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48   July-August 2011 inF* Fitness Journal
QUIZ 2:
                                               PAGE 118




                                    Every day, consumers are bombarded with bogus
                                    claims about the benefits of quick workouts.
                                    Magazine covers offer the "60-second ab exercise"
                                    that will "peel off 7 pounds" or tout faster work-
                                    outs to "burn double the fat in half the time."
                                    Fitness infomercials claim that just minutes a day
                                    will "get you ripped, guaranteed" and boast testi-
                                    monials from users who have (supposedly) lost
                                    more than 50 pounds, or three dress sizes, with
             Research               just 3 minutes of exercise a day.
                                        While the appeal of such claims is obvious,
         suggests that              marketing grossly exaggerates the physical trans-
                                    formation that is possible from short workouts.
          encouraging               However, the fact that exaggerated claims sell
                                    products points to an important reality: nonexer-
       the inactive to              cisers are often intimidated and overwhelmed
                                    by the evidence-based guidelines for physical
         embrace any                activity. The most widely accepted guideline-
              physical              supported by the American College of Sports
                                    Medicine (ACSM), the American Heart
            activity—               Association, the U.S. Department of Health
                                    and Human Services and the World Health
         even at levels             Organization—recommends that adults engage
                                    in a minimum of 30 minutes of moderate-inten-
        that fall short             sity physical activity 5 days a week. This is in
                                    addition to ordinary, everyday activity. To lose
           of industry              weight or sustain a weight loss, even more exer-
                                    cise is required. ACSM's latest recommendation,
         guidelines—                based on a thorough analysis of existing evidence,
             may offer              suggests that significant weight loss is unlikely
                                    with less than 250-300 minutes of moderately
             a bevy of              vigorous exercise per week, or about 1 hour a day,
                                    5 days a week (Donnelly et al. 2009). >>
              benefits.




Baby Steps
   #                                      JL         By Kelly McGonigal, PhD
                                                     By Kelly f




            : 2011 IDtA Fitness Journal
Many in the fitness indus-    diet, alcohol use, menopausal status, hormone use and family
                                     try see 30-60 minutes a day as    history of heart disease.
                                     a reasonable goal, and yet only       The cardiovascular benefits of low levels of exercise are not
                                     11% of Americans currently        fully understood. However, there is evidence that even small
                                     meet the minimum recom-           doses of exercise have a positive influence on metabolism and
                                     mendation (Schoenborn &           cardiovascular physiology. For example, physical activity reliably
                                     Adams 2010). A large section      reduces blood pressure—not just in the long term, as the cardio-
                                     of the population isn't even      vascular system adapts to exercise and people become more fit-
                                     trying. According to the most     but immediately, after a single bout of exercise (MacDonald
                                     recent survey data, 33% of        2002). This effect, dubbed "postexercise hypotension," appears
                                     American adults never exer-       to last for several hours after physical activity and is especially
                                     cise and 55% never engage in      pronounced among those with hypertension.
                                     vigorous activity (CDC 2010).         A study from the University of Connecticut and Hartford
                                     These numbers only increase       Hospital asked. Does a short workout provide the same blood
                                     with age, as the health conse-    pressure benefits as a longer workout (Guidry et al. 2006)? The
                                     quences of being inactive-        researchers recruited 45 sedentary men to test the effects of two
                                     such as cardiovascular disease    sessions of indoor cycling (15 minutes vs. 30 minutes) on blood
                                     (CVD)—also climb.                 pressure. The men were randomly assigned to one of two in-
                                         To sedentary adults, 30-60    tensities (light = 40% VO^max, and moderate = 60% VO2max).
                                     minutes a day can seem            Each participant then completed 3 days of study; a short-work-
impossible. They may feel that they can't find the time or that        out day, a long-workout day and, for comparison, a nonexercise
health challenges or physical pain prevent them from being phys-       control day. Exercise took place between 8:00 AM and 11:00 AM,
ically active for that long. These nonexercisers are most likely       and the participants' blood pressure levels were tracked through-
to be tempted by the promise of benefits from shorter workouts.        out the day.
But can smaller doses of exercise lead to any real change?                 Compared with control days—when participants did not exer-
    This article reviews the evidence that even short sessions of      cise—both the 15- and 30-minute exercise sessions led to lasting
exercise—5-15 minutes a day—have very real benefits for phys-          reductions in blood pressure over the subsequent 9 hours.
ical and mental health. While fitness professionals must steer         Interestingly, the shorter dose provided the same benefit as the
clear ot unrealistic claims that such short doses can "transform       longer dose, and the two intensity levels led to equivalent reductions.
your body" or lead to significant weight loss, there is good rea-          It's worth noting that the participants in this study were over-
son to encourage baby steps among the most reluctant and over-         weight, mostly middle-aged men, with below-average fitness, an
whelmed nonexercisers. If we can't convince sedentary                  average body mass index (BMI) of 29.2 and high-normal to stage
individuals to embrace the industry ideal, we can encourage them       1 hypertension—exactly the kind of people who might be
to start small, which will still improve their quality of life.        interested in the health benefits of exercise, but who might feel
                                                                       overwhelmed by having to fit in 30-60 minutes per day. The
Improving Heart Health                                                 reduced-blood-pressure benefit observed in this study was
In a 2001 landmark report, the Women's Health Study revealed           immediate; the men did not have to "get in shape" first or achieve
the results of a longitudinal study of almost 40,000 women, aged       any particular titness standard. Based on their findings, Guidry
45 years or older, in the United States and Puerto Rico (Lee et        and colleagues suggested that short doses of low-intensity exer-
al. 2001). Participants were observed for an average of 5 years.       cise, especially when performed in the morning (and, ideally,
The report examined whether physical activity levels at the            again in the afternoon), could provide significant cardiovascu-
beginning of the study predicted who developed CVD over the            lar health benefits to a sedentary, aging population.
