Whatever Happened to Physical Activity? 2

Men’s Health Peer Education HEALTH PROMOTION Be active for life (Tab 12)

Be active for life

Contents

Learning outcomes...... 2 Acknowledgments...... 2 Whatever happened to physical activity?...... 2 Further information...... 2

Reviewed: 08/10/2015 Page 1/16 HEALTH PROMOTION Men’s Health Peer Education (Tab 12) Be active for life

Be active for life

Learning outcomes

On completion of this module, and with further directed activities, MHPE volunteers should be able to:

 provide two examples (for each) of how exercise can make a person feel better, the body work better and be good for the mind

 suggest practical responses to common excuses for not exercising

 recall recommended duration and frequency of moderate exercise recommended for Australian adults

 simply describe the meaning of ‘moderate’ activity

 provide at least two examples each of fitness, strength, flexibility and balance exercises

 describe three practical ways of reducing sedentary behaviour

 list five motivating factors that enhance the likelihood of introducing and maintaining a healthy activity regime

 list three safety factors that should be considered in any new activity program

 suggest five motivation strategies to encourage a reluctant mate to commence a regular activity program.

/16 Reviewed: 08/10/2015 Men’s Health Peer Education HEALTH PROMOTION Be active for life (Tab 12)

Acknowledgments

Information in this section has been obtained from the following sources:

 Australian Bureau of Statistics. Australian Health Survey 2011-12. ABS website (www.abs.gov.au/ausstats/[email protected]/mf/4364.0.55.004)

 Department of Health. Australia's Physical Activity and Sedentary Behaviour Guidelines, 2014. Department of Health website (www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth- strateg-phys-act-guidelines)

 Department of Veterans’ Affairs, Choose Health: Be Active: A physical activity guide for older Australians, 2008. DVA website (www.dva.gov.au/about- dva/publications-and-forms/health-publications/choose-health-be-active)

 Heart Foundation, Active Living, 2014. Heart Foundation website (www.heartfoundation.org.au/active-living/Pages/default.aspx)

Whatever happened to physical activity?

Technology has reduced much of the day-to-day physical activity we took for granted years ago. We drive to the supermarket and buy things that we would previously have grown in our garden (and gardening is good gentle exercise). We press a button instead of chopping wood for heat. Machines do much of our work and home entertainment keeps us off our feet for long periods. Although making life easier, our increasing use of ‘labour-saving devices’ has brought with it an increase in men’s waistlines and other health problems.

Most people are aware of the health benefits of regular exercise; however, more than half of Australian adults are inactive (that is, undertake little or no exercise) or are insufficiently active. Of the 43% who meet recommended activity criteria, most are walking only. The proportion of people who are inactive increases with age.

Military training involves plenty of physical activity, and for some is part of a lifelong commitment to exercise. For some veterans, however, exercise reminds them of endless parade-ground drills. And for others, psychological or physical health problems make any exercise hard.

Sedentary behaviour

Sedentary behaviour is sitting or lying for activities (other than sleeping) such as watching TV, using a computer (including at work), in a car or train, on the phone and so on. Sedentary activity occupies, on average, 39 hours each week for an Australian adult; that is more than ten times the duration of physical activity!

Sedentary behaviour is associated with poorer health, including increased risk of type 2 diabetes. These negative effects can occur even in those who otherwise participate in physical activity. It is important to break up the time spent sitting or lying as often as possible.

Why is physical activity so important?

It makes you look and feel better by:

 giving you more energy  helping you sleep better  helping you to relax  increasing sensual awareness and enjoyment  helping you to meet people and make new friends  allowing you to live independently for longer.

It is also good for your mind and can:

 reduce stress and anxiety  improve concentration and reduce your risk for dementia  improve self-confidence and your sense of wellbeing  lift your mood, reduce feelings of sadness, and even treat depression.

It is good for your body and can:

 help to control weight, body fat, blood pressure, cholesterol, diabetes and bone and joint problems (e.g. osteoarthritis)  reduce your risk of heart disease, stroke and some cancers  help to manage pain  help to maintain and increase joint movement  help to prevent falls and injury.

