Cardiovascular
exercise is widely associated in the public mind with what the
popular press calls aerobic exercise. However, aerobic exercise
as many people practice it a leisurely jog, a relaxing bike
ride, even a brisk walk is really of only limited benefit to
your cardiovascular system, doesn’t build muscles, and has
relatively little impact on your stamina and capacity. The kind
of cardiovascular exercise I recommend to my patients (and
follow myself) is very strenuous, operates in the anaerobic
range, and accomplishes tremendous things. For example, many
years ago, before I became a physician, I used to go to diabetes
conventions. There was always a group of doctors who would get
up in the morning, don their running togs, and go running. These
were people who ran every day. I’m not a runner; I work out in
the gym every day with my weights. But I do a particular
cardiovascular workout on an exercise bicycle that I will
explain. And so I would go out with these doctors on their runs.
After a few miles, people would start dropping out.
Eventually, I’d be
the only one left and then I’d go another five miles and come
back. Clearly, although I was older than most of these people,
and not a runner, I had much more stamina. The stamina was
created by this anaerobic cardiovascular exercise.
Exercise Harder,
Exercise Better
Cardiovascular
workouts can be performed on a treadmill, a stair climber, or
bicycle if you’re male, I recommend a recumbent bicycle rather
than the standard upright bike. It’s much more comfortable for
men because the seat is like an ordinary chair. Ideally, your
machine should have a meter that reads the amount of work that
you’re doing in calories per minute as well as total calories,
but certainly you can get a good workout without such an output
display. It is important to wear a pulse meter. The brand that I
like best is called Polar; it costs about $60, and you wear it
around your chest. If you belong to a health club that has a
treadmill with a pulse meter in the handlebars, you won’t have
to put one on your chest, but some sort of pulse meter is
essential. The degree of workout you’re getting is measured by
how fast your heart works. When you get evaluated by a
cardiologist before you start your exercise program, you should
ask what your target pulse rate ought to be. Over time, you can
increase it.
There’s a formula
that we use to specify maximum pulse rate: we take 220 and
subtract from it your age. So if you’re sixty years old, you’d
have a theoretical maximum pulse rate of 160 that is, in theory,
you shouldn’t be able to exercise at a faster pulse rate. Your
doctor will decide based on your overall health and fitness
level what percentage of this would be a good target rate for
you — say, 75—80 percent. Rarely would a doctor start you out at
85 percent of maximum or higher. Eventually, you may find that
you can get up to and beyond your theoretical maximum I can
exercise at 165 even though my theoretical maximum is 152. I can
do this without having a heart attack in part because I’ve been
exercising strenuously for thirty-five years. Don’t expect even
after years of this kind of exercise to get your heart rate up
to or even near your theoretical maximum, or even to your
target, right after you begin your cardiovascular workout. This
takes time. I get to my target pulse rate toward the end of my
workout.
To do a really
effective anaerobic/cardiovascular workout, start out by
selecting a safe, comfortable speed and setting the resistance
of your machine to the point where your muscles are so tired
after about 20 seconds that you can’t go any further. As soon as
you reach this point, you lower the resistance slightly, and
keep going. For treadmills, the resistance will be the angle at
which you’re running uphill. So if you’re using a treadmill, you
need to be able to set the incline of your treadmill from the
handlebars you don’t want to have to get off, reset the angle,
then gel back on. You’ll lose your rhythm, regain some of the
oxygen in your muscles, and defeat the point of the workout.
Lower the
resistance a little at a time, and each time you lower it, shoot
for 20 seconds of exercise until you can’t go anymore. Nearly
from the beginning you’re wiped out, yet you keep doing it at
lower and lower resistance. This is a real workout.
Your goal should
be to get your heart rate up to (but not above) the training
level recommended by your physician. If you can’t reach the
recommended rate within 10 minutes, increase your speed until
you get there. Try to maintain this rate for at least 5 minutes.
When you think you’ve had enough, lower the resistance to zero
but keep your legs moving until your pulse has slowed to a value
about 20% above your starting point. This slow exercise pumps
blood back to your heart from your legs, thereby greatly
reducing the hazard of a post workout heart attack.
It’s unnecessary
to exercise at your target heart rate for more than 5-10
minutes. A cardiovascular workout of this kind for about 15
minutes should be plenty for most people, unless you’re training
for competition. However, I recommend that rather than watch the
clock, you Look at the calorie counter on the machine, if it has
one, and decide on a particular number of calories that you want
to shoot for. Calories are a measure of work done and therefore
a reasonable gauge of your workout. Minutes or even miles don’t
take effort into account. I aim for about 80—100 calories. When
it gets up to that range, I call it quits. But, the point of
this kind of exercise isn’t weight loss, so don’t start looking
at the calorie counter thinking that if you burn 10 more
calories you’ll lose another pound exercise just doesn’t work
that way.