next several years. The researchers found a classic dose-                  Another study looked at longer-term changes in physiology
response relationship, with more physical activity providing a         and supported the idea that 15-20 minutes of exercise a day can
greater protective effect against CVD. But the amount required         improve cardiovascular health (Lippincott et al. 2008). Seventy-
to get a significant benefit was quite small. As little as 60 min-     two sedentary employees, aged 22-62, participated in the
utes of walking per week—less than 10 minutes a day, or a sim-         National Heart, Lung, and Blood Institute's "Keep the Beat" pro-
ple stroll around the block—was associated with significantly          gram. The program gave employees outlines for 15-minute car-
reduced CVD risk. In fact, among women who reported no reg-            diovascular and strength training workouts they could do in the
ular vigorous exercise, women who walked at a light to moder-          National Institutes of Health (NIH) campus fitness centers. It also
ate pace for at least 1 hour a week had half the risk of women         offered tips on fitting short bursts of exercise into the workday—
who did not walk regularly. This effect held even when the             for example, by taking the stairs or walking around campus.
researchers statistically controlled for factors such as smoking.          The study's first observation was that employees did indeed

so                                                 July-August 2011 IDEA Fitness Journal
become more active; adding a 15-minute workout was a feasi-           researchers were able to track and record every time a participant
ble change that previously sedentary employees could fit into         broke a sedentary period by standing or taking a single step. The
their workday. Program participants averaged 98 minutes of            participants also kept a log of any moderate to vigorous physical
exercise per workweek, equivalent to one 15-minute fitness cen-       activity, so researchers could separate the benefits of standhig up
ter workout and a few minutes of extra activity each day By the       troni the benefits of regular exercise. The participants who took
end of the 3-month study, the exercise had paid off. Employees        a higher number of breaks from being sedentary had smaller
in the program showed significant improvements in several             waist circumferences, as well as lower blood glucose and triglyc-
measures ot fitness and CVD risk, including increased peak VO2,       Ă©ride levels. The frequency of stand or step breaks predicted these
improved eiidothelium function, reduced blood pressure and            health measures independent of time spent exercising and total
lower cholesterol.                                                    sedentary time. In other words, every time a person stood up
                                                                      or took a single step, it contributed to his or her health. It didn't
Mitigating the Effects of Sitting                                     matter how active or inactive that person was.
A 15-minute workout may seem to yield impressive benefits, but            This research suggests that fitness professionals can credibly
the smallest dose of exercise that can improve cardiovascular         recommend even the smallest of behavior changes—such as
health may be even shorter. A growing body of research suggests       standing up every half-hour—to sedentary individuals (see the
that spending long stretches of time sitting is a significant risk    sidebar "Recommending the Smallest Dose of Exercise"). Even
factor tor health problems, independent of whether or not a per-      it people are unwilling or unable to commit to a formal exercise
son exercises regularly (Hamilton et al. 2008). More uninter-         program, they can fit brief moments of activity into their days to
rupted sitting is associated with higher waist circumference,         support their health.
blood pressure, blood glucose, cholesterol and triglycérides
levels. The good news: A study from the University of                 Improving Psychological Well-Being
Queensland in Brisbane, Australia, found that the simple act          While more attention is typically paid to the physical health ben-
of breaking a period of sitting with any physical activity was        efits of exercise, its effects on mental health are also well estab-
associated with a healthier metabolic profile (Healy et al. 2008).    lished (Stathopoulou et al. 2006). However, unlike the
    For this study, 168 adults (mean age 53.4 and mean BMI of         dose-response relationship observed for physical health—where
27.2) wore accelerometers—a device that measures the body's           a little exercise is good, but more is often better—the latest
acceleration—during all waking hours for 1 week. The                  research suggests that when it comes to psychological well-



Recommending                                                              stand up and stretch every 30 minutes.

the Smallest                                                              Find an excuse to take a short walk around the home
                                                                          or workplace once an hour.

Dose of Exercise                                                          Walk to the farthest bathroom when going to the restroomi
                                                                          Stand and/or walk around the room when talking on
Len Kravitz, PhD, senior exercise physioiogist for IDEA, researcher       the telephone.
and program coordinator of exercise science at the University of          Get up and move (or at least stand up!) during every
New iVlexico, encourages fitness professionals to recommend stand-        commercial break while watching television or between
or-walk breaks to clients whose work, commute or leisure activities       chapters/articles while reading.                          J»
require hours of sitting. These suggestions could be helpful:                                                             Source: Kravitz 2009^
A Short Dose of Exercise Strengthens Self-Control
Imagine this: You're a participant in   study, the researchers wanted to        cise can strengthen self-control.         Kate Janse Van Rensburg,
a scientific study, and you've just     know: Could a 15-minute walk            The same research team has            MSc, lead author of these studies,
been put through a challenging          before the mental stress test help      shown that a 15-minute tread-         says, "A single session of exercise
mental test designed to stress you      people resist the temptation to         mill walk reduces cravings tor        can reduce the attention-grabbing
out The researcher then walks in        soothe their stress with chocolate?     cigarettes among smokers and          power of temptations. Daily ses-
with your favorite instant stress           All participants were asked to      improves concentration in the         sions of brief exercise could be
reliever: chocolate. The researcher     abstain from chocolate for 3 days,      face of distractions (Janse Van       integrated into any behavior
offers you a variety of chocolate       which previous research has shown       Rensburg & Taylor 2008; Janse         change attempt to help reduce
bars, asks you to choose your fa-       increases cravings (Polivy, Coleman     Van Rensburg, Taylor & Hodgson        cravings and handle withdrawal."
vorite and instructs you to unwrap      & Herman 2005). When the partici-       2009; Janse Van Rensburg et al.       Clients who are trying to quit
it. But before you can savor the        pants arrived at the laboratory, half   2009). One study looked at brain      smoking, cutting back on caffeine,
first creamy mouthful, she tells        of them were asked to walk briskly      activation among smokers pre-         conquering their sweet tooth or
you not to eat it.                      on a treadmill. These participants      sented with images of ciga-           changing to a vegetarian diet could
     Researchers at the University      showed smaller blood pressure           rettes. After exercise, the brain's   all benefit from short doses of
of Exeter, England, put 25 choco-       increases during both the stressful     reward system—which is re-            physical activity. Recommending
late lovers through this mini stress    mental task and the self-control        sponsible for feelings of desire      exercise as a coping strategy for
test as part of a study on exercise     test, suggesting that exercise          and craving—was less reactive         stress and cravings can also trans-
and self-control (Taylor & Oliver       helped them cope better with both       to the images. Another study          form working out from a chore into
2009). We tend to think of exercise     challenges. Exercise also reduced       tracked the eye gaze of smokers       a source of strength—a motivation
as something that requires self-        these participants' chocolate crav-     and found that those who had          that could help people stick with
control, but psychologists are now      ings and urges to eat the candy bar     just exercised spent less time        exercise in the long run.
considering the possibility that it         This is just one study demon-       looking at smoking-related
also increases self-control. For this   strating that short doses of exer-      images.


