How to Stay Fit and Healthy for Life

Want to know how to stay fit and healthy - or keep your kids fit and healthy - for life? Read this article...

(eDiets / Miami Herald: Fitness) - A Guide to Keeping Trim for a Lifetime

Ariel Auerbach is not your typical 10-year-old.

In between karate and kickboxing, she teaches hip-hop dance at Aventura's Olympia Fitness Center. "I love dancing, it's my life. I love to move."

Ariel may only be 10 but she is laying the groundwork for a healthier lifestyle.

The human body goes through profound changes as we age, bringing along the attendant challenges to maintaining it. Experts agree that Ariel isn't too young to begin a health and fitness program, developing a mindset that will carry her throughout life.

"In terms of exercise, the recommendation is clear: Everybody should be doing three or four sessions a week of at least 30 minutes of aerobics for cardiovascular health . . . and sessions of strength training," says Dr. Carla Lupi, assistant clinical professor with the University of Miami's Institute for Women's Health.

Moreover, the exercise that comes naturally to a child -- playing sports, swimming, bike riding -- must continue as you age, health experts say.

"I have a lot of patients who come in in their fourth, fifth and sixth decade and a long time ago gave up physical activity," said Dr. Robert Schwartz, chairman of the Department of Family Medicine and Community Health at the University of Miami. "It's hard to start in your fifth and sixth decade and get into a regular pattern of behavior."

Toward that end, we've developed a guide to keeping you in shape over a lifetime.

ADOLESCENCE: SUBSTANCE ABUSE, STDS CAUSE CONCERN

This is a decade of great change, physically and emotionally.

In a nationwide study on youth risk behavior among 15,214 adolescents from 1991 to 2003, the Centers for Disease Control and Prevention found cigarette smoking and alcohol use decreased, and cocaine use leveled off.

In South Florida, however, the picture was not as bright.

Thoughts of suicide or sadness plagued 30 percent of students surveyed in both Miami-Dade and Broward counties, a 2 percent increase from 1991 to 2003. Almost half, 48.2 percent, of Broward's students smoked cigarettes and 43.9 percent of Miami-Dade's lit up, a slight rise during this period. Three-quarters drank alcohol and more than 30 percent of those surveyed in both counties admitted they had smoked marijuana, almost a 3 percent increase over this period.

"Some new fads are out there where kids are bringing pills from home and going to parties and taking these over-the-counter or prescription drugs," warns Schwartz. "A lot of advice in this period has to do with the dangers that are out there."

Sexually transmitted diseases are also of great concern.

"Teenagers 15 to 19 have the highest rates of reportable sexually transmitted diseases, including in Miami," said Dr. Larry Friedman, the director of the Division of Adolescent Medicine at the University of Miami. Abstain or use condoms to avoid the risk of sexually transmitted diseases.

Fitness-wise, "the primary focus [at this stage] is on how to avoid injury if overexercising," says Schwartz. "Young teens come in with joint problems from overuse or injuries from playing sports. A lot of teens are into bodybuilding and we have to help them understand the dangers of using certain additives."

Ideally, teens should find an exercise they enjoy and pursue it. Lean body mass is the key to good health and can be a challenge in a culturally diverse community such as South Florida's, says Friedman. Food preparation and dietary customs vary.

"Normally, I go to the gym and have made it a routine," says Laura Scott, 16, who will enter her senior year at J.P. Taravella High in Coral Springs. She alternates cardiovascular work with weights and participates in a beach boot camp class Saturdays.

"Mom got me a membership at the gym and my sister is on the track team," Scott says. "It's something to keep me busy and active and fit so I can get the things I need done. [Exercise] helps you to look good when you go out with friends."

The sisters converted their mother, Loraine Gravney, 38. "I got into exercising and going to the gym and now it's a normal lifestyle.'

THE ROARING 20s: EXERCISE IS CRUCIAL IN CHILD-BEARING YEARS

Finding the time to work out in this period can be stymied by college and starting a career. Signs of an expanded waist line are evident thanks to eating on the run and downing drinks at The Rat.

At 21 we can get into nightclubs and thus drink. But our dancing may not be strenuous enough to burn the calories consumed in that third beer.

Lupi also recommends yearly testing for chlamydia if sexually active. "Young women should get their first pap smear three years after starting to have sex and then yearly until 30," she says. Once 30, if there are no problems and you are in a monogamous sexual relationship with a similarly safe partner you can switch to every three years, she advises.

Women who have had a hysterectomy for reasons not related to cancer do not need to have pap smears, Lupi says, citing a study published in the June 23 issue of the Journal of the American Medical Association. The association found that as many as 10 million women who have had a total hysterectomy -- removal of the uterus and cervix -- unnecessarily continued to undergo pap tests.

In our 20s and 30s we are also starting families. And while it's hard to pump iron at Crunch when you're pregnant, this is not the time to give up.

"Studies show that well-exercised women have better pregnancy outcomes and shorter labors -- which is what I always tell them," Lupi says, laughing. "They have better birth outcomes overall and healthier babies and a more appropriate weight gain."

Tips include skipping abdominal work after the first trimester. Avoid falls by selecting activities such as swimming, stationary bikes, treadmills. (Father, too).

All reproductive age women should get folate in their diets, found in dark, leafy vegetables and some fortified cereals. Studies have found that folate reduces neural tube defects and some brain abnormalities in the developing fetus. No proof, yet, that folate reduces the risk of cancer or heart disease in men but the general consensus is that folate is healthy.

