Benefits of Exercise for Disease Prevention

Disease Preventive Benefits of Exercise
We all know how important exercise is to health but do we understand it is fundamental to physiological homeostasis? Only recently has research shown that exercise reduces the risk of many diseases including coronary heart disease, high blood pressure, diabetes, obesity, bone disease and mental health and well- being (Nix, 2015). The World Health Organization estimates global physical inactivity contributes to 3.2 million deaths each year (Higginbotham, 2015). We will discuss the health protective attributes of physical activity and provide recent clinical research on the disease preventive benefits of physical activity.

Cardiovascular Health
Physical activity reduces the risk of heart disease by improving heart and circulatory system function, controlling cholesterol and lowering blood pressure. (Nix, 2015). Exercise strengthens the heart stroke volume (ability to pump more blood per beat) and improves the efficiency of the circulatory system increasing tissue oxygen and VO2 max (Nix, 2015). Aerobic (with oxygen) exercise, including walking, jogging, swimming has been shown to improve cholesterol by reducing LDL and triglycerides (Nix, 2015). Both aerobic and anaerobic (lifting objects, weights, using muscle tension) improve blood pressure. Otsuki, Kotato & Zempo-Miyaki (2016) found habitual exercise decreased systolic blood pressure in woman during low intensity resistance training.

Obesity and Weight Management
Obesity is an endocrine disease that results from an imbalance in energy intake and expenditure (Higginbotham, 2015). It has reached epidemic proportions escalating to 35.7% of adults in 2010 (Higginbotham, 2015) with annual expenditures of $147 billion (Higginbotham, 2015). Because obesity is a primary risk factor to the development of many chronic diseases including diabetes mellitus, coronary heart disease, hypertension, gallbladder disease and cancer, it is a national and WHO priority to develop educational programs to prevent obesity. A six month community based exercise program in Taiwan of 136 obese residents found significant improvements in HDL cholesterol, reduced body weight, reduced waist circumference, reduced systolic and diastolic blood pressure improved fasting glucose levels and lower body mass index ( Chang, Chen, Chien, Lin 2016).

Diabetes
Both aerobic and anaerobic resistance exercise programs are beneficial for individuals with type 2 diabetes and those with glucose intolerance (Nix, 2015). Exercise increases insulin sensitivity at the cell receptor sites (Nix, 215). During a 12 week aerobic and anaerobic exercise trial of patients with type 2 diabetes mellitus Kang, Ko & Baeh (2016) found significant decrease of weight, body fat percentage, waist circumference, blood glucose, insulin resistance, glycated hemoglobin level, and systolic and diastolic blood pressure with a significant increase in cardiorespiratory fitness and muscular strength.

Osteoporosis and Bone Disease
Exercises with bone muscle impact like weight and resistance training has been clinically shown to improve bone mineralization (Nix, 2015). Maintaining muscle mass also protects joints and prevents sarcopenia, the degenerative loss of muscle size and function. Goh and Hart (2016) found strategies to reduce fat mass and increasing lean body mass is important to prevent osteoporosis. BMI is less essential as a biomarker for osteoporosis because muscle weighs more than fat and building muscle has been shown to increase bone mass protecting and improving bone density. In contrast, low impact sports like swimming and cycling are exceptional cardiovascular aerobic exercise and beneficial but they do not have a positive effect on bone mineral density (Abrahin, Rodrigues & Marcal et al. 2016).

Mental Health and Well-Being
Exercise helps you feel well because it increases metabolic rate detoxifying our cells reducing stress and improving state of mind, body and soul. During aerobic exercise, the stress hormone epinephrine, which is associated with fear, is released three times faster than norepinephrine (Seaward, 2015). Exercise also stimulates endorphins, the feel good hormones (Nix, 2015). A large cross sectional study of 824 obese men found that higher cardio and muscular fitness were associated with lower stress and higher mental resources in normal-weight men but not in overweight men (Kettunen, Kyrolainen & Santtila et al 2016). Exercise induces beneficial brain response and increases brain derived neurotropic factor (BDNF) which is associated with improved cognition and alleviation of both anxiety and depression ( Sleiman, Henry,& Al-Haddad et al. 2016). In a 12 week senior brain health exercise program, positive effects were shown in physical fitness, cognitive function and BDNF (Brun & Kang, 2016).

References
Abrahin, O., Rodrigues, RP., Marcal, AC., Alves, EA., Figueiredo, RC., de Sousa, EC.  (2016).  Swimming and cycling do not cause positive effects on bone mineral density:  a systematic review.  Revista Brasileira de Reumatologia.  345-51.  doi: 10.1016/j.rbre.2016.02.013

Byun, JE., Kang, EB.,  (2016).  The effects of senior brain health exercise program on basic physical fitness, cognitive function and BDNF of elderly women – a feasibility study.  Journal of Exercise, Nutrition and Biochemistry.  8-18.  Doi:  10.20463/jenb.2016.06.20.2.2

Chang, SH., Chen, MC., Chien, NH., Lin, HF.  (2016).  Effectiveness of community-based exercise intervention programme in obese adults with metabolic syndrome.  Journal of Clinical Nursing. doi: 10.1111/jocn.13301

Goh, VH., Hart, WG., (2016).  Aging and bone health in Singaporean Chinese pre-menopausal and postmenopausal women.  Maturitas.16-21. doi: 10.1016/j.maturitas.2016.04.004 

Higginbotham, A., (2015).  The complexity of obesity:  beyond energy balance.  Williams’ Essentials of Nutrition and Diet Therapy.  11th edition.  344-57.  Elsevier Mosby.  St. Louis, Missouri

Kang, SJ., Ko, KJ., Baek, UH.  (2016).  Effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in type 2 diabetes mellitus patients.  2088-93. doi: 10.1589/jpts.28.2088.

Kettunen, O., Kyrolainen, H., Santtila, M., Vuorimaa, T., Vasankari, TJ.  (2016).  Greater levels of cardiorespiratory and muscular fitness are associated with low stress and high mental resources in normal but not overweight men.  BMC Public Health.   doi: 10.1186/s12889-016-3470-6.

Klugar, M., Cap, J., Klugarova, J., Mareckova, J., Roberson, DN., Kelnarova, Z.  (2016).  The personal active aging strategies of older adults in Europe:  a systematic review of qualitative evidence.  JBI Database System Review and Implementation Reports.  193-257.  Doi:  10: 11124/JBISRIR-2016-002393.

Nix, S., (2015).  Nutrition and physical fitness.  Williams’ Essentials of Nutrition and Diet Therapy.  11th edition.  325-43.  Elsevier Mosby.  St. Louis, Missouri. 

Otsuki, T., Kotato, T., Zempo-Miyaki, A. (2016).  Habitual exercise decreases systolic blood pressure during low-intensity resistance exercise in healthy middle-aged and older individuals. American of Physiology.  Heart and Circulatory Physiology.  doi: 10.1152/ajpheart.00379.2016 

Seaward, B. (2015). Physical exercise, nutrition and stress.  Managing Stress – Principles and Strategies for Health and Well-Being.  Jones and Bartlett.  Burlington MA.

Sleiman, A. Henry, J., Al-Haddad, R., El Hayek, L., Haidar, EA., Stringer, T, Ulja, D., Chao, M.  (2016).  Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body B-hydroxybutyrate.   Retrieved from:   https://elifesciences.org/content/5/e15092.