9 Just a Little Exercise to Keep You Lively

You may remember the particular joy of running and playing as a child. Racing, leaping, rolling around a backyard, careening through gym class or around the playground, chasing friends around and around a city block, then falling into bed at the end of the day exhausted—but also elated and deeply satisfied. Those feelings aren’t limited to childhood. They’re also accessible through the power of exercise.

Being physically active does remarkable things for the human body and mind. Exercise prevents disease, transforms mood, boosts sleep, and slows aging. Physical activity keeps hormones in balance and slows their rate of decline with age. Routine exercise is as powerful as medications in treating chronic diseases such as heart disease and diabetes; it lacks medication’s side effects and brings many additional benefits. A sedentary lifestyle, on the other hand, accelerates aging and heightens risk for illness and disease, hastening their onset. An absence of physical activity also exacerbates depression and anxiety, undermines sleep, and diminishes energy and vitality. Without regular exercise, it’s difficult for many people to maintain a healthy weight.

Making exercise a priority is your responsibility, part of a commitment to caring for yourself and protecting your health and longevity. It is also your right. Time for exercise often gets delayed, curtailed, or altogether lost by busy schedules and other people’s needs. Habits of inactivity become entrenched. When you don’t have a regular exercise routine, it’s easy to forget that exercise feels good and that it’s pleasurable to work up a sweat, to feel your body developing strength and endurance. It’s also easy to forget that exercise boosts your mood, energy, and cognitive functioning—these are very real, scientifically supported benefits that you don’t want to miss out on! Obviously, women who exercise also feel and look more youthful and have more supple skin, a bright complexion, a strong and confident posture, toned muscles, and trim curves.

I am sure you have heard of these many benefits to staying active. I am also sure you don’t like to be told what to do. My suggestions for exercise are premised on your discovering or knowing what you enjoy doing. Do you like to walk with friends or your pooch? Do you enjoy dancing to music in a Zumba class, perhaps? Do you prefer solitary workouts at a gym or at home, where you ride a stationary bicycle or follow a yoga routine on a DVD or streamed app on your phone? Are you motivated best when you’ve signed up for a spin, yoga, Pilates, or ballet barre class and paid for it?

You know what you like. You know what makes you bored. You know what to do. In this chapter, I am offering you some more information to motivate you to incorporate physical activity into your daily life. That’s right: it’s best for you to move a little every single day. You’ll also find some suggestions for types of exercises that you may enjoy, as well as some information to motivate you—the science of exercise is fascinating! If you are already active regularly—wonderful! If you do not have a regular exercise routine or you’re feeling a bit rusty, you will find some tips on how to get started incorporating physical activity into your daily life. And keep in mind that you want to incorporate both cardio (to get your heart pumping!) and weight-bearing exercises that strengthen your muscles and skeleton.

Exercise and Your Hormonal Health

Estrogen and exercise influence and reinforce one another. Keeping estrogen levels healthy protects and enhances a woman’s ability to be physically active. Estrogen

Guards against bone loss
Protects and enhances muscle strength
Keeps inflammation in check, helping avoid stiffness and pain
Protects the immune system and promotes tissue healing and postexercise recovery
Invigorates energy levels

Estrogen is far from the only hormone that enhances your ability to exercise. Overall hormone balance is important to maintaining physical strength and endurance, to protecting and building bone and muscle, and to facilitating neurogenesis. Beyond estrogen, these hormones are particularly effective at increasing your capacity to exercise:

Testosterone improves overall athletic ability. It protects against and reverses age-related declines in physical skills, including balance, coordination, strength, and endurance. Testosterone helps build bone and muscle. Healthy levels of testosterone—and its enhancements to physical ability and strength—help reduce the frequency and severity of injury.
Human growth hormone (HGH) enhances your overall ability to exercise and have stamina and helps you maintain your fitness level as you age. HGH should not be used for excess muscle development beyond your individual natural physiology.
DHEA enhances cardiovascular performance. DHEA is critical to acclimation for aerobic exercise at high altitudes. It also increases bone strength and promotes greater muscle mass and muscle strength.
Regular exercise keeps cortisol levels in check and works like a miracle stress reducer. It also ups endorphins that further help undermine the negative effects of stress.

