You needn't worry about experiencing any delays when you take this flight. Prompt arrival to your destination is anything but short of a guarantee. No, I am not speaking about air travel, but I am suggesting that you ascend your way to fitness by climbing a flight of stairs (or two).

Public health officials strongly advocate that you opt to take the stairs instead of an elevator while your are at work and/or the mall in order to boost your daily activity level. I am challenging you to take this recommendation a "step" further. Why not swap a session of your regular exercise program for a workout on the stairs once or twice a week? Need a good reason? For one, you burn almost twice as many calories by climbing the stairs than you would if you were to walk at a brisk pace of 3.5 mph for the same amount of time (e.g., about 143 calories versus 72 calories, respectively, in a fifteen minute time period for a person weighing 150 pounds). Other benefits of stair climbing include:*

• Improved aerobic capacity
• Reduced body fat
• Smaller waist circumference
• Lower blood pressure (diastolic blood pressure)
• Decreased LDL (bad) cholesterol

*Information based on a study published in the European Heart Journal (2008) in which 69 subjects exclusively used the stairs for 12 weeks while at work in a hospital.

A bonus to a stair workout is that it strengthens your quadriceps (front thigh), calf, and buttocks muscles as you "carry" your own weight against gravity. You can easily adjust the intensity of your workout by how quickly you ascend the flight and whether you take one step at a time or skip a step. Depending on your fitness level, the stair landing can be used either to rest or to perform strength training exercises (wall push-ups).

Stair climbing is a readily accessible activity that can be taken indoors when weather conditions are inclement. Precautionary measures should be taken when choosing to use the stairs for your workout. Because stair climbing places great demands on your body, you should seek the approval of a physician to ensure you do not have any underlying conditions that warrant treatment and management prior to beginning a program. Stair climbing may not be a good exercise alternative for you if you have arthritis, particularly in your knees or hips. If you have back problems you might want to opt for another form of exercise.

Safety Tips for the Stair Climbing Workout:

• Seek your doctor's approval.
• Wear comfortable, well-fitted shoes with good arch support.
• Inspect the stairwell to be used for hidden hazzards
• Watch out for doors opening at floor exits.
• Warm-up for 5 minutes prior to the session.
• Progress slowly, especially if you are new to exercise in general. For a novice, consider walking up 1 flight of stairs followed by a 1-2 minute rest period. Alternate this scenario until you have completed 10 minutes of actual stair climbing (do not factor in time spent resting). Your goal should be to progress to an uninterrupted 10 minute session of stair climbing (that is, you do not need to rest in between flights climbed). Once you can complete 10 minutes comfortably, continue the progression until you can climb for 20 minutes, and then eventually for 30 minutes. For individuals accustomed to exercise, consider walking up 1 flight of stairs, followed by running up the next. Continue this pattern for 30 minutes. For both groups, a goal may be to add a 1/2 to 1 flight of stairs per week.
• Cool-down for 5-10 minutes
• Choose a stairwell that is well-lit with adequate ventilation.
• Let someone know where you will be and your estimated time of return in the event of an emergency.
• Carry your cell phone with you, especially if choosing a public stairwell that is in a remote area of the building.
• Discontinue exercise if symptoms such as dizziness, lightheadedness, unusual shortness of breath, and/or chest discomfort occur. Seek medical attention if needed.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

Compendium of Physical Activities: Classification of Energy Costs of Human Physical Activities.

European Heart Journal (2008) 29 )Abstract Submission), pp. 385-386, Meyer, P. et. al

"The Stair Climbing Workout - Stairs are Everywhere and They Provide a Great Workout," April 19, 2007, Beecher, J.

     The American College of Sports Medicine, in conjunction with the American Heart Association, recently released their Position Stand on "Exercise and Physical Activity for Older Adults" in the July 2009 issue of Medicine & Science in Sports & Exercise.  This updated version has been expanded to include evidence compiled since 1998 (when the last Position Stand was published) supporting the role of exercise in older adults with chronic diseases and functional limitations, a population in which the safety of exercise was once questioned.  In addition, it addresses the positive impact exercise has on psychological health and well-being and cognitive functioning in older adults.

