Body size or exercise: Which matters most?

Given the choice between being slim despite the fact that you never exercise or being overweight despite the fact that you work out all the time, which would you choose?

If you chose slim and no exercise, would it surprise you to know that your health could ultimately be worse than if you'd chosen to be overweight but exercise regularly?

It may be true. Studies suggest that people who are physically active and overweight have lower rates of cardiovascular disease and mortality than people who are inactive and thin. So whether you're slender or voluptuous, big and tall or thin and small, making physical activity a regular part of your life is vital to improving your health and making your RealAge younger.

Weighing in on health

That's not to say that size doesn't matter at all. The health risks associated with obesity are well documented: increased risk of diabetes, high blood pressure, coronary heart disease, cardiovascular disease, and some types of cancer. But what you don't hear very often is that you can reduce these risks by being physically active, even if you don't lose weight.

Some studies suggest that being overweight is linked with an increased risk in mortality, even among people who are physically fit. Other research disagrees, however.

One reason is that some standard weight and size measurements, such as body mass index (BMI), are not accurate predictors of health risks. BMI, for example, doesn't distinguish between fat and muscle, and it doesn't measure visceral fat -- the fat surrounding abdominal organs. Visceral abdominal fat is a significant risk factor for heart disease andmetabolic syndrome. So some people with a healthy BMI who carry their weight around their middle may actually be less healthy than people labeled overweight who have better fat distribution.

Bottom line: No matter what your size or your BMI, being inactive increases your risk of heart disease, hypertension and type 2 diabetes.

Start with this goal

To improve your health, aim for 30 minutes of moderate aerobic activity most days of the week to help improve your cardiorespiratory fitness. Thirty minutes 4 or 5 days a week might seem like a lot, especially if you haven't been active in a while or you lead a hectic life. But you'll be adding years of good health to your life if you can get yourself to do this on a regular basis.

That's the tricky part, of course: being physically active on a regular basis. Most people are not as active as they should be, and we're all likely to experience times when exercise falls by the wayside. We have our reasons for falling short, but we can overcome these obstacles with the right approach.

So what's stopping you from being consistently active? Read on to determine what your biggest barrier to fitness is and what you can do to overcome it, and start reaping the rewards of exercise.

What's your biggest barrier to exercise?

Choose the description below that best reflects the issue that keeps you from being more physically active and find out how to get around it.

I'm getting older, don't know what to do at my age, and am worried about injury.

It's never too late to get active. Regular physical activity will help keep you strong as you age, making it easier to remain active and be independent longer. For most older people, moderate activity is safe. Moderate physical activity should cause a slight increase in heart rate and breathing. It should feel somewhat challenging, but you should still be able to carry on a conversation without difficulty.

Examples of moderate-intensity activities include:

• Playing tennis (doubles)
• Raking leaves or sweeping the patio
• Walking laps in a pool
• Walking briskly

Check with your doctor before beginning an exercise program for the first time. Your doctor can help you design a program that takes into account any physical limitations or medical conditions you have. A well-designed exercise program should be able to accommodate just about any special circumstances.

Build up your level of activity gradually to help prevent sore muscles or injury. Listen to your body, and don't try to do too much too soon. If something is painful or seems impossibly difficult, ease up or find a less intense activity.

Three tips to get started:

1. Block out some walking time. Walk around the block each morning or every evening after dinner. Walking is a simple and effective way to be active. You don't need any special equipment, just sturdy walking shoes. If you are worried about hurting yourself, recruit a friend, family member, or neighbor to walk with you. Having someone close by who can assist you, if needed, can bring peace of mind.
2. Focus on your flexibility. You may benefit greatly from flexibility exercises and can spend more time doing these and less time doing cardio, if you prefer. And strength and flexibility exercises can help protect you from injury. Simple stretches work fine. Start with these stretches that you can do at home. For some variety, find out whether your local community center offers dance classes for older adults. Dancing can build balance, flexibility, strength, and aerobic fitness. You can also build balance skills with either instructional videos or structured classes on yoga or tai chi.
3. Seek water. Swimming and aqua aerobics are good options if you have aching joints, arthritis, or certain physical limitations. Water activities can build aerobic fitness, muscle strength, and flexibility. And because the water supports most of your weight, water activities won't be jarring on your joints. 