Exercise and your hormones work together. Your hormone levels, especially estrogen, enable and enhance exercise; in turn, exercise helps keep you in hormonal balance. Indeed, regular exercise slows the decline of estrogen and will help keep you feeling agile and alive.

How Exercise Boosts Your Capacity for Wellness

Science has established a great deal of information about the powerful benefits of exercise to mind and body health—and we continue to learn more about just how profoundly important and health promoting physical exercise is to human life.

Many of the benefits you’ll read about below may be familiar to you; some may be new. Until everyone is getting sufficient exercise to help them avoid illness and disease, regulate mood, and slow aging; until we no longer struggle as a society with obesity and metabolic disorders; until we’ve been untethered from our collective reliance on medications to treat diseases that can be prevented and alleviated by physical activity, the fundamental benefits of exercise warrant being regularly and pointedly repeated.

Pumps Your Heart. Physical activity confers deep benefits to cardiovascular health. Exercise—both cardio and strength training (aerobic and anaerobic exercise)—protects against and reduces arterial sclerosis. Regular exercise lowers blood pressure and helps the heart work more efficiently and effectively to move blood throughout the body. Exercise also reduces risk for stroke.

Deters Cancer. Exercise guards against the development of breast cancer and other cancers, lowering cancer risk for women of all ages. The more you exercise, the lower your risk for dying from cancer, including breast cancer. Vigorous exercise reduces breast cancer risk in healthy-weight women by 30 percent. Exercise decreases the rate of growth and spread of benign breast disease that can precede the development of breast cancer. Breast cancer risk is inversely associated with moderate and vigorous physical activity. For women under the age of fifty, moderate exercise was the factor most strongly linked to reduced breast cancer risk. For women over age fifty, vigorous exercise had the most robust connection to lowering breast cancer risk. For women already diagnosed with breast cancer, maintaining an exercise routine leads to higher survival rates.

Boosts Your Immunity. Moderate exercise provides a boost to the immune system, helping the body ward off illness. Exercise also reduces and limits the rise of stress hormones that interfere with healthy immune function. Physical activity promotes detoxifying processes in the body and increases antioxidant function. Exercise that is too frequent or strenuous can backfire on the immune system, however. Exercising too hard can weaken and undermine immune function.

Fights Inflammation. Moderate exercise can help the body reduce inflammation. Both cardiovascular exercise and strength training at moderate levels contribute to lowering inflammation. While physical exertion typically promotes a temporary increase in the body’s inflammatory response, systemic and chronic inflammation decreases with regular moderate exercise. Overtraining and exercising too strenuously, on the other hand, can trigger chronic, unhealthful inflammation.

Supports Your Weight and Metabolism. Exercise in all forms and at all levels of intensity burns calories and can help women maintain a healthy weight or lose weight. Exercise also promotes deep, important changes to metabolic function, helping improve glucose regulation and increase insulin sensitivity, promoting hormone changes that guard against obesity, metabolic disorders, and diabetes. Sedentary women who are postmenopausal who begin to engage in moderate to vigorous exercise show significant changes to their insulin, leptin, and adiponectin levels—all signs of improved metabolic health.

Improves Your Mood. Exercise provides a powerful lift to mood, releasing endorphins that promote feelings of well-being, satisfaction, and confidence. Physical activity boosts production and release of serotonin and of BDNF (brain-derived neurotrophic factor). Exercise can help alleviate depression as effectively or more effectively than antidepressant medications. Exercise helps limit and reduce stress and lowers anxiety. Vigorous exercise is also effective at diminishing panic disorders. The benefits of exercise to mood can be experienced swiftly, often within minutes. There are long-term benefits of regular exercise for mood regulation and for protection against mood disorders.

