Physical exercise is any bodily activity that enhances or maintains "physical fitness and overall "health and wellness. It is performed for various reasons, including increasing growth and development, preventing "aging, strengthening "muscles and the "cardiovascular system, honing "athletic skills, "weight loss or maintenance, and also enjoyment. Frequent and regular physical exercise boosts the "immune system["citation needed] and helps prevent certain ""diseases of affluence" such as "coronary heart disease, "type 2 diabetes, and "obesity["citation needed]. It may also help prevent "stress["citation needed] and "depression, increase quality of sleep and act as a non-pharmaceutical sleep aid to treat diseases such as "insomnia, help promote or maintain positive "self-esteem, improve "mental health, maintain steady "digestion and treat "constipation and gas, regulate "fertility health, and augment an individual's "sex appeal or body image. "Childhood obesity is a growing global concern, and physical exercise may help decrease some of the effects of childhood and adult obesity.["citation needed] Some care-providers["which?] call exercise the "miracle" or "wonder" drug—alluding to the wide variety of benefits that it can provide for many individuals. Aside from the health advantages, these benefits may include different social rewards for staying active while enjoying the environment of one's "culture. Many["quantify] individuals choose to exercise publicly outdoors where they can congregate in groups, socialize, and appreciate "life.
In the United Kingdom two to four hours of light activity are recommended["by whom?] during working hours. This includes walking and standing. In the United States, a 1995 "CDC/"ACSM consensus statement and a Surgeon General's 1996 report state that every adult should participate in moderate exercise, such as walking, swimming, and household tasks, for a minimum of 30 minutes daily.
Physical exercises are generally grouped into three types, depending on the overall effect they have on the human body:
Sometimes the terms 'dynamic' and 'static' are used.["citation needed] 'Dynamic' exercises such as steady running, tend to produce a lowering of the "diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the "systolic pressure to rise significantly (during the exercise).
|Type of adaptation||Endurance
|"Muscle hypertrophy||↔||↑ ↑ ↑|||
|"Muscle strength and power||↔ ↓||↑ ↑ ↑|||
|"Muscle fiber size||↔ ↑||↑ ↑ ↑|||
|"Myofibrillar "protein synthesis||↔ ↑||↑ ↑ ↑|||
|"Neuromuscular adaptations||↔ ↑||↑ ↑ ↑|||
|"Anaerobic capacity||↑||↑ ↑|||
|"Lactate tolerance||↑ ↑||↔ ↑|||
|"Endurance capacity||↑ ↑ ↑||↔ ↑|||
|Capillary growth ("angiogenesis)||↑ ↑||↔|||
|"Mitochondrial biogenesis||↑ ↑||↔ ↑|||
|Mitochondrial density and oxidative function||↑ ↑ ↑||↔ ↑|||
|"Bone mineral density||↑ ↑||↑ ↑|||
|"Inflammatory markers||↓ ↓||↓|||
|Ability in "activities of daily living||↔ ↑||↑ ↑|||
|"Basal metabolic rate||↑||↑ ↑|||
|Percent "body fat||↓ ↓||↓|||
|"Lean body mass||↔||↑ ↑|||
|Resting "insulin levels||↓||↓|||
|"Insulin sensitivity||↑ ↑||↑ ↑|||
|Insulin response to glucose challenge||↓ ↓||↓ ↓|||
|"Resting heart rate||↓ ↓||↔|||
|"Stroke volume (resting and maximal)||↑ ↑||↔|||
|"Systolic blood pressure (resting)||↔ ↓||↔|||
|"Diastolic blood pressure (resting)||↔ ↓||↔ ↓|||
|Cardiovascular risk profile||↓ ↓ ↓||↓|||
Physical exercise is important for maintaining "physical fitness and can contribute to maintaining a healthy weight, regulating digestive health, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system. Some studies indicate that exercise may increase life expectancy and the overall quality of life. People who participate in moderate to high levels of physical exercise have a lower mortality rate compared to individuals who by comparison are not physically active. Moderate levels of exercise have been correlated with preventing aging by reducing inflammatory potential. The majority of the benefits from exercise are achieved with around 3500 "metabolic equivalent (MET) minutes per week. For example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or bicycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week. A lack of physical activity causes approximately 6% of the burden of disease from coronary heart disease, 7% of type 2 diabetes, 10% of breast cancer and 10% of colon cancer worldwide. Overall, physical inactivity causes 9% of premature mortality worldwide.
