Q My dad recently had a mild heart attack, and so I have made up my mind I should start exercising. You have probably given the advice a million times, but what are the recommendations for heart health? — F.G., Winterville

A Best wishes to you and your dad. I asked Clint McNabb, an East Carolina University medical student, to review the physical activity guidelines from the American Heart Association. Here is what Clint learned:

As the obesity epidemic rises in this country, and heart disease remains the No. 1 cause of death, it is imperative that Americans understand the necessity and benefit of regular exercise. Research shows the advantages of regular sustained exercise throughout a person's life include, but certainly are not limited to, overall better cardiovascular health, decrease in the incidence of osteoporosis, help in fighting off excess weight, and generally higher self-esteem and self-confidence.

The American College of Sports Medicine (ACSM) in conjunction with the American Heart Association (AHA) recently updated their physical-exercise guidelines for individuals between the ages of 18-65, as well as setting out separate recommendations for people over the age of 65. Key to both the new and older guidelines is the advice to remain active regardless of the stage of life you are in. Much as the mind needs stimulation to stay alert and responsive, the body needs movement and physical exertion to maintain its natural abilities.

These guidelines recommend for people between the ages of 18-65: 30 minutes of moderately intense aerobic exercise five days a week, or 20 minutes of vigorously intense exercise three days a week. Coupled with the aerobic element is a strength component that advocates eight-10 strength-training exercises of eight-12 repetitions each, twice a week.

The guidelines for individuals over 65 only vary by recommending eight-10 strength-training exercises of 10-15 repetitions. For people over 65 who are prone to falls, balancing exercises should be added to the activity schedule.

Moderately intense is defined in the guidelines as "working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation." An example of this may be a brisk walk, including intentioned arm movements. Vigorously intense exercise requires more effort and does not allow for conversation; examples of this would be brisk walking on an inclined treadmill or jogging. People who wish to lose weight or maintain their current weight should consider 60 to 90 minutes of moderately intense activity.

Many people say they do not have time to participate in regular physical activity. These guidelines acknowledge exercise done in smaller blocks (10 minutes) three times throughout the day can be sufficient to provide the general health of 30 minutes of activity.

A reason sometimes cited for discontinuing an exercise program is boredom. The newer guidelines allow an individual freedom to exercise how they want from day to day. Moderately intense exercise one day can be followed by 20 minutes of vigorous exercise the next, giving a greater variety in the exercise routine.

The overarching principle for the updated guidelines on physical activity continues to try to encourage healthy lifestyles in all people. There are a few tips to support a person's attempt at incorporating exercise into their daily lives. Design an exercise schedule. An event on a schedule day after day can become a habit, and in the case of exercise, this is a good thing. It is not necessary to join a gym to achieve your exercise goals. Walking or jogging around your neighborhood will work just as well as the treadmill at the local gym. Find a partner who you can join with to encourage each other in meeting your exercise goals.

Once your dad has a doctor-approved exercise program, be active with him. Include other members of your family. This will not only help you exercise but will set a great example for your spouse and your children.

Professor Kathy Kolasa, a registered dietitian and Ph.D., works with the Family Medicine Center, Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu, or C/O The Daily Reflector, P.O. Box 1967, Greenville, NC 27835.