Helps You Sleep. Being physically active promotes healthy sleep. Exercise improves both sleep quality and duration and promotes additional time in deep or slow-wave sleep, which is the most restorative and rejuvenating phase of sleep for the body. Exercising too close to bedtime can interfere with sleep, so it’s best to schedule exercise no closer than three hours before lights-out.

Fortifies Cognition. Exercise improves cognitive performance, including memory and learning, and protects against declines in cognitive function with age. A study of menopausal women ages fifty-nine to sixty-eight showed they increased their cognitive function after three months of regular exercise. Both cardiovascular exercise and strength training enhance memory. Research shows running on a treadmill increases the rate at which the hippocampus creates new brain cells.

The Anti-aging Powers of Exercise

One of the most potent—and alluring—benefits of exercise is its ability to slow the aging process. This anti-aging capacity of exercise not only defers and prevents the development of chronic diseases, from obesity and diabetes to cancer and cardiovascular conditions, it also allows you to age well, to grow older with mental and physical prowess, dexterity, flexibility, and endurance. Exercise—even moderate levels and small amounts of physical activity—extends life span. Specifically, physical exercise improves cellular functioning:

Exercise stimulates AMPK, an enzyme that regulates cellular metabolism, guarding against diabetes, obesity, weight gain, and physiological degeneration.
Regular exercise is associated with longer telomeres, the cap-like structures located at the ends of DNA strands that protect DNA from damage. Longer telomeres correspond to increased longevity and lower risk for cancer and other diseases. A recent study shows that athletes have longer telomeres than nonathletes.
Exercise increases mitochondria in cells; mitochondria are the “energy cells” of our body. Mitochondria also stimulate apoptosis, the programmed death of cells that is one mechanism by which the body avoids the development of cancer.

Think About Exercise in a New Way

Many women dread exercise, especially if they are not accustomed to it. So I ask my patients to think about exercise as a little bit of movement each day. Don’t go from zero to sixty. Read through some of the activities described below—you might find one or two that you already enjoy or that spark some interest or curiosity. Give yourself just one simple goal: to come away with a few exercises that you know you can fit into a week.

The timing of exercise and the kind of exercise you do will vary according to your individual preferences, fitness level, and access to a gym or equipment. One woman may love a morning spin class, another a Pilates mat class three times a week. One woman may love the gym, while another feels a strong pull to exercise outdoors. Some women may relish working out with friends or in groups, taking pleasure in the social aspect of exercise, while others may find deep contentment in a solitary run or hike through the woods. I’m less interested in the particular exercise you choose than in making sure that your thinking about exercise becomes more positive.

Here are a few fundamental attitude shifts that I’d like you to consider:

Try to be physically active every day. I recommend trying to do something each day, but not in excess. The most efficient and effective exercise is thirty minutes three times a week. Specifically, it has been shown that thirty minutes of intense interval training three times per week has the most positive effect on health, weight loss, and overall well-being. So take a moment and ask yourself if you can devote a half hour to the broad and lasting benefits of exercise to your health and wellness. That investment of a half hour three days a week suddenly looks like the deal of the century, a fantastically worthwhile use of your time. Exercise can reduce or eliminate reliance on pharmaceutical medications, having been shown as effective (or more so) in treating and lowering mortality for several common chronic diseases, including cardiovascular disease, diabetes, and depression. Think of a daily dose of exercise as your most potent, life-promoting medicine.

Include both cardiovascular and strength activities. A combination of aerobic exercise and anaerobic exercise delivers a full, rounded roster of benefits and protections to a woman’s health while also encouraging variety. Particularly for women, who are at significantly greater risk for osteoporosis as they age than men, regular strength-building exercise can help provide protection to bone health and guard against injury and falls. The combination of cardio and strength activities also boosts metabolism and promotes more effective weight loss.

