result (and only one result) will be used for the CFR. If a treadmill test is not entered, the program will estimate CFR as the average of other methods entered including that from the estimate of Cardiofitness from exercise. If a user wishes to explore the effect of various CFR levels, this can be done by entering a heart rate into the treadmill test options that will produce the CFR value wanted and then asking for an immediate program computation. You MUST press the Calculate button to obtain the result of tests entered before leaving this display. Note that Life Ahead will compare a measured fitness from that estimated from exercise. If these values differ much, a Cardiofitness genetic factor will be computed that will indicate that you will need more or less than average exercise to reach a desired Cardiofitness goal.

The different methods should produce the same order of magnitude values for CFR, as for example, 120, 125 or 130 or as another example, 92, 84 and 87. Accuracy of an individual CFR measurement will vary at least plus or minus 5-7%. But one specific test should be preferred to eliminate the bias from use of various methods. At this time, Life Ahead has adopted the results of TREADMILL TEST C as the reference basis test for the CFR. This is a practical test that most people can take in a monitored facility, and that as above simulates results of the similar test that has been directly related to both Cardiofitness and health for a wide population of men and women.

Some Qualifications on Cardiofitness Tests: Good data have been published on Cardiofitness tests for individuals ranging from ages 30 through 65. There is no assurance that the test results will be equal in usefulness for much older or for very young people. Maximum heart rates may be restricted for some individuals and particularly for those of advanced age. Some individuals have a variety of heart problems that might make results of a fitness test invalid. Life Ahead now does not compute treadmill test results for individuals above age 70. More research is needed to establish a fitness testing regime that will be useful for the widest age range of our population.

Tables of Treadmill Test Results: CFR valuations are directly computed by Life Ahead from entered test results. For those interested, results from the tests also can be estimated from the following tables. A test must increase heart rate at least 30-35 beats per minutes above its low resting rate to be useful. Thus if heart rate does not increase sufficiently, take a result for a next higher level test. It is best to keep heart rates no higher than 50 beats per minute above your resting rate.

TEST B

MEN WOMEN

CFR Values from Heart Rates at 3 minutes walking

at 3.5 mph and 2% Incline

Heart Rate	CFR	Heart Rate	CFR	Heart Rate	CFR	Heart Rate	CFR
130	71	105	112	140	81	115	118
129	72	104	114	139	82	114	120
128	74	103	116	138	83	113	122
127	75	102	118	137	85	112	124
126	76	101	120	136	86	111	126
125	78	100	122	135	87	110	128
124	79	99	125	134	89	109	130
123	81	98	127	133	91	108	132
122	82	97	129	132	92	107	134
121	84	96	131	131	93	106	136
120	85	95	134	130	95	105	138
119	87	94	136	129	96	104	140
118	88	93	138	128	98	103	143
117	90	92	141	127	99	102	145
116	92	91	143	126	100	101	147
115	93	90	145	125	101	100	150
114	95	89	148	124	103	99	152
113	97	88	150	123	104	98	154
112	99	87	153	122	106	97	157
111	101	86	155	121	108	96	159
110	102	85	158	120	109	95	162
109	106	84	161	119	111
108	107			118	113
107	108			117	115
106	110			116	116

TEST C

MEN WOMEN

CFR Values from Heart Rates, 3 minutes walking

at 3.3 mph and 5% Incline

Heart Rate	CFR	Heart Rate	CFR	Heart Rate	CFR	Heart Rate	CFR
140	73	115	117	150	86	125	139
139	74	114	118	149	88	124	141
138	76	113	120	148	90	123	144
137	78	112	122	147	92	122	146
136	80	111	124	146	94	121	150
135	81	110	125	145	96	120	151
134	83	109	127	144	99	119	152
133	85	108	129	143	101	118	154
132	87	107	131	142	103	117	156
131	89	106	132	141	105	116	158
130	90	105	134	140	107
129	92	104	136	139	109
128	94	103	138	138	112
127	96	102	139	137	114
126	97	101	141	136	116
125	99	100	143	135	118
124	102	99	145	134	120
123	103	98	146	133	122
122	104	97	148	132	124
121	106	96	150	131	126
120	107	95	151	130	129
119	109	94	153	129	131
118	111	93	155	128	133
117	113	92	157	127	135
116	115	91	159	126	137

It is hoped that some researchers or those with professional exercise facilities will help us verify and refine our results for Test A and Test B by obtaining data on groups of participants that take all tests, A, B, and C. The key need here is "Do the values in the above tables on tests A and B check with those from reference tests C? If not, what modifications in the tables for A and B are needed? Any help on this would be of much interest to all interested persons. These simple tests could be of great aid to the many people that should not or can not take the somewhat more intensive test C.

Note A: The 5 minute heart rate in the Balke Exercise Test (See More) provides from the massive series of exercise tests done in the Cooper institute provided direct quantitative and highly significant relationships between both VO2 Max measurements, the CFR and actual risk of both heart disease and cancer. The proposed 3 minute test at 3.3 mph and a 5% grade should simulate the heart rates obtained at the 5 minute time of the Balke Tests. But it would be desirable to test this relationship further via a substantial group of actual tests. In the meantime, some professionals may prefer use a heart rate from the actual Balke method that involves increasing grade by 1% each minute for 5 minutes as an alternate to the proposed 5% grade test in Life Ahead. This together with the above table might provide a more precise measure of an CFR than that from the 3 minute Test C method proposed herein. .