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Health Benefit Of Exercise

A while ago I was in a party with friends when a group of guys started chatting and one of them said: “when I was 20 I could eat as much as I wanted and was never able to gain weight, I was skinny; but now even a small portion of anything I eat, stick to my body, especially here”, pointing to his belly. All nodded and started laughing as they looked at each other’s considerable abdomen.

Physical inactivity is one of the reasons for the increase in the waist circumference and is a major health problem, especially in developed countries.  One out of every four adults is physically inactive.

Large studies have found that sedentary behavior is associated with a variety of health problems. Sitting for long time (such as in the office in front of a computer or at home watching TV)  appears to be an independent risk factor for diabetes, cardiovascular disease, cancer and increased mortality

•  The National Health and Nutrition Examination Survey (NHANES) — measured the prevalence of obesity in adults in the United States between 2011 and 2012:  34.9 percent was obese, and  almost one third of children and adolescents  was either overweight or obese

•  JAMA 2014; 311:806.

•  In China, a survey in a sample of 98,658 Chinese adults published in 2013 showed that the prevalence of diabetes  was 11.6% (12.1% in men, 11.0% in women), and over half of Chinese adults were pre diabetic (fasting plasma glucose 100 to 125 mg/dL, 2-hour plasma glucose 140 to 199 mg/dL, or HbA1c 5.7% to 6.4%).

•  JAMA. 2013;310:948-958,916-917.

•  We are facing a worldwide epidemic of obesity, hypertension, diabetes and  cardiovascular disease.

What can we do to prevent all this?

Research has shown a strong evidence of the beneficial effects of physical activity. It can prevent  weight gain, lower the risk of  high blood pressure, type 2 diabetes, metabolic syndrome, coronary heart disease, stroke, colon and breast cancer, depression and early death. There is also moderate evidence of lower risk of hip fracture, lung and endometrial cancer, increase bone density and improve sleep quality. (US Department of Health & Human Services. 2008 Physical Activity Guidelines for Americans.)

What is physical activity?

Physical activity is the body movement produced by muscle contraction that consumes energy above the basal level. It can be measured in terms of metabolic equivalents for task (METs), units which estimate the oxygen consumption during the physical activity. One MET is approximately 3.5 mL O2/kg/min, and represents the  oxygen consumption of a seated adult at rest. Moderate physical activity includes activity performed at an intensity of 3 to 6 METs, such as walking briskly (5 to 8 km per hour), moderate effort cycling, swimming, playing golf, or cleaning at home.  Vigorous physical activity is activity performed at >6 METs, such as running, jump-roping, push-ups, pull-ups, sit-ups, jumping jacks.

Exercise isdefined as a form of physical activity that is planned, structured and repetitive with the purpose of improvingement or maintenmaintainingance of physical fitness. There are 4It may be divided into four majortypesof exercise:

• Aerobic or endurance exercises designed to increase cardiovascular and respiratory fitness, such as walking or running

• Strength (or resistance) exercises designed to increase muscular strength, such as pull up, push up, squat or weight lifting

• Balance exercises designed to improve balance  such as heel-toe walking or Tai Chi.

• Mobility (or flexibility) exercises  to maintain or improve range of motion around a joint or lengthen a muscle, such as stretching or yoga

The 2008 Physical Activity Guidelines recommend the equivalent of 150 minutes per week of moderate intensity physical activity for health.

The beneficial effects of exercise appear to be dose-dependent. However, if we engage in  one or two 75-minute sessions of exercise per week, it also can reduce  mortality.

The benefits of exercise on reducing mortality may plateau after a certain activity level . Above 100 minutes/day of moderate-intensity physical activity do not offer additional reductions in mortality rates

FITT mnemonic:

●F – Frequency: ideally 3-5 times a week of aerobic exercise for 30-50 minutes each.

●I – Intensity: Moderate or greater intensity is recommended. If you increase the intensity of the exercise you can obtain the same effect in a shorter period of time; for example, jogging for 15 minutes can be as effective as walking 30 minutes.

●T – Time: Number of minutes per session is ideally 30 minutes or longer; – The time required depends on both frequency and intensity.

●T – Type: Activities that involve major muscle groups. Walking 7,000 to 10,000 steps a day is a good start.

Strength training exercise  — As we grow older, there is a natural tendency for our muscle mass and bone density to decline. Resistance training program can help slow down this process  and improve strength, function, and quality-of-life.

A resistance training program is usually done at least two days per week and should include exercises that work all the major muscle groups.

What if I don’t have time:

1. Park the car far from the work place and walk, walk before and after lunch, use the stairs instead of elevator, cycling to work

2. Exercise on weekends

3. Find a partner for walking, jogging or cycling

4. Exercise at home: bicycle or treadmill

5. Fitness program available in many applications for smartphones; You can also download an application that counts how many steps you walked during the day (in Wechat there is Werun for example where you can even compare  with your friends for encouragement)

Bibliography From Uptodate

1.The benefits and risks of exercise, Douglas M Peterson, MD, MBA, FACP, FACSM

This topic last updated: Oct 12, 2018.

2.Prescribing exercise for adults, Barry A Franklin, PhD, Robert E Sallis, MD, FAAFP, FACSM, Francis G O’Connor, MD, MPH, FACSM. This topic last updated: Aug 22, 2018.

3. Physical activity and exercise in older adults, Miriam C Morey, PhD. This topic last updated: Jun 18, 2018.

4. The Physical Activity Guidelines for Americans, Katrina L. Piercy, PhD, RD1; Richard P. Troiano, PhD2; Rachel M. Ballard, MD, MPH3; et alSusan A. Carlson, PhD, MPH4; Janet E. Fulton, PhD4; Deborah A. Galuska, PhD, MPH4; Stephanie M. George, PhD, MPH3; Richard D. Olson, MD, MPH1. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854

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