Incorporate variety. Varying forms of exercise and physical activity confers several benefits to a woman’s mind and body health and to her ability to sustain a healthy exercise habit. Switching up exercise types keeps both mind and body challenged, prevents boredom, and generally helps avoid the feeling of being in a rut that can arise when doing the same exercise over and over again. Changing it up and varying the types of exercise helps the body remain continually adaptive to new physical challenges, keeping a broad set of physical skills in play and avoiding the plateaus that can arise with repeated sessions of the same physical activity. Research suggests that adding and maintaining variety to exercise patterns may help boost the longevity-promoting benefits of physical activity.

The Benefits of Strength Training (Anaerobic Exercise)

Boosts metabolism, increases calories burned by the body during exercise and daily activities

Increases lean muscle mass

Prevents bone loss, promotes bone growth (increased bone density), reduces risk for osteoporosis

Improves glucose function and lowers blood sugar levels, reducing risk for diabetes

Enhances mood

Reduces arthritic pain

Decreases risks for injury, both exercise-related and non-exercise-related

Enhances coordination and balance

Benefits of Cardio (Aerobic Exercise)

Increases oxygen levels in the blood

Strengthens heart, increases blood flow throughout the body

Lowers blood pressure

Elevates HDL (“good” cholesterol), lowers LDL (“bad” cholesterol)

Reduces risks for diabetes, cardiovascular disease, stroke, cancer

Lowers blood sugar and improves insulin sensitivity

Moves unwanted substances out of tissues, aids in detoxification

Enhances immune system function

Triggers endorphins, which elevate mood, enhance feelings of well-being, alleviate pain, and diminish stress

Helps maintain and increase physical mobility and flexibility

Burns fat and increases lean muscle

A Targeted Workout

A balanced exercise program contains both aerobic exercise (cardio) and anaerobic exercise (strength training), while also addressing the mind-body connection. Aerobic exercise provides conditioning for the cardiovascular and respiratory systems, while anaerobic exercise targets muscle fitness. Both also contribute to bone strength. Together, regular cardio and strength training will improve the body’s overall fitness levels, help keep you at a healthy weight, and lower your risk for illness and disease. Many of the workouts I discuss below combine cardio and strength training in a single session.

The mind-body component of exercise is an important element not to be overlooked. Mind-body exercise uses several practices—guided imagery, breathing exercises, mindfulness—to deepen awareness of the body, reduce mental and physical stress and tension, and deepen and enhance breathing.

Again, as you work toward a goal of exercising four to five days a week, start slowly. Perhaps your workout is 15–20 minutes. That’s fine. As you become more comfortable (and more fit!), you will more than likely want to sustain your workout longer, gradually reaching 30 or 45 minutes of activity. Ideally, a comprehensive workout will be 45–60 minutes.

If you’ve not been active recently, you may need to start with less frequent or shorter workouts and build up to this goal. Before you begin, consult with your physician about your health and fitness for exercise, and together decide on an approach that suits your individual needs and challenges.

What Is HIIT?

Now, for a total mind-body challenge that can improve your fitness, accelerate weight loss (if that’s your desire), and reset your metabolism, try HIIT, or high-intensity interval training. This approach combines cardio and strength training while varying the intensity of exertion levels. HIIT workouts alternate short periods of vigorous exertion with periods of low to moderate exertion, or active recovery. The bursts of high-intensity effort interspersed with recovery periods provide a highly effective and efficient workout, one that conditions the heart, builds endurance, and strengthens muscles and bones. HIIT workouts are not meant to be long. Rather, they make the most of shorter sessions. Though HIIT workouts are often shorter than traditional workouts, they tend to burn more calories, thanks to the periods of high-intensity exertion. HIIT sessions also prime the body for more postexercise calorie burn than traditional workouts do. HIIT workouts can be tailored to all fitness levels and ages. Each individual works to his or her own level of vigorous exertion and recovery pace of low to moderate exertion. (The American College of Sports Medicine recommends that high-intensity intervals reach 80 percent of an individual’s maximum heart rate and that recovery intervals fall within 40–50 percent of maximum heart rate.)

