Walking: A Complete Guide to the Complete Exercise

Book by Meyers Casey

ONE

Do You Have a Healthy Lifestyle?

You may be wondering why a walking book is starting out talking about “lifestyle” instead of walking. As a 79-year-old with years of hindsight to draw from, I am certain that this chapter on lifestyle is the most important chapter in the book. If I can’t thoroughly convince you that you don’t have any other viable option than to start exercising consistently to preserve your health, maintain your quality of life, and (I hope) increase your longevity, then I have failed, and you have wasted your money on this book. Please read this chapter carefully.

The large conference room at Missouri Western State University was packed for an April 2005 breakfast meeting, provocatively titled “Our Lifestyles Are Killing Us.” The speaker, Lowell Kruse, CEO of Heartland Regional Medical Center, delivered a slide presentation that included a number of charts, graphs, and grim statistics about the current status of our population’s health at the regional, state, and national levels. It wasn’t a pretty picture.

The three leading causes of death in the United States continue to be heart disease, cancer, and stroke, in that order. A chart compiled by the Centers for Disease Control (CDC) and Heartland Regional Medical Center, titled “1990 & 2004 Leading Actual Causes of Death in the U.S. —Human Behaviors,” caught my eye (Figure 1.1). Tobacco use is still the number one cause of preventable death related to lifestyle, but, fortunately, the number of deaths has not increased from 1990 to 2004. Even so, cigarette smoking still accounts for about 400,000 needless deaths annually.

The alarming category in second place was “Poor Diet/Inactivity/ Obesity.” It shows a significant increase from 1990 to 2004 and is only about 2 percent behind tobacco. If its rate of acceleration in the last ten years continues, it will surpass tobacco before this decade is out as the primary cause of preventable death in the United States. As a nation, we are literally sitting and eating ourselves to death. Our self-indulgence and inactive lifestyle are a deadly duo (Figure 1.2).

Our daily lives are dominated by numerous reasons not to exercise. For baby boomers and all those born later, especially children born in the last ten years, what constitutes “normal” daily physical activity is vastly different from those of us born much earlier. I was a child in the thirties and a teenager in the forties, during World War II. In the thirties, obese people were uncommon in the general population, especially young obese people. Old films of World War II draftees in the early forties reveal lean groups of men. I was drafted in 1946, and there wasn’t one fat soldier in my basic training company. It is quite the opposite today and has been so for several decades—especially the last twenty years.

Let’s look at some of today’s reasons our daily energy expenditure has been greatly reduced. In the early 1900s the marriage between the wheel and the internal combustion engine brought us the automobile. Amid cries of “It will never replace the horse,” the automobile has become a dominant force in the American lifestyle. It has spawned drive-through banks, dry cleaners, pharmacies, and of course fast- food restaurants, just to name a few. We even have a drive-through Starbucks in my town. Other human energy savers include elevators, escalators, automatic washers and dryers, riding mowers, golf carts, power tools, automated assembly lines, moving walkways in airports, garage door openers, TV remote controls, and thermostats. With a furnace or stove, we used to carry in the coal and carry out the ashes, and in between we had to get up several times to stoke the fire. With today’s heating and cooling systems and a thermostat, you can keep your house at an even temperature year round without moving a muscle. And these modern conveniences are just the tip of the iceberg.

In addition, we have actually added to our inactivity by spending countless hours watching television, playing video games, and surfing the Internet. The obesity problem for children is skyrocketing, but no wonder. Television has become a babysitter for the very young, who then graduate to video games. Sitting and more sitting. This raises an obvious question: with all of these wonderful modern conveniences, why would anyone in their right mind go out each day and spend their valuable time exercising and, heaven forbid, maybe even work up a sweat? The answer can be summed up in two words—your health.

From the very young to the very old, we have engineered ourselves into a deleterious state of inactivity. Unless you become convinced that a sedentary lifestyle puts your health and longevity at risk, it is unlikely that you will break the bonds of inactivity and be a consistent exerciser. Let me try to convince you.