52                                                        July-August 2011       Fitness Journal
whether short doses of exercise can contribute to lasting changes
Get Your                                                                                   in psychological well-being. A 2009 meta-analysis looked, not just
                                                                                           at the immediate mood benefits of exercise, but at the longer-term
Exercise Mood Boost                                                                        effects on depression (Rethorst, Wipfli & Landers 2009).
                                                                                           Researchers analyzed the results of 58 randomized trials and
Research shows that as little as 5 minutes of outdoor physical activity
                                                                                           found that, overall, exercise interventions (lasting anywhere from
improves mood and self-esteem. What can you—and your clients—
                                                                                           4 to 26 weeks) resulted in significant reductions in depression.
do in 5 minutes?
                                                                                           Once again, shorter workouts yielded the biggest benefit.
•   Get out of fhe office and head for the ciosest greenery or open sky.
                                                                                               Interventions that assigned participants to exercise for fewer
•   Cue up a favorite song on your i/lP3 piayer and walk or jog around
                                                                                           than 30 minutes at a time had significantly larger effects than
    the block.
                                                                                           interventions that assigned longer workouts (e.g., 45-59 minutes
•   Take your dog outside fo play (and chase fhe toy yourseif).
                                                                                           or more than 60 minutes). When researchers compared overall
•   Do a bif of work in your yard or garden.
                                                                                           time spent exercising with degree of improvement, they did not
•   Sfep oufside for some fresh air and do a few simpie sfrefches.
                                                                                           find a linear dose-response relationship. More exercise time did
•   Challenge your kids fo a race or game in fhe backyard or local park.
                                                                                           not translate into bigger improvements. These findings—drawn
                                                                                           from a very large number of studies—provide further support to
being, short doses work as well as, or better than, longer work-                           the idea that sedentary individuals can reap substantial mental
outs (see the sidebar "Get Your Exercise Mood Boost").                                     health benefits from short exercise sessions.
    A recent meta-analysis (Barton & Pretty 2010) reviewed 10 stud-
ies that examined how exercise influences psychological well-being.                        The Benefits of Becoming Active
All 10 studies—which collectively observed more than 1,200 partic-                         The research shows there are substantial benefits to merely mov-
ipants—involved "green exercise," or physical activity that takes place                    ing out of the "sedentary" category. With some outcomes—such
outdoors. Green exercise includes walking, running, biking, hiking,                        as overall risk for cardiovascular disease—more activity is bet-
swimming, gardening, roUerblading, taking your dog or kids to                              ter. But for other measures—such as mood—simply becoming
the park or anything that gets you outside and moving.                                     active provides the full benefit. Barton, who analyzed the bene-
    The researchers were especially interested in what the best                            fits of green exercise, suggests that health professionals might
"dose" of green exercise was for self-esteem and mood. To their                            think about "quitting" sedentary living as equivalent to giving
surprise, the biggest benefits came from the shortest workouts.                            up smoking. Any activity—even a short dose of light intensity-
"The biggest difference was seen in the first 5 minutes," says Jo                          will have immediate positive health outcomes. (For evidence that
Barton, PhD, lecturer in sports and exercise science at the                                exercise can help with food cravings, see the sidebar "A Short
University of Essex, England, and lead author of the review.                               Dose of Exercise Strengthens Self-Control.") Getting a person
"Longer amounts do not necessarily equate to greater rewards."                             out of the sedentary category is a worthy goal, even if it falls
In fact, a 5-minute session improved self-esteem and mood more                             short of ideal activity levels.
than a workout lasting 10-60 minutes. The only dose that came                                  A 2009 randomized controlled trial led by researchers
close to the psychological benefits of 5 minutes was a whole day                           at Louisiana State University demonstrates this point for a wide range
spent being active outdoors—in other words, a green vacation.                              of physical and psychological outcomes (Martin et al. 2009). This
    Barton thinks that "5 Minutes a Day" is a great, targeted message                      6-month study assigned 430 sedentary, overweight or obese women
for sedentary individuals who want to experience the benefits of                           (mean BMI of 31.8) with high blood pressure to one of four condi-
being active but feel overwhelmed by the amount of activity recom-                         tions: a no-exercise control group, and three different exercise groups
mended for weight loss and better physical health. "Five minutes                           aiming to achieve 50%, 100% and 150% of NIH-recommended
seems achievable," says Barton. "If you can engage them in these                           physical activity levels, respectively. (In actual reported activity over
shorter bouts, once they start experiencing the benefits, they will be                     the study, this translated into an average of 74,138 and 184 minutes
more likely to participate more frequently, and for longer periods."                       of exercise per week at an intensity of 50% VO,max.)
    Can't get outdoors? Indoor exercisers need not despair. While                              The researchers measured changes in many dimensions of
a blue sky and green leaves might enhance the mood benefits of                             quality of life, including physical functioning, general health,
exercise, you don't need an inspiring view to get a psychological                          mental health, social functioning and vitality. Exercise improved
boost from working out. One study compared the benefits of                                 all of these outcomes over the course of the 6-month study.
indoor cycling at 60% V02max for 10,20 and 30 minutes (Hansen,                             Importantly, all three exercise groups improved, while the con-
Stevens & Coast 2001). All three exercise sessions increased par-                          trol group did not. There was a clear dose-response relation-
ticipants' energy and decreased their fatigue and negative mood.                           ship for physical and social functioning, with minimum exercise
However, these benefits reached their peak at 10 minutes, and there                        (averaging 10 minutes a day) producing some improvements, but
was no significant benefit to working out longer.                                          more exercise (up to an average of 26 minutes a day) leading to
    A quick mood boost is good, but it's also important to consider                        even greater improvements. But for general health, mental health

                                                          J u l y - A u g u s t 2011 iĂĽCA F i t n e s s J o u r n a l                                            S3
Perhaps the most interesting tlnding of this study is that all of
                                                                        the benefits were independent of weight loss. The average weight
                                                                        loss in the exercise groups over the 6-month period was small
                                                                        (2-3 pounds) and did not vary by exercise condition. But even
                                                                           when the researchers compared the outcomes of women who
                                                                         »- lost weight with those who maintained or gained weight, there
                                                                            was no relationship between weight loss and any of the posi-
                                                                          tive outcomes. Other studies—including the "Keep the Beat"
                                                                        program that increased workplace activity and led to improved
                                                                        titness and cardiovascular health—have reported similar find-
                                                                        ings. The improvement of health does not require weight loss;
                                                                        and often, the two do not go together.