Activity may or may not add years to your life, but it will certainly add life to your years!

If physical activity is so important, why don’t we do it regularly?

Do any of the following reasons/excuses apply to you or your mate? Work out what is really stopping you getting enough physical activity.

I don’t have time! Make exercise a priority: list times wasted in your day. Take every chance to be active: walk to the shop; park in the furthest car park; exercise while watching TV.

I’m always tired! By being active you will actually feel less tired and achieve more in your day.

I have an illness that may worsen with exercise! Health conditions like arthritis, heart disease and asthma can make exercise more challenging, but talk to your doctor or physiotherapist about an appropriate exercise plan. Most health problems are improved by activity. Exercise can assist you manage pain, get stiff joints moving, and make breathing easier.

I might get injured! Falls and injuries increase if muscles are weak. Walking and swimming are low- impact exercises less likely to cause injury. If you can’t swim, try a gentle exercise class at your local pool—great to try in winter in an indoor heated pool! Talk to your doctor, physiotherapist or exercise physiologist.

It costs too much! Plenty of free activities are out there—walk, cycle or jog to buy the newspaper, get off the bus a stop earlier, visit a gallery or museum or a friend—in fact, walk anywhere! You don’t need special shoes, just comfortable ones. Look in local papers and community centres for free activities. GPs and community centres often have free walking groups.

I just can’t be bothered! Motivation is often a problem, so turn it around and make it an excuse to spend time with friends, family or neighbours. Ask them to join you on your walks, or for a game of tennis or golf. Join any exercise group, class, club or gym and you will find others willing to encourage you, in return for your support.

It’s too hot/cold/wet! Rug up against the cold with a coat, hat and gloves—you will be amazed how much warmer you feel on returning home. Beat the heat by going out early, or exercise in air-conditioned venues. Shopping centres are snug over winter and offer a great free opportunity for walking in a cool climate during summer.

Exercise is for the young! Think again. You are never too old—ask any of the veteran athletes in the Masters Games how good they feel. Not everyone can race bikes at 82, but you can move more. Take every opportunity you can to add some physical activity to your day. Try strength training; the frailer you are the more you have to gain.

It’s too hard to get to! Be active around your home: get a local map and plan to explore nearby streets and parks, and appreciate every step as an exercise opportunity. Ask a friend to drive you somewhere you can exercise, and invite him to join you. Community transport, your GP, a local community centre or ex-service organisation may be able to assist.

I’m already worn out! Inactivity is really the killer—our bodies were made to move. Muscles, joints and bones all improve with movement and moderate exercise, but talk to your doctor or physiotherapist if unsure.

It reminds me of military PT! You don’t have to hurt or do lots of repetitions to gain health benefits—choose an activity you actually enjoy.

I’ve never been into sport! Activity doesn’t have to be ‘sport’—try gardening, dancing or any exercise to music, or exploring the neighbourhood.

Movement is an opportunity, not an inconvenience!

What type and amount of activity should I be doing?

No matter what their age, weight, health issues or abilities, all people should do some form of physical activity. If you currently do no physical activity, start by doing some and gradually build up.

The Australian Physical Activity and Sedentary Behaviour Guidelines recommend that everyone:

1. Should be active on most, preferably all, days every week.

2. Accumulate 150 to 300 minutes (2.5-5 hours) of moderate physical activity or 75 to 150 minutes (1.25-2.5 hours) of vigorous physical activity (or a combination of moderate and vigorous) each week. ‘Accumulate’ means that 10-20 minute efforts add up!

3. Do muscle strengthening activities on at least two days each week (see over the page).

4. Minimise the amount of time spent sitting, and break up long periods of sitting as often as possible.

What is ‘moderate’ activity? Moderate intensity activity will cause a slight, but noticeable increase in heart and breathing rates, but still allow you to maintain a conversation. Brisk walking is a great moderate intensity activity.

