Ageing and exercise: building body capital in old age

The WHO defined active and healthy aging as the process of optimizing opportunities for health, participation, and security in order to enhance the quality of life as people age.

Usually, the term “healthy” refers to physical, mental, and social well-being [18]. “Successful aging,” commonly used in gerontology and geriatrics, refers to the optimization of life expectancy while minimizing physical and mental deterioration and disability. It focuses on the absence or avoidance of disease and risk factors for disease, maintenance of physical and cognitive functioning, and active engagement with life (including maintenance of autonomy and social support). Some investigators have broadened the model to include more psychosocial elements, such as life satisfaction, social participation, and functioning, and psychological resources, including personal growth, resolution and fortitude, happiness, relationships between desired and achieved goals, self-concept, mood, and overall wellbeing.

Successful aging is seen as a dynamic process, as the outcome of one’s development over the life course [18]. Inspired by Pierre Bourdieu, ‘cultural capital’ is increasingly being used as a conceptual tool in the understanding of health behavior. Bourdieu’s notion of cultural capital encompasses diverse cultural practices as forms of cultural capital or resources. These resources are learned experiences from the past, and as such they are dispositions that direct and shape present behavior [19, 20]. These resources are learned experiences from the past, and as such, they are dispositions that direct and shape present behavior [19, 20].

Abel [21] points out that cultural factors become important in health promotion, including exercise programs for physical activity, when people themselves are increasingly expected to maintain their health in their everyday lives. Cultural factors heavily influence health promotion behavior because health is not a natural given, but must be acquired and maintained throughout the life course [20]. Health relevant behavior is furthermore associated with broader societal values such as body perceptions, and they are socially learned.

Consequently, this behavior has been turned into cultural assets, e.g. health promoting lifestyle, being incorporated inside the body and serve as cultural capital in everyday life. These health behaviors can be conceptualized as invested and accumulated cultural resources. The acquisition and maintenance of these resources depend on the enjoyment of the activity and require a significant personal time investment. Choosing a lifestyle with regular physical activity is therefore a form of cultural capital. This cultural capital can be transformed or applied to achieve physical health gains, but also other socially desirable means derived from those health gains, such as social belonging [21].

While some of the theoretical approaches using the term “cultural capital” focus more generally on health, others underscore the specific significance of the body as capital. In this regard, Pinxten and Lievens [22] and Antoninetti and Garrett [23], referring to Bourdieu’s three forms of capital (economic, cultural and social), draw attention on the need to expand this to include the “full self” and the “body capital” as such a component. Furthermore, Antoninetti and Garret [23] suggest the following definitorial remark for the body capital component: the individual’s capabilities to manoeuvre in the field of bodily behavior dictated by “personal characteristics of body functions and socially constructed external opinions and attitudes toward” those abilities or disabilities. Notably, diminishing bodily capabilities or the experiences of aging can be mitigated through investment in body capital. Therefore, as Eman [24] suggests, the body might be conceptualized as a site of capital accumulation or an investment opportunity. Additionally, accumulated cultural health capital serves as a tool kit of resources that can be used to create strategies for action. Such action may include health related practices like physical activity [19].

This qualitative study is informed by the interpretative tradition of hermeneutics and phenomenology. The exploration and utilization of the various preconceptions arising between the participant and researcher play an important part in facilitating understanding [25, 26].

The participants taking part in the study are women over the age of 70 years or more who regularly attend group exercise classes at an established workout center for women that represents an alternative to the large fitness chains. The majority of the users are adults between 45 and 65 years, but the center also has various exercise programs for women aged 70 years and older, of whom the oldest participant is 93 years old. The center offers classes of 60 min duration for older adults and senior women twice a week. There are usually about 15 participants in each of the two classes, and some women attend both.

At the request of one of the authors with knowledge of the senior class, the exercise center staff recruited participants by informing the senior classes about the study. Eighteen participants registered their interest in participating in the study, but two of them declined to partake when contacted. Sixteen informants ranging from 70 to 85 years old, the average age being 74.8 years, were interviewed individually (Table 1).