                                                                            This finding is particularly important because it points to a
                                                                        current tension within the fitness industry. We know that many,
                                                                        if not most, clients turn to exercise because they want to lose
                                                                        weight. And while there is growing evidence to support the ben-
                                                                        efits of 5-15 minutes of exercise a day for currently sedentary in-
                                                                        dividuals, this dose falls far short of what research suggests is
                                                                        required to lose a significant amount of weight. At the same time,
                                                                        few sedentary individuals seem willing to invest the time needed
                                                                        to lose weight or maintain weight loss.
                                                                            The fitness industry is in a perfect position to make inroads
                                                                        with the population most resistant to exercise. One way to do this
                                                                        is by encouraging nonexercisers to commit to as little as 5 min-
and vitality, the benefits of the smallest dose were equivalent to      utes a day. To make use of the growing evidence supporting short
those of the two larger doses. Simply transitioning from a seden-       workouts for the sedentary, fitness professionals must become
tary lifestyle to any level of exercise enhanced every aspect of the    comfortable shifting their focus—and their clients' focus—away
women's quality of life.                                                from losing weight as the sole goal of exercise, and toward other



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                                                   July-August 2011 IDl:A Fitness Journal
goals, including decreasing risk for CVD, increasing energy and                                           Hansen, C.J.. Slevcns, L.C., & Coast, I.R. 2001. Exercise duration and mood state: How
                                                                                                            much is enough to feel better? Health Psychology, 20 (4), 267-75.
quality of life, and improving mood, self-esteem and self-control.                                        Healy, G.N., et al. 2008 Breaks in sedentary time: Beneftcial associations with metabolic
These are worthy goals both for the sedentary individual and for                                            risk. Diabetes Care, 31(4), 661-66.
the industry as a whole. •                                                                                lanse Van Rensburg, K., & Taylor, A.H. 2008. The effects of acute exercise on cognitive
                                                                                                            functioning and cigarette cravings during tetnporary abstinence from stnoking.
                                                                                                            Human Psychopharmacology: Clinical and Experimental, 23 (3), 193-99.
Kelly McGonigal, PhD, is a health psychologist and fitness/yoga                                           lanse Van Rensburg, K., et al. 2009. Acute exercise modulates smoking cravings and
instructor at Stanford University and the author q/The Willpower Instinct                                   brain activation in response to smoking-related iniages: An fMRI study.
                                                                                                            Psychopharmacology. 203:5H9-98.
and Yoga for Pain Relief Find out more at www.kellymcgonigal.com.                                         Janse Van Rensburg, K., Taylor, A.H., & Hodgson, T. 2009. The effects of acute exer-
                                                                                                            cise on attentional bias towards smoking-related stimuli during temporary abstinence
© 2011 by IDF.. Health & pitiless Inc. All rights reserved. Reproduction withotit permission is strictly
prohibited.                                                                                                 from smoking. Add/ct/o«, iO4(ll), 1910-17.
                                                                                                          Kravitz, L. 2009. Too much sitting is hazardous to your health. IDEA Fitness lournal, 6
                                                                                                            (9), 14-17.
                                                                                                          Lee, I.-M., et al. 2001. Physical activity and coronary heart disease in women: Is "no paiil,
                                                                                                            no gain" passé? The journal of the American Medical Association, 285 (11), 1447-54.
                                    www.ideafit.com/iuly-2011 -courses
                                                                                                          Lippincott, M.R, et al. 2008. Predictors of endothelial function in employees with seden-
                                        or mail the quiz on page 118.                                       tary occupatiotis in a worksite exercise program. American Journal of Cardiology, 102
References                                                                                                  (7), 820-24.
Barton. ]., & Pretty, J. 2010. What is the best dose of nature and green exercise for im-                 MacDonald, |.R. 2002. Potential causes, mechanisms, and implications of post exer-
  proving mental health? A multi-study analysis. Environmental Science & Technology.                        cise hypotension. Journal of Human Hypertension, 16, 225-36.
  44(10), 3947-55.                                                                                        Martin, C.K., et al. 2009. Exercise dose and quality of life: A randomized controlled trial.
CDC (Centers for Disease Control and Prevention). 2010. National Center for Health                          Archives of Internal Medicine, J69 (3), 269-78.
  Statistics. Summary Health Statistics/or U.S. Adults: National Health Interview Survey Polivy, J., Coleman, J., & Herman, C.P. 2005. The effect of deprivation on food crav-
  2009. DHHS Publication No. (PHS) 2011-1577. Hyattsville, MD: Centers for Disease                          ings and eating behavior in restrained and unrestrained eaters. International Journal
  Control and Prevention. www.cdc.gov/nchs/data/series/sr_10/srlO_249.pdf; retrieved                        of Eating Disorders, 38, 301-39.
  April 30,2011.                                                                                          Rethorst, CD., Wipûi, B.M., & Landers, D.M. 2009. The antidepressive effects of exer-
Donnelly, I.E., et al. 2009. Appropriate physical activity intervention strategies for weight               cise: A meta-analysis of randomized trials. Sports Medicine, 39(6),491-511.
  loss and prevention of weight regain for adults. Medicine & Science in Sports &                         Schoenborn, C.A., & Adams, P.P. 2010. Health behaviors of adults: United States,
  £»)rise,4J (2), 459-71,                                                                                   2005-2007. Vital and Health Statistics Data from the National Health Survey, Series 10
Guidry, M.A., et al. 2U06. The influence of short and long duration on the blood pres-                      (245), 1-132.
  sure response to an acute bout ot dynamic e.xercise. American Heart Journal, ¡51                        Slathopoulou, G., et al. 2006. Exercise interventions for mental health: A quantitative
   (6), 1322.e5-el2.                                                                                        and qualitative review. Clinical Psychology: Science and Practice, 13 (2), 179-93.
