by Dr. John Neustadt

We’re human, and humans were built to move. However, if you’re like most Americans, you spend way too much time on screens and sitting around. The average adult spends more than half of their waking hours being sedentary—sitting at work, watching television at home, playing video games, riding in a car. If tapping the keyboard at a deskjob or scrolling through funny videos and pictures of cute animals on Facebook were considered exercise, we’d all be in phenomenal shape.

Even children are sitting around a lot more these days, which doesn’t bode well for their health as they get older, and for the financial costs to our healthcare system. An estimated 27% of all Americans over the age of 6 years old are inactive—meaning they don’t engage in any regular physical activity.

A hundred years ago, sitting jobs were almost unheard of. People worked more in factories or jobs that required them to stand and move all day. And there screens seemingly everywhere to occupy peoples’ time. Sitting around may sure seem like a normal way of life these days, but just because everyone else seems to be doing it doesn’t make it good for you—or them.

Studies consistently show that more sedentary you are, the greater your risk for getting many chronic diseases, including diabetes, breast cancer and osteoporosis. Being sedentary is also bad for your mood: the risk of depression is 25% higher in people who are the most sedentary when compared with those who are the least sedentary.

Not regularly moving your body does more than make you sick, it makes what you’ve already got worse. If you want healthy joints, sitting around is one of the worst things you can do. People with arthritis pain who aren’t participating in regular exercise have more severe pain and decreased physical function. If your concerned about brain health and want to support healthy memory, learn and focus as you age, being sedentary worsens cognitive function in older adults.

And if all that weren’t enough to get your attention, being sedentary doesn’t only increase your risk of diseases, and can make those you have worse, it can kill you too. A 2014 review of studies reported that being sedentary for more than 8 hours a day increases the risk of death from any cause. Not only that, your risk increases the longer you aren’t moving. One study found that women who sat for 11 or more hours a day had a 52% higher risk of death than women who sat for less than 8 hours per day. A 2015 meta-analysis found that not exercising increases your risk of dying from heart disease and cancer by nearly 20%.

Physical benefits

Exercise is one of the Four Pillars of Health, and its health benefits have been recognized since ancient times. Physicians in ancient India, Greece and Rome prescribed  exercise to their patients more than 2,500 years ago. The first modern studies to show a link between exercise and health were conducted in London in the 1950’s. The researchers found that bus conductors were 27% less likely to have heart disease than less active bus drivers and that postal delivery workers were less likely to have heart disease than less active postal clerks. Since those early studies, countless research studies have confirmed—without a doubt—that exercise prevents and treats disease.

Research shows that being inactive for too many hours each day is a serious health risk and that even small amounts of exercise can have a positive influence on your health. Exercise can give you more energy, boost your mood, improve your sleep and decreases your risk for chronic disease. The benefits of exercise are so impressive that some researchers have gone so far as to say that “exercise acts as a drug.” In fact, the benefits of exercise on some conditions improves them even better than available medications. And as an added bonus, boosting your health with exercise doesn’t come with any of the dangerous drug side effects.

There’s no question that exercise benefits heart health. JAMA Internal Medicine reported in 2016 that young adults who were physically fit (based on their endurance on a treadmill) had a lower risk of developing heart disease over the next 3 decades. The study followed nearly 5,000 US adults for approximately 27 years and found that for each additional minute a person was able to stay on the treadmill at the beginning of the study, there was a 12% reduction in the risk of heart disease and 15% reduction in the risk of death over the duration of the study. Countless studies show that exercise benefits the heart by lowering total cholesterol levels, boosting beneficial HDL cholesterol, promoting blood vessel health, arterial elasticity  and healthy blood pressure.

Exercise is also important for preventing, managing and reversing type 2 diabetes. Exercise improves insulin sensitivity, improves transport of glucose into cells, helps stabilize blood sugar levels and promotes weight loss. One of the reasons exercise is such an effective way to balance blood sugar and lose weight is because it increases the demands for energy and mobilizes fat stores as a source of energy.

Lifestyle programs that include 150 minutes of exercise per week (just 30 minutes, 5 days a week, or about 20 minutes 7 days a week) reduce the risk of developing new onset of diabetes by 58%. A study published in the Journal of the American Medical Association (JAMA) in 2012 showed that diet plus 175 minutes per week of exercise reversed type 2 diabetes in 11.5% of patients within just one year. While medications for diabetes can manage the symptoms, exercise has been shown to actually reverse the condition all together.

