Importance of Exercise Essay

500 words essay on exercise essay.

Exercise is basically any physical activity that we perform on a repetitive basis for relaxing our body and taking away all the mental stress. It is important to do regular exercise. When you do this on a daily basis, you become fit both physically and mentally. Moreover, not exercising daily can make a person susceptible to different diseases. Thus, just like eating food daily, we must also exercise daily. The importance of exercise essay will throw more light on it.

importance of exercise essay

Importance of Exercise

Exercising is most essential for proper health and fitness. Moreover, it is essential for every sphere of life. Especially today’s youth need to exercise more than ever. It is because the junk food they consume every day can hamper their quality of life.

If you are not healthy, you cannot lead a happy life and won’t be able to contribute to the expansion of society. Thus, one needs to exercise to beat all these problems. But, it is not just about the youth but also about every member of the society.

These days, physical activities take places in colleges more than often. The professionals are called to the campus for organizing physical exercises. Thus, it is a great opportunity for everyone who wishes to do it.

Just like exercise is important for college kids, it is also essential for office workers. The desk job requires the person to sit at the desk for long hours without breaks. This gives rise to a very unhealthy lifestyle.

They get a limited amount of exercise as they just sit all day then come back home and sleep. Therefore, it is essential to exercise to adopt a healthy lifestyle that can also prevent any damaging diseases .

Benefits of Exercise

Exercise has a lot of benefits in today’s world. First of all, it helps in maintaining your weight. Moreover, it also helps you reduce weight if you are overweight. It is because you burn calories when you exercise.

Further, it helps in developing your muscles. Thus, the rate of your body will increases which helps to burn calories. Moreover, it also helps in improving the oxygen level and blood flow of the body.

When you exercise daily, your brain cells will release frequently. This helps in producing cells in the hippocampus. Moreover, it is the part of the brain which helps to learn and control memory.

The concentration level in your body will improve which will ultimately lower the danger of disease like Alzheimer’s. In addition, you can also reduce the strain on your heart through exercise. Finally, it controls the blood sugar levels of your body so it helps to prevent or delay diabetes.

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Conclusion of Importance of Exercise Essay

In order to live life healthily, it is essential to exercise for mental and physical development. Thus, exercise is important for the overall growth of a person. It is essential to maintain a balance between work, rest and activities. So, make sure to exercise daily.

FAQ of Importance of Exercise Essay

Question 1: What is the importance of exercise?

Answer 1: Exercise helps people lose weight and lower the risk of some diseases. When you exercise daily, you lower the risk of developing some diseases like obesity, type 2 diabetes, high blood pressure and more. It also helps to keep your body at a healthy weight.

Question 2: Why is exercising important for students?

Answer 2: Exercising is important for students because it helps students to enhance their cardiorespiratory fitness and build strong bones and muscles. In addition, it also controls weight and reduces the symptoms of anxiety and depression. Further, it can also reduce the risk of health conditions like heart diseases and more.

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  • 01 May 2024
  • Correction 07 May 2024

Why is exercise good for you? Scientists are finding answers in our cells

  • Gemma Conroy

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Researchers are looking into the molecular basis of how exercise benefits health, to help treat diseases. Credit: Ozan Guzelce/dia images via Getty

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When Bente Klarlund Pedersen wakes up in the morning, the first thing she does is pull on her trainers and go for a 5-kilometre run — and it’s not just about staying fit. “It’s when I think and solve problems without knowing it,” says Klarlund Pedersen, who specializes in internal medicine and infectious diseases at the University of Copenhagen. “It’s very important for my well-being.”

Whether it’s running or lifting weights, it’s no secret that exercise is good for your health. Research has found that briskly walking for 450 minutes each week is associated with living around 4.5 years longer than doing no leisure-time exercise 1 , and that engaging in regular physical activity can fortify the immune system and stave off chronic diseases, such as cancer, cardiovascular disease and type 2 diabetes. But, says Dafna Bar-Sagi, a cell biologist at New York University, the burning question is how does exercise deliver its health-boosting effects?

“We know that it is good, but there is still a huge gap in understanding what it is doing to cells,” says Bar-Sagi, who walks on a treadmill for 30 minutes, five days a week.

In the past decade, researchers have started to build a picture of the vast maze of cellular and molecular processes that are triggered throughout the body during — and even after — a workout. Some of these processes dial down inflammation, whereas others ramp up cellular repair and maintenance. Exercise also prompts cells to release signalling molecules that carry a frenzy of messages between organs and tissues: from muscle cells to the immune and cardiovascular systems, or from the liver to the brain.

But researchers are just beginning to work out the meaning of this cacophony of crosstalk, says Atul Shahaji Deshmukh, a molecular biologist at the University of Copenhagen. “Any single molecule doesn’t work alone in the system,” says Deshmukh, who enjoys mountain biking during the summer. “It’s an entire network that functions together.”

essay on exercise is good for health

Endurance exercise causes a multi-organ full-body molecular reaction

Exercise is also attracting attention from funders. The US National Institutes of Health (NIH), for instance, has invested US$170 million into a six-year study of people and rats that aims to create a comprehensive map of the molecules behind the effects of exercise, and how they change during and after a workout. The consortium behind the study has already published its first tranche of data from studies in rats, which explores how exercise induces changes across organs, tissues and gene expression, and how those changes differ between sexes 2 – 4 .

Building a sharper view of the molecular world of exercise could reveal therapeutic targets for drugs that mimic its effects — potentially offering the benefits of exercise in a pill. However, whether such drugs can simulate all the advantages of the real thing is controversial.

The work could also offer clues about which types of physical activity can benefit people with chronic illnesses, says Klarlund Pedersen. “We think you can prescribe exercise as you can prescribe a medicine,” she says.

Hard-wired for exercise

Exercise is a fundamental thread in the human evolutionary story. Although other primates evolved as fairly sedentary species, humans switched to a hunter-gatherer lifestyle that demanded walking long distances, carrying heavy loads of food and occasionally running from threats.

Those with better athletic prowess were better equipped to live longer lives, which made exercise a core part of human physiology, says Daniel Lieberman, a palaeoanthropologist at Harvard University in Cambridge, Massachusetts. The switch to a more active lifestyle led to changes in the human body: exercise burns up energy that would otherwise be stored as fat, which, in excess amounts, increases the risk of cardiovascular disease, type 2 diabetes and some cancers. The stress induced by running or pumping iron has the potential to damage cells, but it also kick-starts a cascade of cellular processes that work to reverse those effects. This can leave the body in better shape than it would be without exercise, says Lieberman.

Researchers have been exploring some of the biological changes that occur during exercise for more than a century. In 1910, pharmacologist Fred Ransom at the University of Cambridge, UK, discovered that skeletal muscle cells secrete lactic acid, which is created when the body breaks down glucose and turns it into fuel 5 . And in 1961, researchers speculated that skeletal muscle releases a substance that helps to regulate glucose during exercise 6 .

More clues were in store. In 1999, Klarlund Pedersen and her colleagues collected blood samples from runners before and after they took part in a marathon and found that several cytokines — a type of immune molecule — spiked immediately after exercise and that many remained elevated for up to 4 hours afterwards 7 . Among these cytokines were interleukin-6 (IL-6), a multifaceted protein that is a key player in the body’s defence response. The following year, Klarlund Pedersen and her colleagues discovered 8 that IL-6 is secreted by contracting muscles during exercise, making it an ‘exerkine’ — the umbrella term for compounds produced in response to exercise.

A group of people doing tai chi outdoors with the Shanghai city skyline in the background.

Exercising regularly can strengthen the immune system and stave off disease. Credit: Mike Kemp/Getty

High levels of IL-6 can be beneficial or harmful, depending on how it is provoked. At rest, too much IL-6 has an inflammatory effect and is linked to obesity and insulin resistance, a hallmark of type 2 diabetes, says Klarlund Pedersen. But when exercising, the molecule activates its more calming family members, such as IL-10 and IL-1ra, which tone down inflammation and its harmful effects. “With each bout of exercise, you provoke an anti-inflammatory response,” says Klarlund Pedersen. Although some physical activity is better than none, high-intensity, long-duration exercise that engages large muscles — such as running or cycling — will crank up IL-6 production, adds Klarlund Pedersen.

Exercise is a balancing act in other ways, too. Physical activity produces cellular stress, and certain molecules counterbalance this damaging effect. When mitochondria — the powerhouses that supply energy in cells — ramp up production during exercise, they also produce more by-products called reactive oxygen species (ROS), which, in excessive amounts, can damage proteins, lipids and DNA. But these ROS also kick-start a horde of protective processes during exercise, offsetting their more toxic effects and fortifying cellular defences.

Among the molecular stars in this maintenance and repair arsenal are the proteins PGC-1α, which regulates important skeletal muscle genes, and NRF2, which activates genes that encode protective antioxidant enzymes. During exercise, the body has learnt to benefit from a fundamentally stressful process. “If stress doesn’t kill you it makes you stronger,” says Ye Tian, a geneticist at the Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing.

Exerkines everywhere

Since IL-6 ushered in the exerkine era, the explosion of multiomics — an approach that combines various biological data sets, such as the proteome and metabolome — has allowed researchers to go beyond chasing single molecules. They can now begin untangling the convoluted molecular web that lies behind exercise, and how it interacts with different systems across the body, says Michael Snyder, a geneticist at Stanford University in California, who recently switched from running to weightlifting. “We need to understand how these all work together, because [humans] are a homeostatic machine that needs to be properly tuned,” he says.

In 2020, Snyder and his colleagues took blood samples from 36 people aged between 40 and 75 years old before, during and at various time intervals after the volunteers ran on a treadmill. The team used multiomic profiling to measure more than 17,000 molecules, more than half of which showed significant changes after exercise 9 . They also found that exercise triggered an elaborate ‘choreography’ of biological processes such as energy metabolism, oxidative stress and inflammation. Creating a catalogue of exercise molecules is an important first step in understanding their effects on the body, says Snyder.

essay on exercise is good for health

How an exercise habit paves the way for injured muscles to heal

Other studies have probed how exercise affects cell types. A 2022 study in mice led by Jonathan Long, a pathologist at Stanford University, identified more than 200 types of protein that were expressed differently by 21 cell types in response to exercise 10 . The researchers were expecting to find that cells in the liver, muscle and bone would be most sensitive to exercise, but to their surprise, they found that a much more widespread type of cell, one that appears in many tissues and organs, showed the biggest changes in the proteins that it cranked out or turned down. The findings suggest that more cell types shift gears during a workout than was previously thought, although what these changes mean for the body is still an open question, says Long.

The findings also showed that after exercise, the mice’s liver cells squeezed out several types of carboxylesterase enzyme, which are known to ramp up metabolism. When Long and his colleagues genetically tweaked mice so that their livers expressed elevated levels of these metabolism-enhancing enzymes, and then fed them a diet of fatty foods, the mice didn’t gain weight. They also had increased endurance when they ran on a treadmill. “The improvement in exercise performance by these secreted carboxylesterases was not known before,” says Long, whose weekly exercise regime involves swimming and lifting weights. He adds that if the enzymes could be produced in the right quantities and purity, they could possibly be used as exercise-mimicking compounds.

During a workout, distant organs and tissues communicate with each other through molecular signals. Along with exerkines, extracellular vesicles (EVs) — nanosized, bubble-shaped structures that carry biological material — could be one of the mechanisms behind organ and tissue crosstalk, says Mark Febbraio, a former triathlete who is now an exercise physiologist at Monash University in Melbourne, Australia. In 2018, Febbraio and his team inserted tubes into the femoral arteries of 11 healthy men and drew blood before and after they rode an exercise bike at an increasing pace for an hour. During and after exercise, but not at rest, they found a spike in the levels of more than 300 types of protein that compose or are carried by EVs 11 .

When the team then collected EVs from mice that had run on a treadmill and injected them into another group of healthy mice, most of the EVs ended up in liver cells. In a separate mouse study that is yet to be published, Febbraio and his colleagues found hints that the contents of these liver-bound EVs can arrest a type of liver disease. A big question is whether EVs also deposit genetic material into different cells, and if so, what that means for the body. “We still don’t know a great deal,” he says.

Exercise as medicine

Larger efforts are under way to build a detailed molecular snapshot of how exercise exerts its health-boosting effects across tissues and organs. In 2016, the NIH established the Molecular Transducers of Physical Activity Consortium (MoTrPAC) , a six-year study on around 2,600 people and more than 800 rats that aims to generate a molecular map of exercise. The effort — one of the largest studies on physical activity — is teasing apart the effects of aerobic and endurance exercise on multiple tissue types across different ages and fitness levels.

The first data set is from rats that completed one to eight weeks of treadmill training, and had blood and tissue samples collected at the end. The researchers pinpointed thousands of molecular changes throughout the rats’ bodies, many of which could have a protective effect on health, such as dialling down inflammatory bowel disease and tissue injury 2 . A separate study 3 found that the effects of endurance training differed across sexes: markers associated with the breakdown of fat increased in male fat tissue, driving fat loss, whereas female fat tissue showed an increase in markers related to fat-cell maintenance and insulin signalling, which might protect against cardiometabolic diseases. A third study 4 found that exercise alters the expression of genes linked to diseases such as asthma, and could help to trigger similar adaptive responses.

essay on exercise is good for health

Focus on exercise metabolism and health

A big goal is to uncover why exercise has such varied effects on people of different sexes, ages and ethnic backgrounds, says Snyder, who is a member of the MoTrPAC team. “It’s very obvious that some people benefit better than others,” he says.

Researchers hope that the reams of molecular data will eventually help clinicians to develop tailored exercise prescriptions for people with chronic diseases, says MoTrPAC team member Bret Goodpaster, an exercise physiologist at AdventHealth Research Institute in Orlando, Florida. Further down the track, such insights could be used to develop therapeutics that mimic some of the beneficial effects of exercise in people who are too ill to work out, he says. “That’s not to say that we will have exercise in a pill, but there are certain aspects of exercise that could be druggable,” says Goodpaster, who has taken part in triathlons, marathons and cycling races.

Several teams are already in the early stages of developing exercise-mimicking therapeutics. In March 2023, a team led by Thomas Burris, a pharmacologist at the University of Florida in Gainesville, identified a compound that targets proteins called oestrogen-related receptors, which are known to trigger key metabolic pathways in energy-intensive tissues, such as heart and skeletal muscle, particularly during exercise 12 . When the researchers administered the compound — called SLU-PP-332 — to mice, they found that the treated rodents were able to run 70% longer and 45% farther than untreated mice. Six months later, a separate study, also led by Burris, found that obese mice treated with the drug lost weight and gained less fat than those that didn’t receive the treatment — even though their diet was the same and they didn’t exercise any more than usual 13 .

There is already evidence that exercise itself acts like medicine. In 2022, Bar-Sagi and her colleagues found that mice with pancreatic cancer had elevated levels of CD8 T cells — which destroy cancerous and virus-infected cells — when they did 30 minutes of aerobic exercise for 5 days a week 14 . These killer cells express a receptor for IL-15, another exerkine released by muscles during exercise. The researchers found that when CD8 T cells bind to IL-15, they unleash a more powerful immune response on tumours in the pancreas. This effect prolonged survival of mice with tumours by around 40%, compared with that of control mice. The findings held up when Bar-Sagi and her team analysed tumour tissue taken from people with pancreatic cancer. Those who did 60 minutes of aerobic and strength training each week had more CD8 T cells, and were twice as likely to survive for up to 5 years, than were people in the control group.