Individuals can increase fitness following increases in physical activity levels. Increases in muscle size from resistance training is primarily determined by diet and testosterone. This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population. Studies have shown that exercising in "middle age leads to better physical ability later in life.
The beneficial effect of exercise on the cardiovascular system is well documented. There is a direct correlation between physical inactivity and cardiovascular mortality, and physical inactivity is an independent risk factor for the development of coronary artery disease. Low levels of physical exercise increase the risk of cardiovascular diseases mortality.
Children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness. Studies have shown that academic stress in youth increases the risk of cardiovascular disease in later years; however, these risks can be greatly decreased with regular physical exercise. There is a dose-response relation between the amount of exercise performed from approximately 700–2000 "kcal of energy expenditure per week and all-cause mortality and cardiovascular disease mortality in middle-aged and elderly populations. The greatest potential for reduced mortality is in the sedentary who become moderately active. Studies have shown that since heart disease is the leading cause of death in women, regular exercise in aging women leads to healthier cardiovascular profiles. Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate-intensity activity (40–60% of maximal oxygen uptake, depending on age). Persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival. Persons who remain sedentary have the highest risk for all-cause and cardiovascular disease mortality. According to the American Heart Association, exercise reduces blood pressure, LDL and total cholesterol, and body weight. It increases HDL cholesterol, insulin sensitivity, and exercise tolerance.
Although there have been hundreds of studies on exercise and the "immune system, there is little direct evidence on its connection to illness. "Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human "immune system; an effect which is modeled in a "J curve. Moderate exercise has been associated with a 29% decreased incidence of "upper respiratory tract infections (URTI), but studies of marathon runners found that their prolonged high-intensity exercise was associated with an increased risk of infection occurrence. However, another study did not find the effect. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections. Studies have shown that strenuous stress for long durations, such as training for a marathon, can suppress the immune system by decreasing the concentration of lymphocytes. The immune systems of athletes and nonathletes are generally similar. Athletes may have slightly elevated "natural killer cell count and cytolytic action, but these are unlikely to be clinically significant.
Vitamin C supplementation has been associated with lower incidence of URTIs in marathon runners.
"Biomarkers of "inflammation such as "C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects. In individuals with heart disease, exercise interventions lower blood levels of fibrinogen and C-reactive protein, an important cardiovascular risk marker. The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti-inflammatory effect.
A systematic review evaluated 45 studies that examined the relationship between physical activity and cancer survivorship. According to the study results "There was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality".
Physical exercise was correlated with a lower methylation frequency of two tumor suppressor genes, "CACNA2D3 and "L3MBTL. Hypermethylation of "CACNA2D3 is associated with "gastric cancer, while hypermethylation of "L3MBTL is associated with "breast cancer, "brain tumors and "hematological malignancies. A recent study indicates that exercise results in reduced "DNA methylation at "CpG sites on genes associated with breast cancer.
Physical exercise is becoming a widely accepted non-pharmacological intervention for the prevention and attenuation of "cancer cachexia. ""Cachexia is a multiorganic syndrome associated with cancer, characterized by inflammation, body weight loss (at least 5%) and muscle and adipose tissue wasting". Exercise triggers the activation of the "transcriptional coactivator "peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), which suppresses "FoxO- and "NF-κB-dependent "gene transcription during muscle atrophy that is induced by fasting or denervation; thus, PGC-1α may be a key intermediate responsible for the beneficial antiatrophic effects of physical exercise on "cancer cachexia. The exercise-induced isoform PGC-1α4, which can repress myostatin and induce IGF1 and hypertrophy, is a potential drug target for treatment of "cancer cachexia. Other factors, such as "JUNB and "SIRT1, that maintain skeletal muscle mass and promote hypertrophy are also induced with regular physical exercise.
The "neurobiological effects of physical exercise are numerous and involve a wide range of interrelated effects on brain structure, brain function, and "cognition. A large body of research in humans has demonstrated that consistent "aerobic exercise (e.g., 30 minutes every day) induces persistent improvements in certain "cognitive functions, healthy alterations in "gene expression in the brain, and beneficial forms of "neuroplasticity and "behavioral plasticity; some of these long-term effects include: increased "neuron growth, increased neurological activity (e.g., "c-Fos and "BDNF signaling), improved stress coping, enhanced "cognitive control of behavior, improved "declarative, "spatial, and "working memory, and structural and functional improvements in brain structures and "pathways associated with cognitive control and memory. The effects of exercise on cognition have important implications for improving "academic performance in children and college students, improving adult productivity, preserving "cognitive function in old age, preventing or treating certain "neurological disorders, and improving overall quality of life.
