fitness – The Healthy Life

5 Low Impact Exercises for Healthy Living

Want to turn back the hands of time? Try exercising.

Many of my patients have heard me sing praises for yoga and water aerobics so let’s dive deeper into the topic of low-impact exercises.

Whether you’re entering your 50s or already retired, exercise can make a huge difference in how you feel and move. But selecting the right activities can make all the difference in terms of results and motivation. For example, low-impact workouts can help you stay fit or get fit as you age, while limiting the pain and damage that higher intensity exercises can cause. If you have arthritis or lingering injuries or haven’t worked out in a while, low-impact workouts help you get moving and stay moving. It also improves the stabilizer muscles to improve balance and reduce fall risk.

Here are five low-impact cardio and resistance training exercises that are weight bearing and incorporate balance and flexibility training — great moves for aging exercisers. Be sure to discuss them with your doctor before starting.

Cycling strengthens the musculoskeletal and cardiovascular systems, improves joint mobility, eases stress and burns calories — all while being low impact. You can ride a stationary bike, go for a ride outside or, for a real challenge, take a cycling class.

Cycling can be solitary activity — a time to decompress and relax. It can also be social; grab a friend and go for a ride. And if you like indoor recumbent bikes, you can get caught up on news, social media, emails and texts while riding. Have a competitive spirit? Train for a cycling road race like the Tulsa Tough.

You’ll also burn hundreds of calories an hour (typically between 400 and 700) spinning.

Pilates is a mat and equipment movement system developed by Joseph Pilates. Despite the thousands of die-hard Pilates fitness enthusiasts, it’s actually rooted in therapeutic exercise, making it an effective workout for all ages, fitness levels and injury histories.

Pilates can help you develop a strong core, improving balance, overall stability and posture, as well as reducing back pain and fall risk. It’s downside? It’s not bone-building, so you’ll have to supplement it with walking or hiking. Don’t try teaching Pilates to yourself. Find a studio with small classes to learn the exercises with proper form and how to modify exercises for your specific injuries.

You’ll also burn between 175 and 250 calories per session, depending on intensity.

Strength training obviously strengthens your musculoskeletal system, but it also improves cardiovascular endurance, bone density and daily metabolic rate. Like cycling, you have a few options.

Weight training probably comes to mind first. If you’re new to weight training or just a little rusty, the machines at your local YMCA or gym are your safest bet. Once proficient, you can try cable machines or free weights.

You also need a warmup and cooldown with stretches to complete your workout. Work with a trainer before beginning a weightlifting program. They’ll help you figure out the best exercises for your skill and age.

Don’t see yourself as a gym rat? Try a group resistance exercise class that incorporates props such as bands, balls or circles and/or body weight exercises like pushups, planks and squats.

You’ll burn around 100 calories every half hour of resistance training (depending on your physical make up and the intensity of the workout).

Swimming works your entire body and builds cardiovascular endurance and muscular strength without impacting your joints. If you swam as a child, getting started may simply involve finding a pool. But if you never learned to swim or feel you need to brush up on your skills, most local swim schools and YMCAs offer adult swim classes.

If you like the water but aren’t thrilled with getting your face or hair wet, consider water aerobics. Like swimming, these fun classes work your entire body without putting much pressure on your joints. Facilities with pools such as fitness centers, YMCAs and community centers offer classes. Water aerobics is for ALL ages so don’t shy away from this exercise based upon your perceived skill level.

Like cycling, swimming is a great way to burn calories — around 400 to 500 an hour. That’s also true of water aerobics.

Tai chi is arguably one of the best forms of exercise for people over 50. This Chinese martial art is often described as “meditation in motion.” Studies suggest tai chi’s standing movement combinations may reduce stress and improve coordination, bone density, balance, muscle strength, flexibility and aerobic conditioning. To get going, sign up for classes or hire a private trainer. Learn the exercises and understand your alignment before trying home workouts. You’ll burn between 200 and 300 calories per hour of tai chi.

