PUSH-as-Rx ®™ Wellness Exercise & Fitness

"Can understanding moderate exercise and how to measure the amount of exercise help expedite individuals' health goals and well-being?"

Moderate Exercise

Various physical activity guidelines recommend regular, moderate exercise for achieving and maintaining health and wellness. Getting the minimum, moderate weekly physical activity can help prevent disease, increase mental well-being, support weight loss and maintenance, and improve quality of life.

What Is It?

• Anything that gets the heart pumping and beating faster is considered moderate exercise. (U.S. Department of Health and Human Services, 2018)
• Moderate-intensity cardiovascular exercise includes - brisk walking, yard work, mopping, vacuuming, and playing various sports that require consistent movement.
• When engaged in moderate exercise, individuals should breathe harder but still be able to carry a conversation. (American Heart Association, 2024)
• The talk test is a way to monitor whether the exercise is at moderate intensity.

Benefits

Regular moderate exercise can help (American Heart Association, 2024)

• Decrease the risk of developing conditions like heart disease, type 2 diabetes, and dementia.
• Improve sleep and help with sleep disorders.
• Improve brain functions like memory, focus, and processing.
• With weight loss and/or maintenance.
• Improve bone health.
• Reduce depression, anxiety, and other mental health symptoms.

How Much Exercise?

The prescription for moderate exercise includes:

• 30 minutes a day for five days a week, or two hours and 30 minutes per week. (U.S. Department of Health and Human Services, 2018)
• Physical activity needs to continue for at least 10 minutes to be considered an exercise session.
• Individuals can break up their 30 daily minutes into two to three shorter sessions, each 10 minutes long.
• As the ability to exercise increases, aim to increase moderate activities.
• Individuals will reap even more health benefits if they increase moderate aerobic exercise time to 300 minutes or five hours weekly. (U.S. Department of Health and Human Services, 2018)

Measuring Exercise

• A moderate level of activity noticeably increases heart and breathing rate.
• Individuals sweat but can still carry on a conversation.
• Individuals can talk but can't sing.
• Individuals will feel the exercise but are not huffing and puffing.
• Individuals can use different scales to measure exercise intensity.

Heart Rate

• A moderate-intensity heart rate is 50% to 70% of an individual's maximum heart rate. (Centers for Disease Control and Prevention, 2022)
• An individual's maximum heart rate varies by age.
• A heart rate chart or calculator can determine an individual's maximum heart rate.
• To measure heart rate mid-exercise, individuals can take their pulse or use a heart rate monitor, app, fitness tracker, or smartwatch to ensure they stay at a moderate intensity.

MET

• M.E.T. stands for Metabolic Equivalent for Task and refers to the amount of oxygen the body uses during physical activity.
• Assigning METs to an activity allows individuals to compare the amount of exertion an activity takes.
• This works for individuals with different weights.
• During moderate physical activity, breathing and heart rate increase, and the body burns around 3.5 to 7 calories a minute.
• The actual number burned depends on your weight and fitness level.
• The body uses 1 MET for basic functions like breathing.
• Grades of activity:

• 1 MET - Body at rest
• 2 METs - Light activity
• 3-6 METs - Moderate activity
• 7 or more METs - Vigorous activity

Perceived Exertion Scale

Individuals can also check their activity level using the Borg Rating of Perceived Exertion scale/RPE. (Centers for Disease Control and Prevention, 2022) Using this scale involves monitoring how an individual feels about how hard their body is working during physical activity. The scale starts at 6 and ends at 20. A perceived exertion between 11 and 14 is considered moderate physical activity.

• 6 - No exertion - sitting still or sleeping
• 7-8 - Extremely light exertion
• 9-10 - Very light exertion
• 11-12 - Light exertion
• 13-14 - Somewhat hard exertion
• 15-16 - Heavy exertion
• 17-18 - Very heavy exertion
• 20 - Maximum exertion

Examples

Many activities are counted as moderate-intensity exercise. Choose some appealing and learn to add them to a weekly routine.

• Ballroom dancing
• Line dancing
• Gardening
• House chores that get the heart pumping.
• Softball
• Baseball
• Volleyball
• Doubles tennis
• Brisk walking
• Light jogging
• Walking or jogging on a treadmill
• Using an elliptical trainer
• Bicycling under 10 miles an hour on ground level
• Leisurely swim 
• Water aerobics

Mobility Challenges

• Individuals with mobility issues can achieve moderate intensity using a manual wheelchair or a handcycle and swimming or water aerobics.
• Individuals who can use their legs but can't tolerate walking or jogging can try bicycling or swimming.

Getting More Exercise

There are different ways to incorporate and increase moderate physical activities. These include:

10-minute Activity Bursts 

• Walk briskly for at least 10 minutes at a time.
• Walk at an easy pace for a couple of minutes.
• Pick up the pace for 10 minutes.
• Try to walk during work breaks or lunch and/or before or after work.