A female instructor, who explains, demonstrates and performs exercises leads the class supporting the participants individually and collectively. The aim is to provide functional training, to increase body awareness and to promote the enjoyment of agility exercise. Agility is the ability to change the direction of the body in an efficient and effective manner requiring a combination of balance, speed, strength and coordination [27]. The key to supporting and inspiring performance and to enjoying movement in the exercise class is the use of music, including jazz, classical music, ethnic and soul, pop and tango. Segments of music are tailored to various components of the exercise session matching with tempo movements and the intensity of work out. The activities are performed at a moderately intense level for 60 min. The program consist of weight bearing resistance, balance and stretching exercises, incorporating dancing steps and movements. Exercise equipment includes barre, providing support during various types of exercises and external loads including light hand weights, resistance band or cuffs. The program is varied and with few and short breaks. The participants are informed by their instructors about recommended guidelines for moderate intensity: “your breathing quickens, but you’re not out of breath. You develop a light sweat after about 10 minutes of activity. You can carry on a conversation, but you can’t sing”. Based on these cues the participants are encouraged to adjust the intensity to a preferred intensity without going outof your comfort zone. The exercise programs were performed at moderate level of intensity.

The face to face interviews were conducted in the office of two of the authors (AB & MF).

The authors interviewed the participants from half the group each.We developed an interview guide for this study, see Table 2, which included questions concerning the participants’ experiences of the physical exercise while attending the program. We asked about the influence the exercise had had on their everyday life regarding physical, psychological and social capabilities and whether they had positive or negative experiences with the exercise and how they perceived themselves and others engaging in the exercise. The interview guide was based on existing literature and our own experiences as professionals leading group exercise.

All of the interviews were voice recorded and each lasted approximately one hour. The interviews were transcribed by the interviewers. The data were analyzed using an inductive content analysis and performed collaboratively by all the authors. The inductive approach enables researchers to identify key themes in the area 182 of interest by reducing the material to a set of themes or categories [28]. The intention was to provide a compact yet general description of the phenomenon under investigation. The themes emerged from the raw data by repeated examination and comparison. Using an analytic process, we experienced an increased understanding of the material describing the participants’ experiences with the group exercise program. To ensure the trustworthiness of our analyses, as all qualitative group exercise program. To ensure the trustworthiness of our analyses, as all qualitative analyses entail a degree of interpretation, the four authors read the transcripts independently several times. Following Brinkmann and Kvale [29], the reading of transcripts was performed with an open mind so as to grasp the participants’ own views on the subject. Additional analysis was performed using the following procedures: 1) The transcripts were read to gain a contextualized impression of the text and previous preconceptions were highlighted. 2) Units of meaning were identified and coded and agreement between all four authors was based on consensus after discussion. 3) The meaning in the coded groups was then condensed. 4) The descriptions reflecting the participants’ experiences were generalized into categories and consensus regarding the categorization of statements and emerging themes were reached by discussion between all four authors. The analyses process is described in Table 3. The inductive content analyses eventually led to the use of the theoretical lens of cultural capital, which enhanced our understanding of the women’s experiences participating in the group exercise.

Mapping preconception is a key aspect of qualitative research [30, 31] and highlights the aspects of the researchers’ preconceptions relevant to the study. At the time of the interviews and analysis, our immediate preconceptions were very much linked to the experiences of all authors working and doing research among older persons living in at home and health promotion. Instead of bracketing these, they enabled us to challenge some of the interviewees’ statements and descriptions. These preconceptions were challenged and discussed throughout.

This study has been approved by the Data Protection Official for Research at The Norwegian Social Science Data Services, reference number 41165. All the participants received written information on the purpose and methods of the study, provided their consent to participation in the study and were informed of the right to refuse to participate at any stage in the study.

All of the women held the opinion that aging would lead to changes in health and body functions. Therefore, one of their concerns was to maintain the body’s physical function so as to be better prepared to meet these changes. One of the women who participated in the exercise explained it this way:

“The motivation to participate is linked to health benefits, my feeling of independence and creating capability. As you age, you have an uncertain future ahead of you. I know I’m getting older. I do not want to think about all the obstacles that may occur in a few years’ time, which might make it difficult for me to attend [exercise program]”. (Woman no 2). Another said “The exercise helps me to have the energy to be social and engage in art and culture which I experience is of great importance to me at the moment as well as in the future. I really hope that the day I do not have the energy to participate is far ahead”. (Woman no 12)

By exercising and being active, the women prevented physical deterioration. Through exercise, hey had all learnt that they became more confident about their own capacity and ability to achieve key objectives with regard to their quality of life. They said that it was important to strengthen arms and legs to prevent falls, and to facilitate a faster convalescence after illness.

The women’s investment in the body through exercises created a “sense of energy” (Woman no 4 9) and motivation all of the women to cope with everyday activities, as reflected in the following statements:

“I need a body that gives me opportunities, so it is a good investment. Yes, in those periods when I have not been going to the gym, everything drops, both the initiative and ... Those periods when I have not attended due to illness have been difficult; 2006 just was such a horrible year. Exercise helps to keep me from being dependent on others or getting sick” (Woman no 6). “I have more assets, yes, we do not expect that, but taking a little care of our bodies and staying in shape pays off. Of course, it enables one to continue to go out and get access to different types of experiences. I can stay on my feet longer”. (Woman no 1)

Being aware of the inevitable change in their physical abilities, all these women met those changes by upholding their lifelong habits of physical activity so as to ensure continued independence.