In healthy adults, aerobic exercise has been shown to induce transient effects on cognition after a single exercise session and persistent effects on cognition following regular exercise over the course of several months. People who regularly perform aerobic exercise (e.g., running, jogging, brisk walking, swimming, and cycling) have greater scores on "neuropsychological function and performance tests that measure certain cognitive functions, such as "attentional control, "inhibitory control, "cognitive flexibility, "working memory updating and capacity, "declarative memory, "spatial memory, and "information processing speed. The transient effects of exercise on cognition include improvements in most executive functions (e.g., attention, working memory, cognitive flexibility, inhibitory control, problem solving, and decision making) and information processing speed for a period of up to 2 hours after exercising.
Aerobic exercise induces short- and long-term effects on mood and emotional states by promoting "positive affect, inhibiting "negative affect, and decreasing the biological response to acute "psychological stress. Over the short-term, aerobic exercise functions as both an "antidepressant and "euphoriant, whereas consistent exercise produces general improvements in "mood and "self-esteem.
Regular aerobic exercise improves symptoms associated with a variety of "central nervous system disorders and may be used as an "adjunct therapy for these disorders. There is clear evidence of exercise treatment efficacy for "major depressive disorder and "attention deficit hyperactivity disorder. A large body of "preclinical evidence and emerging clinical evidence supports the use of exercise therapy for treating and preventing the development of "drug addictions. Reviews of clinical evidence also support the use of exercise as an adjunct therapy for certain "neurodegenerative disorders, particularly "Alzheimer’s disease and "Parkinson's disease. Regular exercise is also associated with a lower risk of developing neurodegenerative disorders. Regular exercise has also been proposed as an adjunct therapy for "brain cancers.
Physical exercise has established efficacy as an "antidepressant in individuals with depression and current medical evidence supports the use of exercise as both a "preventive measure against and an adjunct therapy with antidepressant medication for depressive disorders. A July 2016 "meta-analysis concluded that physical exercise improves overall quality of life in individuals with depression relative to controls. One systematic review noted that "yoga may be effective in alleviating symptoms of "prenatal depression. The biomolecular basis for exercise-induced antidepressant effects is believed to be a result of increased "neurotrophic factor signaling, particularly "brain-derived neurotrophic factor.
Continuous aerobic exercise can induce a transient state of "euphoria, colloquially known as a "runner's high" in "distance running or a "rower's high" in "crew, through the increased biosynthesis of at least three "euphoriant neurochemicals: "anandamide (an "endocannabinoid), "β-endorphin (an "endogenous opioid), and "phenethylamine (a "trace amine and "amphetamine analog).
A systematic review noted that, although limited, some evidence suggests that the duration of engagement in a "sedentary lifestyle is positively correlated with a risk of developing an "anxiety disorder or experiencing "anxiety symptoms. It noted that additional research is needed in order to confirm these findings.
A 2010 review of published scientific research suggested that exercise generally improves "sleep for most people, and helps sleep disorders such as insomnia. The optimum time to exercise may be 4 to 8 hours before bedtime, though exercise at any time of day is beneficial, with the possible exception of heavy exercise taken shortly before bedtime, which may disturb sleep. There is, in any case, insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep.
According to a 2005 study, exercise is the most recommended alternative to sleeping pills for resolving insomnia. Sleeping pills are more costly than to make time for a daily routine of staying fit, and may have dangerous side effects in the long run. Exercise can be a healthy, safe and inexpensive way to achieve more and better sleep.
Too much exercise can be harmful. Without proper rest, the chance of "stroke or other "circulation problems increases, and muscle tissue may develop slowly. Extremely intense, long-term cardiovascular exercise, as can be seen in athletes who train for multiple marathons, has been associated with scarring of the heart and heart rhythm abnormalities. Specifically, high cardiac output has been shown to cause enlargement of the left and right ventricle volumes, increased ventricle wall thickness, and greater cardiac mass. These changes further result in myocardial cell damage in the lining of the heart, leading to scar tissue and thickened walls. During these processes, the protein "troponin increases in the bloodstream, indicating cardiac muscle cell death and increased stress on the heart itself.