Although exercising more is a no-brainer for improving health, around 25% of adults globally do not meet the World Health Organization’s recommended levels of exercise each week: 150–300 minutes or more of moderate-intensity exercise, such as a brisk walk; or 75–150 minutes of vigorous-intensity exercise, such as running. David James, an exercise physiologist at the University of Sydney in Australia, who rides his bike to work each day, says that understanding the inner workings of exercise could help to develop clearer public-health messages about why physical activity is important and how it can offset the risk of getting chronic diseases. “That’s a powerful message,” says James.

Nature 629 , 26-28 (2024)

doi: https://doi.org/10.1038/d41586-024-01200-7

Updates & Corrections

Correction 07 May 2024 : An earlier version of this News feature gave an old affiliation for Bret Goodpaster. He is now at AdventHealth Research Institute in Orlando, Florida.

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Exercise: 7 benefits of regular physical activity.

You know exercise is good for you, but do you know how good? From boosting your mood to improving your sex life, find out how exercise can improve your life.

Want to feel better, have more energy and even add years to your life? Just exercise.

The health benefits of regular exercise and physical activity are hard to ignore. Everyone benefits from exercise, no matter their age, sex or physical ability.

Need more convincing to get moving? Check out these seven ways that exercise can lead to a happier, healthier you.

1. Exercise controls weight

Exercise can help prevent excess weight gain or help you keep off lost weight. When you take part in physical activity, you burn calories. The more intense the activity, the more calories you burn.

Regular trips to the gym are great, but don't worry if you can't find a large chunk of time to exercise every day. Any amount of activity is better than none. To gain the benefits of exercise, just get more active throughout your day. For example, take the stairs instead of the elevator or rev up your household chores. Consistency is key.

2. Exercise combats health conditions and diseases

Worried about heart disease? Hoping to prevent high blood pressure? No matter what your current weight is, being active boosts high-density lipoprotein (HDL) cholesterol, the "good" cholesterol, and it decreases unhealthy triglycerides. This one-two punch keeps your blood flowing smoothly, which lowers your risk of heart and blood vessel, called cardiovascular, diseases.

Regular exercise helps prevent or manage many health problems and concerns, including:

  • Metabolic syndrome.
  • High blood pressure.
  • Type 2 diabetes.
  • Depression.
  • Many types of cancer.

It also can help improve cognitive function and helps lower the risk of death from all causes.

3. Exercise improves mood

Need an emotional lift? Or need to lower stress after a stressful day? A gym session or brisk walk can help. Physical activity stimulates many brain chemicals that may leave you feeling happier, more relaxed and less anxious.

You also may feel better about your appearance and yourself when you exercise regularly, which can boost your confidence and improve your self-esteem.

4. Exercise boosts energy

Winded by grocery shopping or household chores? Regular physical activity can improve your muscle strength and boost your endurance.

Exercise sends oxygen and nutrients to your tissues and helps your cardiovascular system work more efficiently. And when your heart and lung health improve, you have more energy to tackle daily chores.

5. Exercise promotes better sleep

Struggling to snooze? Regular physical activity can help you fall asleep faster, get better sleep and deepen your sleep. Just don't exercise too close to bedtime, or you may be too energized to go to sleep.

6. Exercise puts the spark back into your sex life

Do you feel too tired or too out of shape to enjoy physical intimacy? Regular physical activity can improve energy levels and give you more confidence about your physical appearance, which may boost your sex life.

But there's even more to it than that. Regular physical activity may enhance arousal for women. And men who exercise regularly are less likely to have problems with erectile dysfunction than are men who don't exercise.

7. Exercise can be fun — and social!

Exercise and physical activity can be fun. They give you a chance to unwind, enjoy the outdoors or simply do activities that make you happy. Physical activity also can help you connect with family or friends in a fun social setting.

So take a dance class, hit the hiking trails or join a soccer team. Find a physical activity you enjoy, and just do it. Bored? Try something new, or do something with friends or family.

Exercise to feel better and have fun

Exercise and physical activity are great ways to feel better, boost your health and have fun. For most healthy adults, the U.S. Department of Health and Human Services recommends these exercise guidelines:

Aerobic activity. Get at least 150 minutes of moderate aerobic activity. Or get at least 75 minutes of vigorous aerobic activity a week. You also can get an equal combination of moderate and vigorous activity. Aim to spread out this exercise over a few days or more in a week.

For even more health benefits, the guidelines suggest getting 300 minutes a week or more of moderate aerobic activity. Exercising this much may help with weight loss or keeping off lost weight. But even small amounts of physical activity can be helpful. Being active for short periods of time during the day can add up and have health benefits.

  • Strength training. Do strength training exercises for all major muscle groups at least two times a week. One set of each exercise is enough for health and fitness benefits. Use a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.

Moderate aerobic exercise includes activities such as brisk walking, biking, swimming and mowing the lawn.

Vigorous aerobic exercise includes activities such as running, swimming laps, heavy yardwork and aerobic dancing.

You can do strength training by using weight machines or free weights, your own body weight, heavy bags, or resistance bands. You also can use resistance paddles in the water or do activities such as rock climbing.

If you want to lose weight, keep off lost weight or meet specific fitness goals, you may need to exercise more.

Remember to check with a health care professional before starting a new exercise program, especially if you have any concerns about your fitness or haven't exercised for a long time. Also check with a health care professional if you have chronic health problems, such as heart disease, diabetes or arthritis.

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  • AskMayoExpert. Physical activity (adult). Mayo Clinic; 2021.
  • Physical Activity Guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services. https://health.gov/our-work/physical-activity/current-guidelines. Accessed June 25, 2021.
  • Peterson DM. The benefits and risk of aerobic exercise. https://www.uptodate.com/contents/search. Accessed June 24, 2021.
  • Maseroli E, et al. Physical activity and female sexual dysfunction: A lot helps, but not too much. The Journal of Sexual Medicine. 2021; doi:10.1016/j.jsxm.2021.04.004.
  • Allen MS. Physical activity as an adjunct treatment for erectile dysfunction. Nature Reviews: Urology. 2019; doi:10.1038/s41585-019-0210-6.
  • Tips for starting physical activity. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/tips-get-active/tips-starting-physical-activity. Accessed June 25, 2021.
  • Laskowski ER (expert opinion). Mayo Clinic. June 16, 2021.

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Physical Activity Is Good for the Mind and the Body

essay on exercise is good for health

Health and Well-Being Matter is the monthly blog of the Director of the Office of Disease Prevention and Health Promotion.

Everyone has their own way to “recharge” their sense of well-being — something that makes them feel good physically, emotionally, and spiritually even if they aren’t consciously aware of it. Personally, I know that few things can improve my day as quickly as a walk around the block or even just getting up from my desk and doing some push-ups. A hike through the woods is ideal when I can make it happen. But that’s me. It’s not simply that I enjoy these activities but also that they literally make me feel better and clear my mind.

Mental health and physical health are closely connected. No kidding — what’s good for the body is often good for the mind. Knowing what you can do physically that has this effect for you will change your day and your life.

Physical activity has many well-established mental health benefits. These are published in the Physical Activity Guidelines for Americans and include improved brain health and cognitive function (the ability to think, if you will), a reduced risk of anxiety and depression, and improved sleep and overall quality of life. Although not a cure-all, increasing physical activity directly contributes to improved mental health and better overall health and well-being.

Learning how to routinely manage stress and getting screened for depression are simply good prevention practices. Awareness is especially critical at this time of year when disruptions to healthy habits and choices can be more likely and more jarring. Shorter days and colder temperatures have a way of interrupting routines — as do the holidays, with both their joys and their stresses. When the plentiful sunshine and clear skies of temperate months give way to unpredictable weather, less daylight, and festive gatherings, it may happen unconsciously or seem natural to be distracted from being as physically active. However, that tendency is precisely why it’s so important that we are ever more mindful of our physical and emotional health — and how we can maintain both — during this time of year.

Roughly half of all people in the United States will be diagnosed with a mental health disorder at some point in their lifetime, with anxiety and anxiety disorders being the most common. Major depression, another of the most common mental health disorders, is also a leading cause of disability for middle-aged adults. Compounding all of this, mental health disorders like depression and anxiety can affect people’s ability to take part in health-promoting behaviors, including physical activity. In addition, physical health problems can contribute to mental health problems and make it harder for people to get treatment for mental health disorders.

The COVID-19 pandemic has brought the need to take care of our physical and emotional health to light even more so these past 2 years. Recently, the U.S. Surgeon General highlighted how the pandemic has exacerbated the mental health crisis in youth .

The good news is that even small amounts of physical activity can immediately reduce symptoms of anxiety in adults and older adults. Depression has also shown to be responsive to physical activity. Research suggests that increased physical activity, of any kind, can improve depression symptoms experienced by people across the lifespan. Engaging in regular physical activity has also been shown to reduce the risk of developing depression in children and adults.

Though the seasons and our life circumstances may change, our basic needs do not. Just as we shift from shorts to coats or fresh summer fruits and vegetables to heartier fall food choices, so too must we shift our seasonal approach to how we stay physically active. Some of that is simply adapting to conditions: bundling up for a walk, wearing the appropriate shoes, or playing in the snow with the kids instead of playing soccer in the grass.

Sometimes there’s a bit more creativity involved. Often this means finding ways to simplify activity or make it more accessible. For example, it may not be possible to get to the gym or even take a walk due to weather or any number of reasons. In those instances, other options include adding new types of movement — such as impromptu dance parties at home — or doing a few household chores (yes, it all counts as physical activity).

During the COVID-19 pandemic, I built a makeshift gym in my garage as an alternative to driving back and forth to the gym several miles from home. That has not only saved me time and money but also afforded me the opportunity to get 15 to 45 minutes of muscle-strengthening physical activity in at odd times of the day.

For more ideas on how to get active — on any day — or for help finding the motivation to get started, check out this Move Your Way® video .

The point to remember is that no matter the approach, the Physical Activity Guidelines recommend that adults get at least 150 minutes of moderate-intensity aerobic activity (anything that gets your heart beating faster) each week and at least 2 days per week of muscle-strengthening activity (anything that makes your muscles work harder than usual). Youth need 60 minutes or more of physical activity each day. Preschool-aged children ages 3 to 5 years need to be active throughout the day — with adult caregivers encouraging active play — to enhance growth and development. Striving toward these goals and then continuing to get physical activity, in some shape or form, contributes to better health outcomes both immediately and over the long term.

For youth, sports offer additional avenues to more physical activity and improved mental health. Youth who participate in sports may enjoy psychosocial health benefits beyond the benefits they gain from other forms of leisure-time physical activity. Psychological health benefits include higher levels of perceived competence, confidence, and self-esteem — not to mention the benefits of team building, leadership, and resilience, which are important skills to apply on the field and throughout life. Research has also shown that youth sports participants have a reduced risk of suicide and suicidal thoughts and tendencies. Additionally, team sports participation during adolescence may lead to better mental health outcomes in adulthood (e.g., less anxiety and depression) for people exposed to adverse childhood experiences. In addition to the physical and mental health benefits, sports can be just plain fun.

Physical activity’s implications for significant positive effects on mental health and social well-being are enormous, impacting every facet of life. In fact, because of this national imperative, the presidential executive order that re-established the President’s Council on Sports, Fitness & Nutrition explicitly seeks to “expand national awareness of the importance of mental health as it pertains to physical fitness and nutrition.” While physical activity is not a substitute for mental health treatment when needed and it’s not the answer to certain mental health challenges, it does play a significant role in our emotional and cognitive well-being.

No matter how we choose to be active during the holiday season — or any season — every effort to move counts toward achieving recommended physical activity goals and will have positive impacts on both the mind and the body. Along with preventing diabetes, high blood pressure, obesity, and the additional risks associated with these comorbidities, physical activity’s positive effect on mental health is yet another important reason to be active and Move Your Way .

As for me… I think it’s time for a walk. Happy and healthy holidays, everyone!

Yours in health, Paul

Paul Reed, MD Rear Admiral, U.S. Public Health Service Deputy Assistant Secretary for Health Director, Office of Disease Prevention and Health Promotion

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Essay on Benefits of Exercise

Students are often asked to write an essay on Benefits of Exercise in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Benefits of Exercise

Introduction.

Exercise is a vital part of our daily routine. It helps in maintaining our health, improving our mood, and enhancing our overall well-being.

Physical Health

Exercise strengthens our heart and lungs, reducing the risk of diseases. It helps in maintaining a healthy weight and promotes better sleep.

Mental Health

Regular exercise releases endorphins, chemicals that make us feel happier and relaxed. It also boosts our self-esteem and improves concentration.

In conclusion, exercise benefits us in many ways. It’s an excellent tool to stay healthy, happy, and focused. Therefore, we should include it in our daily routine.

250 Words Essay on Benefits of Exercise

Exercise, often underrated, is a potent tool for enhancing physical and mental health. It is a universal remedy that offers numerous benefits, transcending age, gender, and physical ability.

Physical Health Benefits

Exercise primarily enhances physical wellbeing. Regular physical activity strengthens the cardiovascular system, reducing the risk of heart diseases. It aids in maintaining a healthy weight, thus preventing obesity-related illnesses. Moreover, exercise improves bone density, reducing the risk of osteoporosis, and enhances muscular strength and flexibility, thereby preventing injuries.

Mental Health Benefits

Beyond physical health, exercise significantly contributes to mental wellbeing. It stimulates the production of endorphins, the body’s natural mood elevators, leading to reduced stress levels and increased happiness. Regular exercise can also alleviate symptoms of depression and anxiety, enhancing overall mental health.

Cognitive Benefits

Exercise also plays a crucial role in cognitive function. It promotes better sleep, aids in maintaining focus, and improves memory. Studies suggest that regular physical activity can delay the onset of cognitive decline in later years, reinforcing its long-term benefits.

In conclusion, the benefits of exercise are manifold, spanning physical, mental, and cognitive domains. It is a cost-effective, accessible strategy to enhance overall health and wellbeing. As college students, embracing exercise as a regular habit can significantly contribute to academic success and lifelong health. The adage, “A healthy mind in a healthy body,” indeed holds.

500 Words Essay on Benefits of Exercise

Exercise, often regarded as a panacea for numerous health-related issues, has been a subject of extensive research over the years. It is a powerful tool that aids in the enhancement of both physical and mental well-being. This essay aims to explore the multifaceted benefits of exercise, ranging from improved physical health to enhanced cognitive abilities.

The first and most apparent advantage of exercise is its profound impact on physical health. Regular physical activity strengthens the cardiovascular system, reducing the risk of heart disease and stroke. Exercise aids in the regulation of blood pressure and cholesterol levels, two significant risk factors for these conditions.

In addition to cardiovascular health, exercise contributes to better respiratory health by enhancing lung capacity and efficiency. It also plays a crucial role in weight management, as it helps burn calories, preventing obesity and associated diseases like diabetes and certain types of cancer.

The benefits of exercise are not limited to physical health; they also extend to mental well-being. Regular physical activity has been shown to reduce symptoms of anxiety and depression. It stimulates the production of endorphins, often referred to as ‘feel-good’ hormones, which elevate mood and promote a sense of well-being.

Exercise also aids in stress management. Engaging in physical activity diverts the mind from stressors, providing a respite from negative thoughts. Furthermore, the accomplishment of fitness goals often boosts self-esteem and confidence.

Recent research has unveiled the cognitive benefits of regular exercise. It has been found to enhance memory and thinking skills. Exercise promotes the growth of new brain cells and improves connections between neurons, leading to better brain health. It can also slow down the cognitive decline associated with aging, thereby reducing the risk of diseases like Alzheimer’s and dementia.

