Exercise Prescription for a Long Life

Dr. Tom Sullivan PT, DPT, ATC

There are few camps of thought when I bring up cardiovascular exercise to my clients.

1. I already perform exercise regularly because I enjoy grueling workouts.

2. I hate exercise but I manage to muster a few 10-15 minute workouts per week.

3. I want nothing to do with it. Commonly put, "I'm here for a good time, not a long time".

Believe me, I have experienced every bit of 1, 2, and 3. This article is not an attempt to goad you into into something you hate, because, what's the point? Nothing you are forced to do ever lasts.

However, I do believe that knowledge is power. The first step to any health change should focus on what we can control.

How do I live longer with exercise?

Lets start by defining exercise:

Moderate exercise = 150 minutes/week at 50-70% heart rate max

Ex. Walking, slow biking, weightlifting, low intensity exercise

Vigorous exercise = 75 minutes/week at >70% heart rate max

Ex. Running, swimming, fast biking

The American Medical Association released one of their largest studies to date and found the following:

A combination of moderate & vigorous exercise provides the maximum protection against all-cause mortality rate (35-42%). For individuals who don't exercise at all, starting a moderate intensity exercise program for 150 minutes/week reduced their chance of death (22-31%).

Age showed no impact on this study. This means that you will reap the benefits of exercise at all ages. The study also determined that greater intensity exercise had a larger reduction in mortality rate.

So, how do I create a personalized exercise prescription for a long and healthy life?

Example: 43 year old female, she does not regularly exercise

1. Calculate heart rate max using 1 of the 3 calculations below

FOX (general use)

· [ 220 – Age ] – most common and widely used maximum heart rate formula

TANAKA: (over 40)

· [ 207 – 0.7 x Age ] – more precise formula

HUNT: (active people)

· [ 211 – 0.64 x Age ] – slightly more precise formula

43 year old female: TANAKA: (207 - (0.7x43)) = 176.9 beats/min = maxHR

(This means that her maximum heart rate during exercise is approximately 177 beats/min)

2. Calculate exercise prescription for moderate (50-70% HR) and vigorous (>70 HR)

(Using her maximum heart rate, we calculated her ranges for mod & vigorous intensity)

Moderate intensity: 177 bpm x 0.60 = 89-124 beats/min

Vigorous intensity: 177 x 0.75 = 133 beats/min

3. Full exercise prescription:

Moderate intensity: 150 minutes/week at 89-124 beats/min

AND/OR

Vigorous intensity: 75 minutes/week at 133 beats/min

To provide the greatest benefit for this client and reduce her likelihood of all cause mortality, she should ideally exercise for 150 minutes/week at around 110 beats/min and 75 minutes/week at 133 beats/min.

It's a lot of exercise, I get it. The American College of Sports Medicine recommends sticking with the minimum of 150 minutes/week at moderate intensity. This should cover most of your basics.

We live busy lives and keeping consistent is a challenge. This just makes changing your mode of exercise that much more important. Do something you love, enjoy it with someone close to you, and don't forget to put yourself first from time to time. You got this!