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Introduction: This is BayCare Health Chat, another podcast from BayCare Health System. Here's Melanie Cole.

Melanie Cole: Welcome to BayCare Health Chat. I'm Melanie Cole. And I invite you to listen in, as we discuss the 10,000 steps that we keep hearing about. Joining me is Dr. Jennifer Chambers. She's a Family Medicine Physician with BayCare. Dr. Chambers, it's a pleasure to have you join us before we get into the 10,000 steps. Tell us a little bit about the benefits of exercise in terms of disease prevention and wellness, and what does that really mean to get regular physical activity?

Dr. Chambers: So, exercise can help in a lot of ways, and I'm sure we've all heard that before. Obviously it can reduce body fat and decrease our weight, which is probably why a lot of us want to exercise, but it can also increase our lifespan. It can increase our muscle, it can help with chronic pain. I have a lot of patients that I see every day that have chronic pain and exercises, and the first thing that pops into their mind when they think of managing that chronic pain, but it can help, it can improve our mood, our sleep. It can help with balance and mobility, especially for some of my older patients who are having frequent falls. It can also decrease our heart rate because our heart is a muscle and the more efficient that becomes the better it is at doing it to job. And it can also help with our breathing. And there's probably hundreds of more things we could say about exercise, but those are some big things that it can really help with.

Host: Certainly, exercise is medicine, and while it has this insulin like effect, we've heard that it can help with diabetes. Tell us a little bit about some of the diseases and why it's so important for heart disease or diabetes or lung issues. Any of these things that exercise really makes a difference.

Dr. Chambers: Diabetes is a big one that people will hear about. As far as chronic diseases, we can help prevent or improve with exercise, heart disease, as I talked about earlier, the heart's a muscle. So the more we work it, the better it performs. It can help with our blood pressure, with high cholesterol. It can also help with diseases that we don't think of as often like osteoporosis, which is a disease a lot of women get, but men can get as well. So by helping increase our muscle strength, it can help with the osteoporosis. Some studies even suggest that exercise can help with memory. It can help prevent falls as I said, it can help prevent anxiety, depression, and it can even help prevent several types of cancers, which is crazy to think that we could be doing something just a few times a week and help prevent several cancers that we may get throughout our lifetime.

Host: Well, you just mentioned depression and I personally feel this is a really big one for people to understand how does exercise help your mood and can it really help to reduce stress? We're in this very stressful time, everyone is feeling it. How can exercise help us with our mental and emotional health?

Dr. Chambers: So, exercise actually helps increase the production and circulation of these endorphins in our body, which are feel good. Neuro-Transmitters. So by increasing the amount of those in our circulation, it can make us feel better. It can help our body systems learn how to work together, which can reduce some of the symptoms that we actually came cause, or get from stress, including GI symptoms, immune system problems, or even cardiovascular problems that we get from stress. It can be a distractor. If you're working out in the afternoon, it can help you forget the stresses of every day, like a meditation in motion. If you want to think of it that way. Often you'll find that at the end of a workout, you've forgotten or stopped thinking about the days irritations or troubles. And instead you're more focused on your body. It can also increase your self-confidence, which is great for all of us, and it can improve sleep and give you more energy and sometimes sleep fatigue. Those things are all intertwined with depression, anxiety, or mood changes. So if we can improve one, we can improve the other.

Host: That's true. So now let's talk about those 10,000 steps. People keep hearing about that. How much exercise is recommended daily? What are some ways to achieve that? And tell us about 10,000 steps. Is there a rationale for this?

Dr. Chambers: So regular exercise is considered about 150 minutes of moderate exercise a week, or about 75 minutes of vigorous exercise a week. So this can be done in short or long workouts. So you could do 30 minutes a day for five days a week or an hour a day for three days a week. You could even split it up within your day. So you could take a couple of 15 minute jogs or brief walks or three, 10 minute walks during breaks on lunch, rather than doing it all at once. So when we're talking about burning calories, losing weight, we have to think about weight itself. How much is one pound? So approximately 3,500 calories equals a pound. In general, taking an extra 10,000 steps per day burns depending on who you are, approximately 2,000 to 3,500 calories in a week. Of course, that dependent on your current weight, your effort, but it's generally true for most people. So if you're taking an extra 10,000 steps a day and burning up to about 3,500 calories a week, then theoretically, you can lose approximately one pound per week. So that's where the 10,000 steps comes from.