Social Benefits

Exercise often serves as a social activity, providing opportunities to meet new people and strengthen relationships. Participating in group exercises or sports can foster a sense of community and belonging, which is crucial for emotional well-being. Moreover, it can also enhance teamwork and leadership skills, which are invaluable in various aspects of life.

In conclusion, the benefits of exercise are manifold, ranging from physical health improvements to mental and cognitive enhancements. It is a cost-effective and accessible method to maintain overall health and improve quality of life. As college students, integrating regular physical activity into our routine can provide us with the stamina to deal with academic pressures and equip us with skills that are beneficial in the long run. Therefore, exercise is not just about maintaining physical fitness; it is a comprehensive approach to holistic well-being.

That’s it! I hope the essay helped you.

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essay on exercise is good for health

Essay about Exercise – Benefits

Is exercise beneficial? How is it good for you? And what is exercise? Essays like the one below will help you discover the answers to these questions.

Introduction

  • Benefits of Exercise

Works Cited

Do you want to live a good life feeling great with improved mental psyche and energy levels void of some chronic diseases coupled with sound sleep all in one package? Look no further; regular exercising will offer this all-inclusive package of benefits. Many people just know very little about goodness of exercise; regrettably, they do not know how good it can get over time.

The good news is that, exercise delivers results regardless of sex, occupation, physical ability, or age. Exercise results are yours for taking; once you put the input, the output is almost certain.

Unfortunately, people will always find excuses for not exercising and even some will quote myths associated with exercise for them to stay out. Many exercise activities are not strenuous and require very little efforts; for instance, dancing for fun. The truth is; exercise is good because it will help you have good moods, manage chronic diseases, and manage weight giving you good shape.

Goodness of Exercise

Exercise helps in improving one’s mood and mind status. Mood is a state of mind. Physical activity triggers the body to release chemicals known as endorphins. These chemicals enable one to be happy and peaceful. The contemporary society is set in a way that people can work without involving a lot of physical exercise.

Moreover, many people are being forced by circumstances to take jobs that they do not like. Chances that such people will slump into stress, depression, low self-esteem, and insomnia are high.

However, exercising improves all these by improving one’s mood. For instance, during exercise, individuals set goals and by beating the timeline to accomplish these set goals, make one feel good and this improves his or her self-confidence and self-esteem. It is logical that a confident and self-esteemed person will have good moods. Human body is made up of active cells and they need to be kept active; exercise offers these.

As Mayo Clinic Staff posit, “As you exercise, your body gets fitter and stronger, and thus, your mind starts seeing everything, including yourself in a better light” (Para 4). Have you ever heard of people claiming the only thing they do when stressed up is exercise? These few individuals have discovered the secret to let go of in-built pressure. Brain is made up of muscles and exercise is good for brain muscles just as food is good for the body.

Good news to those battling with chronic diseases as hypertension, diabetes and osteoporosis among others; exercise is the way out. Research indicates that regular exercise combats these diseases. According to Hawk, “exercise is the silver bullet for improved health” (Para. 1). In combating heart diseases, exercise strengthens heart muscles, increases High Density Lipoproteins (HDLs), and reduces Low Density Lipoproteins (LDLs). These lipoproteins are cholesterol derivatives and scientists term HDL as ‘good’ cholesterol and LDL as ‘bad’ cholesterol.

Reduction of LDL with subsequent increase of HDL promotes smooth blood flow and replenishes heart functions. In Type II diabetes, the body is insensitive to insulin probably due to weight gain amongst other causes. Exercise helps in shedding weight and this makes the body insulin sensitive. Consequently, this insulin breaks down sugar molecules in the body thus lowering blood sugar levels eventually combating diabetes type II.

Nowadays, poor feeding habits and little or no exercise makes people as young as fifteen to suffer from osteoporosis. However, exercise offers reprieve to this nightmare by strengthening bone tissue formation and maintenance. Finally, research indicates that exercise improves immune system response and this helps to keep minor infections at bay.

Finally, exercise helps in keeping body shape. No one likes obesity or out of shape body. Unfortunately, many people love talking how they hate their over weight bodies without doing anything about it; lip service. Exercise is the way to attaining that elusive figure you have always craved for, over the years.

It is natural that, during physical exercise, the body burns thousands of calories. Body weight results from excess energy, which is converted to fat and stored in different body parts. As one exercises, metabolism rate increases leading to breakdown of fats making your body slimmer and healthy.

Research indicates that, “To lose one pound of fat, you must burn approximately 3500 calories over and above what you already burn doing daily activities” (Buemann & Tremblay 193). These researchers make it clear that normal daily activities are not sufficient to burn the required calories in the body; therefore, exercise is the way out. Fortunately, you do not need to check into a gym to manage weight loss; far from it, 20 to 30 minute walk every day or cycling for fun is enough to keep weight gain under control.

Unfortunately, many people complain that exercise is not good because it is not fun. This is true and it does not apply to exercise alone; it applies to anything that someone does. If you do not enjoy what you are doing, it can never be fun. However, the claims that exercise is not fun are only excuses; not reasons. The fact is, there are many exercise programs, and out of them, every one can find a program that excites him or her. Exercise can be done in a group or individually.

Moreover, most of practices that people do for fun qualify as exercises. For instance, taking a stroll in the neighborhood in the evening is enough to relax one’s mind. Teenagers are fond of cycling for fun; however, even though they do not know it, cycling is a great lot of exercise.

So, what is the way out of these excuses? Identify an exercise that excites you; an exercise that you will do without much hustle. For instance, decide to engage in flexibility training exercises like yoga and sit-ups or even join a dancing group. By doing something that excites you, fun will be inevitable. However, remember to do whatever you are doing on purpose with discipline. Discipline is the key to any successful story you will ever hear.

Exercise is all-inclusive package that will enable you live almost a stress-free life, full of energy with improved self esteem and sound sleep not forgetting how you will be able to combat some diseases like hypertension and diabetes type II. During exercise, the body releases endorphins that restore peace and felicity.

Moreover, nothing equals the thrill that one gets by accomplishing set goals and exercise offers this opportunity to set both short and long-term goals and accomplish them. Again, exercise prompts the body to produce more ‘good’ cholesterol and eliminate the ‘bad’ one thus improving blood flow thus keeping hypertension at bay.

Any good doctor will tell you exercise is as essential as sleep or feeding. Finally, exercise enables you to maintain body shape by shedding those extra pounds. Unfortunately, many people complain that exercise is not fun; however, this is just an excuse, not a reason. There are many exercise programs to choose from, every one can get a program that excites him or her, and as the excitement sets in, fun follows. Anyway, who does not want to live a peaceful and happy life? Not even you, start exercising and start today.

Buemann, Baines & Tremblay, Albert. “Effects of Exercise Training On Abdominal Obesity and Related Metabolic Complications”. Sports Medicine. 2007, 21(1): 191-212.

Hawk, Patricia. “Here’s why Exercise is good for You.” 2009.

Mayo Clinic Staff. “ Exercise: 7 Benefits of Regular Physical Activity. ” 2010. Web.

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May 14, 2024

Understanding how exercise affects the body

At a glance.

  • A study of endurance training in rats found molecular changes throughout the body that could help explain the beneficial effects of exercise on health.
  • Large differences were seen between male and female rats, highlighting the need to include both women and men in exercise studies.

Woman tying her running shoe laces.

Exercise is one of the most beneficial activities that people can engage in. Regular exercise reduces the risk of heart disease, diabetes, cancer, and other health problems. It can even help people with many mental health conditions feel better.

But exactly how exercise exerts its positive effects hasn’t been well understood. And different people’s bodies can respond very differently to certain types of exercise, such as aerobic exercise or strength training.

Understanding how exercise impacts different organs at the molecular level could help health care providers better personalize exercise recommendations. It might also lead to drug therapies that could stimulate some of the beneficial effects of a workout for people who are physically unable to exercise.

To this end, researchers in the large, NIH-funded Molecular Transducers of Physical Activity Consortium (MoTrPAC) have been studying how endurance exercise and strength training affect both people and animals. The team is examining gene activity, protein alterations, immune cell function, metabolite levels, and numerous other measures of cell and tissue function. The first results, from rat studies of endurance exercise, were published on May 2, 2024, in Nature and several related journals.

Both male and female rats underwent progressive exercise training on a treadmill over an 8-week period. By the end of training, male rats had increased their aerobic capacity by 18%, and females by 16%. Tissue samples were collected from 18 different organs, plus the blood, during the training period and two days after the final bout of exercise. This let the researchers study the longer-term adaptations of the body to exercise.

Changes in gene activity, immune cell function, metabolism, and other cellular processes were seen in all the tissues studied, including those not previously known to be affected by exercise. The types of changes differed from tissue to tissue.

Many of the observed changes hinted at how exercise might protect certain organs against disease. For example, in the small intestines, exercise decreased the activity of certain genes associated with inflammatory bowel disease and reduced signs of inflammation in the gut. In the liver, exercise boosted molecular changes associated with improved tissue health and regeneration.

Some of the effects differed substantially between male and female rats. For example, in male rats, the eight weeks of endurance training reduced the amount of a type of body fat called subcutaneous white adipose tissue (scWAT). The same amount of exercise didn’t reduce the amount of scWAT in female rats. Instead, endurance exercise caused scWAT in female rats to alter its energy usage in ways that are beneficial to health. These and other results highlight the importance of including both women and men in exercise studies.

The researchers also compared gene activity changes in the rat studies with those from human samples taken from previous studies and found substantial overlap. They identified thousands of genes tied to human disease that were affected by endurance exercise. These analyses show how the MoTrPAC results from rats can be used to help guide future research in people.

“This is the first whole-organism map looking at the effects of training in multiple different organs,” says Dr. Steve Carr, a MoTrPAC investigator from the Broad Institute. “The resource produced will be enormously valuable, and has already produced many potentially novel biological insights for further exploration.”

Human trials are expected in the next few years. Information on participating can be found here .

—by Sharon Reynolds

Related Links

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  • Getting Active Later in Life Brings Benefits
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  • Personalized Exercise? How Biology Influences Fitness
  • Maintain Your Muscle: Strength Training at Any Age
  • Molecular Transducers of Physical Activity Consortium (MoTrPAC)
  • Participating in MoTrPAC

References:  Temporal dynamics of the multi-omic response to endurance exercise training. MoTrPAC Study Group; Lead Analysts; MoTrPAC Study Group. Nature . 2024 May;629(8010):174-183. doi: 10.1038/s41586-023-06877-w. Epub 2024 May 1. PMID: 38693412. Sexual dimorphism and the multi-omic response to exercise training in rat subcutaneous white adipose tissue. Many GM, Sanford JA, Sagendorf TJ, Hou Z, Nigro P, Whytock KL, Amar D, Caputo T, Gay NR, Gaul DA, Hirshman MF, Jimenez-Morales D, Lindholm ME, Muehlbauer MJ, Vamvini M, Bergman BC, Fernández FM, Goodyear LJ, Hevener AL, Ortlund EA, Sparks LM, Xia A, Adkins JN, Bodine SC, Newgard CB, Schenk S; MoTrPAC Study Group. Nat Metab . 2024 May 1. doi: 10.1038/s42255-023-00959-9. Online ahead of print. PMID: 38693320. The impact of exercise on gene regulation in association with complex trait genetics. Vetr NG, Gay NR; MoTrPAC Study Group; Montgomery SB. Nat Commun . 2024 May 1;15(1):3346. doi: 10.1038/s41467-024-45966-w. PMID: 38693125.

Funding:  NIH’s Office of the Director (OD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Aging (NIA), National Human Genome Research Institute (NHGRI), National Heart, Lung, and Blood Institute (NHLBI), and National Library of Medicine (NLM); Knut and Alice Wallenberg Foundation; National Science Foundation (NSF).

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  • Importance Of Exercises Essay

Importance of Exercise Essay

500+ words essay on the importance of exercise.

We all know that exercise is extremely important in our daily lives, but we may not know why or what exercise can do. It’s important to remember that we have evolved from nomadic ancestors who spent all their time moving around in search of food and shelter, travelling large distances on a daily basis. Our bodies are designed and have evolved to be regularly active. Over time, people may come across problems if they sit down all day at a desk or in front of the TV and minimise the amount of exercise they do. Exercise is a bodily movement performed in order to develop or maintain physical fitness and good health overall. Exercise leads to the physical exertion of sufficient intensity, duration and frequency to achieve or maintain vigour and health. This essay on the importance of exercise will help students become familiar with the several benefits of doing exercise regularly. They must go through this essay so as to get an idea of how to write essays on similar topics.

Need of Exercise

The human body is like a complex and delicate machine which comprises several small parts. A slight malfunction of one part leads to the breakdown of the machine. In a similar way, if such a situation arises in the human body, it also leads to malfunctioning of the body. Exercise is one of the healthy lifestyles which contributes to optimum health and quality of life. People who exercise regularly can reduce their risk of death. By doing exercise, active people increase their life expectancy by two years compared to inactive people. Regular exercise and good physical fitness enhance the quality of life in many ways. Physical fitness and exercise can help us to look good, feel good, and enjoy life. Moreover, exercise provides an enjoyable way to spend leisure time.

Exercise helps a person develop emotional balance and maintain a strong self-image. As people get older, exercise becomes more important. This is because, after the age of 30, the heart’s blood pumping capacity declines at a rate of about 8 per cent each decade. Exercise is also vital for a child’s overall development. Exercising helps to maintain a healthy weight by stoking our metabolism, utilizing and burning the extra calories.

Types of Exercise

There are three broad intensities of exercise:

1) Light exercise – Going for a walk is an example of light exercise. In this, the exerciser is able to talk while exercising.

2) Moderate exercise – Here, the exerciser feels slightly out of breath during the session. Examples could be walking briskly, cycling moderately or walking up a hill.

3) Vigorous exercise – While performing this exercise, the exerciser is panting during the activity. The exerciser feels his/her body being pushed much nearer its limit compared to the other two intensities. This could include running, cycling fast, and heavy-weight training.

Importance of Exercise

Regular exercise increases our fitness level and physical stamina. It plays a crucial role in the prevention of cardiovascular diseases. It can help with blood lipid abnormalities, diabetes and obesity. Moreover, it can help to reduce blood pressure. Regular exercise substantially reduces the risk of dying of coronary heart disease and eases the risk of stroke and colon cancer. People of all age groups benefit from exercising.

Exercise can be effective in improving the mental well-being of human beings. It relieves human stress and anxiety. When we come back from work or school, we feel exhausted after a whole day of work. If we can go out to have a walk or jog for at least 30 minutes, it makes us feel happy and relaxed. A number of studies have found that a lifestyle that includes exercise helps alleviate depression. Those who can maintain regular exercise will also reduce their chances of seeing a doctor. Without physical activity, the body’s muscles lose their strength, endurance and ability to function properly. Regular exercise keeps all parts of the body in continuous activity. It improves overall health and fitness, as well as decreases the risk of many chronic diseases. Therefore, physical exercise is very important in our life.

Exercise can play a significant role in keeping the individual, society, community and nation wealthy. If the citizens of a country are healthy, the country is sure to touch heights in every facet of life. The country’s healthy generation can achieve the highest marks in various fields and thereby enable their country to win laurels and glory at the international level. The first step is always the hardest. However, if we can overcome it, and exercise for 21 days continuously, it will be a new beginning for a healthy life.

