Diet and Exercise

Home Exercise Program

We encourage your interest in a home exercise program. The important thing to remember is to start slowly, exercise regularly, and gradually increase the exercise time and intensity. You will gradually feel the benefits regular exercise can have on your level of energy, your flexibility, and your overall feeling of "well-being."

Recommended Dress For Exercise

Dress in loose, comfortable clothing made of lightweight breathable material. Remember, your body temperature will increase as you exercise, so be careful not to overdress. During cooler months, wear layers of clothing, which you can easily remove during your exercise. Make sure you wear a comfortable supportive pair of walking shoes with a pair of absorbent athletic socks. Your shoes should fit your feet well, should not slide up and down on your heel, but should still allow for toe movement while walking.

Beginning Your Exercise

Take your resting heart rate. Slowly and gently do warm up stretches for approximately 10 minutes. This will help prepare your muscles for exercise and help prevent injury. The end of your warm up should consist of walking around at a normal pace (or bicycling slowly) for at least 5 minutes.

Increase your walking (bicycling) speed and walk (cycle) briskly for approximately 20 minutes within your target heart rate range (THRR see page 2) for the best benefits. Take your heart rate every 10-15 minutes to make sure your heart rate is within your THRR. Using your THRR or ratings of perceived exertion (RPE see page 2) will help guide you in changing your speed. Also, increasing your exercise time builds endurance, and helps to decrease blood pressure, blood lipids, body fat, and stress.

Begin your cool down. Your cool down should take approximately 10 minutes. You need to walk slowly, taking slow deep breaths, and exhaling slowly for several minutes. Again, do some gentle stretches. This will help reduce muscle soreness. To finish your cool down get in a comfortable position and continue to take slow, deep breaths until you feel rested and your heart rate is within 10 beats of your pre-exercise resting heart rate. This will mean you are sufficiently cooled down.

Your Target Heart Rate Range

The goal during your exercise program is to keep your heart rate within your THRR. You receive the best benefits in this range. Based on your treadmill test, your THRR is _________ beats per minute. This is 80% of your maximum heart rate. When beginning your exercise program, aim at the lowest part of your target range. Then gradually build up to the higher part of your target range. To know what you heart rate is during exercise, you must find your pulse.

How To Take Your Pulse

Each time your heart beats, blood is pushed through your arteries creating the pulse you can feel at your neck or wrist. Your heart rate is the number of times your heart beats per minute. To take your pulse:

Have a watch with a second hand in a place where you can see it clearly. It is usually best to have a watch with a "sweep second hand" when you are first learning to take your pulse.
Use your middle and ring fingers of one hand. Place the tips of these fingers firmly along the area shown in the drawing. (You may also find your pulse up and to the side of your "Adam's apple" area in your neck. Press very gently when you are using this site, and touch only one side of your neck at a time.) Concentrate on the end of your fingers as you hold them still on the pulse site. When you feel the pulse against your fingers, concentrate on the rhythm of the beats. Once you get used to the rhythm of the pulse beat, pick your starting point on the clock, and count the beats for a full 10 seconds. Once you have found the number of beats in 10 seconds, multiply by six to find beats per minute.
When you stop exercising to take your pulse, it is best to check it for only 10 seconds. This ensures the most accurate estimate of your heart rate during exercise. With practice, you will be able to find your pulse, count it, compare it to your target rate, and resume your exercise quickly without many pauses in your workout.
If your pulse is irregular or becomes irregular with exercise, you should contact your doctor if this is a new finding before proceeding with your exercise program.

Ratings of Perceived Exertion (RPE)

1+ Light, barely noticeable
2+ Moderate, bothersome
3+ Severe, very uncomfortable
4+ Most severe or intense pain ever experienced

This is a scale for rating your exertion. Perceived exertion is the overall effort or distress of your body during exercise. It may be beneficial for persons who find it difficult to take their pulse, who do not have access to a clock, who have a low level of fitness, who have pace makers, or those taking medications which suppress their heart rates. The rating of perceived exertion (RPE) scale is a tool used to quantify the feelings or sensations experienced during exercise. These feelings indicate the level of effort being exerted during your exercise. To use the scale, estimate the degree of your symptoms according to the scale (degree of chest pain, burning, discomfort, shortness of breath, leg discomfort/pain, or fatigue).


Warm-up stretching increases the flow of blood to the working muscles and encourages the gradual increase of your heart rate. Stretching also helps avoid injuries to the muscles and joints you will be using during exercise. All of these adjustments are necessary for your body to move smoothly from rest to the aerobic phase of your workout. The purpose of a cool-down is to allow your heart rate and blood pressure to slowly decline, back to your pre-exercise values. Your cool-down removes byproducts from the working muscles and also helps redirect the flow of blood from your extremities back to your central circulatory system. When doing the following stretching exercises, or any others, it is important not to bounce. You want your stretches to be slow and relaxing. When you feel a pulling sensation, hold your stretch at that position for five to ten seconds, then relax. Repeat each of the exercises two to three times. You also need to become aware of your breathing during a stretch. Do not hold your breath, but exhale or breathe normally while stretching.

To stretch your neck: Relax your shoulders. Bend your head to one side, then to the other, then forward. Never lean your head back, this puts too much pressure on the discs in your spinal column. Also, turn your head to the right and left.
To stretch your side: Stand with feet shoulder width apart, and keep your knees slightly bent. Reach one arm overhead toward ceiling. The other arm should be on your thigh, to help support your back. Do not allow your waist to twist forward or backward.
To stretch your shoulders and upper back: Arm circles can done with arms stretched out straight or with elbows bent and hands on shoulders. Circle forward and backward.
Once you are through with the circles, round out your shoulders, extending your arms out in front of you. Clasp you hands.
To stretch back of leg and hip: Step one leg back and bend your front knee over your ankle (not over toes). Feet should be flat on the floor. (Do not bounce) Alternate legs.
To stretch thigh: Stand up, or lie on your side. Then bend your leg and grab the ankle with your hand. Try to keep your knee in line with your hip. Pull your foot and leg back toward your buttock. Alternate legs.
To stretch back of leg and lower back: Sit upright on the floor, with one leg extended. Bend the other knee and put the heel of that foot next to the extended thigh. Pull your toes back toward your shin. Keeping your knee straight, reach both hands toward extended foot. Alternate legs.
To stretch back of leg and lower back: Lie with your back to the floor. Bend one knee and put that foot on the floor. Bring the other leg straight up and clasp your hands behind the knee. With extended leg, pull your toes back to shin. Also, you may rotate your ankles.
While still on the floor, bring both knees to your chest and hold. Clasp you hands behind your knees.

Healthy Diets

Your physician has ordered nutrition management as part of your overall healthcare prevention needs or specific medical treatment needs.
If you need further assistance with these recommendations, ask you doctor to refer you to a registered dietitian (R.D.) who can help you with additional nutrition education, cooking suggestions, shopping tips, menu planning, and individualizing a diet to meet your lifestyle needs.
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Smoking Cessation

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