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Health and Fitness Targets

Author: Stan Reents, PharmD
Original Posting: 05/06/2007 12:43 PM
Last Revision: 01/22/2019 11:13 AM

(EDITORIAL NOTE: Some of the reviews you will find here at AthleteInMe.com® are fairly lengthy and detailed. This is intentional, as we want to provide you with information that you can directly apply to your lifestyle or training routine. In this discussion, however, I will simply list recommended health and fitness "target." without an extensive review of published research. Please consult with your personal physician before starting a new exercise program.)

FITNESS DEFINED

So, how is "fitness" defined? Too often the muscled-up body-builder is regarded as the epitome of fitness. But can this person run a 5-K in under 25 minutes? What would his finish time be in an average triathlon? Can he bend at the waist and place his palms flat on the floor?

Some football players can bench-press enormous amounts of weight. But a pole vaulter or gymnast might be able to do 3 times as many pull-ups as the football player. So, who is stronger?

VO2max is an assessment of aerobic fitness. The NFL uses a bench-press test to assess muscular strength. The military has its own set of fitness standards. So there are many ways to define fitness.

The body-builder may not be all that "healthy" either. For example, what is his/her resting heart rate and blood pressure? In fact, there is evidence that weight-lifting can actually have detrimental effects on the cardiovascular system (DeVan AE, et al. 2005). And body fat percentages less than 7-8%, which some body-builders strive for, are also unhealthy. So, don't judge an "athlete" by how he or she looks. Although someone might look healthy, their physique doesn't tell the whole story.

Typically, fitness is assessed by measuring the following 5 parameters:

  • cardiopulmonary (aerobic) capacity
  • muscular strength
  • muscular endurance
  • flexibility
  • body composition

In addition to those 5, I propose that "balance" also be included in assessing a person's fitness. Balance becomes much more important to a person's health as they age. This topic is discussed in "Balance: An Overlooked Aspect of Fitness?"

Each of these parameters is reviewed in detail in the series "Measuring Fitness" (see Articles) so they will only be discussed briefly here.

FITNESS STATS FOR THE "AVERAGE GUY"

The May 2004 issue of Men's Health magazine listed fitness stats for "the average guy" (sorry, no data were provided for women....). Although these measurements were obtained from males ages 18 - 24 years, at the very least, they give us some place to start.

The "average guy":

  • stands 5' 9" and weighs 181 lbs
  • has a body fat percentage of 19.7%
  • was in the best shape of his life at age 23
  • works out at a gym 115 times per year
  • can do 27 pushups
  • can bench-press 93% of his body weight
  • can do 36 crunches in 1 minute
  • has a vertical leap of 19.5 inches
  • has a 41-inch chest
  • has 13-inch biceps
  • has 20-inch thighs
  • can run 1.5 miles in 12.5 minutes
  • has a VO2max of 42 ml/kg/min
  • can reach 1.5 inches beyond his toes while seated

The Men's Health article also mentions that the "average" guy will:

  • lose 1 lb of muscle mass each year (if sedentary)
  • experience a 1% drop in testosterone level each year after age 40

MILITARY FITNESS STANDARDS

Even if you're not in the military, you might be curious how you measure up against their standards...

In 2012, we came across this: the "Navy SEAL Screening Test." Each activity is performed sequentially (ie., as one continuous test) in the order it is listed, with rest periods as specified:


ACTIVITY STANDARD FOR
NAVY SEAL
SCREENING TEST
• Swim (breast and/or side-stroke) 500-yd swim in < 12:30
followed by a 10-min rest, then...
• Push-Ups 42 push-ups in 2 min
followed by a 2-min rest, then...
• Sit-Ups 50 sit-ups in 2 min
followed by a 2-min rest, then...
• Pull-Ups 6 pull-ups (no time limit)
followed by a 10-min rest, then...
• Run (wearing boots & long pants) 1.5 miles in <11:30

Keep in mind, that's just the "screening" test!

CARDIOVASCULAR (AEROBIC) FITNESS

VO2max is the laboratory assessment of aerobic fitness. However, it's a somewhat uncomfortable and inconvenient test.

Heart rate is a very simple, yet very useful indicator of your level of cardiovascular fitness. Everyone should know how to take their own pulse.