Performed regularly, HIIT delivers excellent conditioning for both the cardiovascular and respiratory systems. The endurance building of HIIT will increase your capacity for exercise and physical activity and also provide you with more energy and stamina throughout the day. The brief periods of intense exercise coax your body into its anaerobic training zone, which powers up the body’s metabolism and its ability to burn calories through fat, not muscle. HIIT also stimulates production of the body’s own HGH. Here are some ways to get some HIIT!

Take HIIT classes. HIIT classes have become tremendously popular at gyms and fitness centers. Classes such as spinning and Tabata (a form of HIIT circuit training) employ high-intensity interval training to deliver major workout benefits within short sessions. Many HIIT classes will accommodate a wide range of fitness levels. There are also video and streaming HIIT workouts available. Follow these basic guidelines below to create a custom HIIT routine. Check out Dr. Mark J. Smith’s method for HIIT! (See docsmith.org.)

Designate 1 minute for each exercise move. For 40 seconds, do as many repetitions of the movement as you can. For the remaining 20 seconds, rest or continue to exercise lightly, such as walking in place.

Put a sequence together. After you’ve finished the first exercise and rest interval, move on to the next. Create a string of 1-minute moves (40 seconds on, 20 seconds to rest). Ten individual exercises in sequence, repeated 3 times, will provide you with a robust, balanced half-hour HIIT workout. If 30 minutes is too much at first, start with a shorter duration and work toward 15, 20, and eventually 30 minutes as a goal. The same goes for the timing of intervals. If 40 seconds of vigorous movement is overwhelming, scale it back to 30, with 30 seconds of rest.

Target your upper and lower body. If you’re putting together your own routine, be sure to include moves that target different parts of the body, including arms and shoulders, thighs, buttocks, and calves. Always engage your core muscles for support and stability and to build core strength.

Turn a regular workout into a HIIT workout. One of the great advantages of HIIT is its adaptability. Almost any workout can be converted into a HIIT workout by including periodic intervals of vigorous exertion, such as sprinting, into an otherwise moderate workout. Creating HIIT workouts from forms of exercise you’re already doing is a great way to begin to incorporate HIIT into your exercise routine. Some of the most common workouts that can become HIIT sessions are:

Walking

Jogging

Swimming

Cycling

Hiking

Rowing

Stair stepping/elliptical training

To convert these popular workouts to HIIT sessions, simply add periodic bursts of vigorous exertion. If you’re running, sprint for 30 seconds and run in recovery mode for 4–5 minutes before sprinting again. A swim or a cycle can become a HIIT workout using the same basic formula: 30 seconds of moving as vigorously as you can through the exercise, alternating with 4–5 minutes of low to moderate effort.

Another advantage of HIIT? It’s highly portable. You don’t need lots of equipment—you can use your body’s own weight to build strength and raise your heart rate. Adding some simple equipment, such as hand weights and a jump rope, can expand your HIIT options. It’s also not necessary to engage in complicated routines. Simple moves that are already familiar to many active women can be combined into a HIIT workout you can do anywhere—your living room, a hotel room, your vacation cabin.

If you’re already working out and familiar with common exercise moves, you may feel ready to jump right in and create your own HIIT workout. If you’re not familiar with these exercises, I recommend scheduling a few sessions with a trainer, who can help you learn the proper methods and form for these or other moves.

A few words of caution: some classes and other HIIT-influenced workouts take the valuable, effective exercise strategy of HIIT to an unhealthful extreme. An hour of nonstop, frantic cycling is not a HIIT workout—it’s sixty minutes of overexertion that can damage your body and undermine your health. Make sure you’re working out for thirty minutes, no more—even if that means leaving class early. (Better yet, find a HIIT class that doesn’t exceed thirty minutes.)

As always, listen to your body and don’t push yourself to overdo the vigorous intervals of HIIT or to skimp on the rest intervals. Keep in mind what vigorous exertion feels like and also what moderate and low exertion feel like. Remember, your exercise should leave you feeling energized, not exhausted and depleted.