     These new guidelines were developed for adults 65 years and older.  However, the recommendations are relevant for those individuals between the ages of 50-64 years who have clinically apparent chronic health conditions or who have functional restrictions that limit physical activity, fitness, and mobility.  In general, these new recommendations are consistent with the recently released 2008 Physical Activity Guidelines for Americans by the Department of Health and Human Services.*

  Based on a growing body of knowledge, the ACSM and the AHA have made the following conclusions regarding the effects of exercise and physical activity on the older adult population:**

• Inactivity should be avoided.  Some exercise is better than none.  Health benefits are gained with any amount of physical activity; although, health gains are greater as the frequency, duration and/or intensity of exercise and physical activity increases.
• If chronic health conditions are present, physical activities should be performed as abilities and health status allow.
• Physical fitness can be improved through an accumulation of physical activity and participation in exercise.
• Advancing age is associated with an increased relative risk for developing and dying from cardiovascular disease, certain cancers, obesity, and type 2 diabetes.  It is also associated with a greater incidence of osteoporosis, muscle tissue loss (sarcopenia), and arthritis.  However, engaging in regular physical activity greatly reduces these risks.  In addition, exercise can be used to treat these diseases.
• Independent of cardiovascular fitness, muscular strength and power are indicators of all-cause and cardiovascular mortality.
• Average life expectancy is increased by participation in regular physical activity which maintains functional capacity and reduces risk of chronic diseases.
• Middle-aged and apparently healthy older adults can initiate aerobic and resistance training exercise and experience a qualitatively similar physiological response to that of younger adults.  In fact, the body's ability to adapt to such physical activities is well preserved into the 70's.  Therefore, age-related declines in functional capacity should not prevent an individual from participating in these exercises.
• Older adults may take longer to reach the same level of physiological improvements than their younger counterparts.
• Older adults do not tolerate exercise in temperature extremes as well as younger adults.
• Compared to their sedentary peers, athletic older adults who engage in vigorous-intensity aerobic exercise have a more desirable body composition (greater bone mineral density, larger relative muscle mass, and less abdominal and total body fat), lower blood pressure, better cholesterol profile, and can sustain exercise longer for a given workload (i.e. experience less cardiac stress and muscular fatigue).
• Compared to their sedentary peers, older adults who engage in regular resistance training activities are approximately 30-50% stronger, have a greater muscle mass, and tend to be leaner.  Furthermore, compared to older adults who engage in aerobic training alone, those who participate in resistance training exercises have greater bone mineral densities and increased muscular strength and power.
• Participation in moderate- to high-intensity resistance training increases lean body tissue and decreases fat mass.  In addition, high-intensity resistance training has been shown to be an effective treatment modality for clinical depression.
• Exercise programs that include aerobic, strength, flexibility, and balance activities reduce the risk of falls for older adults.
• Both fitness level and participation in aerobic exercise are associated with a lower incidence of clinical depression and anxiety and a reduced risk for cognitive decline and dementia.

The ACSM and the AHA recommend the following in their recent Position Stand:

• Engage in regular moderate-intensity physical activity for at least 150-300 minutes per week or 75-150 minutes per week of vigorous-intensity exercise.
• Participate in moderate- to vigorous-intensity strength training exercises at least 2-3 days per week.  A regimen of eight to ten exercises of 8- 12 repetitions each that involve the major muscle groups of the body should be followed.
• Incorporate flexibility exercises into the exercise program on a least 2 days of the week.
• Perform balance exercises, especially for individuals who frequently fall or who have mobility limitations.

* For a summary of the national guidelines read my February 17, 2009 post "Exercise Recommendations: An Overview."  For more detailed information, visit www.health.gov.paguidelines.

** For the purposes of the Position Stand, physical activity is defined as body movement that results from contracting muscles and requires an increase in energy expenditure.  Raking the yard is an example of physical activity.   Exercise is defined as planned and structured participation in physical activity with the purpose to improve health/fitness.  An aerobic dance class is an example of exercise.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

Medicine & Science in Sports & Exercise Vol. 41, No. 7, July 2009 "Position Stand; Exercise and Physical Activity for Older Adults," pp. 1510-1523; Wojtek J et al.

     Exercise makes sense, literally.  There is a growing body of evidence, from both human and animal studies, that routine aerobic exercise can boost brain power.  Cognitive decline was once thought to be inevitable as one aged.  Over recent years, however, investigators are discovering that regular exercise is associated with a reduced risk for and/or delayed onset of dementia in the aging population.  It appears that acquiring "brain fitness" is possible and is as important as achieving cardiovascular fitness for optimal health and well-being in the later years.

