Exercise

Physical activity definition is any movement that uses skeletal muscles and requires more energy than resting.

Physical activity includes a wide variety of movements that takes place during awake time, whether through chores, transportation, work, and/or leisure.

Physical activity promotes general, good health and endocrine, immune, and metabolic processes that prevent development of varying illnesses.

It is known the different types of physical activity may give different health benefits.

Aerobic physical activity: running, fast biking, increase oxygen uptake, and improves cardiovascular function.

Anaerobic activity such as resistance training helps to increase muscle strength and mass.

Exercise is known to lessen the risk of cardiac disease, cognitive decline, some cancers, and mental health disorders, as well as all-cause mortality.

Systemic physical activity leads to increased neuroplasticity and reduces inflammation within the hippocampus and decelerates neurodegeneration.

The benefits of regular physical activity include stress reduction, sleep quality improvement, mood enhancement, muscle strength and tone enhancement, and cardiovascular and lung fitness augmentation that improves quality of life and aging outcomes.

Physical activity is associated with a general decrease in risk of many common non-communicable diseases, including: coronary heart disease, hypertension, diabetes, and cancer, and also with obesity, poor bone health, depression, and anxiety.

Physical activity may enhance brain health and cognitive function, strengthen muscles and bones, which may prevent falls among older adults.

There is increased microbiota abundance, diversity, and composition with physical activity training, changing the function of the gut microbiota in favor of the patient, including improvements in immune function and inflammatory profiles.

Total physical activity is a combination of the frequency, duration and intensity of physical activity.

The intensity of physical activity is often categorized as vigorous, moderate, and light.

There is evidence that physical activity association with cancer survival is improved and is stronger post diagnosis than pre-diagnosis.

One third of cancer survivors have little or no participation in leisure time physical activity while spending prolonged time sitting.

Hundreds of studies, and several million participants have shown that there is a 10 to 20% reduction in bladder, breast, endometrial, renal, colon, and gastroesophageal cancers in people with a dynamic lifestyle.

Exercise is associated with a 40 to 50% reduction in mortality and people with prostate, breast, and colorectal cancer.

Regular physical activity  may serve as a nonpharmacological prevention and treatment strategy for various comorbid conditions such as hypertension, obesity, or overweightness, improves mental health and quality of life, delays dementia onset and can be used to reduce public health care costs.

Regular physical activity lowers the risk of all forms of dementia, including Alzheimer’s disease, and reduces feelings of anxiety and depression in healthy people.

Aerobic exercises performed regularly (running, jogging, brisk walking, swimming, and cycling) are associated with greater scores on neuropsychological function and performance tests measuring certain cognitive function, such as attention control, inhibitory control, cognitive flexibility, working memory, declarative memory, spatial memory, and information processing.

Long-term effects of aerobic exercise may include increased neuron growth, increased neurological activity and signaling of Fos and BDNF, improved stress coping, enhanced cognitive control of behavior, improved declarative, spatial, and working memory, and structural and functional improvements in brain structures and pathways associated with cognitive control and memory.

Exercise’s effects on cognition may affect academic performance in children and college students, improve adult productivity, preserve cognitive function in old age, preventing or treating certain neurological disorders, and improving overall quality of life.

The corner stone of treatment plans to manage obesity and sedentarism.

During exercise cardiovascular and respiratory mechanism are integrated to meet oxygen needs of tissues and extra CO2 and heat must be removed from the body.

Exercise intolerance is an important marker for disease severity and decrease well-being in individuals with heart, lung, renal, musculoskeletal, and neurologic disease.

Activity energy expenditure, as measured by doubly AA labeled water is considered to be the gold standard of physical activity.

Estimated that in the US, nearly $117 billion in annual health care costs and 10% of all premature deaths are associated with failure to meet recommended aerobic physical activity.

 

Exercise improves sleep,  boosts the immune system, keeps the  mind sharp, and helps maintain muscle tone.

 

Vigorous physical activity affects immune systems, mainly natural killer cells, and CD8 positive T cells against tumors, as well as decreased inflammatory markers, such as prostaglandin E2, and an increase in gut microbiota diversity, while also potentially reducing the levels of tumor promoting bacteria.

Physical activity underlies physical fitness and well-being, weight loss, weight maintenance, diabetes prevention or treatment, and cardiometabolic health.

During physical exercise, skeletal muscle secretes myokines into the bloodstream such as: IL-6, IL-7 and IL-15.

Such exercise may act through these myokines by acting on information and immunity, decreasing tumor growth and enhancing sensitivity to chemotherapy and anti-PD-1 antibodies in pancreas cancer.

Remaining sedentary for more than 12 hours daily is linked with a higher risk of death and being sedentary for eight hours, but a little more than 20 minutes of exercise closed the gap.

A multifactorial behavior, that is a modifiable risk factor for the development of obesity and premature mentality.

Physical activity fosters normal growth and development and can make people feel better, function better, sleep better, and reduce risk of many chronic illnesses.

Physical activity is a cornerstone in the secondary prevention of cardiovascular disease and is associated with low risk of mortality from cardiovascular disease and all causes.