Host: And if somebody is having trouble and especially during these times, when people seem to be a bit more sedentary, how do we best track our steps? How do we know if we're getting the 10,000?

Dr. Chambers: So, we all know about the devices that are out there, everybody's got an Apple watch or a Fitbit or some other similar fitness trackers, which are actually great. That's a good way to not only track your weight, your steps, but your calorie intake, how long you're standing, how long you're sitting. There's all kinds of things, I used to have a ring actually that counted my steps. There's phone apps that you can download. But in those cases, you kind of have to have your phone on your person the whole time, even regular old pedometers, that just count your steps. And you can find a lot of these devices on Amazon. If you're not able to use those devices, you don't want to buy one, keep track of it. You can actually use mileage to estimate how many steps you're getting in a day. So it takes about, again, depending on your height and the length of your stride, it can take about two to 3000 steps to walk one mile. So 10,000 steps would be about four to five miles again, depending on the person. So you know that doesn't have to be something that you necessarily get up and do, you know, two miles in the morning, two miles in the evening. Again, you can do little breaks throughout lunch. We'll talk about some other tips too, about how to get those extra steps in, but in general, about four or five miles a day.

Host: So then talk about it. If we find we're not getting enough, what are some ways that we can get more steps? We've always heard, Oh, park further away or take the stairs if you can, but tell us some different ones. Maybe that we haven't heard ways we can get more steps, more activity in our day.

Dr. Chambers: I tell my patients to be creative. Anything that you are sitting down and doing, you could probably stand up and do walk around the house while you're doing activities. Like when you're brushing your teeth for two minutes in the morning and in the evening, or when you're talking to your mom in the evening for 30 minutes, you could be pacing around the house the whole time and getting those extra steps in. When you're at work, you could use a restroom on a different floor and take the stairs so that you're not just walking the 10 feet to the restroom, that's right there in your office. You could take a lap around the office, building at lunchtime. A thing I always am telling my coworkers here is walk to someone's desk instead of messaging them or emailing them on the instant messenger. Taking those extra 10 steps, five, 10, 20 times a day really builds up your steps in the day, rather than just sending that really quick message on instant messenger. So pay attention to what you're doing. And imagine even right now, we could both be walking around while we're talking to each other. So just being creative with the things that we're doing, but you're right, walking up escalators, parking further away, taking the stairs. Those are some pretty basic ones. But even though they're basic, we all don't do them all the time. So making sure that we're trying to do them to get those steps in every day.

Host: I think one of the questions that I've always gotten in my 30 years in this business is do you have to do it all at once? When you mentioned the three to four miles and the steps does it all have to be at once and can exercise, whether it's a robotic or strength training, whatever we're talking about, does it have to be all at once or can it be spaced in increments throughout the day or the week?

Dr. Chambers: It absolutely can be spaced out. And I live in Florida. It's 95 degrees, nine months out of the year, going on a 30 minute or a 60 minute walk or jogging outside biking. Sometimes it's just not realistic because it's hot and exhausting. So splitting that up, even if it's a bunch of small little breaks, again, especially doing it during work, you're already at work. So just make it part of your work routine. Every time you have a break, maybe every time you go to the restroom, make that break a little bit longer, do a lap around the building or inside if you have room. Splitting those miles up during the day and throughout the week is still perfectly acceptable. So our goal while we should have daily goals is really a week together. So sometimes I have to cram my workouts into just two or three days because I'm very busy the rest of the time, other days I might do two or three things a day all week to get my steps in. So yes, it can absolutely be split up.

Host: Now tell us about the types of exercise briefly. We hear about aerobic and strength, training, functional training flexibility does the level of intensity matter when we're trying to achieve our steps, does strength, training count towards our steps, would yoga count towards those steps? Tell us a little bit about what types of exercise other than walking, will count towards this physical activity? Maybe not the 10,000 steps.