Inappropriate exercise can do more harm than good, with the definition of “inappropriate” varying according to the individual. For many activities, especially "running and "cycling, there are significant injuries that occur with poorly regimented exercise schedules. Injuries from accidents also remain a major concern, whereas the effects of increased exposure to air pollution seem only a minor concern.
In extreme instances, over-exercising induces serious performance loss. Unaccustomed overexertion of muscles leads to "rhabdomyolysis (damage to muscle) most often seen in new army recruits. Another danger is "overtraining, in which the intensity or volume of training exceeds the body's capacity to recover between bouts. One sign of Overtraining Syndrome (OTS) is suppressed immune function, with an increased incidence of upper respiratory tract infection (URTI). An increased incidence of URTIs is also associated with high volume/intensity training, as well as with excessive exercise (EE), such as in a marathon. Marathon training requires the runner to build their intensity week to week which makes them more susceptible to injury the more they increase their mileage. A study shows that in the last 10–15 years up to 90% of marathon runners have suffered a physical injury from their training.
Stopping excessive exercise suddenly may create a change in mood. Exercise should be controlled by each body's inherent limitations. While one set of joints and muscles may have the tolerance to withstand multiple "marathons, another body may be damaged by 20 minutes of light jogging. This must be determined for each individual.
Too much exercise may cause a woman to miss her periods, a symptom known as "amenorrhea. This is a very serious condition which indicates a woman is pushing her body beyond its natural boundaries.
Not only can excessive exercise cause physical damage, it can also cause psychological damage. Every athlete strives for perfection in their sport. This is what may begin their excessive exercising regime. If an athlete fails in this quest for perfection, this could result in anxiety, depression and low-self esteem. A study of 179 athletes, all of whom were Olympians or potential Olympians, was carried out in 2002 to find a relationship between perfectionism and sport-related competitive anxiety. It was found that athletes with lower self—esteem had higher personal standards and in comparison, those with high self-esteem had little concern in making mistakes or doubting themselves.
Resistance training and subsequent consumption of a protein-rich meal promotes "muscle hypertrophy and gains in "muscle strength by stimulating "myofibrillar muscle protein synthesis (MPS) and inhibiting muscle protein breakdown (MPB). The stimulation of muscle protein synthesis by resistance training occurs via "phosphorylation of the "mechanistic target of rapamycin (mTOR) and subsequent activation of "mTORC1, which leads to "protein biosynthesis in the "ribosome via phosphorylation of mTORC1's immediate targets (the "p70S6 kinase and the "translation repressor protein "4EBP1). The suppression of muscle protein breakdown following food consumption occurs primarily via increases in "plasma "insulin; however, a suppression of MPB of comparable magnitude has also been shown to occur in humans from a sufficient elevation of plasma "β-hydroxy β-methylbutyric acid.
Aerobic exercise induces "mitochondrial biogenesis and an increased capacity for "oxidative phosphorylation in the "mitochondria of skeletal muscle, which is one mechanism by which aerobic exercise enhances submaximal endurance performance. These effects occur via an exercise-induced increase in the intracellular "AMP:"ATP ratio, thereby triggering the activation of "AMP-activated protein kinase (AMPK) which subsequently phosphorylates "peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), the "master regulator of mitochondrial biogenesis.
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as "myokines which promote the growth of new tissue, tissue repair, and multiple anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases. Exercise reduces levels of "cortisol, which causes many health problems, both physical and mental. Endurance exercise before meals lowers blood glucose more than the same exercise after meals. There is evidence that vigorous exercise (90–95% of "VO2 max) induces a greater degree of physiological "cardiac hypertrophy than moderate exercise (40 to 70% of VO2 max), but it is unknown whether this has any effects on overall morbidity and/or mortality. Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). "Ventricular hypertrophy, the thickening of the ventricular walls, is generally beneficial and healthy if it occurs in response to exercise.
The persistent long-term neurobiological effects of regular physical exercise[note 1] are believed to be mediated by transient exercise-induced increases in the concentration of "neurotrophic factors (e.g., "BDNF, "IGF-1, "VEGF, and "GDNF) and other "biomolecules in peripheral "blood plasma, which subsequently cross the "blood–brain barrier and "blood–cerebrospinal fluid barrier and bind to their associated "receptors in the brain. Upon binding to their receptors in "cerebral vasculature and "brain cells (i.e., "neurons and "glial cells), these biomolecules trigger intracellular "signaling cascades that lead to "neuroplastic biological responses – such as "neurogenesis, "synaptogenesis, oligodendrogenesis, and "angiogenesis, among others – which ultimately mediate the exercise-induced improvements in cognitive function.