Engaging in moderate intensity aerobic activity and muscle strengthening exercise at recommended levels is linked with a 48% lower risk of death from flu or pneumonia compared to those engaging in activity that fall short of these guidelines.

Ideal physical activity is associated with lower high-sensitivity C-reactive protein levels, and a lower prevalence of coronary artery calcification compared with poor physical activity.

Ideal PA is associated with a lower rate of incident CHD compared with poor PA.

Promotion of ideal PA may be an important way to reduce the risk of subclinical and future clinical CHD in African Americans.

Physical activity is defined as any bodily movement produced by skeletal muscles requiring energy expenditure.

The steepest reduction in disease risk, such as coronary heart disease, occurs at the lowest level of physical activity.

Muscle strengthening activities, including resistance training and weight lifting, cause the body‘s muscles to work against an applied force or weight.

Muscle strengthening activities often involve lifting heavy objects, such as weights, multiple times to strengthen various muscle groups.

Muscle strengthening activity can involve using elastic bands or body weight for resistance.

Muscle strenghthening activity has 3 components:intensity, frequency, and sets and repetitions.

Intensity relates to how much weight or force is used relative to how much one is able to lift.

Frequency is how often one does a muscle strengthening activity.

Sets and repetitions describes how many times a person does the muscle strengthening activity.

The effects of muscle strengthening activity are limited to the muscles doing the work.

The most effective exercises to reduce blood pressure are isometric exercises.

Multi component physical activity programs include balance, muscle strengthening and aerobic physical activity, gait coordination, and physical function training.

Health benefits begin immediately after exercising and even short episodes of small amounts of physical activity are beneficial.

Only 26% of men, 19% of women, 20% of adolescents report performing sufficient activity.

Benefits from exercise occurs in men and women of all ages and ethnicicities, young children to older adults, women in pregnancy or postpartum, and people living with chronic conditions or disability, or people who want to reduce the risk of disease.

Women might benefit more than men from the same amount of exercise, with regular leisure time physical activity tied to a 24% lower risk of all cause mortality in women versus a 15% lower risk in men.

 

In people  whose level of physical activity placed them in the top third had a 17% decrease in fecal bile acid concentration compared to those whose level of physical activity placed them in the lowest third.

Contracting muscles release multiple substances known as myokines which promote the growth of new tissue, tissue repair, and various anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases.

Exercise lowers blood pressure, reduces the need for blood pressure and cholesterol lowering medications, and may improve mortality.

Higher exercise capacity is associated with increased mortality, myocardial infarction rates, and revascularization.

Activity energy expenditure captures energy expended on all types of physical activity including low intensity physical activity and moderate to vigorous physical activity.

Higher levels of activity energy expenditure have reduced rates of mortality and incident mobility impairment.

Individuals who maintain and ability to regularly engage in physical movement have marked improvement in executive functioning parameters.

Increasing exercise intensity is a strong determinant of cardiorespiratory fitness across individuals.

Muscle blood flow increases during exercise and the circulation of the rest of the body must be maintained.

Oxygen is extracted from the blood in exercised muscles and an increase in ventilation occurs eliminating heat, increases oxygen and excretes extra CO2.

During exercise the amount of oxygen entering the blood via the lungs is increased because the amount of O2 added to each unit of blood and the pulmonary blood flow per minute or increased.

With exercise, the PO2 of blood flowing into the pulmonary capillaries falls from 40 to 25 mmHg or less, so the alveolar-capillary PO2 gradient is increased and more oxygen, enters the blood.

Blood flow per minute in the pulmonary circulation increases with exercise from 5.5 L limited to is much is 20-35 L per minute, and the total amount of 02 entering the blood increases from 250 mL per minute at rest to as high as 4000 mL per minute.

During exercise the amount of CO2 removed from each unit of blood is increased, and the CO2 excretion increases from 200 mL per minute to as much is 8000 mL per minute.

The amount of oxygen entering the blood is increased with exercise as the amount O2 added to each unit of blood and pulmonary blood flow per minute are increased.

With exercise the increase in 02 uptake disproportionate to workload up to a maximum, and above this maximum 02 consumption levels off and blood lactate levels rise.

During exercise lactate comes from muscles in which aerobic resynthesis of energy stores cannot keep pace with utilization and an oxygen debt is incurred.

Exercise stimulates the production of soluble factors that are released by skeletal muscle, termed myokines.

Continuous exercise can produce a transient state of euphoria – an affective state involving the experience of pleasure and feelings of profound contentment, elation, and well-being – which is known as a “runner’s high”.

These factors exert autocrine, paracrine, and endocrine actions.

Myokines include interleukins, growth factors, and substances that control cell growth.

Myokine molecules signal to skeletal muscle, adipose tissue, liver, the heart, the brain, and blood vessels.

The exercise hormone irisin is released by exercising skeletal muscle to act on white fat cells to increase energy expenditure by brown fat like development.

Resistance exercise improves lean body mass, increasing the basal metabolic rate and energy expenditure.

With the onset of exercise ventilation increases abruptly, and then gradually increases further.

With moderate exercise ventilation increases mostly due to an increase in the depth of respiration, accompanied by an increase in the respiratory rate when exercise is more strenuous.