Walking Workouts

• Individuals can walk indoors, outdoors, or on a treadmill.
• Proper posture and walking techniques make it easier to achieve a brisk pace.
• Once comfortable walking briskly for 10 minutes, begin to extend walking time.
• Try different walking workouts that offer fast walks, jogging intervals, and/or adding hills or treadmill inclines.

New Activities

• Individuals are recommended to experiment with various exercises to find what works for them.
• Consider roller skating, blading, or skateboarding to increase heart rate.

Moderate physical activity will get and keep the body in shape. Individuals should not become distressed if they can only do a little at first. Allow time to build endurance and gradually make time each day for enjoyable physical activities.

Transform Your Body

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

U.S. Department of Health & Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition. Retrieved from https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. (Healthy Living, Issue. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Centers for Disease Control and Prevention. (2022). Target heart rate and estimated maximum heart rate. Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm

Centers for Disease Control and Prevention. (2022). Perceived exertion (Borg Rating of Perceived Exertion Scale). Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm

Many individuals are trying to get fit and stay active through physical activity and exercise. Getting back to a previous fitness routine is an achievable and realistic goal. Fitness means having the energy and strength to perform physical activity and the body feeling as good as possible. Getting fit improves total health. But it does not require training like an athlete. Just walking for a half-hour every day can help individuals reach an adequate fitness level that helps them feel better and increase energy levels.

Benefits of Getting Fit

Getting the body fit and in shape:

• Increases endurance
• Increases muscle strength
• Delivers oxygen and nutrients to tissues
• Improves cardiovascular health
• Helps release toxins
• Improves overall energy levels
• Improves sleep
• Handle stress better

Being fit allows the body to work harder without as much work, the mind is better focused, the body burns more calories, even when at rest, and proper weight is maintained. Fitness reduces the risk of falls, heart attack, diabetes, high blood pressure, and certain cancers.

How Much Physical Activity Is Needed?

Experts say the goal should be one, or a combination, of these:

• Moderate aerobic activity, like brisk walking, for at least 2½ hours a week.
• It is up to the individual how many days to exercise, but it is best to be active at least three days a week.
• Activity is recommended at least 10 minutes at a time. For example, an individual could:
• Take a 10-minute walk three times a day, five days a week.
• Take a half-hour walk three days a week.
• On the other four days, take a 15-minute walk.
• Take a 45-minute walk every other day.

Vigorous exercise is recommended at least three days a week for at least 10 minutes at a time. This activity makes the body breathe harder and increases heart rate. More vigorous activities, like running, could be included for at least one hour a week. This can be spread out 75 minutes, whichever way is more convenient for the individual. For example, an individual could:

• Run for 25 minutes 3 times a week.
• Run for 15 minutes 5 times a week.

Children as young as preschool age need activity as well. Encourage children ages 6 to 17 to engage in moderate to vigorous exercise for at least 1 hour every day.

Types of Physical Activity

Aerobic fitness

• This makes the body breathe faster and makes the heart work harder.
• Activities include walking, running, cycling, and swimming.
• It is also known as cardio or cardiovascular training.

Muscle fitness

• Muscle strength means building stronger muscles and increasing the length of time they can be used.
• Activities like weight lifting, push-ups, squats, and resistance bands can improve muscular fitness.

Flexibility

• Flexibility is the ability to move the joints and muscles through their full range of motion.
• Stretching exercises can help generate flexibility.

Being More Physically Active

Moderate physical activity is safe for most individuals, but it's recommended to talk to a doctor before engaging in physical activity/exercise. To help get started:

Make physical activity part of everyday

• Make a regular habit of using stairs, not elevators, and walking, bicycling to do errands near home.

Start walking

• Walking is a great fitness activity that most individuals can do.
• Make it a habit to take a daily walk with family, friends, coworkers, or pets.

Find a workout partner

• Working out with a partner can make exercising more enjoyable.

Find fun activities that you can stick with

• Vary activities, so they don't become boring and monotonous.
• Use a calorie-burning application to determine how many calories are burned during exercise and daily activities.

Body Composition

Damaged Collagen

There are several reasons the body's collagen production can slow down or become less efficient. The quality of the collagen made can decrease as well. Environmental factors can be avoided to protect collagen production; however, damage from disease and natural processes is inevitable. Aging is the most common cause of decreased natural collagen. As the body ages, collagen production and quality decrease. This leads to thinner, more fragile skin and achy joints. Certain chronic diseases like lupus and rheumatoid arthritis cause collagen deficiency, leading to issues that include:

• Joints
• Blood vessels
• Organs
• Skin

To avoid collagen damage, avoid environmental factors like:

• Smoking 
• UV exposure can accelerate the average rate of collagen damage that comes with aging.
• UV exposure damage can also play a role in certain skin cancers.
• Excessive sugar and fat intake increases inflammation and decreases protein synthesis.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American College of Sports Medicine, et al. (2009). Position stand: Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41(7): 1510–1530.