Did you find the “Importance of Exercise essay” useful for improving your writing skills? Do let us know your view in the comment section. Keep Learning, and don’t forget to download the BYJU’S App for more interesting study videos.

Frequently Asked Questions on the Importance of Exercises Essay

What are the benefits of exercising regularly.

Regular exercise helps in the relaxation of the mind and body and keeps the body fit. It improves flexibility and blood circulation.

Which are some of the easy exercises that can be done at home?

Sit-ups, bicycle crunches, squats, lunges and planks are examples of easy exercises which can be done at home without the help of costly equipment.

Is cycling an effective form of exercise?

Cycling is a low-impact exercise and acts as a good muscle workout.

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Home — Essay Samples — Nursing & Health — Physical Exercise — The Comprehensive Benefits of Exercise: A Path to Health and Wellness

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The Comprehensive Benefits of Exercise: a Path to Health and Wellness

  • Categories: Healthy Lifestyle Physical Exercise

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Words: 603 |

Published: Sep 7, 2023

Words: 603 | Page: 1 | 4 min read

Table of contents

Chapter 1: physical benefits of exercise, chapter 2: mental benefits of exercise, conclusion: embracing the benefits of exercise, 1. improved cardiovascular health, 2. increased muscle strength, 3. improved flexibility, 4. reduced risk of chronic diseases, 1. enhanced cognitive function, 2. improved mood and mental health, 3. stress reduction, 4. enhanced sleep quality.

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essay on exercise is good for health

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  • Published: 16 November 2020

Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews

  • Pawel Posadzki 1 , 2 ,
  • Dawid Pieper   ORCID: orcid.org/0000-0002-0715-5182 3 ,
  • Ram Bajpai 4 ,
  • Hubert Makaruk 5 ,
  • Nadja Könsgen 3 ,
  • Annika Lena Neuhaus 3 &
  • Monika Semwal 6  

BMC Public Health volume  20 , Article number:  1724 ( 2020 ) Cite this article

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Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes.

Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised.

Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I 2  = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I 2  = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions.

There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns.

Trial registration

Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.

Peer Review reports

The World Health Organization (WHO) defines physical activity “as any bodily movement produced by skeletal muscles that requires energy expenditure” [ 1 ]. Therefore, physical activity is not only limited to sports but also includes walking, running, swimming, gymnastics, dance, ball games, and martial arts, for example. In the last years, several organizations have published or updated their guidelines on physical activity. For example, the Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits [ 2 ]. The evidence about the health benefits of regular physical activity is well established and so are the risks of sedentary behaviour [ 2 ]. Exercise is dose dependent, meaning that people who achieve cumulative levels several times higher than the current recommended minimum level have a significant reduction in the risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events [ 3 ]. Benefits of physical activity have been reported for numerous outcomes such as mortality [ 4 , 5 ], cognitive and physical decline [ 5 , 6 , 7 ], glycaemic control [ 8 , 9 ], pain and disability [ 10 , 11 ], muscle and bone strength [ 12 ], depressive symptoms [ 13 ], and functional mobility and well-being [ 14 , 15 ]. Overall benefits of exercise apply to all bodily systems including immunological [ 16 ], musculoskeletal [ 17 ], respiratory [ 18 ], and hormonal [ 19 ]. Specifically for the cardiovascular system, exercise increases fatty acid oxidation, cardiac output, vascular smooth muscle relaxation, endothelial nitric oxide synthase expression and nitric oxide availability, improves plasma lipid profiles [ 15 ] while at the same time reducing resting heart rate and blood pressure, aortic valve calcification, and vascular resistance [ 20 ].

However, the degree of all the above-highlighted benefits vary considerably depending on individual fitness levels, types of populations, age groups and the intensity of different physical activities/exercises [ 21 ]. The majority of guidelines in different countries recommend a goal of 150 min/week of moderate-intensity aerobic physical activity (or equivalent of 75 min of vigorous-intensity) [ 22 ] with differences for cardiovascular disease [ 23 ] or obesity prevention [ 24 ] or age groups [ 25 ].

There is a plethora of systematic reviews published by the Cochrane Library critically evaluating the effectiveness of physical activity/exercise for various health outcomes. Cochrane systematic reviews (CSRs) are known to be a source of high-quality evidence. Thus, it is not only timely but relevant to evaluate the current knowledge, and determine the quality of the evidence-base, and the magnitude of the effect sizes given the negative lifestyle changes and rising physical inactivity-related burden of diseases. This overview will identify the breadth and scope to which CSRs have appraised the evidence for exercise on health outcomes; and this will help in directing future guidelines and identifying current gaps in the literature.

The objectives of this research were to a. answer the following research questions: in children, adolescents and adults (both healthy and medically compromised) what are the effects (and adverse effects) of exercise/physical activity in improving various health outcomes (e.g., pain, function, quality of life) reported in CSRs; b. estimate the magnitude of the effects by pooling the results quantitatively; c. evaluate the strength and quality of the existing evidence; and d. create recommendations for future researchers, patients, and clinicians.

Our overview was registered with PROSPERO (CRD42019120295) on 10th January 2019. The Cochrane Handbook for Systematic Reviews of interventions and Preferred Reporting Items for Overviews of Reviews were adhered to while writing and reporting this overview [ 26 , 27 ].

Search strategy and selection criteria

We followed the practical guidance for conducting overviews of reviews of health care interventions [ 28 ] and searched the Cochrane Database of Systematic Reviews (CDSR), 2019, Issue 1, on the Cochrane Library for relevant papers using the search strategy: (health) and (exercise or activity or physical). The decision to seek CSRs only was based on three main aspects. First, high quality (CSRs are considered to be the ‘gold methodological standard’) [ 29 , 30 , 31 ]. Second, data saturation (enough high-quality evidence to reach meaningful conclusions based on CSRs only). Third, including non-CSRs would have heavily increased the issue of overlapping reviews (also affecting data robustness and credibility of conclusions). One reviewer carried out the searches. The study screening and selection process were performed independently by two reviewers. We imported all identified references into reference manager software EndNote (X8). Any disagreements were resolved by discussion between the authors with third overview author acting as an arbiter, if necessary.

We included CSRs of randomised controlled trials (RCTs) involving both healthy individuals and medically compromised patients of any age and gender. Only CSRs assessing exercise or physical activity as a stand-alone intervention were included. This included interventions that could initially be taught by a professional or involve ongoing supervision (the WHO definition). Complex interventions e.g., assessing both exercise/physical activity and behavioural changes were excluded if the health effects of the interventions could not have been attributed to exercise distinctly.

Any types of controls were admissible. Reviews evaluating any type of health-related outcome measures were deemed eligible. However, we excluded protocols or/and CSRs that have been withdrawn from the Cochrane Library as well as reviews with no included studies.

Data analysis

Three authors (HM, ALN, NK) independently extracted relevant information from all the included studies using a custom-made data collection form. The methodological quality of SRs included was independently evaluated by same reviewers using the AMSTAR-2 tool [ 32 ]. Any disagreements on data extraction or CSR quality were resolved by discussion. The entire dataset was validated by three authors (PP, MS, DP) and any discrepant opinions were settled through discussions.

The results of CSRs are presented in a narrative fashion using descriptive tables. Where feasible, we presented outcome measures across CSRs. Data from the subset of homogeneous outcomes were pooled quantitatively using the approach previously described by Bellou et al. and Posadzki et al. [ 33 , 34 ]. For mortality and quality of life (QOL) outcomes, the number of participants and RCTs involved in the meta-analysis, summary effect sizes [with 95% confidence intervals (CI)] using random-effects model were calculated. For binary outcomes, we considered relative risks (RRs) as surrogate measures of the corresponding odds ratio (OR) or risk ratio/hazard ratio (HR). To stabilise the variance and normalise the distributions, we transformed RRs into their natural logarithms before pooling the data (a variation was allowed, however, it did not change interpretation of results) [ 35 ]. The standard error (SE) of the natural logarithm of RR was derived from the corresponding CIs, which was either provided in the study or calculated with standard formulas [ 36 ]. Binary outcomes reported as risk difference (RD) were also meta-analysed if two more estimates were available. For continuous outcomes, we only meta-analysed estimates that were available as standardised mean difference (SMD), and estimates reported with mean differences (MD) for QOL were presented separately in a supplementary Table  9 . To estimate the overall effect size, each study was weighted by the reciprocal of its variance. Random-effects meta-analysis, using DerSimonian and Laird method [ 37 ] was applied to individual CSR estimates to obtain a pooled summary estimate for RR or SMD. The 95% prediction interval (PI) was also calculated (where ≥3 studies were available), which further accounts for between-study heterogeneity and estimates the uncertainty around the effect that would be anticipated in a new study evaluating that same association. I -squared statistic was used to measure between study heterogeneity; and its various thresholds (small, substantial and considerable) were interpreted considering the size and direction of effects and the p -value from Cochran’s Q test ( p  < 0.1 considered as significance) [ 38 ]. Wherever possible, we calculated the median effect size (with interquartile range [IQR]) of each CSR to interpret the direction and magnitude of the effect size. Sub-group analyses are planned for type and intensity of the intervention; age group; gender; type and/or severity of the condition, risk of bias in RCTs, and the overall quality of the evidence (Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria). To assess overlap we calculated the corrected covered area (CCA) [ 39 ]. All statistical analyses were conducted on Stata statistical software version 15.2 (StataCorp LLC, College Station, Texas, USA).

The searches generated 280 potentially relevant CRSs. After removing of duplicates and screening, a total of 150 CSRs met our eligibility criteria [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 ] (Fig.  1 ). Reviews were published between September 2002 and December 2018. A total of 130 CSRs employed meta-analytic techniques and 20 did not. The total number of RCTs in the CSRs amounted to 2888; with 485,110 participants (mean = 3234, SD = 13,272). The age ranged from 3 to 87 and gender distribution was inestimable. The main characteristics of included reviews are summarised in supplementary Table  1 . Supplementary Table  2 summarises the effects of physical activity/exercise on health outcomes. Conclusions from CSRs are listed in supplementary Table  3 . Adverse effects are listed in supplementary Table  4 . Supplementary Table  5 presents summary of withdrawals/non-adherence. The methodological quality of CSRs is presented in supplementary Table  6 . Supplementary Table  7 summarises studies assessed at low risk of bias (by the authors of CSRs). GRADE-ings of the review’s main comparison are listed in supplementary Table  8 .

figure 1

Study selection process

There were 54 separate populations/conditions, considerable range of interventions and comparators, co-interventions, and outcome measures. For detailed description of interventions, please refer to the supplementary tables . Most commonly measured outcomes were - function 112 (75%), QOL 83 (55%), AEs 70 (47%), pain 41 (27%), mortality 28 (19%), strength 30 (20%), costs 47 (31%), disability 14 (9%), and mental health in 35 (23%) CSRs.

There was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% CI 0.78 to 0.96]; I 2  = 26.6%, [PI 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]; 10 CSRs, 187 RCTs, 27,671 participants) following exercise when compared with various controls (Table 1 ). This reduction was smaller in ‘other groups’ of patients when compared to cardiovascular diseases (CVD) patients - RR 0.97 [95% CI 0.65, 1.45] versus 0.85 [0.76, 0.96] respectively. The effects of exercise were not intensity or frequency dependent. Sessions more than 3 times per week exerted a smaller reduction in mortality as compared with sessions of less than 3 times per week RR 0.87 [95% CI 0.78, 0.98] versus 0.63 [0.39, 1.00]. Subgroup analyses by risk of bias (ROB) in RCTs showed that RCTs at low ROB exerted smaller reductions in mortality when compared to RCTs at an unclear or high ROB, RR 0.90 [95% CI 0.78, 1.02] versus 0.72 [0.42, 1.22] versus 0.86 [0.69, 1.06] respectively. CSRs with moderate quality of evidence (GRADE), showed slightly smaller reductions in mortality when compared with CSRs that relied on very low to low quality evidence RR 0.88 [95% CI 0.79, 0.98] versus 0.70 [0.47, 1.04].

Exercise also showed an improvement in QOL, standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I 2  = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]; 15 CSRs, 408 RCTs, 32,984 participants) when compared with various controls (Table 2 ). These improvements were greater observed for health related QOL when compared to overall QOL SMD 0.30 [95% CI 0.21, 0.39] vs 0.06 [− 0.08, 0.20] respectively. Again, the effects of exercise were duration and frequency dependent. For instance, sessions of more than 90 mins exerted a greater improvement in QOL as compared with sessions up to 90 min SMD 0.24 [95% CI 0.11, 0.37] versus 0.22 [− 0.30, 0.74]. Subgroup analyses by the type of condition showed that the magnitude of effect was the largest among patients with mental health conditions, followed by CVD and cancer. Physical activity exerted negative effects on QOL in patients with respiratory conditions (2 CSRs, 20 RCTs with 601 patients; SMD -0.97 [95% CI -1.43, 0.57]; I 2  = 87.8%; MES = -0.46 [IQR-0.97, 0.05]). Subgroup analyses by risk of bias (ROB) in RCTs showed that RCTs at low or unclear ROB exerted greater improvements in QOL when compared to RCTs at a high ROB SMD 0.21 [95% CI 0.10, 0.31] versus 0.17 [0.03, 0.31]. Analogically, CSRs with moderate to high quality of evidence showed slightly greater improvements in QOL when compared with CSRs that relied on very low to low quality evidence SMD 0.19 [95% CI 0.05, 0.33] versus 0.15 [− 0.02, 0.32]. Please also see supplementary Table  9 more studies reporting QOL outcomes as mean difference (not quantitatively synthesised herein).

Adverse events (AEs) were reported in 100 (66.6%) CSRs; and not reported in 50 (33.3%). The number of AEs ranged from 0 to 84 in the CSRs. The number was inestimable in 83 (55.3%) CSRs. Ten (6.6%) reported no occurrence of AEs. Mild AEs were reported in 28 (18.6%) CSRs, moderate in 9 (6%) and serious/severe in 20 (13.3%). There were 10 deaths and in majority of instances, the causality was not attributed to exercise. For this outcome, we were unable to pool the data as effect sizes were too heterogeneous (Table 3 ).

In 38 CSRs, the total number of trials reporting withdrawals/non-adherence was inestimable. There were different ways of reporting it such as adherence or attrition (high in 23.3% of CSRs) as well as various effect estimates including %, range, total numbers, MD, RD, RR, OR, mean and SD. The overall pooled estimates are reported in Table 3 .

Of all 16 domains of the AMSTAR-2 tool, 1876 (78.1%) scored ‘yes’, 76 (3.1%) ‘partial yes’; 375 (15.6%) ‘no’, and ‘not applicable’ in 25 (1%) CSRs. Ninety-six CSRs (64%) were scored as ‘no’ on reporting sources of funding for the studies followed by 88 (58.6%) failing to explain the selection of study designs for inclusion. One CSR (0.6%) each were judged as ‘no’ for reporting any potential sources of conflict of interest, including any funding for conducting the review as well for performing study selection in duplicate.

In 102 (68%) CSRs, there was predominantly a high risk of bias in RCTs. In 9 (6%) studies, this was reported as a range, e.g., low or unclear or low to high. Two CSRs used different terminology i.e., moderate methodological quality; and the risk of bias was inestimable in one CSR. Sixteen (10.6%) CSRs did not identify any studies (RCTs) at low risk of random sequence generation, 28 (18.6%) allocation concealment, 28 (18.6%) performance bias, 84 (54%) detection bias, 35 (23.3%) attrition bias, 18 (12%) reporting bias, and 29 (19.3%) other bias.