Associated with decreased risk of coronary disease.

Physical activity can prevent many chronic diseases, including diabetes cardiovascular and respiratory diseases, neurodegenerative conditions, and some types of cancer.

Exercise volumes exceeding 150 minutes of exercise per week induces superior improvements in hemoglobin A1 C levels.

Physical activity and other stress – inducing behaviors are known to trigger the incidence of acute cardiovascular diseases, such as myocardial infarction, sudden cardiac death, and stroke.

These triggering events can promote sympathetic activation, catecholamine secretion, systemic vasoconstriction, and increased heart rate and blood pressure, which can lead to increased myocardial oxygen demand and subsequently hemodynamic deterioration.

Physical activity aids weight loss and weight maintenance.

In a Iowa State university study of 55,137 adults, it was found that over a 15 year follow up individuals that ran, even at a slow speed for as little as 5-10 minutes a day have a greatly reduced mortality risk, adding 3 years to an individual‘s life expectancy.

Physical activity concentrated within one to two days is associated with a similar low risk of cardiovascular outcomes to more evenly distributed activities.

Physical activities associated with a lowered risk of 13 cancers including: breast and colon cancers.

 

Exercise decreases deoxycholate in the colon. 

 

There is a positive association of exercise and physical activity with cancer prevention, tolerance to cancer-directed therapies of radiation and chemotherapy, reduction in recurrence, and improvement in survival.

It is found that vigorous exercise like fast bicycling or running reduces the risk of pre-menopausal as well as post-menopausal breast cancer.

The intensity of certain cancer sites, such as breast, and colon cancers, is dose dependent, and has a greater risk reduction associated with vigorous physical activity (VPA) compared with lower intensities.

Vigorous intermittent lifestyle physical activity (VILPA) refers to brief and sporadic. (1-2 minute bursts of very fast walking or stair climbing) bouts of vigorous physical activity during daily living.

Small amounts of vigorous intermittent lifestyle physical activity (VILPA) is associated with lower incident cancer risk.

Physically active people use less medication, have shorter hospital stays and require fewer physician visits.

 

Physical exercise have been shown to markedly increases BDNF synthesis in the brain, being partly responsible for exercise-induced neurogenesis and improvements in cognitive function.

Active people who move about and spend less time sitting have healthier blood lipid profiles and blood glucose levels than those who meet the minimum recommended activity levels but who sit for prolonged periods.

Physical activity is included in treatment programs to improve quality-of-life and delay progression and harmful consequences of the condition.

Exercise elevates productivity and decreases work and school absences.

Exercise has a positive effect in the treatment for anxiety and depression and can help improve social relationships.

Adolescents who stay physically active during their teens may lower the risk of depressive symptoms at age 18.

Has anti-depressive properties as well as the ability to increase positive mood.

Exercise associated with decreased risk of mild cognitive impairment.

Men are reportedly more physically active than women.

Men demonstrates a 1.7 METs higher than women, but their survival is equivalent to that of women demonstrating 2.6 METs lower.

Physical activity participation leads to physiologic adaptations associated with improved cardio respiratory, vascular, musculoskeletal, mental, and metabolic health.

Benefits with regular exercise include protection against heart attacks, stroke, hypertension, peripheral arterial disease, obesity, diabetes, erectile dysfunction, sarcopenia, osteoporosis, dementia, depression, breast cancer and colon cancer.

Exercise over a period of 10 days is nearly as effective as antidepressants for the treatment of depression.

Regular exercise slows consequences of aging and promotes a longevity.

Exercise increases the cannabis-like substances of the body, which subsequently helps lessen inflammation and could potentially help in treating a number of conditions such as heart disease, cancer, and arthritis.

Even modest amounts of leisure time physical exercise can extend life expectancy by as much as 4.5 years.

Physical activity effects are pervasive across one’s lifespan.

Exercise capacity is a strong predictor of mortality, MI, and downstream revascularization inpatients with coronary artery disease.

Exercise therapy increases functional capacity, reduces hospitalization and mortality in male patients with heart failure.

Average American adult exercise time is 18 minutes.

No medication treatment influences as many organ systems in a positive fashion as physical activity.

Among at risk patients, regular vigorous exercise is associated with decreased peripheral arterial disease and all-cause mortality.

Physical exercise like daily aerobic exercise, especially endurance exercise,  prevents the development of drug addiction and is an effective adjunct therapy  for amphetamine addiction.

 

Exercise leads to better treatment outcomes when used as an adjunct treatment, particularly for psychostimulant addictions.

 

Consistent aerobic exercise may lead to better treatment outcomes when used as an adjunct treatment for drug addiction.

Aerobic exercise decreases psychostimulant self-administration, reduces the relapse rate of drug-seeking, and induces increased dopamine receptor D2 (DRD2) density in the striatum.

 

Exercise may also prevent the development of a drug addiction by altering ΔFosB or c-Fos immunoreactivity in the striatum or other parts of the reward system.

 

In an assessment of 55,137 adults between 18-100 years of age: weekly runners were 30% less likely to die from all-causes, and 45% less likely to die from CV causes (Lee D et al).

