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After you have made some basic decisions about a fitness program based on your health status, you need to consider some general questions and recommendations in a logical sequence.

Screening

Determining your health status is an important first step in becoming fit.

Regular Physical Activity

Once you have determined that you are capable of participating in a fitness program, you must make a commitment to regular physical activity before you begin the program. Improvements in fitness levels are both lost and gained quickly. The only way to maintain the fitness levels you achieve is to participate in a regular program of physical activity. In addition, if exercise is to be useful in a weight-control program, it must be done on a regular basis. Just look at former champion athletes who now lead sedentary lives; you will see that neither fitness nor desirable body composition lasts long once activity ends.

Start Slowly

For many people it has been several years since they were active and fit. If it took years for you to get out of shape, it is reasonable that you should allow three to five months or so to get into shape. You will find that it does not take a great deal of activity initially to "overload" the body and create a training effect. For that reason, and because you wish to minimize the likelihood of sore muscles and injury, you should begin an exercise program slowly. It is better to do too little than too much. Although the idea of "no pain, no gain" may be appropriate to athletes training for championship competition, it is irresponsible when applied to fitness programs. Do too little rather than too much at the start of your fitness program.

Warm-up and Cool-down

Just as it is important for you to gradually build up from light work to moderate work over a period of weeks and months, it is also important to include a progression in each workout. Begin each exercise session with some low-intensity activities, including some appropriate stretching and strengthening exercises. The warm-up provides a smooth transition from the resting state to the higher level of energy expenditure and effort in the main part of your workout.

At the end of the exercise session, gradually diminish the intensity to allow your body to make the transition back to rest. This will reduce your chances of experiencing light-headedness, which can sometimes occur when you stop an activity suddenly. The cool-down can include some of the same stretches used in the warm-up to further stretch the muscles when they are warm. If an exercise session must be shortened due to lack of time, keep the warm-up and cool-down periods and reduce the time you spend in the main part of your workout.

Periodic Testing

One of the major differences between fitness programs offered by health and fitness professionals and other fitness programs is the opportunity for self-evaluation. A good fitness program provides periodic testing of the various fitness components to give you feedback about how you are doing in relation to your goals.

A general rule of thumb is to make about a 10 percent change over a three-month period in the areas that need improvement. Once you achieve your goal, periodic testing provides evidence that you are holding your own. If you are doing your fitness program on your own, use the various self-tests for each fitness component. You might want to test yourself at three months, six months, one year, and then annually to determine your progress.

Frequency of Workouts

Both light to moderate and vigorous activity should be part of your regular fitness regime. After including light to moderate activity in your regular routine each day, we recommend adding additional moderate to vigorous exercise to achieve both cardiovascular fitness and weight-loss goals three or four times per weekor about every other day. (The same recommendation holds for muscular strength and endurance training programs.) Exercising fewer than three times a week requires a very high intensity of activity to achieve a cardiovascular training effect, and the higher intensity is associated with more injuries. In addition, it is difficult to achieve a weight-loss goal when you exercise fewer than three times a week. If you exercise strenuously more than four times a week, the risk of injury increases. A daily light to moderate routine combined with a day-on, day-off routine for more vigorous activity seems to be optimal and makes an exercise program easy to schedule.

Total Energy Cost and Length of Each Workout

Spending at least 30 minutes in light to moderate activity daily, plus expending 200 to 300 calories per exercise session every other day is recommended in order to achieve a cardiovascular training effect and meet body composition goals. The total caloric cost of a workout is determined by the duration and intensity of the workout. Generally, you need about 30 to 40 minutes during a workout to achieve a 200- to 300-calorie expenditure when working at the appropriate intensity, since some time is spent in flexibility and warm-up activities. If you do very light activity, then the duration has to be extended in order to achieve the caloric-expenditure goal.

Progression

The first step in beginning a fitness program is to include more activity as part of daily living (e.g., walking instead of driving when possible). The second step is to accumulate at least 30 minutes of moderate-intensity activity daily. You should be able to walk four miles briskly before undertaking more strenuous activity. By achieving this goal, you will have established a regular pattern of activity and made some body composition changes that will make the transition to more strenuous exercise easier. After you are able to jog 3 miles (or walk 6 miles briskly, cycle 12 miles, or swim 3/4 of a mile), then you may want to include some games and sports as part of your fitness program. The progression from walking to jogging to running should occur over a period of months.

Intensity

When you are at the stage of incorporating at least 30 minutes of light to moderate activity into your daily routine, there is no need to emphasize doing the activity at a certain intensity level. When you have progressed to including more vigorous activity on alternate days, then you are ready to consider the issue of exercise intensity.

Exercise intensity is best described by the overload it places on the cardiorespiratory system during a workout. The threshold needed to achieve the training effect is lower for the very sedentary (50 percent of maximal cardiorespiratory function) compared to the very fit (85 percent of maximal cardiorespiratory function). The primary way to judge exercise intensity is to see how high your heart rate is during the activity, since heart rate increases in a regular manner with exercise intensity. You can estimate your appropriate exercise intensity by calculating a target heart rate (THR) zone. The THR zone represents the range of heart-rate values that are high enough to cause a training effect yet low enough to allow you to exercise long enough to achieve the total work needed for a training effect.

As you will see from the following example, the 50-year-old does not have to exercise at a very high heart rate to achieve a training effect. This is a central point in beginning a fitness program. Begin at the low end of the THR zone and be more concerned about doing long-duration, low-intensity exercise than the opposite. Furthermore, we strongly recommend that participants be able to walk four miles before they become concerned about exercise intensity. Many individuals may be able to reach their THR with walking exercise alone.

Although some electronic devices can give you your heart rate ''on the go," they are not necessary. If you monitor your heart rate immediately after stopping exercise, the value is a good estimate of what your heart rate was during the exercise. Within 5 seconds after stopping the exercise, count the pulse rate at your neck or wrist for 10 seconds. Since heart rate decreases quickly after exercise is stopped, you must monitor it quickly for an accurate estimate. Multiply the 10-second heart-rate value by six to calculate the heart rate in beats per minute.

Types of Activities

At the beginning of a fitness program we recommend activities that are easily controlled in terms of intensity, provide an adequate means of expending calories, and have a low probability of causing injury. Walking, cycling, and swimming are examples of such activities. Emphasize low intensity and long duration at the start of your program, progressing to more and varied activities as you become more fit.