In 114 (76%) CSRs, limitation of studies was the main reason for downgrading the quality of the evidence followed by imprecision in 98 (65.3%) and inconsistency in 68 (45.3%). Publication bias was the least frequent reason for downgrading in 26 (17.3%) CSRs. Ninety-one (60.7%) CSRs reached equivocal conclusions, 49 (32.7%) reviews reached positive conclusions and 10 (6.7%) reached negative conclusions (as judged by the authors of CSRs).

In this systematic review of CSRs, we found a large body of evidence on the beneficial effects of physical activity/exercise on health outcomes in a wide range of heterogeneous populations. Our data shows a 13% reduction in mortality rates among 27,671 participants, and a small improvement in QOL and health-related QOL following various modes of physical activity/exercises. This means that both healthy individuals and medically compromised patients can significantly improve function, physical and mental health; or reduce pain and disability by exercising more [ 190 ]. In line with previous findings [ 191 , 192 , 193 , 194 ], where a dose-specific reduction in mortality has been found, our data shows a greater reduction in mortality in studies with longer follow-up (> 12 months) as compared to those with shorter follow-up (< 12 months). Interestingly, we found a consistent pattern in the findings, the higher the quality of evidence and the lower the risk of bias in primary studies, the smaller reductions in mortality. This pattern is observational in nature and cannot be over-generalised; however this might mean less certainty in the estimates measured. Furthermore, we found that the magnitude of the effect size was the largest among patients with mental health conditions. A possible mechanism of action may involve elevated levels of brain-derived neurotrophic factor or beta-endorphins [ 195 ].

We found the issue of poor reporting or underreporting of adherence/withdrawals in over a quarter of CSRs (25.3%). This is crucial both for improving the accuracy of the estimates at the RCT level as well as maintaining high levels of physical activity and associated health benefits at the population level.

Even the most promising interventions are not entirely risk-free; and some minor AEs such as post-exercise pain and soreness or discomfort related to physical activity/exercise have been reported. These were typically transient; resolved within a few days; and comparable between exercise and various control groups. However worryingly, the issue of poor reporting or underreporting of AEs has been observed in one third of the CSRs. Transparent reporting of AEs is crucial for identifying patients at risk and mitigating any potential negative or unintended consequences of the interventions.

High risk of bias of the RCTs evaluated was evident in more than two thirds of the CSRs. For example, more than half of reviews identified high risk of detection bias as a major source of bias suggesting that lack of blinding is still an issue in trials of behavioural interventions. Other shortcomings included insufficiently described randomisation and allocation concealment methods and often poor outcome reporting. This highlights the methodological challenges in RCTs of exercise and the need to counterbalance those with the underlying aim of strengthening internal and external validity of these trials.

Overall, high risk of bias in the primary trials was the main reason for downgrading the quality of the evidence using the GRADE criteria. Imprecision was frequently an issue, meaning the effective sample size was often small; studies were underpowered to detect the between-group differences. Pooling too heterogeneous results often resulted in inconsistent findings and inability to draw any meaningful conclusions. Indirectness and publication bias were lesser common reasons for downgrading. However, with regards to the latter, the generally accepted minimum number of 10 studies needed for quantitatively estimate the funnel plot asymmetry was not present in 69 (46%) CSRs.

Strengths of this research are the inclusion of large number of ‘gold standard’ systematic reviews, robust screening, data extractions and critical methodological appraisal. Nevertheless, some weaknesses need to be highlighted when interpreting findings of this overview. For instance, some of these CSRs analysed the same primary studies (RCTs) but, arrived at slightly different conclusions. Using, the Pieper et al. [ 39 ] formula, the amount of overlap ranged from 0.01% for AEs to 0.2% for adherence, which indicates slight overlap. All CSRs are vulnerable to publication bias [ 196 ] - hence the conclusions generated by them may be false-positive. Also, exercise was sometimes part of a complex intervention; and the effects of physical activity could not be distinguished from co-interventions. Often there were confounding effects of diet, educational, behavioural or lifestyle interventions; selection, and measurement bias were inevitably inherited in this overview too. Also, including CSRs only might lead to selection bias; and excluding reviews published before 2000 might limit the overall completeness and applicability of the evidence. A future update should consider these limitations, and in particular also including non-CSRs.

Conclusions

Trialists must improve the quality of primary studies. At the same time, strict compliance with the reporting standards should be enforced. Authors of CSRs should better explain eligibility criteria and report sources of funding for the primary studies. There are still insufficient physical activity trends worldwide amongst all age groups; and scalable interventions aimed at increasing physical activity levels should be prioritized [ 197 ]. Hence, policymakers and practitioners need to design and implement comprehensive and coordinated strategies aimed at targeting physical activity programs/interventions, health promotion and disease prevention campaigns at local, regional, national, and international levels [ 198 ].

Availability of data and materials

Data sharing is not applicable to this article as no raw data were analysed during the current study. All information in this article is based on published systematic reviews.

Abbreviations

Adverse events

Cardiovascular diseases

Cochrane Database of Systematic Reviews

Cochrane systematic reviews

Confidence interval

Grading of Recommendations Assessment, Development and Evaluation

Hazard ratio

Interquartile range

Mean difference

Prediction interval

Quality of life

Randomised controlled trials

Relative risk

Risk difference

Risk of bias

Standard error

Standardised mean difference

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Pawel Posadzki

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Supplementary Table 1. Main characteristics of included Cochrane systematic reviews evaluating the effects of physical activity/exercise on health outcomes ( n  = 150). Supplementary Table 2. Additional information from Cochrane systematic reviews of the effects of physical activity/exercise on health outcomes ( n  = 150). Supplementary Table 3. Conclusions from Cochrane systematic reviews “quote”. Supplementary Table 4 . AEs reported in Cochrane systematic reviews. Supplementary Table 5. Summary of withdrawals/non-adherence. Supplementary Table 6. Methodological quality assessment of the included Cochrane reviews with AMSTAR-2. Supplementary Table 7. Number of studies assessed as low risk of bias per domain. Supplementary Table 8. GRADE for the review’s main comparison. Supplementary Table 9. Studies reporting quality of life outcomes as mean difference.

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Posadzki, P., Pieper, D., Bajpai, R. et al. Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health 20 , 1724 (2020). https://doi.org/10.1186/s12889-020-09855-3

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The Health Benefits of Exercise and Physical Activity

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Physical inactivity is a modifiable risk factor (similar to dyslipidemia and hypertension) for a variety of chronic diseases, including cancer and cardiovascular disease. Exercise provides a clear health benefit, which serves in the primary and secondary prevention of these disease processes (the most important being a reduction in cardiovascular disease and premature death). The physiologic mechanisms for such a benefit occur at both a cellular and multisystem level. Prolonged periods of occupational or leisure-time sitting have adverse health effects independent of exercise performed before or after. Almost any form of physical activity (PA) is beneficial, whether part of a regular exercise program or as a series of intermittent, incidental, non-purposeful, lifestyle-embedded activity (causing non-exercise activity thermogenesis or NEAT). The health benefits of exercise appear to be dose-dependent. Physicians should recommend near daily exercise which includes at various times strength training, stretching, and aerobic activity in addition to emphasizing adjustments that allow for reduced sitting and increased activity during daily routines. Patients should understand that for optimal health, exercise is no longer optional.

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Introduction

Physical inactivity is a modifiable risk factor for cardiovascular disease, obesity, depression, cancer, diabetes mellitus, hypertension, and osteoporosis. Physical exercise reduces the risk of premature death and prolongs longevity, and is an important treatment modality in the primary and secondary prevention of the above disorders [ 1 ]. For most states in this country, less than half of the population meets CDC exercise recommendations [ 2 •]. The decline in physical activity (PA) occurs both at work and in leisure time, and may have at least partially contributed to the increase in obesity over the past 30 years. Low recreational physical activities have been associated with a threefold increase for major weight gain in men and a fourfold increase in women [ 3 ]. Surveys of PA across the lifecycle show that physical exercise peaks in the middle high-school age range and begins declining through high school and into adult life. A vicious cycle of decline occurs between inactivity and loss of skeletal muscle mass which accelerates with age. With avoidance of activity requiring effort, there is increased loss of exercise capacity. This loss causes the perception of effort associated with even sub-maximal work to worsen, as the anaerobic threshold decreases. The vicious cycle contributes to further inactivity and deterioration of physical function. The only treatment that can break the cycle is exercise.

Impact of Exercise on Aging

Exercise provides powerful health benefits for quality of life, physical function, and independent living throughout the life cycle. Exercise impedes the aging process and promotes longevity. Observational studies have shown that even in the presence of disease processes such as hypertension (HTN), chronic obstructive pulmonary disease (COPD), diabetes, smoking, high body mass index (BMI), and hypercholesterolemia, increasing PA has a dose-dependent effect in decreasing relative risk of death [ 4 ]. In a study of subjects over a 13-year time period, both baseline fitness, and improvement in physical fitness through exercise and PA was associated with significant increases in longevity [ 4 ]. Functional independence with advanced age relates to the overall level of physical fitness. Physical fitness is most affected by the status of the cardiorespiratory and vascular systems, as well as muscle function [ 5 •].

Garatachea et al. provide an excellent review of the effect of exercise on the physiologic changes associated with aging [ 5 •]. Exercise exerts its positive influence on both a cellular level and at the level of organ systems. At the cellular level, exercise helps reduce genomic instability, epigenetic alteration, loss of proteostasis, dysregulated nutrient sensing, cellular senescence, and altered intracellular communication that leads to inflammation. These effects alter the way the body performs transcellular signaling in the skeletal muscle, the turning on and off of genes through epigenetics, and the manner in which the system manages reactive oxygen species [ 5 •]. On a multisystem level, the benefits of exercise include improvement in brain, cardiovascular, lung, and muscle function, favorable alterations in body composition, and advantageous changes in metabolic responses. The report concludes by suggesting that in the future, pharmaceuticals should be designed which mimic the effects of exercise on the aging process [ 5 •].

Effect of Exercise on Treatment of Disease

Robert Butler from the National Institute on Aging has said that “If exercise could be put in a bottle, it would be the strongest medicine money could buy” [ 6 ]. Exercise helps prevent common chronic diseases (primary prevention), and often plays an important role in the treatment of these disease processes (secondary prevention). Specific benefits from exercise have been seen with cardiovascular disease, stroke, diabetes mellitus, depression, cancer, obesity, and osteoporosis [ 7 , 8 ]

Cardiovascular Disease

Increased levels of PA and physical fitness have a graded effect in reducing the risk of death from cardiovascular disease. The relative risk from all cause and cardiovascular disease mortality is reduced 20–35 % by exercise and PA [ 9 ]. In an observational study, subjects in the lowest quintile of exercise had a relative risk of 3.4 in men and 4.7 in women for death compared to those in the highest quintile [ 10 ]. An increase in activity-related energy expenditure by as little as 1000 kcal or 1 metabolic equivalent (MET)-hour of exercise per week has a mortality benefit of 20 % [ 11 ]. Physically inactive women have a 52 % increase in death, a cardiovascular disease-related death that is doubled, and a cancer-related death rate that is increased by 29 % [ 11 ]. These risks on mortality from inactivity are similar to other modifiable risk factors such as HTN, hypercholesterolemia, and obesity. In randomized controlled trials (RCT)s, exercise and PA are valuable for the secondary prevention of cardiovascular disease. Whereas in the past, traditional recommendations for patients with a heart attack included rest and physical inactivity. Newer information demonstrates that exercise actually attenuates or reverses risk of cardiovascular disease [ 12 ]. The benefit of exercise is seen in cardiac rehabilitation, where increasing PA reduces the risk of premature death following a myocardial infarction [ 12 ]. Added energy expenditure of 1600 kcal/week from exercise may halt the progression of heart disease and energy expenditure of >2200 kcal/week can lead to plaque reduction [ 13 ]. The minimum training recommendation for patients following myocardial infarction is to reach 45 % of their heart rate reserve through cardiac rehabilitation [ 12 , 13 ].

Multiple mechanisms have been identified whereby exercise reduces the risk of premature death [ 4 ]. Exercise affects body composition by decreasing abdominal adiposity and improving weight control. Exercise enhances lipid profiles by reducing serum triglyceride levels, raising HDL, and reducing the LDL/HDL ratio. In addition, a recent meta-analysis showed beneficial changes in lipoprotein subclasses associated with regular exercise including a reduction in small LDL-p and an increase in large LDL-p [ 14 ]. Exercise enhances hemodynamics by decreasing blood pressure, increasing cardiac function, and improving coronary blood flow. Autonomic tone is enhanced and shear stress-mediated endothelial function is improved. Exercise reduces systemic inflammation, as evidenced by reduced C-reactive protein (CRP) levels. Improved psychological well-being in response to exercise is associated with reduced stress, anxiety, and depression [ 4 ].

PA is inversely correlated with risk of incident stroke as shown in a large nurses’ health study [ 15 ]. Habitual exercise reduces risk of stroke by 40–50 % at the highest level of PA. Change in PA is protective against stroke as evidenced by the fact that an increase of 3.5 h of exercise or PA per week is associated with a 29 % reduction in ischemic stroke [ 15 ].

Diabetes Mellitus

Exercise is valuable in both the primary and secondary prevention of diabetes mellitus. Aerobic and resistant-type exercise reduces the likelihood of developing type-2 diabetes mellitus. For each 500 kcal of energy expended per week, there is an associated 6 % reduction in the likelihood of type-2 diabetes (which may be even greater with increasing BMI) [ 16 ]. In patients already diagnosed to have diabetes mellitus, walking 2 h per week is associated with a 39–54 % reduction in all-cause mortality from diabetes mellitus, and a 34–53 % reduction in mortality related to cardiovascular disease [ 17 ]. The benefit of exercise on glycemic control appears to be greater with resistance training than aerobic exercise. A meta-analysis of exercise and PA in diabetes showed that exercise reduces hemoglobin A1C by 0.66 %, an effect similar to intensive glucose-lowering pharmacologic therapy [ 18 ]. The mechanisms by which exercise benefits diabetes relate to the fact that exercise increases glycogen synthetase and hexokinase activity [ 4 ]. Exercise reduces GLUT-4 protein and messenger RNA expression and increases muscle capillary density, which helps improve glucose delivery to the muscle [ 4 ].

Increasing PA, either occupational or at leisure, has been shown to exert a primary preventative effect on two cancers—breast and colon cancer [ 19 ]. Moderate exercise of as little as 4–5 METs (equivalent to mowing the lawn or brisk walking), is required to achieve this effect [ 20 ]. Exercise is associated with a 20–30 % reduction in the incidence of breast cancer in women, and a 30–40 % reduction in the incidence of colon cancer in both men and women [ 20 ]. In those patients already diagnosed to have one of these cancers, exercise reduces the likelihood for cancer recurrence and reduces risk from cancer death by as much as 26–40 % [ 21 ]. PA improves quality of life and overall health status in cancer patients. The mechanisms by which exercise improves risk from cancer may relate to reduced fat stores, an increase in energy expenditure offsetting a high-fat diet, activity-related changes in sex hormone levels, improvement in immune function, and reduced generation of free oxygen radicals [ 4 ].