Yoga is another effective workout. It’s easy on your joints and helps improve strength, balance, coordination and bone density. Some styles of yoga provide a rigorous workout, while others focus on teaching proper alignment or restoring the nervous system. If funds, time, or mobility are limiting your ability to utilize exercise classes like yoga, check out YouTube for free classes in your own home. Also, consider looking at chair yoga for seniors if you have significant mobility limitations.

If you have spinal issues such as herniated discs, stenosis, osteoporosis or arthritis, you’ll probably have to modify or maybe even skip certain yoga poses to avoid pain and injury. Forward flexion poses such as downward-facing dog, big toe pose and child’s pose can exacerbate herniations; extension poses like sphinx, cobra and cow poses are problematic for stenosis.

The wonderful thing about low-impact exercise is that it can help every person, no matter your physical prowess. Whether you are training for your 5th Ironman or just starting rehabilitation for a hip fracture, there is a class for you.

Bones, Bones, Bones

🌟 Osteoporosis: What You Can Do to Protect Your Bones

Osteoporosis is known as a “silent disease” because bone loss often goes unnoticed until a fracture happens. The good news? Bone health can be improved at any age. Here’s how.

🦴 What Is Osteoporosis?

Osteoporosis happens when bones lose density and become easier to break. Common fracture sites include the spine, hip, and wrist.

🧍‍♀️ Who’s at Higher Risk?

People are more likely to develop osteoporosis if they:

✔ are age 50+
✔ are female (especially post-menopause)
✔ are low weight or have low muscle mass
✔ have low calcium/Vitamin D intake
✔ smoke or drink heavily
✔ use long-term steroids
✔ have a family history of fractures

💪 Exercises That Help Build Strong Bones

Exercise doesn’t just help—it’s one of the best tools to slow bone loss and prevent falls. Three categories matter most:

1. Weight-Bearing Exercises (Bone Strength)

These make your bones work against gravity. Great options:

🏃‍♀️ Walking (30–45 min, 4–6 days/week)
🚶‍♂️ Hiking
🕺 Dancing
🎾 Pickleball or Tennis
🪁 Low-impact aerobics

Tip: If you haven’t been active, start with 10–15 minutes/day and add time gradually.

2. Resistance & Strength Training (Bone + Muscle)

Strength training stimulates bone remodeling and prevents falls. Examples:

🏋️ Free weights
📦 Resistance bands
💪 Bodyweight exercises:

Squats or chair-sits (10–15 reps)

Wall push-ups (10–15 reps)

Step-ups (10 each leg)

Target: 2–3 days/week with rest days in between.

3. Balance & Stability Training (Fall Prevention)

Most fractures happen after a fall. These help prevent that:

🧘 Tai Chi
🌿 Yoga (modified)
🦩 Single-leg balance (hold 10–30 sec)
👣 Heel-to-toe walking (down a hallway)

Even 5–10 minutes/day makes a difference.

🍎 Nutrition for Bone Health

Pair exercise with nutrients that support bone growth:

🥛 Calcium — dairy, leafy greens, almonds, tofu
🌞 Vitamin D — sunlight, fatty fish, fortified foods, supplements if needed
🥩 Protein — helps maintain muscle and bone structure

🩺 When Should You Ask About a Bone Scan?

Talk to your doctor if you:

✔ are a woman 65+ or a man 70+
✔ have broken a bone from a minor fall
✔ are younger but have risk factors
✔ are on long-term steroids
✔ are losing height or have a stooped posture

✨ Bottom Line

You can’t change getting older, but you can change how strong your bones stay. Early screening, smart exercise, and proper nutrition all reduce fracture risk and help keep you active and independent. Don’t forget, treating osteoporosis is MUCH easier than treating a hip fracture or being in chronic pain from a spine fracture. Don’t be afraid to talk to your doctor about medications for treating osteoporosis; it is critical you understand the pros and cons of your treatment while minimizing side effects!

Understanding Your Metabolic Health

Fundamentally, your metabolic health is about how well your body responds to and processes food. Our metabolism’s job is to convert what we eat and drink into energy to power your body’s functions. When everything is working well, your body has the energy to do a range of amazing things – from breathing to circulating blood to creating and repairing cells to movement and exercise.