The American Heart Association’s (AHA) 2005 update “Heart Disease and Stroke Statistics” states, “Today, nearly seven of every 10 U.S. adults are overweight, and about three of every 10 are obese. And among children, overweight and obesity are rising at an alarming rate.” The report continues, “Since 1991, the prevalence of obesity increased 75 percent, and obesity has increased among every ethnic group.” According to the AHA, the estimated annual cost of obesity- related diseases in the United States is about $100 billion.

If I asked you to name the major risk factors for heart disease, you would probably say high cholesterol, high blood pressure, and cigarette smoking. You would be right, but there is one more that almost everyone misses. It is physical inactivity, also called sedentary living. In the mid-nineties the AHA added sedentary living to its list of major risk factors, giving it equal status with the most infamous cause of preventable death, cigarette smoking. If you are a nonsmoker but are sedentary, you are at a similarly high risk for heart disease. Sedentary living does its damage to the body slowly over an extended period of time just as cigarettes do. Most people in their 50s, 60s, and older tend to become more sedentary each passing year. And as the AHA report states, “While our level of activity declines, our rates of heart disease increase.”

I would be remiss if I didn’t emphasize that in terms of annual body count, the most destructive lifestyle of all is cigarette smoking. Year in and year out, it wins the death derby by a country mile. If you are a smoker, you can’t walk enough miles or eat enough heart- healthy foods to undo the damage caused to your body by smoking. Dr. Tedd Mitchell of the Cooper Clinic says, “Nothing even comes close to smoking as the biggest cause of preventable death. It is in a class by itself.” He added, “We know that smoking is a major contributor to premature death from heart disease, stroke, lung cancer, and emphysema, but cigarettes are also linked to many other diseases the public has not been warned about, such as pancreatic cancer.” Many smokers have been able to quit, but unfortunately, many others have tried and failed.

Nicotine in cigarettes is a highly addictive drug that develops a tenacious hold on the brain’s chemical receptors. Most cigarette smokers have great difficulty conquering this addiction when they try to quit. Cigarette companies have artfully characterized smokers as having the “smoking habit,” because they don’t want people to know that they are addicted to a pernicious drug. If you have tried unsuccessfully to quit smoking, keep trying. Nicotine addiction is far more difficult to overcome than breaking a “habit.” In a strange twist of logic, some people (particularly women) continue to smoke because they believe it helps them stay slim. There is some truth to that, but they are trading a ham for a hot dog in that deadly deal. Life expectancy statistics reveal that cigarette smokers die eight to ten years sooner than nonsmokers. Smoking truly is a lifestyle that is killing us.

Obesity’s role in our nation’s escalating health care costs is now headline news. “Health Spending Soars for Obesity” was the headline for the lead story on the front page of the June 27, 2005, USA Today. The story revealed that private health insurance spending on illnesses related to obesity has increased more than tenfold since 1987. In April 2005 the prestigious Mayo Clinic issued a conference report titled “Action on Obesity: Report of a Mayo Clinic National Summit.” In the report they listed diseases associated with being overweight or obese, which include coronary heart disease, congestive heart failure, hypertension (high blood pressure), type II diabetes, obstructive sleep apnea and other lung diseases, pulmonary hypertension, stroke, degenerative joint disease, many types of cancer, and gall bladder disease, plus a number of other diseases with long names that are unfamiliar to the average layman—including me. Many of these diseases are life-threatening and can lead to premature death.

Obesity is often determined by your body mass index (BMI). The BMI is a formula for adults, age 20 and over, by which you can determine if you are actually underweight, normal weight, overweight, or obese. Do you know which BMI category you are in? The formula by which you can compute your BMI with any calculator is as follows:

BMI = weight in pounds, divided by your height

in inches squared (height in inches X height in inches) X 703

For instance, if you weigh 220 pounds and you are 6 feet tall:

220

(72 X 72 = 5,184) = 0.0424

0.0424 X 703 = 29.8 BMI

The following table (Figure 1.3) lists the BMI weight status for: (1) underweight, (2) normal, (3) overweight, and (4) obese.