What is ‘vigorous’ activity? Vigorous intensity activity requires more effort and makes you breathe harder and faster (‘huff and puff’). Examples include running or fast cycling, some team sports or hard manual labour.

Try to be active every day if you can, especially if you want to lose weight. If you are already active, consider doing more—more time, more effort, more often. Always remember to listen to your body and not to overdo it.

If you have not exercised for some time, are older or are starting a new physical activity, you should start at a level that is easily manageable and gradually build up the recommended amount, type and frequency of activity. It is advisable to talk to your doctor before beginning a new exercise program.

Older Australians (65+)

The above Physical Activity Guidelines 2014 can be considered and applied as able for older Australians, but National Guidelines were not reviewed and updated for this group. Guidelines therefore remain as stated in the Choose Health: Be Active booklet behind Tab 13. In brief, these are that all older people:

1. Do some form of physical activity

2. Be active in as many ways as possible, incorporating fitness, strength, balance and flexibility

3. Accumulate 30 minutes of moderate activity on most, preferably all, days

4. Who have stopped physical activity, or starting a new one, should start slowly and gradually build up

5. Continue to be as physically active as possible according to capability and safety.

Falls are a major cause of injury, disability, hospitalisation, aged care entry and death in older men. One of the many risk factors is fear of falling, which results in less activity (‘in case I fall’). A great way to reduce falls risk, however, is to exercise, combining strength, flexibility and balance elements (see ‘Four types of physical activity’ on the next page). Eat well, and ask your GP about local falls prevention initiatives.

How do I get started, or get a mate started, and stick at it? Some find it easy to start a new activity program, while others may take a bit more motivation. Even when under way, maintaining activity can be tough, so don’t be too hard on yourself if you miss a session. Be proud of yourself for taking the plunge and get back on track quickly.

Choose your activities: Think about the four types of physical activities and choose some from each group that you might enjoy and want to try.

Set a date to start: There is no time like now! Start slowly and gradually increase your activity level at a safe pace.

Be social: Involve a friend, colleague, neighbour or relative in your activity routine —this will help keep you both motivated and committed, and double the fun.

Build relationships, but don’t rely on others to do exercise. The activities should be pleasurable (including the changes they bring to your life), and gradually you will make them part of your routine.

/16 Reviewed: 08/10/2015 Four types of physical activity

There are four types of activity needed to keep us healthy and fit for life. Try to include at least one activity from each type.

Moderate fitness Strength activities Flexibility activities Balancing activities activities These activities help to Strength activities help Flexibility activities help Practising balancing will keep your heart, lungs your muscles and bones you to move easily, and help to prevent falls and and blood vessels stay strong and make it include gentle reaching, can strengthen healthy (‘aerobic’ easier for you to do daily bending and stretching. If important small muscles activities). Choose from: tasks as you get older. you stay flexible you will in the body. For older Build them into your be better able to perform men some of the  brisk walking or everyday life, and many daily activities and exercises in Choose jogging (take the include: you will reduce your Health are ideal for dog, or the kids) chance of an injury. Try: balance practice. Or try:  yard and garden  climbing stairs work  weight, strength or  tai chi  heel-to-toe slow  continuous resistance exercises  bowls (indoors and walking (with eyes swimming (gym or isometrics) outdoor) shut when well-  aerobics  lifting and carrying  stretching exercises practised and steady, if safe to do  cycling (lycra not (e.g. groceries or  housework (stretch so) needed) small children) and bend to the  one-leg standing (try  golf (no cart!)  callisthenics (e.g. corners) to increase your  push ups and sit ups)  yoga martial arts time; with eyes shut  housework  heavy yard work  yard work. (e.g. digging and after practise, if safe (vigorous, to some to do so) shifting soil). Try to do some form of up-tempo music!)  tai chi.  dancing (there are stretching every day— Schedule specific never enough men!) even if it is only while strength exercises two to you are watching Note that all balance  aqua-aerobics three times a week and television. exercises can be risky.  tennis. build them into everyday Introduce them activities. gradually, and have Try to do something from something you can hold this list for at least 30 on to at all time if minutes most days. If needed. Talk to your you prefer, you can doctor before trying break it up into 10 or these exercises. 15 minute segments.