     According to Janet Fletcher Brady, M.S. Director of Medical Programs for LifeSpan (www.lifespanfitness.com), and cofounder/developer of Fitness Forever (www.fitnessforever.com/), "Age doesn't matter.  It is what you do as you age that has a big impact."  Living a healthy lifestyle overall, such as not smoking (smoking restricts blood flow and oxygen supply to the brain thereby impairing brain function), maintaining a healthy body weight, consuming a well-balanced diet that consists of antioxidant rich fruits and vegetables and foods rich in Omega 3's, engaging in intellectually challenging activities (crossword puzzles), and participating in regular physical activity preserve brain function.

     It has been long known and well established that routine exercise is good for the cardiovascular system and chronic disease prevention.  Now there is enough research to support its role in promoting brain health.  "What is good for the heart is great for the brain" states Brady.  "Exercise improves [blood] circulation which improves oxygen circulation, penetration, and pick-up at the cellular level" explains Brady.

     Starting around the third decade of life, decreases in the brain's gray and white matter occur which impair function and result in cognitive decline.  Age-related changes are greatest in the frontal, parietal, and temporal lobes of the brain.  These areas are responsible for the brain's "executive control."  "Executive control" refers to those tasks that entail complex thought and attention.  These areas of the brain function so that you can formulate plans of action, coordinate tasks, switch between tasks, disregard irrelevant information, and retain and process information over a short period of time (working memory).  Declines in the "executive control" processes of the brain threaten independent living in the later years.  Fortunately, research has found that these areas of the brain are spared the greatest as a function of aerobic fitness.

     A study on "Ageing, Fitness and Neurocognitive Function" conducted by Kramer et al. and published in the July 29, 1999 issue of Nature, found that aerobic training in previously inactive adults (ages 60-75 years) led to significant improvements in performance on tasks that relied on the "executive control" processes of the brain.  In another study, conducted by Colcombe et al. and published in The Journals of Gerontology Series A: Biological Sciences and Medical Sciences (58:M176-M180 [2003]), the researchers found that declines in brain tissue density were greatly reduced as a function of cardiovascular fitness when they assessed fitness levels of 55 adults (mean age 66.5 years) and compared their high-resolution magnetic resonance imaging brain scans.  In a subsequent study conducted by Colcombe et al., the investigators found that brain volume increased, particularly in the prefrontal and temporal areas of the brain (those most affected by age), as a result of aerobic fitness training.

     Researchers are still investigating the mechanism by which aerobic exercise leads to improvements in brain function in humans.  However, based on the findings of research conducted on animals, aerobic training appears to lead to the formation of new neurons (brain cells) and blood vessels as well as increases in the number of synaptic connections and levels of neurotransmitters and nerve growth factors.

     Although any form of aerobic activity is better than none, Brady explains that certain types of physical exercise are best for optimal "brain fitness."  First, exercises that incorporate cross-lateral movements (those that cross the midline of your body) are best.  These movements lead to an increase in blood flow to all areas of the brain and result in an increase in the number of synaptic connections formed in the brain.  Second, activities that include "cued-movements" (actions performed after being prompted by a signal or cue to move, such as with an instructor led aerobic dance class) are beneficial.  These help to focus attention.  Your mind needs to be actively engaged in order to retain information.  Brady also states that any physical activity that requires you to develop a new skill is important to enhance brain function.

     So what does this mean  for your exercise routine?  Brady says to "Exercise smarter.  Break-out, don't be repetitive.  Add brain-based activity that involves cross-lateral and cued-exercise movements to your routine."  If you are a runner, for example, add a few sessions per week of aerobic dance class or other exercises that incorporate the above brain boosting movements.  Following these recommendations will not only lead to a fit body, but a fit brain.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

Phone Interview March 25, 2009 with Janet Fletcher Brady, M.S., Director of Medical Programs for LifeSpan (www.lifespanfitness.com); (www.fitnessforever.com/)

ACSM's Health & Fitness Journal March/April 2009 (13)2:27-31; "Exercising the Brain", Brady, J.

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:M176-M180 (2003) "Aerobic Fitness Reduces Brain Tissue Loss in Aging Humans", Colcombe, S.J. et al.

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:1166-1170 (2006) "Aerobic Exercise Training Increases Brain Volume in Aging Humans", Colcombe, S.J. et al.

Nature 400, 418-419 (29 July 1999) "Ageing, Fitness and Neurocognitive Function", Kramer, A.F. et al.

Proceedings of the National Academy of Sciences of the United States of America, 2004 March 2; 101(9): 3316-3321, "Cardiovascular Fitness, Cortical Plasticity, and Aging", Colcombe, S.J., et al.

"Nutrition and Brain Function: Food for the Aging Mind", USDA Agricultural Research Service (www.ars.usda.gov/is/AR/archive/aug07/aging0807.htm)