Exercise has a profound effect on the immune system, influencing the activity of white blood cells that battle infections and ward off cancer. A Cochrane review of 11 clinical trials found evidence that people who exercise on a regular basis experience a shorter duration of symptoms when they get an upper respiratory tract infection, like the common cold. There is also solid evidence that physical exercise reduces the risk of cancer, particularly breast cancer and colon cancer.

People who have conditions that limit their mobility or range of motion can experience improvements from exercise. In patients with osteoarthritis or rheumatoid arthritis, exercise promotes better physical function, reduces pain and boosts energy. In people with osteoporosis, exercise plays an important role in helping people maintain strong bones. By improving strength and balance, it can also reduce the risk for falls and fractures.

The net result of improved health from exercise is a longer and healthier life. Even modest increases in energy expenditure, adding up to about 1000 calories per week, can lower your risk of dying by about 20%.

Mental health benefits

In addition to improving the physical health of the body, exercise also improves cognitive function and emotional health. Exercise has a direct effect on the brain because it promotes the release of a chemical called brain-derived neurotrophic factor (BDNF). BDNF helps new connections form between brain cells throughout life, a process called neuroplasticity. Increased levels of BDNF may partly explain why exercise improves mental performance and reduces the decline in mental function associated with age. The benefits of exercise on the brain extend to children and adolescents as well, with 5-minutes of relay exercise improving focus and attention by 30% in kids with attention-deficit/hyperactivity disorder (ADHD).

Exercise is a natural mood enhancer. Researchers have known since the 1980s that exercise triggers the release of endorphins, which activate opioid-like receptors in the body and brain. The release of endorphins can decrease pain and create a temporary sense of euphoria. This explains what many refer to as the “runner’s high,” which some people experience with endurance training. A 2014 systematic review of 5 clinical trials concluded that moderate aerobic exercise, performed 3 times a week for at least 9 weeks, is helpful in reducing the symptoms of depression. Simply put, exercise makes you feel good.

Your biochemistry needs exercise

The reason exercise has such a profound effect on so many different body systems is very similar to the reason diet and nutrition do. In a separate article about healthy eating, I described how food influences health. Our bodies are biochemical in nature, and biochemistry very simply refers to all of the metabolic pathways in the body that use vitamins, minerals, fats and protein to do their jobs. The body uses nutrients to create hormones, produce brain chemicals, regulate cellular communication, maintain a strong immune system, grow stronger bones and ultimately to influence all body functions. While food provides the raw materials for our biochemsitry, exercise has a direct and measurable effect on how the body uses those nutrients. Exercise changes the body’s metabolism and biochemistry at a cellular level.

Some ways in which exercise improves the biochemistry of the body include improving mitochondrial health, protecting against free radicals, balancing inflammation and promoting healthy gene expression.

During exercise, skeletal muscles require a steady supply of energy and therefore place a high demand on mitochondria—the energy-producing parts within our cells. Cells respond to exercise by creating more mitochondria and improving the efficiency of existing mitochondria. This results in more cellular energy, feeling more energetic and alert and burning more calories. Improving mitochondrial function may reduce the risk of many debilitating conditions, including Alzheimer’s disease, migraine headaches, chronic fatigue syndrome, fibromyalgia, heart disease and diabetes.

Exercise also has the effect of protecting against oxidative damage (free radicals). Studies show that the low concentration of free radicals generated during exercise stimulate activity of antioxidant enzymes and antioxidant defense systems in the body to more efficiently neutralize free radicals. Moderate, regular exercise acts as an antioxidant.

Exercise reduces chronic inflammation, partly by making fat cells healthier. Fat is not just a nuisance for many people, it’s an active tissue that produces chemical signals. One category of molecules that fat produces are inflammatory chemicals. Inflammation is a cause of many chronic diseases, and since having excess fat increases inflammation,  fat can contribute to the onset of pre-diabetes, high blood pressure and atherosclerosis (hardening of the arteries). Studies show that exercise reduces the inflammation that is created by fat cells, leading researchers to say that “exercise makes fat cells ‘fit.’”