Some of the activities above, such as tai chi, dancing or exercise classes, incorporate two or more of these groups. Try to include some indoor and outdoor activities, and preferably some involving other people. The greatest health benefits, motivation and pleasure will come from mixing up the activities chosen.

Be active every day in as many ways as you can

Build motivation: Create challenging, but achievable, goals. Be realistic—don’t make it too hard for yourself in the beginning. A golf cart is ok to start, but isn’t aerobic exercise. So challenge yourself—remember we always value those things we work hard to achieve.

Set some goals (for example):

 ‘I will walk every day for 10 minutes after meals.’  ‘I will park further from the shops every trip.’  ‘I will go dancing every week.’  ‘I will enter a 5 km fun run in three months time.’  ‘I will lose 4 cm off my waist in six months.’

Goal setting is a powerful process for thinking about your ideal future, and for motivating yourself to turn this plan into reality. By knowing precisely what you want to achieve, you know where you have to concentrate your efforts.

Use reminders: Place notes around your home—on the fridge, or on the front door so you see them before leaving the house. Place your walking shoes near the door or in the car; better still, use them instead of the car.

Get into a routine: Plan your activity, both the time and place. Make a regular time for physical activity in your diary or on your calendar. But be spontaneous also—if you feel like it, do it! Value every opportunity to move!

Use a diary, a wrist monitor or an app: Record your activities and how you feel. This is a great way to monitor your progress (see ‘Measures of success’ below). But don’t measure weight or waist too frequently—these are changes designed to occur slowly. Once a month is plenty.

Make an activity chart to put on the fridge—give yourself a big tick when things are achieved—and share your success with friends and family. You deserve their praise (see ‘Choose health’ booklet in Resources section of this module).

Set a timeline for certain measures of success. Be realistic—it is more motivating to succeed than fail.

Get some help from a coach, trainer or exercise physiologist.

Choose a role model: This could be someone close who is regularly active and fit. Ask them how they stay motivated.

Expect setbacks: Even the most committed athletes sometimes have trouble sticking to a regular program. Don’t give up, merely acknowledge the hiccup and start again.

Vary your activities  Change the time or place you normally exercise to keep it interesting. Walk somewhere else, in the opposite direction, or at dawn.

 A period of ill health can interfere with your activity plans. Don’t give up all together, start out again at an easy level and build up or choose something more appropriate for a while. You will get back to speed faster than when you first started. Even chair-based exercises offer a chance to build up fitness. Talk to your doctor, physiotherapist or exercise physiologist.

 Don’t get bored by doing one fitness activity—there are many possibilities. Try something new. There is always golf, bowls, tennis, walking or swimming, but think of other things. How about learning some new dance steps, trying rowing, a bush walk, table tennis, climbing the steps of the highest building in your city (a few times if it is low-rise!), or join a team in activities offered by community centres or a local gym?

 Lift some weights—take up a specially designed strength training program at your local gym. Many offer these at low cost at quieter times for people who have retired. This is great for building strength and preventing falls.

 Join a tai chi or yoga class—lots of blokes do. There’s no need for fancy gear, just wear a T-shirt and pair of shorts or baggy pants and enjoy.

 If you are already active and reasonably fit, think outside the usual activities to discover something new. You may need the assistance of a coach or group to help you, but challenge yourself to learn a new skill, like: – modified team games – entering a veterans/masters club competition in your favourite sport (athletics, cycling, swimming, table tennis etc.) – a team sport (netball, touch footy, hockey etc.) – rock climbing at an indoor centre – abseiling – canoeing.

 Staying active on a regular basis can be a challenge. Things will come up that break your normal routine, like going on holidays, an injury or illness or personal matters. The key is to treat any setback as temporary and get back on track as soon as you can.

