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Regular Exercise
Regular exercise is strongly recommended as one of the most effective means to prevent chronic diseases and maintain good health. A sedentary lifestyle may be an even stronger predictor of morbidity and mortality than such established risk factors as smoking, hypertension and diabetes. Physical inactivity is associated with increased incidence of a variety of diseases such as cardiovascular diseases and stroke, obesity, diabetes mellitus, cancer, osteoporosis, Alzheimer’s and Parkinson’s diseases.
Physical activity is any sustained skeletal muscle body movement such as walking, jogging, dancing, swimming etc. , that increases energy expenditure compared with rest. Exercise is physical activity that is planned, purposeful and repetitive on a regular basis so as to improve or maintain health and fitness. Exercises may be divided into four major types. Aerobic exercises involve continuous and rhythmic movements of large muscle groups such as walking or running, which can increase cardiovascular and respiratory fitness. Aerobic means “with oxygen” and refers to exercise where the muscles get adequate oxygen from the blood to sustain prolonged activity. Aerobic exercise causes the heart rate to increase and breathing to become more labored. Strength or resistance exercises involve brief and repetitive muscle contractions such as weight lifting, pull up, push up, squat, which can increase muscular strength. This type of exercise refers to anaerobic (“without oxygen”) where the muscles do not get enough oxygen from the blood to sustain prolonged activity. Balance exercises such as heel-toe walking or tai chi can improve balance and proprioception. Mobility or flexibility exercises such as stretching or yoga can improve range of motion around joints. It is important to have all four types of exercise in your exercise program.
Exercise program should begin with a 5-to 10-minute period of warm-up (light aerobic exercise as walking slowly, the stretches and flexibility movements). The warm-up period allows for a gradual increase in heart rate and may reduce the risk of injuries. Then mix up aerobic exercise, strength exercise, balance and motility exercise so as to keep the workout fun and interesting. After the workout, cool down by performing stretch or light aerobic exercise for 5 minutes. The exercise program should be enjoyable so as to encourage a long-term commitment. There is no age specific heart rate recommendation, a specific heart rate is not necessary to achieve health benefits. If you feel breathless, tired and sweating, you have exercised hard enough.
A minimum of 30 minutes of moderate-intensity aerobic exercise (eg. brisk walking) is suggested on five days per week. Alternately, 20 minutes of vigorous-intensity aerobic exercise (eg. jogging) on three days each week is recommended, with no more than two consecutive days without physical activity. If you cannot exercise for 30 minutes straight, try to exercise for 10 minutes or so at a time, 3 or 4 times a day. Even exercising for shorter amounts of time can be good for you. There is no one exercise program for all individuals. In general, the vast majority are encouraged to begin a gentle exercise program and to gradually progress to a more vigorous program as tolerated.
Any exercise program should be designed to fit into the health and physical conditions of the participant. Existing medical conditions, age and preferences of types of exercise should also be considered and evaluated.
People without chronic diseases such as heart disease, diabetes, kidney disease or concerning symptoms such as chest discomfort, dyspnea, dizziness generally do not require a medical screen prior to committing an exercise program. Patients with significant illness or concerning symptoms should be clinically evaluated before performing exercise program. Moreover, exercise should be avoided when a patient is significantly ill.
The benefits of regular exercise far outweigh the possible risks. Musculoskeletal injury is the most common risk of exercise. To exercise safely and avoid problems, be sure to drink water during and after exercising, and choose an environment that is safe, good ventilated, not so hot, cold or wet. It is better to exercise one hour before meal (for diabetic patients, one hour after meal), and you must have companions if you are old, weak or sick. If you have chest pain or tightness, nausea or vomiting, palpitation, dizziness or fainting, stop exercising and consult your doctor especially if symptoms persist or progress for more than 10 minutes.
Regular exercise has a variety of health benefits. Regular exercise reduces risk of all-cause and disease-specific morbidity and mortality. Regular exercise plays an important role in the management of at least 26 medical diseases, including cardiovascular disease, stroke, hypertension, diabetes, cancer. Thus, engaging in regular exercise is one of the best medicine and should be used more extensively.
Reducing weight in overweight and obese people results in lowering cardiovascular and diabetic risks. Exercise results in clinically significant weight loss, leading to glucose homeostasis and improvement in cardiometabolic risk factors such as body fat, visceral fat, lipids, insulin sensitivity. Exercise lowers blood pressure, reduces risk of cardiovascular disease and stroke. Exercise improves blood vessel endothelial function and autonomic nervous function and has protective effects against ischemic heart disease and cardiac arrhythmias. Moreover, exercise has important role in the prevention and treatment of diabetes mellitus. Physical activity also prevents or delays the development of other long-term diabetes complications, such as pathology of the nervous system, retina and kidney, and may slow progression of existing complications.
Platelets, high levels of plasma fibrinogen, plasminogen activator inhibitor type 1 (PAI-1) activity, tissue-type plasminogen activator (t-PA) antigen and increased plasma viscosity play important roles in the pathogenesis and progression of cardiovascular and cerebrovascular diseases. Exercise reduces platelet adhesion and aggregation, lowers PAI-1 activity and t-PA antigen, lowers plasma viscosity, and improves fibrinolytic activity, therefore improves hemostatic factors associated with thrombosis and protects against ischemic heart disease and stroke.
Exercise modulates brain cell formation, brain metabolism and blood vessel formation, therefore benefits on brain function and health. Exercise improves sleep, stress and anxiety, depression, and cognitive function.
Regular exercise is associated with enhanced vaccination responses, lowers numbers of exhausted/senescent immuneT-cells, increases T-cell proliferative capacity, lowers circulatory levels of inflammatory cytokines, increases white blood cell phagocytic activity, lowers inflammatory response to infection, greater immune NK-cell cytotoxic activity and longer white blood cell chromosome telomere lengths in aging humans, all of which indicate that regular exercise can regulate and improve the immune system and delay the onset of immunosenescence (declining function of immune system) with age .
Exercise benefits people of all ages and may decrease all-cause morbidity and increase lifespan. Some physical activity is better than none, and it is never too late to become physically active. Key benefits of exercise in older adults include better overall health, improved strength, flexibility, mobility and fitness, which can improve daily function, help to maintain independence, and reduce the risk of falls and fall-related injuries. Regular exercise can retard the aging process and ameliorate the insidious onset of age-associated diseases. Exercise maintains aerobic capacity, muscle mass and muscle strength. Exercise has beneficial effects on bone density, size and shape, improving osteoporosis and bone health. Exercise increases antioxidant defense mechanisms. Exercise benefits motor function, gait, cognitive function and neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases. Physical inactivity is associated with an increased risk of more than ten types of cancer. Exercise protects against cancer such as breast, intestinal, kidney, lung, stomach cancers. Moreover, physical activity is associated with major cancer-related outcomes, including quality of life.
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