RODAHL 2019 Be Fit For Life

BY KAARE RODAHL
Be Fit for Life: A Practical Guide to Physical Well-Being

The Last of the Few
North: The Nature and Drama of the Polar World
MEDICAL BOOKS:
Nerve as a Tissue (edited with Bela Issekutz, Jr.)
Fat as a Tissue (edited with Bela lssekutz, Jr.)
Muscle as a Tissue (edited with S. M. Horvath)
Bone as a Tissue (edited with J. R. Nicholson and E. M. Brown)
Kaare Rodahl, M.D.
BE FIT FOR LIFE

A Practical Guide to
Physical Well-Being
Illustrated by Dorothy Robinson
HARPER & ROW, PUBLISHERS

New York
BE FIT FOR LIFE A Practical Guide to Physical Well-Being. How
to increase the effectiveness of your body and your capacity for
work and enjoyment through a simple program of exercise, rest
and diet.
This sensible and easy-to-follow guide by a leading authority in

physical medicine tells how to achieve and maintain physical
fitness, not as an end in itself out as the means to a more
enjoyable and fruitful life. Designed for men and women who can
devote only a few minutes a day to exercise, the book is unique in
demonstrating how a program for fitness can be integrated into a
busy daily schedule.
Dr. Rodahl shows how lo in crease your capacity for work and
play through a program of moderate exercise coupled with a
common-sense approach to diet and rest. The book includes self-
tests to determine your present level of fitness; four graduated
exercise program for children and woman; an additional program
for children, a chapter on diet and nutrition, with includes a fresh
approach to weight loss; prescriptions for effective relaxation and
sound sleep, a special program for those over sixty five.
Formerly director of research at Lankenau Hospital, Philadelphia,

Dr. Rodahl now directs the Institute for Work Phisiology in
Norway.
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The verses on pages 105 and 106 are reprinted with permission of
The Macmillan Company from Jump the Rope Jingles, by Emma
Victor Worstell. (c) 1961 The Macmillan Company.
BE FIT FOR LIFE: A Practical Guide to Physical Well-Being. Copyright

(c) 1966 by Kaare Rodahl. Printed in the United States of America. All
rights reserved. No part of this book may be used or reproduced in any
manner whatsoever without written permission except in the case of
brief quotations embodied in critical articles and reviews. For
information address Harper & Row, Publishers, Incorporated, 49 East
33rd Street, New York, N.Y. 10016.
FIRST EDITION
Library of Congress Catalog Card Number: 64-18064
To Mary Ethel Pew
5
Contents
Preface ......................................................................................................... 8
1 One Life to Life..................................................................................... 1
2 How Fit Are You? ................................................................................. 7
2.1 Work Stress ............................................................................... 9
2.2 Emotional Stress ......................................................................10
2.3 Environmental Stress .............................................................. 13
2.4 Illness ....................................................................................... 14
2.5 Your fitness profile................................................................... 15
2.5.1 Part I..................................................................................... 15
2.5.2 Part II .................................................................................. 20
2.5.3 Part III ................................................................................. 22
2.6 Conclusion ............................................................................... 38
3 Effective exercise................................................................................ 41
3.1 Why Exercise? .......................................................................... 41
3.2 What Kind of Exercise? .......................................................... 44
3.3 How Much Exercise? .............................................................. 46
3.4 The Exercise Program ..............................................................47
4 The Basic Program ............................................................................. 51
4.1 Joint Mobility Exercises ......................................................... 52
4.2 Muscle strength....................................................................... 56
4.3 Endurance ............................................................................... 60
5 The Standard Program ..................................................................... 62
5.1 Joint mobility exercises .......................................................... 64
5.2 Muscle strength........................................................................67
5.3 Endurance ............................................................................... 70
6 The Maintenance and Advanced Programs ......................................73
6.1 The Maintenance Program ......................................................73
6.2 The Advanced Program ........................................................... 77
6.2.1 Advanced Program for Men ................................................ 77
6.3 Advanced Program for Women .............................................. 88
7 Fitness for Everyday Life ...................................................................97
7.1 Exercise Habits ........................................................................97
7.2 Posture .................................................................................... 98
7.3 Postural Exercises ..................................................................102
7.4 Exercise for Children ............................................................ 104
8 Rest and Sleep ................................................................................. 109
8.1 Physical fatigue ..................................................................... 109
8.2 Fatigue and the Sedentary Worker ....................................... 110
8.3 For the Housewife .................................................................. 114
8.4 Psychic Fatigue ...................................................................... 116
8.5 Fatigue and Biological Rhythm ............................................. 119
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8.6 Stimulants ..............................................................................120
8.6.1 Caffeine ..............................................................................120
8.6.2 Pep Pills ............................................................................. 121
8.7 Relaxants ................................................................................ 122
8.7.1 Alcohol ............................................................................... 137
8.7.2 Nicotine ............................................................................. 122
8.7.3 Tranquilizers ..................................................................... 123
8.8 Sleep ....................................................................................... 124
8.8.1 What Is Sleep? ................................................................... 124
8.8.2 How Much Sleep Do You Need? ....................................... 126
8.8.3 How to Get to Sleep and Stay Asleep ................................ 127
8.9 Relaxation .............................................................................. 132
8.9.1 Relaxation on the Job ....................................................... 132
8.9.2 Relaxation at Home........................................................... 133
9 Effective Diet .................................................................................... 135
9.1 Food to Build the Body .......................................................... 135
9.2 Food as Fuel ........................................................................... 136
9.3 Energy Requirements ............................................................ 137
9.4 Obesity.................................................................................... 141
9.5 Diet and Body Weight ............................................................ 141
9.6 Exercise and Overweight ....................................................... 149
9.7 A Weight-Reducing Program of Diet and Exercise .............. 151
9.8 Diet in General ....................................................................... 152
9.8.1 Good Eating Habits ........................................................... 152
9.8.2 Undernutrition .................................................................. 153
9.8.3 Frequency of Meals ........................................................... 154
9.8.4 Water ................................................................................. 156
9.9 Summary ................................................................................ 156
10 Fitness for Those Over 65 .......................................................... 157
10.1 The Will to Live ...................................................................... 157
10.2 The Physiology of Aging ........................................................ 158
10.3 Preventing Illness .................................................................. 166
10.4 Exercise ..................................................................................168
10.5 Function ................................................................................. 177
11 Appendix of Exercises..................................................................... 180
11.1 Appendix 1: The Basic Program ............................................ 181
11.2 Appendix 2: The Standard Program ..................................... 187
11.3 Appendix 3: The Maintenance Program ............................... 193
11.4 Appendix 4: Advanced Program for Men ............................. 195
11.5 Appendix 5: Advanced Program for Women ........................198
11.6 Appendix 6: Daily Exercises for Those Over 65....................201
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Preface
As a physician who has practiced medicine in both the Old and
the New Worlds –as a physiologist who now heads a research
institute in Norway devoted to human performance and the
biology of fitness, and who for eight years headed an American
medical research organization involved in the study of human
functions- as a former director of research of an institute in
Alaska concerned with the performance of our soldiers, and as a
leader of several Arctic expeditions, I have had the opportunity to
perform or to observe over one thousand experiments concerning
the effects of exercise in health and disease, how it is related to
stress, performance in everyday life, rest and recreation, nutrition
and obesity, the aging process and the enjoyment of living. I have
been especially interested in the testing of fitness in the ordinary
individual, and the most effective ways of achieving the greatest
fitness with the least investment of time and effort, compatible
with the busy schedule of most middle-aged men and women of
our modern society. These experiments have shown that fitness is
not a matter of interest merely to the muscle men or the fitness
fanatics. It concerns everybody, for it is a way of life.
This book is based on the facts obtained from all these

experiments. The scientific details are published elsewhere. This
book contains the essence of our results prepared for the lay
reader. It also contains the facts of numerous studies reported by
others. And it contains the thoughts and opinions of many of my
colleagues and collaborators as well, with whom I have had the
privilege of discussing the questions that developed in the course
of writing this book.
I am particularly grateful to Bela Issekutz, Jr., M.D., Head of the

Department of Physiology, Newton C. Birkhead, M.D., Ph.D.,
Head of the Department of Clinical Physiology, and John J. Kelly,
Jr., M.D., and James W. Daly, M.D., cardiologists in the Division
of Research of the Lankenau Hospital. I am equally grateful to
Charles Rupp, M.D., Chief of Neuropsychiatry, and Edward L.
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Bortz, M.D., Senior Consultant and expert on aging, Lankenau
Hospital, and Henry F. Page, M.D., Physician-in-Charge, Aging
Research Clinic of the Division of Research, Lankenau Hospital. I
am especially grateful to Mr. John Steinmetz, physical education
specialist of the Division of Research, Lankenau Hospital, who
has tested all the exercises suggested in this book.
I am greatly indebted to Mrs. Dorothy Robinson, who has

illustrated the book, and to Mrs. Carolyn Hyatt, who prepared the
manuscript.
KAARE RODAHL, M.D.
9
1 One Life to Life
Most people are not completely healthy, whether they feel well or
not. A person’s state of health is a relative matter. To be
completely healthy is to be completely free of disease, but this
ideal state is rarely attained. Most people are more or less well or
more or less sick –somewhere in a gradual transition from health
to illness or from illness to recovery. Disease, as a rule, does not
set in all of a sudden; it is more often than not a gradual,
reversible process. The severity of the symptoms may depend on
what organs are involved and to what extent the function of each
cell of each affected organ is impaired. However, the fact that the
disease process is frequently reversible means that it can be
interrupted. Further deterioration can be prevented and normal
function restored or maintained –just as the functioning of a car
engine can be prolonged by preventive maintenance. The sooner
the disease process is interrupted, the more easily it may be
reversed.
This aspect of health –the detection and treatment of disease- is a

matter for you to take up with your physician. However, health is
not merely physical. It encompasses the entire human being,
including his mental outlook, his vigor and his ability to engage
himself fully in the processes of living. Perhaps I belabor the
obvious in pointing out that a person free of mental and organic
illness qualifies as healthy. The word “healthy” may be applied
accurately –and all too often is applied- to someone whose body
functions adequately only while at rest or during periods of mild
physical activity. This may be “health” in the technical sense, but
is far short of what most human beings need and deserve. And it
surely is far short of what they might attain.
After all, man was created not only to rest but to work, and to
function sometimes under great burdens. The ability to cope with
such burdens comfortably is the hallmark of a state of being much
publicized in recent years but woefully misunderstood. I refer to
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physical fitness, a term that undoubtedly evokes all manner of
bleak images in the mind of anyone who does not yet grasp its
true significance. Physical fitness, contrary to the popular
misconception, is not exclusively a concern of athletes, or would-
be athletes. It is not inevitably a matter of rubber sweat suits and
50-mile hikes. On the contrary, physical fitness is of great (but
not at all grim) importance to sedentary people who neither
intend nor need to change their way of life. The fact is that
physical fitness, so easily achieved that it is almost laughable, is
linked inseparably to personal effectiveness –the kind of
effectiveness that enables the individual to handle the extra
burdens and stresses of an unusually hard day, or week, or
month, without undue strain or fatigue.
Like other aspects of so-called physical health, physical fitness is

not entirely physical. Indeed, one is tempted to eliminate the
adjective and call it “fitness” and be done with it. Just as the
hurdens and stresses of life are often purely mental and
emotional but take their physical toll, fitness –a quality achieved
by mainly physical means- has profound mental and emotional
effects, all of them beneficial. Readers disposed to argue the point
may be assured that the pages of this book contain ample
evidence for it. In the meantime, it perhaps is sufficient to
observe that anyone willing to take the few easy steps that lie
between him and physical fitness will shortly begin to feel better.
He will feel better because he will be better, and the improvement
will reflect itself in every nook and cranny of his existence,
including the mental and emotional, to say nothing of the
vocational, the marital and the recreational.
How does one develop the physical fitness of the body? The same
way as one developed one’s mind-by increasing its capacity to
perform work. This is really all fitness is. The fit person as
increased the effectiveness of his body by subjecting it to steadily
increased, but not necessarily unpleasant tasks, and has reached
the point where his reservoirs of muscular and organic work
capacity are more than sufficient to meet the demands of life. Not
only his back and his legs and his arms but, above all, his heart,
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lungs and other internal organs now function well within their
capacities. Such a person is more than merely technically healthy.
He is as healthy as he can get. And his resistance to many kinds of
illnesses is likely to be much higher than it was before he became
fit.
Yet one may well ask, “What about the millions of people who are
nowhere near this happy state of fitness yet manage to hold
demanding jobs, provide successfully for their families and
otherwise lead happy, rewarding lives?” My answer is that such
people manage to carry it off because of their motivation, their
drive, their willingness to make the extra effort required by their
lack of strengt and vigor. In short, I doubt that life is all that
happy or rewarding for them. Their physicians encounter a good
deal of fatigue and frustration among them. Their ineffective
bodies are more susceptible than they need be to the organic
consequences of stress, such as peptic ulcer, skin ailments and
even heart disease. So I offer some questions of my own: How
much better off would these people be if they were healthier and
more fit? Instead of being “half sick,” limping along without
feeling really well, yet not feeling bad enough to collapse into bed,
sup pose they were “90 percent healthy,” or as close to optimum
health as possible, and in excellent physical condition? Could they
then accomplish more, feel better, have more fun? If so, what
would it take in terms of effort and time to achieve this?
The reader will guess the general tenor of my answers to such

questions. The details are contained in this book. In the pages
that follow I shall show the reader how he can cultivate a more
effective body, how he can approach health and happiness while
continuing to work at his sedentary job and discharge his other
responsibilities.
As a family man as well as a physician, with very little free time at

my disposal, I hasten to say that I know that few people are in a
position to make a career of becoming healthy and fit. The
ordinary person can scarcely abandon his normal pursuits and
run off to climb mountains, or live on a farm, or bask by the sea.
Real life demands that most of us continue to spend 50 weeks a
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year working, usually under great tension. What leisure we have
should be devoted to enjoyment and to our families. This book is
prepared in the light of such realities. It is perhaps a little
different from most health books in being uncompromisingly
realistic. It also explains to the reader why he should take the
steps. It recommends, how to take these steps and what benefits
he can reasonably expect.
I intend to show in these pages how little time and effort need he
invested by those who want more from this one life we have to
live. You need not become a fitness fanatic or a health bug; your
program of self-improvement can be amazingly simple, and what
is even more important, it can fit comfortably into the normal
routine of your life.
From my own experience with people of all ages, with youngsters,

middle-aged men and women, postcoronary patients,
semiinvalids and even oldsters who have retired to inactivity and
decay, I know that significant improvement can be achieved
through a very reasonable but regular program within weeks. I
have observed in the course of such a program that untrained
sedentary persons have improved their physical work capacity by
as much as 25 percent in a month. In the process, they have
become trimmer and peppier, lighter of foot and brighter of
spirit.
I recall a middle-aged housewife who came to see us. She

complained of feeling miserable, tired, irritable, frustrated. She
had a constant backache, no strength, and never felt like going
anywhere, she said. It was hard for her to get out of bed in the
morning, and at the end of the day she felt utterly exhausted. We
found no organic disease to account for her difficulties. It seemed
obvious to us that her problem was, mainly, to get into shape
physically and to benefit from the boost such improvement might
give to her morale. Grudgingly, she agreed to devote 10 minutes a
day to a schedule of simple physical exercises, and to follow a
slimming diet, for she was slightly overweight. The result was
most gratifying. When she returned 3 weeks later, she was
4
actually cheerful, even vivacious. Having become trimmer and
having toned up her muscles, she felt like a new person. To be
sure, she was a new person. She was now able to do her work
adequately and have energy left over for a full evening’s activity
with family and friends.
A 50-year-old business executive, meticulous and well groomed

but visibly reluctant to push himself physically, had always
received a clean bill of health from his physician. Yet he was not
convinced, for when he exerted himself to his limit, especially
when he ran to catch the train, he had a strange and frightening
feeling of fullness in his chest. He had always been halfheartedly
in favor of physical exercise and liked to swim. However, because
of his fear of overexertion, he did not swim hard, preferring to
float listlessly. When he came to our clinic, his electrocardiogram
when he was at rest was normal, but when we tested him during
the stress of pedaling a stationary bicycle –a far more demanding
test- his electrocardiogram showed definite evidence of
insufficient blood supply to the heart, at which point he also
experienced the same sensation of pressure in his chest that
bothered him when he ran for the train.
On the basis of a series of studies in which it was determined

precisely how far he could safely push himself without straining
his heart, and yet exercise vigorously enough to achieve a
significant effect, he set out to train three half-hour periods a
week. In addition, he gave up smoking. In a week he began to feel
better. Moreover, he began to regain his self-confidence and
vigor. Shortly thereafter he reported that his friends were
remarking on his improved appearance. After a month his
electocardiogram had improved; he could now do more work
before any abnormality developed in the electrocardiogram, and
could do more physical work with less strain on his heart. “This is
the best thing that ever happened to me,” he claimed, when he
came for his first monthly recheck.
Though not every reader is in a position to have a tailor-made

program worked out for him, he will find that by following the
5
sensible, medically proved means set forth in this book his
working hours will have become less tiring and more productive,
his leisure more zestful, his tension less pressing. After as little as
a week of relaxed attention to the suggestions I shall offer him, he
can expect to feel and see for himself, and to hear from his friends
and family, that good things are happening to him. I can make
this promise with utmost confidence, because I have seen the
promise fulfilled over and over again.
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2 How Fit Are You?
Mr. Brown spends an adventurous day in the office, where he
solves four problems which have been threatening to drench his
finances in red ink. After coming home he plays a set of tennis.
Later, he and his wife drive to the club for dinner, dance until
eleven and return home aglow. At nine in the morning he is back
at his desk ready for a full day’s work. I take my hat off to him; he
sounds fit.
Mr. Jones is another matter. Any single one of the exertions

which marked Brown’s day would be more than enough for poor
Jones. Any two would prostrate him. Although he is technically
free of illness, something is wrong with Jones. He is unfit.
Modern medical science measures fitness, or lack of it, in terms of

one’s ability to tolerate stress. A man as fit as the hypothetical
Brown is a rare bird nowadays; life stresses are spice to him.
Jones is far more typical; life stresses are a strain to him. If they
occur too thick and fast, he is overwhelmed and gives way. He
becomes lired and joyless; he gets headaches or bowel trouble,
and his common colds are more disabling than those that afflict
the fit.
His enemy is unfitness, and his enemy’s ally is the phenomenon

known as stress. Although much has been written about stress in
recent years, few people really understand what it is.
Stress means nothing more nor less than the rigors of life –all
of them. A germ which invades your body, a draft from the
window, a hard day at the office, a quarrel, a foot race, a visit
from an unloved relative, a skid on the highway, an imminent
deadline –all these are stresses. So, indeed, are the illnesses
which sometimes derive from inability to withstand stress. Even
the most fundamental basis for our existence, the expenditure of
energy, is a stress. This necessitates a speeding up of the
metabolic processes of the body. More oxygen has to be delivered
to the muscles; more waste products have to be carried away. All
7
this places a greater demand on the blood circulation. It strains
the capacity of the heart, just as driving an automobile at high
speed strains the engine more than driving it at slow speed.
Like everything else in nature, stress is a relative thing: a stress

unbearable to one person may be sheer play to another; indeed,
many forms of stress are harmful only to the unfit. In fact, most
forms of stress are essential to life. Constant challenge accounts
for our mental and physical development. The child develops his
muscles by stressing them, working them. The study and
selfdiscipline which result in intellectual achievement are the
wholesome imposition of stress on the brain. Stress, then, is not
all bad. The problem is not how to avoid it but how to cope with
it. This is fortunate, because most stresses are unavoidable.
They always have been. Lacking the technology that protects

modern man against the elements and delivers his food to him in
packages, our prehistoric ancestor had to be rugged, nimble and
brave; otherwise, he was unable to win shelter, kill game or repel
his enemies, and he perished. Obviously, modern man’s life is
more complicated than that. The stresses have multiplied beyond
calculation. We seek not only food and shelter but possessions,
social prominence, even fame, and we strive to ensure a good life
for our children. We do this at a pace that would have killed the
most rugged cave man. We frequently uproot our families to
move vast distances in quest of greater opportunity. We breathe
polluted air; we expose ourselves to radiation; we drive death-
dealing vehicles. We train our skills for years and then hurl
ourselves headlong into occupational competition with
adversaries no less skilled. Wherever we turn we encounter
physical, mental and emotional stress. For most of us, even
leisure is stressful. That many of us succumb to these pressures
should be no surprise, considering how we disarm ourselves with
unfitness. That more of us do not succumb is testimony to the
fundamental resilience of the human race.
Let us now review the most burdensome forms of stress and the
ill effects they may exert on those unfit to withstand them.
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2.1 Work Stress
Practically all work, even if it is sedentary, requires expenditure of
energy and involves physical stress. In ordinary office work, for
instance, the body spends twice as much energy as it does at rest;
a housewife climbing stairs spends five times that amount. And
the heavier the work, the greater the stress.
But all this is relative. It depends on how fit and effective the body
is. If the work load requires an energy output which is greater
than one-third of the person’s peak working capacity, we have
found that fatigue is inevitable at the end of an 8-hour day. For
instance, if a person’s capacity to take up and utilize oxygen per
minute. This is why a fit person who has a high oxygen uptake
capacity can do more work with less fatigue than one who is unfit.
Even housework, which, by the way, in terms of energy
expenditure has been found by direct measurement to be as heavy
as a man’s work in light industry, may tax too much of the energy
reserves of a modern housewife who is unfit and therefore has
less energy to spend. No wonder, therefore, that so many
housewives complain of fatigue and feel exhausted.
In addition, the housewife may have to perform many of her

domestic chores in the most awkward positions. She may be
stooping over the sink washing dishes, or teetering around on
high heels and bending down to pickup things from the floor. If
unfit, this makes her especially vulnerable to low back pain,
mainly because of weak back and abdominal muscles, often
combined with poor posture, let alone the added burden of
possible obesity.
The unfit office worker is pretty much in the same boat. His
sudden engagement in energetic weekend gardening may
overstrain his flabby muscles. The agony of an incapacitating sore
back may be the result. In fact, low back pain is the most common
consequence of overstraining a weak and unfit body. It is a
prevalent affiiction in many vocational toils and in the military
service. Apart from being exceedingly painful, it is also very
9
costly. It accounts for a large part of the total sick days and loss of
earning power of our labor force, and for the nation’s loss in work
output. And the worst of it is that most cases of backaches might
have been prevented had the person been fit.
Even greater catastrophes may await the unfit, middle-aged

homeowner suddenly setting out to shovel snow. While snow
shoveling for the fit is a most invigorating exercise, it may be fatal
to the unfit with an untrained heart. As he suddenly, without a
proper warm-up, attempts to lift the heavy shovel filled with
soggy snow, bracing himself and holding his breath, tensing every
muscle in his body and exerting himself beyond his limits, he may
be overstraining his heart, which is struggling to adjust to the
great demand suddenly made upon it. This may cause an abrupt
rise in the blood pressure and provide the ideal condition to
precipitate a heart attack or a stroke.
The fit person has a greater margin of safety; he adjusts more

quickly to work stress. His trained heart works more efficiently
and is therefore less strained; his stronger muscles are better able
to protect his back. He is therefore a better risk all around. This is
particularly important for people in occupations which require
them to spend a lot of time on their feet, such as those who work
in laboratories, dental offices, operating rooms, stores, kitchens
and behind counters. We have found that the fatigue, the feeling
of tiredness and the high heart rate toward the end of the day in
many such persons may be due to inadequate fitness, for these
symptoms are absent in those who are physically fit.
2.2 Emotional Stress
Inability to endure the stress of work may be a matter not only of
physical but also of emotional fitness. All emotions, whether love
or hate, anger or joy, involve stress. Some emotional stress is
unavoidable in normal living, and life without emotions would be
rather dull. The problem is to cultivate an effective body that is
not easily overwhelmed by emotional strain.
10
Emotions act on the body through the involuntary nervous
system, which prepares it to cope with a difficult situation, to
meet an emergency, to get ready for the “fight” or for the “flight,”
in the case may be. In animals, as well as in primitive man, this
basic “fight or flight” behavior provides an effective way of
alleviating tensions. But in civilized man laws, etiquette and
moral codes make such behavior socially unacceptable. As one of
my distinguished colleagues put it: “One cannot strangle one’s
secretary because she has fouled up one’s schedule, nor flee from
the office because of a dissatisfied customer. Nor can one bite a
beautiful blonde who inadvertently lands on one’s toes with her
high heels, as she steps back in the elevator.” Yet civilized man is
as much subject to stressful emotions as were his evolutionary
ancestors.
Emotions themselves are invaluable to the emotionally fit

individual, whom they merely stimulate in a helpful way. But in
the emotionally unfit, whose emotions cause him persistent
worry, anger, fear and frustration, they are harmful, for such a
person “bottles up” his tensions and is unable to discharge his
emotions. When emotional tension is allowed to build up too
often or to last too long, so that it is no longer possible to take it
easy or get a good night’s sleep, the resulting strain may cause
nervous disorders, ulcers, allergic reactions and even heart
disease.
We all know that emotions may produce many kinds of symptoms

in a body that is free of organic disease. As a matter of fact, a large
number of the patients who seek a physician because of such
common symptoms as headache, palpitation, shortness of breath,
digestive distress, diverse aches and pains, weight loss, fatigue
and difficulty in sleeping are found, on careful examination, to be
free of any organic disease. Call it hypochondria, if you will, but
their complaints are as real and distressing as those due to
cancer, heart disease, rheumatism or other serious ailments.
The trouble may start with mere symptoms without evidence of

clinical disease, but if the emotional stresses persist, organic
11
disease may eventually develop, for it is generally accepted that
emotional stress may not only aggravate but actually bring about
organic bodily ills. In fact, about half of all people seeking medical
care are suffering from ailments caused or made worse by such
emotional factors as persistent worry, fear or anxiety. On the
other hand, organic disease is capable of producing emotional or
psychic symptoms, such as mental depression in the hypothyroid
or neurotic anxiety in many coronary patients.
Emotional tension may play a prominent role in certain kinds of

heart and circulatory disorders, especially high blood pressure.
Psychic disturbance may cause the outbreak of skin or respiratory
disease, and may trigger off an attack of asthma. It may play a
role·in joint and muscular ailments, eye disorders and certain
metabolic diseases. The gastrointestinal tract is particularly
sensitive to emotional stress. Worries, fear or conflicts in the daily
life may result in various gastrointestinal troubles, from the well-
known and harmless stomach-ache to the most severe peptic
ulcer or colitis. The point is that such emotions can harm only the
ineffective body that fails to adapt to the strain, and consequently
becomes a victim of it, while in the effective, adaptable body it is
rendered harmless.
Physical fitness in itself is no guarantee of emotional wellbeing,

but the person who takes the trouble to put his body in shape, to
stay trim and energetic, is naturally more likely to feel better
about himself than one who allows his body to go to pot,
tobecome sluggish and obese. He may find that the additional
self-esteem has improved his outlook on life, on work and on his
family. His stronger body and his better health may allow him to
become more engrossed in his work and the things he enjoys in
life, without worrying too much about himself. Consequently, his
personal problems are less likely to get under his skin. His
vigorous activities may make him physically tired, so that he
sleeps better, while the unfit may be plagued with insomnia. In
the unfit, sleeplessness, which may be the result of faulty
adaptation to stress, itself becomes a stress. Insomnia is then the
cause of additional stresses, as the overtired person struggles to
12
work his way through the day. Thus, his pressures snowball. He is
caught in a vicious cycle which sooner or later makes him
susceptible to such consequences of emotional stress as mental
illness, ulcer or skin ailments.
2.3 Environmental Stress
Ever since the cave, man’s life has been limited by the stress and
challenge of his surroundings. In order to get along, he has had to
adjust himself to his environment; the better his adjustment, the
more effective he is. And the fitter he is, the better he is able to
adjust to such environmental factors as climate, altitude and air
pollution.
The paradisaical balminess of Southern California’s celebrated
climate severely affects Northeastern athletes who try to compete
there before having adapted to the weather. This is because
physical exhaustion occurs much more quickly when an
unacclimatized person exerts himself physically in the heat. If fit
and physically active, he will become acclimatized to heat in less
than a week, with a marked improvement in his physical work
capacity. Failure to adjust may, on the other hand, result in heat
exhaustion or even death from heat stroke.
In contrast, when a person moves from the heat of California to

the cold of Alaska, his success in getting along depends primarily
on his ability to adjust mentally to the North, to get used to the
discomfort of being cold, but, above all, on his mental and
physical fitness. When one is exposed to cold, survival ultimately
depends on the ability of one’s body to produce as much heat as it
is losing to the surroundings. Failure to do so may result in
frostbite, chilblains or even death from cold exposure. The only
way a man exposed to cold without shelter for a long time can
keep himself warm is by vigorous physical exercise. The fitter he
is, the longer he can keep it up. Survival in the Arctic, therefore, is
a matter of the survival of the fittest.
When people move into high mountains, they experience general

discomfort, shortness of breath and fatigue. Their physical work
13
capacity may suddenly drop to half of what it was at sea level. The
fit person, who had a high work capacity to start with, has a
greater margin of safety and can afford to lose half of his capacity
temporarily, and still be able to get along without serious threats
to his life, while the unfit may be completely incapacitated.
Furthermore, in the effective body various com- pensatory
mechanisms are brought into play at once, so that within a few
days the early, unpleasant symptoms disappear through the
process of altitude acclimatization.
When people congregate in cities, pollution of the air is