Resting Heart Rate Reflects Aerobic Fitness

Athletes with a high level of aerobic fitness (eg., cross-country skiers, marathon runners, triathletes, cyclists, etc.), often have a resting heart rate slower than 60 bpm. For example, in the 1970's, the great tennis player Bjorn Borg was reported to have a resting HR of 38. Back then, a HR this slow was considered an anomaly. Today, it is recognized that aerobically-fit athletes routinely demonstrate a very slow resting HR. The lowest value ever measured was in Tour de France cyclist Miguel Indurain: 28 beats per minute!

Several studies have shown a clear relationship between resting heart rate and how far athletes ran per week (Williams PT. 1996):

Miles run per week / resting HR:

MILES RUN RESTING HR
(females only)
0-10 miles/wk 69
10-20 miles/wk 66
20-30 miles/wk 65
30-40 miles/wk 63
40-86 miles/wk 61

A resting HR less than 60 bpm in an aerobically fit person is not harmful; it simply means the circulatory system is more efficient at delivering and using oxygen. Nevertheless, even elite athletes have limits to how slow their HR can be before medical issues arise.

Resting Heart Rate Also Reflects Poor Cardiovascular Health!

Medical students are taught that a heart rate of 60-90 beats per minute is "normal." However, curiously, no age-related population norms exist for resting HR.

Just as a healthy and strong cardiovascular system allows the heart to beat at a more relaxed pace, the resting HR in a person with poor aerobic fitness beats at a faster rate. A resting HR of 75 or higher has been associated with an increased risk of sudden cardiac death (Jouven X, et al. 2005).

As long as you don't feel lightheaded when you stand up, and/or are not taking beta-blockers, digoxin, diltiazem, or verapamil, a resting HR of 60-70 bpm is desirable. If you are performing aerobic exercise regularly and your pulse is less than 70, you can feel confident that your cardiovascular system is pretty healthy!

So, learn to monitor your resting HR. True resting HR is taken just as you wake up in the morning, even before sitting up in bed. No alcohol should be consumed the night before. This topic is discussed in greater detail in: "Heart Rate, Exercise Intensity, and Training".

Recovery Heart Rate

How quickly your heart rate slows down after exercise ends is also regarded as an important indicator of health and aerobic fitness. A healthier cardiovascular system "recovers" more quickly. Recovery HR is taken 60 seconds after exercise ends and is compared to peak HR during exercise. This topic is also discussed in detail in the related story "Heart Rate, Exercise Intensity, and Training".

MUSCULAR FITNESS

Muscular fitness is determined by assessing both strength and endurance. The bench press is commonly used to assess muscular strength whereas exercises such as pull-ups and push-ups assess muscular endurance. Obviously, as we age, it becomes more difficult to attain the same physical limits as we did when we were in our twenties. So, it is important to consider age when developing fitness targets for the general population.

Muscular Strength

The NFL uses a 225-lb bench-press test to assess strength. In 1999, Justin Ernest did 51 reps! But, this test is not realistic for the average weekend warrior. There are 2 ways to assess muscular strength: (a) the one-repetition maximum (1-RM) and (b) estimation using sub-maximal weight.

During the 1-RM test, weights are progressively added until the subject can only perform 1 repetition with good form. Because this kind of test can be risky, it is safer to estimate the 1-RM by measuring how many reps of a specific weight can be performed. Warpeha offers this table for estimating 1-RM:


No. of Reps % of 1-RM Multiply Wt. Lifted By:
1 100% 1.00
2 95% 1.05
3 93% 1.08
4 90% 1.11
5 87% 1.15

So, if you can bench-press 120 lbs. 5 times (with good form!), then, your 1-RM would be: [120 lbs] x [1.15] = 138 lbs.

Muscular Endurance

The American College of Sports Medicine (ACSM) has established population norms for the push-up test for men and women. These fitness charts are available in the excellent book ACSM Fitness Book (see below). "Average" values for men and women in the push-up test are:


AGE MALES FEMALES
20-29 yrs 24-29 push-ups 16-21 push-ups
30-39 yrs 19-23 push-ups 14-20 push-ups
40-49 yrs 13-18 push-ups 12-17 push-ups
50-59 yrs 10-13 push-ups 9-12 push-ups
60-69 yrs 9-10 push-ups 6-11 push-ups

The military also has specific fitness cutoffs. For example, in July 2010, the Air Force adopted new fitness standards. Many different parameters are evaluated, and each one is graded on a sliding scale. These points are then totaled for the final ranking. The Air Force push-up test evaluates how many push-ups can be performed in one minute. To get a perfect "10" (on a 10-point sliding scale), soldiers must perform as follows:

AGE MALES FEMALES
<30 yrs 67 or more 47 or more
30-39yrs 57 or more 46 or more
40-49 yrs 44 or more 38 or more
50-59 yrs 44 or more 35 or more
60+ yrs 30 or more 21 or more

In the elderly, a sit-to-stand test is used: This test counts how many times a person can stand up from a seated position in a specified amount of time.

