Guest Commentary: Fitness for All

Michael Toscani, Pharm.D
Project Director
Jefferson School of Population Health

Obesity rates in the United States have reached epidemic proportions. The impact on our healthcare system in terms of type 2 diabetes and related cardiovascular disease will cost us billions in the next 10 years. One solution to this multi-factorial issue involves physical activity and exercise. However, there is a lack of consistent adherence to recommended physical activity guidelines.

Guidelines issued by the American College of Sports Medicine (ACSM) recommend 20 to 60 minutes of continuous aerobic activity three to five times a week, at 60% to 90% of your maximum heart rate. The ACSM also recommends doing resistance training two to three days a week. One set of eight to 10 exercises for major muscle groups (eight to 12 repetitions of each exercise) is ideal.

The second set of guidelines, from the U.S. Surgeon General, recommends that you accumulate 30 minutes of "moderate intensity" physical activity (such as walking, vacuuming, climbing stairs, and yard work) on most days – in two 15-minute bouts, three 10-minute bouts, or one 30-minute bout.

I’ve had the pleasure of being involved in a “Bootcamp” Fitness Class for the past 5 years. The creator of the program was a retired Major in the Marine Corps. His vision was to structure a variety of workouts that encompass the requirements of the guidelines but can be tailored for a wide group of participants at all levels of fitness. The group meets each day (M-F) from 6-7 AM at a local high school. All the workouts are outside, beginning with a 10-15 min warm up and ending with a cool down period. They are designed to offer a variety of training experiences and leadership opportunities for the participants. Participants work out at the level they are comfortable with.

A typical week is outlined below:
• Monday- Walk /run alternating speeds followed by abdominal core exercises
• Tuesday- Use a deck of cards (each suit corresponds to a different exercise designed to work large muscle groups, 2-14 reps each), 52 exercises
• Wednesday- Bike ride, run/walk or swim
• Thursday-Aerobic training and calisthenics/weight training using 4 corners of the workout area and fitness stations alternating periodically with a yoga class several months of the year.
• Friday- Leg exercises (squats, etc) combined with push ups, abdominal exercises and others selected by the group

Some of the results I have observed have been extraordinary for participants, who range in age from 35-65 years old. Some participants have many chronic medical conditions, including a renal transplant recipient and donor, lymphoma survivor, type 1 diabetes, hypertension, and dyslipidemias. Anecdotal results have included blood sugar and blood pressure reductions, normalized lipid profiles, weight loss, and improved cardiovascular fitness and a general sense of well being and confidence with continued participation for many months and years.

This approach and regimen is certainly not for all; however, the importance of having a “team fitness” approach undoubtedly improves attendance, adherence to fitness and dietary guidelines and could be a valuable piece of the complex puzzle of our health care system. Participants should always seek medical advice before engaging in these programs.

It would be great to see more randomized studies to test these observations and help provide more evidence to support individuals to achieve greater levels of fitness.

Hoo Rah !!!