Multiple component community-wide campaigns are frequently used in an attempt to increase a population's level of physical activity. A 2015 Cochrane review, however, did not find evidence supporting a benefit. The quality of the underlying evidence was also poor. However, there is some evidence that school-based interventions can increase activity levels and fitness in children. Another Cochrane review found some evidence that certain types of exercise programmes, such as those involving gait, balance, co-ordination and functional tasks, can improve balance in older adults. Following progressive resistance training, older adults also respond with improved physical function. Survey of brief interventions promoting physical activity found that they are cost-effective, although there are variations between studies.
Environmental approaches appear promising: signs that encourage the use of stairs, as well as community campaigns, may increase exercise levels. The city of "Bogotá, "Colombia, for example, blocks off 113 kilometers (70 mi) of roads on Sundays and holidays to make it easier for its citizens to get exercise. These "pedestrian zones are part of an effort to combat chronic diseases.
To identify which public health strategies are effective, a Cochrane overview of reviews is in preparation.
Physical exercise was said to decrease healthcare costs, increase the rate of job attendance, as well as increase the amount of effort women put into their jobs.
Children will mimic the behavior of their parents in relation to physical exercise. Parents can thus promote physical activity and limit the amount of time children spend in front of screens.
Overweight children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness. According to the Centers for Disease Control and Prevention in the United States, both children and adults should do 60 minutes or more of physical activity each day. Implementing physical exercise in the school system and ensuring an environment in which children can reduce barriers to maintain a healthy lifestyle is essential.
Worldwide there has been a large shift towards less physically demanding work. This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor saving technology in the home, and fewer active "recreational pursuits. "Personal lifestyle changes however can correct the lack of physical exercise.
Research in 2015 indicates integrating "mindfulness to physical exercise interventions increases exercise adherence, self-efficacy and also has positive effects both psychologically and physiologically.
Exercising looks different in every country, as do the motivations behind exercising. In some countries, people exercise primarily indoors, and in others, people exercise primarily outdoors. People may exercise for personal enjoyment, health and well-being, social interactions, competition or training, etc. These differences could potentially be attributed to geographic location, social tendencies, or otherwise.
In Colombia, citizens value and celebrate the outdoor environments of their country. In many instances, they utilize outdoor activities as social gatherings to enjoy nature and their communities. In Bogotá, Colombia, a 70-mile stretch of road known as the Ciclovía is shut down each Sunday for bicyclists, runners, rollerbladers, skateboarders and other exercisers to work out and enjoy their surroundings.
Similarly to Colombia, citizens of Cambodia tend to exercise socially outside. In this country, public gyms have become quite popular. People will congregate at these outdoor gyms not only to utilize the public facilities, but also to organize aerobics and dance sessions, which are open to the public.
Sweden has also begun developing outdoor gyms, called utegym. These gyms are free to the public and are often placed in beautiful, picturesque environments. People will swim in rivers, use boats, and run through forests to stay healthy and enjoy the natural world around them. This is especially possible in Sweden due to its geographical location.
Chinese exercise, particularly in the retired community, seems to be socially grounded. In the mornings, dances are held in public parks; these gatherings may include Latin dancing, ballroom dancing, tango, or even the jitterbug. Dancing in public allows people to interact with those with whom they would not normally interact, allowing for both health benefits and social benefits.
These sociocultural variations in physical exercise show how people in different geographic locations and social climates have varying motivations and methods of exercising. Physical exercise can improve health and well-being, as well as enhance community ties and appreciation of natural beauty.
Proper "nutrition is as important to health as exercise. When exercising, it becomes even more important to have a good diet to ensure that the body has the correct ratio of "macronutrients while providing ample "micronutrients, in order to aid the body with the recovery process following strenuous exercise.
Active recovery is recommended after participating in physical exercise because it removes "lactate from the blood more quickly than inactive recovery. Removing lactate from circulation allows for an easy decline in body temperature, which can also benefit the immune system, as an individual may be vulnerable to minor illnesses if the body temperature drops too abruptly after physical exercise.
