Ways Exercising Benefits Your Health – Nick Miller, PharmD

The month of May is National Physical Fitness and Sports Month. In this month’s two-part blog series, we will be discussing some basic tenets of physical fitness, and ways you can incorporate fitness and sports into your busy adult life. According to the National Health and Nutrition Examination Survey (NHANES) of 2006, the authors report that 58% of waking hours were spent in sedentary behaviors. If you are not engaging in AT LEAST three 30-minute sessions of moderate-intensity physical activity every week, you are, by definition, living a sedentary lifestyle. You are at a higher risk of obesity, heart disease, and death than those who exercise.

Working out can seem like a chore sometimes. I can personally vouch for the existence of “workout burnout”—or loss of the desire to exercise. There are days that I get home from work at the pharmacy where all I want to do is kick off my shoes, order a pizza, and watch Netflix until my eyes bleed. This is obviously not a healthy thing to do—and leads me a rule that I want you to implement in your daily life. That rule is to do SOMETHING active, every day. In one large study, individuals who engaged in brief physical activity (15 minutes daily or 90 minutes weekly) had a 14% reduction in all-cause mortality and a three-year longer life expectancy compared with those who were inactive.^[1]

I once attended a seminar where the speaker was talking about the formation of habitual behaviors in day-to-day life. What he said that day has always stuck with me: “If you can set a goal to perform a behavior for 30 days, it will become a habit—it will become second nature to you.” My challenge to you is to set a goal to “keep your shoes on” after you get home from work and do something active for 30 minutes every day for 30 days straight. I guarantee you that you will notice physical improvements during this timeframe. Now, you don’t need to run wind sprints or bench press 225lb every single day, but you need to incorporate some higher intensity exercise into your routine every few days. But 30 minutes of activity could be something as simple as walking on a treadmill (on an incline!) while you watch Netflix on your smartphone. It could be taking a walk around your neighborhood with your spouse and kids and trying to catch fireflies after your home-cooked dinner. Did you play sports in high school? Volleyball? Soccer? Baseball? There are a ton of adult leagues around the metroplex where you can play in both recreational and competitive leagues to try and recapture some of that glory of your younger years.

Regular exercise will decrease stress, anxiety, and depression and improve your body’s hormonal regulation. Lifting weights will increase muscle mass and increase your metabolic rate (or the rate at which your body uses calories from foods). So ladies, lifting weights will not make you look like a bodybuilder. Rather, it will help you lose fat and increase your muscle tone. We should all strive for a mix of planned exercises: both aerobic exercise (cardio) & strength training (weight lifting). If we couple planned exercises with lifestyle changes (drinking water instead of soda/sweet tea, taking the stairs, portion control at dinner, cooking and eating non-processed foods at home, etc.) the results can be dramatic.

Here is some science for you:

• Aerobic exercise lowers bad cholesterol (VLDL), and increases good cholesterol (HDL).^[2,3]
• Regular physical activity is associated with decreased levels of inflammation.^[4]
• Long-term aerobic exercise and resistance training reduces systemic blood pressure.^[5]
• Exercise may reduce the risk of stroke.^[6,7,8]
• Aerobic exercise may improve blood sugar control may prevent the development of type 2 diabetes.^[9,10,11]
• Exercise may provide decreased risk of breast, intestinal, prostate, endometrial, and pancreatic cancer.^{[12,13,14,15]}
• Preventing obesity (through exercise) may lead to significant health benefits over the course of a lifetime. Compared to weight-loss diet alone, diet coupled with either exercise or exercise and resistance training is associated with a greater reduction in body fat and enhanced preservation of body lean mass, compared with weight-loss diet alone. Aerobic exercise and resistance training, even in the absence of low calorie diet, may result in weight loss and a reduction in body fat.^{[16,17,18,19]}
• Weight-bearing exercise is associated with an increase in bone density in men and women.^[20,21] In addition, among patients diagnosed with osteoporosis, exercise is associated with a decreased risk of hip fractures.^[22,23]
• Regular physical activity may reduce the risk of dementia in older patients. Exercise has also been associated with improved cognitive function in young adults.^[24]

Sources:

1. Wen CP, Wai JP, Tsai MK, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 2011; 378:1244.
2. Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116:682.
3. Hambrecht R, Niebauer J, Marburger C, et al. Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol 1993; 22:468.
4. Hamer M, Sabia S, Batty GD, et al. Physical activity and inflammatory markers over 10 years: follow-up in men and women from the Whitehall II cohort study. Circulation 2012; 126:928.
5. Strasser B, Siebert U, Schobersberger W. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports Med 2010; 40:397.
6. Wendel-Vos GC, Schuit AJ, Feskens EJ, et al. Physical activity and stroke. A meta-analysis of observational data. Int J Epidemiol 2004; 33:787.
7. Armstrong ME, Green J, Reeves GK, et al. Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United Kingdom. Circulation 2015; 131:721.
8. Howard VJ, McDonnell MN. Physical activity in primary stroke prevention: just do it! Stroke 2015; 46:1735.
9. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991; 325:147.
10. Lynch J, Helmrich SP, Lakka TA, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 1996; 156:1307.
11. Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999; 282:1433.
12. Michaud DS, Giovannucci E, Willett WC, et al. Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 2001; 286:921.
13. Kushi LH, Doyle C, McCullough M, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 2012; 62:30.
14. Wolin KY, Yan Y, Colditz GA, Lee IM. Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer 2009; 100:611.
15. Boyle T, Keegel T, Bull F, et al. Physical activity and risks of proximal and distal colon cancers: a systematic review and meta-analysis. J Natl Cancer Inst 2012; 104:1548.
16. Irwin ML, Yasui Y, Ulrich CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003; 289:323.
17. Slentz CA, Duscha BD, Johnson JL, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE–a randomized controlled study. Arch Intern Med 2004; 164:31.
18. Hankinson AL, Daviglus ML, Bouchard C, et al. Maintaining a high physical activity level over 20 years and weight gain. JAMA 2010; 304:2603.
19. Lee IM, Djoussé L, Sesso HD, et al. Physical activity and weight gain prevention. JAMA 2010; 303:1173.
20. Wolff I, van Croonenborg JJ, Kemper HC, et al. The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and postmenopausal women. Osteoporos Int 1999; 9:1.
21. Kelley GA, Kelley KS, Tran ZV. Exercise and bone mineral density in men: a meta-analysis. J Appl Physiol (1985) 2000; 88:1730.
22. Gregg EW, Cauley JA, Seeley DG, et al. Physical activity and osteoporotic fracture risk in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med 1998; 129:81.
23. Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 2002; 288:2300.
24. Loprinzi PD, Kane CJ. Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects. Mayo Clin Proc 2015; 90:450.