Dr. Nelson, I have been doing aerobic exercise 3 times a week and strength training 2 times a week for a year now. But lately I have reached a level of little change. How can I do to start seeing results again?

You are experiencing with what we call a "plateau" and while it is not uncommon, I understand that it can be frustrating. At this point, increasing the intensity of your workouts is what will make the difference. For instance, if you are currently walking three days a week for thirty minutes at 3.5 mph with a 1.0 % grade, increase your speed to 3.7 mph and increase your grade to 2.0%. Depending on where you're at now, this may seem like a very minor or a very major increase, but it is just to offer a guide on furthering aerobic progression.

You may also want to consider a different activity for one of your three workouts. If you bike three times per week, try walking or using a stair climber one day each week instead.

For strength training, increasing intensity is also key. Make sure you are fully challenging your muscles—you should only be able to complete eight to twelve repetitions before needing a rest. Also, swapping out old strengthening exercises and adding new ones will help by challenging your muscles in a new way. There are several exercises available for working the same muscle groups and a fitness instructor, exercise video or well-illustrated book can provide new ideas.

Remember that when you reach a plateau, you will eventually overcome it and start progressing again, but it is critical to persevere and stick with your program to enjoy those later successes.