The benefits of exercise have been known since antiquity. Dating back to 65 BCE, it was "Marcus Cicero, Roman politician and lawyer, who stated: "It is exercise alone that supports the spirits, and keeps the mind in vigor." Exercise was also seen to be valued later in history during the Dark Ages as a means of survival by the barbaric tribes of Northern Europe.
More recently, exercise was regarded as a beneficial force in the 19th century. After 1860, Archibald MacLaren opened a gymnasium at the University of Oxford and instituted a training regimen for 12 military officials at the university. This regimen was later assimilated into the training of the British Army. Several mass exercise movements were started in the early twentieth century as well. The first and most significant of these in the UK was the Women's League of Health and Beauty, founded in 1930 by "Mary Bagot Stack, that had 166,000 members in 1937.
However, the link between physical health and exercise (or lack of it) was only discovered in 1949 and reported in 1953 by a team led by "Jerry Morris. Dr. Morris noted that men of similar social class and occupation (bus conductors versus bus drivers) had markedly different rates of heart attacks, depending on the level of exercise they got: bus drivers had a sedentary occupation and a higher incidence of heart disease, while bus conductors were forced to move continually and had a lower incidence of heart disease. This link had not previously been noted and was later confirmed by other researchers.
Physical exercise has been shown to benefit a wide range of other mammals, as well as salmon, juvenile crocodiles, and at least one species of bird.
However, several studies have shown that lizards display no benefit from exercise, leading them to be termed "metabolically inflexible". Indeed, damage from overtraining may occur following weeks of forced treadmill exercise in lizards.
Several studies of rodents have demonstrated that maternal or juvenile access to wheels that allow voluntary exercise can increase the propensity to run as adults. These studies further suggest that physical activity may be more "programmable" (for discussion, see "Thrifty phenotype) than food intake.
Conclusions[:] Among women, adherence to lifestyle guidelines involving diet, exercise, and abstinence from smoking is associated with a very low risk of coronary heart disease.
We followed 84,941 female nurses from 1980 to 1996 [...]. During 16 years of follow-up, we documented 3300 new cases of type 2 diabetes. Overweight or obesity was the single most important predictor of diabetes. Lack of exercise, a poor diet, current smoking, and abstinence from alcohol use were all associated with a significantly increased risk of diabetes, even after adjustment for the body-mass index.
The Political Declaration of the High Level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases of September 2011, recognizes the critical importance of reducing unhealthy diet and physical inactivity.
Aerobic physical exercise (PE) activates the release of neurotrophic factors and promotes angiogenesis, thereby facilitating neurogenesis and synaptogenesis, which in turn improve memory and cognitive functions. ... Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission.
The benefits of regular exercise, physical fitness and sports participation on cardiovascular and brain health are undeniable ... Exercise also enhances psychological health, reduces age-related loss of brain volume, improves cognition, reduces the risk of developing dementia, and impedes neurodegeneration.
Aerobic physical exercise produces numerous health benefits in the brain. Regular engagement in physical exercise enhances cognitive functioning, increases brain neurotrophic proteins, such as brain-derived neurotrophic factor (BDNF), and prevents cognitive diseases [76–78]. Recent findings highlight a role for aerobic exercise in modulating chromatin remodelers [21, 79–82]. ... These results were the first to demonstrate that acute and relatively short aerobic exercise modulates epigenetic modifications. The transient epigenetic modifications observed due to chronic running training have also been associated with improved learning and stress-coping strategies, epigenetic changes and increased c-Fos-positive neurons ... Nonetheless, these studies demonstrate the existence of epigenetic changes after acute and chronic exercise and show they are associated with improved cognitive function and elevated markers of neurotrophic factors and neuronal activity (BDNF and c-Fos). ... The aerobic exercise training-induced changes to miRNA profile in the brain seem to be intensity-dependent . These few studies provide a basis for further exploration into potential miRNAs involved in brain and neuronal development and recovery via aerobic exercise.
A range of validated platforms assessed CF across three domains: executive function (12 studies), memory (four studies) and processing speed (seven studies). ... In studies of executive function, five found a significant ES in favour of higher PA, ranging from small to large. Although three of four studies in the memory domain reported a significant benefit of higher PA, there was only one significant ES, which favoured low PA. Only one study examining processing speed had a significant ES, favouring higher PA.
CONCLUSIONS: A limited body of evidence supports a positive effect of PA on CF in young to middle-aged adults. Further research into this relationship at this age stage is warranted. ...