inevitable, and the larger the city, the worse it is. The reason is
that in the course of his daily life modern man produces a variety
of waste products which he is constantly dumping into the air
that he breathes. Air pollution is especially hard on people who
suffer from chronic respiratory disorders, but is far less
detrimental to healthy people.
2.4 Illness
Stress, as we have said, is implicated in disease, and disease itself
is a stress which may make the patient sicker. Take the common
cold as an example. 1t starts with a simple germ, the cold virus. If
the body is fatigued or overstrained, its resistance to the invasion
of germs may be reduced, and the development of the
pathological state known as the common cold is the result. The
cold in itself is an additional stress because it produces toxic
substances in the body. These further reduce one’s resistance,
which may make the cold worse, thus increasing the patient’s
stresses and leading to more illness. This chain reaction may
spiral until the poor patient is completely incapacitated or even
bedridden, while the body is mustering its defenses against the
primary agent that triggered off the entire chain of events, the
germ.
A body that is fit in the first place is better equipped to fight off
the germ. It may even be spared the agony of the common cold,
and if afflicted by the bug, it may be less severely affected. But
14
above all, the fit person has greater resilience; he bounces back
more quickly to full health and normal functions.
2.5 Your fitness profile
The following pages contain a simple series of fitness profile
questionnaires which will enable you to see for yourself how fit or
unfit you are. Since total fitness involves more than mere bodily
strength and endurance, these questionnaires also include
questions relating to your attitude, your motivation, your vigor,
mode of life and body weight. Finally, they include tests designed
to assess the most important components of your physical fitness.
When answering the questions, be honest with yourself; record
the answer that first comes to your mind. Answer all questions;
guess if you are not sure. When you have gone through it all, you
will end up with a numerical score indicating the level of your
own total fitness.
2.5.1 Part I
Answer all questions carefully. Make a check mark at the
aproppriate answer to each of the questions. If your answer does
not exactly coincide with any one of the choices given, check the
one that you think is closest to your answer.
QUESTION ANSWER
1 Where are you reading this book?
Slouching in a chair or lying on a couch (a) ()
Resting in bed (b) ()
Sitting erect (c) ()
2 What did you do immediately after dinner last night?
Went to bed (a) ()
Sat around the house, read or watched TV,or went to
a party or to a meeting (b) ()
Worked physically, or took the dog for a walk, or
played with the children (c) ()
3 What did you do before breakfast today?
Got dressed and read the paper (a) ()
Exercised or went for a brisk walk (b) ()
Exercised and went for a brisk walk (c) ()
15
4 When you are going somewhere, do you usually: Look for a place
to park as close as possible
to the building (a) ( )
Think nothing of parking some distance away and
walking several blocks, if need be (b) ( )
Prefer to walk if you can (c) ( )
5 Do you take regular exercise?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
6 Do you get 6 to 8 hours sleep at night?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
7 Do you usually wake up of your own accord at a regular hour
without the use of an alarm clock?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
8 Do you smoke more than 20 cigarettes a day?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
9 Do you inhale?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
10 Do you drink more than 6 cups of coffee or tea a day?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
11 Do you regularly take 2 or more alcoholic drinks a day?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
12 Do you feel that you can easily keep up physically with people of
your own age?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
13 Do you feel that you could easily expand your present activities,
16
and take on more work than what you now have?
No (a) ( )
Sometimes (b) ( )
Yes (c) ( )
14 If you were commuting by train, and you arrived at the station as
the last train that evening was about to pull away from the
platform, would you:
Decide to stay in town (a) ( )
Hurry without losing your dignity (b) ( )
Make a desperate dash for the train (c) ( )
15 In a standing position, take a deep breath and hold it; watch the
second hand on your wristwatch or clock and note how many
seconds you can hold your breath:
Less than 30 seconds (a) ( )
At least 45 seconds (b) ( )
About 60 seconds (c) ( )
16 Having now completed the breath-holding test, and having
recorded the number of seconds you could hold your breath in
this initial test, make a guess as to how many seconds you think
you can hold your breath in a subsequent trial; then go ahead
and try it again and see if you are:
Able to hold your breath longer than you estimated (a) ( )
Able to hold your breath precisely as long as you
guessed (b) ( )
Unable to hold your breath as long as you thought
you could (c) ( )
17 Guess how many consecutive push-ups you think you may be
able to perform; then go ahead and try and see if your estimate
is:
Lower than your actual performance (a) ( )
Equal to your actual performance (b) ( )
Higher than your actual performance (c) ( )
18 Do you find that you have, or have had, most medical symptoms
you hear about?
Yes (a) ( )
Maybe (b) ( )
No (c) ( )
Count your score by adding separately all the (a) checks, all the
(b) checks and all the (c) checks. Each (a) check counts O points,
each (b) check counts 1 point, and each (c) check counts 2 points.
17
Add all the points to arrive at the total score of Part 1 of your
Fitness Profile.
The eighteen questions in this part are designed to evaluate how

healthy your habits are, how fit you feel, the state of your
motivation and whether your self-appraisal of your health is
realistic. A score between 18 and 20 is average, a score below 10 is
definitely unsatisfactory, and a score above 30 is superior,
regardless of your age or sex.
Questions I through 5 are related to your habits involving

physical activity. Your answers to these questions will portray
your attitude toward physical activity, and the score will
numerically express whether you are more or less active
physically than the average person. Most people will score no
more than 1 on any one of these questions. Your answer to
Question 4 may be especially revealing of your attitude toward
physical exercise.
The majority will check (a), and only people naturally inclined to
exercise will check (b) or (c).
Questions 6 through 11, concerned with rest, recuperation,

smoking and drinking, are designed to determine how healthy
your habits are. Regular habits usually make for better
adjustment and more efficient function, and provide for adequate
rest and recuperation. This does not mean that strict and
constant adherence to a fixed schedule is a must, for occasional
deviations from a monotonous schedule and a certain amount of
change are beneficial; they add spice to life. Nevertheless, if your
answer to Question 7 is No, it means that you may not be getting
enough sleep; this in the long run may impair your health. While
a moderate amount of tobacco, alcohol, coffee or tea may be
stimulating to some people, any abuse is detrimental to
everybody. Statistics have shown that the smoking of more than a
pack of cigarettes a day is infinitely more harmful than the
smoking of less than ten cigarettes a day. Inhaling vastly
increases the statistical risk of health impairment. Alcoholic
18
beverage in small amounts may be a tonic to some people, but
regular consumption of two or more alcoholic drinks a day may in
some individuals over a decade or more gradually develop into
alcoholism. While all this is relative, depending on one’s
constitution, the higher the “habit score” in Questions 6 through
11, the better off one is in the long run.
Your answers to Questions 12 and 13 are a measure of how fit you
feel. All of us experience wide variations in our state of well-
being; our health and vigor vary. But, in general, there are
considerable, consistent differences between people in vitality
and dynamic vigor. Questions 12 and 13 are designed to bring out
such differences. Your answer to Question 12 will indicate how
you compare with people of your own age in terms of yourn
physical fitness feeling. Your answer to Question 13 will reveal the
state of your physical and mental vigor, for only a person with pep
and vitality will answer Yes to Question 13.
Questions 14 through 17 have to do with your state of motivation.

Motivation is the force that drives you along in the pursuit of your
arms. It may be the most important key to your success, for there
are numerous examples to show that sick or physically
handicapped people with a strong and persistent drive may attain
outstanding results. In general, the strength of your motivation
may be judged by how much you are willing to pay in terms of
effort or sacrifice to achieve a specific objective. In answering
Question 14, a motivated person will be prepared to sacrifice his
dignity and check (c), scoring 2 points. In Question 15,.a highly
motivated person should be able to endure the agony of holding
his breath for at least 45 seconds to score 1 point. If you have
checked (c) in Question 16, because you were unable to old your
breath as long as you thought you could, you overestimated your
breath-holding capacity and were unable to attain your expected
goal. This means that your level of aspiration is higher than your
actual physical capacity. A high level of aspiration is for all
practical purposes the same as a high level of motivation. You
therefore score 2 points if you check (c) in Question 16 or
Question 17.
19
Question 18 is designed to determine whether your selfappraisal
of your health is realistic, or whether you may tend to be a
hypochondriac, which would be the case if your answer to this
question were Yes. If so, you may look for helpful suggestions in
the following chapters. This does not mean, however, that you are
by any means an inferior human being, for many promment
citizens have suffered from hypochondria. Napoleon who lived in
a constant unfounded fear of cancer, which took the life of his
father, is a typical example. What it does mean, however, is that
you suffer more than youi have to, and that you may not be
enjoying life as much as you should.
2.5.2 Part II
Answer all questions; guess if you are not sure. If your answer is
Yes; if your answer is No, circle the No.
QUESTION ANSWER:
1 Is your body weight now within 10 pounds of what Yes No
it used to be when you were about 21 years old?
2 Is your body weight within 10 pounds of what it Yes No
should be according to the table of “ideal body
weight” on following page?
3 If, standing upright, you grasp a fold of your Yes No
abdominal skin just below your waistline, between
your thumb and forefinger, is the distance between
your thumb and forefinger pinching the skin fold
less 1 inch?
4 When you look at your figure in the mirror, are you Yes No
satisfied with what you see?
Each Yes is worth 2 points; add and record your total
body weight score:
Gross overweight usually carries with it serious heath handicaps

and a shortening of life expectancy. For a middle-aged man, an
overweight of 10 pounds may mean an increased mortality of
almost 10 percent, and an overweight of 50 pounds, an increased
mortality of over 50 percent. If obesity is combined with heart
disease, life expectancy is further lessned. The continuous burden
of the excess fat represents not only an additional load on joints
20
and legs, but fuel and oxygen. Statics show that people who are
greatly overweight are more susceptible to certain diseases, such
as diabetes and cardiovascular disease. They may have less
resistance to infection and may even tend to have more accidents
than slim people. It has been found generally that a person’s
weight at 21 years of age is fairly close to the ideal body weight.
DESIRABLE WEIGHT IN POUNDS TAKEN IN INDOOR CLOTHING*

Height
in Small frame Medium frame Large frame
shoes
Men Women Men Women Men Women
4’10’’ 95 101 111
4’11’’ 98 104 114
5’0’’ 100 107 117
5’1’’ 103 110 120
5’2’’ 116 106 123 113 133 123
5’3’’ 119 109 126 116 136 126
5’4’’ 122 112 130 119 140 129
5’5’’ 125 115 133 123 144 133
5’6’’ 128 119 136 127 147 137
5’7’’ 132 123 140 131 151 141
5’8’’ 136 127 145 135 156 146
5’9’’ 140 131 149 139 160 150
5’10’’ 145 135 153 143 165 154
5’11’’ 149 139 157 147 169 159
6’0’’ 153 143 162 151 174 163
6’1’’ 157 166 178
6’2’’ 161 171 183
6’3’’ 166 176 188
6’4’’ 170 181 193
* Courtesy of the Metropolitan Life Insurance Company
The closer one can maintain this weight throughtout life, the
better. It is generally better to be too lean than too fat, as far as
your health is concerned. In any case, some minor deviations, up
to 10 pounds, from the ideal weight are quite permissible and
should cause no concern. So much depends on how you feel about
your fat. The ideal score in this test is 8 points, however.
21
2.5.3 Part III
The assessment of your state of physical fitness is so simple that
there is no reason why you could not make it yourself in your own
home. However, if you have, or have reason to suspect, any
significant illness or physical limitation, the initial test should be
done with the approval of your doctor or under medical
supervision. Medical supervision is especially important if you are
over 50 years of age and have never engaged regularly in physical
excercise.
The following tests are designed to help you arrive at your own
physical fitness profile. These tests may be carried out any time
during the day, for it makes little difference in the result whether
the test is taken in the morning or at night. They should not be
taken sooner than one hour after meals, however. Since alcohol
may affect your performance in several of these tests, no alcoholic
beverage should be consumed prior to the tests. It is suggested
that you allow about a 5 minute rest between each of them. You
may prefer to spread the tests out over several days rather than
complete them all in one session.
I have taken great care in the development of these tests to make

them suitable or applicable to persons of both sexes and of all
ages. No flexibility tests, such as the usual bending and toe-
touching, have been included for two reasons: In most instances
this kind of flexibility is not important and may have little or
nothing to do with physical fitness. When a person has to bend
down to touch the floor, he should never do this without bending
his knees anyway, in order to save his back. Second, this kind of
bending is apt to overstrain the spine of persons with weak trunk
muscles. A disabling case of low backache may be the result,
which may prevent the reader from proceeding any further with
this book!
22
2.5.3.1 Test 1. Endurance
TASK 1. HOPPING IN PLACE
From a standing position, hop up and down on the floor 20 times;
feet must be lifted at least 1 inch from floor. Stop and remain
standing for exactly 1 minute; then count the number of pulse
beats in 15 seconds. Record results as follows:
 Pulse beats under 17: 3 points
 Pulse beats 17 to 20: 2 points
 Pulse beats 21 to 23: 1 point
 Pulse beats over 23: 0 points
 Score:
TASK 2. STRADDLE HOP

From a standing position, feet together and arms at side, jump
and land with feet apart (about 15 inches) and arms raised
sideward to shoulder height. Return with a jump to the starting
position and count 1; repeat 25 times in rapid succession. Stop
and count immediately the pulse for 15 seconds. Score as follows:
 Unable to complete: 0 points
 Pulse beats over 35: 1 point
 Pulse beats under 25: 3 points
 Score:
23
TASK 3. CLIMBING STAIRS
Climb 10 steps of a flight of stairs 5 times without a stop, starting
at the foot of the stairs and ascending and descending 5 times as
fast as you can, noting the time it takes. Immediately upon
completion, stop and count the number of pulse-beats in 15
seconds.
a) If completed in 15 seconds or less: 2 points
If completed in 30 seconds or less: 1 point
If completed in over 30 seconds : 0 points
Score (a):
b) Pulse beats 30 or less: 2 points
Pulse beats 31 to 35: 1 point
Pulse beats 36 or over: 0 points
Score (b):
SCORE (a) + (b):
24
TASK 4. STEP TEST
Take your shoes off and step up and down on an ordinary chair or
piano bench about 18 inches high, once every 2 seconds for 1
minute (about 30 times), and as soon as you stop, count the
number of pulse beats in 15 seconds. Record results as follows:
 Pulse beats over 37: 1 point
Score:
25
TASK 5. RUNNING IN PLACE.
Complete 100 running steps, counting a step each time the foot
touches the floor, lifting feet about 2 inches from floor. Stop and
count number of pulse beats in 15 seconds. If you can complete
the 100 steps in less than ½ minute, give yourself 2 points extra.
The score depends on your pulse rate at the end of the run, as
follows:
a) Unable to complete: 0 points
Pulse beats over 35: 1 point
Pulse beats 31 to 35: 2 points
Pulse beats 25 to 30: 3 points
Pulse beats unde 25: 4 points
Score (a):
b) If 100 steps completed in less than ½ minute: 2 points
If steps completed in ½ minute or over: 0 points
Score (b):
Score (a) + (b):
Scores:
 Task 1:
 Task 2:
 Task 3:
 Task 4:
 Task 5:
 Total endurance score (sum of all 5 task scores):
26
The fitter a person, the lower his pulse rate during a given work
load, and the faster his pulse rate drops back to resting values
when he stops exercising. Your pulse rate at the end of a given
exercise may therefore be used as a meaningful index of the state
of your physical fitness. The highest obtainable score in this
section for endurance is 20 points.
In order for you to get a rough idea of where you stand, you may
compare your own test score with these approximate values:
Men Women
Below age Age 50 and Below age Age 50 and
50 above 50 above
Excellent 16 14 14 12
Good 10 8 8 6
Fair 7 5 5 3
Poor 5 3 3 1
2.5.3.2 Test 2. Strength
For practical purposes, you may assess the approximate strength

of the major muscle groups of your body by the following simple
tests.
TASK 1. PUSH-UPS.
Strength of arms and shoulders is tested by push-ups.
Men: Start in a lying position on the floor, face down, hands

placed at shoulder level with palms flat on the floor. Lift your
body by straightening your arms and keeping your back straight,
with only palms and toes on the floor. Arms must be fully
extended; then bend the arms slowly again until your chest
touches the floor. Repeat this as many times as you can without
resting between each push-up. Your achievement may be scored
as shown below.
27
Women: Because the muscle strength of women is only about
one-half to two-thirds that of men, most women are not able to
perform push-ups as described above. Comparable results can be
obtained by allowing women to perform modified push-ups as
follows: Lean against the end of a table or chest of drawers with
arms fully extended, as shown in the figure. Bend your arms until
your chest is touching your hands. Repeat this as many times as
you can and score according to the number of consecutive push-
ups you have accomplished.
 5 push-ups: 0 points
 15 push-ups: 1 point
 Score:
28
TASK 2. KNEE BENDS.
Strength of thigh and leg muscles can be tested by consecutive
deep knee bends without support. Start in a standing position,
hands stretched out in front. Bend down as far as you can,
allowing arms to drop to the sides until fingers touch the floor, as
shown in the figure, and return to starting position. Repeat as
many times as you can.
 1 knee bend: 0 point
 10 knee bends: 1 points
Score:
29
TASK 3. SIT-UPS.
Strength of the abdominal muscles can be assessed by a simple
sit-up test. Start by lying on your back on the floor with knees
bent, feet together, heels about 12 inches from buttocks, and arms
at the side. Hook your feet under the bed or a heavy chair. Sit up
to a vertical position, then allow yourself to roll slowly back to the
lying position again. Repeat without a stop as many times as you
can.
 1 sit-up: 0 points
 10 consecutive sit-ups: 1 point
 20 consecutive sit-ups: 2 points
 30 consecutive sit-ups: 3 points
 Score:
30
TASK 4. V-SITS.
To assess the strength of both thigh and abdominal muscles, start
by lying flat on your back on the floor, hands at the side. Raise
your legs and trunk from the floor simultaneously, at the same
time touching your knees with your fingertips, as shown in the
figure. Return to the starting position and repeat as many times
as you can.
 1 V-sit: o points
 5 V-sits: 1 points
 Score:
31
TASK 5. BACK-LIFTS.
To assess the strength of your back muscles, start by lying flat on
the floor, face down, with a firm pillow under your hips, arms
outstretched overhead, as shown in the figure. Then raise arms,
head, shoulders and both legs fromthe floor until your body is
straight, as illustrated in the figure. Return to starting position
and repeat as many times as you can.
 1 back lift: 0 points
 Score:
Scores:
 Task 1:
 Task 2:
 Task 3:
 Task 4:
 Task 5:
 Total strenght score:
You may compare your score with the following average figures:
32
Men Women
Below age Age 50 and Below age Age 50 and
50 above 50 above
Excellent 15 12 12 10
Good 12 7 9 5
Fair 8 5 5 4
Poor 5 3 3 2
Physical work capacity not only depends on the oxygen and fuel
supply of the working muscles. It also depends to a large extent
on the actual strength of those muscles. Muscle strength is
directly proportional to the size of the muscle, which increases as
a child grows. Muscle strength is about the same for boys and
girls of the same age up to puberty. From then on, the muscle
strength of girls increases very little, while it continues to increase
markedly in boys. It reaches its maximum around the age of 20,
when the strength of men is about 50 percent greater than that of
women, on an average. This applies to almost all muscle groups,
with one exception: the muscles of the jaw engaged in chewing
and speaking are almost as strong in women as in men. However,
there are marked individual variations so that an exceptionally
strong woman may have greater muscle strength than an
exceptionally weak man. From our studies at Lankenau of over
one thousand people, the strength of the upper extremities,
shoulders and arms appears to be one of the weakest points of
American males.
From the age of about 30 there is a gradual decline in muscle

strength, and the decline is most pronounced in men, so that at
65 years of age a man’s strength is only about 80 percent of what
it was at the age of 20. The strength of women, on the other hand,
remains more or less the same, with only a slight loss with the
advancing years. The result is that after the age of 65 there is
much less difference in muscle strength between men and women
than was the case at the age of 20. The decline in strength with
age is a phenomenon which takes place in all the muscles of the
body.
33
2.5.3.3 Test 3. Coordination
Your performance in everyday life also depends greatly on your
motor skill and coordination. It is a common experience that
physical fitness is often associated with well-developed body
coordination; our own studies at Lankenau have confirmed this.
The following tests, which we used there, are designed to assess
your coordination.
TASK 1. GENERAL BODY COORDINATION
Start in a lying position, stretched out on your back on the floor,
hands at sides. On the signal “Go,” get up from the floor to a
standing position, turn completely around one time and lie down
on the floor again in the starting position. Time yourself with the
aid of the second hand on your wristwatch. If you can complete
the entire maneuver in less than 5 seconds, you get 2 points; in
less than 10 seconds, 1 point. If it takes you longer than 10
seconds, your score is 0.
 5 seconds: 2 points
 10 seconds: 1 point
 Over 10 seconds: 0 points
 Score:
TASK 2. HAND COORDINATION
Sit down on a chair at a table, placing both hands in front of you
on the table, palms down. Start tapping the table with the right
hand at a rate of about 2 taps a second, while at the same time
you slowly run the left hand evenly along the edge of the table
from right to left for a distance of about 1 foot, without any
jerking and without changing in any way the rate of tapping of the
right hand. If you succeed in 3 trials, you get 1 point; otherwise
your score is 0.
 Score:
TASK 3. MANUAL DEXTERITY
Sit down ata table with a box of ordinary wooden matches (about
32 in a box). On the signal “Go,” start to pick up the matches from
the box, one at a time, using only one hand, and build a square
stack of matches with the heads of the matches pointing to the left
and away from you, as shown in the sketch. Then put all the
34
matches back into the box, all heads facing the same way. If you
can complete this test in less than 3 minutes, you get 1 point;
otherwise your score is 0.
 Score:
TASK 4. REACTION TIME

Adjust the faucet in your bathroom or kitchen sink so that it
keeps dripping at the rate of about 1 drop every second. Place
your hand, palm up, 3 inches away from the path of the water
drop and 3 inches below the faucet. Watch as the drop appears
below the faucet, and see if you can catch it on your hand. If you
can accomplish this in 3 trials, you get 1 point; failing this, your
score is 0.
 Score:
Scores:
 Task 1:
 Task 2:
 Task 3:
 Task 4:
 Total coordination score:
35
A satisfactory score for an average person is 4 points for persons
under 50 years of age, regardless of sex, and 3 for persons over 50
years of age.
2.5.3.4 Test 4. Endurance, Strength and Coordination Combined

Using an ordinary skipping rope or a piece of clothesline about
8½ feet long, see if you can skip 50 times without stopping and
without the rope touching your feet or head. You may choose any
method of skipping, and may practice one before the actual test.
Score as follows:
 50 consecutive skips: 3 points
 Less than 10 consecutive skips: 0 points
 Score:
A score of 3 is excellent for anybody; most persons below 50 years

of age should score 2, and persons above 50 years of age should
manage to score 1, regardless of sex.
36
2.5.3.5 Test 5. Balance
TASK 1. DIVER STANCE TEST
Stand on the floor, legs straight and heels together. Raise your
arms forward to shoulder height, then lift both heels from the
floor and, when you feel that you have regained balance and are
standing steady, close your eyes and see how many seconds you
can hold this position. Note the time from the moment you close
your eyes until you have to open them again, move your feet or
lower your arms. You may practice once before the actual test.
 Less than 5 seconds: 0 points
 5 seconds: 1 point
 10 seconds: 2 points
 Score:
TASK 2. DRESSING TEST

See if you can stand in the middle of the room without support
and dress yourself completely without having to sit down or hold
on to anything. If you can accomplish this, you get 1 point;
otherwise your score is 0.
 Score:
37
Scores:
 Task 1
 Task 2
 Total balance score
Most individuals should score 2 points in this section; however,

people over 50 years of age often fail in Task 2.
Your physical fitness rating in Part III, Tests 1-5 combined, may
be compared with the following ratings:
Men Women
Age 50 Age 50 Your
Below Below
and and score
age 50 age 50
above above
Excellent 35 and 25 and 30 and 20 and
above above above above
Good 30 to 34 20 to 24 25 to 29 15 to 19
Fair 25 to 29 15 to 19 20 to 24 10 to 14
Poor 24 or 14 or 19 or 9 or
below below below below
2.6 Conclusion
lf you now add up all the scores from Parts I, II and III, you end up
with a numerical total fitness score. In order for you to compare
38
yourself with what is considered average for your age, you may
use this table of approximate average values.
AVERAGE SCORES ON THE FITNESS PROFILE
Men Women
Test Below age Age 50 Below age Age 50 Your score
50 and above 50 and above
Part I 20 18 20 18
Part II 4 4 6 4
Part III
Test 1 10 7 8 4
Test 2 12 7 9 5
Test 3 4 3 4 3
Test 4 2 1 2 1
Test 5 2 2 2 2
Sum of
test 1 to 5 30 20 25 15
AVERAGE
TOTAL
FITNESS
SCORE 54 42 51 37
Now that we know roughly where we stand, where do we go from

here? If your total fitness grade indicates that there is room: for
improvement, the next step depends on whether or not you are
motivated to make the effort to improve. Your score for Questions
14 through 17 on pages 20-21 may give you a hint in this respect.
Assuming that you do decide to go ahead, where do you start?

You might as well start here and right now, for this is as good
time as any. By having completed the test, you have already found
your place on the fitness scale. All you have to do now is to
proceed accordingly, as follows:
1) If you have any physical disabilities or any organic disease,
check with your physician before you do anything.
2) If you are over 50 years of age and have never exercised
regularly in the past, turn to Chapter 4 for the preparatory
conditioning exercises, regardless of your score, and ask your
physician what he thinks.
39
3) If you are a man below 50 years of age and your score in Part
III is less than 30, or if you are a woman not yet aged 50 and
your score in Part III is less than 25, turn to Chapter 4 and
start at the beginning with the preparatory conditioning
exercises.
4) If you are a man and your score in Part III is above 30, turn to
Chapter 5 for the intermediate or Standard Program for men.
If you are a woman and your score in Part III is above 25,
turn to Chapter 5 for the Standard Program for women, and
start there.
5) If you are a man or a woman and your total fitness score is
above 60, you may turn to the latter half of Chapter 6 for the
Advanced Program, and start there.
6) If you are over 65 years of age and have your physician’s
permission, turn to Chapter 10 for the special program for
this age group.
Once you yourself are well on your way, you may turn your
attention to your spouse or your children and get them involved
as well.
40
3 Effective exercise
3.1 Why Exercise?
“Why should I exercise when I get along so well without it?” This
is the attitude of a great many people who, while not questioning
the desirability of being physically fit, doubt that it is worth the
effort. Whenever they feel the urge to exercise, they promptly sit
down to wait for the urge to subside. Some of them say they get
all the exercise they need as pallbearers, carrying their athletic
friends to their graves. Yet it is a fact that physical activity is
essential for optimum health.
The fact that we do need exercise is most convincingly shown by

observing what happens to the body when it is deprived of it.
Prolonged bed rest is a good example. Although bed rest is
essential in the treatment of many diseases, prolonged
immobilization in bed may have a devastating effect upon a
person’s capacity to do physical work. Several recent
investigations, including our own studies of healthy young men,
have shown that 6 weeks of continuous confinement to bed
results in a 50 percent loss of physical work capacity. Some of the
men could barely manage for 5 minutes a work load that prior to
the bed rest they could casily manage for a whole hour.
Continuous bed rest causes a marked loss of calcium from the
bones. It also makes one prone to faint when standing up,
because of a transient loss of the body’s ability to regulate blood
pressure. This harmful effect, however, is soon overcome once
one becomes active again. The tendency to faint when standing
up disappears within hours; the excessive calcium loss is
overcome within a few days. But it takes about 3 weeks of training
to regain the level of physical fitness one ha<;l before the bed
rest.
Exercise develops muscle tone, increases muscle strength and

muscle endurance, thus affording protection to the more fragile
parts of the body, especially the back and the spine, and resulting
in better posture and a healthier appearance. It improves the
41
efficiency of lung ventilation; it increases the reserve capacity of
the heart and stimulates blood circulation so that the various
organs of the body are more adequately supplied with blood,
oxygen and energy fuel. All this results in greater stamina and
less fatigability. In addition, physical exercise may provide an
emotional outlet for the worries of daily life. It may enhance the
feeling of well-being and make your everyday problems and
confticts less vexatious by helping you to sleep better and by
relaxing tension. Furthermore, vigorous physical activity tends to
eliminate overweight and obesity.
Physical activity causes many more blood vessels to develop in

the muscle tissue, including the muscle tissue of the heart. A
person who engages regularly in vigorous exercise, therefore, may
be better prepared to survive the occlusion of one of the blood
vessels of the heart since he has more spare ones to take over.
Recent studies have shown that exercise may even facilitate the,
development of new blood vessels in the heart muscle after an
occlusion has occurred. Exercise may therefore not only protect a
sound heart, but also help to heal one that is sick.1
In an inactive, resting person, the blood vessels in the muscles

become narrower, which means the heart has to work harder to
pump the blood through them. When the person starts to
exercise, the blood vessels in his muscles expand greatly. Because
the blood can now be pumped more easily through the larger
pipes, exercise reduces the strain on the heart and may even
cause a drop in the blood pressure. This is why moderate exercise
may have a beneficial effect in many hypertensive patients, and is
also why an active person can tolerate emotional stress much
better than one who is inactive. Sudden anger or excitement are
more apt to increase the blood pressure to dangerously high
levels when the person is resting than when he is physically
active. The old idea of getting up and going for a brisk walk when
1Petren, et al., Arbeitsphysiologie, Vol. 9, p. 376, 1936; Eckstein, Circulation

Research, Vol. 5, p. 230, 1957.
42
under emotional stress therefore makes a great deal of
physiological sense.
This may well be the reason why physical activity appears to be a

protection against coronary heart disease. Recent studies2 have
shown that the incidence of coronary heart disease is higher in
sedentary than in physically active people. The disease occurs
much later in life and is less severe in those who are physically
active. Physical exercise may not only prevent coronary heart
disease, but may also improve the performance of the heart in
patients who have already had a heart attack. This has been
shown in our recent studies at Lankenau Hospital. By subjecting
patients to a carefully controlled exercise program starting 6
weeks after the heart attack, we were able to restore the
electrocardiogram to normal in several cases. In many patients
we could improve the physical work capacity to a point where
they could return to quite strenuous physical work.
Physical exercise of sufficient intensity and duration inevitably

leads to physical fitness. And even sexual activity requires some
degree of fitness. I recall an experiment which we performed
among married airmen in Alaska. A group of them were required
to spend several weeks in the wilderness in the middle of the
winter on a simulated survival exercise. For 3 weeks they were
forced to keep vigorously active in order merely to survive. In the
process they all became physically fit for the first time in their
lives. They returned to their families with a new lease on life.
Those most pleasantly surprised with the change were their
wives! When physical fitness is tied to sex, it becomes everybody’s
business.
Vigorous physical exercise over and above the normal demands of

daily living is necessary in order to develop a strong, durable and
efficient body that can withstand the stresses of life without
undue strain. Since exercise increases one’s working capacity, the
fitter you are, the less likely fatigue is to occur. When an
2 Morris, et al., British Medical Journal, Vol. 2, p. 1485, 1958.