Osteoporosis

Exercise has a valuable effect in the primary prevention of osteoporosis. Routine PA minimizes age-related bone loss. Weight-bearing exercise (especially resistance exercise) increases bone density compared to low impact non-weight-bearing exercise. Exercise prevents 1 % of bone loss per year, an effect which is greater in post-menopausal than pre-menopausal women [ 22 ]. In RCTs, exercise reduces the risk and number of falls, as well as the risk of fracture [ 22 ]. Even in men, PA reduces the risk of fracture by 62 % over the age of 21 years [ 23 ]. Exercise is also valuable in the secondary prevention of osteoporosis. RCTs in the past have shown that exercise with resistance training increases bone density in older osteoporotic women by as much as 1.4 %, while agility training alone increases bone density by 0.5 % [ 24 ]. Stretching, which was used as sham control, was shown to have no effect on the expected decrease in bone density with age [ 24 ]. In a 12-year follow up of over 60,000 post-menopausal women, risk of hip fracture was lowered 6 % for each increase of three MET-hours per week of activity (the equivalent of walking three miles in 1 h) [ 25 ]. Active women with at least 24 met-hours of exercise per week had a 55 % lower risk of hip fracture than sedentary women with no other exercise. Walking at least 4 h per week was associated with a 41 % lower risk of hip fracture than walking less than one hour per week [ 25 ].

Exercise has a valuable therapeutic effect on the treatment on multiple types of depression, including dysthymic, seasonal, bipolar, post-natal, pre-menstrual, atypical, and major depression [ 26 ]. The value in treating depression comes from an innate anti-depressive effect from exercise. Combining exercise with psychotropic medications achieves better treatment results than the same medications alone [ 26 ]. Exercise is relatively inexpensive, safe, and has minimal side effects when done correctly. Exercise may help reduce the dose of anti-depressive medications required. Subjects are less likely to relapse with an active exercise program [ 26 ].

The patients with depression who are most likely to benefit from exercise include those with age <20 or >40 years, higher education, higher baseline physical status, females, untrained subjects, and those with mild to moderate depression [ 26 ]. There are a number of aspects of exercise that get the optimal results in treating depression including programs that are structured, individually tailored to the patient, low to moderate intensity, when it is used as an adjunct to medication therapy, and exercise that is a combination of aerobic or resistive training performed 3–4 times per week [ 26 ]. The mechanism of effect from exercise on depression occurs on a systemic level as well as a direct effect on central nervous system (CNS) function. Exercise appears to increase serotonin, ACTH, endorphins, and endocannabinoids within the CNS. On a systemic level, exercise increases norepinephrine and reduces cortisol, tumor necrosis factor (TNF), and interleukin-6 [ 26 ].

In a controversial article that appeared in Time magazine in 2009, the journalist John Cloud wrote about “The Myth of Exercise” and its effect on treating obesity [ 27 ]. The article suggested that exercise was not good for weight management in obesity. The author pointed out that exercise leads to increased appetite and intake of food and causes a decrease in non-exercise energy expenditure, and therefore that exercise was a poor strategy for weight loss [ 27 ]. A number of letters to the editor of Time magazine followed the publication of this article, including letters from the American Society for Sports Medicine, arguing that facts were misrepresented and that the article gave the wrong message about the health benefits of exercise.

A recent review by Swift clarified the role of exercise in managing or preventing obesity, and suggested that Cloud’s article was in fact an accurate portrayal of the facts [ 28 ]. The key issue of Swift’s review is that exercise without caloric restriction is unlikely to succeed in weight loss [ 28 ]. Increasing PA can prevent weight gain, but it requires 150–250 min per week of moderate to vigorous exercise or 1200–2000 kcal/week expended through exercise to accomplish this feat [ 29 ]. Aerobic exercise by itself is minimally helpful in promoting weight loss, successful in loss of only 0–2 kg total [ 29 ]. Extreme high-volume aerobic exercise can achieve significant weight loss, but this is usually unsustainable by most obese patients. Moderate intensity, surprisingly, is no different than vigorous intensity in achieving weight loss, unless subjects are matched for exercise duration. Resistance training by itself has no impact on weight loss, and aerobic training combined with resistant training has no greater effect than aerobic training alone. However, adding caloric restriction to aerobic training does result in successful weight loss of 9–13 kg, and higher intensity of exercise has the potential for even greater weight loss [ 29 ]. Some obese subjects do experience weight compensation in response to exercise, defined by the circumstances where less weight is lost than expected with the amount of exercise sustained, often a factor related to an increase in caloric intake [ 28 , 30 ]. This is more likely to occur in women performing 150 % of weekly recommendations (compared to women performing only 100 % or 50 % of weekly recommendations) [ 28 , 30 ]. Even if minimal or no weight loss occurs in response to exercise, obese subjects still benefit from the increase in PA due to increased cardiorespiratory fitness, glucose control, endothelial function, improvements in hyperlipidemia, quality of life, and a reduction in future weight gain [ 28 ].

Caloric restriction is better than exercise for significant weight loss initially, and the weight loss is not necessarily enhanced significantly by adding exercise [ 28 ], although exercise training plus caloric restriction does improve body composition by increasing fat loss and decreasing loss of lean body mass [ 31 ]. The greatest value of exercise in the management of obesity occurs not in the initial weight loss, but in the situation where obese patients have lost weight successfully and now require substantial PA to maintain that weight loss [ 28 ]. Interestingly, an “energy gap” has been identified as the difference in energy expenditure before and after weight loss [ 32 ]. The energy gap is estimated to be approximately 8 kcal per day per pound of weight lost. An energy gap, for example, of 40 lbs lost would be associated with 320 kcal of energy. Sustaining this weight loss successfully would require either a continued reduction in energy consumption by 320 kcal per day, or increasing activity-associated energy expenditure by the same amount [ 32 ]. Based on the Set Point theory, both biological and environmental pressures oppose the strategy of food restriction in keeping weight off, but the same effect does not occur with increased PA [ 32 ]. Therefore, while food restriction is the key to weight loss, PA is the key to successful maintenance of the weight lost [ 32 ]. The ACSM has identified that people who successfully maintain weight loss average at least 250 min of PA per week [ 29 ].

Low Back Pain

A 2016 systematic review and meta-analysis reviewed 23 randomized controlled trials evaluating the prevention of low back pain [ 33 ]. Over 30,000 patients were involved in these studies. Ultimately, the combination of exercise (varying regimens of abdominal strengthening, core stability, cardiovascular, and isometrics) plus education regarding prevention of low back pain was found to reduce the risk of low back pain as well as sick leave related to low back pain. Exercise alone was also found to have an impact but had a more short term effect (<12 months), thought to be due to cessation of exercise following the intervention. Other interventions, including back belts, insoles, and education alone were not found to have any impact [ 33 ].

Not All Exercise is Created Equal

Physical activity versus physical fitness.

The lay public tends to use the terms PA and physical fitness interchangeably, but subtle differences between the two exist. Physical fitness is a physiologic state of being with regard to daily living and/or sports performance [ 4 ]. Physical fitness is comprised of cardiovascular, musculoskeletal, body composition, and metabolic components [ 4 ]. Physical fitness is similar to PA, but is more predictive of health outcomes. For example, a high-fit versus a low-fit person is estimated to have a 50 % lower mortality [ 34 ]. Physical fitness, therefore, becomes a better measure of PA than self-reporting. From a public health standpoint, however, it is better and more productive to encourage the public to be physically active and not push the need to be physically fit. Eventually, increased activity should lead to physical fitness.

In the past, guidelines for optimal health seemed to have had a singular focus on aerobic fitness. But a new paradigm shift has occurred with the addition of the concept of musculoskeletal fitness [ 4 ]. In other words, health status can improve due to increased PA in the absence of changes in aerobic fitness. Regular PA can decrease risk factors from chronic disease and disability without changing cardiac output or oxidative potential, especially in the elderly [ 4 ]. The shift has been to focus on the health benefits of musculoskeletal fitness, which may be a critical factor in the functional threshold for dependence with the aging population. Loss of muscular fitness can result in loss of capacity for daily living, and a cycle of decline can ensue [ 4 ]. Improvement in musculoskeletal function can delay the onset of disability, dependence, and chronic disease [ 35 ]. Musculoskeletal fitness is associated with fewer functional limitations and a reduced incidence of cardiovascular disease, diabetes, degenerative joint disease, and coronary artery disease [ 35 ]. Therefore, resistance training that works all the major muscle groups (including legs, hips, back, abdomen, chest, shoulders, and arms) and flexibility exercise, which are necessary to achieve musculoskeletal fitness, are recommended to be done at least twice weekly, to complement aerobic fitness and optimize overall health status.

Adverse Health Risk from Sitting

In an effort to delineate those factors which contribute to the obesity epidemic, researchers are increasingly focused on the adverse health risk from prolonged sitting [ 36 •]. A newly recognized occupational hazard has evolved because of workers needing to sit at a computer screen throughout the workday. Each mean hour of sitting after a total mean of 7 h per day is associated with a 5 % increase in premature death [ 36 •]. More time sitting at work has been shown to correlate with more sitting in leisure time. Prolonged sitting while watching TV at home, for example, has adverse effects on mental health, well-being, and muscle strength. Long sedentary hours have been linked to a twofold increase in diabetes, a twofold increase in cardiovascular disease, a 13 % increase in the incidence of cancer, and a 17 % increase in mortality related to cancer [ 36 •]. It is estimated that the average worker in the USA and England spends 60–70 % of waking hours in a sedentary sitting position. The effect of sitting has been likened to the transmission of a car. Sitting for such a prolonged period is like putting a car in reverse, causing one’s overall health status to go in the wrong direction [ 36 •]. Approximately 20–30 % of the time is spent in light intensity activity, described as postural changes, standing and movement, or ambulation. For less than 5–10 % of waking hours, individuals spend in moderate to vigorous PA. The adverse effect of sitting on health status is independent of the exercise or PA done before or after [ 36 •]. In other words, no amount of PA later can overcome the negative health effects of prolonged sitting.

Changes in the workplace environment may be the key issue to minimizing the negative effects of prolonged sitting. Particularly, in the UK, recommendations and guidelines have been developed to avoid this health hazard [ 36 •]. Workers are encouraged to accumulate up to 2 h per day at work standing or performing light walking, with the goal to progress ultimately to 4 h per day. Workers should interrupt seat-based work with standing-based work. However, workers should avoid both prolonged periods of standing as well as prolonged periods of sitting. Adaptation of these guidelines may lead to musculoskeletal complaints and fatigue, which should be monitored by managers in the workplace. Such health promotion strategies should eventually extend from the workplace to the leisure time [ 36 •].

Non-Exercise Activity Thermogenesis

Non-exercise activity thermogenesis (NEAT) has been described as unstructured PA, energy expended unrelated to sleeping, eating, or sports exercise. NEAT is energy expended outside of purposeful exercise [ 37 ]. Surprisingly, this incidental, non-purposeful lifestyle-embedded PA can have tremendous health benefits. Three components of NEAT include body posture, ambulation, and all other movements (the most important of which may be fidgeting) [ 38 ]. Researchers involved in the study of obesity are finding that in some cases what delineates the lean subject from an obese one is a difference in NEAT, not exercise-associated activity thermogenesis [ 38 ]. Early experiments which helped identify NEAT came from studies where energy requirements were measured and all subjects were placed on a diet of 1000 cal over requirements [ 39 ]. Subjects were then videotaped, and in a blinded fashion designated as fidgeters or non-fidgeters. At the end of the trial, those patients who were designated as fidgeters failed to gain weight, while those identified to be non-fidgeters sustained significant weight gain. The increase in kilocalories of energy expenditure attributed to NEAT was inversely proportional to fat gain in pounds [ 39 ]. NEAT ranges from 15 % of total energy expenditure (TEE) in sedentary subjects to as much as 50 % of TEE in fidgeting physically active people [ 39 ]. Fidgeting has been shown in twin studies to be genetic, with an estimated >62 % heritability [ 40 ]. Simply standing or lightly ambulating can increase energy expenditure by an average of 350 kcal/day (range 269–477 kcal/day) [ 37 ]. NEAT tends to be greater in men than women, in obese subjects rather than lean, and in those with more education than those with less [ 38 , 39 ]. NEAT tends to be seasonal and overall, declines with age [ 39 ]. The concept of an energy gap is pertinent to NEAT. An average citizen in the USA has been shown to gain 1–2 lbs each year through their adult life. An energy gap of 100 kcal additional energy consumed each day would account for this weight gain [ 41 ]. NEAT can be an important contributor to TEE, such that increases in NEAT of as little as 100–150 kcal of activity per day could prevent such weight gain (by offsetting the energy gap) in the vast majority of people [ 41 ]. Recommendations now suggest that if you were not lucky enough to inherit fidgeting, you should “act like a fidgeter,” standing often, getting up from sitting, pacing, parking at the back of a parking lot, and taking stairs instead of elevators [ 40 ].

Continuous Versus Interval Exercise

Long bouts of continuous exercise as a strategy for weight loss or weight maintenance can be a contentious and challenging recommendation for the general public. Longer duration, continuous exercise may be difficult and not particularly enjoyable for patients and may not fit as well with work or home schedules. Research now has shown that interval exercise, which involves alternating short bouts of high-intensity exercise with lower-intensity exercise that allows for partial recovery, can match the health benefits of continuous exercise [ 42 ]. Studies in patients with class-1 obesity (BMI 30–34.9 kg/m 2 ), walking at a moderate level of intensity, randomized to two 15-min intervals of walking versus one 30-min interval, showed essentially the same improvements in overall health status [ 42 ]. Both intermittent and continuous exercise resulted in improvement of maximum oxygen consumption, body composition, and lipid profiles. In some categories, interval exercise even exceeded the benefit seen with continuous exercise (such as VLDL levels and percent fat lost) [ 42 ]. The value of these findings for intermittent exercise stems from three factors: there is less attrition with recommendations for interval exercise, time constraints, and short periods of interval exercising may allow for greater intensity of PA [ 42 ]. An additional study involving 28 sedentary overweight or obese men compared five 45- to 60-min sessions of continuous moderate intensity cycling per week for 6 weeks with three 20-min sessions of high-intensity interval exercise per week (for a total of 60 min) for 6 weeks. Similar improvements in cardio-metabolic risk factors including improved insulin sensitivity, cardiovascular fitness, and a reduction in blood lipids and body fat percentage were observed in the groups [ 43 ]. While cardiovascular fitness was improved to a greater extent in the continuous exercise group, this study, along with numerous other studies of interval exercise showing similar outcomes in different populations, are encouraging in that they show many of the same improvements in overall health with a substantially reduced time commitment [ 43 ]. This is especially relevant as lack of time is cited as the most common reason for not exercising by many. In addition, interval exercise can be easily adapted to an individual’s starting fitness level by adjusting either the duration or intensity (or both) of the high-intensity component of exercise. This may be especially beneficial for sedentary overweight or obese individuals who are new to exercise. In light of both the potential health and time saving benefits, interval exercise training appears to be an appealing and worthwhile exercise option in addition to, or instead of, continuous exercise. The good news for public health is that short walks on a subject’s lunch break or brief periods of activity before and after work all count, and the sum of their duration may have similar benefits to a single continuous interval of exercise of the same duration.

Success of Pedometers

The use of pedometers to increase PA was generated years ago in Japanese walking clubs. The rationalization for the pedometer was that the average stride was estimated to be 2.5 ft. Therefore, 2000 steps should approximately equal a mile, 10,000 equaling about 5 miles [ 44 ]. Based on this rationalization, PA can be classified as sedentary (<5000 steps per day), low active (5000 to 7500 steps), somewhat active (7500 to 10,000 steps), and active (>10,000 steps per day). Highly active physical exercise is associated with >12,500 steps per day [ 44 ]. This is an arbitrary categorization, however, and 10,000 steps per day may be too little for children or too much for the elderly. Weight loss using a pedometer without caloric restriction is associated with minimal to modest weight loss of <2 kg [ 44 ]. Health benefits associated with use of the pedometer may be limited to a reduction in blood pressure, with not much change in cholesterol, triglycerides, or fasting glucose [ 44 ].

