When it comes to exercising, there’s so much disparate information out there regarding the optimal amount. Does a brisk walk after dinner count? Or, is it better to log a major sweat session at spin class? To clear up this confusion, we’ve asked Penn Medicine cardiologist Dr. Neel Chokshi for his take on this conundrum. Here, his best strategies for exercising efficiently and effectively:
How much exercise do you recommend for your patients?
A general rule I tell my patients is that some activity is better than no activity. So, every little bit counts.
The formal exercise recommendations by the American Heart Association suggest at least 150 minutes of moderate intensity exercise or 75 minutes of vigorous intensity or some combination of the two on a weekly basis. I formulate a more practical regimen tailored to each patient based on this guideline. For those who have never formally exercised, I suggest starting slow and gradually ramping up activity levels over days to weeks to ensure no ill effects of exercise. (This is especially important for inactive individuals >40 years old and those with significant medical conditions.) The most common prescription is to exercise three times per week for AT LEAST 30-45 minutes at a time.
How should the amount or frequency of your exercise regimen change as you get older?
I tell my patients to establish steady exercise routines at all ages, young and old. At younger ages (18-30), people are generally healthy and may not see the necessity for exercise. It is important to develop these habits so they are natural moving forward. Walking daily should be like brushing your teeth.
As people transition from high school/college to professional/family lives, the biggest constraint is usually time. I suggest finding creative means to integrate 30 minutes of walking or other activity in between meetings or incorporating exercise into their social life.
As you get older (>35-40s), you are likely more susceptible to sports-related musculoskeletal injuries. Further, your recovery time to rebound from high-intensity activities increases. I suggest being more aware about exercise that may be high stress (such as running outdoors and it’s impact on knees or heavy lifting and back issues).
The risk of osteoporosis increases after the age of 50 and more so in women. Weight bearing exercises have benefits in maintaining bone health. I often encourage my patients above 50 to incorporate resistance training and weight-bearing activities into their routine.
In your opinion, what’s the best kind of exercise for your patients?
I think the best exercise is doing what you enjoy because that is usually what will lead to the highest quality of a work out. For example, I enjoy playing sports – playing a few games of basketball or few hours of tennis is always better than any number of hours spent at the gym. This is key.
Do I need to see a doctor before I start exercising?
Not necessarily. However, if you are >40 years old and are fairly inactive or you have medical conditions (e.g. heart issues), I suggest having a conversation with your doctor prior to starting a routine. In general, if you start at a slow pace and increment gradually, most will be okay.
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This interview has been edited for length.