43
individual feels tired in the course of his ordinary work, it does
not help him merely to rest. He has to improve his level of fitness
too. Simply to lighten the load does not solve the problem, for
without exercise the work capacity also declines. In the end, even
the lightest of loads may be too much.
Exercise benefits all people, young or old, sick or well. Even semi-
invalids can lead relatively effective lives when fit. They may
hasten toward that goal through some of the exercise routines
recommended for them in these pages.
While physical fitness is an asset in everyday living, it may be a

matter of life or death in an emergency. This is true even if it is
just a matter of running for the last train home. The unfit person
may not only miss the train, but may even suffer a fatal heart
attack in addition.
A fit person can accomplish a given amount of work with a much

lower heart rate than one who is unfit. When a person is
undergoing physical training, his heart rate declines as his fitness
improves. The lower the heart rate, the more economically the
heart works. In an unfit person the heart may beat 180,000 times
in 24 hours. In a fit person doing the same work it may only have
to beat 140,000 times. This is a saving of 40,000 beats due to
physical fitness alone.
3.2 What Kind of Exercise?
Not all kinds of exercise are equally beneficial. Dynamic exercise
is generally superior to static exercise. The former involves
motion of the body; the latter does not. Running, skipping, tennis
and calisthenics are examples of the dynamic type. The so-called
isometric exercises are examples of the static type. They involve
merely tensing the muscles without doing anything or getting one
anywhere. All that isometric exercise does is to increase the
strength of the muscles involved; it does not improve fitness or
work capacity. Since such isometric exercises have nevertheless
become so popular, it must be because people believe that this
44
way they get something for nothing; they think that they get
fitness without effort. All they have to do is to sit in a chair and
push their hands against the resistance of the armrest, or to link
the hands tightly together and then pull them apart without
losing the grip. While this may result in larger and stronger
muscles, it does not improve endurance or the function of the
heart and circulation. In fact, it may do the heart more harm than
good.
Let us consider a typical example of isometric exercise, such as

standing in a doorway pushing the hands hard against the door
frame as if one were trying to push it apart. Or grabbing one end
of a piano, trying to lift it off the floor. The fixed, tensed muscles
of the arms, back and legs tend to choke their blood vessels,
restricting blood flow to the muscles. The tensed muscles fail to
pump the blood back to the heart. If the subject at the same time
holds his breath, as is almost always the case, this hinders further
the return of the blood to his heart. The heart has to step up its
pumping action to keep up the blood flow. A strain on the heart
and a rise in blood pressure may be the result.
In dynamic exercise, on the other hand, the muscles are

periodically tensed and relaxed; this is less fatiguing. It pumps
the blood through the muscles and back to the heart. The blood
vessels are wide open; consequently, the blood pressure does not
rise, but may actually drop. The result is less strain on the heart.
Whatever the exercise program, a proper warm-up is essential to

lessen the load on the heart. All it takes is a few minutes of
limbering-up exercises, such as jogging in place. This will cause
the blood vessels in the muscles to dilate, which will allow the
blood to rush unhindered through the muscles in preparation for
the actual effort that is to follow. And, what is equally important,
it prevents the blood pressure from rising too high or too
abruptly. The more strenuous the training effort, the longer and
more vigorous should be the warm-up exercises. In most cases, 1
to 5 minutes is adequate. In the case of competitive athletes,
however, it may take 15 to 20 minutes of quite vigorous activity to
45
complete the warm-up. This is because the physical work capacity
of the body is improved when the body temperature is moderately
elevated. Before you go out to shovel snow, for instance, a 3-
minute jogging in place will greatly reduce the load on your heart.
Another important factor is proper breathing in order to air the

lungs adequately. Most nonathletes are unaware of this fact. To
get into the habit, it may be well to practice once in a while: Stand
erect, take a deep breath while lifting the shoulders, pulling them
back and lifting the rib cage; then let the shoulders and rib cage
relax. Repeat this about 10 times. While exercising, don't forget to
breathe deeply. Try to develop a pattern of rhythmic breathing;
lift the rib cage completely during inhalation, let it sink back to a
relaxed position as you are breathing out.
The training program obviously depends on what one is training

for. There are different exercises for different purposes, but some
are of more general value than others. In the following pages we
shall suggest a variety of exercises grouped to take into account
age, sex and level of fitness, and designed to provide maximum
general benefit with a minimum expenditure of time.
3.3 How Much Exercise?
The fitter one is, the more it takes to improve one’s fitness.
Athletes may have to train for six months to reach peak
performance, especially older athletes, but an unfit person can
achieve an amazing improvement in a surprisingly short time. As
a matter of fact, it takes no more than a couple of half-hour
training sessions a week, or less than 15 minutes a day, for a
month to improve materially one’s level of fitness. And once that
level is attained, it takes very little effort to maintain it.
It cannot be repeated too often that in order to improve one’s

level of fitness one has to do more than one does in one’s ordinary
everyday living. For a housewife doing regular housework and
nothing else, merely to continue to do housework is not enough;
she has to do something more vigorous in addition. Playing tennis
46
twice a week may be all that is needed; or running up one flight of
stairs 10 times a day; or skipping rope 5 minutes daily.
Merely to engage in a sport once in a while, or even regularly, in

itself is no guarantee of fitness. In Scandinavia, where I grew up,
participation in sports is not in itself looked upon as a means of
developing fitness. To the Scandinavians, a sport is a matter of
recreation. But in order to perform well in a particular sport, they
need to be fit. Here, on the other hand, it is a common conception
that to engage in some sort of sport is the same as becoming
physically fit; that one may enjoy the sport and become fit in the
process. This may be true in the case of some sports, such s tennis
or squash, for instance. But as a rule this is not so; it depends on
how vigorous the sport is, or how vigorously you go at it.
Swimming may be a superb exercise to develop fitness, but if all
one does is to float and never exert oneself, it is without effect.
Playing golf may fatigue the player, but it does not as a rule
improve his physical fitness, because a golfer strolling along the
golf course does not stimulate his heart and circulation enough to
develop fitness unless he walks very briskly.
In order really to enjoya sport, one has to be fit to start with. Then
the sport becomes less tiring, more enjoyable and more satisfying
because one performs better. Most sports will maintain one’s
level of fitness, once attained. On the other hand, infrequent
participation in strenuous sports by an unfit person may be
directly harmful. I remember a volleyball player who played on a
team once a week. Because he was unfit, this was more than his
muscles and cardiovascular system could tolerate. He did not play
often enough to condition himself physically to a point where he
could comfortably take it. He ended up with heart trouble. What
he should have done was to engage in a regular training program
twice a week in addition, or to play volleyball at least twice a week
instead of once.
3.4 The Exercise Program
A person’s fitness depends on three attributes: strength, flexibility
and stamina. Strength is needed to move your body about and to
47
perform the physical tasks of your daily life. Strong trunk muscles
protect the spine and other vital parts of your body. The stronger
your muscles, the more you can do without muscular aches or
fatigue. Flexibility or joint mobility is necessary for smooth
motion and in order for you to move your body gracefully.
Flexibility allows you to use your body effectively with the
expenditure of a minimum of energy. The simple task of getting
in and out of an automobile, for instance, may be quite awkward
for one who has stiff or inflexible joints. Stamina is essential in
any prolonged activity, and depends largely on the capacity of the
heart and circulation to supply blood and oxygen to the various
parts of your body. Failure in this, which is basically the same as
lack of stamina, will lead to fatigue and exhaustion. Therefore all
three of these attributes, strength, flexibility and stamina,
contribute equally to the state of general fitness.
The exercise programs which follow are balanced programs

designed to increase all three aspects of fitness. You will note that
these programs do not include any special breathing exercises.
This is not necessary if the prescribed exercises are carried out
properly and with sufficient vigor. When you exercise vigorously,
especially in the endurance exercises, the carbon dioxide
produced in the working muscles will stimulate the breathing
center in the brain, forcing you to breathe adequately to ventilate
the lungs properly. In the muscle strength exercises, such as
push-ups or sit-ups, however, it is important not to hold your
breath as you may be inclined to do. This tends to hinder the
normal ftow of the blood.
You will also note that all bending exercises which are especially
apt to hurt the back are excluded. Back flexibility is not essential
to fitness so long as there is joint mobility, because in most
activities the spine should be kept straight and all bending should
be accomplished by the use of the hips and the joints of the
extremities. Since the abdominal muscles play a major role in
protecting and supporting the back, special emphasis has been
placed on the development of strong abdominal muscles.
48
To develop the optimum muscle strength, two or three maximum
muscular contractions, each of about 3 to 5 seconds’ duration,
once or twice a day, are all that is needed. In this manner you may
increase the muscle strength by as much as 30 to 50 percent in 3
months.
To develop endurance, almost any kind of vigorous physical

activity will do, but it must last for at least 2 or 3 minutes at a
time. It must be sufficiently vigorous to bring the heart rate up to
more than 120 beats a minute. For all practical purposes, this
means that it must cause you to be out of breath. Experience has
shown that when the exercise is less vigorous than that, no
improvement occurs. Walking briskly, hiking, running, skipping,
bicycling, playing tennis or vigorous swimming will do this.
Most people will say that they have no time .for a fitness program.
Most people in our day and age do not have the time for anything.
They have to take the time for whatever they want to do. The
problem is not so much to find the time, but to establish
priorities. The point about physical exercise is that it pays off; the
time invested in it will pay off in terms of improved performance,
looks and a feeling of well-being. And what is more, it may enable
you to do more in the end, enable you to add more hours of
activity to your day.
As you improve your fitness by exercise, you will have to keep

increasing the intensity of the exercise to achieve further
improvement, otherwise improvement will level off. An untrained
person who is tested stepping up and down on a piano bench for a
minute may end up with a heart rate of 160. He now sets out to
skip rope 5 minutes a day for a month. When he is retested 4
weeks later, his heart rate has dropped to 130, an improvement of
about 20 percent. He now continues the same exercise program
for another 4 weeks. A retest reveals a further drop in heart rate
to 120, an improvement of less than 10 percent. Continuing the
same amount of exercise produces no further improvement
because it is no longer sufficient to increase his level of fitness. He
now steps up his exercise by skipping more vigorously, but
49
without extending the total time of skipping beyond the 5 minutes
a day. Four weeks later a retest reveals that his heart rate has
dropped to 100. And so he continues until in 6 months he has
almost doubled his level of fitness and reached a point where no
further improvement can be achieved, however much he tries. He
has reached his highest attainable limit of physical fitness.
In the following chapters we shall describe a variety of exercise

programs designed for people of all ages and with different levels
of fitness. Having completed the tests in the previous chapter, you
have already established where you fit in on the fitness scale. You
may now start with the program recommended for your age and
level of fitness. Whatever you do, don’t start at a level higher than
that indicated by your test scores; if anything, it is better to start
at a level too low than too high. Start gently, and ease yourself
into the exercise program. When an unfit person hurls himself
too vigorously into a strenuous exercise program, he may easily
become stiff and sore and discouraged. Unless exceptionally
motivated, this may be all that is needed to make him forever
allergic to exercise. In fact, too vigorous exercises may hurt him,
especially if he has a weak back. (My orthopedic friends tell me
that they had never been so busy as during the recent spell of
enthusiasm for the Royal Canadian Air Force exercises!)
Moderation is a virtue, and a gradual progression is essential. Be
patient but persistent. If in doubt, ask your physician.
Children can do the same exercises as their parents, and in the

same order. They should start with the Standard Program, and
then advance to the Maintenance or Advanced Program,
combined with the supplementary exercises suggested in Chapter
8. Since there is very little difference in the development of
strength and fitness between boys and girls up to the age of 12 to
14 years, children of both sexes may follow the same program up
to that age.
50
4 The Basic Program
This is the beginner’s program of limbering-up exercises. Its
purpose is to condition the body to physical activity, to put it in
shape to endure the stress of exercise. It is very important that we
make this point clear. A body unaccustomed to vigorous physical
activity must be gradually conditioned by gentle exercises over a
period of several weeks in order to be able to take the more
strenuous program.
This program is specifically designed as a starting point for

people who have never exercised regularly before, especially for
those who are over 50 years of age. People over 65 should start
with the program outlined in Chapter 10 and then pickup this
Basic Program and go on from here. This Basic Program may also
be suitable for convalescents who have completely recovered from
an illness and who are now preparing themselves to return to
work. For them, however, medical approval is essential. This
program is also the proper starting point for those who had an
unsatisfactory score in Part III of the physical fitness tests (below
30 for men and below 25 for women).
This Basic Program will gradually and safely prepare you for the
next level of activity, the Standard Exercise Program. The Basic
Program requires 5 to 10 minutes daily, 5 days a week, for 3
weeks. During the first week you simply learn what to do. The
second week you just do it, and the third week you put your soul
into it and exert yourself vigorously. At the end of the third week
retest yourself. If your retest score is still below 30 (25 for
women), continue the Basic Program for an additional week and
repeat the test. Continue this until you pass. If your retest score is
30 (25 for women) or better, you qualify for the Standard
Exercise Program and you may turn to Chapter 5 and proceed
from there.
51
4.1 Joint Mobility Exercises
You may start to work on your joints before you get out of bed in
the morning.
ANKLE JOINTS
Lying on your back, stretch the foot downward as far as it will go,
then bend it back. Turn the ankle in and turn it out. Repeat with
other foot.
KNEE JOINTS
Lying on your back, bend one knee as far as it will go, by bringing
up the knee toward the chest. Repeat with other leg.
52
HIP JOINTS
From your supine position turn over on left side and bend left
knee. Keeping right knee straight and parallel with the bed, bring
right leg forward as far as it will go. Without putting leg down, lift
it straight up as far as it will go, then bring it backward as far as it
will go. Return leg to starting posi tion. Repeat once. Turn over on
right side and perform the same motions with the left leg twice,
keeping right leg bent.
LOWER BACK
Lying on your back with knees bent and arms relaxed at your
side, lift upper body and bend forward until you have attained a
sitting position, using arms to aid you in getting up if necessary.
Repeat once.
53
NECK
Sitting upright, arms supporting you at each side, bend your head
slowly as far back as you can; then as far forward as it will go;
then sideways to the left and to the right, trying to touch the
shoulder with the ear. Repeat.
Rotate your head carefully and slowly in a semicircular motion,

starting by turning the head to the left, trying to see backward
over your left shoulder, then look straight up at the ceiling, and
finally turn your head to the right, trying to see backward over
your right shoulder. Repeat once.
54
SHOULDER JOINTS
Lie down, roll over on left side, rotate extended right arm in a
circular motion forward, upward, backward and down;, bringing
the arm as far out in all directions as the shoulder joint will
permit. Repeat once. Roll over on right side and repeat the same
motions twice with the left arm.
ELBOW JOINTS
Roll over on your back, bend both arms in the elbow joints as far
as they will go, or until you touch your shoulders with your
fingertips. Repeat once.
55
WRIST JOINTS
Lying on your back, hold one wrist up in other hand and rotate
your wrist joint as far as you can in all directions. Repeat with
other wrist.
FINGER JOINTS
Close your fists as tightly as you can, then relax and stretch your
fingers as far as you can.
4.2 Muscle strength

The following exercises will serve to strengthen the major muscle
groups of your body which are regularly used during your
everyday activities to a point where they will be conditioned to
56
endure the more strenuous exercises to follow in the Standard
Program.
BACK STRETCHING
The back stretchers, which play a role in the protection of the
back and spine, may be effectively strengthened by lying face
down with a firm pillow under your hips and then raising arms
and legs until your body is absolutely straight. Hold it straight for
3 seconds. Start by repeating this exercise 3 times each day
during the first week, increase to 4 times daily during the second
week, and 5 times daily during the third week. It is important that
you do not try to overstretch or overextend your back; this might
hurt your spine and give you a backache. Lift your body, resting
on the pillow, merely enough to make it straight and no more.
MODIFIED SIT-UPS
The strength of the abdominal muscles, which also serve to
protect your back, may be developed simply by lying on your back
in bed or on the floor, with knees bent and feet fixed under a
heavy object, and raising the upper part of the body. Do this 3
times in succession each day during the first week, increase to 5
times during the second week, and 10 times during the third
week.
57
PUSH-UPS
These are valuable exercises for several reasons. They are
particularly effective in strengthening the arm and shoulder
muscles, which often are a weak point, even in men. The weight
to be lifted is proportional to the body weight, so the more you
gain weight, the more you have to lift. Finally, push-ups will
develop the pectoral muscles, which may serve to “accentuate the
positive” in the female figure. Push-ups are therefore good for
women too. Since women do not as a rule have the same muscle
strength as men, a modification of this exercise is necessary for
them.
Men: Lying on your stomach, hands under shoulders, palms flat

on the floor, straighten arms and lift body, keeping back straight,
with only palms and toes touching the floor. Extend arms fully,
then bend them slowly until chest touches floor. Repeat without a
stop 3 times each day the first week, increase to 4 the second
week, and do 5 push-ups during the third week. For the reason
explained on page 50, you should keep breathing normally, or
even more deeply than normal, throughout this exercise. Breathe
in as you push up, breathe out on your way down.
58
Women: Lean with extended arms against the edge of a firm
table, chest of drawers, dresser or bed end. Bend arms slowly
until chest touches hands, then extend arms fully again. Keep
breathing regularly. Repeat without a stop 3 times each day the
first week, increase to 4 the second week, and do 5 during the
third week.
KNEE BENDS
The muscles of the thighs and lower extremities may effectively
be trained by a series of deep knee bends. Raise the arms forward
to shoulder height, raise yourself on your toes, then bend your
knees as far as you can, maintaining a steady balance,
simultaneously dropping the arms and touching the floor with the
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fingertips. Hold for 3 seconds, then come up again. Repeat this 3
times daily the first week, 4 times the second week, and 5 times
the third week. (In addition to knee bends, using the stairs
whenever the opportunity presents itself may further help to
strengthen the thigh muscles. Both ascending and descending are
equally effective in this regard.)
4.3 Endurance
The simplest and most effective way to train your cardiovascular
system is by running and by skipping rope. In this Basic Program
we start with running, and since the effect on the heart and
circulation is roughly the same whether you run in place or run
along a road, we suggest, for practical reasons, running in place.
You start with a loose jog in order to warm up, and jog 50 steps
gently and rather slowly (counting a step each time one foot
touches the floor). Rest for 15 seconds, and then run in place 100
steps. The first week you do this as gently as you can, but as you
become more proficient, try to lift the legs higher and try to
bounce a little farther off the floor each day. The second week run
100 steps in place (following the 50-step warm-up), rest 15
seconds, and then proceed with another 100 steps. The third
week, increase this to a total of 300 running steps with a 15-
second rest between each 100 steps
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The above exercises constitute the basic, minimum program
which in itself will greatly enhance your fitness, improve your
posture and deve1op strength and endurance. Whatever else you
can do in addition will add to this foundation, and the more of it,
the better. But remember to start easy and build up the level and
intensity of physical activity gradually.
For your convenience, the week-by-week progression of the Basic

Program is outlined in chart form at the end of the book.
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5 The Standard Program
This program is designed for every adult, of both sexes, up to the
age of 65 who has demonstrated, by scoring over 30 (25 for
women) in the tests in Part III Chapter 2, that he or she qualifies
for it. It will require 10 minutes daily, 5 days a week, for 3 weeks.
It is designed to give you the maximum amount of fitness for a
minimum investment of time and effort.
In this program, as in those that follow, rope skipping plays a

major role. Of all the different exercises we have investigated, we
find that nothing surpasses the simple skip rope in producing the
greatest fitness in the least amount of time. Five minutes of rope
skipping a day, 5 days a week, improved the physical work
capacity of a group of our young laboratory technicians by 25
percent in one month. We have also found that rope skipping is
superior to many of the complicated and time-consuming
physical education programs. If a couple of very simple physical
conditioning exercises that will strengthen the arms, legs, back
and abdominal muscles (push-ups, sit-ups, knee bends) are
added to the rope skipping program, one may achieve a
maximum of benefit from a simple 10-to-15-minutes-a-day
program.
The advantage of the skip rope is that it not only trains the heart,
resulting in improved physical endurance, but also increases the
muscle strength of legs and arms in addition to improving
coordination and posture. A skip rope costs practically nothing; a
piece of ordinary clothesline will do. Rope skipping does not
require any elaborate space, facilities or gymnasium. You can skip
in your bedroom, hall or living room, on the porch, lawn, street or
sidewalk, in the classroom or in the corridor. It can be fun and
lends itself well to competition. It is easy to learn, and it looks
impressive.
The individual skip rope should be about 8½ feet or longer,

according to the person’s height. The thickness should be about
3/8 of an inch or more, depending on the weight of the rope. The
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lighter the rope, the thicker it should be. A very satisfactory skip
rope can be made from Samson Sash Cord (Spot Cord) No. 7. It
comes in 100-foot lengths and can be purchased in almost any
hardware store. The ends of the rope should be tied into a knot to
prevent fraying. There are fancier ropes available too, ropes made
of nylon, with handles supplied with hall bearings for smooth
operation. Some ropes even have a musical toy in the handle
which will play a tune as you jump.
The trick in skipping rope is to keep it in motion by the smallest

possible circular movements of the wrist joints. The rope should
not hit the floor; if it does, it is too long. Adjust the length of the
rope by grabbing the ends firmly in your hands. With the loop of
the rope held tightly under your buttocks, stretch the arms
forward as shown in the figure. When the arms are fully extended
and the rope is stretched tight, the length is just right for
skipping. As you skip, there should be hardly any noise except the
whistling of the rope through the air. Skipping with the correct
smooth and flexible motion of the ankle and knee joints will
produce none of the hard thuds against the floor that will result if
you skip with stiff ankles.
As you start to skip, hold the rope loosely in the hands, the elbows
slightly bent, and the rope hanging down touching the heels. To
begin with, it is merely a matter of getting used to skipping and of
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developing proper coordination. This does not take very long-5
days should do it. Each person should skip at the tempo which
suits him. However, the speed must be such that the skipper
eyentually gets out of breath and his heart is pounding. Anything
short of this does not result in any appreciable training effect.
Most people find it convenient to start jumping with both feet

together, but it is more effective as a training method to jump
from foot to foot, as when running in place. Start with a 1-minute
warm-up period of slow jumping; rest 15 or 30 seconds, and start
skipping at a faster rate until out of breath. If you get out of step
or have to stop because the rope gets caught, start again
immediately and carry on until the required number of skips has
been completed. In this manner you may carry on until you
eventually are able to make 500 skips without stopping. Different
rope skipping techniques will be described under the different
programs. As your coordination and fitness improve, you should
be able to increase the rate of skipping without increasing the
total time required for the exercise.
5.1 Joint mobility exercises
SHOULDER ROLL
Stand with feet apart, arms hanging loosely at your sides. Rotate
the shoulders by lifting shoulder blades as in a shrug, in a circular
motion. Rotate forward 5 times, then backward 5 times. Increase
to 10 times the second week, and the same but more vigorously
the third week.
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ARM SWINGING
Stand with feet apart, arms along sides; Swing both arms
simultaneously in a large circular motion in front of the body like
two propellers, 5 times from right to left, and then 5 times from
left to right. Increase to 10 times the second week, and the same
but more vigorously the third week.
ARM AND LEG SWINGING

Stand erect, holding the edge of a table, chest of drawers or
doorknob with the right hand. Swing left arm and left leg back
and forth continuously in opposite directions as far as you can 5
times, counting 1 each time the leg moves forward. As the arm
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and leg swing all the way out, lift yourself on the toes. Turn
around and swing the right arm and leg 5 times. Increase to 10
times the second week, and the same but more vigorously the
third week.
HIP ROLL
Stand erect, feet apart, hands on hips. Rotate hips slowly in a
swaying motion so that the pelvis, viewed from above, is moved in
a circular pattern from right to left, and then from left to right, 5
times each way. Increase to 10 times the second week, and 10
times the third week.
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NECK BENDING
Standing erect, bend your head slowly as far back as you can, then
as far forward as it will go, then sideways to the left and to the
right, trying to touch the shoulder with the ear. Repeat. Rotate
your head carefully and slowly in a semicircular motion, starting
by turning the head to the left, trying to see backward over your
left shoulder, then look straight up to the ceiling, and finally turn
your head to the right, trying to see backward over your right
shoulder. Repeat.
5.2 Muscle strength

HALF V-SIT
From a lying position on your back, arms at your side, raise the
legs and upper part of your body simultaneously, while at the
same time you slide your hands along the thighs until the fingers
touch your knees. Hold for about 3 seconds, then return to
starting position. Repeat 5 times. Increase to 10 times the second
week. During third week do 10 consecutive half V-sits without a
halt.
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PUSH-UPS
Men: Lying on your stomach, hands under shoulders, palms flat
on the floor, straighten arms and lift body, keeping back straight,
with only palms and toes touching the floor. Extend arms fully,
then bend them quickly until chest touches floor. Repeat in rapid
succession 5 times; keep breathing regularly. During second week
do 5 push-ups in rapid succession, rest for 5 seconds and repeat
another 3 push-ups in rapid succession. During third week do 5
push-ups in rapid succession, rest for 5 seconds, do another 3
push-ups without stopping, then rest for 5 seconds and finally do
another 3 push-ups.
Women: Lying on your stomach, hands under shoulders, palms

flat on the floor, straighten arms and lift body, keeping back
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straight, with only palms, knees and toes touching the floor.
Extend arms fully, then bend them quickly until chest touches
floor. Repeat in rapid succession 5 times; keep breathing
regularly. During second week do 5 push-ups in rapid succession,
rest for 5 seconds, and do another 3 consecutive push-ups.
During third week do 5 push-ups in rapid succession, rest for 5
seconds, repeat another 3 push-ups in rapid succession, rest for 5
seconds and finally do another 3 push-ups.
KNEE BENDS
In standing position, feet 5 inches apart, raise arms forward to
shoulder height, raise yourself on toes, then bend knees slowly as
far as you can, simultaneously dropping hands until fingers touch
floor. Hold for 3 seconds, then straighten your knees fully again
while bringing the arms up to shoulder height. Repeat 5 times.
Increase to 7 times the second week, and 10 times the third week.
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HAND GRIP
Grasp a small rubber ball in each hand, then squeeze the ball as
tightly as you can 5 times. Increase to 10 times the second week.
5.3 Endurance
WARM-UP
First week. Jog gently 50 steps, with arms and feet moving easily.
Rest for 15 seconds. Then:
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ROPE SKIPPING
Jump with both feet together 50 times. If you get out of step or
have to stop because you become entangled in the rope, start
again immediately and carry on until you have completed 50
skips the first day. Add 10 skips each day as you go along, making
a total of 90 skips the last day of the week.
Second week: Jump from foot to foot, as when running in place;

complete 100 skips the first day. Add 10 skips each day as you go
along, making a total of 140 skips the last day of the second week.
Increase the rate of skipping slightly each day so that at the end of
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the week 140 skips are completed in about the same time it took
to complete 100 skips at the beginning of the week.
Third week: Jump from foot to foot, as when running in place.