Exercise in the Intensive Care Unit

Exercise is becoming increasingly important in one of the least expected circumstances, that of a critically ill patient in the intensive care unit (ICU). Researchers have found that exercising muscle increases the uptake of amino acid fuel and promotes greater protein synthesis [ 45 , 46 ]. Patients in the ICU on a ventilator in some centers are gotten out of bed and encouraged to walk with assistance in the hallway. Other centers have used a pedaling device, some of which can even be adapted for passive activity in a patient who is otherwise sedated and minimally responsive. Exercise in the critical care setting helps maintain muscular strength, reduces the risk for long-term neuromuscular weakness, shortens rehabilitation, and is more likely to result in the patient being discharged to their home [ 45 , 46 ].

Recommendations for Public Health

Similar to the Food Guide Pyramid designed by the USDA, an activity pyramid has been created to guide the public in strategies to increase flexibility, muscular strength, and aerobic capacity ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ). Every day, subjects are encouraged to increase activity in leisure and at work. Three to five times per week, aerobic activity should occur, accumulating 150 min each week ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ). Two to three times per week, muscular activity focusing on flexibility and strength training should be scheduled. Sitting more than 30 min at a time, watching TV, or staring at a computer screen should be minimized or reduced as much as possible ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ).

Guidelines differentiate between moderate and vigorous intensity of PA. Moderate intensity is defined by a 3–5 MET level of effort, and includes activities that cause some increase in breathing and heart rate (such as walking 3–4 miles per hour, bicycling on level ground, light swimming, gardening, or mowing a lawn) [ 4 ]. Vigorous intensity is defined by ≥6 METs, and is exemplified by activities causing large increases in breathing, heart rate, and sweating. Such activities of vigorous intensity would include jogging or running at faster than a 10 min mile, aerobic dancing, competitive sports, heavy yard or construction work, brisk swimming, or fast bicycling [ 4 ].

The amount of PA needed to optimize health is not clear. The particular dose of exercise required to achieve benefits with regard to a particular disease process is difficult to ascertain. For cardiovascular disease, the intensity of PA is inversely and linearly associated with increased mortality, with the biggest effect seen as a reduction of premature death [ 47 ]. PA of >2000 kcal per week extends life by 1–2 years by age 80 [ 47 ]. An average energy expenditure of 1000 kcal per week is associated with a 20–30 % decrease in all-cause mortality. Beginning at a minimum of 1000 kcal per week, increasing benefits are seen with increasing energy expenditure, suggesting a dose-response gradient to the effect of exercise on cardiovascular health [ 47 ]. For diabetes mellitus, there is decreased risk from this disease process with PA of >5.5 METs for at least 40 min per week [ 48 ]. Walking 2 h per week decreases the risk of premature death from diabetes [ 48 ]. Moderate exercise defined by a >4.5 METs for 30–60 min per day reduces both the risk of colon cancer and breast cancer [ 19 ]. For women in particular, >7 h per week of moderate exercise has been shown to be successful in reducing risk of breast cancer (TI01). For osteoporosis, the dose-response gradient is less clear, with recommendations simply emphasizing that osteogenic adaptation is load-dependent and site-specific [ 4 ]. The Center for Disease Control (CDC), the American College of Sports Medicine, and the Healthy People 2010 recommendations provide guidelines for aerobic activity for public health purposes [ 49 ]. Adults should engage in PA of moderate intensity for at least 150 min per week or engage in PA of vigorous intensity for at least 75 min per week. Bouts of exercise may be broken up into smaller increments lasting at least 10 min [ 49 ].

Should Anyone Not be Exercising?

Jim Fixx was a celebrity journalist who helped contribute to the running craze seen in the 1980s in the USA. His sudden death from cardiovascular disease, while jogging, raised questions as to the need for medical evaluation prior to engaging in a program of increasing PA. Moderately strenuous PA may trigger ischemic events, particularly among sedentary people. There is an increased incidence of primary heart attack in high-intensity exercise. In competitive athletes, 80 % of deaths are caused by coronary artery disease. Some subjects do need to have their health risks assessed prior to engaging in an aggressive program.

The degree to which a person is evaluated prior to exercise depends on the presence or absence of cardiovascular disease risk factors and whether the exercise will be moderate or vigorous in intensity [ 50 ]. Subjects at low risk would be those who are young in age (<45 years for male, <55 years for female), are asymptomatic, and have ≤1 cardiovascular risk disease factors. These patients do not need a medical evaluation or stress test for moderate or even vigorous exercise. Subjects at moderate risk are older (men >45 years, women >55 years), or have ≥2 risk factors for cardiovascular disease. For moderate exercise, no medical evaluation may be needed, but these subjects should undergo a stress test. If exercise of vigorous intensity is planned, both a medical evaluation and a stress test should be performed. For those patients at high risk, however, defined by ≥1 sign or symptom of cardiovascular, pulmonary, or metabolic disease, both a full medical evaluation and stress test should be performed before any program is undertaken [ 50 ].

Specifically, those subjects who should not be exercising are those experiencing an acute myocardial infarction, subjects with unstable angina, systolic blood pressure >180, diastolic pressure >110 ml/Hg, uncontrolled diabetes mellitus, poorly controlled congestive heart failure, or thrombophlebitis [ 50 ].

While formal studies have shown that physician counseling is time-intensive and only minimally effective in changing behavior, physicians should no longer avoid the subject of recommendations for exercise as part of the healthcare they deliver to their patients. Physicians can begin by suggesting lifestyle changes such as climbing stairs at work, parking further away from the door on errands, walking regularly, and doing chores at home and in the yard. Clinicians should write on a prescription pad for the patient, specifying the type of exercise, duration, frequency, and intensity. The physician upon discharge from an office visit should determine plans for support and follow up to encourage success, manage obstacles, and prevent relapses. Clinicians should encourage their outpatients to involve community services such as physical therapy, mall-walking programs, school tracks, safe neighborhoods, the YMCA, and walk-a-thon’s.

Physicians should counsel that exercise is not an option. The exercise does not have to be continuous to be effective, and any physical activity counts. Patients should sit less, stand more, and plan their exercise activity at the beginning of each week. Subjects should be encouraged to find activities which they enjoy and involve others to maintain compliance. As Edward Stanley, the Earl of Derby in 1873 said, “Those who think they have not time for bodily exercise will sooner or later have to find time for illness” [ 51 ].

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Four men running on a track, dawn light visible on the horizon.

  • MIND, BODY, WONDER

Why the world's oldest sport is still one of the best exercises

Few physical activities can match the cardiovascular benefits of running. It’s also good for your muscles, bones, and mind—and can help you live longer.

When it comes to cardiovascular exercise, running is in a class of its own.

It's a sport that has endured millennia—the oldest and once only Olympic event   was a sprint known as the stadion, but its practical benefits date back to prehistoric times.

"In order to hunt and survive, humans had to develop the ability to run millions of years ago, so it's engrained in who we are as a species," says Alyssa Olenick, an exercise physiologist at the University of Colorado Anschutz Medical Campus. "Over the centuries, it's grown into one of the most popular and accessible worldwide sports for both elite athletes and everyday people."

Today, some 50 million Americans regularly engage in the activity that appeals to both the old and young alike and is about   as popular   among women as it is among men.

( Oral contraceptives may help lower the risk of sports injuries )

"Across all age groups, running helps to improve cardiovascular fitness and reduce overall mortality, to manage weight, to improve bone density and muscle strength and coordination, and to reduce stress and improve mental health," says Danielle Ponzio, an orthopedic surgeon at the Thomas Jefferson University Hospital in Philadelphia and a co-author of running-related research .

For Hungry Minds

Though running isn't for everyone—people with certain medical conditions may need to pursue non-weight-bearing exercises such as swimming —it's a sport that benefits its participants as much today as it would have helped runners in ancient times.

Unparalleled cardiovascular and respiratory benefits

The most consistently studied benefit of running is improved heart health. It does this, in part, by making the heart "a stronger, more efficient pump," says Allison Zielinski, a cardiologist at Northwestern Memorial Hospital and the co-director of the sports cardiology program at Northwestern Feinberg School of Medicine. A stronger cardiac muscle, she explains, improves one's cardiac output —a scientific measurement of how much blood the heart can pump in a minute, which healthcare providers use to gauge the strength and efficiency of a patient's cardiovascular system.

Zielinski adds that running also affects one’s autonomic nervous system—the body’s network responsible for regulating involuntary physiological processes such as digestion and respiration—by reducing one's resting heart rate. This is significant because studies show that every 10-beat-per-minute increase in one's resting heart rate is associated with a 16 percent increase in mortality risk.

Such improvements in cardiovascular performance are among the reasons the United States Centers for Disease Control and Prevention recognizes running as a "vigorous-intensity" activity—the health agency's highest measurement of aerobic exercise.

Running has also been shown to improve circulation, causing " favorable changes in your blood vessels, including increased capillary density and improved endothelial reactivity—something known as vasodilation," Zielinski explains.

Research shows that running improves lung capacity and performance as well. It accomplishes this, in part, by improving the maximum rate at which one can utilize oxygen—a measurement known as VO2max. This measurement reflects the maximal amount of oxygen-rich blood someone can pump out of their heart and deliver to their muscle to drive movement, says Olenick.

Living longer and better

This has a direct association with improved all-cause mortality as "even a small increase in VO2max can have meaningful improvements in long-term health," says Olenick. But it's only one of many markers of longevity associated with running.

One landmark 15-year study published in the Journal of the American College of Cardiology,   for instance, found that running for even five to 10 minutes a day resulted in an average three-year life expectancy gain. Duck-Chul Lee, a co-author of the research and a professor of physical activity epidemiology at Iowa State University College of Human Sciences, says these benefits are accomplished, in part, because "running reduces the risk of many diseases and conditions including coronary heart disease and type 2 diabetes."

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A nother longitudinal study found runners had a 39 percent lower mortality rate and experienced less physical disability than non-runners. Running has also been associated with decreased LDL cholesterol levels and improved blood pressure .

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The activity is good for muscle growth and increasing bone density, which is especially important for older people. "As we age, we tend to lose muscle mass and bone density," says Ponzio, "and weight-bearing exercise like running is an effective way to counter these losses." Indeed, one study shows that long-distance running in particular increases biological markers of bone formation.

Because of these and related benefits, "running can reduce your risk of developing osteoporosis and arthritis," says Austin "Ozzie" Gontang, a clinical psychotherapist and the director of the San Diego Marathon Clinic in California.

Healthy weight management is another quality-of-life advantage associated with running. One reason for this is that running at even a moderate pace of five miles per hour (many runners run in excess of 12 mph) burns 590 calories per hour in a 154-pound person, which is as much or more than any other CDC-measured physical activity including swimming, weightlifting, bicycling, or playing basketball. "Running is a powerful tool for burning calories and is crucial for weight loss and maintenance," says Gontang.

In this regard, it's also helpful that running increases energy expenditure and boosts one's metabolism by helping the body metabolize fats and carbs , "both during exercise and after we eat," says Olenick. In similar fashion, running has also been shown to help with healthy blood-sugar regulation.

Mental health advantages

Running's mental health plusses are no less intriguing. "Running can be done on your own, but often has a social component as well, whether it's running with a friend or being part of a running club or virtual community," says Karmel Choi, a clinical psychologist at Massachusetts General Hospital and Harvard Medical School. "This adds to the emotional benefits by reducing isolation and increasing a sense of support and motivation."

The activity can also be good for depression. Choi points to a recent study that found that individuals with depression who started running regularly "recovered at similar rates to those taking antidepressants." She's published supportive research and notes that her team estimates that if someone swapped just 15 minutes of sitting for 15 minutes of running each day, they could "reduce their risk of depression by as much as 26 percent." Part of the reason for this is because running has been shown to release "feel-good hormones like endorphins and dopamine , that have been linked to better mood, reduced stress, and even the 'runner’s high,'" Choi explains.

Beyond helping one feel better, running is associated with improved cognitive function. "Running can boost brain function by enhancing memory and learning capabilities," says Gontang. He says this occurs because running increases blood flow to the brain and stimulates the production of a molecule known as the brain-derived neurotrophic factor (BDNF), "which supports the growth of new neurons and protects existing brain cells."

Getting started

Perhaps most compelling of all is that there are very low costs and almost no barriers of entry associated with participating in the sport. "Running can seem intimidating because it sometimes seems like people need all the latest watches or gear or tools or shoes to participate, but people can simply start with a road or trail near them, and often things they already own," says Olenick.

To get started, begin slow and then work up to higher and higher fitness levels.

"Try and make it easier to increase physical activity in your daily life and within the context of daily activities you're already doing such as parking a bit further from the grocery store or taking the stairs at work," suggests Rajesh Vedanthan, a physician and population health scientist at NYU Langone Health in New York City. From there, he suggests briskly walking around the block before attempting jogging and then running.

Even after getting used to the movement, Lee suggests alternating running laps with walking or jogging laps. Adopting proper form and posture is also recommended. "Keep your head up and look forward as you run to align your spine," offers Gontang. He also says it's important to keep your shoulders relaxed and to keep your elbows at 90 degrees and to "avoid overstriding."

Developing a running schedule, finding a running buddy (the family dog counts!), and setting realistic and measurable goals are additional ways of staying motivated and keeping yourself accountable. "Proper shoe type and fit are also important," advises Ponzio.

As you go, she suggests listening to your body, avoiding doing too much, too quickly, and varying your surroundings, terrain, and destination. "Eventually, sign up for some races as the adrenaline of being part of something bigger with a community of like-minded runners is really so special," she says. "It keeps runners coming back for more."

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Role of Physical Activity on Mental Health and Well-Being: A Review

Aditya mahindru.

1 Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Pradeep Patil

Varun agrawal.

In addition to the apparent physical health benefits, physical activity also affects mental health positively. Physically inactive individuals have been reported to have higher rates of morbidity and healthcare expenditures. Commonly, exercise therapy is recommended to combat these challenges and preserve mental wellness. According to empirical investigations, physical activity is positively associated with certain mental health traits. In nonclinical investigations, the most significant effects of physical exercise have been on self-concept and body image. An attempt to review the current understanding of the physiological and psychological mechanisms by which exercise improves mental health is presented in this review article. Regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal axis. Depression and anxiety appear to be influenced by physical exercise, but to a smaller extent in the population than in clinical patients. Numerous hypotheses attempt to explain the connection between physical fitness and mental wellness. Physical activity was shown to help with sleep and improve various psychiatric disorders. Exercise in general is associated with a better mood and improved quality of life. Physical exercise and yoga may help in the management of cravings for substances, especially in people who may not have access to other forms of therapy. Evidence suggests that increased physical activity can help attenuate some psychotic symptoms and treat medical comorbidities that accompany psychotic disorders. The dearth of literature in the Indian context also indicated that more research was needed to evaluate and implement interventions for physical activity tailored to the Indian context.

