Estimating Your Baseline Fitness Level

If you are currently not physically active, you should start with an exercise program that's of low intensity, duration, and frequency. It should also be progressive, such as walking at a comfortable pace and increasing over time to a brisk walk. That is, the MET level should start around 4 (easy walking) and progress to 6 (brisk walking). If you are in the low-fitness group, we discuss an easy way to start exercising effectively right away. If you and your health care team decide that it is fine for you to do a fitness test at home, you should use the three-minute step test to guide you in determining the intensity of your exercise program and in measuring your progress toward your goals. If your physician orders an exercise stress test, you should ask to receive your fitness level (which is a measure of your oxygen consumption, usually written as VO₂max).

The in-home test is much less scientific and has not been extensively studied in the diabetic population. Therefore it is less accurate than those fitness tests performed by professionals. Nonetheless, it can be a convenient and useful tool for you to use in your action plan.

When you are just starting to exercise on a regular basis, you can find your ideal intensity by calculating your maximal heart rate (220 minus your age) and then calculating your low-intensity heart rate, which is roughly 60 percent of your maximal heart rate. To find out what your target heart rate is at a certain intensity, follow the procedures described in chapter 4.

After warming up, start your chosen exercise at a slow pace. Exercise at a comfortable pace. Remember, if you have not exercised recently, you should start at a low level of intensity (50 to 60 percent). A good rule to follow is to exercise at a level that allows you to have a conversation while working out. At the end of five minutes stop and take your pulse rate as described in chapter 4. If your pulse rate is near your target, then remember how this intensity feels and maintain the pace. If you are below your target rate and feel that you can increase your intensity, do so until you reach your target heart rate.

THREE-MINUTE STEP TEST

This test estimates your cardiorespiratory fitness level. After going through the test, find out where you are on the fitness scale (table 6.1). You can use this test to measure your progress; as your fitness improves your three-minute heart rate will decrease.

Equipment:

You will need a 12-inch step (typical house steps) and a stopwatch or watch with a second hand.

Procedure

1. Start the test by standing on the level floor facing the step. Step up with one foot, followed by the other foot; then step down with the first foot, followed by the other foot. Continue doing this in an "p, up, down, down-fashion for three minutes.
2. When three minutes have passed, stop and take your pulse and compare it to the fitness scale in table 6.1.