Common Exercises for HIIT

Lunges: front, side, and back

Squats

Push-ups, traditional and modified

High knee steps

Butt kicks

Jumping jacks

Mountain climbers

Planks

Bicycle crunches

Biceps curls

Triceps dips

Shadowboxing

Jumping rope

Tone and Strengthen

These workouts also often combine cardio and strength training, but without the bursts of vigorous exercise of HIIT. These exercises can engage you at low to moderate or even vigorous exertion, raising your heart rate and providing conditioning for your cardiovascular system. They also will work both large and small muscle groups, helping create muscle that is long, lean, and toned while also building bone strength and promoting flexibility.

Some forms of exercise, such as yoga, place particular attention on the mind-body connection. Bear in mind that any exercise can be a mind-body exercise when you incorporate attention to breathing, awareness of the body, and a gentle, mindful focus on your thoughts, feelings, and sensations in the present moment.

Yoga. With its emphasis on building total-body strength and enhancing flexibility, yoga is an excellent regular component of a woman’s exercise routine at any age. Yoga promotes mindfulness, helps flush the body of toxins, improves breathing, and promotes stress reduction. There are many varieties of yoga out there, some more physically rigorous than others. A good instructor can help you develop a practice suited to your individual fitness needs and goals.

Pilates. Pilates is a guided routine of exercises that develop the body’s core strength, as well as muscles in the upper and lower body. Like yoga, Pilates can improve flexibility, as well as overall muscle tone and development. Pilates emphasizes breathing, mindfulness, and a deepening awareness of the body.

Tai chi. An ancient form of Chinese martial art, tai chi is a powerful mind-body practice that combines slow, deliberate physical movement with deep breathing and mindfulness. Tai chi helps build muscle strength and flexibility, improves balance, and can provide some aerobic benefit as well.

Walking or jogging. A brisk walk or a light jog elevates the heart rate and tones muscles, especially in the lower body. These workouts also contribute to muscle joint flexibility. Women who enjoy running should absolutely do so. Be aware, however, that running is hard on your joints, especially the lower back and knees, and can lead to overexertion and overtraining. It’s wonderful to challenge your body and mind through fitness training, but only to a point. Light to moderate running delivers greater health benefits and less risk of injury and the negative effects of overexertion than extremely fast-paced or very long runs. Walking confers nearly all the benefits of running without exposing the body to the risks of injury and overtraining. If you run, do so outdoors or on a treadmill. You can turn a walk or a run into a hike by climbing a hill outdoors, by raising the incline on the treadmill, or by using the elliptical or stair-stepper training machines.

Dance. These exhilarating workouts provide total body benefits. They improve coordination, balance, and flexibility. Dancing engages several muscle groups at once and builds overall fitness levels, toning and strengthening muscles and elevating heart rate. The combination of movement and music can be mentally and emotionally uplifting, delivering powerful sensations of freedom and release. There are so many options available if you want to incorporate dance into your exercise routine. Afro-Caribbean, Latin, hip-hop cardio, and ballet barre are among the many types enjoyed by the women I see in my practice.

Swimming. Swimming is a terrific total-body conditioning and strengthening workout for women of all ages and fitness levels. Swimming builds and tones muscles in the upper and lower body and delivers a strong cardiovascular workout—all at very low impact to the body. It can be especially useful for women with back and knee issues or women with muscle and joint pain and stiffness, including women with arthritis and fibromyalgia.

Take Time to Recover

Recovery and rest are essential to a balanced exercise regimen and to protecting health and preventing injury. I understand the temptation to push harder and the desire to progress quickly toward fitness goals. Yet many of my patients report having their best workouts after their rest day. This comes as no surprise to me. Rest days don’t get in the way of progress; rather, they fuel it. Commit to your rest days and to finding some time every day to relax and recharge.