In the above study reduced mortality risks were the same for those who ran less than 1 hour a week as well those who ran more than 3 hours a week.

CV mortality in the above study was significantly reduced among runners even 5-10 minutes a day at slow speed, compared to non runners.

Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial showed no difference in outcomes in stable ischemic heart disease-death, myocardial infarction, hospitalization for unstable angina- during a 55 month follow-up between PCI patients and those treated with medical therapy and lifestyle modification (Boden WE. Et al).

There is an inverse relationship between energy expenditure in walking and other vigorous exercise and the incidence of coronary artery disease.

Suggested that physical exercise is the treatment for depression is a moderate to large affect.

Regular physical activity is associated with a lowered risk of post myocardial depression.

2 minutes of moderate intensity activity counts the same as 1 minute of vigorous activity.

Vigorous physical activity is more efficient than moderate activity in inducing cardio respiratory and metabolic fitness, a stronger predictor of morbididity and mortality than activity.

Even a few minutes of brief, vigorous physical activity for individuals with low leisure time activity may decrease the risk of cancer.

Vigorous intermittent lifestyle physical activity (VILPA) defined as activity comprising daily life (stair climbing, running to catch a bus.) when analyzed over seven years suggested that individuals with a little less than four minutes per day of vigorous activity, how does 17% decrease risk of total cancer, and a 20% decrease risk for cancer sites possibly associated with low physical activity (Stamatakis E).

VILPA of a little more than four minutes per day is associated with a reduction in risk of cardiovascular disease, cancer, and all cause mortality in both exercisers and non-exercisers (Stamatakis E).

Physical activity helps to increase the transition from metabolic unhealthy obesity to metabolic healthy obesity, which may contribute to a reduction in subsequent development of type two diabetes and major cardiovascular disease complications.

Physical activity is positively associated with the transition from being metabolically unhealthy obese or metabolically healthy obese.

Brisk walking daily for 20 minutes confers 30-40% reduced risk of myocardial infarction.

Low levels of cardiorespiratory fitness associated with a high risk of cardiovascular disease and all cause mortality.

Maintenance of very high physical activity levels throughout young adulthood significantly

reduces the risk of becoming overweight or obese.

Exercise reduces cardiovascular mortality, and particularly coronary mortality by improving endothelial function, autonomic tone, inflammation and control of risk factors.

Studies show that 10 to 40% cancer risk reduction in the most physically active study participants when compared to least active participants.

Aerobic capacity, as an indicator of physical fitness and function, decreases 10-33% over a 12 week period of chemotherapy for breast and other cancers (Winter-Stone KM).

Exercise during and after treatment reduces cancer recurrence and disease specific mortality rates of 30% to 60% in breast and colon cancers.

A moderate amount of physical activity can achieve many protective benefits of exercise, such as walking for 30 minutes 5 days a week at a speed of about 2.5 miles per hour can convey health benefits.

American College of Sports Medicine Exercise for Cancer survivors:

Engage in 150 minutes of moderate intensity activity or 75 minutes per week of vigorous physical activity

Strength training should be performed 2 days or more/week and should involve the eight major muscle groups.

Increased exercise or physical activity and cardiorespiratory fitness mitigates CV disease progression.

Physical activity has a dose response association with cognitive function, and even at low physical activity frequencies is associated with cognitive function during aging.

People doing physical activity even at low frequencies have better cognitive function than those during no physical activity as they age.

In patients with chronic kidney higher physical activity associated with a slower rate of GFR decline.

Higher hand grip strength and gait speed is associated with low risk of death with chronic kidney disease.

There is an inverse, independent and graded association between higher exercise capacity and the rate of the development of chronic kidney disease in men.

The average daily exercise capacity of approximately 6.5 METs is necessary to realize health benefits by middle-aged and older men.

Higher exercise capacity at baseline after MI associated with lower risk of death.

Among at risk individuals regular vigorous physical activities are associated with decreased PAD and all-cause mortality (Chang P et al).

Exercise has anti thrombotic , anti atherosclerotic, anti-ischemic, and anti arrhythmic effects.

NHANES: An ideal level of physical activity is defined as ≥150 minutes per week of moderate activities, ≥75 minutes per week of vigorous activities, or ≥150 minutes per week of a combination of moderate and vigorous activities.

Guidelines Physical Activity: 150-300 minutes of moderate intensity or 75-150 minutes of vigorous intensity aerobic activity weekly.

Using the above guidelines: a benefit threshold at approximately 3-5 recommended leisure time physical activity minimum and no excess risk at 10 or more times the minimum (Arem H et al).

83% of patients with cardiovascular disease failed to meet the current physical activity recommendations.

Physical Activity Guidelines Steering Committee reveal outcome of 14.2 year population sample of 661,137 men and women Evaluating leisure physical activity: leisure time activity is associated with reduce mortality risk with similar six and cancer and cardiovascular disease related mortality.

In the above analysis mortality risk reduction tapers significantly after reaching three times the minimum leisure time physical activity and that performing moderate-intensity activity at two times the minimum amount had the same benefit as those performing 10 times the recommended level.

Also in the above analysis vigorous activity provided a benefit, but it was similar to activity at the moderate intensity level and the affected vigorous activity waned after achieving 20% mortality rate reduction in individuals meeting the minimum requirement.