Unfortunately, abnormal chemical reactions in your body can disrupt this process. This is called a metabolic disorder, and when it occurs, your body can end up with too much of one thing and not enough of another, resulting in poorer health.

Your unique metabolic health is shaped by some things you cannot control – your age, gender and genes – as well as things that you can, including your gut microbiome, your stress level, mental health, sleep, diet and exercise. It’s a complex mechanism that can be difficult to fine tune for good health.

However, there are positive approaches you can make to maintain and maximize your metabolic health status. First, let’s look a little deeper at metabolic health.

Metabolic Health 101

At its most basic but also most critical level, metabolism sustains the minimal energy required for life, providing constant fuel for essential bodily functions. Think of it as all the systems that our body powers without any thought or action on our part – all the functions essential to life even when we’re resting that still require calories: breathing, digestion, thought, body temperature regulation, blood circulation, cell growth and repair, and hormone level management.

How much energy your body needs to perform these tasks has a name: basal metabolic rate (BMR). BMR is the minimum amount of calories your body needs to function when you’re at rest and not doing anything. Typically, those processes above use 60 to 70 percent of the fuel we consume. Your digestive system uses about 10 percent to process foods and the rest fuels physical movement.

Though there are averages, this mix is unique to individuals. An athlete might consume more calories to fuel movement and the percentages change. Someone who lives a sedentary life may consume fewer calories because they move less.

These adjustments can be frustrating, especially if you struggle with weight. For example, a fast metabolism makes it easy for some people to eat a lot of food and not gain weight. A slow metabolism may make it hard for people to lose weight just by cutting calories.

Since your metabolism naturally regulates itself to meet your body’s demands, this is also why weight loss can stall, slow down or plateau due to significant calorie intake reduction and rapid weight loss decreasing your BMR. The relationship between metabolism and weight is complex.

Things That Affect Your Metabolic Health

Ironically, how much you weigh and how much fat your body has are some of the things that most affect your metabolic health. For example, abdominal fat cells can raise levels of free fatty acids. These are chemicals that can raise the levels of hormones that affect how your body controls blood glucose levels, the basic energy blocks our metabolism creates from food.

For example, if you have too much adiposity in your midsection, your body may not respond well to insulin, which is the key to getting glucose from your bloodstream and into your cells where it can power your body. This is called insulin resistance.
These same free fatty acids can raise your bad LDL cholesterol levels and lower your good cholesterol levels, putting you at risk for heart disease. Insulin resistance can cause hypertension and raise triglyceride levels, which can cause artery walls to harden.

These extra fatty acids can also cause increased inflammation, which can cause plaque to build up inside your artery walls. This plaque can break off resulting in a heart attack or stroke.

So, high blood sugar, high LDL or bad cholesterol, low HDL or good cholesterol, high triglycerides and hypertension can all be signs of poor metabolic health – any three of this combination is called metabolic syndrome.

How to Support Your Metabolism and Your Metabolic Health

It may naturally regulate, but that doesn’t mean your metabolic health is just on autopilot. For your metabolism to perform efficiently requires some focus and action on your part. Mainly you need to eat a well-balanced diet that provides all the essential nutrients your body’s complex biological functions and processes need. See my blog post about macronutrients and special diets. https://myhealthyliving.org/2025/06/01/which-diet-is-best/

Eat at regular times and eat the right amount of calories. Your doctor can help you determine your Basal Metabolic Rate and help you calculate how many calories per day is appropriate for your BMR and your activity.

Beyond diet, you need to get enough exercise (resistance and interval training) and sleep — at least seven hours per night. Shorter sleep is associated with more belly fat and metabolic disorders.

You also need to manage your mental health and stress. Though not directly linked to metabolic rate, stress can impact how much we eat and how much (or little we sleep).

If you’re struggling with any of these things, partner with your doctor to assess lifestyle changes and medications that can help turn your metabolic health around.

Now, it’s time for something new. This is my first of (hopefully) many meal preparation vlogs. Let me know what you think below and don’t forget to click the “Subscribe” button on this web page to get notifications every time I post.

Which diet is best?