Longer and faster exercise isn’t always better. Overtraining, whether exercising too often or pushing oneself too hard, can cause stress and damage to the body. Extreme exertion breaks down the body’s ability to repair itself and can even damage DNA. Also, the older we get, the more vulnerable we are to the damaging effects of very vigorous exercise. This doesn’t mean that you should avoid breaking a sweat, but do pay attention to your body’s signals about the impact exercise is having on your body and mind. Avoiding too-vigorous exercise and overtraining helps avert injury, and you heal faster from injuries if you exercise moderately. Maintaining moderation and balance in your exercise enables you to sustain a regular routine—week in, week out and over the course of a life span. Keeping up with consistent exercise as you age slows the aging process and protects against disease.

The signs of overtraining:

Muscle pain and stiffness that lasts for hours or days after a workout, and may be intense
Fatigue after a workout that persists throughout the day and perhaps into the next
Feeling as though you need a nap after an exercise session
Coming down more frequently with colds and flu and taking longer to recover
Difficulty and diminished ability performing daily tasks

How Strenuous Is Too Strenuous?

When figuring out what you enjoy doing for physical exercise, you’ll likely hear physicians or fitness experts talk about different levels of exercise intensity—moderate exercise, vigorous exercise, light exercise. Do you know how to gauge physical exertion?

Light exercise: Exercising lightly is considered exertion slightly beyond a normal resting state. Examples of light physical activity for most people include slow or leisurely walking, light cleaning, gardening, and any other activities that require standing and some movement for fifteen to twenty minutes—even a little bit of movement counts!

Moderate exercise: Moderate physical exertion involves more pronounced changes to the body. When you exercise moderately, the heart rate is elevated and a person may sweat lightly. Breathing becomes more rapid and pronounced, but it’s still possible for most people to hold a conversation. Brisk walking, cycling at a light or slow pace, swimming leisurely, yoga, Pilates, light circuit training, and strength training are examples of moderate exercise.

Vigorous exercise: Exercise at a vigorous level of intensity elevates the heart rate significantly. Sweating is steady and can be profuse. Breathing is rapid and heavy—during vigorous exercise, it can be difficult to have a conversation or speak more than a few words at a time. Running, hiking at a fast pace or up a steep hill, swimming, high-intensity circuit or interval workouts that combine cardio and strength training, and spinning are all forms of vigorous exercise that will get your heart pumping and your fat burning.

Keep in mind that any and all levels of exercise are valuable and contribute to your health and well-being. For people who are moving into a new exercise routine after being sedentary, you might want to take things slowly—starting with a low or moderate level of exertion. Whatever your level of fitness, it’s important to balance challenging yourself with listening to your body and paying attention to the signs it is sending you about your exertion levels. Exercise at the right level of intensity should make you feel invigorated, not drained.

Metabolic energy equivalent, or MET, is a method used by scientists and fitness experts to measure physical exertion. One MET is the amount of energy a person requires just to be awake and alert, resting quietly. Exercise intensity with MET is measured by how much more energy the activity requires than this resting baseline.

Light exercise: 1–3 MET

Moderate exercise: 3–6 MET

Vigorous exercise: more than 6 MET

MET can be a useful tool in assessing exertion, but it’s neither comprehensive nor perfect. MET levels do not take into account age, fitness level, or other individual factors that make significant contributions to exercise’s impact and difficulty. A moderate workout in MET terms for one individual may be a vigorous workout for another. MET can be a useful guideline in many cases, such as when attempting to distinguish between a moderate workout and a vigorous one. But the most important gauge is the body’s own response to physical exertion.

Eating and Snacking When You’re Active

It’s natural to experience an increase in your appetite when you begin to exercise regularly or when you increase the amount and frequency of exercise in your routine. The trick is not to let your hunger undermine the good that exercise can do in helping manage weight. I’ve seen many of my patients enthusiastically dive in to a new exercise regimen, eagerly anticipating both the health benefits and the weight loss they expect to receive—only to feel deeply discouraged a few months later when they’ve put on weight, not lost it. There are ways to handle the hunger that may arise when you boost your exercise levels so you can derive the deepest, fullest benefits from your hard work.