THE MIDDLE YEARS: LIFT SOME WEIGHTS TO PROTECT BONES

From pregnancy to, uh-oh, menopause.

"The time of menopause is when women should be most worried as they lose their estrogen and go through a rapid phase of bone loss," warns Dr. Silvina Levis, a professor in the University of Miami Department of Medicine

Lifting weights and other strength-building exercises become even more important to help ward against osteoporosis -- men aren't immune to it, either. Smoking and diet sodas can lead to bone loss. A test to gauge bone density is advisable.

Ariel's mother, Bari Auerbach, 40, takes part in Women's Figure competitions, a bodybuilding sport.

"Fitness is an all-encompassing mind-body experience," she says. "When you feel good about yourself and look good on the outside it goes to how you feel on the inside. I go in a gym and have a great workout and whatever is bothering me dissipates."

Even though you're working out, don't forget the calcium, needed for bone strength. Adults should have at least 1,000 milligrams of calcium daily but, note, the stomach can only absorb 500 milligrams at a time. Thus, if pills are your means of obtaining calcium, swallow them four to six hours apart. Foods high in calcium include dairy products and dark green leafy vegetables.

"What we do as children and adolescents will reflect on our risk of osteoporosis later," Levis says. "Little girls should be concerned about building up their bones."

The National Institutes of Health, along with the University of Miami, is conducting a two-year study on women ages 45 to 80 to determine whether soy products have any effect on bone loss.

"It's called the Spare Study," Lupi says, "to see if soy products will spare them from the bone loss."

Another must after 40 is to book a colorectal cancer screening test.

This is important for both sexes. "It is one of the top three cancers for women over 50," says Lupi, naming breast, lung and colorectal cancer. Forty percent of women with the latter die from it, as opposed to 20 percent of those with breast cancer.

Yet, many people avoid the test out of fear -- not of the results but of the test itself.

"Women are generally good about getting mammograms but people are reluctant to screen for colorectal cancer," Lupi says. "That's my biggest message now."

And then there's obesity, soaring in the United States and linked to a rise in type 2 diabetes cases -- even among the young.

The Diabetes Research Institute, as part of a 2001 clinical trial, studied 4,000 subjects -- 160 from Miami -- with impaired glucose tolerance, a condition that often precedes diabetes. Those who engaged in a modest exercise program of 150 minutes per week, the recommended level, and a weight-reducing diet, cut their risk of getting type 2 diabetes by 58 percent.

"This is quite a big impact," says Dr. Ronald Goldberg, professor of medicine at the Diabetes Research Institute of the University of Miami.

"The message . . . in terms of preventing diabetes is that physical activity is very important, mostly because it helps people control their weight," Goldberg says. "We inherit a tendency, not the actual disease."

Risk factors for type 2 diabetes include weight gathered around the middle, high triglyceride levels and a low level of good cholesterol.

This would describe Goldberg's patient, Mary Minto, about seven years ago. At risk for diabetes, Minto, now 43, enrolled in the Diabetes Prevention Program and started working out at the Diabetes Research Institutes's wellness center in Miami.

"I was always thin and then, oh my gosh, I was toting an extra 100 pounds. My blood trigylcerides were 400-something. They told me if I don't change my eating habits and lose weight I could get diabetes. I went home and cried."

Minto joined a gym in North Miami, began weight training, took up kickboxing, tae-kwon-do and works out six to seven hours weekly. She shed 100 pounds on her 6'-2" frame.

'I'm lucky. I came out of it unscathed. When I first started I couldn't even walk down the street. My diabetes counselor said, `Picture your normal weight with a 100 pound sack of potatoes on your back, you're not going to go too far.' I never thought of it that way."

THE SENIOR YEARS: WATCH FOR ROADBLOCKS IN WORKOUT REGIMEN

Bill Mullaney is an example of good living. At 81, this Depression-era child, former Navy man and retired postal employee discovered dancing at USO events while serving in World War II. He hasn't stopped two-stepping since.

"I go dancing at least once a week, that is my health plan," Mullaney says a few hours after working out with the walking group at Kendall's Dadeland Mall, which he does three times a week. Mullaney has even run the class when the instructor couldn't make it, calling out aerobic moves while singing a spirited chorus of Take Me Out to the Ballgame or some such oldie.

"I was always active, a lot of running, loved sports," he says. "Whenever I have a chance to run, rather than walk, I do. I eat mostly vegetables and raw green salads at least three times a week. Never smoked or had any drugs."

Two knee replacements slowed his pace -- briefly. "I feel pretty fantastic."

Age can throw roadblocks into a fitness regimen. Hypertension, arthritis, strokes, muscle stiffness, heart problems, a greater risk of falling and fatigue could loom.

However, "even with a physical limitation we try and get people to think about alternative types of exercise," Schwartz says. Running or walking in the shallow end of pool for resistance, for instance.

"If you don't have access to water, go to the beach. We live next to the water and water exercises for obesity or chronic joint disease are great and very cheap," Schwartz adds. "People do come in after heart attacks and can usually go back to exercises."

Tai chi, with its graceful movements, is also recommended to improve balance.

"To some degree," Dr. Schwartz concludes, "I tell people that exercise won't make you live longer but you will live your older years in a more healthy fashion."