If these tips don't jumpstart your fitness program, don't give up. The options are endless, and with appropriate guidance from fitness and healthcare experts, you should have all the tools and support you need to work out safely and effectively.

I'm out of shape and it seems like such a long road ahead.

Although getting physically fit or losing weight is certainly an achievable goal no matter what your starting point, if you focus on that fairly vague and lofty goal right from the beginning, you are likely to get discouraged. Instead, break things down into smaller, more specific, more realistic goals.

It may help to know that the first few hundred extra calories you burn will give you the greatest health benefit. So take it day by day, focus on living a more active life overall, and the rest will fall into place.

Three tips to get started:

1. Make it manageable. Set your goals as small and as specific as you need in order to get motivated. Instead of saying to yourself, "I'm going to get in shape," set a more realistic short-term goal with a very specific objective. For example, your first goal might be to walk for 5 minutes today and tomorrow. Or you might set a goal of walking up and down the stairs in your house two additional times every day this week. Do whatever you need to do to make the concept of being active seem manageable to you on a moment-by-moment basis.
2. Ease into it. Start with a scaled-down version of whatever plan you've created for becoming more active. If walking is your activity of choice, begin with 5-minute walks and eventually build up to 10-, 20-, or 30-minute walks. Or start exercising just 2 days per week, then work your way up to 5 days per week over a period of months. Start small, and as soon as you feel you can do more, commit to the extra effort. But don't bother thinking about the next step until you feel great about what you are currently doing.
3. Work with what you've got. If you're very overweight or have aching joints, arthritis, or a physical limitation, you'll do best to focus on activities that make exercise easier in the beginning. Swimming or other water-based activities are good options. They provide an excellent resistance and cardiovascular workout, and the water will support most of your weight, so you may be able to do stretches and movements that might be too difficult on dry land. Enlist the help of your healthcare provider or physical therapist in designing a workout plan that's appropriate for you. 

Take it day-by-day. If you focus on the short-term and keep setting new goals, before you know it, you'll be looking back with pride on the long road you traveled.

I'm simply too busy and don't know where I'd find the time for regular exercise.

It can be a challenge to find time to be active when you've got a hectic schedule. Start by taking a moment to remind yourself that your health is at stake. You're not wasting time by being physically active, you're buying time. The time you spend exercising now comes back to you later in the form of a longer, more active life.

Also, the chances are good that you'll save more time than you spend, because you'll sleep better and be more rested. You will most likely notice that you are less nervous and distracted as well. All of this will help you to get more done in less time.

So make physical activity just as important as the other items on your to-do list.

Three tips to get started:

1. Make a multitasking strategy. Can you walk and chew gum at the same time? Then talking and walking at the same time won't be a stretch. A daily walking program doesn't have to mean cutting back on family time if you combine the two. Take walks in the evening to catch up with your partner, kids, friends, or parents. Another way to multitask: Combine exercising and commuting. You can bike to work or park a mile away and walk to and from your car. Other multitasking options: Have walking meetings with colleagues, clean the house at high speed for a cardio boost, and catch up on your reading by listening to books on tape while exercising. Finally, wear a pedometer. This simple, affordable device counts the number of steps you take. With a little effort, you can probably figure out creative ways to make your normal daily life active enough to meet the recommended 10,000 steps per day.
2. Schedule exercise into your appointments. Take an extra 10 minutes before or after each appointment, and use that time to walk around the block or up and down the stairs. Schedule exercise into your outings with friends and family as well. Instead of dinner and a movie, make it lunch and a hike or breakfast and a bike ride. Keep a pair of running shoes in the trunk of your car so you can grab a few active moments whenever your schedule allows.
3. Use exercise to unwind. With a jam-packed schedule, stress-reduction strategies are a must to help ward off needless aging. Exercising allows you to kill two birds with one stone because in addition to getting you fit, exercise is a natural stress-reducer. It boosts blood levels of endorphins, which are the body's natural mood enhancers, and decreases blood levels of cortisol, the body's stress hormones.

However you manage to squeeze in time for exercise, your body and mind will thank you for it. Before long, you'll really miss it when you don't get to exercise because of the impact it has on your physical and emotional well being.

I'm usually too exhausted by the end of the day. I just can't get motivated. I'd rather relax.