Hamilton, M.T., et al. 2008. Too little exercise and too much sitting: Inactivity physiol-                Taylor, A.H., & Oliver, A.J. 2009. Acute effects of brisk walking on urges to eat choco-
  ogy and the need for new recommendations on sedentary behavior. Current                                   late, affect, and respon.ses to a Stressor and chocolate cue: An experimental study.
   Cardiovascular Risk Reports. 2, 292-98.                                                                  A;)pefiie, 52(1), 155-60.




                  nĂ­te. Empower, Motivate




                                                                       July-August 2011 IDEA Fitness Journal                                                                                    55
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Brief Bouts and Baby Steps

  • 1. Brief B 48 July-August 2011 inF* Fitness Journal
  • 2. QUIZ 2: PAGE 118 Every day, consumers are bombarded with bogus claims about the benefits of quick workouts. Magazine covers offer the "60-second ab exercise" that will "peel off 7 pounds" or tout faster work- outs to "burn double the fat in half the time." Fitness infomercials claim that just minutes a day will "get you ripped, guaranteed" and boast testi- monials from users who have (supposedly) lost more than 50 pounds, or three dress sizes, with Research just 3 minutes of exercise a day. While the appeal of such claims is obvious, suggests that marketing grossly exaggerates the physical trans- formation that is possible from short workouts. encouraging However, the fact that exaggerated claims sell products points to an important reality: nonexer- the inactive to cisers are often intimidated and overwhelmed by the evidence-based guidelines for physical embrace any activity. The most widely accepted guideline- physical supported by the American College of Sports Medicine (ACSM), the American Heart activity— Association, the U.S. Department of Health and Human Services and the World Health even at levels Organization—recommends that adults engage in a minimum of 30 minutes of moderate-inten- that fall short sity physical activity 5 days a week. This is in addition to ordinary, everyday activity. To lose of industry weight or sustain a weight loss, even more exer- cise is required. ACSM's latest recommendation, guidelines— based on a thorough analysis of existing evidence, may offer suggests that significant weight loss is unlikely with less than 250-300 minutes of moderately a bevy of vigorous exercise per week, or about 1 hour a day, 5 days a week (Donnelly et al. 2009). >> benefits. Baby Steps # JL By Kelly McGonigal, PhD By Kelly f : 2011 IDtA Fitness Journal
  • 3. Many in the fitness indus- diet, alcohol use, menopausal status, hormone use and family try see 30-60 minutes a day as history of heart disease. a reasonable goal, and yet only The cardiovascular benefits of low levels of exercise are not 11% of Americans currently fully understood. However, there is evidence that even small meet the minimum recom- doses of exercise have a positive influence on metabolism and mendation (Schoenborn & cardiovascular physiology. For example, physical activity reliably Adams 2010). A large section reduces blood pressure—not just in the long term, as the cardio- of the population isn't even vascular system adapts to exercise and people become more fit- trying. According to the most but immediately, after a single bout of exercise (MacDonald recent survey data, 33% of 2002). This effect, dubbed "postexercise hypotension," appears American adults never exer- to last for several hours after physical activity and is especially cise and 55% never engage in pronounced among those with hypertension. vigorous activity (CDC 2010). A study from the University of Connecticut and Hartford These numbers only increase Hospital asked. Does a short workout provide the same blood with age, as the health conse- pressure benefits as a longer workout (Guidry et al. 2006)? The quences of being inactive- researchers recruited 45 sedentary men to test the effects of two such as cardiovascular disease sessions of indoor cycling (15 minutes vs. 30 minutes) on blood (CVD)—also climb. pressure. The men were randomly assigned to one of two in- To sedentary adults, 30-60 tensities (light = 40% VO^max, and moderate = 60% VO2max). minutes a day can seem Each participant then completed 3 days of study; a short-work- impossible. They may feel that they can't find the time or that out day, a long-workout day and, for comparison, a nonexercise health challenges or physical pain prevent them from being phys- control day. Exercise took place between 8:00 AM and 11:00 AM, ically active for that long. These nonexercisers are most likely and the participants' blood pressure levels were tracked through- to be tempted by the promise of benefits from shorter workouts. out the day. But can smaller doses of exercise lead to any real change? Compared with control days—when participants did not exer- This article reviews the evidence that even short sessions of cise—both the 15- and 30-minute exercise sessions led to lasting exercise—5-15 minutes a day—have very real benefits for phys- reductions in blood pressure over the subsequent 9 hours. ical and mental health. While fitness professionals must steer Interestingly, the shorter dose provided the same benefit as the clear ot unrealistic claims that such short doses can "transform longer dose, and the two intensity levels led to equivalent reductions. your body" or lead to significant weight loss, there is good rea- It's worth noting that the participants in this study were over- son to encourage baby steps among the most reluctant and over- weight, mostly middle-aged men, with below-average fitness, an whelmed nonexercisers. If we can't convince sedentary average body mass index (BMI) of 29.2 and high-normal to stage individuals to embrace the industry ideal, we can encourage them 1 hypertension—exactly the kind of people who might be to start small, which will still improve their quality of life. interested in the health benefits of exercise, but who might feel overwhelmed by having to fit in 30-60 minutes per day. The Improving Heart Health reduced-blood-pressure benefit observed in this study was In a 2001 landmark report, the Women's Health Study revealed immediate; the men did not have to "get in shape" first or achieve the results of a longitudinal study of almost 40,000 women, aged any particular titness standard. Based on their findings, Guidry 45 years or older, in the United States and Puerto Rico (Lee et and colleagues suggested that short doses of low-intensity exer- al. 2001). Participants were observed for an average of 5 years. cise, especially when performed in the morning (and, ideally, The report examined whether physical activity levels at the again in the afternoon), could provide significant cardiovascu- beginning of the study predicted who developed CVD over the lar health benefits to a sedentary, aging population. next several years. The researchers found a classic dose- Another study looked at longer-term changes in physiology response relationship, with more physical activity