FLEXIBILITY

The most common test for determining flexibility is called the sit-and-reach test. To perform this test, the person attempts to touch their toes while seated on the floor, with legs straight out in front, toes pointing up. A measurement is made by determining how far their fingertips reach on a scale. This measurement is compared to a table of population norms. These age-group norms can also be found in the ACSM Fitness Book (see below).

HEALTH TARGETS

We've already discussed heart rate. Measuring your heart rate before, during, and immediately after aerobic exercise can tell you about not only your fitness, but, also, your cardiovascular health. It turns out that blood pressure, body composition, and just a couple lab tests also provide a lot of information about your general state of health:

Blood Pressure, Resting

In an otherwise healthy person, resting (ie., while sitting) BP should be no higher than 120/80. A systolic BP of 120-129 is considered "elevated." When systolic BP reaches 130, or diastolic BP increases above 80, a person is said to have "hypertension" (Whelton PK, et al. 2018).


CATEGORY
(adults)
BLOOD PRESSURE CUTOFFS
Normal less than 120/80
Elevated • Systolic BP 120-129
AND
• Diastolic BP less than 80
Hypertension: Stage 1 • Systolic BP 130-139
OR
• Diastolic BP 80-89
Hypertension: Stage 2 • Systolic BP 140 and above
OR
• Diastolic BP 90 and above

Blood Cholesterol and Triglycerides

Many people know their cholesterol level. This number is likely to be their "total" cholesterol. By itself, the total cholesterol value is not very useful. It's more important to know the "LDL-cholesterol" value and the "HDL-cholesterol" value. LDL, the "bad" cholesterol, can be lowered by limiting saturated and trans fat and refined carbohydrates in the diet. HDL, or "good" cholesterol, can be increased by regular aerobic exercise.

• Total Cholesterol:

TOTAL CHOLESTEROL REPORTED AS mg/dL REPORTED AS mmol/L
High 240 mg/dL and higher 6.2 mmol/L and higher
Borderline 200-239 mg/dL 5.2-6.2 mmol/L
Desirable < 200 mg/dL < 5.2 mmol/L

• LDL-Cholesterol (aka: the "bad" cholesterol):

LDL-CHOLESTEROL REPORTED AS mg/dL REPORTED AS mmol/L
Very High 190 mg/dL and higher 4.9 mmol/L and higher
High 160-189 mg/dL 4.1-4.9 mmol/L
Borderline 130-159 mg/dL 3.4-4.1 mmol/L
Near Optimal 100-129 mg/dL 2.6-3.3 mmol/L
Optimal < 100 mg/dL < 2.6 mmol/L

• HDL-Cholesterol (aka: the "good" cholesterol):

HDL-CHOLESTEROL REPORTED AS mg/dL REPORTED AS mmol/L
Desirable 60 mg/dL and higher 1.6 mmol/L and higher
Acceptable 40-60 mg/dL 1.0-1.5 mmol/L
Low < 40 mg/dL < 1.0 mmol/L

• Triglycerides:

TRIGLYCERIDES REPORTED AS mg/dL REPORTED AS mmol/L
Very High 500 mg/dL and higher 5.6 mmol/L and higher
High 200-499 mg/dL 2.3-5.6 mmol/L
Borderline 150-199 mg/dL 1.7-2.2 mmol/L
Acceptable < 150 mg/dL < 1.7 mmol/L

High-Sensitivity C-Reactive Protein

During the past 2 decades, the blood test "high-sensitivity C-reactive protein" (hs-CRP) has become as important as LDL-cholesterol. In fact, I regard hs-CRP as even more useful (Ridker PM. 2003a). Whereas your LDL-cholesterol helps to assess the risk of medical events related to atherosclerosis, hs-CRP reflects not only atherosclerosis severity, but a lot more. When your hs-CRP is elevated, it means you are in a state of inflammation, even though you can't feel it. Many years of low-grade inflammation is now regarded as a substantial factor leading to not only coronary heart disease (Yeh ETH, et al. 2003), but, also, several forms of cancer and even dementia.