Complete 100 skips without stopping. Rest 15 seconds. Complete
another 100 rapid skips, making a total of 200 each day.
At the end of the third week, repeat the tests in Part III of the
Fitness Profile (p. 27). If your score is below 35 (30 if you are a
woman), continue the third week part of the Standard Program
for another week, then repeat the tests. Continue the Standard
Program until you make the grade.
If your score is 35 or above, you have attained a remarkably good

standard of physical fitness. You have now a choice between the
simple Maintenance Program outlined in Chapter 6, which is
designed to maintain this level of fitness, or the Advanced
Program outlined in the latter half of Chapter 6, designed for
those who aspire to the elite class.
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6 The Maintenance and Advanced Programs
6.1 The Maintenance Program
You have by now probably discovered that it takes very little in
terms of time and effort to improve your fitness significantly. lt
takes even less to keep this level of fitness. The Maintenance
Program is designed to do just that. It requires less than 10
minutes a day, 5 days a week, but it should be continued regularly
and be made a part of your life and habits; above all, remember to
keep it up when you are away, traveling or on vacations. Once you
slip and get out of the habit it may be difficult to pick it up again.
The Maintenance Program is built around the skip rope. If 5

minutes a day is all the time you have for exercise, use it to skip
rope. This is without a doubt the most efficient way you can use
those 5 minutes; it will guarantee you a reasonable level of
physical fitness. If you can add another 5 minutes, do some push-
ups, sit-ups, knee bends and joint mobility exercises.
ROPE SKIPPING
Start with a 1-minute warm-up period of slow jumping, using any
method of jumping you please. Rest 30 seconds and start
skipping very vigorously at a fast rate until you are out of breath.
Skip from foot to foot, as when running in place, and look up and
keep your body erect and the back straight. Start with 100 skips
the first day; add 10 skips each day as you go along until you are
able eventually to make 500 skips without stopping. You should
make it a point to do at least 200 skips a day, 5 days a week. As
you progress, increase the speed of skipping so that the total time
per day required for this rope skipping remains the same,
although the number of skips is increased.
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PUSH-UPS
Complete 10 rapid push-ups in succession daily; men with only
toes and hands touching floor, women with only toes, knees and
hands touching floor. Do not hold your breath.
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KNEE BENDS
A total of 10 deep knee bends a day is sufficient to maintain the
strength of the leg muscles and to maintain full mobility in the
knee joints in most ordinary people. Keep the back as straight as
possible by standing against a wall with heels close to the
baseboard and bend all the way down.
HALF V-SITS
The strength of the abdominal muscles can be maintained simply
by doing 10 half V-sits a day. From a lying position on your back,
raise the upper and lower parts of your body while at the same
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time touching the knees with your hands 10 times in rapid
succession.
SHOULDER ROLL
To maintain the full functional range of the shoulder joint, rotate
the shoulders vigorously by lifting the shoulder blades in a
circular motion 10 times forward, then 10 times backward.
NECK BENDING
To maintain full flexibility of the neck, bend the head as far as it
will go 5 times: forward, backward, to the left, to the right.
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6.2 The Advanced Program
This is the program for those who have the desire and the time to
excel beyond the ordinary level in physical fitness. It is only for
those who scored 60 or better in the total fitness tests in Chapter
2 or better than 35 (30 for women) in Part III of the Fitness
Profile in that chapter. It requires about 15 minutes a day, 5 days
a week.
The program is slightly different for women and for men. It

consists of the same three basic components as the previous
programs: joint mobility, muscle strength and endurance. Follow
each drill exactly as prescribed, increase the effort progressively
until you can do no better. To provide variety and recreation, use
every opportunity to augment this program by the supplementary
exercises suggested in Chapter 8.
6.2.1 Advanced Program for Men
6.2.1.1 Joint mobility exercises
SHOULDER ROLL
Stand erect, feet apart, arms hanging loosely along sides. Lift and
rotate shoulders in a circular motion upward, forward, downward
and backward 25 times, changing direction every 5 times.
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CRAWL STROKE
Stand with feet wide apart, trunk leaning forward. Swing arms
alternately as in crawl stroke 25 times, stretching arm as far
forward as you can, and then pushing it forcefully backward as in
vigorous swimming. Count 1 each time one arm swings forward.
ARM AND LEG SWINGING

Standing erect, hold on to the edge of a table or doorknob with
the right hand. Swing left leg vigorously forward as far as you can
while at the same time you swing the free arm backward. As the
leg is swinging forward, bounce off the floor as high as you can
with your right foot. Then swing the leg backward, while at the
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same time you swing the arm forward and lift yourself high on
your toes with your right foot. Repeat 10 times. Then turn around
and do the same thing with the right arm and leg.
DEEP KNEE BENDS

Stand with feet together, hands resting on hips. While keeping
trunk straight and raising yourself on toes, bend knee as far as
you can until buttocks are brought as close as possible to the
heels. Repeat 15 times.
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WALKING ON HEELS
Stand erect, arms hanging loosely along sides. Lift balls of feet as
far from the floor as you can, standing on your heels. When you
have gained full balance, walk 10 steps on your heels, using arms
to maintain balance.
6.2.1.2 Muscle strength

PUSH-UPS
Presumably, if you have gane through the standard and
maintenance courses, you can do 10 normal push-ups with ease.
Now try to do the 10 push-ups with the hands placed as far down
toward the stomach as you can.
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SIT-UPS
Lie down on your back with knees bent and feet hooked under a
heavy chair. Stretch arms overhead and grab hold of the feet of an
ordinary chair or stool. Lifting it with straight arms, sit up 10
times. Increase the number of sit-ups by one every day until you
can accomplish 25 such sit-ups in rapid succession.
BODY LIFTING
Sit down in a chair with sturdy armrests, grab hold of the
armrests with your hands, lift yourself by the arms off the chair,
with legs stretched out horizontally. Hold for 3 seconds; repeat 5
times.
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CHINNING
Fix a chinning bar securely in a door opening. Nail a piece of
wood under the bar attachments at each end to prevent it from
slipping. Lift yourself up by the arms until your chin is over the
bar. Increase the number gradually until you can do 10 complete
chinnings consecutively. Then, while hanging by the arms, lift
your legs from the floor and hold them straight in a horizontal
position and do a complete chinning. Gradually increase the
number until you can do 10 consecutive chinnings with raised
legs.
THE STOOL STUNT

Place three ordinary stools in a row on the floor; lie on your back
on these stools so that your head rests on one, your buttocks on
the second, and your heels on the third. Then lift your seat off the
middle stool, grab that stool with the right hand and, keeping the
body straight, suspended between the two other stools, lift the
middle stool over your body, grab it with the left hand and place it
back under your seat from the opposite side.
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KNEE BENDS ON ONE LEG
Stand on toes, feet together, arms stretched out in front at
shoulder height; raise left leg from the floor and stretch it out in
front of you with the heel 4 inches from the floor. Holding it
there, bend the right knee slowly as far as you can without losing
balance. Change over and do the same thing standing on the left
leg. Repeat twice.
CABLE EXERCISE
Stand erect, feet 15 inches apart. Grasp the handles of the cables
firmly, extend arms fully and raise them above your head. Then
pull the handles apart to stretch the springs until the arms are
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completely extended sideways. Hold for 3 seconds. Then allow
the springs to return to the original length. Repeat.
Extend arms fully in front of you at shoulder height. Then pull

handles out until arms are fully extended sideways and springs
touch your chest. Hold for 3 seconds. Return and repeat.
Lower the extended arms and hold the springs about 12 inches
away from your body in front of your thighs. Then pull the
handles apart until the springs touch your body. Hold for 3
seconds. Return and repeat.
Raise the hands holding the handles to shoulder height and keep
the springs horizontal. Bend left arm so that left hand, holding
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the left handle, rests on your chest just below your neck. Now
stretch right arm straight out to the side until it is fully extended,
without moving the left hand. Hold for 3 seconds. Return and
repeat.
Do the same thing in the opposite direction, holding the right

hand still in front of your chest and extending the left arm all the
way out to the side. Return and repeat.
Lower the left extended arm and hold it about 12 inches away
from your left hip. Pull the right handle upward and outward
until the springs are fully stretched and touch your chest. Hold
for 3 seconds. Return and repeat.
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Do the same thing in the opposite direction, holding the right
ex-tended arm still and pulling the left arm upward and outward.
Hold for 3 seconds. Return and repeat.
6.2.1.3 3. Endurance
WARM-UP
Run in place 100 steps; lift knees as high as you can, and bounce
at least 4 inches off the floor. Rest 15 seconds, and do 100
straddle hops as follows: Start with the feet together, arms at
sides. Jump into the air and land with feet about 18 inches apart,
raising arms sideways to shoulder height at the same time. Jump
back to starting position and count 1. Continue until you have
completed 100.
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ROPE SKIPPING
Skip 200 times, skipping from foot to foot, as when running in
place. Each successive day add another 10 skips and continue
until you have reached 500 consecutive skips without stopping.
At this point you modify the programas follows: Start by

completing 200 skips as above. Then you start skipping with feet
together, and on every third skip you make a high jump and allow
the rope to swirl around twice before you alight. Carry on until
you have completed another 100 skips in this manner. When you
can do this with ease, you may carry on and complete another
100 skips, but as you continue to skip, gradually bend your knees
until you are jumping in a squatting position.
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6.3 Advanced Program for Women
6.3.1.1 Joint mobility exercises
SHOULDER ROLL
Stand erect, feet apart, arms at sides. Lift and rotate shoulders in
a circular motion 20 times, first forward, then backward changing
direction every 5 times.
ARM CIRCLING
Stand erect, feet apart, arms at sides. Make large circles with one
arm at a time, keeping arm extended, moving it like a propeller in
a circular pattern from the starting position, backward, upward,
forward and downward, 10 times; then change direction: forward,
upward, backward and downward.
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KNEE RAISING
Stand erect, feet together, hands at sides. Keeping back straight,
raise left knee as high as you can, grasp it with both hands and
pull it toward body. Then lower foot back to floor and do the same
thing with the right knee. Repeat 5 times for each foot.
HIP ROLL
Stand erect, feet apart, hands on hips. Rotate hips widely in a
circular swaying motion so that the pelvis, viewed from above, is
moved in a circular pattern, 5 times from right to left and 5 times
from left to right.
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DEEP KNEE BENDS
Stand with feet together, hands resting on hips. Keeping back
straight and raising yourself on toes, bend knees as far as you can
until buttocks are brought as close as possible to the heels. Repeat
10 times.
WALKING ON HEELS
Stand erect, arms at sides. Placing weight on heels, lift balls of
feet from floor as high as you can and walk 10 steps on your heels.
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6.3.1.2 Muscle strength
PUSH-UPS
Lie down on floor, face down, hands under shoulders, palms
down. Keeping body perfectly straight, with only toes and palms
touching floor, straighten arms fully to lift body, then bend arms
quickly until chest touches floor. Repeat without a pause 3 times;
rest 3 seconds and repeat another 3 consecutive push-ups. Rest 3
seconds and repeat 3 final push-ups in rapid succession.
SIT-UPS
Lie down on your back with knees bent and feet hooked under a
heavy chair, with arms stretched overhead. Keeping arms
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straight, sit up to vertical position. Repeat 10 times. Add one
additional sit-up each day until you can accomplish 25 such sit-
ups with ease.
BODY LIFTING
Sit down in a chair with sturdy armrests, grab hold of the
armrests with your hands, and lift yourself by the arms off the
chair with legs stretched out horizontally. Hold for 3 seconds.
Repeat 5 times.
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KNEE BENDS ON ONE LEG
Stand on toes, feet together, arms stretched out in front at
shoulder height. Raise left leg from floor and keep it stretched out
in front of you with the heel 6 inches off the floor. Now bend the
right knee slowly as far as you can without losing balance. Return
to upright position, change over and do the same thing standing
on the left leg.
POWER GRIP
This is a bent steel rod fitted with a handle on each end. It can be
purchased in most sporting goods stores. Grasp the handles
firmly and raise your hands above your head. As you bring your
hands down in front of you to shoulder height, keeping arms fully
extended, squeeze the handles as closely together as you can.
Hold 3 seconds. Repeat 3 times.
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6.3.1.3 Endurance
WARM-UP
Complete 100 straddle hops with arm swings as follows: Start
with feet together, arms at sides. Jump and land with feet about
18 inches apart, and at the same time raise arms sideways in a
wide swing and clap hands over head. Jump back to starting
position and count one.
ROPE SKIPPING
Skip 100 times, skipping from foot to foot, as when running in
place. Each successive day add another 10 skips, and continue
until you have reached 200 consecutive skips without stopping.
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Then add the following drills: After a 15-second rest, start to skip
with feet together, and on every third skip make a high jump and
allow the rope to swirl around twice before you alight, and carry
on until you have completed 100 skips in this manner. Rest 30
seconds.
Start to skip with feet together again, and as you continue,

gradually bend your knees until you are jumping in a squatting
position.
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Complete 100 skips in this manner. Rest 30 seconds. Then
proceed to jump with feet together and cross the rope in front
every other time for 50 skips. Then cross your legs every other
time as you continue to swing the rope for another 50 skips. Rest
30 seconds. Then hold the rope in one hand and jump as you
keep swirling the rope in a circular motion parallel to the floor, 25
times.
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7 Fitness for Everyday Life
7.1 Exercise Habits
The exercises in the preceding chapters constitute basic
programs. Whenever the occasion presents itself, you should try
to supplement them. Take a walk whenever you can; never pass
up an opportunity to use your feet. Get off the bus a few blocks
before your destination and walk the rest of the way, especially if
it is uphill. Walk the dog every day, a whole mile if possible. The
dog may provide you with an excuse even to run once in a while.
Make it a habit to walk briskly, time yourself, and try to make at
least 100 steps a minute; 120 steps a minute is better.
Never pass up an opportunity to climb stairs. Whenever you feel

that you can, run up the stairs instead of simply walking. Make it
a goal to climb at least ten flights of stairs a day. Seize every
chance you have to take part in the children’s games or exercises.
Both you and they will enjoy it. Try to keep up with them; it will
keep you young longer.
On weekends take a long walk or a hike. Include the entire family

and head for hilly, varied terrain. This will give you the
opportunity to use muscles which you may have forgotten you
had.
Walking is still one of the best forms of recreation and

conditioning. It also stimulates your metabolism, and when
combined with short periods of running it is the most basic form
of physical conditioning, the one used by many athletes. A very
effective program is alternating bouts of 3-minute walking and 3-
minute running, for a total period of 20 to 30 minutes. Start at a
slow rate and increase the speed gradually, keeping the running
and walking periods constant at 3 minutes. This will effectively
increase your body’s capacity for oxygen transport. The training
session may end up with a few all-out spurts of 10 to 30 seconds’
duration, preferably uphill, in order to develop strength and
speed in addition to endurance.
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This type of training program may be difficult for most people
because it is time-consuming and requires proper terrain or
facilities for running. However, it is enjoyable if you live in a
suitable area and have the time. Fortunately, roughly the same
effect can be achieved with the skip rope in your own bedroom.
7.2 Posture
Your posture has a great deal to do with your health and
performance. Good posture contributes to your fitness because it
prevents overstraining certain muscles, aids your blood
circulation and protects your internal organs. Exercise, in turn,
helps to develop good posture by strengthening muscle tone.
According to military statistics, 60 percent of all cases of low back
pain are due to faulty posture. Low back pain is one of the most
frequent causes of incapacitation. In many cases, postural
backache need never occur if one learns how to lie, sit, stand,
work and lift correctly.
Lying: In view of the amount of time we spend lying down,

correct lying posture is obviously important. The pillow should be
high enough so that when you are lying on your side, the head is
level with the trunk. The best mattress is one of felted cotton or
hair, or firm sponge rubber thick enough to be comfortable. If you
use a box spring, a piece of 5-ply plywood the length and width of
the bed should be placed between the mattress and the
bedsprings. A sagging bed permits the muscles and ligaments of
one side of the body to relax, but stretches those on the opposite
side. It also tends to distort the abdominal organs and chest.
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When getting out of bed, roll over on the side, bring the knees
forward, then drop the legs over the side and push up with the
elbow and opposite hand.
Sitting: The sitting posture is of equal importance since many

people spend most of the day sitting. The basic sitting position
should be with the trunk and head erect and centered over the
pelvis, or tilted slightly forward with a slight lumbar arch when
writing or working at a table. The hips and knees should be flexed
at a right angle. But this is merely the basic position. Frequent
variations and changes of position are natural and necessary to
avoid fatigue and tension. Make it a habit to practice getting up
from the chair smoothly and gracefully without using the
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armrests. This will improve your muscle tone, coordination and
balance.
Standing: The ideal standing posture is a “staging” position, not a

permanent position. Your knees should be loose and your
buttocks squeezed tightly, feet parallel and about 6 inches apart.
Your body should be vertical and essentially straight. Your
shoulders should rest naturally on the chest and not be held
rigidly back. The body should achieve its full height in this
position so that you actually experience a feeling of tallness. Such
an erect posture will improve your appearance. When the spine is
straightened and the posture erect, the stretched trunk tends to
pull the soft parts with it, so that the abdomen is automatically
pulled in. This results in an erect appearance, with a flat stomach.
Like the sitting position, the basic standing position is not

maintained unchanged for prolonged periods. It should be varied
frequently for comfort and rest. The weight should be shifted
from one leg to the other, or from the balls of the feet to the heels
and back again. This is important, for a body in motion tires less
readily than one that is tense and rigid. Good posture should be
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one of comfort, requiring little effort and no tension. When
standing in a streetcar or a bus, stand sideways and hold on to the
back of a seat rather than to an overhead strap. Practice good
posture once in a while by placing a book on top of your head and
trying to hold it there by balancing with your head.
Prolonged standing, especially on a hot day, may cause some

persons to faint because the blood forms pools in the veins of the
the legs, preventing an adequate supply from reaching the brain.
To overcome this, keep tensing the leg muscles once every 10 or
15 seconds or so. The rhythmic leg-muscle contractions squeeze
the blood out of the legs and push it uptoward the head.
Walking: When walking, the knees and ankles should be limber,

the toes pointed straight ahead. The head and chest should be
held high for better balance and appearance. You should swing
the legs directly forward from the hip; you should push your feet
off the ground with your toes and never shuffle. The shoulders
and arms should swing freely and naturally. Make it a habit to
walk crisply at a rate of at least 100 steps a minute. To practice
good walking posture, try to walk on your toes while balancing a
book on top of your head.
Bending: When stooping or bending, don’t forget to bend the

knees first, otherwise you may strain your back. When lifting or
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carrying loads, the load should be as close as possible to the axis
of the body in order to minimize the load on the body.
7.3 Postural Exercises

These simple exercises may be carried out before getting out of
bed in the morning. They are designed to develop three elements
of good posture: high position of the chest, flattening of the back
and proper use of the abdominal muscles.
Lying on the back, with knees bent, take a deep breath, lifting the
chest as high as you can. Hold the chest in this position and
exhale by tightening the abdominal muscles, pulling the abdomen
inward and upward. Relax for 3 seconds. Repeat this exercise 5
times.
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Lying on the back, with knees bent, bring right knee up to chest,
then lower it slowly back. Relax. Repeat with left leg. Repeat 10
times.
Lying on the back, with knees bent, bring both knees slowly up to
chest. Tighten muscles of abdomen, press back flat against bed.
Hold knees to chest 10 seconds, then lower them slowly. Relax.
Repeat 5 times.
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Lying on the back, with knees’; bent, clasp knees, bring them up
to chest, while at the same time rolling forward to a sitting
position. Roll back and forth 5 times.
7.4 Exercise for Children

Children are endowed with an urge to be active. If given half a
chance, they will find a way to satisfy their desire for exercise
wherever they are, whether they live in a castle or in an igloo.
Even so, the best results are achieved through regular exercise
and vigorous games. As a result of our inspection of different
YMCA summer camps for children, we found that unless a
definite schedule of vigorous exercise was included in the
program, no improvement could be detected in children who had
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enjoyed a month’s stay at the camp. However, when a strenuous
daily exercise program was followed in addition to ordinary play,
a significant improvement in physical fitness did occur. Thus the
ordinary play engaged in by children following their own
inclinations may not be of sufficient intensity and duration to
have any training effect. This is probably because children play in
short spurts of activity, followed by frequent rest periods.
The sooner children start to exercise, the better it is. In fact, it is

not too early to start them as toddlers in order to develop their
muscle strength, endurance, coordination and, the chances are,
better and stronger hearts.
The more vigorous the exercise, the better the results. In children
each bout of very strenuous activity should last at least 1 minute.
But to avoid overexertion, it should preferably not exceed 3
minutes.
The critical time, as far as exercise is concerned, is apt to come

during the transition from teen age to young adulthood or after
college. At that time, the necessity of earning a living and other
factors tend to lead to a more sedentary mechanized type of
existence. For this reason it is important to form early activity
habits that can be maintained throughout life. What a man is able
to do at the age of 70 depends largely on what he could do at 7. By
that time his endowed potentials are established, his·physical
foundation is laid, and his habits are being formed. These may
determine his level of activity for the rest of his life.
It is particularly important for the individual to acquire early

skills in exercises or sports that he can continue later in life by
himself or in small teams, such as tennis, swimming or squash,
rather than those in which he is dependent on large team effort,
such as soccer or baseball. It is also an advantage to be well
versed in sports widely practiced in different parts of the country
so that one may count on being able to enjoy such activities
wherever one may happen to be living later on in life. Thus as one
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moves from place to place, one is more likely to find the
opportunity to play tennis than to engage in cross-country skiing.
A program most likely to be successful with children may consist
of morning or evening exercises, supplemented by vigorous
games, competitive sports and rope skipping during the day. But
bear in mind that children are affected by what their parents and
the adults around them do. The grownups have to serve as an
example. Do not expect the children to exercise unless you do it
first or do it with them. Encourage your children to join you in the
Standard Exercise Program, Chapter 5, and let them proceed
from there.
As is true for adults, few things are more effective in developing

total fitness in a child than an ordinary skip rope. It will develop
strength, coordination and endurance, and it is fun. The children
should be encouraged to carry their skip ropes with them to
school and to the playground. They may spend the time skipping
while waiting for the school bus if it is too far to walk to school.
They may skip during recess. If the school has no gymnasium and
no funds for a physical education teacher, they may use the skip
rope and achieve almost as much. It adds to their fun if they jump
to the tune of chants and jingles, such as these taken from a
collection by Emma Víctor Worstell, Jump the Rope Jingles.
Marco Polo went to France

To teach the ladies how to dance;
First a kick, then a bow,
Marco Polo showed them how.
Rich man, poor man, beggarman, thief,

Doctor, lawyer, merchant, chief;
Silk, satin, calico, rags;
Little house, big house, pigpen, barn.
Numerous variations of rope skipping may be developed by the

application of a child’s imagination. Two children may jump with
one rope, each holding on to the rope with one hand and on to
each other with the other hand. Or they may use a rope or
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clothesline 25 to 30 feet long, fasten one end to a tree or a fence,
and have one child turn the other end while the rest of the
children, side by side, skip the same rope.
The long rope turned by two children lends itself to many

interesting games. Here is one example: The jumpers form a
single line and move forward and jump over the rope, one at a
time, until all of them have jumped. They then turn around and
repeat the same maneuver from the opposite side. When one
misses, he is out; the rest continue, and the one who is the last to
miss is the winner. Or they may start off skipping together, side
by side, and chant this jingle as they keep turning the rope:
My mother and your mother

live across the street.
Every night
they have a fight.
This is what they say:
Icky bicky soda cracker.
Icky bicky boo.
Icky bicky soda cracker.
Out goes y-o-u.
At this point one steps out of the skipping group. This is

continued until they have all stepped out.
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8 Rest and Sleep
Function is the essence of life, and in order to function well the
body needs rest to recuperate, to recover from the wear and tear
of life. It needs sleep to recharge itself with vital energy.
Inadequate rest may cause a feeling of chronic fatigue. This and

occasional bouts of sleeplessness are the most common
complaints of middle-aged men and women today. The reader is
almost certain to have had his share of both.
Occasionally fatigue and insomnia may be symptoms of organic

disease. This can only be determined by consulting your
physician. But in the vast majority of cases they are the result of
tension or anxiety, and not enough exercise. Much fatigue and
sleeplessness are caused by insufficient physical activity.
Assuming there is no organic cause of fatigue and sleeplessness,
the exercises suggested in this book should help to relieve both.
Varied use of all parts of your body through physical exercise is
the most efficient way of insuring rest. Thus, paradoxically, the
cure of fatigue and sleeplessness may not be more rest but rather
more activity of the right kind. Physical activity relieves nervous
tension. It provides an outlet for emotional steam, change for the
weary mind. It relieves muscular tension, which is often the result
of anxiety and the unvaried use of the body in sedentary life.
Exercise has already been discussed in the previous chapters.

In this chapter we shall discuss what means, in addition to
exercise, you may use to achieve adequate amounts of rest and
sleep.
8.1 Physical fatigue
Fatigue is a natural reaction of the body. There is nothing
abnormal about it. It is a safety mechanism designed to protect
your body from too much wear and tear.
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Physical fatigue is the result of overstraining the body. It occurs
when the rate of work exceeds your physical working capacity.
This may occur in intense work of short duration or during more
moderate prolonged work. The greater the overstraining, the
longer it takes for the body to recuperate. But this also depends
on your state of fitness. The fitter you are, the faster you will
recover after an exertion. During rest the balance between energy
supply and the demand on your tissues is restored.
Physical fatigue is much simpler to cope with than fatigue caused

by psychic factors, such as boredom, monotony, emotional
tension, anxiety and mental stress. Psychic fatigue is by far the
most common kind of fatigue in most sedentary occupations.
Some degree of fatigue is inevitable in our high-pressured life. It

varies from day to day. There are days when we feel on to of
things and nothing seems to wear us out. This may be owing to a
particular feeling of well-being that day; it may be owing to
exceptional interest in the task before us, or to special
encouragement we have been given. Fatigue varies from season to
season, or with the weather from day to day, and with one’s
general state of health. It is more likely to occur during recovery
from an Illness, and it is more prevalent in older people. It is very
common in women during their monthly periods. It is certainly to
be expected after prolonged hard work, especially in hot weather.
8.2 Fatigue and the Sedentary Worker
Physical fatigue is not limited to those doing hard manual labor.
Even sedentary people such as businessmen and office workers
do some physical work in the course of their regular daily
activities. Sitting is physical work. The energy expended in
working at a desk may be double that of resting in bed, especially
If the work demands great mental effort and concentration. These
cause muscle tension, which requires expenditure of energy.
Relatively speaking, some sedentary workers who are unfit may in
the performance of their daily work exert themselves physically
almost as muchas a manual laborer who is fit. Furthermore,
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sedentary work is apt to cause a gradual loss of physical work
capacity, for the capacity declines if you do not use it fully.
Much fatigue is also due to aching muscles caused by sitting or

standing in one position too long. This you may overcome by
varying your working position. Stretch once in a while, walk
around or stretch out on a couch for a few minutes to facilitate the
blood flow to your head. One of my efficiency-minded dentist
friends had perfected his technique and working arrangement in
his office toa point where he no longer had to take a step. All the
instruments he needed were placed in his hand by an efficient
technician. He hardly had to move an arm. This enabled him to
treat more patients in a day, but he did so at the expense of his
own health. He soon developed muscular pains and varicose
veins. Under the old system he had had to take a step or two to
reach for his instruments, which allowed him to vary his position,
to move his muscles and to stimulate his circulation. A body in
motion tires less readily than one that is static.
In any sedentary occupation, a correct sitting position is

important. The chair must be tailored to support the framework
of the body sitting in it. One of the major reasons for muscular
pains is poor chair design. Chairs and sofas which do not
completely hold your body in shape force you to maintain your
posture b:y continuous muscular tension, which puts a strain on
the muscles and joints in the back, arms, legs, neck and
shoulders.
The ideal chair is the straight-backed armchair, such as the type

used at the head of the dining room table. The seat height should
be equal to the length of your legs from the bottom of your heels
to the back of your knees. The use of low chairs and overstuffed
furniture is undesirable because they usually fit you poorly. They
cause a slumped or doubled-up position, and are hard to get into
and out of.
Chair armrests should support your arms at almost the same level
as the table top. The distance between the seat and the table top
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should be about 11 inches. Sit well forward and flatten the back by
tightening the abdominal muscles. Keep neck and back in a
straight line with the spine, and bend forward from the hips.
When you drive or ride in an automobile, place a board 12 x 15
inches behind your back. The seat should be brought well for-
ward so that your knees are bent when operating the brake or
clutch.
Avoid sitting too long in one position. In prolonged sitting at a

desk or typewriter your body is held rigidly in a fixed position. To
keep this position, your muscles have to stay contracted. may lead
to muscular fatigue or even painful muscular spasm. To avoid
this, change position from time to time, and occasionally get up
and move about. On a long automobile trip, stop every hour or
two and stretch your legs. When reading for a long time, find a
comfortable chair and sit with your legs elevated. Or better still,
use a rocking chair. The rocking motion will keep your muscles
relaxed.
It is also fatiguing to focus your eyes on one thing too long, like
reading or writing continuously for prolonged periods. Focusing
the eyes requires active contraction of the muscles which change
the curvature of the eye lens. You should therefore rest your eyes
occasionally by changing focus. Look up from your book or
papers and relax your eyes by looking far away or by just gazing
into space for a few seconds.
One of the unfortunate sources of fatigue and drowsiness which

many businessmen have to cope with is the heavy business
luncheon, especially if a certain amount of lunchtime drinking is
involved. Alcohol acts as a depressant on the central nervous
system, and its apparent stimulating effect is only transitory. If
you have to stay alert and have important work to do in the
afternoon, you would therefore be better off to pass up the
lunchtime drink. It would probably also pay you not to eat all the
courses offered at the luncheon, and to take a very light snack
later in the afternoon instead. A glass of skim milk or a cup of
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coffee with a cookie is stimulating and will help keep your blood
sugar up.
A certain amount of fatigue or drowsiness after a heavy meal is

natural, and is due to an increased blood flow to the gut for the
digestive processes, at the expense of the blood supply to the
brain. It usually lasts for an hour or two. This may be disturbing if
you have to work in the evening. Try to stretch out and doze off
for an hour or so after dinner, then wash in cold water to wake
yourself up; otherwise you may be tempted to go to bed for the
night. You may also overcome this transitory drowsiness just by
sticking to the work and pushing on. The fatigue will eventually
vanish as the nervous stimuli to the brain gain the upper hand.
You then feel fresh again and are good for another two or three
hours.
A few simple physical exercises may be amazingly effective in

warding off tiredness if your work is sedentary, since exercise
stimulates the blood flow to your vital organs, including the brain,
and speeds up the metabolic exchange in the tissues. If you find
yourself glued to your office chair for hours on end, grasp the
armrests firmly and lift yourself out of the chair by your arms two
or three times in succession. If you can do this while keeping your
legs stretched out in front of you, so much the better. Then put
your feet up on the desk and lean back in your chair for a few
minutes once every couple of hours. This will help you ward off
the feeling of tiredness in your legs. If you have a lot of
documents to read, don’t do this sitting at your desk if you have a
comfortable chair with a footrest in your office. Move over to it
and put your feet up while you do the reading.
Uncomfortable heat increases fatigability, because your heart has

to pump harder in order for the blood to carry the heat from the
interior of your body to the skin. This puts an extra strain on your
heart. Fatigue is the result. An effective way of counteracting
fatigue, therefore, is to provide a comfortable temperature at your
place of work. The ideal room temperature for sedentary work is
about 70° F.
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8.3 For the Housewife
The more strenuous your work, the more important it is for you
to develop good work habits. This is especially true for
housewives who often have to tax their physical strength close to
the limits of their capacity. If in addition they have small children
to take care of, the chances are that they are going to be tired
occasionally, no matter what they do.
It is important that you select a relaxed and comfortable position

