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So, if you were hypertensive, and we were giving you some fab personal training sessions, here’s a summary of the exercise recommendations and the type of programme you would be on.
A warm up should be done every session for 10 to 15 minutes up to about 60 to 80% of your maximum heart rate, or until you are getting breathless and feeling warm. The main session must include Cardio Vascular exercise 3 to 5 times a week. 20 to 60 minutes of rhythmic exercise using large muscle groups is recommended, like swimming, jogging, cycling, cross training and rowing. If you have any joint problems the rowing, cycling and cross training would be best. You should be working at a level that makes you breathless and sweaty, or RPE (more on this later) of 11-13.
Resistance training should be done 2 to 3 times a week. 1 to 2 sets (groups) of exercises should be done in a circuit format so that your heat rate is elevated, and at 15 to 20 repetitions on each exercise to loss of form. You should cool down after all of this, slowly decreasing the intensity for 10 to 15 minutes. Flexibility (stretching) should be done after every session, each muscle used in your workout should be stretched to a point of discomfort for 15 to 20 seconds, 1 to 3 times. There is a full set of stretches on our Knowledge page, as well as further information on resistance training, Cardiovascular work, nutrition and flexibility. Remember to ask your GP, have a health check, or even better have a free consultation with one of our personal trainers before commencing a new exercise regime.
Clever Stockholm scientist Borg developed this scale as a guide to how hard exercise is. It runs from 1 to 20, and as the numbers increase so does the perceived level of exertion.There is also a modified scale that runs from 1 to 10. As a basic rule of thumb it works well, but does have the disadvantages of not allowing for individual variations, medications, genetics, poor communication and those who don’t feel pain so much (like the olympic rowers!). Or hypochondriacs. Most personal trainers will use references to heart rate, for example, “work at 60 to 80% of MHR” would mean work at 60 to 80% of your maximum heart rate. (More on this later!)
Last blog we looked at the Borg scale of perceived exertion, today we’ll look at another method of finding effective exercise levels, maximum heart rate. The more physical exertion you do, the greater the demand from the body for oxygen. We use oxygen to create energy, so the more energy we need the more O2 demand, so your heart speeds up passing more blood through the lungs where it is oxygenated.
There is a limit to how high this heart rate can go, with variations according to genetics, fitness levels and age. The older we get the lower our maximum heart rate will be. Closely connected with this is resting heart rate, or the amount of times your heart beats at rest. The average for this is 72 beats per minute, with females being slightly faster. Again, there are variations according to fitness levels, genes and age. The fitter your cardiovascular system is, the more efficient your heart and lungs are at pumping and oxygenating blood, so the lower your resting heart rate will be. The author is proud to let you know that at the last test his was 42 – to be expected really for such an uber-fit personal trainer!
The important thing is that if we know a person’s maximum heart rate, we can then prescribe exercise levels at a percentage of this. For example, to maintain cardiovascular fitness, you should exercise at or above 60% of maximum heart rate for 20 minutes three times a week. To develop aerobic fitness you should exercise at higher levels, 65 to 85% of MHR (maximum heart rate). This is why some people and some aerobic gym machines have heart rate monitors, so you can see if you are exercising at the right level.
The most common formula for working out this maximum heart rate is 220 minus age. However this is only a guide, as maximum heart rates can vary a lot according to the factors mentioned above. If you have smart personal trainer in London then the better formula is
HRmax = 205.8 − (0.685 × age)
although there is still a deviation of +/- 6.4 beats per minute. The Borg scale is still very useful for seeing if you are going at the right level, as is the simple conversation test. If you can speak freely during exercise in full sentences then you need to speed up. If you can only get out single words between huffs and puffs then you may need to ease up a bit. Ideally you should only be able to speak in short brief sentences before having to get some air. This equates roughly to 60% of maximum heart rate. Remember if in any doubt have a word with your GP before starting or increasing exercise.
