Break exercise up or do it all at once? Both are valid options
DEAR DR. ROACH: I am a 68-year-old woman in good health, but I am overweight. For the past few months, I have been vigilant about keeping track of my diet and have been walking 13,000-14,000 steps each day. I have lost enough pounds to be noticeable. About half of my steps are on a treadmill; I started at 2.5 mph and gradually increased to 2.8 mph. I usually walk between 2 and 2.5 miles at a time. I find that I do not start to sweat until I have passed the 1-mile mark. My question: Would I get as much benefit if I divided my treadmill walks into two sessions, or should I continue to walk 2-2.5 miles at one time? -- S.M.
ANSWER: Congratulations on your exercise. That's a big investment in your health, and I am glad it is paying off for you in being able to lose a few pounds. Regular exercise of any kind improves a person's health and reduces the risk of developing many chronic diseases, even without a single pound of weight loss, so I always tell people not to get discouraged if there isn't any weight lost.
Breaking your exercise session up is perfectly fine, and you should get just about the same overall health benefit from breaking it up as doing a single session. Many of my patients find it easier to break up their exercise sessions into two or more sessions a day. Whatever works best for you and that you will keep up with is best.
DEAR DR. ROACH: Regarding shingles, is there a chronological benchmark for older people where shingles vaccination in no longer a major concern and/or provides no longer needed protection? -- J.Q.
ANSWER: There is no upper age limit for the shingles vaccine. The risk of complicated shingles continues to increase with older age, meaning that older people are more likely to develop postherpetic neuralgia, which is a terrible and life-altering pain syndrome that may develop after a case of shingles. Worse, the older a person is, the longer the pain may last. For this reason, the vaccine is even more important for our oldest people. Having seen several patients in horrible pain after shingles, I am a very strong proponent of the vaccine.
Of course, if a person has a very poor life expectancy due to another condition (such as terminal cancer), it may not be worth the day or two of sore arm and feeling unwell that each dose of the shingles vaccine may cause. Otherwise, the shingles vaccine is recommended for all people over 50, but even more critically for those 70 and over, if they have not gotten the new, two-dose recombinant shingles vaccine, Shingrix. Even people who have had the older, one-dose vaccine (Zostavax) should get Shingrix. Even those who have already had shingles should get the vaccine. Finally, even those who don't recall getting chickenpox as a child should get the vaccine. It's two doses, with the second dose two to six months after the first. No vaccine is perfect, but Shingrix is about 91% effective at preventing postherpetic neuralgia.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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