Many of my patients ask me which diet is best to help them lose weight, live longer, improve physical prowess, reduce blood sugar, among many other reasons people choose to diet. They’re often shocked when I tell them I don’t like the word ‘diet.’ The term insinuates that you will be operating a very strict food regimen for a short period of time to achieve a desired effect. Think about your friend or coworker that said they were going on the ‘X’ diet for ‘Y’ reasons. You can fill in the blank because we all know someone (assuming you haven’t done it yourself) who has said this phrase. What was the end result for this person? I’m willing to bet they’re no closer to their ‘diet’ goals today than they were when they began their journey. This is not to say that I haven’t had patients who are successful at achieving their health goals through a specific diet plan – in fact, I’ve had many! But, this is not the majority. Most can’t sustain their diet for more than 6 months and, unfortunately, many regain their initial body weight by 4 years.

A healthy lifestyle, whether you need to lose weight or biohack, should be specific, measurable, achievable, time-bound, and SUSTAINABLE. I’ll repeat the last word – SUSTAINABLE. Strict diets can be counterproductive to achieving your ultimate health goals. While this may be a carnivore based regimen (I don’t recommend this for cardiovascular reasons in most people), it could also be a Mediterranean or plant based regimen for others. The key is that everyone is different. Intrapersonal, interpersonal, community, social, and religious beliefs often dictate how a “normal” diet looks. This is where your physician or nutritionist can help guide you.

So, where do you start? I prefer to educate my patients based on what is known to be healthy standards.

Protein: Most information available online recommends adults eat 0.8g protein per kilogram of ideal body weight. However, this is the minimum amount required to prevent a protein deficiency, which can lead to bone fractures, poor muscle mass, and increase risk for falls. Most adults without kidney disease should be closer to 1.5-2g protein per kilogram of ideal body weight in combination with physical activity to maximize health. For reference, a 5oz chicken breast is around 40g protein. One cup of greek yogurt is 17g protein. One cup of cooked black beans is 15g protein. Protein shakes can easily get you to your goal protein and are easy to drink on the go for the busy workers. I like to drink my protein shakes between patient encounters.

Fiber: The goal should be 30 grams of fiber per day. Insoluble fiber is in many foods including whole grains, legumes, fruit, and vegetables. A diet high in fiber is linked to a reduced risk of cardiovascular disease and multiple cancers including colorectal, breast, pancreatic, and gastric. While I do recommend eating whole grains daily, I prefer to get my fiber from fruit and vegetables because most people are grossly deficient on the consumption of these. Raspberries and blueberries are the most fiber dense with 8g per cup. Apples have around 4g in a medium sized apple. Kale has roughly 5g per cup and broccoli has 3g per cup.

Water: The proper amount of water consumption differs by person and activity level. However, a good starting place is 1oz water per kilogram of body weight. This would be the minimum recommended volume for most people. Again, discuss with your physician first as this may differ depending on the presence of comorbid conditions like kidney failure, cirrhosis, congestive heart failure, or use of certain medications. Those who work in hot environments or are highly physically active should be closer to 2oz water per kilogram of ideal body weight. A rough evaluation of your hydration level can be determined simply by standing up from a seated position. If you get dizzy with standing, you may be dehydrated.

You’ll notice I left out carbohydrates. This was intentional. While the body cannot survive without glucose, a carbohydrate required in the production of ATP (the main energy carrying molecule in the body), it is a common misconception that we should limit the amount of fruit in our diet due to the high carbohydrate content. Don’t fall into this trap. While you should discuss this with your physician, the benefits obtained from eating fruit (and their respective complex carbohydrates) are far greater than the potential risks. Further, think about all the other high glycemic index foods you eat in a day and figure out which ones you could replace with a high quality piece of fruit that will help lower your risk of an innumerable number of diseases. I do not condone a diet high in simple carbohydrates. Examples of simple carbohydrates are white breads, chips, candy, syrups, white pasta, white rice, etc. These foods are considered high glycemic index foods and will quickly wreck your dietary and lifestyle goals.