Data from the Women's Health Study revealed that elevated blood levels of hs-CRP were a stronger predictor of cardiovascular events than elevated LDL-cholesterol levels (Ridker PM, et al. 2002). The Women's Health Study also revealed that a hs-CRP value above or below 3.0 mg/L was as useful at predicting future cardiovascular risk as was the accumulation of traditional criteria for metabolic syndrome (Ridker PM, et al. 2003b). A separate study found that hs-CRP correlated with the degree of carotid stenosis but LDL-cholesterol did not (Mullenix PS, et al. 2007).

Here are the cut points for hs-CRP:


hs-CRP VALUE RISK
above 10 mg/L (repeat test
after 1 month)
3 - 10 mg/L High risk
1.0 - 3.0 mg/L Moderate risk
less than 1.0 mg/L Low risk

Blood Glucose

Insulin and glucose metabolism are often abnormal in the obese and in people with hypertension (Reaven GM, et al. 1996). Thus, it is important to know your blood glucose:

  • Fasting: 75-100 mg/dL
  • 2-hr postprandial (2 hrs after eating): less than 140 mg/dL

After an overnight fast, if the blood glucose level is 100-125 mg/dL, this is considered "impaired."

BODY COMPOSITION

Forget the bathroom scale. The following measurements will give you a much better idea of your overall health.

Body Mass Index (BMI)

Body mass index compares weight to height. A high BMI value has been shown to predict a higher risk of death from cardiovascular disease, especially in men (Calle EE, et al. 1999). But, while BMI is an important measurement in obese and deconditioned people, it is not very useful in the heavily-muscled body-builder. This is because the value does not discriminate between fat weight and muscle weight.

Use our BMI Calculator and Tables to determine your own specific value.


BMI CATEGORY
> 40 Extreme Obesity
30 - 39.9 Obese
25 - 29.9 Overweight
18.5 - 24.9 Desirable
< 18.5 Underweight

NOTE: The BMI limits listed above do NOT apply to children.

Body Fat Percentage

Upper limits of body fat percentage have been established to define obesity:


ADULTS PERCENT BODY FAT
CUTOFF FOR OBESITY
Men more than 25% body fat
Women more than 32% body fat

Lower limits for body fat percentage have also been established. Following the deaths of 3 college wrestlers in 1997, the NCAA established a 5% body fat minimum for collegiate athletes. The National Federation of High School Associations (NFHS) set the following limits for high school wrestlers:


HIGH-SCHOOL
WRESTLERS
LOWER LIMIT FOR
HEALTHY BODY FAT PERCENT
Boys not less than 7% body fat
Girls not less than 12% body fat

Waist-to-Hip Ratio

This is simply the circumference of the waist divided by the circumference of the hips.

Recently, the waist-to-hip ratio has been found to be an important predictor of health problems and the medical community has gradually shifted away from the BMI value in favor of the waist-to-hip ratio as a better indicator of health problems related to overweight and obesity. Obesity is linked to hypertension, diabetes, heart disease and many other medical conditions. Losing weight helps to get them under control.

Waist-to-hip ratios are different for men and women:


RISK MEN WOMEN
High Risk > 1.0 > 0.85
Mod. High Risk 0.9 - 1.0 0.80 - 0.85
Low Risk < 0.9 < 0.8

EXERCISE RECOMMENDATIONS

You can keep every one of these fitness and health parameters in the "healthy" range with a combination of diet modification and regular exercise.

In July 2011, the American College of Sports Medicine (ACSM) published their latest exercise recommendations for healthy adults (Garber CE, et al. 2011). They are summarized as follows:


TYPE OF EXERCISE WEEKLY AMOUNT
Aerobic Exercise Moderate Intensity:
30 min/day, 5 days per week

Vigorous Intensity:
20 min/day, 3 days per week
Resistance Exercise 2-3 days per week
Flexibility Exercise 2-3 days per week
Neuromotor Exercise
(eg., tai chi, yoga)
2-3 days per week

If you are seeking optimum "fitness," then you would need to perform all 4 of these types of exercise each week. However, if you are sedentary and just want to start improving your "health," keep in mind that a reduction in the risk for cardiovascular disease begins with as little as 500 kcal of exercise per week. Going for a 30-minute walk around your neighborhood every day might be all it takes to prevent a heart attack or stroke!