In the above study individuals performing very high levels of activity, that is more than 10 times the recommended minimum did not have an elevated risk of mortality.

Studies suggest a higher risk of arrhythmias with prolonged endurance training or sudden death due to electrical and myocardial,remodeling.

Cardiac overuse injury is a consequence of too much exercise.

Cardiac overuse injury may be associated with cardiac arrhythmias that are life-threatening, accelerated coronary plaque formation, premature aging of the heart, myocardial fibrosis, plaque rupture and acute coronary thrombosis, and sudden cardiac death (O’keefe JH et al).

An intermediate level of physical activity is defined as 1 to 149 minutes per week of moderate activities, 1 to 74 minutes per week of vigorous activities, or 1 to 149 minutes per week of a combination of moderate and vigorous activities.

NIH Consensus Development Panel recommends 30 minutes of moderate intensity physical activity on most, preferably all, days of the week.

Older adults with low physical activity are at increased risk of mortality compared to those with moderate to high levels of activity.

Strong legs associated with healthier brain aging.

Reduces the risk of sudden cardiac death and acute myocardial infarction but does transiently increase the risk of both of these cardiovascular events.

Adaption to exercise include enlargement of all four cardiac chambers and modest changes in the left wall thickness.

Exercise may preserve neuronal structures by stimulating brain-derived neutropic factor and neuronal growth.

Exercise may support brain plasticity and sustain brain vascular health by decreasing cardiovascular risk, promoting endothelial function, improving glucose and insulin regulation and improving cerebral perfusion.

Exercise reduces inflammation, which is higher in patients with vascular disease.

Improves bone mineral density (BMD) in healthy sedentary postmenopausal women.

Higher levels of moderate and vigorous intensity physical activity daily in children and adolescents is associated with better cardio metabolic risk factors regardless of the amount of sedentary time (Ekelund U et al).

Adults average 5100 steps per day in U.S.

Amish average 18000 steps per day and have only a 4% obesity rate.

Improving the cardiorespiratory fitness from low to moderate to high progressively improves cardiovascular prognosis and overall survival.

Survival benefits from improvements in cardiorespiratory fitness plateaus at about 10 metabolic equivalents, with no additional survival benefit from higher CRF levels.

30 minutes of regular vigorous physical activity enhances health and well-being, but performing three-hour bouts of strenuous physical activity does not multiply the health benefits.

Extreme exercise may result in acute elevations in cardiac troponin and B type natriuretic peptide and evidence of transient myocardial dysfunction.

Exercise is associated with a U- shaped association with vascular disease risk and mortality, suggesting and attenuation of health benefits at higher physical activity doses above the recommended physical activity levels of 150 minutes of moderate-to-vigorous intensity physical activity per week.

High-level lifelong endurance exercise increases myocardial gadolinium enhancement suggesting myocardial fibrosis in older endurance athletes.

In the National Walker’s And Runners’ Health study running or walking decreased cardiovascular disease mortality risk progressively at most levels of exercise in patience after a cardiac event, but the benefits of exercise on cardiovascular mortality and ischemic heart disease is lessened at the highest levels of exercise.

In a study of 18,000 women in the Women’s Health study found that walking intensities or cadence associated with all-cause mortality was attenuated  by walking amounts measured as  steps per day.

Mortality rate progressively decreases with more steps walkEd per day even after adjusting for intensity

Participating in leisure-time running is associated with a lower risk of the development of type two diabetes in adults.

After myocardial infarction reduces overall mortality and mortality from cardiovascular disease.

Secondary prevention exercise trials in conjunction with optimal medical therapy reduces total mortality by 20%, cardiac mortality by 26%, and non-fatal myocardial infarction by 21% (Leon AS et al).

Associated with a reduced risk for recurrent colon cancer.

Observational studies show higher levels of postoperative diagnosis exercise exposure associated with reductions and the risk of recurrence and cancer specific mortality in patients with nonmetastatic breast, prostate, and colorectal cancers.

Preclinical studies suggest exercise exhibits antitumor activity.

The risk of epilepsy later in life may be reduced in men who exercise as young adults.

Epilepsy is 79% and 36% less likely to develop in men who have a high level of fitness than in those with low and medium fitness levels, respectively.

A meta-analysis demonstrated a 38% reduction in all cause mortality in patients with type II DM (Sluik D et al).

Exercise decreases basal insulin levels, increases insulin sensitivity, and decreases glycated hemoglobin levels.

 

Weight loss increases insulin sensitivity is proportional to the degree of weight loss, and can range from 20% to 200%.

A few weeks of exercise can enhance insulin sensitivity by ~20% in previously sedentary obese adults, independent of weight loss.

 

Physical activity is associated with improved insulin sensitivity, and physical inactivity is associated with an increased insulin resistance.

After 13 weeks of aerobic exercise, with 20-40 minutes minutes per day of training improved. fitness and demonstrated dose response benefits for insulin resistance and general and visceral adiposity in sedentary overweight or obese children, regardless of sex or race (Davis CL at al).

Physical activity may lower risk of progression of gestational diabetes to type 2 DM (Bao W et al).

