Getting the most out of life involves the ability to be active, which requires a healthy heart. It is clear the combination of good nutrition and adequate physical activity are the two most important things you can do for long-term health.

Ideally, we all have a mix of exercises that help with strength, flexibility, speed and endurance. Perhaps the most daunting types of exercise are endurance exercises, such as running, biking and paddling. One of the best things about starting an endurance exercise program is that a person can start at any level and improve at their own pace.

Possibly the most challenging part of any individual sport, including endurance sports, is making the decision to start and then following through with it.

QUESTION: What is a good way to get started with endurance exercise?

ANSWER: Getting some professional guidance, some camaraderie and positive feedback along the way is ideal. One time-tested approach that provides all of these elements is the Honolulu Marathon Clinic directed by Honolulu cardiologist Dr. Jack Scaff. For over 40 years this free nine-month program has helped individuals get started with (and, for some, addicted to) the endurance sport of marathon running and/or walking. The clinic model is simple and easy to follow. Work up to walking or running one hour at a time, three times a week.

Q: When and where does the Honolulu Marathon Clinic meet?

A: This year the clinic will meet once a week on most Sundays from March 12 until the marathon on Dec. 10. The location is the old driving range at Kapiolani Park, across the street from Paki Hale (3833 Paki Ave.). Promptly at 7:30 a.m., Scaff or other experienced professionals present a 10-minute talk on topics covering the many practical aspects related to training, fitness and health. Following the talk, people join up with other participants with the same level of fitness and head out for group runs or walks.

Q: Do you need to be in shape to start with the clinic?

A: No. People at all levels of fitness participate in this program. A marathon goal is not needed to enjoy and benefit from the clinic. The only commitment needed is to show up weekly and, of course, to put one foot in front of the other. The program is designed to take you from couch potato to marathon level over nine months.

Q: What if you have significant health problems?

A: If you have significant health problems, you should get participation clearance from your physician. But a Marathon Clinic “prescription” may be exactly what you need. When it started in 1974, the clinic was an extension of a cardiac rehabilitation program run by Scaff. Five men with heart disease were Marathon Clinic “test subjects,” and they all succeeded in raising their fitness level and completing the marathon. At the time, the concept of heart patients completing a marathon was unheard of, and some considered it dangerous. The success was published in the New York Academy of Sciences and later recognized by the American Medical Association as a “landmark event” in the evolution of cardiology.

Over the years there have been many participant success stories by people with various diseases going through this time-tested training program. Scaff refers to these people as the Marathon Clinic “dream team.” For current clinic information, visit honolulumarathonclinic.org.

Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa. Dobbs also works with University Health Services.