while working. If possible, you should avoid working in a
standing position for long, since standing raises the heart rate,
which puts a strain on your circulation. It also impairs the venous
return of the blood to your heart. All this leads to fatigue. If you
can accomplish your work in a sitting position, do it sitting. If you
have to work standing, do it in an upright rather than in a half-
bent position. Instead of stooping down to pick up your small
child from the floor, bend the knees and hips, not the waist. This
will save your back. For the same reason, never bend over without
bending your knees. When carrying a heavy load, whether your
child or a bag of groceries, hold it close to your body. Instead of
leaning over to wash out the bathtub, sit down on the edge of it.
The kitchen sink must be high enough so that you can wash the
dishes without having to bend over too much. Adjust the height of
the ironing board so that you do not have to bend over it. Or
better still, sit and iron. If you have to iron for a long while in a
standing position, place one foot on a footrest to relieve sway-
back, Check your body position frequently. Draw the abdomen in,
flatten the back, keep the knees slightly bent.
It’s a mistake to save the hardest and most unpleasant jobs until
the end of the day. The longer the unpleasant task is postponed,
the harder it becomes. Get it out of the way as soon as possible
while you still have the strength. And try not to be overambitious.
It is better to leave a few things undone than to work yourself into
the ground. Most men would probably prefer to return to a
reasonably rested wife in a slightly untidy house at the end of the
day than to come home to an exhausted wife in a spotless house.
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And don’t think that you can accomplish all the week’s housework
in one day, even if it is the day you have someone to help you.
Even if you could, you would probably overstrain yourself and
suffer from sore muscles the rest of the week. The object is not to
get the job done as rapidly as possible, but to get it one as easily
as you can, to get it done with the least amount of fatigue. Most of
us can afford to take a little longer doing what we have to do in
order to prevent undue strain. When you hurry, you spend an
unreasonable amount of energy in proportion to the work you
accomplish. This is uneconomical. You should set your pace
according to your capacity, and stick to it.
Prolonged continuation of the same activity may lead to fatigue

and boredom, as well as to muscular pains and aches. It is
therefore important to be able to vary your activities.
Furthermore the work should be interrupted by rest periods at
proper intervals. The frequency and duration of the rest periods
depend on the intensity of the work; the harder you work, the
more frequently you should rest to avoid fatigue. As a rule, a few
minutes’ rest every half-hour is all that you need; breaks longer
than this may be a waste of your time. Many short rests are far
more effective in combating fatigue than several hours’ rest at one
stretch. For heavy physical tasks, such as those that require
carrying a load or climbing stairs, the most efficient pattern is to
work in brief bursts lasting 30 to 60 seconds, and to rest for 30
seconds in between each burst. In this manner you may be able to
keep up an amazingly high work output for hours without fatigue.
The need to work and rest intermittently is especially important

in housework. Studies in Sweden have shown that when a
housewife keeps going all day there is considerable strain on her
heart. In order to recuperate and to avoid fatigue, make it a habit
to lie down between chores. Stretch out horizontally whenever
you can. This is good for your circulation. Instead of sitting down
in a chair to look at the paper, stretch out on a couch with the
paper. You can get more done with less fatigue if you rest briefly
at intervals during the day.
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Because it is tiring to use the same muscles for a very long time yo
should keep changing from one task to another. By doing this,
you not only relax your muscles but enchance your circulation
and eliminate the danger of overstraining any one muscle group.
Instead of spending all morning ironing, it is better to portion it
out into half-hour periods, doing something else like washing or
mending in between. Instead of waxing all the floors some in the
house at once, or cleaning all the windows at one time, spread the
job over several days and do only so much at one time.Start
several of these tasks at once and keep switching from one task to
the other. This may not sound very efficient, but it really is in the
long run And what is more, It spares your muscles and saves you
from being bored.
Start the morning by making a list of all the jobs you intend to
complete that day. List every job, however small or insignificant
and then check off each one as it is completed This will give you a
feeling of accomplishment, while the mere action of walking over
to the table for the check list will provide a break or a change
8.4 Psychic Fatigue
Your mind is the master of your body. But the final expression of
all mental activity must take the form of some bodily reaction.
Your mind has no other way of expressing itself. When your mind
is relaxed, your body is relaxed too. When you are under mental
tension, your central nervous system will automatically call for a
tensing of most of the muscles of your body. This connection
between your mind and body is maintained through your nerves,
some of which stimulate the production of hormones. These, in
turn, may exert a profound influence on the state of your body.
The emotion of fear or anger, for instance, stimulates the adrenal
glands to produce hormones, which serve to ready your body to
meet a crisis at the expense of such functions as the digestive
processes. This may abolish your feeling of fatigue but impair
temporarily the digestion of your meal. But when you have been
operating under mental tension for a long time, the constant
tensing of your muscles, which automatically accompanies mental
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tension, may wear you out. It may cause muscular pains and
aches, elevate the heart rate and impede the circulation. The
result is a straining of the heart. All this together produces
general fatigue. If you are bored and have to force yourself to
carry on a monotonous task in which you have no interest, your
mind has to push your body to do it in the face of considerable
resistance. This requires much greater effort on your part than
when you have an enthusiastic interest in the task before you.
When the body rebels, much of its energy is wasted in overcoming
the resistance.
Physical activity is an effective way to discharge tension and

excessive nervous energy. It helps get your mind off the sore spot;
it provides variety, opens new avenues for your thoughts. It
relaxes the clamped-down blood vessels in your muscles and
reduces the load on the heart, at the same time stimulating
circulation as a whole and enhancing the metabolic processes. It
is therefore both relaxing and invigorating. A physically active
body can better tolerate emotional stress than one that is inactive.
When you are angry, the best thing you can do is to get up and go
for a brisk walk. Take a walk before lunch. This may help you to
forget your work and your problems. You will then enjoy your
meal and digest your food better. Before dinner, take time to relax
the tension which you have been building up throughout the busy
day. Allow plenty of time for this letdown. Leave your office or
place of work early enough so that you do not have to rush. If you
have a place to shower, take one before you leave. You will then
arrive home refreshed and ready to enjoy your family. If this is
not possible, take the trouble to undress and stretch out on a bed
or a couch for a few minutes after you get home. Then take a
shower and dress for dinner. The time you devote to this will pay
off in terms of well-being and family harmony.
Make it an absolute rule never to argue or to hold family court at

the meal table. This will upset your digestion and ruin the family
spirits. If you can, take a few minutes to talk over your family
problems after the children are off to school in the morning while
you are calm and rested. If there is any disagreement, make it a
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point to come to an understanding before bedtime. After a row,
take the initiative to make it up before you go to sleep. Then you
will all sleep better.
The purpose of life is to live, to apply all your human potential in

the act of living. Work is merely a means to that end and not an
end in itself. To function effectively is to be able to accomplish
your work well and still have enough time and energy left to play
and to enjoy life in the exciting world around you.
Just as work is a necessary part of life since it supports it, so are

leisure and recreation a part of living. Wholesome recreation
during your leisure time with your friends and family is not only
an expression of living; it also helps you work better. In any
healthy society there must be a sensible balance between work
and play. There is every reason, therefore, to schedule your
recreation as you schedule your work and to take recreational
appointments as seriously as business appointments. This
includes vacations too. Everyone needs to get away once in a
while from the same old routine, from the rut, to sean new
horizons, to view new scenery or just to have a change. A change
is refreshing. You are apt to be more efficient when you return.
The harder your work, the more play you need in order to keep up
the hard work. But when you leave work to play, you must also
leave behind the problems connected wtth the work. After a hard
day’s work, don’t bring home a briefcase full of unfinished
business to work on when you need to rest. Instead of resting as
you watch the ball game on television, you may find that you are
thinking about all the work you should be doing. In the morning
you may return to work with the briefcase full of the same old
unfinished business, frustrated instead of refreshed.
To make life enjoyable, you have to put some zest into it. Your
natural sense of humor will do this for you with a little
encouragement on your part. Nothing can quite equal the tonic
effect of good-humored, hearty laughter. Besides, vigorous
laughter is, probably the most pleasant and effective method of
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acquiring physical fitness, especially in training the chest and
abdominal muscles and the diaphragm. Laughter also improves
your respiration. Humorous books and funny shows are therefore
much better for your health than tragic dramas and mystery
books or murder stories. There is a great deal of wisdom m the
philosophy that encourages lightheartedness during meals. And
there is a sound physiological principle to support the custom of
the amusing after-dinner speaker. It has been shown
experimentally that laughter makes you relax, while frowning has
the opposite effect. In addition, laughter also has a favorable
effect on digestion by increasing intestinal motility.
8.5 Fatigue and Biological Rhythm
People are all different. But most people can be fitted into two
main categories: those who function best in the morning and
those who function best at night. The former group tend to
bounce out of bed full of energy and are most effective early in the
day, but they tend to peter out and are usually reacty for bed by
ten at night. The latter group have great difficulty in getting up.
They function poorly in the morning but pick up steam as the day
progresses, reach their peak of efficiency at night and stay up late.
For the former type, fatigue at night is natural. For the latter type,
fatigue in the morning is inevitable. Whether you belong to the
one or the other group, you are bound to find that at some point
of the day or evening you are not operating at your peak capacity.
It is, of course, advisable to devote your peak period, whatever it
may be, to work requiring the greatest concentration and to allot
the other times to routine work that demands less mental
concentration.
The precise reason for this difference in pattern of performance is

not known, but it seems to be related to individual differences in
basic biological rhythms, in the setting of the biological clock, so
to speak. It has been found that a person’s 24-hour biological
rhythm is associated with a certain pattern in his metabolic body
processes. When people are kept in continuous darkness or in
continuous light, these fluctuations still persist, showing that they
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are factors basic to the individual. But when experimental
subjects are made to live by clocks which are so constructed that
their day has only 22 hours instead of 24, some adjust their
pattern accordingly within a matter of a week or so. Instead of
living a 24-hour day, they adjust to a 22-hour day. However, this
is not true of all people.
Such individual differences in performance patterns may cause

some difficulty on the job. A late-rising, late-functioning type may
find it hard to adjust to a 9-to-5 schedule. A person who has his
brightest period in the morning may find it difficult to aqjust to a
night job. Since you cannot always change your job to suit your
biological rhythm, you may have to change your rhythm to suit
the job. For most people this is possible. If you are faced with this
problem, you have to place yourself on a regular schedule and
may have to adhere to it rigidly for as long as several weeks before
you are completely adapted. You should retire at a fixed hour
every night. You may have to use sleeping pills the first few nights
in order to break your old habits. Then arise at the fixed hour in
the morning whether you feel like it or not. Regularity is the key.
Most people will find that they will adjust within a week or ten
days.
8.6 Stimulants
In addition to your incorporating rest in the working pattern
itself, there are powerful stimulants at your disposal to enhance
the work output of your body and to combat fatigue.
8.6.1 Caffeine
One of the most popular stimulants is coffee. A cup of coffee
contains about 1 ½ grains of caffeine; a cup of strong tea contains
a little less than this. Caffeine tends to facilitate mental and
muscular effort, to diminish drowsiness and psychic and motor
fatigue. Moderate doses of caffeine, equivalent to about three
cups of coffee, may produce a quicker and clearer flow of thought
and speed the disappearance of fatigue. They may facilitate more
sustained intellectual effort, greater mental keenness and more
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efficient association of ideas. They will also increase the reaction
speed, though accuracy of movement is usually impaired by
caffeine. This effect may often last for several days.
The use of caffeine will cause no harm if limited to reasonable

amounts, i.e., less than about six cups of coffee a day. The trouble
is that nervous people, who are most liable to be adversely
affected by it, are the ones least likely to show moderation. The
bad effects of caffeine are not very serious. They consist of
nervousness, tremor, palpitation, insomnia, headache and diges-
tive disturbances.
8.6.2 Pep Pills
There are about a dozen different antidepressant drugs or
so-called “psychic energizers” for the physician to choose from.
The amphetamine preparations are the most commonly known.
The capacity of amphetamines to elevate mood and induce a
rather fictitious state of well-being is the basis for their medical
value and widespread use as stimulants. Unfortunately, this
commonly involves prolonged administration, which in many
cases leads to varying degrees of drug dependence.
Amphetamines have a great capacity to develop tolerance in the
user. This is apt to lead to the need for gradually increasing doses
to achieve the desired effect. The patient may end up taking
amounts hundreds of times greater than the original dose, which
may bring about undesirable side effects and profound behavioral
changes.
Relief of fatigue and sleepiness can be achieved temporarily by

taking amphetamines. The trouble with this is that it obscures the
natural danger signals of fatigue. Furthermore, the stimulation
may be followed by insomnia, increased fatigue, nervousness,
irritability and melancholia. Amphetamines should therefore not
be used promiscuously. They are definitely contraindicated if you
have high blood pressure or coronary disease, because they cause
a rise in blood pressure.
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Pep pills such as amphetamines clearly have no place in the
ordinary life of normal, healthy people. Their use is only justified
in extreme emergencies, such as those encountered in certain
military operations. Even then they should be administered under
close medical supervision.
8.7 Relaxants
8.7.1 Nicotine
The chief function of nicotine is its habitual use in tobacco as a
source of pleasure, to pour oil on the troubled waters of life, to
create tranquillity. Nicotine, as such, causes a short-lived
stimulation, followed by depression. In large doses it has a toxic
effect. However, most, if not all, of the desired effects of tobacco
smoking may be traced back to the habit itself, the act of taking a
smoke and the conditioned reflex involved.
Many of our life habits are built around similar systems of

conditioned reflexes. If one settles down to think or to work out a
problem, the smoker automatically reaches for a cigarette. The
less nervous thinker may reach for his pipe or a cigar instead.
This becomes part of the required ritual and setting of many
creative workers. When they give up smoking, they become lost,
irritable, restless and inefficient, until they find another way of
establishing a system of such reflexes which become part of their
accustomed etting. It may be a matter of establishing an oral
reflex by chewing gum or drinking whisky, or an auditory reflex
by playing music.
In moderation, the amount of nicotine entering the body may

have little pharmacological effect on the habitual smoker.
However, in nonsmokers even a single cigarette may cause an
increase in heart rate and blood pressure, an effect which is by no
means relaxing. Excessive smoking causes unpleasant symptoms
of acute nicotine poisoning in the form of dizziness, headache,
nausea, palpitation and perspiration, and occasionally chest pains
resembling angina pectoris.
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8.7.2 Tranquilizers
A great variety of drugs have been tried to produce tranquillity or
general sedation. Today there are at least thirty different
tranquilizers to choose from. They are being used on an
enormous scale. Tranquilizers and muscle relaxants are now
among the ten most frequently used drugs.
There is no question but that the tranquilizers have done wonders

in facilitating the control of the most difficult symptoms of
psychiatric patients. Nor is there any doubt that these drugs have
also been grossly overused in the treatment of the ordinary
anxieties of everyday life. It is in such cases of ordinary anxiety
that they are the least useful.
There may be justification for the use of tranquilizing drugs as a

first-aid measure in the treatment of cases of disabling anxiety,
but they should not be used at all for slight emotional tension or
minor anxiety states. Patients suffering from the latter might be
better off by being allowed to come to grips with their problems
and to adapt to them. There is no substitute for a proper
adjustment to life. Real tranquillity stems from emotional
balance. This has to be developed by the person himself. It is
unrealistic anyway to think that life could be entirely free of
anxiety. Some degree of anxiety develops alertness, and the tasks
of our time call for alert minds, not tranquilized cerebration.
The tranquilizing drugs are powerful agents which have

potentially harmful effects. Their common side effects include
drowsiness and impairment of intellectual and manual skills.
Prolonged use may cause motor impairments, less speed and
precision, greater fatigue and change of personality. Sedation
with large doses of tranquilizers may be unsafe for persons
operating aircraft or motor vehicles. They should be used with
extra caution by patients with peptic ulcers and gastrointestinal
irritability.
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8.8 Sleep
8.8.1 What Is Sleep?
As long as you are awake there is a great deal of activity going on
in your brain. This activity consists mainly of electrical and
chemical reactions. Complex molecules moving about, in and
around the nerve cells, are combined into new molecules, or
broken down into pieces that are put together into still new
molecules that are needed for your brain to function. The leftover
bits and pieces are gathered together and removed. New
materials are constantly brought in by transport molecules in the
blood and stacked away.
In the course of a day’s work in this hectic molecular business

center of your brain, much of its stores are depleted. Molecules
that have been used to transport other vitally needed molecules
are floating about. The remains of used molecules are piling up.
At the end of a hard day with a great deal of thinking, there may
be just as much chaos in your brain as there is in a busy
supermarket at the end of a hectic day. Although the clerks have
struggled continuously to keep the store tidy, the shelves filled
and the business in good running order, they need a few hours of
undisturbed peace to straighten out the mess.
This is more or less what happens in your brain during sleep. The
door to the outside world is shut off, so to speak. The constant
inflow of nervous impulses to your brain is slowed down so that
your brain cells can attend to their own business. They need
peace to put “their own house in order,” to recharge themselves
with energy to be ready for the next day’s business. Resting
quietly may accomplish a great deal in the way of restoration of
your body, but it does not quite substitute for sleep.
There are currently two diametrically opposed the ones

explaining the mechanism underlying sleep. The first is based on
the assumed existence of a sleep center in the brain. When this
center is activated, it supposedly sends the individual to sleep.
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The second, and most favored, theory postulates that there is no
such thing as a sleep center, but rather a waking center in the
brain. This theory proposes that stimulation of the center causes
the individual to arouse and to stay awake. Sleep is the result of
the absence of such stimulation. This would explain why physical
and mental relaxation and a toning down of external stimuli are
essential for the normal transition from wakefulness to sleep, and
for maintaining the sleeping state.
The sleep pattern fluctuates quite regularly in the course of the

night. Your deepest sleep occurs during the first hour and the
most shallow sleep toward the end of the night, just prior to
awakening. Each sleep cycle lasts for about an hour or two, so
that you are almost awake more or less once every two hours. It is
during these brief periods of very light sleep that your dreaming
occurs. It appears that most people have at least three or four
dreams in the course of the night and that there often is a certain
connection between each of the dreams.
The fact that the brain is not entirely idle during sleep is also
evident from experiments showing that a person may assimilate
information relayed to him with the aid of a gramophone record
during slumber or light sleep. But this he cannot do during sound
sleep. On the other hand, human subjects may learn to press a
button to avoid electrical shock even during profound sleep. This
shows that although you “shut the door” to the outside world
during sleep, the door is sufficiently ajar to allow some inflow of
stimuli from your environment.
During sleep your various bodily processes are slowed down to

idling speep. The metabolic rate is reduced by about 10 percent.
Respiration is reduced, as are the heart rate and the blood
pressure. the muscles are relaxed and intestinal motility is
reduced, as is the secretion of gastric juice. There is an increased
activity of the sweat glands. The blood vessels in the skin are
dilated, which is apt to give you a fresh, pink complexion white
sleep. During the awakening process there is an abrupt increase
in heart rate and blood pressure. In disturbed sleep there may be
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sudden, marked elevations in blood pressure and heart rate. This
may explain the fact that many cases of heart attack occur in
patients while they are asleep, as suggested by Dr. MacWilliams
(British Medical Journal, Vol. 2, p. 1196, 1923).
8.8.2 How Much Sleep Do You Need?
The need for sleep varies a great deal from one person to another.
It certainly varies with age. Most adults need 6 to 8 hours a night;
older persons may get along with as little as 5 hours. The best
indication that you have had enough sleep is waking up at a
regular hour on your own accord without the use of an alarm
clock, feeling refreshed and ready to go. A physically fit person
can get along with less sleep than one who is unfit, just as the fit
person recuperates more quickly following physical exertion than
one who is unfit.
The amount of sleep you need does not have to be taken all at
once, or in one stretch. Naps during the day may replace hours of
night sleep. In fact, frequent naps may be more effective than
prolonged continuous sleep. Since the first few hours of sleep are
best, a 1-hour nap may be as valuable as the last 2 hours of sleep
in the morning. You would therefore be ahead if, instead of
getting up at seven, you got up at five and took an hour’s nap in
the afternoon to replace the 2 hours’ sleep you missed in the
morning. If you are in the habit of retiring early, then there is
truth in the old saying that sleep before midnight is more
refreshing than sleep later in the night, hour for hour, because the
quality of your first hours of sleep is best.
Adequate sleep does not only depend on the number of hours you
sleep. It also depends on how soundly you sleep. This depends
partly on whether or not you are an habitually light sleeper and
are easily aroused. You sleep best in a quiet, darkened room. The
temperature in your bedroom should be between 50° and 65° F.
Experiments have shown that at this temperature most adults will
sleep soundly for 8 hours. Temperature higher than 70° to 75° F
is too hot for prolonged comfortable sleep. At temperatures below
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60° F your sleep may be interrupted because you feel cold. If you
sleep with the window wide open during cold weather in the
middle of the winter and the room temperature drops below 50°
F, your body will lose heat and you will start shivering and wake
up.
Vivid dreams and nightmares also affect the qualíty of your sleep.
They tend to keep you in a state of shallow sleep and prevent you
from sinking back into a sound, deep sleep. Going to bed on a full
stomach often aggravates this condition.
Snoring is a frequent cause of disturbed sleep when it is violent

and persistent. When you sleep, the muscles in the pharynx are
relaxed, which allows the soft palate to vibrate if you breathe with
your mouth open. The way to overcome snoring is by sleeping on
your side. If this does not help, you can certainly stop it by
supporting the jaw with a bandage around your head. Mouth
breathing is often caused by a congested nose. It may therefore
help to use nose drops to clear your nose before you go to bed.
8.8.3 How to Get to Sleep and Stay Asleep
Disturbance in the sleep pattern is one of the most common
complaints in our restless existence. Almost all of us at one time
or another have experienced some difficulty in falling asleep or in
remaining asleep. It may be due to overexcitement, worrying,
becoming too involved in a problem or simply having had too
much coffee or other stimulating beverage. Such transitory
sleeplessness is harmless. Missing a few hours of sleep or even a
whole night’s sleep is usually without consequence to your health,
even if it occurs as often as once a week. The situation usually
takes care of itself. You eventually go to sleep when you have
become too tired to stay awake. Besides, much supposed
sleeplessness is more apparent than real. You may think you have
been awake all night, when in fact you have been dozing off quite
a bit. I have heard patients insist they have not slept all night,
though they had been sound asleep and even snoring loudly when
I looked in on them.
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The more you become concerned about your inability to fall
asleep, the harder it is. “Trying” to go to sleep only makes matters
worse. If you allow yourself to get worked up, annoyed or excited
over the fact that you cannot go to sleep, a sleepless night is
almost inevitable. Some people are kept awake simply because of
fear of insomnia.
In most such benign cases of sleeplessness, all you have to do is to

relax and say to yourself that it does not really matter very much
in the long run whether you sleep or just lie there comfortably in
bed with your eyes closed. Merely lying down and allowing your
muscles to relax facilitates sleep through the slowing down of the
impulses to your brain. The quieter the sursoundings, the easier it
is.
Sleep is a part of your pattern of life. It is a habit, and as such it is

subject to conditioned reftexes. This is the basis for the various
sleep-inducing tricks with which we are all familiar: listening to
monotonous rhythmic sounds, the surge of the surf against the
sand, waves rolling against the side of the a ship, the spray
splashing against the porthole, the rocking of he ocean swell, the
whispering wind stirring the leaves, countmg sheep or the lullaby.
The common denominator in all these tricks is regularity. If you

have difficulty in going to sleep, you should adhere strictly to a
fixed schedule. Develop a pattern of behavior keyed to the
attainment of sleep. Make it a point not to become engrossed in
any serious mental work, any exciting TV shows or reading after
supper. Take your time, read an amusing book, watch a funny
show, take a long walk and go to bed at a regular hour. Be sure
that your mattress is absolutely flat and the bed large enough and
properly made. Open the window and settle down, lying on one
side with your knees bent, and think about somethmg very
pleasant, or some event that you are looking forward to.
Make a pact with yourself not to take your problems to bed with
you. If you are brooding on an unpleasant problem or building up
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emotional strain, blow off steam or get it off your chest before
bedtime. If there is something you must worry about, make it a
point to set aside 15 minutes after you wake up in the morning for
the exclusive purpose of worrying about it, preferably after your
morning exercises and after you have had your breakfast. Make it
a habit to postpone all your worrying until then. The chances are
that by that time you will find that there is not so much to worry
about after all.
If you are subject to insomnia, avoid any stimulating beverage

before bedtime; it is apt to keep you awake. A glass of red wine
kept at room temperature may be helpful. Avoid any meal or
snack within two hours of bedtime. A distended stomach is apt to
give you a restless night. Too much to drink before bedtime will
probably force you to get up in the middle of the night.
Benjamin Franklin advised his sleepless friends to get out of bed,

open the window, shake the pillow and then go back to bed and
sleep. When such tricks are effective in producing sleep, it is
probably because they set up conditioned reflexes. All condi-
tioned reflexes play an important role in producing sleep.
Many people may fall asleep easily enough and sleep soundly for
a few hours, only to wake up and not be able to get back to sleep
again. If this is your problem, the first thing to do is to see if you
can find an obvious reason for it. If you do, take steps to remedy
the situation. It may be a certain noise occurring regularly every
night, such as that of a passing train. If it is impossible to do
anything about the noise, you may try to create your own low,
monotonous noise to drown the disturbance, like keeping a fan
going or keeping the air conditioner on, if you can get used to it.
Check your room temperature and see that it is cool enough. If
you use a double bed, it may be your restless spouse moving
about that disturbs you. If so, try single beds. If you are awakened
in the middle of a dream, try to pick up the threads and continue
the dream on your own as if you were asleep and dreaming. This
may help you to get back to sleep, for it is known that a dream is
often continued from one sleep period to the next. Be patient and
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stay where you are, relax and keep your eyes closed rather than
getting up or putting on the light toread, since activity will
produce a nervous stimulation that will keep you awake. Breathe
deeply or, better still, yawn. Remember, the best setting for sound
sleep is a quiet, dark and cool bedroom, a comfortable, roomy
bed, anda relaxed mind anda physically tired, healthy body.
Chronic insomnia may occasionally be a symptom of organic

disease, but such conditions are quite rare. Physical ailments,
especially those accompanied by pain or discomfort like migraine
headache, asthma or arthritis, may be a cause of disturbed sleep.
The approach in such cases is medical care for the underlying
disease. In the majority of cases, however, persistent insomnia is
the result of emotional disturbances, tension and anxiety. It
requires proper medical care and should not be subject to lay
experimentation.
Most of the over-the-counter sleep preparations are of little or no

value in severe insomnia. Some of them may be dangerous if
abused. Such preparations generally contain antihistamines,
scopolamine or bromide. Some of them contain salicylates or
vitamins. Antihistamines are particularly effective in treating
allergic conditions. Their ability to produce drowsiness is an
undesirable side effect, and these drugs should not be used to
treat insomnia. Their other side effects include dizziness, blurred
vision, nervousness and blood changes. Furthermore,
antihistamines are only slightly more effective than sugar pills in
producing sleep. They should not be used for the treatment of
insomnia. Besides, you may build up a tolerance for the drug.
Scopolamine is a toxic substance that may produce severe
symptoms and precipitate acute glaucoma in susceptible persons
because of its ability to increase intraocular pressure. Overdosage
of bromide may produce mental disorders. Salicylates are
effective in the treatment of pain but are not drugs to produce
sleep. None of the vitamins have any hypnotic effects.
Barbiturates are sedative drugs which in the hands of a physician
are safe. In most cases they are effective agents to induce sleep,
dull apprehension and obtain tranquillity in patients who need
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such medication. Barbiturates in therapeutic doses usually bring
on natural sleep within 20 to 30 minutes, lasting about 6 to 8
hours. Such sleep is no different from natural physiological sleep.
You usually awaken refreshed, but you may not be as alert as
usual. Some drowsiness may persist during the day, and mental
functions, including attentiveness, may be impaired. The real
disadvantage is that there are marked individual variations in
response to the same dosage. The response may also be quite
variable from time to time in the same individual. If you have
previously received large amounts of barbiturates and are given
the drug again after a period without it, you are likely to exhibit
an exaggerated response. There is a relatively small liability of
addiction with small doses. But there is always the danger of
becoming dependent on the drug out of fear that you will be
unable to sleep without it. You may keep taking the drug more
and more often and in increasing doses as your tolerance for
barbiturates develops. Finally, toxic symptoms may appear. Such
symptoms include acute depression, neurosis, clouding of
consciousness, euphoria or irritability.
It should be borne in mind that sleeping pills are artificial aids.