Anspaugh DJ, et al. (2011). Building muscular strength and endurance. Wellness: Concepts and Applications, 8th ed., pp. 111–137. New York: McGraw-Hill.

Centers for Disease Control and Prevention (2004). Strength training among adults aged 65 or older. MMWR, 53(2): 25–28.

U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.

Williams MA, et al. (2007). Resistance exercise in individuals with and without cardiovascular disease: 2007 update: A scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation, 116(5): 572–584.

Individuals striving to be healthy may not know where or how to start. Can hiring a health coach help individuals start their wellness journey and reach their goals?

Hiring A Health Coach

It's easy to get caught up in the desire to make changes, but it is another thing to actually set a consistent plan in motion. Hiring a health coach can help individuals understand the information, develop an effective wellness routine that suits their lifestyle, and achieve health and wellness goals. A primary healthcare provider could be a resource and have referrals to reputable health coaches in the area.

What Do They Do?

Health coaches are experts in helping individuals reach health and wellness goals. This can be:

• Reducing stress
• Improving self-care
• Focusing on nutrition
• Starting exercise
• Improving quality of life

A health coach helps create a plan and makes it happen.

• Health and wellness coaches use motivational interviewing and evidence-based approaches to empower individuals in their wellness journey. (Adam I Perlman, Abd Moain Abu Dabrh. 2020)
• They help identify areas that need improvement, develop a plan, and encourage the individual all the way like a personal fitness trainer.
• Health coaches work with physicians and/or other health professionals in a clinical setting or as individual providers.
• Their role is to provide a holistic approach to health and wellness.

Services Provided

Health coaches can provide and assist with: (Shivaun Conn, Sharon Curtain 2019)

• Diet and nutrition
• Exercise, movement
• Sleep
• Mental and emotional health
• Occupational wellness
• Relationship building
• Social skills building

A health coach is someone who helps organize and balance various aspects of an individual's life so they can learn to maintain optimal health.

• They will help overcome barriers when struggling.
• A health coach listens and provides support for whatever an individual's goals may be.
• A health coach is there until the goal is reached.

Qualifications

It is important to ensure the providers being considered have the necessary qualifications. Because some certification programs offer a focus on specific areas like nutrition, it's recommended to identify what is needed before choosing a health coach. Health coaches do not need a university degree, however, many certifications are affiliated with colleges and have educational partnerships that qualify coursework and award college credits. Training to become a health coach consists of: (Shivaun Conn, Sharon Curtain 2019)

• Health
• Fitness
• Goal setting
• Coaching concepts
• Nutritional concepts
• Motivational interviewing
• Stress management
• Changing behaviors

Health Goal Examples

Health coaching is not a one-size-fits-all approach. A primary healthcare provider or physician provides a diagnosis and medical plan, and a health coach helps guide and support the individual through the plan. However, hiring a health coach does not require a medical condition to employ services. A few examples of health goals that health coaches address include:

• Improving quality of life
• Reducing stress and management
• Lifestyle habits
• Weight loss
• Exercise
• Physical activity
• Emotional and psychological health
• Quitting smoking

Finding a Health Coach

A few things to consider.

Health Goals

• Determine goals and expectations.
• There are many types of health coaches and some may specialize, therefore try to determine the expertise needed to achieve the goals.

Budget

• Determine how much money will be invested, as many insurance providers do not cover the cost of a health coach.
• Health coaches may charge between $50 to $300 per session.
• Some will offer packages, memberships, and/or discounts.

Certifications

• Look into their certification.
• Is it accredited?
• This will ensure choosing a coach who has received the training and expertise needed to provide quality care.

Compatibility

• Consult with potential coaches.
• Ask questions and see if they are compatible with specific health goals.
• Interview as many as needed.

Availability/Location

• Virtual sessions, in-person meetings, and/or a combination?
• How long are the sessions?
• Frequency of meetings?
• Finding a coach that is flexible and convenient will help maintain a healthy coach/client relationship.

Multidisciplinary Evaluation and Treatment

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Perlman, A. I., & Abu Dabrh, A. M. (2020). Health and Wellness Coaching in Serving the Needs of Today's Patients: A Primer for Healthcare Professionals. Global advances in health and medicine, 9, 2164956120959274. https://doi.org/10.1177/2164956120959274

Conn, S., & Curtain, S. (2019). Health coaching as a lifestyle medicine process in primary care. Australian journal of general practice, 48(10), 677–680. https://doi.org/10.31128/AJGP-07-19-4984