Don’t reward yourself with food. It can be tempting to give yourself some leeway to indulge in “treat” foods as a reward for working out. But this habit detracts from the rewards that exercise itself offers to your health and weight. Using food as a reward, even for exercise, isn’t a good idea. Find other ways to treat yourself for making the effort to exercise. Think about what relaxes you—a long hot soak in the tub? An hour with a cup of tea and a good book?—and reward yourself accordingly. Even better, take exercise, and the time you spend being physically active, as its own reward, and pay attention to your body getting stronger, more fit, and more limber.

Snack smart. Planning for your hunger before it strikes will help you avoid making unhealthful choices. The right preworkout snack will fuel your activity, not slow you down. Eating after you’ve exercised can help you avoid the deep hunger that often sends us in search of all the “wrong” sorts of foods—sugary treats, salty and starchy snacks. The right combination of lean protein, high-nutrient carbohydrates, and healthy fats consumed in snacks between meals will help keep your blood sugar even and stimulate hormones (ghrelin) that induce feelings of fullness.

Supplements to Maximize Your Exercise Results

A diet of healthful, unprocessed whole foods in moderation helps prepare the body to be physically active. High-quality nutritional supplements can further support a woman’s ability to exercise regularly, increasing her capacity for physical exertion and promoting swift and full recovery from both injury and exercise’s regular wear and tear on the body. By taking the recommended amounts of these supplements, you can enhance the results of your regular exercise routine:

Vitamin D

D-ribose

Quercetin

L-carnitine

Theanine

L-glutamine

Rhodalia—herb

Planning Your Week of Exercise

How you set up your weekly workout routine will depend on your particular schedule and obligations. I encourage my patients to make time in their schedule to exercise in the morning. Morning exercise provides a potent energy boost and fires up the body’s metabolism. It also gets the day’s exercise on the books before the rest of life gets in the way. Job and family responsibilities may make regular morning workouts unrealistic. If you can schedule one or two a week, great. If all your workouts need to happen at lunch or in the evening, that’s perfectly okay. One of the keys to sticking with an exercise regimen is to schedule your workout sessions with a realistic eye for how your daily life unfolds.

A similar principle holds for the days of the week you work out. Ideally, you’d work out two to three days in a row, take a rest day, and resume for another couple days of more intense physical activity. If your commitments to work and family make this schedule difficult, opt for a schedule of five days on, two days off—or whatever weekly routine or rhythm suits you. Some people find it’s helpful to align their five days of exercise with the Monday–Friday workweek.

If you haven’t exercised in a while, it’s best for you to start slowly. You may also want to check with your physician or health care provider so that you choose a routine that is both realistic and safe. It’s easy to injure yourself if you suddenly go from zero or sixty. If this is the case, I have noted adjustments you can make so that you can introduce exercise and gradually build up your level of intensity. For instance, if you have not been exercising and feel a bit out of shape, don’t jump right into a HIIT routine. Instead, begin with walking regularly for twenty to thirty minutes four or five times a week. Your body will adjust in one or two weeks, and then you may feel ready to try a more intense form of cardio … or not. Regardless of your starting point, you can always benefit from doing some strengthening with light weights, as well as including gentle stretches and ten to fifteen minutes of mindfulness as a way to rest and restore.

Take a look at the weeklong plan below and read through the suggestions to see what activities appeal to you and what schedule is realistic for you, and then carve out time to make it happen!

YOUR HEALTH JOURNAL: TRACK YOUR ACTIVITY

Use your journal to record your exercise. Write down the time and day and the type of exercise. You might even want to jot down what you liked and what you’d prefer to skip. These notes will help you stay motivated and in tune with yourself and keep your exercise routine in the forefront of your mind and your priorities. As you plan your exercise for the week, make sure you write down specific days when you rest and restore your body. For example, if you’ve had a day of an intense HIIT workout, then follow it with a day of no workout. If, however, you walked and did yoga one day, followed with another day of light exercise (a bike ride or some gardening), then you might not need a full rest day. Listen to what your body is telling you and trust it.