They are crutches which relieve the symptoms without solving the
underlying problems that cause insomnia. People frequently
become unnecessarily concerned over their apparent inability to
go to sleep. And so they reach for the sleeping pill to secure a
good night's sleep. If one pill does not work, they may reach for
more until they have taken too many. To overcome their lassitude
the following day, some patients may resort to pep pills to get
them selves fully awake. If they take too many and become too
excited, they may be tempted to take a tranquilizer before the day
is over to restore the balance. Such patients are constantly
walking a tightrope, balancing sedatives against pep pills, at the
expense of their health. Yet all they may actually need is some
vigorous physical exercise, for there is no better sleeping pill than
physical fatigue.
To sleep more than you need does not do you any more good than
to sleep just enough. If you awaken of your own accord refreshed
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in the morning and go to bed at night when you are sleepy after
having felt alert all day, you can be sure that you are getting
enough sleep. There is nothing to be gained by trying to sleep
longer, for instance, by allowing yourself to go back to sleep again
after you have awakened in the morning. If you allow yourself to
become used to sleeping more than the usual 8 hours, you will
probably end up by sleeping longer but less soundly, and you will
have gained nothing. On the contrary, you will have wasted
valuable time.
Keep in mind that sleep is a natural function.It is the response to

a natural need of the body. If left alone, nature usually takes care
of itself. The less you worry about it, the less you interfere with it,
the better it is. You may rest assured that no one has ever died
from lack of sleep. Sleeplessness tends to correct itself.
8.9 Relaxation
Relaxation involves the release of muscle tension. All the muscles
of your body are always under some tension; they have to be,
otherwise your joints would fall apart. Some tension is good. It is
the increased persistent tension caused by overactive nerves or
overstimulation that is harmful.
To remedy this, it is necessary first to recognize that muscular

overtension may be the result of emotional tension or anxiety.
Next you must try to unwind overtensed muscles in the course of
your working day, and especially at the end of the day. This will
increase your chances of sound sleep. Make specific efforts to
arrange for the various muscles of the body to relax for brief
periods. A few minutes are usually all that is needed.
8.9.1 Relaxation on the Job
If you work in an office, and it is practical, take a few minutes
every couple of hours to put your feet up on the desk, lean back in
the chair and close your eyes. Rest your arms heavily on the
armrest and find a comfortable position for your feet so that your
ankles are relaxed. Place your back firmly against the back of the
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chair. You should now be able to feel how heavy your limbs are as
they rest without your own support on the desk and the chair.
Stay like this for a minute or so, but don’t keep watching the time.
Then pull in the stomach muscles, hold for 5 seconds, then relax.
Repeat 5 times. Take a deep breath and hold for 5 seconds, then
relax. Repeat 5 times. Lift your shoulders as high as you can, then
let them sag back into a relaxed position. Repeat 5 times. Bring
your hands up to the back of your head and massage your neck
muscles gently with the tips of your fingers, using a slow, firm,
rotary motion. Then bring the arms back into resting position.
Open and close the hands slowly and completely. Bend the fingers
backward as far as you can. Repeat 5 times.
Then stand up and let the arms hang loosely at your sides. Now
shake your arms vigorously with hands loose. This will loosen up
the wrist joints. Stand on one leg and “shake” the other leg, letting
the foot drop in the ankle joint. Then go back to work.
If you are a housewife working at home, you can use the same
relaxing exercises, except that instead of using the desk and chair
use a bed or a couch wide enough so that the arms may relax
comfortably at the sides of your body.
8.9.2 Relaxation at Home
At the end of the day, before dinner or before bedtime, take a
brisk walk for about 15 minutes. Then undress and stretch out on
your back on the bed for a few minutes. Place a pillow under your
head and a pillow under your knees. Stretch your legs and let the
ankles relax. Rest your knees completely on the pillow. Place your
arms comfortably at your sides. Relax your wrists. Close your eyes
and just lie there for a few minutes.
Turn around on your stomach, remove the pillows, and ask your
spouse to massage your neck and back gently, using a slow, firm,
rotary motion. Then get up, take a warm shower or, better still, a
warm bath, and get dressed for dinner or for bed, whichever the
case may be.
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If you have the opportunity to take a massage by a good
professional masseur two or three times a week, this may well be
worth the time and money in terms of the relaxation it produces.
Or take a sauna bath once a week. But I know of no better way to
relax than to settle comfortably in a large, wide hammock in the
sun on a balmy summer day in the garden or on the porch. You
should try it. Put a pillow under your knees, let all your limbs rest
listlessly and comfortably, let your ankles drop, your knees rest
heavily on the pillow, and relax your arms along the sides. Close
your eyes and listen to the natural sounds around you. Let your
thoughts drift aimlessly for as long as you care to.
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9 Effective Diet
9.1 Food to Build the Body
We are a product of what we eat. Elements in the food we
consume are used to build our body structures – all of them. The
same is true for all animals. If we feed a pig fish-oils, for instance,
the bacon from the pig will eventually taste fishy. It is therefore
important that we eat the right kind of food to provide the right
kind of building material for the body.
The main building blocks of your body are proteins. They are
essential in the building of new tissue structures during growth,
and to replace parts of old cells that are constantly being broken
down during wear and tear throughout your life. Proteins are
made from about twenty-two different amino acids. Of these,
eight are essential and must be a regular part of your diet. Milk,
meat and fish are excellent sources of essential amino acids. An
adult needs about 0.5 grams of protein per pound of body weight
per day. This amounts to a total of about 70 grams for an adult
man. Growing children from 2 to 14 years of age need about twice
that amount. From then on, the need declines as the children stop
growing and become adults.
Minerals are also necessary for the maintenance of your body

structures. Calcium is the major mineral constituent of your body.
It is essential for the active building up and tearing down of your
bones and teeth. Small amounts of it are also essential for normal
blood coagulation, nerve activity and muscle function. Roughly, 1
gram of calcium a day is adequate to cover your need, whether
you are an adult, a growing child or an older person. This amount
is contained in a quart of skim or whole milk. During pregnancy
the requirement may be slightly more than this, as may also be
the case during lactation.
You also need iron in your daily diet. It is an essential part of the
hemoglobin of the blood, which is the carrier of oxygen. It is also
a part of some vital enzymes. Normal adult males need to
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consume about 10 milligrams of iron a day. Adult females may
need about 15 milligrams a day. The difference is due to losses by
women during menstruation. Fifteen milligrams a day is also
recommended for growing children. The required amount of iron
is contained in a regular diet consisting of milk, eggs, meat, fish,
vegetables, fruit, bread and cereal. Liver is by far the richest
dietary source of iron.
Vitamins are needed to “grease the wheels” of your human

machinery. You need vitamin A to keep your skin healthy, to
prevent night blindness and to fend off infections. You need the B
vitamins for the sake of your appetite and digestion, to maintain a
healthy nervous system, a healthy skin, and for your metabolic
processes. You need vitamin C to keep the cells of your body
together, to strengthen the walls of your blood vessels, to keep
your teeth and gums healthy, to resist infection and so that your
wounds may heal. You need vitamin D in order to build strong
bones. As long as you live on a varied diet including plenty of
milk, fruit and vegetables, you have no reason to worry about not
getting all the vitamins you need.
9.2 Food as Fuel
Food is also fuel for your body. The energy fuel contained in
certain components of the diet are combusted in the body with
the aid of the oxygen we breathe. This combustion provides the
energy we need for all our actions. It keeps our human machinery
running. Only about one-fifth of the energy in the food we eat is
transformed into work. The rest is converted into heat. Part of
this heat is used to maintain a comfortable body temperature.
The rest of it is wasted. Energy produced by food combusted in
the body is expressed in terms of calories. One calorie is roughly
the amount of energy you need to walk about 15 steps.
Some of the food energy taken into the body is used at once, but
most of it is stored temporarily, largely as fat. This stored energy
can then be mobilized as needed, to tide us over between meals,
during a fast or during periods when we spend more energy than
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we take in. The storage capacity of the body is large enough so
that most people can starve several days without danger. The
longest fast known was for 72 days.
Of the different components of the diet, only carbohydrate, fat

and protein can provide energy. But these nutrients do not
contribute equally to the energy-yielding processes of your body.
Protein is not utilized as a fuel as long as the total caloric supply is
adequate. Under these conditions the protein is used almost
exclusively to replace the cellular material which is broken down
and eliminated through the normal process of wear and tear. It is
only when you are underfed or when you are starving that protein
has to be resorted to as a source of energy, at the expense of your
body structures. The result is body wasting. The choice of energy
fuel for the body is therefore actually limited to fat and
carbohydrate. The extent to which one or the other of these two
types of fuel is being used in the body depends on a number of
factors: the intensity of your physical activity, whether the activity
is brief or prolonged, and the kind of diet you are eating. Less fat
is burnt when you are living on a high carbohydrate diet. When
you are eating a lot of sweets, you are preventing your body from
mobilizing its own fat depots and from burning fat. The result
may be the excessive deposition of fat in the adipose tissue.
9.2.1 Alcohol
Small doses of alcohol may appear to have a stimulating effect.
The motor and psychic functions are set into more active motion;
you bubble with activity. Your sense of self-assurance grows,
though your ability to judge yourself and your actions is impaired.
This is actually the result of a depression of the psychic processes
which have a restraining influence on your behavior, such as
inhibition, thoughtfulness, judgment, observation power and
ability to concentrate. When these inhibitory functions are
suppressed, your entire behavior becomes more daring and
impulsive.
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Moderate doses, such as two or more shots of whisky, may exert a
demonstrably depressive effect on some of your intellectual
functions. Precision and accuracy suffer. Fine coordination is
impaired and you have a tendency to underestimate dangers.
The widespread use of alcoholic beverages is not entirely due to

their effects as a mood lifter. Alcohol is also largely used as a
relaxant, as a means of easing the tensions of the working day, of
relieving the pressures and the worries of work. For this purpose,
the custom of a drink before dinner may be effective. It may be of
considerable benefit if you are able to tolerate alcohol without
danger of addiction, especially as you grow older. The use of good
table wines may be of particular value and may add pleasure to
life. Some of the effects are probably due to the habit itself, the
establishment of conditioned reflexes. The mere preparation of
the customary drink before the main meal of the day, at the
termination of your daily labors, may be mentally associated with
the easing of pressure.
9.3 Energy Requirements
Any excess intake of calories over and above your body’s daily
need will be stored as fat. The result is weight gain. Caloric
requirement, therefore, is largely a matter of energy balance, of
caloric intake in relation to caloric expenditure. Caloric
requirement is directly proportional to your body size and the
degree of your physical activity. As a rough guide, ordinary
sedentary, middle-aged people need about 16 calories per pound
of body weight a day. This corresponds to about 2,500 calories for
a 160-pound man. Of this amount, about half is needed merely to
keep the life processes going; the other half is used to produce
work. The daily caloric needs of an average 160-pound, sedentary,
middle-aged man may be broken down roughly as follows:
ACTIVITY CALORIES
Sleeping, 8 hrs. at 70 cal./hr. 560
Dressing, toilet, 1 hr. at 160 cal./hr. 160
Lying, 1 hr. at 90 cal./hr. 90
Standing, 1 hr. at 120 cal./hr. 120
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Walking, 1 hr. at 250 cal./hr. 250
Sitting, 10 hrs. at 110 cal./hr. 1,100
Eating, 2 hrs. at 110 cal./hr. 220
TOTAL 24 HR. EXPENDITURE 2,500
As long as he adheres to this general activity pattern, there will be

only minor fluctuations in his caloric expenditure. And if he
regularly takes in roughly this amount of calories, his body weight
will remain the same. But as he grows older he is apt to be less
active, resulting in a gradual decline in his energy expenditure.
Consequently, if he continues to eat about the same as before, he
will no longer spend what he takes in. The difference he will
deposit as stored energy in his fat depots. Thus, if he takes in
some 350 calories more than he spends each day (the amount of
calories contained in a piece of apple pie), he will have stored
3,500 calories in 10 days. This means that he will have deposited
about 1 pound of fat in his body, for there are approximately
3,500 calories in each stored pound of fat. If this is continued day
after day, he will have gained about 35 pounds in body weight in a
year. Simply omitting a single piece of apple pie from his daily
diet would have prevented this weight gain. Or if he had kept up
his former level of physical activity, he could have continued to
enjoy his apple pie without gaining weight. It is true that it is
easier to check weight gain by eating less than by exercising more,
but it is the balance between the two that counts.
In 1958 the daily caloric allowance recommended by the nutrition

experts in the United States was 3,200 calories for a 25-year-old
man weighing 145 pounds, and 2,300 calories for a 128-pound,
25-year-old woman. In 1964 the Food and Nutrition Board
recommended a reduction in this amount to 2,900 calories a day
for the man and 2,100 calories for the woman – a cutback of 300
calories for the man and 200 calories for the woman. This
reduction was decided on because of a decrease in physical
activity and an increase in the consumption of calorie-containing
alcoholic beverages between 1958 and 1964. In my own opinion,
even these revised recommended caloric intakes are too high for
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most sedentary, middle-aged people. The reason why I believe
this to be the case is that most men and women are less active
than we think they are. Whenever we have measured the calories
actually spent by middle-aged individuals, we have come up with
figures that are lower than the generally accepted allowances.
Furthermore, it has been shown that people who attain healthy
old age are usually slightly underweight. Wartime experiences
have also shown that when people are subject to caloric
restrictions considerably below the accepted standards, they are
actually healthier than before. I therefore believe that it is safer to
recommend the intake of too few rather than too many calories,
and that the intakes for middle-aged and older men and women
should be about 200 calories less than the officially
recommended allowances.
The officially recommended daily caloric allowances in relation to

body weight are roughly as follows:
CALORIES PER DAY FOR MEN

Body weight, pounds Age 25 Age 45 Age 65
110 2,300 2,050 1,750
121 2,450 2,200 1,850
132 2,600 2,350 1,950
143 2,750 2,500 2,100
154 2,900 2,600 2,200
165 3,050 2,750 2,300
176 3,200 2,900 2,450
187 2,350 3,050 2,550
CALORIES PER DAY FOR WOMEN

Body weight, pounds Age 25 Age 45 Age 65
88 1,600 1,450 1,200
99 1,750 1,600 1,300
110 1,900 1,700 1,450
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121 2,000 1,800 1,550
128 2,100 1,900 1,600
132 2,150 1,950 1,650
143 2,300 2,050 1,750
154 2,400 2,200 1,850
9.4 Obesity
Obesity is not only a matter of aesthetics, but a health hazard that
may shorten life. This is truer for men than for women. For a
middle-aged man, each pound of overweight means an increased
chance of premature death of about 1 percent. A person weighing
from 10 to 20 pounds more than his ideal body weight (see table
on page 21) is classified as overweight. He is considered obese if
he weighs over 30 pounds more than his ideal body weight.
Changes in the body weight are, in the final analysis, the result of
the delicate balance between caloric intake and caloric
expenditure. It is a remarkable fact that in most adults this
balance between intake and expenditure is so well controlled that
the body weight may fluctuate by only a few pounds over a period
of a year in a man who consumes a total of half a ton of food in
that time.
Obesity is probably such a prevalent problem today because we

have retained our ancestors’ fondness for food but have given up
their more strenuous physical activity. In the time of our
grandparents a heartier diet was needed because of the harder
Obesity may result from underexercising or from overeating, or

from a combination of both. Let us first consider overeating.
9.5 Diet and Body Weight

Most sedentary people in our way of life find it difficult to
exercise as much as they need to in order to maintain their ideal
body weight. A certain control of caloric intake is therefore
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necessary. This control is fairly easy for those who are already
lean. All they need to do is to continue to do what they have been
doing and to keep an eye on their weight and on their waistline.
Checking your weight on an ordinary bathroom scale once a
month may be all that is needed. Or better still, check your
waistline daily by observing how tight the belt is. When it begins
to pinch, it is time to cut down on the food, or simply cut out
desserts or snacks for a month, or fast for a day every week for a
month. This may allow you to lose as muchas 3 to 5 pounds in a
month. To lose a substantial amount of weight, in the order of 20
to 30 pounds, is a different problem. It requires some serious
attention anda certain amount of sacrifice. But it is worth the
effort. Here is how we may go about it:
First: Check your weight on a reliable scale to determine the exact

magnitude of your overweight. Compare your present weight with
your “ideal body weight” in the table on page 21 in Chapter 2. The
difference is your excess weight.
Second: The next thing to do is to decide whether or not you want

to attain your ideal body weight or settle for something less than
that. The loss of some weight is better than losing none at all,
though it would be best to lose all the excess weight while you are
at it. Ask your physician what he thinks.
Third: Decide with the advice of your physician how fast you want
to lose this excess weight. This depends on your temperament,
your will power and how much stress you are encountering in
your daily life at home andat work.
WEIGHT CONTROL CHART

Directions: Indicate the desired weight reduction rate by drawing a line
on the chart. If you plan on losing a pound a week, or 20 pounds in 20
weeks, your desired weight reduction line would run from the top left
corner of the chart to the bottom right cerner. Mark your progress by
weighing yourself once a week (at the same time and on the same scale),
putting a dot in the proper square. Thus you can compare your actual
weight loss with the planned loss.
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0
12
Loss in pounds
16
20
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Weeks
The rate of weight reduction is finally set by the amount of caloric

reduction you decide upon. Most people in our society today need
about 16 calories per pound of body weight, on an average, to
maintain their desired weight. If your ideal body weight for your
height is 160 pounds and you want to stay at 160 pounds, you
need to eat: 16 x 160 = 2,560 calories.
Suppose your ideal body weight is 160 pounds, but your actual
body weight now is 190 pounds, an excess weight of 30 pounds.
Most of the excess weight is fat or adipose tissue. Each pound of
adipose tissue represents approximately 3,500 stored calories. If
you eat less than 2,560 calories a day, the difference is taken from
your stored calories to make up the 2,560 calories you spend
daily. The fewer calories you eat, the more calories you will be
drawing from your fat stores, and the faster you will lose weight.
In order to lose 1 pound a week, you need to eat 500 fewer
calories per day than you need to maintain your weight, since 500
calories x 7 = 3,500 calories, which is equal to 1 pound of adipose
tissue. To lose 1 pound per week, you should be eating
2,560 - 500 = 2,060 calories per day. A 2,000-calorie diet is given
on page 146.
143
If you would like to lose 2 pounds a week, you must eat
2,560 - 1,000 = 1,560 calories per day. An example of such a diet
is given on page 145. For those who need even more drastic cuts
in caloric intake, a 1,000-calorie diet is given on page 144.
If you are in a hurry to lose weight, you can achieve an optimum

rate of weight loss by going on a 600-calorie-a-day diet for
periods of a week ata time with a week of a 1,500-calorie diet in
between, though such a crash program should never be carried
out except under the direct supervision of a physician. The 600-
calorie diet should consist of 50 grams of carbohydrate, 75 grams
of protein and about 10 grams of fat a day. The simplest and most
economical way to accomplish this is by using a formula-type diet
prepared as follows: Mix 1 egg, 2 ounces of skim milk powder, 2
ounces of “casec” powder (made by Mead Johnson), 1 ounce of
sugar, ½ ounce of cornstarch, 1 tablespoon of instant coffee, 1
tablespoon of vanilla flavoring, with 1 quart of water, in a Waring
blender, and divide into five equal servings. Or to save yourself
the trouble of preparing this, you may prefer to buy commercial
products of similar composition.
A standard daily menu yielding about 1,000 calories would be

something like this:
1,000-CALORIE DIET
FOOD AMOUNT CALORIES
Breakfast: 350 calories
Fresh fruit or juice. 2 servings – 1 cup. 80
Eggs – cooked without fat. 1. 75
Bread or cereal. 1 slice of bread or small 70
serving of cereal.
Butter or margarine. 1 level teaspoon. 45
Skim milk or buttermilk. 1 glass – 8 ounces. 80
Coffee or tea. 0
Lunch: 260 calories
Cottage cheese, meat or ½ cup of cheese or 2 145
eggs. ounces of meat or 2 eggs.
Vegetables. ½ cup. 35
144
Fruit – raw or cooked or 1 serving – ½ cup. 40
canned without sugar.
Dinner: 340 calories
Lean meat, fish or poultry. 3 ounces (average 220
serving).
Snack: 60 calories
Fruit – raw or cooked 1 ½ servings – ¾ cup. 60
without sugar.
1,500-CALORIE DIET
Fresh fruit or juice. 2 servings – 1 cup. 80
Eggs – cooked without fat. 1. 75
Bread or cereal. 1 slice of bread or a serving 70
of cereal (1 cup prepared
or ½ cup cooked.
Milk. 1 glass – 8 ounces. 170
Coffee or tea. 0
Lunch: 570 calories
Bread. 1 slice. 70
Fruit, plain custard or plain ½ cup of fruit or custard, 100
cookies. or 1 cookie.
Lean meat, fish or poultry. 3 ounces (average 220
serving).
145
2,000-CALORIE DIET
Fresh fruit or juice. 1 servings – ½ cup. 40
Eggs. 2. 145
Bacon, crisp. 2 slices. 90
Bread or cereal. 2 slices of bread or 1 cup 135
prepared of cereal.

Coffee or tea. 0
Lunch: 565 calories
Bread. 1 slice. 70
Fruit, plain custard or plain ½ cup of fruit or custard, 100
cookies. or 1 cookie.
Meat, fish or poultry. 4 ounces. 290
Vegetables 1 cup. 80
Fruit, canned with sugar. 1 cup. 100
Ice cream. 2 scoops. 150
This diet would yield about 2,000 calories, adequate protein, and
all the necessary vitamins and minerals in ample amounts to
cover the daily needs.
In general, it is unwise to try too drastic a weight reduction for
prolonged periods. In the first place, a severe caloric restriction
over several months will cause protein to be mobilized from your
muscles, including your heart muscle, in order to supply the
needed energy for your body. Second, refeeding, especially with a
high carbohydrate diet following prolonged starvation, may
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possibly cause elevation of blood pressure and other harmful
effects. It is usually wise not to try to lose more than 2 pounds per
week. More rapid weight loss than this may cause you to be tired
and irritable. It is always wise to consult your physician before
starting a weight reduction program.
Having now decided on the rate of weight reduction and the

corresponding diet, the next thing to do is to get started. Check
your weight once a week, on the same day and at the same time of
the day, and record your weight loss on the chart on page 143.
This allows you to follow your progress from week to week. It may
make a considerable difference in your weight whether you weigh
yourself before or after a bowel movement, or before and after
emptying your bladder. It is therefore best to record the weight in
the morning after you have voided and had your bowel
movement, but before breakfast.
Take your time and eat slowly. You may find it helpful to fill the
stomach with water before a meal. Drinking a large glass of water
just as you sit down at the table may help quench the appetite.
Many obese persons are reluctant to drink water for fear that it
may add to their body weight. This is untrue. In healthy
individuals, even if they are obese, excess water is eliminated in
the urine. The body retains only what it needs.
Remember that appetite and hunger are two different things. You
can educate your appetite. But the feeling of hunger serves as a
warning device signaling that your body is in need of food. Your
appetite regulates in a more settled manner what quantities and
what kind of food you may eat. You may have an appetite for a
tasty dessert even though the main course has abundantly
satisfied your hunger.
While you may allow yourself the luxury of indulging in

something you like once in a while, it helps to stay away from
gravies, fat meat, cream, cakes and candy. It would also pay you
to go easy on liquor. If you really need your daily drink,
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remember to subtract an item from your diet which contains
about 200 calories. This is the caloric price you pay for the drink.
Each gram of alcohol burnt in your body yields 7 calories of

energy, amounting to 200 calories per ounce. This is more energy
than sugar has, and only slightly less than fat. There is, however,
one major difference between alcohol and ordinary foodstuffs. In
the case of sugar or fat, the different cells of the body burn what
they need and the rest is stored for later use. Alcohol, on the other
hand, can only be burnt in the liver. Since the rate of oxidation of
alcohol in the liver cells is limited, the combustion of alcohol in
the body proceeds at a fixed rate which cannot be speeded up.
The rest of the alcohol circulates in the blood and cannot be
stored for later use as a source of energy, as is the case with sugar
and fat. An individual may take in about 50 calories per hour in
the form of alcohol (one glass of port per hour or a highball every
two hours), without being visibly intoxicated. This corresponds to
about two-thirds of the amount of calories he needs when he is
inactive. Alcoholic consumption may therefore representa
considerable intake of calories and lead to overweight.
As you start on the reducing diet you may experience a sudden

considerable drop in body weight, followed by a more gradual
decline. This initial drop, which may indeed be encouraging, is
largely due to loss of body water. This water is regained later on
and is therefore of little or no importance in the long run. What
happens is that during the first day or two of caloric restriction,
the limited amounts of stored carbohydrate are mobilized to
cover the energy need. Since carbohydrate is stored dissolved in
water, the mobilized carbohydrate is removed from the body
depots together with the water. This water is promptly eliminated
in the urine. When you stop your reducing diet and start eating an
ordinary diet again with all the calories you need, the first thing
your body does is to replace the carbohydrate which you have
depleted while on the reducing diet, and a certain amount of
water has to be stored with it in the body. This accounts for the
rapid, transient weight gain when changing from caloric
restriction to an adequate diet.
148
Appetite-depressing drugs, unless specifically prescribed by your
physician, are not important in weight reduction. These drugs are
effective in depressing appetite temporarily. However, most
persons may soon develop a tolerance to these drugs, and after a
while they lose their effect. Side effects are common. They include
dry mouth, irritability, palpitation, restlessness and insomnia.
9.6 Exercise and Overweight
As long as you exercise enough you may enjoy good food in large
quantities. You may even gorge yourself occasionally in delicacies
without gaining weight. In fact, it is quite evident that physical
activity is the key factor in obesity.
A half-hour’s walk each day may cost you 200 calories in energy.
Over a whole year this may amount to a caloric expenditure of
36,000 calories, or about 10 pounds of body fat. While it is true
that it takes an enormous amount of exercise to lose a pound of
body fat at once (walking at 3 mph for 10 hours), it takes only a
30-minute walk every day to lose this amount in about 2 weeks.
During light or moderate work, such as walking, the energy is

supplied by fat and carbohydrate in about equal amounts. But the
longer the work lasts, the more fat and less carbohydrate are
burnt. In work lasting several hours, it is mainly fat that is used as
a source of energy. Vigorous exercise causes the adrenal glands to
produce hormones which stimulate metabolism in such a way
that the body continues to burn fat long after the exercise. Even
15 minutes of vigorous exercise causes an increase in the
combustion of fat, which may last for several hours following the
exercise. This means that if you are physically active you are more
likely to burn up your fat depots than if you are inactive.
In extremely strenuous physical work, however, carbohydrate is

the primary fuel. The reason is that in very heavy work when the
oxygen supply to the muscles is inadequate, the muscle cells can
burn only carbohydrate and are unable to utilize fat. The fitter
149
you are, the greater is your ability to supply oxygen to your
muscle cells, and the greater is your ability to burn fat from your
adipose tissue even during heavy work.
In overweight adult patients it is often possible to trace the onset

of obesity to a sudden decrease in activity. N umerous studies
have shown that the majority of obese children are far less active
than normal children, though they have no higher average caloric
intake than control children of the same height and age.
The obese person has a different attitude toward physical exertion

than do normal individuals. When we studied very obese men and
women on the stationary bicycle at the Lankenau Hospital, we
observed that they complained of fatigue and felt exhausted at
low work loads which were easily tolerated by normal individuals.
In these obese subjects there was no objective physiological sign
of fatigue or exhaustion. All available evidence indicates that the
obese person is no different from the non-obese in his utilization
of calories. When we carefully check caloric intake against energy
expenditure in obese subjects in our metabolic ward, we find that
it balances out the same way it does in any healthy individual. If
anything, a fat person tends to spend more energy than a lean
person doing the same physical exercise, since he has a heavier
body to move about.
The amount of calories expended in exercise is in direct

proportion to the amount of exercise. The exercise programs
suggested in Chapters 4-8 are primarily designed to achieve
physical fitness, but they also involve the expenditure of
considerable calories. The following figures are rough estimates
of how many calories an average person would spend in each of
the exercise programs:
Exercise program Calories

Exercise for men and women over 65 years of age 50
The Basic Program 75
The Standard Program 100
150
The Maintenance Program 150
Teh Advanced Program 200
9.7 A Weight-Reducing Program of Diet and Exercise

As I have pointed out earlier, there are only two factors involved
in weight reducing: more exercise and fewer calories. Suppose
you are overweight. Suppose, as you were reading the beginning
of this chapter, you made up your mind to lose weight. Let us say
you have decided to lose 1 pound a week by eating 500 calories a
day less than you have in the past, and have selected the
appropriate diet described earlier in this chapter to accomplish
this. You may double this weight loss if you add another 500
calories’ worth of exercise a day. Or you might have been more
ambitious and decided to lose 2 pounds a week. To accomplish
this on dietary restrictions alone, you would have to cut out 1,000
food calories a day. The chances are that this would leave you
feeling hungry. But if you could spend 500 calories more a day in
the form of exercise, you would only have to sacrifice 500 food
calories a day, probably not enough to cause hunger. Your weight
reduction will therefore be far more painless if you combine
dietary restriction with exercise.
When changing from a very inactive existence to a moderately

active regimen, such as adding an additional 500-calorie energy
expenditure to your daily schedule, your appetite does not
increase. As long as the caloric intake remains the same, the
added daily expenditure of 500 calories alone will amount to a
weight loss of 1 pound a week, or about 50 pounds in a year. Thus
the calories lost through exercise do count.
How do you go about expending an extra 500 exercise calories a

day without interfering with your busy schedule?
To start with, the daily exercise programs suggested for you in