providing a and supported the idea that 15-20 minutes of exercise a day can greater protective effect against CVD. But the amount required improve cardiovascular health (Lippincott et al. 2008). Seventy- to get a significant benefit was quite small. As little as 60 min- two sedentary employees, aged 22-62, participated in the utes of walking per week—less than 10 minutes a day, or a sim- National Heart, Lung, and Blood Institute's "Keep the Beat" pro- ple stroll around the block—was associated with significantly gram. The program gave employees outlines for 15-minute car- reduced CVD risk. In fact, among women who reported no reg- diovascular and strength training workouts they could do in the ular vigorous exercise, women who walked at a light to moder- National Institutes of Health (NIH) campus fitness centers. It also ate pace for at least 1 hour a week had half the risk of women offered tips on fitting short bursts of exercise into the workday— who did not walk regularly. This effect held even when the for example, by taking the stairs or walking around campus. researchers statistically controlled for factors such as smoking. The study's first observation was that employees did indeed so July-August 2011 IDEA Fitness Journal
  • 4. become more active; adding a 15-minute workout was a feasi- researchers were able to track and record every time a participant ble change that previously sedentary employees could fit into broke a sedentary period by standing or taking a single step. The their workday. Program participants averaged 98 minutes of participants also kept a log of any moderate to vigorous physical exercise per workweek, equivalent to one 15-minute fitness cen- activity, so researchers could separate the benefits of standhig up ter workout and a few minutes of extra activity each day By the troni the benefits of regular exercise. The participants who took end of the 3-month study, the exercise had paid off. Employees a higher number of breaks from being sedentary had smaller in the program showed significant improvements in several waist circumferences, as well as lower blood glucose and triglyc- measures ot fitness and CVD risk, including increased peak VO2, Ă©ride levels. The frequency of stand or step breaks predicted these improved eiidothelium function, reduced blood pressure and health measures independent of time spent exercising and total lower cholesterol. sedentary time. In other words, every time a person stood up or took a single step, it contributed to his or her health. It didn't Mitigating the Effects of Sitting matter how active or inactive that person was. A 15-minute workout may seem to yield impressive benefits, but This research suggests that fitness professionals can credibly the smallest dose of exercise that can improve cardiovascular recommend even the smallest of behavior changes—such as health may be even shorter. A growing body of research suggests standing up every half-hour—to sedentary individuals (see the that spending long stretches of time sitting is a significant risk sidebar "Recommending the Smallest Dose of Exercise"). Even factor tor health problems, independent of whether or not a per- it people are unwilling or unable to commit to a formal exercise son exercises regularly (Hamilton et al. 2008). More uninter- program, they can fit brief moments of activity into their days to rupted sitting is associated with higher waist circumference, support their health. blood pressure, blood glucose, cholesterol and triglycĂ©rides levels. The good news: A study from the University of Improving Psychological Well-Being Queensland in Brisbane, Australia, found that the simple act While more attention is typically paid to the physical health ben- of breaking a period of sitting with any physical activity was efits of exercise, its effects on mental health are also well estab- associated with a healthier metabolic profile (Healy et al. 2008). lished (Stathopoulou et al. 2006). However, unlike the For this study, 168 adults (mean age 53.4 and mean BMI of dose-response relationship observed for physical health—where 27.2) wore accelerometers—a device that measures the body's a little exercise is good, but more is often better—the latest acceleration—during all waking hours for 1 week. The research suggests that when it comes to psychological well- Recommending stand up and stretch every 30 minutes. the Smallest Find an excuse to take a short walk around the home or workplace once an hour. Dose of Exercise Walk to the farthest bathroom when going to the restroomi Stand and/or walk around the room when talking on Len Kravitz, PhD, senior exercise physioiogist for IDEA, researcher the telephone. and program coordinator of exercise science at the University of Get up and move (or at least stand up!) during every New iVlexico, encourages fitness professionals to recommend stand- commercial break while watching television or between or-walk breaks to clients whose work, commute or leisure activities chapters/articles while reading. J» require hours of sitting. These suggestions could be helpful: Source: Kravitz 2009^
  • 5. A Short Dose of Exercise Strengthens Self-Control Imagine this: You're a participant in study, the researchers wanted to cise can strengthen self-control. Kate Janse Van Rensburg, a scientific study, and you've just know: Could a 15-minute walk The same research team has MSc, lead author of these studies, been put through a challenging before the mental stress test help shown that a 15-minute tread- says, "A single session of exercise mental test designed to stress you people resist the temptation to mill walk reduces cravings tor can reduce the attention-grabbing out The researcher then walks in soothe their stress with chocolate? cigarettes among smokers and power of temptations. Daily ses- with your favorite instant stress All participants were asked to improves concentration in the sions of brief exercise could be reliever: chocolate. The researcher abstain from chocolate for 3 days, face of distractions (Janse Van integrated into any behavior offers you a variety of chocolate which previous research has shown Rensburg & Taylor 2008; Janse change attempt to help reduce bars, asks you to choose your fa- increases cravings (Polivy, Coleman Van Rensburg, Taylor & Hodgson cravings and handle withdrawal." vorite and instructs you to unwrap & Herman 2005). When the partici- 2009; Janse Van Rensburg et al. Clients who are trying to quit it. But before you can savor the pants arrived at the laboratory, half 2009). One study looked at brain smoking, cutting back on caffeine, first creamy mouthful, she tells of them were asked to walk briskly activation among smokers pre- conquering their sweet tooth or you not to eat it. on a treadmill. These participants sented with images of ciga- changing to a vegetarian diet could Researchers at the University showed smaller blood pressure rettes. After exercise, the brain's all benefit from short doses of of Exeter, England, put 25 choco- increases during both the stressful reward system—which is re- physical activity. Recommending late lovers through this mini stress mental task and the self-control sponsible for feelings of desire exercise as a coping strategy for test as part of a study on exercise test, suggesting that exercise and craving—was less reactive stress and cravings can also trans- and self-control (Taylor & Oliver helped them cope better with both to the images. Another study form working out from a chore into 2009). We tend to think of exercise challenges. Exercise also reduced tracked the eye gaze of smokers a source of strength—a motivation as something that requires self- these participants' chocolate crav- and found that those who had that could help people stick with control, but psychologists are now ings and urges to eat the candy bar just exercised spent less time exercise in the long run. considering the possibility that it This is just one study demon- looking at smoking-related also increases self-control. For this strating that short doses of exer- images. 52 July-August 2011 Fitness Journal