The Centers for Disease Control Web site (www.cdc.gov/nccdphp/dnpa/ bmi/bmi-adult-formula.htm) provides a full discussion of the BMI and also has a BMI calculator. Just plug in your height and weight and your BMI comes up with the click of a mouse. CDC cautions that two people can have the same BMI but a different percentage of body fat. A weight lifter with a large muscle mass and a low percentage of body fat, for instance, may have the same BMI as a person whose body fat percentage is much higher, because BMI is calculated using weight and height only. If you aren’t lifting weights, your BMI may be telling you to lose weight.

The CDC cautions that it is very important to remember that the BMI is just one of many factors related to developing a chronic disease (such as heart disease, cancer, or diabetes). The CDC lists other factors besides BMI that also may be important to your risk of chronic disease: physical activity, diet, waist circumference, blood pressure, blood sugar level, cholesterol level, and family history of disease.

Another way to determine if you are overweight is to measure your waist at its narrowest point. It should be no larger than 40 inches for men and 35 inches for women. A Canadian study published in Lancet found that waist-to-hip ratio was also a way to determine if you are at risk for heart disease. Just measure your waist and hips with a tape measure and then divide your waist by your hips. Above-average risk for women is more than 0.85 and for men 0.9. High risk is above 0.95 for women and 1.0 for men.

The BMI and the other measurements are simply guidelines to alert you if you are at increased risk for developing a chronic disease. If your measurement numbers are higher than normal, the CDC recommends that you talk to your doctor to see if you should lose weight; they say, “Even a small weight loss (just 10% of your current weight) may help lower the risk of disease.”

The April 2004 AARP Bulletin stated that the highest proportion of obese people (28 percent) was in the 50-to-64 age group, according to the CDC. The CDC’s statistics also revealed that for Americans 65 and older the obesity figure drops to 19 percent—still high but an improvement. A CDC spokesperson said while there are many reasons why the older group has fewer obese people—some are thin because of chronic health conditions—“some obese people just don’t survive into their 60s.” This is a grim reminder that baby boomers who are obese need to develop a healthy lifestyle ASAP. Procrastination could be deadly.

If you are obese or are fighting an overweight problem, the weight- related diseases cited earlier by the Mayo Clinic are lurking in your future. I had a weight problem until I finally became a regular exerciser at the young age of 52. (Looking back more than a quarter century, 52 really does seem young.) If excess weight is your concern, you have my sympathy, because I know it is pure hell. Unfortunately, most of us tend to focus on our double chins and other aspects of our physical appearance instead of our health, which should be our primary concern. Without good health, everything else is irrelevant.

As I near the end of the longevity spectrum, I can tell you that status, image, money, power, and worldly possessions are meaningless if your health is gone. As the old saying goes, “You can’t take it with you.” When you get up into my age range it seems like everything either leaks or dries up, so you have to do whatever it takes to keep yourself healthy and functioning every day. Exercise is the key. Without exercise, I wouldn’t be alive today to write this update. Someday, exercise may be a lifesaver for you.

A paragraph from my first book, Aerobic Walking, published in 1987, is more appropriate today than it was then. It comes from a study at Harvard’s School of Public Health on the connection between exercise and fatness. The author stated, “In his hundreds of thousands of years of evolution man did not have any opportunity for sedentary life except very recently. An inactive life for man is as recent (and as ‘abnormal’) a development as caging is for an animal. In this light, it is not surprising that some of the usual adjustment mechanisms would prove inadequate.” Simply stated, over thousands of years our physiological systems developed to function with considerably more physical activity than we are getting today.

The modern conveniences that we are surrounded with, plus an overabundance of food, rob us of our ability to get enough physical activity to maintain a healthy weight range. Generally speaking, if you are an overweight baby boomer, you should try to achieve the weight you were when you were fully grown and at your leanest and fittest. Old family photo albums will show that you were fully grown and probably at your prime weight in your late teens or early twenties. Heredity, however, plays a significant role in whether you are fat or thin in your late teens.