Chapters 4-8 will take care of the expenditure of at least 100 of
those 500 calories. If in addition you make it a point in the course
of your regular work to get up and walk about for about 2 minutes
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every half-hour, you will spend another extra 100 calories.
Walking briskly for a total of half an hour a day will account for
another 200 calories. This you can manage easily by walking 5
minutes on your way to work either by walking to the station, or
from the parking lot to your place of work, or simply by walking
around the block. Do the same thing on your way home. In
addition, take a brisk 5-minute walk on your way to lunch. You
have now spent 15 minutes walking. The remaining 15-minute
walk you may take at home in the evening, perhaps by exercising
the dog. You have now spent 400 of the 500 extra calories. The
remaining 100 calories of your quota you may spend by a
combination of stair climbing and recreation. Walk 20 flights of
stairs every day. This will account for about 50 calories. The
remaining 50 calories you may take care of by playing one game
of golf a week, or by participating in two exercise periods a week
at the “Y” or by going for a 1-hour vigorous hike during the
weekend. Each of these three types of activities will cost you
about 500 calories and will make up the remaining 50 calories a
day you need to fill your quota.
I think you will find this to be a reasonable, realistic program of

weight control which almost anyone can accomplish. Combining
as it does a reasonable caloric restriction with moderate exercise,
the chances are that you will lose 2 pounds of weight a week and
feel no hungrier than usual.
9.8 Diet in General
9.8.1 Good Eating Habits
Eating the right foods is essential to health, but the effect of an
improper diet does not become apparent overnight. It may take
months or years to develop symptoms of malnutrition. It is
therefore important to develop good eating habits and to adhere
regularly to a balanced, adequate menu. This does not mean that
you cannot occasionally deviate from the regular diet; in fact,
some variety once in a while is beneficial. It helps to break the
monotony and makes life more interesting. Nor is there any
reason why the preparation of meals should be complicated. All
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you need to do is to adhere in general to a few very simple basic
rules.
Rule One: You should make it a point to include a food rich in

protein at every meal. You have a choice of meat, fish, eggs, milk
or milk products such as cheese or ice cream. This would
ordinarily provide the required amounts of proteins needed for
the maintenance of your body tissues.
Rule Two: You should eat vegetables at least once a day to secure
essential vitamins and minerals.
Rule Three: A glass of fruit juice daily may add to your intake of
ascorbic acid, essential for healthy blood vessels, bones, teeth and
gums.
Rule Four: Bread and cereal serve mainly to make up the rest of
the calories needed.
Rule Five: Since the common sources of vitamins may vary

considerably with the seasons, it is advisable to take a vitamin-
mineral pill every day during the winter, especially in northern
latitudes.
9.8.2 Undernutrition
On the whole, the problem in our society is no longer so much a
matter of satisfying nutritional requirements as of avoiding
overnutrition. But there are some exceptions, especially among
chronically ill patients. Older people who live by themselves,
especially, are apt to skip meals. For simplicity they may prefer to
use foods which do not require much preparation but which are
nutritionally inadequate. Over months or years this may lead to a
deficiency disease.
Body weights more than 10 percent below the “ideal body weight”
are usually considered abnormal, especially in young, growing
boys and girls (see table on page 21). The most common dietary
cause of underweight is inadequate caloric intake. If you are
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underweight, additional calories are therefore the obvious
treatment. A liberal intake of protein (up to 100 grams per day) is
also required to rebuild your body tissues. Frequent feedings are
advisable. An ordinary diet supplemented with cream, butter, rich
desserts and nourishing in-between-meal snacks may be all that
is needed. You will tolerate uncooked fats such as cream, butter
or salad oils better than cooked fried fats. A tall glass of malted
milk shake contains about 500 calories and may be the simplest
way to provide the added calories you need to achieve the desired
weight gain. The use of anabolic agents, derivatives of the male
sex hormones, may be effective in enhancing weight gain in
underweight older men; however, since these agents may have
undesirable side effects, it is imperative that they be administered
only under careful medical supervision.
Underweight is often caused by lack of appetite. In many cases,

especially older people, a highball or a tall mixed drink before
dinner or wine with the meal may help to stimulate the appetite
and enhance the digestion of food. Diluted alcohol in
concentrations below 15 percent increases the saliva flow and the
gastric juice secretion. This effect is more pronounced in the case
of wine than in the case of hard liquor because of the wine’s
content of aromatic substance. Alcohol in concentrations over 20
percent may, on the other hand, cause irritation of the mucous
membranes and be harmful.
9.8.3 Frequency of Meals
Most people eat three meals a day, but this may not be the ideal
schedule for everyone. The equivalent of three moderate-sized
main meals, divided into five or six smaller meals, plus two or
three snacks may be better. It has been shown that if all the
calories are supplied in one single meal a day, more protein will
be needed and a relatively larger proportion of the diet will be
converted into body fat. On a diet of frequent smaller meals the
reverse is the case. Several smaller meals may be especially
indicated for people who tend to have low blood sugar because –
since each meal stimulates the production of insulin, a hormone
154
that lowers the blood sugar– strong stimulation of insulin
production following a single large meal may result in a
subsequent drop in blood sugar. This causes a feeling of weakness
and fatigue. Some of the common late-afternoon fatigue may be
due to this. It is conceivable that several smaller meals may
maintain a steadier level of insulin production. Another
disadvantage of large, voluminous meals is that they distend the
stomach. When such a “stretched” stomach is not filled, it reacts
with a sensation of emptiness or hunger. When small meals are
taken, the stomach is apt to shrink, as it becomes accustomed to
being satisfied with smaller helpings. This may prevent
overeating. In individuals with coronary artery disease, a large
meal may precipitate an attack of chest pain; yet another reason
for small meals.
Some people have the habit of skipping breakfast. This is a bad

mistake. Several studies have shown that the omission of break-
fast results in inferior intellectual and physical productivity in the
morning compared to that of the afternoon. In several
experiments subjects who ate no breakfast but only had black
coffee showed a deterioration in physical work capacity and in
reaction time. Furthermore, it is logical to eat when the stomach
is empty, as is the case in the morning after a whole night’s fast.
Snacks of the proper kind and in sensible amounts may add to

your vigor. But they must contain the essential elements of
nutrition, especially proteins, minerals and vitamins, without
being too rich in calories; otherwise they may do you more harm
than good and merely produce weight gain. A glass of whole milk
and an apple, or a glass of skim milk andan open-face cheese
sandwich are examples of good snacks. They are nourishing
because they contain essential nutrients. Yet each of these snacks
contains only 250 calories. A bottle of soft drink anda piece of
frosted cake contain double that many calories; so do five pieces
of candy or forty pieces of potato chips. Yet they have practically
none of the important nutrients. They are rich in pure calories
without the other dietary elements which your body needs.
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The old rule of an apple a day has several benefits to offer: Apples
contain large amounts of vitamin C. They also contain a
substance, pectin, which in animal experiments has been found to
retard atherosclerosis. Apples after meals also reduce dental
decay and improve gum health in children.
9.8.4 Water
The chemical reactions taking place in your body, which are vital
to life, can only proceed as long as the various chemical
substances are dissolved in water. This is why two-thirds of the
body weight is water. In the course of a day about a quart of water
is lost through the urine, because the waste products which are
eliminated through the kidneys have to be dissolved in water
before they are excreted. Another quart of water is lost through
the skin and through the lungs. In order to maintain the body’s
normal water content, therefore, you have to take in at least 2
quarts of water each day. Of this amount, at least 1 quart is taken
in with the food you eat; the rest has to be taken in the form of
drinking water or other beverages. Since thirst is not always a
dependable guide to the amount of water you need, it is better to
drink too much than too little. Make it a habit to drink water
regularly, both after meals and in between meals –at least 5
glasses of water a day.
9.9 Summary
This discussion leaves us with the conclusion that it is the
composition of the diet, the frequency of the meals and the
intensity and duration of physical activity that determine whether
fat or carbohydrates are being used predominantly as fuel for
your human machinery. Prolonged moderate physical activity,
such as walking, mobilizes the fat from the adipose tissue and
increases the combustion of fat in your body. A similar increased
utilization of body fat also takes place when you eat a diet low in
carbohydrates. A high protein, low carbohydrate diet, plus
exercise, is therefore the best approach to weight control.
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10 Fitness for Those Over 65
10.1 The Will to Live
Your effectiveness as you grow older depends on many factors.
Heredity is one of them. Long lives tend to run in certain families.
Longevity certainly depends on your health, and health may in
part be genetically controlled too. But there is also a great deal
you yourself can do, for health and vigor at any age depends on
keeping all your organs active. As a matter of fact, many of the
known age changes may be the result of progressive mental and
physical inactivity. How well you perform, get along and enjoy life
as you grow older depends primarily on your motivation, your
outlook and your appetite for life.
The question is not how long you may live, but how much alive
you are while you do live. And if you want to enjoy life, now is the
time. Not tomorrow or the next day or when you retire. You live
but once, and to enjoy living is to live to the fullest every day, and
happy people live longest. This was shown by a recent Gallup
survey of more than 400 persons over 95 years of age. One of the
most significant findings was the fact that they were a remarkably
happy group, satisfied with their lot in life.
To live effectively is to function for a purpose. Anything short of

this is mere existence. This means that you must maintain your
interest in life and the world around you. You have to be useful to
society. This does not mean that you have to start a major project
or set the world on fire. It is often the little things that count;
minor incidents may make all the difference. A little
encouragement may be all that it takes for you to revive your zest
and to keep your interest alive. I recall seeing a 70-year-old man,
a retired dentist, come to life in our Aging Research Clinic. He
came into the office looking shabby, apathetic and depressed.
Since the death of his wife five years before he had been going
downhill. He had lost his interest in life, and no one seemed to
care. They had had no children, and he was living by himself. His
appetite was poor, he was undernourished, Apart from this there
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was nothing seriously wrong with him. He was simply fading
away for lack of a will to live.
He was admitted to the Aging Research Clinic at the Lankenau

Hospital, and given a thorough going-over. The mere attention
shown him at the clinic stimulated his interest. He was persuaded
to enroll in a physical training program and we made him
exercise. This improved his performance, made him more alert
and gave him an appetite. Admitted to the research ward and fed
an adequate diet, he soon began to look better and gradually
regained his self-confidence. We prescribed new glasses for him
so that he could read with ease. He left the hospital a different
person, nourished, groomed and motivated to take a part in life.
He engaged a housekeeper, got himself a job as a part-time
salesman of dental equipment, and took up boating as a hobby.
And all it took was a little stimulation.
10.2 The Physiology of Aging
Your body is composed of individual cells glued together into
tissues of different kinds which serve different purposes. Of these
cells there are some, such as the brain cells, that last for the entire
length of life. They are unique and indispensable; they function
day and night, year after year, without any apparent change.
Other cells, such as those of the supporting tissues, are constantly
undergoing changes, being built up and torn down and thus
renewing themselves throughout life. It is in these cells that the
major age changes may be detected.
If one of these cells is removed from the human body and made to
grow artificially in a tissue culture, it is possible to keep it alive
and to make it go on living almost indefinitely. In the living
organism, on the other hand, the life of a cell is of a definite,
rather limited duration.
The cells in most tissues of the living organism, then, undergo

certain characteristic changes with age. There is a gradual
shrinking of the active tissue substance, which is replaced by
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more passive, supporting, connective tissue. This occurs in the
muscle tissue and it occurs in the endocrine glands. The result is
that as your body ages it contains fewer active cells. The energy-
yielding metabolic processes are corrrespondingly reduced. At the
same time, changes take place in your blood vessels and your
circulatory system which may result in impaired oxygen supply to
your cells and incomplete removal of metabolic products from the
tissues. This is accompanied by a change in the enzyme systems
as well. One of the most important age changes in the tissues is a
reduced ability to regenerate, to create new cells or tissues.
Many of the age changes in the cells may be explained by the

impairment of blood circulation, which deprives the cells of
oxygen and nutrients. Vigorous physical exercise stimulates
circulation and enhances the transport of vital nutrients to the
cells. This explains why physical activity plays such an important
role in the maintenance of effective function as you grow older.
Aging is a normal process of all living matter. In man it starts at

birth and continues throughout life. Exact scientific knowledge
about the nature of the aging process is very limited. Much of
what we think we know is largely speculation. There is no doubt,
however, that significant changes do occur at the cellular level,
which determines the biological age of the individual. Profound
biochemical alterations take place in the cell itself. It looks as
though the cell eventually loses its basic vitality, as though it had
spent all its energy, or exhausted its endowed will to go on
renewing itself. It is presently assumed that this quality is
incorporated in the genetic material of the cell. This makes it even
more likely that your longevity, your ability to last, is largely
genetically controlled.
Normally some change takes place with age in all the major
functions which determine the total performance capacity in all
people. If the efficiency of the sensory, motor and intellectual
functions were plotted on a chart, it would follow a curve showing
an increase during early life, followed by a platean during
adulthood and a decline during later life. The decline may be
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delayed significantly, however, if you subject these functions to
continued stress. Recent studies have shown that there is no
significant deterioration in the intelligence of older persons who
remain intellectually active. Any decay in their mental ability, in
their learning and memory capacity, may largely be ascribed to
disuse. Continued exercise of your capacity to learn will delay the
onset of its loss. It is well known that professional proof- readers,
for instance, retain their accuracy in proofreading long after 70
years of age. I also know a manuallaborer who, after the age of 65,
by persistent practice learned to become a successful creative
writer. This shows that intellectual abilities can not only be
retained but also developed after the age of 65.
Loss of sensory function with age may impair your ability to keep
in touch with your surroundings. The progressive loss of vision
with advancing age is a most revealing index of your biological
age. At 50 there is a fifty-fifty chance that you will need glasses. At
60 most people need them. This progressive loss may be delayed
if you make it a habit always to read or work in good light. You
should avoid overstraining your eyes or taxing them to a point
where they feel painful and fatigued. Protect them from strong
sun glare by using sunglasses. Frequent headaches, indistinct
vision and a feeling of discomfort or eyestrain may be the first
indication that you need glasses or that the glasses you have are
not strong enough.
Periodic eye examination by an eye specialist at least once a year

is especially important for anyone over 65. It will permit early
diagnosis of serious eye disorders, such as glaucoma, which if
untreated may lead to blindness. It is estimated that half of the
cases of blindness could have been prevented by early diagnosis
and prompt treatment.
Loss of hearing may be as disturbing as the loss of visual acuity.

Often such hearing loss may be improved by proper medical
treatment. If not, there is no reason to be ashamed of using a
hearing aid. The chances are that you will have no difficulty as
long as you talk with only one or two persons at a time. When
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several people are talking simultaneously, you may find it difficult
to follow the conversation. To protect yourself against needless
hearing loss, have your hearing tested regularly. Ask your doctor
to clear your ears of wax at your regular visits. Blow your nose
gently, only one side at a time. Otherwise you may force bacteria
from your throat up into your middle ear and start a middle ear
infection. For the same reason, avoid swimming in overcrowded
swimming pools. If you notice any pain or discharge in the ear,
see your doctor at once. If you have to be exposed to loud noise
for long periods, use ear plugs.
Unless you continuously exercise your coordination by using your

hands in tasks requiring precision, speed and accuracy, you will
gradually lose some of your motor function as you grow older.
However, practice will improve your motor function even if you
are over 70 years old. You will also notice a remarkable
improvement in motor function as a result of as little as a month’s
regular vigorous physical exercise. This will even improve your
reaction time, an important asset when you are driving a car in.
busy traffic.
Your skin is a most revealing mirror of the aging process. It is apt

to lose its elasticity and smoothness as you grow older. It becomes
wrinkled, dry and scaling, and may lose much of its sensitivity to
touch. Too much exposure to sunlight hastens this process. Some
exposure to the sun, sufficient to give you an attractive sun tan,
will on the other hand improve your appearance and make you
look healthy. This has a great psychological effect. You can soften
the horny layer of the skin by using water-in-oil emulsions or
dispersible bath oils. This will reduce scaling and itching.
In sedentary people there is a gradual decrease of physical work

capacity after age 20. The maximum work capacity of an inactive
man at 75 is only about half that of a hoy of 17. In a well-trained,
physically fit older individual, however, the decline in physical
work capacity is very small, and an older untrained person may
improve his work capacity markedly with training, possibly
attaining a level very close to what he had as a young man. The
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same applies to muscle strength. A well-trained 65-year-old man
may be superior in physical work capacity to an untrained 35-
year-old man, which serves to show that some of the important
age changes are not inevitably a result of aging, but rather the
result of disuse and inactivity. Physical activity and physical
conditioning are the key to effective aging and a protection
against decay.
In inactive people there is a decrease in the respiratory functions

with increasing age. This is much less marked if you are
physically active. Vigorous physical exercise stimulates the
respiratory functions and facilitates proper ventilation of the
lungs. With age, many people develop the habit of breathing
through the mouth, usually owing to anatomical changes in the
nose. This causes dryness of the mouth and lips and disturbed
sleep. Mouth breathing is less efficient than nose breathing and
interferes with normal respiration and circulation. You should
therefore train yourself always to breathe through the nose. One
way to do this is to support your jaw with a bandage wrapped
around your head before you go to sleep. If your nose is
congested, use nose drops. If the problem persists, see your
physician. Occasionally the obstruction of the air passage of the
nose may be caused by a septal defect, which may be remedied by
minor surgery.
A slow, gradual decline in the function of some of the endocrine

glands may take place with age. The role of the endocrine glands
is to produce hormones, which are the chemical regulators of
many of the important functions of the body. As the hormones
are produced, they are secreted directly into the blood, which
carries them to every cell of the body where they exert their effect.
A decline in the activity of some of these glands may cause a
degrading of your functional capacity as you grow older. It is
conceivable that some of these changes in the endocrine glands
may be due to lack of use or lack of stimulation. Some of the
symptoms of impaired hormonal function may be remedied by
hormonal therapy. But this is a two-edged sword, for with the
substitution of synthetic hormones the glands are not stimulated
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to produce their own, and further decay of the glandular function
may be the result. Thus there is no substitute for stimulating your
body to maintain its normal functions naturally, as long as
possible.
Reduced activity of the thyroid gland is particularly common in

people over 65 years of age. This gland plays a major role in the
control of the energy metabolism of the body. Increased thyroid
function increases the metabolic processes; reduced function
causes a reduced metabolic rate. People with low thyroid function
may appear depressed. They react slowly and often complain of
being cold. They may have slow reflexes, impaired memory and
reduced capacity for learning. Thyroid gland deficiency may cause
fatigue, weakness and deterioration of the blood vessels. It may
also predispose to cerebral thrombosis, for reduced thyroid
function may cause a sluggish circulation of the blood. The decay
of the function of the gland may be so slow and gradual that the
individual himself is unaware of the change. As a rule this
condition can only be diagnosed by specific laboratory tests which
measure the person’s basal metabolic rate, or his blood level of
iodine or the amount of iodine his thyroid gland is picking up
from the blood to be used for the production of thyroid hormone.
Periodic, thorough medical check-ups are therefore important,
because this condition is reversible and lends itself to effective
treatment. Thyroid deficiency can be treated with pills containing
thyroid hormone. The effect of such treatment can be quite
dramatic. I recall a 75-year-old man who suffered from thyroid
deficiency. He was lying motionless in bed; his eyes were lifeless,
his voice hoarse and weak, his lips and tongue were thickened,
and his eyes protruded. After three months of thyroid treatment
he was completely changed, as by a miracle. He was up and about,
his appearance had returned to normal, and he was full of life.
There is no doubt that a gradual decline in thyroid function

slowly taking place over several decades may be responsible for
some of the changes which accompany aging. Whether the
function of the thyroid gland can be stimulated by physical
activity is not known for certain. It is my own feeling that it can.
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Vigorous physical activity causes a marked stepping up of the
metabolic processes, which may stimulate the thyroid to produce
more hormone to meet the increased requirement. If this is kept
up long enough, an adaptation may occur. The result may be a
lasting increase in the production of hormone. This is the usual
way tissues respond to stress.
In contrast to some of the endocrine glands such as the thyroid,

the ovaries undergo much more abrupt changes with age. At
menopause they suddenly stop producing eggs. But in most
women adequate amounts of female sex hormones continue to be
produced in spite of this, mainly by the adrenal glands, for the
rest of their lives. Therefore, there is no change of sexual life after
menopause. In fact, the freedom from the fear of unwanted
pregnancy may allow women to enjoy sexual relations
unrestrained as never before.
The male gonads continue to function in most men and to

produce sperm throughout the entire life span. Even if the
function of the gonads should decline, it would make little
difference, for most of the male sex hormones are produced by
the adrenals anyhow.
In some patients a state of pseudo senility may occur around the

age of 70. The symptoms are fatigue, loss of muscle strength and
lack of endurance, loss of weight, emotional disturbance and
depression. The skin becomes thin, the muscles waste, the
patients appear shrunken. This is often caused by failure of the
sex 1 hormones as well as of the thyroid hormone. In such cases,
hormone treatment under medical supervision may have a
dramatic effect in restoring health and vigor. The skin texture
improves, and pep and well-being are restored.
Male sex hormones are quite effective in increasing muscle

strength and encouraging weight gain in older men. The newer
drugs now available on prescription have much less undesirable
side effects than was the case with the original drugs. In the
hands of a physician these drugs are quite safe. There is, however,
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no justification for the theropeutic use of sex hormones to
enhance libido and sexual potency in older individuals. It is better
to stick to nature’s way of regulating body functions. Artificial
stimulation of the sexual functions may do more harm than good,
for the stimulation caused by them may be more than an aging
body can safely cope with.
The sex hormones are also necessary to protect the bones from
atrophy. Osteoporosis, a condition characterized by loss of
minerals in the bones, may in some cases be due to a relative sex
hormone insufficiency. It may also be caused by prolonged
administration of steroids produced by the adrenal glands. But
none of these factors are as important in normal bone
metabolism as regular physical activity in which the bones are
subjected to stress by the weight of the body.
In most individuals the amount of sex hormones produced, even

during the later years of life, is ample to maintain a reasonable
degree of libido and to support sexual activity. Some decline with
age is natural. But a person who was sexually hyperactive in his
younger years is also likely to maintain greater sexual activity in
old age than one who was sexually less active in his youth. A
sudden upsurge of sexual activity in old age is very unlikely.
Age has little effect on a woman’s sexual capacities until very late
in her life. Any decline in the sexual activity of the married female
is due largely to a gradual decline in male sexual functions, which
normally occurs after the age of 45. It is most marked after the
age of 65. This reduction is due to a decline in libido and reduced
sexual capacity. Kinsey found that in a group of men the average
frequency of sexual intercourse at age 50 was less than twice a
week, and less than once a week at 70. At 70 one-third of the men
were sexually inactive, and about half of them were inactive at the
age of 75. However, sexual interest and sexual relations have a
normal place in the life of the older person. Several recent surveys
have shown that almost half of the couples 60 to 90 years of age
are still sexually active.
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10.3 Preventing Illness
You become more prone to disease as you grow older. This is not
only because older people are more susceptible, but also because
the statistical chance of contracting any one disease is greater the
longer you live. There is, on the other hand, a greater chance of
developing immunity against disease the longer you live. Some of
the diseases common late in life are avoidable and may be
prevented by proper care over the years. Some may be
unavoidable but are definitely curable. But some are the results of
wear and tear. Nothing, not even the universe, can last forever.
There is a slow process of decay and dissipation of energy all
around us, as well as within us. Even if we could extend the
human life span beyond one hundred years, each one of us
eventually has to die from something.
As you become older, the chances grow greater that you harbor
hidden diseases, or ailments that do not produce obvious clinical
symptoms. Your reaction to a disease may be less pronounced
than it was in your younger days. You may, for instance, have
pneumonia without any cough or pain in the chest. You may even
have a ruptured appendix without any local symptoms. You may
fall and fracture your hip and yet be trying to walk because you
are unaware of the fracture.
Early detection of disease is the key to effective treatment. With

the modern therapeutic measures available, the chances of
satisfactory treatment are far greater than they were when you
were young. Subject yourself, therefore, to regular medical check-
ups, at least once a year, even if you think there is nothing the
matter with you. If you think there is anything wrong, don’t delay
seeing your doctor.
In addition to periodic medical check-ups, there is also a great

deal you yourself can do every day to prevent or avoid illness.
Because you tire more easily with the years, the need for more
frequent opportunities to recuperate is greater. Take regular
vacations, at least twice a year if you can. Take all the sleep you
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need, and a short nap during the day. You should not expect to
bounce back to full health and vigor after a sick spell as quickly as
you did when you were young. All this may make you more
vulnerable to the detrimental effects of both physical and mental
stress. The important point is to know your own limitations, and
to keep active without exceeding your capacity.
Nutrition plays just as important a role in your physical, mental

and social well-being as you grow older as it did when you were
young. You need about the same amount of all the essential
nutrients as you did before, but if you are inactive you need many
fewer calories. Adequate nutrition is often neglected by older
people, particularly by those who live alone. This is especially true
for single men. Lack of teeth, or dentures which do not fit
properly, as well as ailing digestion and mental depression are
largely to be blamed for this. However, the recommended or
generally accepted nutritional allowances for older and physically
rather inactive persons afford a large margin of safety, for they
need much less than the young and vigorously active. If you have
trouble chewing, see the dentist. Select food that is easy to chew
and to digest. Use ground meat or use meat tenderizers or, better
still, eat a lot of fish. Try creamed meat or chicken cut into small
pieces, mixed with potatoes and peas. If you don’t mind skim
milk, drink a quart a day. If you don’t like milk, take cheese,
cottage cheese, cheese omelet and ice cream instead. Take regular
frequent small meals, preferably four or five light meals a day.
Check your body weight every month and stay slender. Avoiding
obesity is an essential part of successful aging.
With the longer life expectancy today, it is more important than

ever to take good care of your teeth. They have to last you a great
deal longer than was the case in your grandparents’ days. Tooth
decay is not primarily a result of aging, for most of it occurs
before the age of 25. Tooth loss is largely dueto neglect. Most of
the loss of teeth may be ascribed to disease of the gums and the
tissues in which the teeth are supported, the so-called periodontal
disease, such as pyorrhea, which destroys the tissues around the
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teeth. Eventually the teeth become loose and may fall out or have
to be extracted. Some degree of this condition is present in about
half of all people by the age of 50. This ailment may affect your
appetite, your digestion of food and your nutrition. Meticulous
tooth brushing carried out properly so that the teeth and gums
are kept clean is the most effective method of prevention and
treatment. Ideally the teeth should be brushed after each meal.
Chewing a few slices of an apple after each meal is also helpful.
Regular visits to the dentist, every six months or so, for a dental
check-up and for the removal of mineral deposits on the teeth,
which damage the gums, is an essential part of oral hygiene.
Throughout this book we have stressed the importance of
physical activity and exercise in the preservation of health. They
are also a major factor in effective aging, and require healthy feet.
As you grow older your feet become particularly vulnerable,
especially if you are overweight. The majority of foot troubles can
be traced to poor shoes that didn’t fit. Above all, your shoes
should be big enough. It is especially important that they are
roomy across the toes. The sole should be stiff in order to support
your arch. They should be changed every day so that they may dry
out. When not used they should be supported by shoe trees to
retain their shape. Use bedroom slippers in the bedroom only.
They are not made to support your feet like regular shoes. Walk
barefooted whenever you can. Use foot powder every day,
especially between the toes, to keep the skin dry and to prevent
growth of fungi which may cause athlete’s foot. Stay away from
damp, cold floors to protect the circulation to your feet. Trim your
toenails carefully.
10.4 Exercise
Exercise is particularly important to the readers who are over 65
years of age. The older you are, the more exercise you need. It is
fortunate that as you grow older you can better afford the time to
exercise. There is therefore, as a rule, no excuse for being inactive.
Exercise develops endurance, it is an antidote against fatigue, it
stimulates metabolism, and it helps you to handle your fat. If
aching joints and muscles prevent you from exercising, bear in
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mind that prolonged inactivity is apt to make them worse. Stiff
and moderately painful joints usually improve with exercise. Use
the joint mobility exercises described on page 52 to get started.
Once you have limbered up, the chances are that you will have no
further difficulty the rest of the day.
Correct posture is also important. It is actually more important

the older you get, for it helps distribute the burden of your body
weight evenly on your joints. In addition, good posture supports
your morale. Physical activity, the ability to move about and go
places on your own, gives you the satisfaction of independence
and the assurance of performance.
Disease, even heart disease and arthritis, need not necessarly

keep you from exercising. On the contrary, weak, disused muscles
do not protect the joints as they should. The joints themselves
decay through disuse. In such cases, frequent minor traumas,
especially in people who are overweight, may result in damage
and degeneration of the cartilage and brittleness of the bones,
leading to stiff joints, muscular pains, osteoporotic bone changes
and arthritis. These are extremely common symptoms in older
people. The worst part of it is that these pains and aches are often
needless. Weight control, correct posture with proper distribution
of the body weight on the different joints, and regular exercise are
effective measures in warding off the development of such
symptoms.
Exercise is the most important factor in the treatment of mild

arthritis, for it helps you to maintain joint function. But it must be
carried out under the supervision of a physician. It must be
carried out regularly and faithfully. It may hurt to begin with, but
if you start gently the pains will subside as you proceed. You may
start limbering up the larger joints, such as the knee joint, while
you are stilllying in bed. This will allow you to exercise the joint
without having to put weight on it. Use the joint exercises
described in Chapter 4.
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It helps to heat the affected joints before you start the exercise. If
several joints are affected, take a hot bath; if only one or two
joints are involved, use an electric heat pad or hot compresses.
Applying them for 15 minutes on the affected joint will relieve the
pain and the stiffness. A painful joint causes the muscles, around
the joint to contract. This fixes the joint and makes motion more
painful. Heat relaxes the muscles, and thereby loosens the joint.
It also causes an increased blood flow to the affected parts, which
is healthy. If there are recurrent pains during the day, you may
repeat the heat treatment every 3 or 4 hours to obtain relief.
The electric heat pads are very convenient. The commercially

available Hydrocollator steam packs are also effective and simple
to use. Or you may use an old clean wool rag. Soak it in very hot
water, wring it out, apply it to the affected joint and cover it with
a sheet of plastic. Wrap it in a dry towel to retain the heat. Keep it
on for 15 minutes. For effective heat treatment of single joints,
you may also use a 250-watt reflector heat bulb about 2 feet away
from the skin. The period of each treatment should not exceed
about 15 minutes. Such local heat treatment is generally more
effective in the treatment of arthritis than is a change of climate.
The worst thing you can do is to keep the arthritic joint fixed in a
bent position in order to relieve pain. This will only increase your
chances of developing a stiff, crippling joint. In advanced
arthritis, drug treatment is usually necessary, but even in such
cases joint function may be restored to a point where the patient
may be able to care for himself.
Exercise is a new and vitally important treatment of coronary

heart disease. In our coronary heart patients we prefer to use the
stationary bicycle as a precise method of graded exercise. This is
by far the safest and most effective method. But in the absence of
such a device, walking is the next best method. When completely
recovered from the heart attack, start a carefully planned and
gradually increasing physical exercise program as soon as your
doctor feels that you are ready. This is usually 6 weeks after the
attack. Start by walking at a very leisurely pace a few yards each
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day. Increase the distance gradually until you can easily cover
500 yards a day. When you have accomplished this for 5 days
without dífficulty, set out to walk half a mile in 15 minutes. Do
this every day for 5 days. Then increase to 1 mile in 25 minutes
daily for 5 days. Then walk 2 miles in 1 hour each day for 5 days.
From then on, increase the distance a little each day until you are
able to cover 4 miles in an hour. Keep this up 5 days a week. It
may take you several months to reach this point, but do not push
it. Take your time, but be persistent. This exercise program, if you
can tolerate it (and this of course must be decided by your
physician), may improve your electrocardiogram and your cardiac
performance substantially. It will develop a better blood supply to
your heart and cause it to work more efficiently.
If such a program improves a sick heart, it must obviously also be

helpful in preventing the development of the disease process in
the first place. The evidence at hand suggests that this is indeed
the case.
Peripheral vascular disease, causing different degrees of

inadequate circulation to hands and feet, is also very common in
older people. The feet are most often affected, becoming painful,
especially when one walks or stands for prolonged periods. The
symptoms are usually caused by the narrowing of the arteries
supplying the extremities with blood. The only physiological way
to improve the circulation in such cases is by daily exercise which
will improve circulation and stimulate the development of new
blood vessels. Walking will do this. With your physician’s
permission, walk until you get pains in your legs and continue for
a minute or two after the pain occurs. Rest and put your feet up
for 5 minutes. Then continue for another bout. Do this every day.
Most probably you will find that you gradually can increase the
distance covered before the pain occurs, until you finally may be
able to carry on your normal daily activities without much
trouble.
It is a common misconception that if you are over 40 years of age

and unaccustomed to physical activity, you should not start
171
exercising or take up any sports. The fact is that anyone can be
trained at any age. But it is harder to start the older you are. If
you have engaged in lifelong physical activity, therefore, you are,
at a distinct advantage. But all such exercise in people over
middle age who are unaccustomed to it should be under close
medical supervision. This is a must if you have any medical
problems.
The following program is specifically tailored for men and women

after the age of 65, as a starting point. At the end of 2 months you
should be ready to start the Basic Program outlined in Chapter 4,
and to proceed from there, as you qualify, to the Standard
Program in Chapter 5, and eventually to the Maintenance
Program outlined in Chapter 6.
BODY STRETCHING TO STRETCH WAIST AND TO LIFT RIBS
Stand erect, feet parallel and apart, hands clasped behind head,
arms straight and pressed against the ears. Bend trunk to the
right, bounce or pull gently twice, then bend to the left and
bounce twice. Repeat 5 times.
FORWARD LUNGE TO STRENGTHEN THIGH MUSCLES