  • 6. whether short doses of exercise can contribute to lasting changes Get Your in psychological well-being. A 2009 meta-analysis looked, not just at the immediate mood benefits of exercise, but at the longer-term Exercise Mood Boost effects on depression (Rethorst, Wipfli & Landers 2009). Researchers analyzed the results of 58 randomized trials and Research shows that as little as 5 minutes of outdoor physical activity found that, overall, exercise interventions (lasting anywhere from improves mood and self-esteem. What can you—and your clients— 4 to 26 weeks) resulted in significant reductions in depression. do in 5 minutes? Once again, shorter workouts yielded the biggest benefit. • Get out of fhe office and head for the ciosest greenery or open sky. Interventions that assigned participants to exercise for fewer • Cue up a favorite song on your i/lP3 piayer and walk or jog around than 30 minutes at a time had significantly larger effects than the block. interventions that assigned longer workouts (e.g., 45-59 minutes • Take your dog outside fo play (and chase fhe toy yourseif). or more than 60 minutes). When researchers compared overall • Do a bif of work in your yard or garden. time spent exercising with degree of improvement, they did not • Sfep oufside for some fresh air and do a few simpie sfrefches. find a linear dose-response relationship. More exercise time did • Challenge your kids fo a race or game in fhe backyard or local park. not translate into bigger improvements. These findings—drawn from a very large number of studies—provide further support to being, short doses work as well as, or better than, longer work- the idea that sedentary individuals can reap substantial mental outs (see the sidebar "Get Your Exercise Mood Boost"). health benefits from short exercise sessions. A recent meta-analysis (Barton & Pretty 2010) reviewed 10 stud- ies that examined how exercise influences psychological well-being. The Benefits of Becoming Active All 10 studies—which collectively observed more than 1,200 partic- The research shows there are substantial benefits to merely mov- ipants—involved "green exercise," or physical activity that takes place ing out of the "sedentary" category. With some outcomes—such outdoors. Green exercise includes walking, running, biking, hiking, as overall risk for cardiovascular disease—more activity is bet- swimming, gardening, roUerblading, taking your dog or kids to ter. But for other measures—such as mood—simply becoming the park or anything that gets you outside and moving. active provides the full benefit. Barton, who analyzed the bene- The researchers were especially interested in what the best fits of green exercise, suggests that health professionals might "dose" of green exercise was for self-esteem and mood. To their think about "quitting" sedentary living as equivalent to giving surprise, the biggest benefits came from the shortest workouts. up smoking. Any activity—even a short dose of light intensity- "The biggest difference was seen in the first 5 minutes," says Jo will have immediate positive health outcomes. (For evidence that Barton, PhD, lecturer in sports and exercise science at the exercise can help with food cravings, see the sidebar "A Short University of Essex, England, and lead author of the review. Dose of Exercise Strengthens Self-Control.") Getting a person "Longer amounts do not necessarily equate to greater rewards." out of the sedentary category is a worthy goal, even if it falls In fact, a 5-minute session improved self-esteem and mood more short of ideal activity levels. than a workout lasting 10-60 minutes. The only dose that came A 2009 randomized controlled trial led by researchers close to the psychological benefits of 5 minutes was a whole day at Louisiana State University demonstrates this point for a wide range spent being active outdoors—in other words, a green vacation. of physical and psychological outcomes (Martin et al. 2009). This Barton thinks that "5 Minutes a Day" is a great, targeted message 6-month study assigned 430 sedentary, overweight or obese women for sedentary individuals who want to experience the benefits of (mean BMI of 31.8) with high blood pressure to one of four condi- being active but feel overwhelmed by the amount of activity recom- tions: a no-exercise control group, and three different exercise groups mended for weight loss and better physical health. "Five minutes aiming to achieve 50%, 100% and 150% of NIH-recommended seems achievable," says Barton. "If you can engage them in these physical activity levels, respectively. (In actual reported activity over shorter bouts, once they start experiencing the benefits, they will be the study, this translated into an average of 74,138 and 184 minutes more likely to participate more frequently, and for longer periods." of exercise per week at an intensity of 50% VO,max.) Can't get outdoors? Indoor exercisers need not despair. While The researchers measured changes in many dimensions of a blue sky and green leaves might enhance the mood benefits of quality of life, including physical functioning, general health, exercise, you don't need an inspiring view to get a psychological mental health, social functioning and vitality. Exercise improved boost from working out. One study compared the benefits of all of these outcomes over the course of the 6-month study. indoor cycling at 60% V02max for 10,20 and 30 minutes (Hansen, Importantly, all three exercise groups improved, while the con- Stevens & Coast 2001). All three exercise sessions increased par- trol group did not. There was a clear dose-response relation- ticipants' energy and decreased their fatigue and negative mood. ship for physical and social functioning, with minimum exercise However, these benefits reached their peak at 10 minutes, and there (averaging 10 minutes a day) producing some improvements, but was no significant benefit to working out longer. more exercise (up to an average of 26 minutes a day) leading to A quick mood boost is good, but it's also important to consider even greater improvements. But for general health, mental health J u l y - A u g u s t 2011 iĂĽCA F i t n e s s J o u r n a l S3