GUIDANCE

Regular exercise will improve both your health and your fitness. But, before beginning a new exercise routine, keep the following in mind:

Consult your physician: If you (a) have any medical conditions (in particular, heart disease, hypertension, diabetes mellitus, asthma, back pain, osteoporosis), (b) have not exercised in a long time, or (c) are more than 40 years old, you need to discuss your exercise plan with your physician.

Consider hiring a personal trainer: A properly educated and certified personal trainer can be very helpful if you have not exercised regularly. Make sure the trainer you hire understands and recommends aerobic exercise as well as strength training. See: "How To Choose a Personal Trainer" for more information.

Monitor your progress: Learn how to monitor your heart rate during each exercise session. Stop exercising if your heart rate gets too high, or, if you feel faint or have sensations in your chest. Also monitor your progress, but don't set unrealistic goals and don't try to progress too fast (this is where a personal trainer can be helpful).

FOR MORE INFORMATION

An excellent book for people who want to get serious about their fitness is ACSM Fitness Book. Although this book was published in 2003, and, an extensively-updated version was published in 2011, we still like the 2003 edition because it is shorter, succinct, and easy-to-read. Both editions of this book contain many tables and charts that help the reader determine their level of fitness and track their progress. Dozens of color photographs demonstrating the proper position for various stretches and exercises are also provided.

For those who are interested in the most recent ACSM exercise and fitness book, go to: Complete Guide to Fitness & Health.

Both books are reviewed in our Book Reviews section.

Many of the health targets listed above can be found at the web site for the National Cholesterol Education Program.

For those who are interested in track & field, performance standards for masters athletes can be found at: National Masters News.

Readers may also be interested in these related topics:

EXPERT HEALTH and FITNESS COACHING

Stan Reents, PharmD, is available to speak on this and many other exercise-related topics. (Here is a downloadable recording of one of his Health Talks.) He also provides a one-on-one Health Coaching Service. Contact him through the Contact Us page.

REFERENCES

Brown RE, Riddell MC, Macpherson AK, et al. The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk. Am J Hypertension 2013;26:1005-1010. Abstract

Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med 1999;341:1097-1105. Abstract

Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC-7 Report. JAMA 2003;289:2560-2572. Abstract

DeVan AE, Anton MM, Cook JN, et al. Acute effects of resistance exercise on arterial compliance. J Appl Physiol 2005;98:2287-2291. Abstract

Garber CE, Blissmer B, Deschenes MR, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidelines for prescribing exercise. Med Sci Sports Med 2011;43:1334-1359. Abstract

James PA, Oparil S, Carter BA, et al. 2014 evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507-520. Abstract

Jouven X, Empana JP, Schwartz PJ, et al. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;352:1951-1958. Abstract

Mullenix PS, Steele SR, Martin MJ, et al. C-reactive protein level and traditional vascular risk factors in the prediction of carotid stenosis. Arch Surg 2007;142:1066-1071. Abstract

Reaven GM, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities - the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996;334:374-381. Abstract

Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 2003a;107:363-369. Abstract

Ridker PM, Buring JE, Cook NR, et al. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events. An 8-year follow-up of 14,719 initially healthy American women. Circulation 2003b;107:391-397. Abstract

Ridker PM, Rifai N, Rose L, et al. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347:1557-1565. Abstract

Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol 2001;37:153-156. Abstract

Whelton PK, He J, Appel LJ, et al. Primary prevention of hypertension. Clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 2002;288:1882-1888. Abstract

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC...Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiology 2018;71:2199-2269. Abstract

Williams PT. High-density lipoprotein cholesterol and other risk factors for coronary heart disease in female runners. N Engl J Med 1996;334:1298-1303. Abstract

Yeh ETH, Willerson JT. Coming of age of C-reactive protein. Using inflammation markers in cardiology. Circulation 2003;107:370-372. Abstract

ABOUT THE AUTHOR



Stan Reents, PharmD, is a former healthcare professional. He is a member of the American College of Lifestyle Medicine (ACLM) and a member of the American College of Sports Medicine (ACSM). In the past, he has been certified as a Health Fitness Specialist by ACSM, as a Certified Health Coach by ACE, as a Personal Trainer by ACE, and as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics) and has written for Runner's World magazine, Senior Softball USA, Training and Conditioning and other fitness publications.




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