Associated with decreased kidney function decline in the elderly.

Physical activity confers metabolic benefits that may moderate long-term risks of glomerulosclerosis and progressive renal dysfunction.

Physical activity is associated with reduced incidence of cognitive impairment after 2 years in elderly people (Etgen T).

Physical activity maintained at high levels through young adulthood may lessen weight gain as young adults transition to middle age, and this is particularly true for women (Hankinson AL et al).

Activity energy expenditure may be protective against cognitive impairment in a dose response manner ( Middleton LE et al).

Physical activity in midlife and late life is associated with lower rates of dementia and cognitive impairment in late life.

A Swedish study demonstrated that women who exercise vigorously in middle-age have a 65% reduction in the prevalence of dementia, and those with a low level of fitness experience at increased risk of about 35% (Horder H).

People who participate in higher levels of physical activity have slower rate of cognitive decline compared with individuals who are less active.

Physical activity, including walking, done regularly is associated with better preservation of cognitive function in older women with vascular disease or risk factors (Vercambre MN et al).

400 meter walk test used as a measure of mobility because loss of the ability to walk 400m predicts for multiple adverse outcomes such as mobility, worsening disability, cardiovascular disease, need for institutionalization and mortality.

In elderly exercise and progressive strength training reduces risk factors for falling and enhances BMD.

Studies have documented an inverse association between job-related physical electricity, and overall coronary heart disease.

In a study of 190,000 US railroad workers death caused by atherosclerosis was more frequent in relatively sedentary clerks and moderately active switchmen, than in men who had high physical activities (Taylor HL).

Jerusalem Longitudinal Cohort Study enrolled elderly individuals in a prospective study and concluded: continuing and initiating physical activity associated with better survival and function supporting such activities in advanced age.

Jerusalem Longitudinal Cohort Study an 18 year longitudinal cohort study revealed exercise benefits regardless of increasing age and the magnitude of difference between physically active and sedentary participant increased with advancing age.

Jerusalem Longitudinal Cohort Study maximal survival benefit was observed among the oldest age group.

90 minutes of aerobic exercise combined with 60 minutes of resistance exercise over 3 days per week is optimum to reduce insulin resistance and improve function on previously sedentary older abdominally obese adults (Davidson).

Inverse relationship between measures of total physical activity and all-cause mortality.

Low leisure time physical activity reduces total mortalty, mortality from cardiovascular disease, and mortality from cancer: 15 min per day for 6 days a week reduced all cause mortality by 14%, cancer mortality by 10%, and mortality from cardiovascular disease by 20% (Wen CP et al).

One in 10 Americans die prematurely of disorders with origins related to physical inactivity.

Frequency may be more important than intensity for favorably influencing cholesterol levels.

25% of American adults are completely sedentary and more than 60 percent are not regularly active at the recommended level of 30minutes per day.

39% of white women and 57% of women of color do not get enough exercise.

30-45 minutes of walking three times weekly reduces the risk of myocardial infarction by 50% in women.

Even infrequent moderate intensity activity is associated with a significant reduction in death compared with a completely sedentary lifestyle.

Reduces vascular resistance, decreases cardiac output, and decreases plasma noradrenaline concentrations.

Exercise training in a rehabilitation setting rate of cardiac arrest is 1 per 112,000 patient-hours and the rate of non-fatal myocardial infarction is 1 294,000 patient-hours with a mortality rate of 1 per 784,ooo patient-hours.

Regular exercise decreases insulin resistance, lowers blood pressure, and reduces serum fibrinogen levels, plasminogen activator inhibitor 1 activity and platelet adhesion.

Promotes muscle insulin sensitivity, insulin-mediated transport of glucose from blood to muscle, improves autonomic nervous system function, and lowers heart rate.

Physical exercise has been associated with the reduction of physical and cognitive complications related to central nervous system disorders.

Moderate exercise is linked to increased neurogenesis, survival, and neuronal differentiation and migration.

Stimulates glucose uptake by skeletal muscle, reducing insulin secretion, and promotes lipolysis.

Contributes to a fall in systemic blood pressure and reduces body mass.

Increases lipoprotein lipase activity in skeletal muscle that enhances the clearance rate of plasma triglycerides and increases HDL cholesterol

Inversely associated with risk of colorectal cancer, with the strongest relationship in men.

Inverse relationship between physical activity and colorectal cancer development, with an overall relative risk of 0.76 based on a meta-analysis of 52 observational studies (Wolin KY et al).

IN the Health Professionals Follow-up Study the overall mortality in a cohort of 668 men with stage I-stage III colorectal cancer a value weighted by physical activity categories: more physical activity was associated with lower risk of colorectal cancer specific and overall survival (Meyerhardt JA et al).

Aerobic exercise during radiation treatment of the breast can prevent declines in erythrocyte levels experienced by non exercising peers.

The benefits of increased physical activity may be greatest in the oldest patients.

Physical activity increases well being as demonstrated by meta-analysis

No increased mortality associated with increasing levels of physical activity.

Initiated during early pregnancy enhances fetoplacental growth rate.