If you can achieve the above quantities of protein and fiber (from varied sources including fruit, vegetables, and some whole grains) and limit the amount of simple carbohydrates in your diet, there’s a good chance you will be eating a well balanced diet. The good news is you don’t have to be perfect with your diet. In fact, I would argue that you should NOT be perfect with your diet. Enjoying some cheat meals is not a bad thing. The important component is that you eat a cheat meal (or any meal for that matter) in moderation. Aim for 1 cheat meal per week or less and stay committed to your goals. Share these goals with your family and friends for extra credit!

This recipe is a family favorite in my house. We call it the black bean special. I think it’s special because it is a one pan dish (meaning easy to make!) and is super healthy and flavorful. This recipe was adapted from one of my favorite cookbooks, “How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss” by cardiologist and lifestyle medicine expert Michael Greger, MD. I highly recommend this book as well as its precursor, “How Not to Die.”

Boil 1 cup of dry quinoa in equal parts of chicken broth and water for 5 minutes. In the boiling water, add 2 tbsp of nutritional yeast, 2 tsp ground turmeric, 2 tsp ground ginger, 2 tsp ground cumin, 1 tsp cayenne pepper, Then, mix in 1 bag of frozen broccoli florets and cover for an additional 8 minutes. With two minutes remaining, add 1 can of drained/rinsed black beans. An alternative to the quinoa would be farro (higher in fiber than quinoa) or brown rice. Share your recipes and book recommendations below!

Exercise as medicine

The first marathon occurred in 490BC when an Athenian ran 26 miles from the battle of Marathon to Athens announcing the phrase “Victory” following successful defeat of the Persian army. The marathon was revitalized nearly 2500 years later in the 1896 Olympic games held in Greece. The winner had a time of 2:28:50. A picture of this race is depicted below. Since that time, hundreds of thousands of runners have completed the grueling 26.2 mile marathon across the world.

While running a marathon is an impressive feat and show of physical prowess, you don’t need to achieve this standard to improve your health. The Centers for Disease Control and Prevention (CDC) recommends U.S. adults obtain 150 minutes of moderate physical activity per week. Moderate activity includes brisk walking, playing tennis, water aerobics, dancing, or pushing a lawn mower. You don’t need to run a marathon to improve your health.

In fact, exercise is associated with reduced fatigue, stress, low back pain, and risk of falls. it is also associated with improved cholesterol, cardiovascular health, sleep, mental health, insulin sensitivity, biological health, pain perception in those with osteoarthritis, and sleep. Exercising 150 minutes per week has been linked to a 25% and 30% reduction in breast cancer and colon cancer, respectively.

These effects are amplified with more exercise. Impressively, achieving 150 minutes of brisk walking per week results in ~2.5 years of life gained. This increases to ~4.5 years of life gained with 500 minutes of brisk walking per week. These effects mediate inflammation in the body (IL-6, C reactive protein, TNF-alpha), gut microbiome through increased availability of short chain fatty acids, insulin sensitivity via the GLUT4 pathway, and cardiovascular health through increased nitric oxide and vascular endothelial growth factor production. As a result of these health benefits, the American College of Lifestyle Medicine now argues that physical activity should be a vital sign measured at your doctor visits. Kaiser Permanente healthcare system did this with over 1.7 million patients!

Although the goal should be to exercise at least 150 minutes per week, or 30 minutes 5 days per week, you should not be discouraged if you cannot achieve this due to your schedule or current physical health. For instance, if I did not have 30 minutes to exercise consecutively in a day, I would not exercise at all due to my own mental barrier. I’ve changed this negative perspective towards those busy work days and now will get at least 10 minutes of power walking before work, at lunch, and when I get home from work if this is all I can do. The key is to get your heart rate up. Many of my patients will take is to bring your lunch to work and walk while you eat. This is achievable if you set your mind to it.

Another barrier many people have is fear of physical activity due to current low levels of fitness. If this is you, the answer is to have SMART goals. S: specific. M: measurable. A: achievable. R: relevant. T: time-bound. For example, if you are currently walk less than 1000 steps per day due to pain, then you need to make a SMART goal specific to your current state. I would recommend taking small steps first. In this scenario, your SMART goal may be the following: ‘I will walk 1500 steps per day and perform chair yoga (look it up, it’s free on Youtube!) for 10 minutes each morning for 2 weeks.’ Once this goal has been accomplished, you expand upon the previous SMART goal and create more challenging SMART goals. More advanced athletes should also have SMART goals to accomplish at least the minimum standards of 150 minutes per week.