A bit more unusual than hypertension, but interesting and possibly problematic as well, hypotension or low blood pressure can present with the following symptoms: tiredness, general weakness, light headedness and fainting, blurred vision, dizziness, palpitations, confusion, and nausea. I know, this is what you usually feel after a heavy Saturday night out (or possibly after a week at work) but we’re talking about having these symptoms normally. People with a blood pressure of less than 100/60 are more likely to experience these symptoms when standing up quickly or standing still after exertion (blood pooling, more on this later) but hypotension is rarely harmful and only in unusual cases will drugs be prescribed. There can be a number of causes (NIH 2002):
Surprise surprise, exercise is the best course of treatment, so get going or get one of our fab personal trainers to come and sort you out. Any REPS level 3 trainer will be able to ensure that you do a proper warm up and cool down (very important for hypotensives) and also that you remain hydrated during your session.
Obesity can be defined as “the excessive storage of body fat, frequently resulting in a significant impairment of health” (Wallace, 1997). It used to be considered a condition that leads to associated diseases but the World Health Organisation (WHO) now recognises it as a disease in it’s own right, and one which is largely preventable through changes in lifestyle and nutrition. The current facts are quite scary, but in a way good for us weight loss orientated personal trainers. The following is taken from the NHS statistics report on nutrition and obesity from Jan 2008.
So from this we can see that we are most certainly getting fatter. The repercussions of this are many, and we will go into this in future blogs coming up shortly. We will also be having a look at what these figures mean for the future should the current trends continue. Although regionally the Thames valley and London are some of the less badly off in terms of obesity, at Diets Don’t Work we still get the majority of our enquiries for personal trainers for weight loss. Have a look about on the street as you walk through town. Are there many thin people? Tomorrow we’ll be looking at the future figures for obesity as the trend for us to become fatter continues…and of course some tips for how to reverse this trend!
Today we continue to look at obesity, and in particular the risk factors involved with those who are obese. The ironic thing is that once our very overweight personal training clients have started to make progress in the right direction they can’t go back. You feel so much better both mentally and physically when you are exercising and eating well, the journey to better health is actually really enjoyable, honest!! Again the following is taken from the NHS obesity report from 2006. “NICE guidelines highlight overweight and obesity as risk factors for developing other long-term health problems such as coronary heart disease, type 2 diabetes, osteoarthritis and some cancers.
The proportion of both men and women at very high risk of the health effects of obesity increased with age peaking in the 65 to 74 age group, where 30% of men and 34% of women were in this category”. So if you are overweight and aged 65-74, get some exercise, have a go with a personal trainer and start eating well. “In 2006, women were more likely than men to have a raised waist circumference. In 2006, around a fifth of men and almost a quarter of women were at very high risk of health problems due to obesity”. That’s 1 in five people or more who will suffer ill health at the least, and in the worst case scenario are very likely to leave their loved ones early because of their lifestyle and poor nutrition.
The future for us in terms of obesity looks grim. If current trends continue then more and more of us will be seriously overweight. Again, the following is taken from the NHS obesity report 2008:
“In October 2007, Foresight at The Government Office for Science produced the Tackling Obesities: Future Choices report. HSE 1994 to 2004 data was used as a basis for modeling estimates of obesity prevalence up to 2050. By 2015 the Foresight Report predicts that if current trends persist, 36% of men and 28% of women aged 21 to 60 living in England will be obese. By 2025, these figures are estimated to rise to 47% and 36% respectively.”
But all is not lost. Many of our personal training clients come to us at a point when they are very overweight. Although it takes time to lose weight correctly, safely and permanently, with the right changes to exercise and nutrition you CAN change your life for the better, and actually enjoy it too!! If you are still in doubt have a look at our success stories page.
Again today we are looking at the NHS report into obesity from 2008. Although in terms of BMI, men were more overweight that women, there is no allowance made for increased muscle mass in men (see previous blog on BMI), but on the more reliable (in our humble opinion) waist to height ratio women in Britain tend to be larger than men. The report says: “In 2006, 37% of adults had a raised waist circumference. The proportion of people classified as having a raised waist circumference was higher for women than for men (41% and 32% respectively) and this was true for all age groups. Although the prevalence of morbid obesity remains relatively low, women were more likely to be morbidly obese than men (3% for women, and 1%for men). Results from the HSE 2006 show that in England the proportion of adults with abnormal BMI decreased between 1993 and 2006, from 41% to 32% among men and from 49% to 42% among women.”