If you are exhausted at the end of the day, that's all the more reason to exercise. Research shows that as few as 10 weeks of regular exercise can leave people feeling more energized than they did prior to engaging in a program of physical activity.

We all struggle with motivation from time to time, but by continually putting off activity, you're turning it into a nagging chore, and that could be part of what's making you feel so lethargic. It's time to regain control of the situation.

Three tips to get started:

1. Get exercise out of the way early. If you find you lack motivation at the end of the day, part of your problem may be timing. Don't put exercise off until you're too tired to do it. Plan your workout for the time of day when you feel most energized. A 10-minute walk or jog before heading off to work may be just the ticket. Or you may be able to use your lunch hour for a trip to the gym. Just don't skip lunch—that will leave you feeling more drained. Nibble on your sandwich at your desk when you get back from working out.
2. Make exercise a social obligation. One of the most effective ways to lick the lazies is to make exercise appointments with other people. If you know someone is relying on you to show up at the park or the gym, it will be harder to blow it off. Pick up the phone or send an e-mail—now—to set a time to get together and do something active with a friend or coworker. You can make it fun—throw a Frisbee in the park or play a sloppy game of tennis at lunchtime. If you're feeling ambitious, you can set a time to meet a fitness-focused friend at the gym after work so he or she can show you the ropes. Signing up for an exercise class can keep you committed to weekly workouts as well.
3. Walk for good. Turning exercise into something you do for others may be just the motivation you need to get moving. Sign up for a charity walk to raise funds for a cause close to your heart. Enlist the participation of others, and schedule times to walk together. Give yourself a goal, and try to beat it. Some charity walks offer regular group get-togethers, trainings, and other motivational activities.

If you see exercise as a mindless activity—a mere means with no end—then it's pretty unlikely you'll make it a regular part of your life. Finding an exercise angle that gives physical activity meaning for you is the key to staying motivated.

It's not practical. The weather's often bad and I don't know what to do indoors.

Being active is key to a long and healthy life. And many of the things we might do to stay active—walking, gardening, riding bikes, swimming—tend to lend themselves to the outdoors. So when wet, inclement weather kicks in, it can really put a damper on your exercise groove. Especially if you're one of those people who gets bored doing the same indoor workout day after day.

Whether you feel housebound by the weather or some other aspect of your geographical surroundings, you can beat this obstacle to fitness by thinking outside the box—or the house.

Three tips to get started:

1. Make the most of community resources. Local community centers or colleges may have a number of indoor facilities for use, including indoor tennis courts, pools or tracks. While you're there, see what kind of activities and classes are available. You may find the winter months are a great time to brush up on your dusty tap-dancing skills or learn how to rumba for the first time.
2. Use the weather to your advantage. Ice skating, cross-country skiing, sledding, shoveling snow and building a snowman all provide excellent forms of exercise. Bundle up and embrace the cold. Just be sure to take things slowly. Allow your lungs to get acclimated to cold-weather workouts with short periods of exercise. With proper acclimation and gear—such as ski masks that warm and moisten air as it passes into your mouth—you should be able to get your fill of exercise without hurting your respiratory health.
3. Make over your indoor workout. For the days when it is truly impossible to head outside or make the trek to your favorite indoor exercise facility, it's good to have a backup plan. Keep your home stocked with options for working out indoors. Invest in a variety of exercise videos and DVDs—from standards, such as aerobics, to the truly unusual, such as a belly dancing or hip-hop how-to. The more variety the better—you're less likely to get bored. You may also want to consider investing in some traditional exercise equipment for the days when you don't feel as creative. An exercise ball, treadmill, stationary bike or weight bench offer a quick and easy option for fitting in 30 minutes of activity.

Think of the cold, wet winter months as your opportunity to get truly creative. When the weather is better, you can go back to your old standbys. Start thinking now about new ways to be active next winter.

I hate exercising.

Some people love a structured exercise program—they go to the gym, they do the weight circuit, they have their 30 minutes on the treadmill, and they love every minute of it. If a structured exercise plan doesn't appeal to you, there's no crime in that. But it's also not a legitimate obstacle to fitness because—here's the good news—you don't have to exercise.

That's right. There are lots of things you can do that count toward meeting physical activity goals and they don't have to fall under the category of traditional exercises to make you younger and fitter.