How do I know I am getting there? Measure the changes: Less effort, longer distances, faster times, centimetres lost (waist) or gained (muscle), kilojoules burned, losing weight or more fun are all signals of success. Chart them, use an app or computer, or put them in your diary, but don’t measure too often.

See the difference: Digital photos, once a month. Fit into new (or old) clothes.

Feel the difference: Tell your mates if you feel great after your exercise; because you will (after some practice). You will do things in six months that you can’t now.

You will smile more.

People will notice, and say so.

The old saying ‘no pain, no gain’ is not true. Slow down or stop if you feel any pain, and see you doctor if pain persists.

Make sure your activities are safe Start slowly: Check with your GP about the exercise you would like to commence, and any pre-existing health issues. Start slowly and give your body time to warm up at each session. Do some stretching exercises to help avoid muscle soreness and injury. Gradually increase your activity level over weeks and months, not days. Ask a professional to show you correct techniques. There are plenty of books in the library or gym and information on the internet to help.

Wear comfortable clothes: You don’t need to go out and buy new clothes to get started. Wear loose comfortable clothes and appropriate, supportive shoes. This will make your activities safe and more enjoyable.

Drink enough water: Remember to drink lots of water before, during and after your activity. Drink before you are thirsty—this is especially important in hot weather. Talk to your GP, physiotherapist or professional coach before spending money on sports drinks.

Set the right pace: You should be able to talk without losing your breath as you are doing your activity (low to moderate intensity). As you gain fitness or strength you will be able to increase your exercise intensity and still talk.

Increase gradually: All too often our enthusiasm overrides our capacity. This can lead to injury and burn out before you have established an activity pattern. Gradually increase both the intensity and time you spend doing any activity.

Skin protection: It is important to be active outdoors and to get some sunlight most days for sufficient vitamin D, strong bones and to help mood and sleep. But the risks associated with excessive sun exposure are real. Lots of veterans have sun- related skin problems. Remember to slip on a shirt, slop on some sun block, slap on a hat, seek shade and slide on some sunglasses!

Going to the gym: This can be a valuable, effective and social part of your activity schedule. Find a gym where you feel comfortable and get a professional assessment and program. Warm up by walking or cycling, and do some stretching.

Use light weights on lots of machines. Take your time and do some ‘warm-down’ exercises.

‘80 per cent of success is showing up.’ Woody Allen

Talking with an unmotivated mate

We all know exercise is good for us, and that most of us need to do more. As the Stages of Change model points out, some people see no need to change. Your mate may never get off the couch, no matter how well you put the case. That is his choice, but give yourself a pat on the back for encouraging him.

Sometimes it takes a health scare to move a bloke to change, and sometimes nothing will. Motivation has to come from within, so think about what might make it worth his while, emotionally or physically. Look at the earlier list of ideas for getting started. Here are a few other suggestions that you might toss into the conversation:

 Ask your mate about his views of exercise. He may have suffered an injury, and be nervous about starting again, or he may be worried about his heart. Or he does not want to fail. This will shape your approach.

 Are there issues with transport, access or cost?

 Is the plan for exercise convenient for work, family, ability and time?

 Give him a website or brochures as a gentle conversation starter.

 Chat with others on blogs—plenty of veterans motivate one another when times are tough, just as they learnt to do under pressure years ago.

 Visualise the ‘new’ you. ‘Six months to the next reunion (or beach holiday), mate. Let’s blow them away with how good we look.’

 Find some success stories.

 If the problem is not wanting to ‘just do a routine’, try a gym that has lots of options: weights, spin, step, yoga.

 If he is worried about how he looks, start off with walking after dark.

 ‘You’ll live long enough to play with the grandkids’ works for some.

 ‘You come up with something we’ll do together (it may not be exercise), and then it’s my turn (gentle exercise)’.

 Explore some rewards. You and your mate get to try a new coffee place each time you finish the workout. Or do your routine in less than 45 minutes, and treat yourselves to a fishing weekend. Find a ‘treat’ that is meaningful to him.