Heart rate recovery of less than 12 beats per minute in the first minute following exercise predicts all-cause mortality in patients undergoing exercise stress testing.

Resistance exercise improves fatigue in men with prostate cancer receiving androgen therapy.

Weight lifting in men with prostate cancer receiving androgen deprivation therapy improves body composition, physical function, and quality of life, and experience reductions in fatigue.

Protective role in breast cancer.

Physical activity after the diagnosis of breast cancer associated with a reduction in total and breast cancer mortality and recurrence from the Nurse’s Health Study.

Meta-analyses indicate that women who are physically active have a reduced risk of breast cancer, with the most active demonstrating a reduced risk by 30-40%.

Breast cancer survivors engaging in slow, progressive weight lifting program, strengthened their affected arms and had a lower incidence and severity of lymphedema.

In a large 16 year prospective cohort study premenopausal women that spent time bicycling demonstrated a significantly lowered change in weight, and the relationship was stronger among women with excess weight (Lusk AC).

Increased physical activity is associated with reduced risk of breast cancer in postmenopausal women, longer duration provides the most benefit, and activity level need not be strenuous.

30% reduction in incidences of coronary heart disease, stroke and type 2 diabetes by brisk walking (>3 mph ) for at least 3 hours a week compared with those that do less.

As little as 100min/wk of brisk walking may be associated with some areas of improved health.

Investing as little as 150min/wk in moderate intensity aerobic activity or 75 min/wk in vigorous activity, or an equivalent combination of the two is associated with substantial health benefits (US Dept of Health and Human Services).

Resistance training decreases HbA1c by 0.66% in individuals with type 2 diabetes (Boule NG et al).

Aerobics study showed 12 year cardiovascular and overall mortality approximately 60% lower with moderate to high cardiovascular fitness at baseline compared with those with low baseline fitness (Wei M et al).

Individuals that engage in strong or intense exercise have a reduction in ischemic heart disease by a third compared to those who exercise in a weak fashion.

Among postmenopausal women 30% report to having no physical activity at all, and this percentage increases with age.

Fitness declines 1-2% each year during the postmenopausal period.

There is a 14% reduction in ischemic heart disease for those who exercise in a moderate fashion.

Reduced Disability and Mortality Among Aging Runners: A 21-Year Longitudinal Study-reported reduced disability and mortality over 21 years for runners compared to controls (Chakravarty).

Cardiorespiratory fitness strongly associated with high mitochondrial function.

A substantial percentage of coronary artery disease patients manifest a progressive diminution in finger pulse wave amplitude during exercise.

Protective for hypertension, anxiety and depression.

Reduces depressive symptoms among patients with chronic illness(Herring, MP et al).

A substantial percentage of coronary artery disease patients manifest a progressive diminution in finger pulse wave amplitude during exercise.

Associated with a decreased risk of dementia.

Improves cognitive function in older adults with subjective and objective mild cognitive impairment.

Evidence suggests physical activity associated with lower rates of cognitive decline.

Exercise is associated with improved cerebral blood flow, neuronal connectivity, maintenance of improvement in brain volume, favorable changes in brain derived neurotrophic factor and neurogenesis.

Among sedentary older adults a 24 month physical activity program compared with health education did not result in improvements in the global or domain specific cognitive function (The LIFE Randomized Trial).

Physical activity associated with increased blood perfusion to areas of the brain the modulate attention.

Long-term effects of aerobic exercise may include increased neuron growth, increased neurological activity and signaling of Fos and BDNF, improved stress coping, enhanced cognitive control of behavior, improved declarative, spatial, and working memory, and structural and functional improvements in brain structures and pathways associated with cognitive control and memory.

Exercise’s effects on cognition may affect academic performance in children and college students, improve adult productivity, preserve cognitive function in old age, preventing or treating certain neurological disorders, and improving overall quality of life.

Higher physical fitness scores as measured by VO2 max, are associated with better executive function, faster processing speed, and greater volume of the hippocampus, caudate nucleus, and nucleus accumbens.

Physical activity performed by the elderly may play a role in protecting against Alzheimer’s disease.

Leisure time physical activity protects against lumbar radicular pain by 16%., but has no protective effect on sciatica.

Aerobic exercises in older high functioning adults compared to a group with stretching and toning exercises demonstrated greater task related activities in attentional control areas reflecting increased synaptogenesis, increased blood supply, and cholinergic effects (Colcombe).

Among patients with advanced cancer resistive exercise along with protein supplements may increase muscle strength and maintain functional status.

During exercise, muscle proteins get broken down into free amino acids and then undergo the process of oxidizing in mitochondria to produce energy. 

 

Eating whey protein supplements enhance the body’s protein recovery and synthesis after exercise because it increases the free amino acids in the body’s free amino acid pool.

 

Exercise can be classified into three groups: aerobic exercise, resistance training, and stretching exercises.

Aerobic exercise includes brisk walking, jogging, bicycling, swimming, and tai chi.

Stretching exercise as in yoga.

Resistance training relates to weights and resistance bands.

Exercise systems can combine different elements such as Pilates focusing on increasing muscle flexibility and strength.

Calisthenics are aerobic exercise that use the body’s weight as the source of resistance.