The exercise was described by the women as giving them “strength to initiate things themselves,” (Woman no 10) and that they no longer remained apathetic because of an untrained body. The advantage of having a “vital body,” (Woman no11) as one put it, was that it contributed to self-initiated opportunities for activities and ventures for all the women. Others said “the body becomes more alive” (Woman no 3) when they are doing exercise and that they all felt they had more power in the execution of their daily tasks and keep health promoting habits. According to the women, this surplus of energy gave other benefits too, such as a good humor and enthusiasm for social events. As one said:

The body is important for me as a human being with regard to the physical and emotional experiences I get the energy to control my thoughts better. The exercise makes me more positive and therefore it gives additional energy to control emotions and not let me be overwhelmed by melancholy, which can happen. I think all people can get a little wistful at times, and it is then one needs energy to think about what opportunities one actually has in establishing good habits and to do something about it if one can. Yes, I feel that the training makes me more positive; I smile more and stay in a better mood. In addition, this means that I receive positive feedback from others. (Woman no 1)

Through regular exercise, the women were able to maintain their bodily physical agility, which in turn meant that they acquired body capital and achieved several gains as described here: “The training gives me a little energy and makes me move both physically and mentally.” (Woman no 3) To these women, engaging in training appears to help them keeping their motivation for continued physical activities by generating emotional well-being and a sense of control or being empowered. Another said: “The exercises allow me to experience a connection between body and mind. Helps to reduce distress and sadness. The exercises improve my self-esteem and attention as well as provides a sense of belonging. I think the exercises contribute to good health and maintain my… - I experience that I’m able to do things that are important to me (Woman no 8).

The physical training of the body had a positive, emotional gain for all the women. Some of them recounted, for example, that training “gives an appetite for life,” (Woman no 8) and the additional energy surplus they experienced from the training allowed them to be socially more active. The group exercise constitutes an arena for contact with other people. One woman said: Will simply make contact with people - I feel better about myself - Maybe I’m better embedded in my own body - I actually have the profits to contact and to get involved with other people (Woman no 7).

By exercising, the women achieved other types of capital such as social capital in terms of social participation and being together with friends. It was their experience that a trained body meant they felt safer, they could be physically more active and consequently participate more in social situations with other people. The following account illustrates this experience:

“I believe that the training enables me to move more outside the home and the outdoor life promotes social participation. I see myself as a fighter. That means it is about not giving up about rewarding oneself for the efforts. The social benefit is what you gain from being with others, and this is not obvious when one is old. I’m curious about other people, very curious”. (Woman no 14)

The effort they put into exercise to have a well-trained body also contributed to the women feeling physically attractive in addition to creating an energy surplus and better opportunities for social participation. It appears that some invested in their body to maintain physical functions with the purpose of increasing their external attraction towards others. One participant has experienced receiving positive feedback about her body and describes it this way:

I am a vigorous and graceful adult woman who is relatively flexible and strong. Moreover, I get a lot of praise for it, not least from those who do not know that I am training, but who guess that I’m engaged in something. It’s nice, I actually like it very much that I’m visible [laughs]. (Woman no 13)

By feeling physically strong through the exercise, the women also gained a “sense of safety” (Woman no 15) and could “easily engage in social activities” (Woman no 16). In addition, the exercise contributed to the women’s physical attractiveness and well-being, which might contribute to socially activity.

This study has limitations regarding transferability. First, our sample may not reflect the views of the wider population living at home. Second, this study was conducted in an urban area and may not be generalizable to more rural settings or other populations. Furthermore, the sample consists of women who have been engaging in group exercise, not individual exercise, which most likely makes a difference for their motivation regarding participation [51].

A strength of this study is that we apply a qualitative approach, which contributes to greater depth of understanding by exploring the subjective experiences of older women participating in a training program. This study is also unique in applying a theoretical framework based on cultural capital and health, with a specific focus on women aged 70 years or over and their experiences of participating in an exercise class.

Furthermore, in qualitative studies, the role of the researchers as producers of knowledge is important. Thus, we realize that our own preconceptions of exercise and physical activity in older age might have influenced our interpretations since all of us had positive experiences with exercise. However, all the women were asked questions about negative experiences with exercise, but nobody reported negative experiences.