The benefits of exercise that people end up feeling may ultimately be the end results of how exercise improves genetic expression. A 6-month clinical trial showed that aerobic exercise increased the activity of anti-inflammatory genes and decreased activity of pro-inflammatory genes. Researchers have proposed that many benefits of exercise result because of changes in genetic expression, including improved cellular glucose uptake, which reduces diabetes risk and benefits people with pre-diabetes or diabetes; improved fat metabolism, which means we burn fat for efficiently that can then result in reducing inflammation. And of course, can get you fitting into smaller clothes sizes. And improved heart health.

How much is enough?

There is a common misconception that a person needs to pump iron at the gym or run for miles at a time to achieve the full benefits of exercise. This simply isn’t true.

A 2015 article published in the Journal of the American Medical Association (JAMA), concluded that it only takes 15 minutes per day of moderate exercise for people to start experiencing health benefits. People who did this lost weight, saw improvements in their blood pressure  and blood sugar control and reduced their risk of getting cancer and their risk of death.  Similar results can be achieved with just 5-10 minutes per day of vigorous exercise (such as jogging).

This is great news for most people, since it destroys the idea that you have to workout as if you were training for a triathlon or bulk up with high-intensity weight training. And there’s a very simple test to guide you in understanding whether or not  your exercise is “moderate”. It’s called the talk test. The Centers for Disease Control and Prevention (CDC) defines modersate exercise as being able to talk but not sing. So if you’re able to belt-out the latest Top 20 hit while on a walk, you aren’t exercising at a moderate intensity. You’ll want to kick it up a notch and get that increae your heart rate. If you can hold a conversation, but get too winded if you were to sing, then you’re exercising at moderate intensity. Can’t even talk while exercising? Then you’ll be doing vigorous exercise.

Examples of moderate exercise include brisk walking, bicycling (at a pace slower than 10 miles per hour), water aerobics, ballroom dancing, general gardening or housework. Examples of vigorous exercise include jogging, running, swimming laps, aerobic dancing, jumping rope or hiking up a mountain with a heavy backpack.   

While 15 minutes a day of moderate exercise can provide excellent health benefits, if you want to exercise longer you can get even greater health advantages. Health benefits of exercise increase with longer duration or intensity of exercise until about 90 minutes per day but then plateaued beyond that.

Moderate exercise can include things you enjoy doing, such as going for a brisk walk, dancing, gardening or housework. OK, so maybe you don’t enjoy housework, but if you perceive of housework as beneficial and as exercise, it can produce some great results. A 2007 study evaluated the effect of mindset on health in hotel maids. Some in the group of 84 women were told how their work was good exercise and informed about the health benefits.

After just one month after being informed, and being reminded of the health benefits during the four week study, those who had been told that their work was exercise, perceived themselves to be getting significantly more exercise than before. But the effects weren’t all in their heads. The informed group showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio and body mass index. So if you have to do housework, remind yourself of how healthy it is and how much wonderful exercise you’re getting.

And if you prefer walking, that’s great exercise too. Recent research shows you don’t even need as much of that as people used to think. Simply walking an average of 7,000 steps a day decreases the risk for dying from any cause by up to 70%.

Simple Exercise Ideas

There’s a lot you can do to improve your health with exercise. One trick to keeping exercise fresh and interesting is to do different things during the week. Switch it up a little and have fun. Go for a walk. One study that reviewed data from nearly half a million healthy people, looked at the effect regular walking has on the risk of developing cardiovascular disease. The study found that the people who walked the most experienced a 31% lower risk of developing cardiovascular disease and a 32% lower risk of dying than people who walked the least. And the more the person walked, the greater the benefit.

If strength training, or working your flexibility or balance is more your thing, then pursue activities that help you work on improving those areas of your health. A study comparing the effects of aerobic exercise with yoga and tai chi found that all 3 of the exercises provided equal physical benefits but only the yoga and tai chi also improved mood and sleep. A published case study showed that salsa dancing can benefit patients with Alzheimer’s disease.

There are so many other activities you could do too: swim, ride a bike, golf, gardening. go paddle boarding, practice Qi gong. The opportunities to move your body and improve your health are endless. There are also simple exercises you can work into your daily life that you can even do while brushing your teeth and working around the house. Get creative. Have fun. You can even organize it with a friend or group of friends to help you all keep each other motivated. The point is that participating in any physical activity on a regular basis will get you on the path to feeling and looking better, and who doesn’t want that?

And while exercise is a crucial component of overall health, not all exercises are appropriate for everyone. If you have a medical condition, check with your healthcare provider before starting a new exercise routine to make sure it is safe and appropriate.

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