Introduction and background

Physical activity has its origins in ancient history. It is thought that the Indus Valley civilization created the foundation of modern yoga in approximately 3000 B.C. during the early Bronze Age [ 1 ]. The beneficial role of physical activity in healthy living and preventing and managing health disorders is well documented in the literature. Physical activity provides various significant health benefits. Mechanical stress and repeated exposure to gravitational forces created by frequent physical exercise increase a variety of characteristics, including physical strength, endurance, bone mineral density, and neuromusculoskeletal fitness, all of which contribute to a functional and independent existence. Exercise, defined as planned, systematic, and repetitive physical activity, enhances athletic performance by improving body composition, fitness, and motor abilities [ 2 ]. The function of physical activity in preventing a wide range of chronic illnesses and premature mortality has been extensively examined and studied. Adequate evidence links medical conditions such as cardiovascular disease and individual lifestyle behaviours, particularly exercise [ 3 ]. Regular exercise lowered the incidence of cardiometabolic illness, breast and colon cancer, and osteoporosis [ 4 ]. In addition to improving the quality of life for those with nonpsychiatric diseases such as peripheral artery occlusive disease and fibromyalgia, regular physical activity may help alleviate the discomforts of these particular diseases [ 5 ]. Exercise also helps with various substance use disorders, such as reducing or quitting smoking. As physical exercise strongly impacts health, worldwide standards prescribe a weekly allowance of "150 minutes" of modest to vigorous physical exercise in clinical and non-clinical populations [ 6 ]. When these recommendations are followed, many chronic diseases can be reduced by 20%-30%. Furthermore, thorough evaluations of global studies have discovered that a small amount of physical exercise is sufficient to provide health benefits [ 7 ].

Methodology

In this review article, a current understanding of the underlying physiological and psychological processes during exercise or physical activity that are implicated in improving mental health is presented. Search terms like "exercise" or "physical activity" and "mental health", "exercise" or "physical activity" and "depression", "exercise" or "physical activity" and "stress", "exercise" or "physical activity" and "anxiety", "exercise" or "physical activity" and "psychosis," "exercise" or "physical activity" and "addiction" were used as search terms in PubMed, Google Scholar, and Medline. An overwhelming majority of references come from works published within the past decade.

The impact of physical health on mental health

There is an increasing amount of evidence documenting the beneficial impacts of physical activity on mental health, with studies examining the effects of both brief bouts of exercise and more extended periods of activity. Systematic evaluations have indicated better outcomes for mental diseases with physical activity. Numerous psychological effects, such as self-esteem, cognitive function, mood, depression, and quality of life, have been studied [ 8 ]. According to general results, exercise enhances mood and self-esteem while decreasing stress tendencies, a factor known to aggravate mental and physical diseases [ 9 ]. Studies show that people who exercise regularly have a better frame of mind. However, it should be highlighted that a consistent link between mood enhancement and exercise in healthy individuals has not been established.

Additionally, human beings produce more of these two neurochemicals when they engage in physical activity. Human bodies manufacture opioids and endocannabinoids that are linked to pleasure, anxiolytic effects, sleepiness, and reduced pain sensitivity [ 10 ]. It has been shown that exercise can improve attention, focus, memory, cognition, language fluency, and decision-making for up to two hours [ 11 ]. Researchers state that regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal (HPA) axis, lowering cortisol secretion and restoring the balance of leptin and ghrelin (Figure ​ (Figure1) 1 ) [ 12 ].

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HPA: hypothalamus-pituitary-adrenal

This image has been created by the authors.

Regular exercise has immunomodulatory effects such as optimising catecholamine, lowering cortisol levels, and lowering systemic inflammation. Physical activity has been shown to increase plasma brain-derived neurotrophic factor (BDNF), which is thought to reduce amyloid-beta toxicity linked to Alzheimer's disease progression [ 13 ].

Although no causal correlations have been proven, methodologically sound research has discovered a related improvement in mentally and physically ill populations. These findings are based on research and studies conducted all across the globe, particularly in the Western Hemisphere. In order to address a widespread health problem in India, it is useful to do a literature review that draws on research conducted in a variety of settings. In addition, the prevalence of these mental illnesses and the benefits of exercise as a complementary therapy might be made clear by a meta-analysis of research undertaken in India [ 14 ].

This review also analysed published literature from India to understand the effects of exercise on mental health and the implications for disease management and treatment in the Indian context. Results from Indian studies were consistent with those found in global meta-analyses. The Indian government has made public data on interventions, such as the effects of different amounts of physical exercise. Exercising and yoga have been shown to be effective adjunct therapies for a variety of mental health conditions [ 12 ]. Though yoga may not require a lot of effort to perform, other aspects of the program, such as breathing or relaxation exercises, may have an impact on a practitioner's mental health at the same time. Due to its cultural significance as a common physical practice among Indians and its low to moderate activity level, yoga would be an appropriate activity for this assessment [ 15 ].

Yoga as an adjunctive treatment 

Although yoga is a centuries-old Hindu practice, its possible therapeutic effects have recently been studied in the West. Mind-body approaches have been the subject of a lot of studies, and some of the findings suggest they may aid with mental health issues on the neurosis spectrum. As defined by the National Center for Complementary and Alternative Medicine, "mind-body interventions" aim to increase the mind's potential to alter bodily functions [ 16 ]. Due to its beneficial effects on the mind-body connection, yoga is used as a treatment for a wide range of conditions. Possible therapeutic benefits of yoga include the activation of antagonistic neuromuscular systems, stimulation of the limbic system, and a reduction in sympathetic tone.

Anxiety and depression sufferers might benefit from practising yoga. Yoga is generally safe for most people and seldom causes unintended negative consequences. Adding yoga to traditional treatment for mental health issues may be beneficial. Many of the studies on yoga included meditation as an integral part of their methodology. Meditation and other forms of focused mental practice may set off a physiological reaction known as the relaxation response. Functional imaging has been used to implicate certain regions of the brain that show activity during meditation. According to a wealth of anatomical and neurochemical evidence, meditation has been shown to have far-reaching physiological effects, including changes in attention and autonomic nervous system modulation [ 17 ]. Left anterior brain activity, which is associated with happiness, was shown to rise considerably during meditation. There's also some evidence that meditation might worsen psychosis by elevating dopamine levels [ 18 - 20 ]. We do not yet know enough about the possible downsides of meditation for patients with mental illness, since this research lacks randomised controlled trials.

Physical activity and schizophrenia

Schizophrenia is a debilitating mental disorder that often manifests in one's early years of productive life (late second decade). Remission of this disorder occurs in just a small fraction of cases. More than 60% will have relapses, and they might occur with or without noticeable deficits. Apart from delusions, hallucinations, and formal thought disorders, many patients exhibit cognitive deficits that emerge in the early stages of the disease and do not respond adequately to therapy [ 21 ].

Treatment for schizophrenia is challenging to master. Extrapyramidal side effects are a problem with first-generation antipsychotic drugs. Obesity and dyslipidemia have been related to second-generation drugs, which may cause or exacerbate these conditions. The majority of patients do not achieve complete remission, and many do not even experience satisfactory symptom relief. Even though certain antipsychotic medications may alleviate or even exacerbate negative and cognitive symptoms, these responses are far less common. This means that patients may benefit from cognitive rehabilitation. Because of their illness or a negative reaction to their medicine, they may also have depressive symptoms. This would make their condition even more disabling. Many patients also deal with clinical and emotional complications. Tardive extrapyramidal illnesses, metabolic syndromes, defect states, and attempted suicide are all in this category. Patient compliance with treatment plans is often poor. The caregivers take on a lot of stress and often get exhausted as a result.

Evidence suggests that increased physical activity can aid in attenuating some psychotic symptoms and treating medical comorbidities that accompany psychotic disorders, particularly those subject to the metabolic adverse effects of antipsychotics. Physically inactive people with mental disorders have increased morbidity and healthcare costs. Exercise solutions are commonly recommended to counteract these difficulties and maintain mental and physical wellness [ 22 ].

The failure of current medications to effectively treat schizophrenia and the lack of improvement in cognitive or negative symptoms with just medication is an argument in favour of utilising yoga as a complementary therapy for schizophrenia. Even without concomitant medication therapy, co-occurring psychosis and obesity, or metabolic syndrome, are possible. The endocrine and reproductive systems of drug abusers undergo subtle alterations. Numerous studies have shown that yoga may improve endocrine function, leading to improvements in weight management, cognitive performance, and menstrual regularity, among other benefits. In this context, the role of yoga in the treatment of schizophrenia has been conceptualized. However, yoga has only been studied for its potential efficacy as a therapy in a tiny number of studies. There might be several reasons for this. To begin with, many yoga academies frown against the practice being adapted into a medical modality. The second misconception is that people with schizophrenia cannot benefit from the mental and physical aspects of yoga practised in the ways that are recommended. Third, scientists may be hesitant to recommend yoga to these patients because of their lack of knowledge and treatment compliance.

In a randomised controlled experiment with a yoga group (n = 21) and an exercise group (n = 20), the yoga group exhibited a statistically significant reduction in negative symptoms [ 2 ]. In accordance with the most recent recommendations of the National Institute for Health and Care Excellence (NICE), the above research provides substantial evidence for the use of yoga in the treatment of schizophrenia. According to a meta-analysis of 17 distinct studies [ 23 ] on the subject, frequent physical activity reduces the negative symptoms associated with schizophrenia considerably.

Physical activity and alcohol dependence syndrome

Substance abuse, namely alcohol abuse, may have devastating effects on a person's mental and physical health. Tolerance and an inability to control drinking are some hallmarks of alcoholism. Research shows that physical activity is an effective supplement in the fight against alcohol use disorder. In addition to perhaps acting centrally on the neurotransmitter systems, physical exercise may mitigate the deleterious health consequences of drinking. Evidence suggests that persons with alcohol use disorder are not physically active and have low cardiorespiratory fitness. A wide number of medical comorbidities, like diabetes mellitus, hypertension, and other cardiovascular illnesses, occur with alcohol use disorders. Physical exercise may be highly useful in aiding the management of these comorbidities [ 24 ].

Physical exercise and yoga may help in the management of cravings for substances when other forms of therapy, such as counselling or medication for craving management are not feasible or acceptable. Physical exercise has been shown to have beneficial effects on mental health, relieve stress, and provide an enjoyable replacement for the substance. However, the patient must take an active role in physical activity-based therapies rather than passively accept the process as it is, which is in stark contrast to the approach used by conventional medicine. Since most substance use patients lack motivation and commitment to change, it is recommended that physical activity-based therapies be supplemented with therapies focusing on motivation to change to maximise therapeutic outcomes.

One hundred seventeen persons with alcohol use disorder participated in a single-arm, exploratory trial that involved a 12-minute fitness test using a cycle ergometer as an intervention. Statistically, significantly fewer cravings were experienced by 40% [ 24 ]. Exercise programmes were found to significantly reduce alcohol intake and binge drinking in people with alcohol use disorder in a meta-analysis and comprehensive review of the effects of such therapies [ 25 ].

Physical activity and sleep

Despite widespread agreement that they should prioritise their health by making time for exercise and sufficient sleep, many individuals fail to do so. Sleep deprivation has negative impacts on immune system function, mood, glucose metabolism, and cognitive ability. Slumber is a glycogenetic process that replenishes glucose storage in neurons, in contrast to the waking state, which is organised for the recurrent breakdown of glycogen. Considering these findings, it seems that sleep has endocrine effects on the brain that are unrelated to the hormonal control of metabolism and waste clearance at the cellular level. Several factors have been proposed as potential triggers for this chain reaction: changes in core body temperature, cytokine concentrations, energy expenditure and metabolic rate, central nervous system fatigue, mood, and anxiety symptoms, heart rate and heart rate variability, growth hormone and brain-derived neurotrophic factor secretion, fitness level, and body composition [ 26 ].

After 12 weeks of fitness training, one study indicated that both the quantity and quality of sleep in adolescents improved. Studies using polysomnography indicated that regular exercise lowered NREM stage N1 (very light sleep) and raised REM sleep (and REM sleep continuity and performance) [ 22 ]. As people age, both short- and long-term activities have increasingly deleterious effects on sleep. In general, both short- and long-term exercise were found to have a favourable effect on sleep quality; however, the degree of this benefit varied substantially among different sleep components. On measures of sleep quality, including total sleep time, slow-wave sleep, sleep onset latency, and REM sleep reduction, acute exercise had no effect. But both moderate and strenuous exercise has been shown to increase sleep quality [ 27 ]. According to a meta-analysis of randomised controlled trials, exercise has shown a statistically significant effect on sleep quality in adults with mental illness [ 28 ]. These findings emphasise the importance that exercise plays in improving outcomes for people suffering from mental illnesses.

Physical activity in depressive and anxiety disorders

Depression is the leading cause of disability worldwide and is a major contributor to the global burden of disease, as per the World Health Organization. However, only 10%-25% of depressed people actually seek therapy, maybe due to a lack of money, a lack of trained doctors, or the stigma associated with depression [ 29 ]. For those with less severe forms of mental illness, such as depression and anxiety, regular physical exercise may be a crucial part of their treatment and management. Exercise and physical activity might improve depressive symptoms in a way that is comparable to, if not more effective than, traditional antidepressants. However, research connecting exercise to a decreased risk of depression has not been analysed in depth [ 30 ]. Endorphins, like opiates, are opioid polypeptide compounds produced by the hypothalamus-pituitary system in vertebrates in response to extreme physical exertion, emotional arousal, or physical pain. The opioid system may mediate analgesia, social bonding, and depression due to the link between b-endorphins and depressive symptoms (Figure ​ (Figure2 2 ).

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The "endorphin hypothesis" states that physical activity causes the brain to produce more endogenous opioid peptides, which reduce pain and boost mood. The latter reduces feelings of worry and hopelessness. A recent study that demonstrated endorphins favourably improved mood during exercise, and provided support for these theories suggested that further research into the endorphin theory is required [ 31 ].

Physical activity and exercise have been shown to improve depressive symptoms and overall mood in people of all ages. Exercise has been implicated in lowering depressive and anxious symptoms in children and adolescents as well [ 32 ]. Pooled research worldwide has revealed that physical exercise is more effective than a control group and is a viable remedy for depression [ 33 ]. Most forms of yoga that start with a focus on breathing exercises, self-awareness, and relaxation techniques have a positive effect on depression and well-being [ 34 ]. Despite claims that exercise boosts mood, the optimal kind or amount of exercise required to have this effect remains unclear and seems to depend on a number of factors [ 35 ].

Exercise as a therapy for unipolar depression was studied in a meta-analysis of 23 randomised controlled trials involving 977 subjects. The effect of exercise on depression was small and not statistically significant at follow-up, although it was moderate in the initial setting. When compared to no intervention, the effect size of exercise was large and significant, and when compared to normal care, it was moderate but still noteworthy [ 36 ]. A systematic evaluation of randomised controlled trials evaluating exercise therapies for anxiety disorders indicated that exercise appeared useful as an adjuvant treatment for anxiety disorders but was less effective than antidepressant treatment [ 37 ].

Conclusions

The effects of exercise on mental health have been shown to be beneficial. Among persons with schizophrenia, yoga was shown to have more positive effects with exercise when compared with no intervention. Consistent physical activity may also improve sleep quality significantly. Patients with alcohol dependence syndrome benefit from a combination of medical therapy and regular exercise since it motivates them to battle addiction by decreasing the craving. There is also adequate evidence to suggest that physical exercise improves depressive and anxiety symptoms. Translating the evidence of the benefits of physical exercise on mental health into clinical practice is of paramount importance. Future implications of this include developing a structured exercise therapy and training professionals to deliver it. The dearth of literature in the Indian context also indicates that more research is required to evaluate and implement interventions involving physical activity that is tailored to the Indian context.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

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