Dr. Chambers: The aerobic exercise is actually when our heart rate and breathing increases during activity. And that activity that we're doing is carried out for a long period of time, rather than in a short burst. So an example might be brisk walking, swimming, running, biking, or other activities most of us would just consider cardio. So the intensity does matter, before I had mentioned that regular exercise is 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise. So there's different ways to measure your intensity. Some are easy. Intensity is very subjective. So what may be moderate to me, maybe vigorous to someone else so we can measure it on a scale, say a scale of one to 10. With moderate exercise being, say a five to eight and a vigorous being above eight. You can use that fancy heart rate monitor you have if you have one available, you're aiming for a target heart rate.

So, in that case, it's a little more complicated. I might do this if I go to a class and they do the calculations for me, but you can do it at home as well. So your maximum heart rate, you're simply subtracting your age from 220, and then moderate exercise would be about 50 to 60% of that maximum heart rate. And vigorous exercise is going to be about 70 to 85% of that maximum. My favorite way is the talk test for moderate exercise, you should be able to talk but not sing. And when you're doing vigorous exercise, you shouldn't be able to get out more than a few words. So no real talking or singing. That's the easiest way I think. You had mentioned weightlifting and other types of exercise, weightlifting important. It builds our lean muscle, which is more metabolically active than fat, which means we burn more calories at rest with more lean muscle.

So, it is just as important for weight loss as the cardio that we had previously been talking about, that can help with balance bone health, things like yoga, Pilates, all of these things are very important. Most pedometers don't count those at steps, but those more fancy fitness apps or even programs that you can log into on your computer will actually allow you to convert that into minutes of exercise. Because while we can count the 10,000 steps that we're discussing, we can also count the minutes per week. And some of those applications will transfer over, say 30 minutes of yoga will give you a certain amount per week, but converting it straight to steps is difficult, but it's still important to do for many other reasons. Like we were talking about with balance and bone health and strength and building that lean muscle

Host: Before we wrap up, are there any exercise warning signs you'd like people to be aware of when you think it's important, they consult with their physician? And really Dr. Chambers, as you wrap up for us, the tips for motivation that are needed to keep going. Because I think especially right now, but all the time people need that motivation. They just don't seem to have it and they need something to help them keep going, keep moving forward and keep up with their physical activity.

Dr. Chambers: Well, if you're not a regular exercise or you're just starting out, you might want to ask your physician, if you have any major medical problems, if you're male over 45 or female over 55. But of course, during exercise or after starting a new exercise program, it's important to stop and talk to your physician before beginning any exercise again, if you're having chest pain, trouble breathing, if you're feeling dizzy, having any tingling, numbness, or persistent pain, or even if you're just feeling off. So those are some warning signs to look for, for sure. I think the most important thing with keeping motivation with exercise is choosing things you enjoy. If you don't like it, you're not going to do it. You can always make it a social activity. I enjoy going to classes. People will meet up with friends, somebody to hold them accountable, but also chat with before or after, share your goals with.

I do tell some of my patients, workout in the morning activities and stresses of the day can really deter us from exercising later in the day. We can always make up excuses for why we're not going to go to the gym after work. So doing it in the morning can be a good motivator that way. Make sure you're tracking your progress, sharing it with other people who can be your cheerleaders and make it convenient for yourself. Don't join the gym 50 miles away, walk in your neighborhood, do online exercise videos, join a gym nearby and remember to reward yourself. Maybe not reaching for food or other things to take back what we've worked so hard for, but reward yourself for reaching your goals.

Host: That's great information, really usable. Thank you so much Dr. Chambers for joining us today and really explaining to the listeners why those 10,000 steps are so important and how they can get them. So thank you again, and to learn more about Bay Care's primary care services, please visit our website at baycare.org for more information, and to get connected with one of our providers. Please also remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. Share this show with your friends and family on social media. We're learning from the experts at BayCare together, and everybody can learn why those 10,000 steps are so important and the best ways to achieve our physical activity goals. Thanks for listening.