 ‘This can be quiet time, away from the missus.’ Or the kids. Or with the missus, or your mates. We all have a different social drive that can motivate.

 ‘Relieve your stress mate. Walking/running/swimming works for me.’

 Competition is the driver for some. Challenge your mate, and use results, apps or devices (see next page) if they help to motivate the (friendly and safe) rivalry.

 Do it for charity. The two of you can ask your mates to sponsor you (‘Harry hasn’t run 5 metres since Puckapunyal. A 5 km fun run—I’ll give you $100 if he does it’). Wear the charity T-shirt when you train. It may be an altruistic aim, but it will be a huge smile when you collect the money!

Exercising with a mate is safer and more fun; you may be the person that gets the ball rolling, but in the long run he must determine his own motivation. Real success is when he looks forward to exercise, smiles more and plans for the future.

Need more advice, information or support

If not physically active, see your GP before substantially increasing your exercise load.

Further information

A Healthy and Active Australia Useful links to national nutrition and activity initiatives, including a Healthy Weight calculator. Healthy Active website (www.healthyactive.gov.au)

Australia’s Physical Activity and Sedentary Behaviour Guidelines The guidelines recommend the amount of physical activity you need to do to enhance your health and wellbeing. Brochures with practical ideas. Department of Health website (www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg- phys-act-guidelines)

Choose Health: Be Active. A physical activity guide for older Australians Guidelines, practical ideas and planning guides in a booklet aimed at older Australians of all levels of physical ability. Choose Health website (www.dva.gov.au/about-dva/publications/health- publications/choose-health-be-active)

Heart Foundation Great exercise and nutrition information. Go to ‘Active living/walking’ to find free local walking groups. Heartmoves program for those with health issues; workplace wellness; app to track treatments; great recipes and much more. Heart Foundation website (www.heartfoundation.org.au)

Lift for Life A structured, evidence-based resistance training program for people with diabetes or those at risk of developing type 2 diabetes or other chronic conditions. Life for Life website (www.liftforlife.com.au)

The DVA Heart Health Program This program is designed to increase physical health and wellbeing through practical exercise, nutrition and lifestyle management support. Call 1300 246 262 or visit the Veterans Heart Health website (www.veteranshearthealth.com.au) or the DVA Heart Health Program website (www.dva.gov.au/health-and- wellbeing/wellbeing/heart-health-program)

LiveLighter Started in WA and now available nationally; a great program encouraging nutrition and activity changes for individuals, workplaces and communities. Create an online ‘dashboard’ and establish a 12-week planner, including recipes and activities, and track your progress. LiveLighter website (www.livelighter.com.au)

DVA Factsheet: Exercise Physiologists For eligible veterans, exercise physiology services can be helpful in the delivery of clinical exercise interventions to manage chronic disease. DVA Factsheets (www.dva.gov.au/factsheets)

Apps Note all are free at Apple store or Google play (for Android) unless specified

Better Health Channel A fantastic all-round health resource: Personalise for health alerts; healthy recipes; extensive ‘lifestyle’ information; first aid advice; health contacts.

FitnessBuilder Workouts, exercises, videos and tracking of progress. Paid ‘pro’ versions also available.

iMapMyWalk This app lets you keep track of how far you’re walking, and how many kilojoules you’ve burnt by storing the information on your phone.

Sports Tracker This app contains a built-in GPS to track your performance as you get fit. It analyses your workout data, and is great for mates as it lets you share your information and photos.

TeamUp The TeamUp app helps overcome some of the key barriers to participation in physical activity, such as time, transport, social isolation and cost. Used by formal sports groups as well as casually in the community.

Wrist devices There are many brands on the market that will measure distance walked/run/ridden, heart rates, kilojoules burned, and so on. Some will link to your smartphone or computer, or have other features. A cheap pedometer or free phone app might also satisfy your needs.

/16 Reviewed: 08/10/2015