From a standing position, arms at your side, step forward on your
right leg, lunge by shifting your weight onto this leg, and return.
Repeat with left leg; 10 times with each leg. The position of the
172
lunging leg should be such that the thigh is parallel with the floor;
the lower leg should be perpendicular to the floor.
FROG KICK TO STRENGTHEN INNER THIGH AND ABDOMINAL MUSCLES

Lie down on your back with legs straight and feet together. Bend
knees and lift feet 6 inches from floor. Bring the soles of the feet
together while pulling them up toward your buttocks. Then
straighten legs and thrust feet apart like the frog kick in
swimming. Repeat 10 times.
STOMACH EXERCISE
Get down on your hands and knees; keep arms straight. Relax the
stomach muscles as much as you can. Then tighten the stomach
173
muscles by pulling the stomach up as high as possible, causing
the back to hump like an aggressive cat, then relax to starting
position. Repeat 5 times.
BUTTOCKS SQUEEZER TO STRENGTHEN BUTTOCKS AND THIGH MUSCLES

Lie down on your stomach and support upper body by resting on
elbows, feet 12 inches apart, heels turned out as far as possible.
Now tighten the buttocks muscles and bring heels together and
hold for 3 seconds. Repeat 5 times.
174
STRIDE STEPS IN PLACE
Start from a standing position, feet together. Hop, bringing one
leg forward, the other backward. Alternate 25 times.
STRADDLE HOPS
Start from standing position, hop and land with your feet apart,
bringing arms up to shoulder height, then back to starting
position. Start with 10 hops, add 5 hops each day, up to 50 hops.
175
RUNNING IN PLACE
Move arms vigorously, lift knees as high as you can. Start with 50
slow steps, gradually increasing to 200. Count 1 each time a foot
touches the floor; gradually increase the speed.
ROPE SKIPPING
When you have limbered up and conditioned your self by the
above program for a month, you should be ready to add the rope
skipping exercise if your physician approves. Skip on the rug in
your living room or bedroom, or on the lawn. Skip with both feet
together to start with, then eventually skip in a running fashion
with alternating feet. Start with 10 skips a day; add 5 skips each
·day until you have reached 100 skips.
176
STATIONARY BICYCLE RIDING
This is the safest method of gaining endurance and fitness for
anybody who needs carefully controlled and graded exercise. If
you can afford to buy a stationary training bicycle, do so and
install it in your bedroom. If not, you may have an old abandoned
bicycle somewhere. See if you can get the local garage to make
you a metal supporting frame which will keep the rear wheel free
from the floor while you operate the pedals. Use the bicycle
dynamo as a brake for the rear wheel to increase the load. Start
with 5 minutes a day, gradually increasing to 30 minutes a day.
Such a stationary bicycle is an excellent training aid for many

types of patients and people who are physically handicapped.
Even one-legged people can use the stationary bicycle by hooking
the foot to the pedal with the aid of a stirrup. This will make it
possible to pedal with one leg to develop strength, as well as en-
durance and general fitness.
10.5 Function
Function is the essence of life, and the healthier you are, the
better you function. But disease may not be the limiting factor in
your functional capacity as you grow older. It depends more on
the state of your mind and the strength of your motivation. This is
177
the lesson we learned from our Aging Research Clinic at
Lankenau. We could find no relationship whatever between the
number of a person’s medical maladies and his state of vitality.
Some of the persons with very few minor symptoms were more
depressed, bitter and useless than patients with as many as ten
different pathological findings. The presence of chronic disease is
therefore no deterrent to meaningful life in a well-motivated
older individual. I recall a 72-year-old salesman, who suffered
from arthritis, diabetes, high blood pressure, cancer of the
prostate and a few other maladies. Yet he was active, cheerful and
effective. He was on the road doing a little business almost every
day. Another man of about the same age had no significant
symptoms at all. He was withdrawn and negative in his appraisal
of everything. He spent most of the time sitting around doing
nothing, and was a burden to his wife and children.
We found that those who have been used to fending for

themselves all their lives are the ones who can take old age best.
Those who have always been pampered appear to be more fragile.
They apparently never learned how to overcome adversity, or
personal, social or economic setbacks. Persons who are outgoing
and interested in many things are better off than those who never
cultivated any real interest in anything but themselves, their
spouse or their children. Those who have learned to appreciate
the value of good books are infinitely better equipped to enjoy old
age than those who have never developed the habit of reading.
Watching the large number of older persons from all walks of life
parading through our Aging Research Clinic, I was impressed
with the fact that it is those who keep themselves mentally and
physically active and fit who fare best.
Stay alert arid don’t allow yourself to lose interest in the world
around you. Force yourself to cultivate interests besides your job
and your immediate family. If you. must retire, make plans well
in advance to keep yourself busy wlth something you understand
or can do well. Do not think that you have to start a second career
178
when you retire. Above all, find something to do that you enjoy
doing.
There may be many times when it may seem almost impossible

for you to do what you have to do. At times when you feel rotten it
may be very difficult to get started in the morning. But there is
only one thing to do: lift yourself out of bed by your bootstraps
and keep going. The chances are that once you have overcome the
inertia you will be all right for the rest of the day. I know a
business executive who suffered from a low blood sugar. He had
to push himself out of bed every day, in the face of a strong
temptation just to remain in bed because he felt so bad. For an
hour he would struggle with himself every morning to get going.
He would take cold showers, exercise, drink coffee and move
about in the garden. Once he got limbered up he felt fine and
could work very effectively the rest of the day.
It is essential that you remain active if you are to make the most
of life as you grow older. Each period of life has a charm of its
own and should be lived accordingly. Young adulthood with the
vigorous pursuit of action may be exciting. But the depth of each
living experience increases as life progresses. The insight
becomes more penetrating. The breadth of human awareness
widens with the years. Thus your life may become richer as you
grow older, providing you remain active and fit. Then you may
gain the benefit of maturity yet retain the fitness of youth.
179
11 Appendix of Exercises
The pages that follow contain the Basic, Standard, Maintenance,
Advanced and Over-65 exercise programs in chart form. Once you
have mastered the exercises described in detail elsewhere in the
book, these charts may be used as a convenient reference.
180
11.1 Appendix 1: The Basic Program
The Basic Program* Week One
*For detailed instructions see Chapter 4
1. JOINT MOBILITY Repeat each exercise twice.
ANKLE JOINTS Lying on your back, stretch the foot downward as
far as it will go, then bend it back. Turn the ankle
in and turn it out. Repeat with other foot.
KNEE JOINTS Lying on your back, bring knee toward the chest as
far as it will go.
HIP JOINTS Turn over on left side. Bend left knee, keep right
knee straight. Bring right leg forward, lift it
upward, bring it backward. Return leg to starting
position. Turn over on right side. Repeat the same
motions with left leg, keeping right leg bent.
LOWER BACK Lying on your back with knees bent, lift upper
body and bend forward to sitting position. If
necessary, use arms to aid you in getting up.
NECK Sitting upright, arms supporting you at each side,
bend your head slowly: backward, forward, then
sideways to the left and to the right. Rotate your
head carefully and slowly in a semicircular motion,
starting by turning the head to the left, trying to
see backward over your left shoulder, then look
straight up at the ceiling, and finally turn your
head to the right, trying to see backward over your
right shoulder.
SHOULDER JOINTS Lie down, roll over on left side, rotate extended
right arm in a circular motion forward, upward,
backward and down;, bringing the arm as far out
in all directions as the shoulder joint will permit.
Repeat once. Roll over on right side and repeat the
same motions twice with the left arm.
ELBOW JOINTS Roll over on your back, bend both arms in the
elbow joints as far as they will go, or until you
touch your shoulders with your fingertips. Repeat
once.
WRIST JOINTS Lying on your back, hold one wrist up in other
hand and rotate your wrist joint as far as you can
in all directions. Repeat with other wrist.
FINGER JOINTS Close your fists as tightly as you can, then relax
and stretch your fingers as far as you can.
2. MUSCLE STRENGTH
BACK STRETCHING Lying face down with a firm pillow under your hips
and then raising arms and legs until your body is
absolutely straight. Hold it straight for 3 seconds.
181
Repeat 3 times.
MODIFIED SIT UPS Lying on your back with knees bent and feet
hooked under a heavy object, raise the upper part
of your body into sitting position 3 times in
succession.
PUSH-UPS Men: Lying face down, hands under shoulders,
palms flat on the floor, straighten arms and lift
body, keeping back straight and only palms and
toes touching the floor. Extend arms fully, then
bend them slowly until chest touches floor. Repeat
without a stop 3 times. Breathe in as you push-up,
breathe out on your way down.
Women: Lean with extended arms against the edge
of a firm table, chest of drawers, dresser or bed.
Bend anns slowly until chest touches hands, then
extend arms fully again. Breathe in as you push-
up, breathe out on your way down. Repeat 3 times.
KNEE BENDS Raise arms forward to shoulder height, raise
yourself on toes, then bend knees slowly as far as
you can while dropping hands until fingers touch
floor. Hold for 3 seconds. Then straighten your
knees fully again. Repeat 3 times.
3. ENDURANCE
WARM-UP Jog gently 50 steps, with arms and feet moving
easily. Rest for 15 seconds.
RUNNING IN PLACE Run in place 100 steps, counting a step each time
one foot touches the floor.
182
The Basic Program* Week Two
far as it will go.
right shoulder.
once.
2. MUSCLE STRENGTH
Repeat 4 times.
183
succession.
3. ENDURANCE
RUNNING IN PLACE Lift feet about 2 inches from floor. Count one step
each time one foot touches the fioor. Run 100
steps. Rest 15 seconds. Run 100 steps.
184
The Basic Program* Week Three
far as it will go.
right shoulder.
once.
2. MUSCLE STRENGTH
Repeat 4 times.
185
succession.
3. ENDURANCE
RUNNING IN PLACE Lift feet about 2 inches from floor. Count one step
each time one foot touches the floor.
Run 100 steps; rest 15 seconds.
Run 100 steps; rest 15 seconds.
Run 100 steps.
186
11.2 Appendix 2: The Standard Program
The Standard Program* Week One
1. JOINT MOBILITY
SHOULDER ROLL Stand with feet apart, arms hanging loosely at your
sides. Rotate the shoulders by lifting shoulder
blades as in a shrug, in a circular motion. Rotate
forward 5 times, then backward 5 times.
ARM SWINGING Stand with feet apart, arms along sides; Swing
both arms simultaneously in a large circular
motion in front of the body like two propellers, 5
times from right to left, and then 5 times from left
to right.
ARM AND LEG SWINGING Stand erect, holding the edge of a table, chest of
drawers or doorknob with the right hand. Swing
left arm and left leg back and forth continuously in
opposite directions as far as you can 5 times,
counting 1 each time the leg moves forward. As the
arm and leg swing all the way out, lift yourself on
the toes. Turn around and swing the right arm and
leg 5 times.
HIP ROLL Stand erect, feet apart, hands on hips. Rotate hips
slowly in a swaying motion so that the pelvis,
viewed from above, is moved in a circular pattern
from right to left, and then from left to right, 5
times each way.
NECK BENDING Standing erect, bend your head slowly as far back
as you can, then as far forward as it will go, then
sideways to the left and to the right, trying to touch
the shoulder with the ear. Repeat. Rotate your
straight up to the ceiling, and finally turn your
right shoulder. Repeat.
2. MUSCLE STRENGTH
HALF V-SIT From a lying position on your back, arms at your
side, raise the legs and upper part of your body
simultaneously, while at the same time you slide
your hands along the thighs until the fingers touch
your knees. Hold for about 3 seconds, then return
to starting position. Repeat 5 times.
187
bend them quickly until chest touches floor.
Repeat in rapid succession 5 times. Keep breathing
regularly.
Women: Lying face down, hands under shoulders,
palm flat on the floor, straighten arms and lift
body, keeping back straight and only palms, knees
and toes touching the floor. Extend arms fully,
then bend them quickly until chest touches floor.
Repeat in rapid succession 5 times. Keep breathing
regularly.
KNEE BENDS In standing position, feet 5 inches apart, raise
arms forward to shoulder height, raise yourself on
toes, then bend knees slowly as far as you can,
simultaneously dropping hands until fingers touch
floor. Hold for 3 seconds, then straighten your
knees fully again while bringing the arms up to
shoulder height. Repeat 5 times.
HAND GRIP Grasp a small rubber ball in each hand, then
squeeze the ball as tightly as you can 5 times.
3. ENDURANCE
easily. Rest for 15 seconds
ROPE SKIPPING Jump with both feet together 50 times. Add 10
skips each day as you go along, making a total of
90 skips the last day of the week.
188
The Standard Program* Week Two
1. JOINT MOBILITY
to right.
leg 10 times.
times each way.
2. MUSCLE STRENGTH
your knees. Hold for about 3 seconds, then return
to starting position. Repeat 10 times.
189
Repeat in rapid succession 5 times. Rest 5 seconds
and repeat another 3 push-ups in rapid succession.
Keep breathing regularly.
Repeat in rapid succession 5 times. Rest 5 seconds,
and do another 3 consecutive push-ups. Keep
breathing regularly.
3. ENDURANCE
ROPE SKIPPING Jump from foot to foot, as when running in place.
Complete 100 skips the first day. Add 10 skips each
day as you go along, making a total of 140 skips the
last day of the second week. Increase speed
gradually.
190
The Standard Program* Week Three
1. JOINT MOBILITY
to right.
leg 10 times.
times each way.
2. MUSCLE STRENGTH
your knees. Return immediately to startíng
position and repeat 10 times without a halt.
191
do another 3 push-ups in rapid succession; rest 5
seconds, and finally repeat another 3 rapid push-
ups.Keep breathing regularly.
repeat another 3 push-ups in rapid succession; rest
5 seconds, and finally do another 3 rapid push-
ups.Keep breathing regularly.
3. ENDURANCE
ROPE SKIPPING Jump from foot to foot, as when running in place.
Complete 100 skips without stopping. Rest 15
seconds. Complete another 100 rapid skips,
making a total of 200 each day.
192
11.3 Appendix 3: The Maintenance Program
The Maintenance Program Daily Exercises, 5 days a week*
1. ENDURANCE
ROPE SKIPPING Start with a 1-minute warm-up period of slow
jumping, using any method of jumping you please.
Rest 30 seconds and start skipping very vigorously
at a fast rate from foot to foot, as when running in
place, and look up and keep your body erect and
the back straight. Start with 100 skips the first day;
add 10 skips each day as you go along until you are
able eventually to make 500 skips without
stopping. As you progress, increase the speed of
skipping
2. MUSCLE STRENGTH
Repeat in rapid succession 10 times. Do not hold
your breath.
Repeat in rapid succession 10 times. Do not hold
your breath.
your knees. Return immediately to startíng
position and repeat 10 times without a halt.
3. JOINT MOBIUTY
193
the shoulder with the ear. Repeat 5 times.
194
11.4 Appendix 4: Advanced Program for Men
Advanced Program for Men Daily exercises, 5 days a week*
1. JOINT MOBILITY
SHOULDER ROLL Stand erect, feet apart, arms hanging loosely along
sides. Lift and rotate shoulders in a circular motion
upward, forward, downward and backward 25
times, changing direction every 5 times.
CRAWL STROKE Stand with feet wide apart, trunk leaning forward.
Swing arms alternately as in crawl stroke 25 times,
stretching arm as far forward as you can, and then
pushing it forcefully backward as in vigorous
swimming. Count 1 each time one arm swings
forward.
ARM AND LEG SWINGING Standing erect, hold on to the edge of a table or
doorknob with the right hand. Swing left leg
vigorously forward as far as you can while at the
same time you swing the free arm backward. As
the leg is swinging forward, bounce off the floor as
high as you can with your right foot. Then swing
the leg backward, while at the same time you swing
the arm forward and lift yourself high on your toes
with your right foot. Repeat 10 times. Then turn
around and do the same thing with the right arm
and leg.
DEEP KNEE BENDS Stand with feet together, hands resting on hips.
While keeping trunk straight and raising yourself
on toes, bend knee as far as you can until buttocks
are brought as close as possible to the heels.
Repeat 15 times.
WALKING ON HEELS Stand erect, arms hanging loosely along sides. Lift
balls of feet as far from the floor as you can,
standing on your heels. When you have gained full
balance, walk 10 steps on your heels, using arms to
maintain balance.
2. MUSCLE STRENGTH
PUSH-UPS Lying face down, palms against the floor under
shoulders, with only toes and palms touching floor
and body kept perfectly straight, straighten arms
fully, then bend them until chest touches floor, 10
times in rapid succession. Remember to breathe
normally. When you can accomplish this with ease,
try to do the 10 push-ups with the hands placed as
far down toward the stomach as you can.
SIT-UPS Lie down on your back with knees bent and feet
195
hooked under a heavy chair. Stretch arms
overhead and grab hold of the feet of an ordinary
chair or stool. Lifting it with straight arms, sit up
10 times. Increase the number of sit-ups by one
every day until you can accomplish 25 such sit-ups
in rapid succession.
BODY LIFTING Sit down in a chair with sturdy armrests, grab hold
of the armrests with your hands, lift yourself by the
arms off the chair, with legs stretched out
horizontally. Hold for 3 seconds. Repeat 5 times.
CHINNING Fix a chinning bar securely in a door opening. Nail
a piece of wood under the bar attachments at each
end to prevent it from slipping. Lift yourself up by
the arms until your chin is over the bar. Increase
the number gradually until you can do 10 complete
chinnings consecutively. Then, while hanging by
the arms, lift your legs from the floor and hold
them straight in a horizontal position and do a
complete chinning. Gradually increase the number
until you can do 10 consecutive chinnings with
raised legs.
THE STOOL STUNT Place three ordinary stools in a row on the floor; lie
on your back on these stools so that your head
rests on one, your buttocks on the second, and
your heels on the third. Then lift your seat off the
middle stool, grab that stool with the right hand
and, keeping the body straight, suspended between
the two other stools, lift the middle stool over your
body, grab it with the left hand and place it back
under your seat from the opposite side.
KNEE BENDS ON ONE LEG Stand on toes, feet together, arms stretched out in
front at shoulder height; raise left leg from the
floor and stretch it out in front of you with the heel
4 inches from the floor. Holding it there, bend the
right knee slowly as far as you can without losing
balance. Change over and do the same thing
standing on the left leg. Repeat twice.
CABLE EXERCISES Use a cable consisting of two handles connected
with steel springs. This can be purchased in most
sporting goods stores. Start with one spring. As
your strength develops, add a second and
eventually a third spring. Follow exercises
illustrated in the sketches on pages 83-84. Repeat
each exercise twice.
3. ENDURANCE
196
WARM-UP Run in place 100 steps; lift knees as high as you
can, and bounce at least 4 inches off the floor. Rest
15 seconds, and do 100 straddle hops as follows:
Start with the feet together, arms at sides. Jump
into the air and land with feet about 18 inches
apart, raising arms sideways to shoulder height at
the same time. Jump back to starting position and
count 1.
ROPE SKIPPING Skip 200 times, skipping from foot to foot, as when
running in place. Each successive day add another
10 skips and continue until you have reached 500
consecutive skips without stopping. At this point
you modify the programas follows: Start by
completing 200 skips as above. Then you start
skipping with feet together, and on every third skip
you make a high jump and allow the rope to swirl
around twice before you alight. Carry on until you
have completed another 100 skips in this manner.
When you can do this with ease, you may carry on
and complete another 100 skips, but as you
continue to skip, gradually bend your knees until
you are jumping in a squatting position.
197
11.5 Appendix 5: Advanced Program for Women
Advanced Program for Women Daily exercises, 5 days a week
For detailed instructions see Chapter 6
1. JOINT MOBILITY
SHOULDER ROLL Stand erect, feet apart, arms at sides. Lift and
rotate shoulders in a circular motion 20 times, first
forward, then backward changing direction every 5
times.
ARM CIRCLING Stand erect, feet apart, arms at sides. Make large
circles with one arm at a time, keeping arm
extended, moving it like a propeller in a circular
pattern from the starting position, backward,
upward, forward and downward, 10 times; then
change direction: forward, upward, backward and
downward.
KNEE RAISING Stand erect, feet together, hands at sides. Keeping
back straight, raise left knee as high as you can,
grasp it with both hands and pull it toward body.
Then lower foot back to floor and do the same
thing with the right knee. Repeat 5 times for each
foot.
widely in a circular swaying motion so that the
pelvis, viewed from above, is moved in a circular
pattern, 5 times from right to left and 5 times from
left to right.
DEEP KNEE BENDS Stand with feet together, hands resting on hips.
Keeping back straight and raising yourself on toes,
bend knees as far as you can until buttocks are
brought as close as possible to the heels. Repeat 10
times.
WALKING ON HEELS Stand erect, arms at sides. Placing weight on heels,
lift balls of feet from floor as high as you can and
walk 10 steps on your heels.
2. MUSCLE STRENGTH
PUSH-UPS Lie down on floor, face down, hands under
shoulders, palms down. Keeping body perfectly
straight, with only toes and palms touching floor,
straighten arms fully to lift body, then bend arms
quickly until chest touches floor. Repeat without a
pause 3 times; rest 3 seconds and repeat another 3
consecutive push-ups. Rest 3 seconds and repeat 3
final push-ups in rapid succession.
SIT-UPS Lie down on your back with knees bent and feet
hooked under a heavy chair, with arms stretched
198
overhead. Keeping arms straight, sit up to vertical
position. Repeat 10 times. Add one additional sit-
up each day until you can accomplish 25 such sit-
ups with ease.
BODY LIFTING Sit down in a chair with sturdy armrests, grab hold
of the armrests with your hands, and lift yourself
by the arms off the chair with legs stretched out
horizontally. Hold for 3 seconds. Repeat 5 times.
KNEE BENDS ON ONE LEG Stand on toes, feet together, arms stretched out in
front at shoulder height. Raise left leg from floor
and keep it stretched out in front of you with the
heel 6 inches off the floor. Now bend the right knee
slowly as far as you can without losing balance.
Return to upright position, change over and do the
same thing standing on the left leg.
POWER GRIP This is a bent steel rod fitted with a handle on each
end. It can be purchased in most sporting goods
stores. Grasp the handles firmly and raise your
hands above your head. As you bring your hands
down in front of you to shoulder height, keeping
arms fully extended, squeeze the handles as closely
together as you can. Hold 3 seconds. Repeat 3
times.
3. ENDURANCE
WARM-UP Complete 100 straddle hops with arm swings as
follows: Start with feet together, arms at sides.
Jump and land with feet about 18 inches apart,
and at the same time raise arms sideways in a wide
swing and clap hands over head. Jump back to
starting position and count one.
ROPE SKIPPING Skip 100 times, skipping from foot to foot, as when
running in place. Each successive day add another
10 skips, and continue until you have reached 200
consecutive skips without stopping. Then add the
following drills: After a 15-second rest, start to skip
with feet together, and on every third skip make a
high jump and allow the rope to swirl around twice
before you alight, and carry on until you have
completed 100 skips in this manner. Rest 30
seconds. Start to skip with feet together again, and
as you continue, gradually bend your knees until
you are jumping in a squatting position. Complete
100 skips in this manner. Rest 30 seconds. Then
proceed to jump with feet together and cross the
rope in front every other time for 50 skips. Then
cross your legs every other time as you continue to
swing the rope for another 50 skips. Rest 30
199
seconds. Then hold the rope in one hand and jump
as you keep swirling the rope in a circular motion
parallel to the floor, 25 times.
200
11.6 Appendix 6: Daily Exercises for Those Over 65
Daily Exercises for Men and Women Over 65, 5 days a week*
BONY STRETCHING Stand erect, feet parallel and apart, hands clasped
behind head, arms straight and pressed against the
ears. Bend trunk to the right, bounce or pull gently
twice, then bend to the left and bounce twice.
Repeat 5 times.
FORWARD LUNGE From a standing position, arms at your side, step
forward on your right leg, lunge by shifting your
weight onto this leg, and return. Repeat with left
leg; 10 times with each leg.
FROG KICK Lie down on your back with legs straight and feet
together. Bend knees and lift feet 6 inches from
floor. Bring the soles of the feet together while
pulling them up toward your buttocks. Then
straighten legs and thrust feet apart like the frog
kick in swimming. Repeat 10 times.
STOMACH EXERCISES Get down on your hands and knees; keep arms
straight. Relax the stomach muscles as much as
you can. Then tighten the stomach muscles by
pulling the stomach up as high as possible, causing
the back to hump. Relax to starting position.
Repeat 5 times.
BUTTOCKS SQEEZER Lie down on your stomach and support upper body
by resting on elbows, feet 12 inches apart, heels
turned out as far as possible. Now tighten the
buttocks muscles and bring heels together and
hold for 3 seconds. Repeat 5 times.
STRIDE STEPS Start from a standing position, feet together. Hop,
bringing one leg forward the other backward.
Alternate 25 times.
STRADDLE HOPS Start from standing position, hop and land with
your feet apart, bringing arms up to shoulder
height, then back to starting position. Start with 10
hops, add 5 hops each day, up to 50 hops.
RUNNING IN PLACE Move arms vigorously, lift knees as high as you
can. Start with 50 slow steps, gradually increasing
to 200. Count 1 each time a foot touches the floor;
gradually increase the speed.
ROPE SKIPPING Skip on the rug in your living room or bedroom, or
on the lawn. Skip with both feet together to start
with, then eventually skip in a running fashion
with alternating feet. Start with 10 skips a day; add
5 skips each ·day until you have reached 100 skips.
201
This exercise should be carried out only under
close medical supervision.
202
IMPRESSION AND TYPOGRAPHY DATA OF PAPER EDITION:
 Format by The Etheredges
 Set in linotype Baskerville
 Composed by The Haddon Craftsmen
 Printed by Murray Printing Company
 Bound by The Haddon Craftsmen
 Harper & Row, Publishers, Incorporated
203

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BY KAARE RODAHL

Be Fit for Life: A Practical Guide to Physical Well-Being

BE FIT FOR LIFE

Illustrated by Dorothy Robinson

HARPER & ROW, PUBLISHERS

This sensible and easy-to-follow guide by a leading authority in

Formerly director of research at Lankenau Hospital, Philadelphia,

BE FIT FOR LIFE: A Practical Guide to Physical Well-Being. Copyright

Library of Congress Catalog Card Number: 64-18064

To Mary Ethel Pew

This book is based on the facts obtained from all these

I am particularly grateful to Bela Issekutz, Jr., M.D., Head of the

I am greatly indebted to Mrs. Dorothy Robinson, who has

KAARE RODAHL, M.D.

This aspect of health –the detection and treatment of disease- is a

Like other aspects of so-called physical health, physical fitness is

The reader will guess the general tenor of my answers to such

As a family man as well as a physician, with very little free time at

From my own experience with people of all ages, with youngsters,

I recall a middle-aged housewife who came to see us. She

A 50-year-old business executive, meticulous and well groomed

On the basis of a series of studies in which it was determined

Though not every reader is in a position to have a tailor-made

Mr. Jones is another matter. Any single one of the exertions

Modern medical science measures fitness, or lack of it, in terms of

His enemy is unfitness, and his enemy’s ally is the phenomenon

Like everything else in nature, stress is a relative thing: a stress

They always have been. Lacking the technology that protects

In addition, the housewife may have to perform many of her

Even greater catastrophes may await the unfit, middle-aged

The fit person has a greater margin of safety; he adjusts more

Emotions themselves are invaluable to the emotionally fit

We all know that emotions may produce many kinds of symptoms

The trouble may start with mere symptoms without evidence of

Emotional tension may play a prominent role in certain kinds of

Physical fitness in itself is no guarantee of emotional wellbeing,

In contrast, when a person moves from the heat of California to

When people move into high mountains, they experience general

When people congregate in cities, pollution of the air is

The eighteen questions in this part are designed to evaluate how

Questions I through 5 are related to your habits involving

Questions 6 through 11, concerned with rest, recuperation,

Questions 14 through 17 have to do with your state of motivation.

Gross overweight usually carries with it serious heath handicaps

DESIRABLE WEIGHT IN POUNDS TAKEN IN INDOOR CLOTHING*

I have taken great care in the development of these tests to make

TASK 2. STRADDLE HOP

2.5.3.2 Test 2. Strength

For practical purposes, you may assess the approximate strength

Men: Start in a lying position on the floor, face down, hands

From the age of about 30 there is a gradual decline in muscle

TASK 4. REACTION TIME

2.5.3.4 Test 4. Endurance, Strength and Coordination Combined

A score of 3 is excellent for anybody; most persons below 50 years

TASK 2. DRESSING TEST

Most individuals should score 2 points in this section; however,

AVERAGE SCORES ON THE FITNESS PROFILE

Now that we know roughly where we stand, where do we go from