  • 7. Perhaps the most interesting tlnding of this study is that all of the benefits were independent of weight loss. The average weight loss in the exercise groups over the 6-month period was small (2-3 pounds) and did not vary by exercise condition. But even when the researchers compared the outcomes of women who »- lost weight with those who maintained or gained weight, there was no relationship between weight loss and any of the posi- tive outcomes. Other studies—including the "Keep the Beat" program that increased workplace activity and led to improved titness and cardiovascular health—have reported similar find- ings. The improvement of health does not require weight loss; and often, the two do not go together. This finding is particularly important because it points to a current tension within the fitness industry. We know that many, if not most, clients turn to exercise because they want to lose weight. And while there is growing evidence to support the ben- efits of 5-15 minutes of exercise a day for currently sedentary in- dividuals, this dose falls far short of what research suggests is required to lose a significant amount of weight. At the same time, few sedentary individuals seem willing to invest the time needed to lose weight or maintain weight loss. The fitness industry is in a perfect position to make inroads with the population most resistant to exercise. One way to do this is by encouraging nonexercisers to commit to as little as 5 min- and vitality, the benefits of the smallest dose were equivalent to utes a day. To make use of the growing evidence supporting short those of the two larger doses. Simply transitioning from a seden- workouts for the sedentary, fitness professionals must become tary lifestyle to any level of exercise enhanced every aspect of the comfortable shifting their focus—and their clients' focus—away women's quality of life. from losing weight as the sole goal of exercise, and toward other The Ultimate Personal Trainer Software Suite Exercise, Fitness Assessment, Nutrition, Meal Plans, Scheduling, Billing, Retention ManagemenI : maker nutritionhnaker • Schedule trainers, clients, classes • Assess daily calorie requirements • Print dietitian designed meal plans • Perform billing/revenue reporting One • Marketing tools Integrated • Analyze diet and eating habits • Retention management Suite • Print meal plan shopping list or f XPERT ^ Four Separate Programs FiTness Maker Create exercise handouts • Maintain fitness assessment results Create fitness programs • Provide physiologic age service Use for post-rehab • Perform health risk screens Email programs • Print complete fitness reports For free demo call 800-750-2756 or download your free demo at www.BioExSystems.com July-August 2011 IDl:A Fitness Journal
  • 8. goals, including decreasing risk for CVD, increasing energy and Hansen, C.J.. Slevcns, L.C., & Coast, I.R. 2001. Exercise duration and mood state: How much is enough to feel better? Health Psychology, 20 (4), 267-75. quality of life, and improving mood, self-esteem and self-control. Healy, G.N., et al. 2008 Breaks in sedentary time: Beneftcial associations with metabolic These are worthy goals both for the sedentary individual and for risk. Diabetes Care, 31(4), 661-66. the industry as a whole. • lanse Van Rensburg, K., & Taylor, A.H. 2008. The effects of acute exercise on cognitive functioning and cigarette cravings during tetnporary abstinence from stnoking. Human Psychopharmacology: Clinical and Experimental, 23 (3), 193-99. Kelly McGonigal, PhD, is a health psychologist and fitness/yoga lanse Van Rensburg, K., et al. 2009. Acute exercise modulates smoking cravings and instructor at Stanford University and the author q/The Willpower Instinct brain activation in response to smoking-related iniages: An fMRI study. Psychopharmacology. 203:5H9-98. and Yoga for Pain Relief Find out more at www.kellymcgonigal.com. Janse Van Rensburg, K., Taylor, A.H., & Hodgson, T. 2009. The effects of acute exer- cise on attentional bias towards smoking-related stimuli during temporary abstinence © 2011 by IDF.. Health & pitiless Inc. All rights reserved. Reproduction withotit permission is strictly prohibited. from smoking. Add/ct/o«, iO4(ll), 1910-17. Kravitz, L. 2009. Too much sitting is hazardous to your health. IDEA Fitness lournal, 6 (9), 14-17. Lee, I.-M., et al. 2001. Physical activity and coronary heart disease in women: Is "no paiil, no gain" passĂ©? The journal of the American Medical Association, 285 (11), 1447-54. www.ideafit.com/iuly-2011 -courses Lippincott, M.R, et al. 2008. Predictors of endothelial function in employees with seden- or mail the quiz on page 118. tary occupatiotis in a worksite exercise program. American Journal of Cardiology, 102 References (7), 820-24. Barton. ]., & Pretty, J. 2010. What is the best dose of nature and green exercise for im- MacDonald, |.R. 2002. Potential causes, mechanisms, and implications of post exer- proving mental health? A multi-study analysis. Environmental Science & Technology. cise hypotension. Journal of Human Hypertension, 16, 225-36. 44(10), 3947-55. Martin, C.K., et al. 2009. Exercise dose and quality of life: A randomized controlled trial. CDC (Centers for Disease Control and Prevention). 2010. National Center for Health Archives of Internal Medicine, J69 (3), 269-78. Statistics. Summary Health Statistics/or U.S. Adults: National Health Interview Survey Polivy, J., Coleman, J., & Herman, C.P. 2005. The effect of deprivation on food crav- 2009. DHHS Publication No. (PHS) 2011-1577. Hyattsville, MD: Centers for Disease ings and eating behavior in restrained and unrestrained eaters. International Journal Control and Prevention. www.cdc.gov/nchs/data/series/sr_10/srlO_249.pdf; retrieved of Eating Disorders, 38, 301-39. April 30,2011. Rethorst, CD., WipĂ»i, B.M., & Landers, D.M. 2009. The antidepressive effects of exer- Donnelly, I.E., et al. 2009. Appropriate physical activity intervention strategies for weight cise: A meta-analysis of randomized trials. Sports Medicine, 39(6),491-511. loss and prevention of weight regain for adults. Medicine & Science in Sports & Schoenborn, C.A., & Adams, P.P. 2010. Health behaviors of adults: United States, £»)rise,4J (2), 459-71, 2005-2007. Vital and Health Statistics Data from the National Health Survey, Series 10 Guidry, M.A., et al. 2U06. The influence of short and long duration on the blood pres- (245), 1-132. sure response to an acute bout ot dynamic e.xercise. American Heart Journal, ¡51 Slathopoulou, G., et al. 2006. Exercise interventions for mental health: A quantitative (6), 1322.e5-el2. and qualitative review. Clinical Psychology: Science and Practice, 13 (2), 179-93. Hamilton, M.T., et al. 2008. Too little exercise and too much sitting: Inactivity physiol- Taylor, A.H., & Oliver, A.J. 2009. Acute effects of brisk walking on urges to eat choco- ogy and the need for new recommendations on sedentary behavior. Current late, affect, and respon.ses to a Stressor and chocolate cue: An experimental study. Cardiovascular Risk Reports. 2, 292-98. A;)pefiie, 52(1), 155-60. nĂ­te. Empower, Motivate July-August 2011 IDEA Fitness Journal 55
  • 9. Copyright of IDEA Fitness Journal is the property of IDEA Health & Fitness, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.