Anaerobic exercise has the major benefit on cardiovascular health due to its ability to increase maximum oxygen consumption, increase stroke volume, and decreased resting heart rate.

Resistance exercises increases muscle mass and strength.

Resistance exercises do not burn as many calories as aerobic exercises per time engaged in the activity.

Resistance exercise build muscle strength and are good for decreasing falls and improving balance.

Stretching exercise improve range of motion and function of joints, increase tendon flexibility, and improve muscle performance to prevent and treat musculoskeletal injuries.

Increase muscle mass results in increased metabolic demand which results in decreased body fat.

Recommended individuals accumulate 10,000 steps per day to meet physical activity guidelines.

The physical activity associated with walking a typical 18 hole golf course allows an accumulation of more than 10,000 steps of physical activity.

Increase in physical activity alone, without decreased intake of calories is associated with only modest weight reduction.

For weight loss it is recommended 150 – 175 minutes of brisk walking or similar aerobic exercise per week.

Jogging the equivalent of 20 miles a week without caloric restriction resulted in a weight loss of 2.9 kg in 8 months (Slentz).

Physical activity without calorie restriction can reduce visceral adipose tissue and improves insulin resistance.

Standing a quarter of the time per day or more is associated with decreased risk of obesity.

 

Higher daily step count linked with lower all-cause mortality

 

Higher daily step counts were associated with lower mortality risk from all causes.

 

NCI/CDC and National Institute on Aging found that the number of steps a person takes each day, but not the intensity of stepping, had a strong association with mortality.

 

The study tracked a representative sample of U.S. adults aged 40 and over; approximately 4,800 participants wore accelerometers for up to seven days between 2003 and 2006.

 

The participants were followed for mortality through 2015 via the National Death Index.

 

Compared with taking 4,000 steps per day, a number considered to be low for adults, taking 8,000 steps per day is associated with a 51% lower risk for all-cause mortality.

 

Taking 12,000 steps per day is associated with a 65% lower risk compared with taking 4,000 steps.

 

In this study there was no association between step intensity and risk of death after accounting for the total number of steps taken per day.

 

The study found  higher step counts were associated with lower all-cause death rates among both men and women; among both younger and older adults; and among white, black, and Mexican-American adults.

 

Higher  step counts were also associated with lower rates of death from cardiovascular disease and cancer.

 

Adults should move more and sit less throughout the day.

 

Adults are recommended to get at least 150 minutes of moderate-intensity physical activity per week.

 

Being physically active has many benefits, including reducing a person’s risk of obesity, heart disease, type 2 diabetes, and some cancers.

 

High-Intensity Interval Training Helps To Reverse Aging Process

High-intensity interval training triggers cells to produce more proteins for their protein building ribosomes and their energy generating mitochondria, which effectively stops cellular level aging.

High intensity training (HIIT) optimizes improvements in cardiovascular fitness with less exercise time compared with moderate and low intensity exercise programs.

HIIT increases the adherence and participation rates in exercise training regimens compared with more traditional regimens and traditional exercise programs, in large part due to greater enjoyment of exercise and the time commitment.

HIIT Improves cardiovascular fitness and reduces cardio metabolic disease risk factors.

HIIT can improve key metabolic disease risk factors including body composition, insulin sensitivity, blood pressure in normal weight adults, and obesity classifications. 

 

HIIT has great benefits compared with moderate to low intensity steady state or interval exercise.

 

A study of young and old groups, were divided into high-intensity interval biking, another group of participants did weight strength training, and another group did a combination of interval training and strength training. 

Biopsies were then taken from the thigh muscles and the muscle cell molecular makeup was compared to samples of muscle cells taken from sedentary participants. 

Insulin sensitivity and lean muscle mass of the participants was assessed as well.

The better results were produced at the cellular level with high-intensity interval training: younger age group  participants from the interval training group had an increase of 49% in mitochondrial capacity, and an even more dramatic increase of 69% in the older participants. 

Insulin sensitivity was also improved with interval training, indicating a lower chance of getting diabetes. 

Interval training was not as effective at increasing muscle strength.

The energy producing capacity of the mitochondria of cells gradually diminishes as we age. 

Exercise stimulates cells to generate more gene coding RNA copies for proteins of the mitochondria and proteins in charge of the growth of muscle. 

The ability of ribosomes to build proteins of the mitochondria also seemed to improve with exercise. 

High-intensity exercise programs in fact reverse age-related decline in the function of the mitochondria and proteins necessary for muscle building.

High intensity functional training (HIFT) incorporates functional and multi modal movements including plyometrics and strength training where is HITT incorporates unimodal exercises of running and rowing.

Physical inactivity, characterized by prolonged sitting and a low step count, elevates postprandial plasma lipids and thus risk of disease.

Interruption of prolonged sitting of 8 h of inactivity with hourly cycling sprints of only 4-s duration each improves postprandial plasma lipids.

8-h period of sitting, or a trial with equal sitting time interrupted with five SPRINTS every hour. 

No differences between interventions were found for plasma insulin or glucose.

SPRINTS displayed a 31% decrease in plasma triglyceride and a 43% increase in whole-body fat oxidation when compared with sitting.