Finally, you need peer support (or peer pressure if you are a glass half empty kind of person). This should come in the form of family and friends as well as your personal physician. Tell your friend that you are on an exercise journey to reduce your risk of breast or colon cancer. Bring them on your next lunchtime power walk. Ask them to be your accountability partner. This should also come in the form of your physician. Physicians who are physically active are more likely to encourage and counsel patients on healthy lifestyles compared to inactive physicians. They also have real-world physical activity experience and tips that can help you along your lifestyle journey. Finally, having a physically active physician can provide first hand experience and counsel to help you improve. You should always ask your physician before starting any physical training program. Find your accountability partner, create a team, and share tips on how you improved physical activity in your life below. Here’s a picture of my team from a recent race.

Let’s talk about your heart!

Welcome back to the My Healthy Living blog, friends. One of the most common conditions I see is cardiovascular disease in my Internal Medicine clinic. Unfortunately, it also happens to be the leading cause of death in the United States and has almost certainly affected you or a family member directly. For the naysayers who believe it won’t happen to you; over 48% of Americans greater than 20 years have cardiovascular disease, defined by the presence of hypertension, coronary artery disease, stroke, or congestive heart failure. This is likely an under-representation too because there is currently no clinical practice guideline that recommends a screening for coronary artery disease in an asymptomatic patient. Go to the doctor and ask about heart health!

Only 28% of Americans eat the CDC recommended 5 servings of fruit and vegetables per day (1 serving = banana or bell pepper for size reference). This means that there is lots of room for improvement! Interestingly, the risk of heart disease decreases by nearly 25% in people who eat these fruit and vegetable serving recommendations. This risk reduction is independent of other lifestyle changes like physical activity, smoking cessation, and weight control.

However, don’t assume that all plant based diets are going to prevent you from having that widow maker heart attack. Eating an unhealthy plant based diet -primarily refined carbohydrates (white bread/pasta) – is linked to a 32% increase in cardiovascular disease compared to a health plant based diet. The goal should be to eat 5 servings of fruit, 5 servings of vegetables, 1-2 ounces of nuts, and 2-3 servings of legumes (1 serving = 1/2 cup cooked) per day. Plants contain phytochemicals which help with antio-xidation (think cancer prevention and anti-aging effects) as well as anti-inflammation. These phytochemicals are not found in animal products.

One way I have personally helped hundreds of patients improve their diet is through making slow, intentional changes in their lives. Evaluate how many servings of fruit you eat per day. If you only eat 1 apple per day, you won’t keep the doctor away; I know… I know… I’m a dad. If this is the case, I would encourage you to start with 1 apple and 1 banana starting next week. One way I have personally achieved this is by eating a piece of fruit on my way to work and bringing 3-4 more pieces of fruit (think easy to eat fruit like apples, bananas, oranges) with me to work. When I see the extra fruit on my desk, I’m encouraged to eat them throughout my busy day. This is easy and achievable for anybody. For the skeptics that say it’s too expensive to eat this much fruit, I ask that you compare the cost of a large bag of apples or oranges that will last you at least 3-5 days on this plant-based diet to your daily Starbucks or breakfast burrito you picked up on the way to work.

Let’s make this lifestyle change together and prevent cardiovascular disease! Leave your plant based recipes below and let me know your preferred way to prepare chickpeas.

Here’s my dinner from last night. It included a significant amount of protein, insoluble fiber, complex carbohydrates, whole grains, and vegetables. I ate my 5 servings of fruit while at work.

Ingredients:

One can chickpeas
Yellow onion, diced
Bag of frozen broccoli
Bag of brown rice
Teriyaki sauce

Recipe: saute the onions with some garlic until fragrant. Add the drained chickpeas and continue browning for 3-5 more minutes. While the chickpeas are warming, steam the broccoli and prepare the rice. I prefer the boil-in-a-bag rice for simplicity. Finally, combine all of the cooked ingredients into a large pan and add the desired amount of Teriyaki sauce. Enjoy!