While it is obviously not true in all cases, women generally have a higher percentage of body fat than men. As the child bearing sex, survival response in evolution means that women carry more fat, and so will be better able to cope with food shortages, thus increasing the likelihood of successful reproduction and survival of the species. This biological difference between women and men is quite marked in terms of body fat %. Body fat content is 25% for women at normal size compared to 15% for men. All other things being equal, such as age and exercise levels, women require fewer calories per pound of body weight daily than do men; this is connected to their lower levels of lean muscle and testosterone. Female hormones also make it easier to convert fat into food, again part of the survival/perpetuation of the species tactic.
Women more often do the cooking in the households, so nibbling and eating on the go is also more likely. In our experience as personal trainers, complications also arise with post-menopausal women, when losing weight can take longer and be less consistent regardless of nutrition and exercise levels. It will come eventually, you can’t deny the laws of physics (energy in vs energy out) so if you do fall into this category, stick with it. HRT (hormone replacement therapy) can also make it much harder for some women to lose weight, particularly those on separate courses of oestrogen and progesterone. Again this is just my own personal experience as a personal trainer in Berkshire dealing mainly with female clients.
Finally, in fat-prone women, contraceptive pills cause the body to produce increased amounts of fat and water. Estrogen alone will cause increased deposition of fat (just like in those instances where HRT is being taken). Anyone on the pill needs to decrease caloric intake by at least 10% in order to maintain the same weight!
Both sexes also suffer from a loss of lean muscle mass with age, and as lean muscle affects the metabolic rate, loss of it will also increase the likelihood of being overweight.
So don’t be so quick to judge females who don’t quite look like Elle Mcpherson. There are a lot of barriers to weight loss success for women, but they are overcome with the correct exercise and nutrition. Have a look at our success stories page.
Separating myth from fact and continuing on the obesity theme, we ask: how do we gat fat cells and once we have them do we keep them forever? Can they get smaller?
We store fat in our adipose tissue just under the skin. When we go into a state of surplus (taking in more energy or food, than we are using) we make more fat cells in order to store this excess energy for a rainy day. Or a famine, if you know what I mean. These fat cells can increase in size by 15 times, and as they are cells, so very small, and we have very many of them, this means you will get really fat.
The healthy adult body that is at a ‘normal weight’ has approximately 20 to 27 billion (yes billion) fat cells. The overweight adult body’s fat cell count depends on how overweight the individual is and can range from 75 billion to over 300 billion. The more fat cells, the harder it can be to lose weight, so that’s a very good reason to begin now instead of producing additional fat cells which will only serve to make future weight loss efforts even more difficult.
Unfortunately the body cannot break these fat cells down, so as the supposed myth says, yes, we keep them forever. The only way to actually remove them is through surgery, but if you are not getting enough exercise and eating too much of the wrong things, then you will simply manufacture more fat cells and enlarge them. So it really is best to not get fat in the first place. If it’s too late, don’t worry because lots of people can and do successfully lose weight and keep it off. If you really need help do call us and we can get you sorted with a personal trainer.
Where do we store our fat? As personal trainers we are constantly hearing our clients moan about their bust getting smaller but their hips and bum taking longer, so what’s the score? Two clever authors Vega and Jimenez describe the different types or areas of fat storage as follows: android obesity (apple shaped) denotes the excess fat being stored around the abdomen. Gynoid obesity (pear shaped) denotes the excess fat being stored on the hips and thighs. Fat that is stored around the abdomen or tummy (as in android obesity) is an indicator on its own for type 2 (adult onset) diabetes, CHD (chronic heart disease) and high blood pressure. Waist measurements can be used to evaluate those at high risk, for men anything over 40 inches or 102cm is danger, for women anything over 35 inches or 88cms indicates danger.
A general rule of thumb is as follows; the first place you put on the fat is usually the last place you will lose it from. For many women who lose weight with our personal trainers in London the weight goes on first to the thighs and the bum, and then the tummy, the face and finally the bust. This pattern quite often reverses itself in weight loss. So the bust comes first, the face and arms next, and then finally the bum and thighs. So if you are trying to lose weight but can’t seem to shift the poundage from your butt it may just be a matter of persistence and patience. I’m not backing this up with any science, but of the many women I have personally trained this does seem to be the pattern, and our personal trainers in London back this up, as does other evidence from personal training and health studies.
Men on the other hand tend to hold fat around the waist. This often referred to beer belly is not necessarily connected with beer, but just nutrition that is both excessive and high in saturated fats. The best way to control this is of course by eating healthily while exercising in a correct and structured manner.