Three tips to get started:

1. Think "active," not "exercise." Here's a list of activities that can help you fill your physical activity quota for the day: playing Frisbee; washing the car; building a fence; gardening; dancing; running after your dog at the park; mowing the lawn with a push mower; ironing; sculpting clay; woodworking; laying down linoleum in your kitchen; painting the garage; roller-skating; walking at the mall (shop if you must); acting in a community play; dancing at a club or alone in your living room; hiking with a friend; taking a paddleboat around a lake. If you can strike the right balance of cardiorespiratory, flexibility, and strength-training exercise with your physical activities, you may never have to darken the doors of a gym again.
2. Take a fitness vacation. Spend your vacation engaging in physical activities in exotic locales instead of taking a vacation from exercise. Do your research; you can find vacation packages at spas, ranches, or retreats that will fill your days with hiking; yoga; kayaking; horseback riding; tennis; skiing; surfing; snorkeling; or a combination of activities. For those in need of a bigger challenge, a fitness boot camp may be the preferred option. Just be sure to choose a package that is appropriate for your current fitness level and abilities. Bring what you learn home with you and put it into daily practice.
3. Figure in the fun factor. Do whatever you have to do to make physical activity enjoyable for you. Choose scenic routes for your walks: a neighborhood with beautiful homes, a picturesque park, or a stunning riverside or beach walk. Invite good company on your active outings, so the time will fly by. Treat yourself on the weekends—drive (or better yet, cycle) to a nearby state park or botanical garden you've been meaning to visit. Enjoy your surroundings, and try as many different activities as you need in order to stay interested, challenged and motivated.

Being physically active will make you more energetic and boost your mood almost immediately. You'll sleep better, feel good about yourself, find it easier to relax and you may really enjoy the new, active you.

I usually find a way to be active.

Good for you! You are part of a minority of health-minded people who exercise regularly or spend a significant portion of their time being active.

Because you exercise regularly, if you are in good health, your body could probably benefit from more vigorous—as opposed to moderate—physical activity to improve your cardiovascular fitness.

Here are some ways you can shift from moderate to more vigorous physical activities.

Moderate activities:

• Playing tennis (doubles)
• Raking leaves or sweeping the patio
• Walking laps in a pool
• Cycling 5–9 miles per hour on a flat surface
• Playing Frisbee
• Walking briskly
• Gardening 

Vigorous activities:

• Playing tennis (singles)
• Shoveling heavy snow
• Swimming laps in a pool
• Cycling more than 10 miles per hour or on hilly terrain
• Roller-skating
• Jogging or hiking
• Mowing lawn with a push mower

And if you have a friend or family member who needs some help getting motivated, consider sharing your energy by inviting him or her for a walk or another active outing, being mindful of the person's fitness level.

Active advantage

If you can overcome the obstacles that leave your activewear gathering dust, regular physical activity provides an impressive array of health benefits, regardless of your size. Thirty minutes of moderate activity each day (or at least 4 or 5 days a week) can help to:

• Reduce high blood pressure
• Prevent heart disease
• Reduce risk of stroke
• Lower cholesterol levels
• Reduce total and visceral fat
• Improve cardiovascular function
• Reduce risk of colon cancer
• Prevent osteoporosis
• Reduce risk of developing type 2 diabetes and improve health outcomes for those with diabetes
• Reduce risk of depression, elevate mood
• Support restful sleep
• Reduce tension and increase energy

Weight not, want not

Whether you hit the gym, hit the road, or sneak in a few minutes of Frisbee each weekend, try not to focus on losing weight. It's more important to your health and well-being for you to be active than to stress too much about your size. In fact, research suggests that people who are overweight today are healthier than most normal-weight people were a generation ago.

To be sure, weight loss is a smart goal if your weight is hurting your health. If you're obese, even if you currently have no signs of poor health, research suggests you may be at high risk of developing diabetes and heart disease in later life. If you want to lose weight while you're getting healthier and more fit, you may need to increase the amount or intensity of your activities. For example, if you don't see results after 1 or 2 months of 30 minutes of moderate activity 5 days a week, spend more time exercising, or try adding a few more vigorous activities to your life without reducing the time you spend being active.

Regardless of your size, however, by working with your body to incorporate physical activity into your everyday life instead of working against it, you're improving your health and making your RealAge younger. Before long, you'll feel healthier, look healthier and be healthier.