Significant positive effects of PA on cognitive function were found in 12 of the 14 included manuscripts, the relationship being most consistent for executive function, intermediate for memory and weak for processing speed.
Exercise has established efficacy as an antidepressant in people with depression. ... Exercise significantly improved physical and psychological domains and overall QoL. ... The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement. In particular, several cross-sectional and intervention studies have shown a positive association between physical activity and cognition in older persons  and an inverse correlation with cognitive decline and dementia . Older adults enrolled in a 6-month aerobic fitness intervention increased brain volume in both gray matter (anterior cingulate cortex, supplementary motor area, posterior middle frontal gyrus, and left superior temporal lobe) and white matter (anterior third of corpus callosum) . In addition, Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources, including decreased activation of the anterior cingulated cortex. One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity, increases brain volume, stimulates neurogenesis and synaptogenesis, and increases neurotrophic factors in different areas of the brain, possibly providing reserve against later cognitive decline and dementia [89, 90].
A large collection of research in humans has shown that a single bout of exercise alters behavior at the level of affective state and cognitive functioning in several key ways. In terms of affective state, acute exercise decreases negative affect, increases positive affect, and decreases the psychological and physiological response to acute stress . These effects have been reported to persist for up to 24 hours after exercise cessation [28, 29, 53]. In terms of cognitive functioning, acute exercise primarily enhances executive functions dependent on the prefrontal cortex including attention, working memory, problem solving, cognitive flexibility, verbal fluency, decision making, and inhibitory control . These positive changes have been demonstrated to occur with very low to very high exercise intensities , with effects lasting for up to two hours after the end of the exercise bout (Fig. 1A) . Moreover, many of these neuropsychological assessments measure several aspects of behavior including both accuracy of performance and speed of processing. McMorris and Hale performed a meta-analysis examining the effects of acute exercise on both accuracy and speed of processing, revealing that speed significantly improved post-exercise, with minimal or no effect on accuracy . These authors concluded that increasing task difficulty or complexity may help to augment the effect of acute exercise on accuracy. ... However, in a comprehensive meta-analysis, Chang and colleagues found that exercise intensities ranging from very light (<50% MHR) to very hard (>93% MHR) have all been reported to improve cognitive functioning .
Interestingly, some symptoms of OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia, increasing lactate tolerance, and exercise-induced euphoria, are important for training.
The runner's high describes a euphoric state resulting from long-distance running.
This systematic review and meta-analysis found that physical activity reduced depressive symptoms among people with a psychiatric illness. The current meta-analysis differs from previous studies, as it included participants with depressive symptoms with a variety of psychiatric diagnoses (except dysthymia and eating disorders). ... This review provides strong evidence for the antidepressant effect of physical activity; however, the optimal exercise modality, volume, and intensity remain to be determined. ...
Few interventions exist whereby patients can hope to achieve improvements in both psychiatric symptoms and physical health simultaneously without significant risks of adverse effects. Physical activity offers substantial promise for improving outcomes for people living with mental illness, and the inclusion of physical activity and exercise programs within treatment facilities is warranted given the results of this review.
Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). ... Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans.
This omission is relevant, given the evidence that aerobic-based physical activity generates structural changes in the brain, such as neurogenesis, angiogenesis, increased hippocampal volume, and connectivity (12,13). In children, a positive relationship between aerobic fitness, hippocampal volume, and memory has been found (12,13). ... Mental health outcomes included reduced depression and increased self-esteem, although no change was found in anxiety levels (18). ... This systematic review of the literature found that [aerobic physical activity (APA)] is positively associated with cognition, academic achievement, behavior, and psychosocial functioning outcomes. Importantly, Shephard also showed that curriculum time reassigned to APA still results in a measurable, albeit small, improvement in academic performance (24). ... The actual aerobic-based activity does not appear to be a major factor; interventions used many different types of APA and found similar associations. In positive association studies, intensity of the aerobic activity was moderate to vigorous. The amount of time spent in APA varied significantly between studies; however, even as little as 45 minutes per week appeared to have a benefit.
Considered overall, the studies included in the present review showed a strong effectiveness of exercise combined with antidepressants. ...
This is the first review to have focused on exercise as an add-on strategy in the treatment of MDD. Our findings corroborate some previous observations that were based on few studies and which were difficult to generalize.41,51,73,92,93 Given the results of the present article, it seems that exercise might be an effective strategy to enhance the antidepressant effect of medication treatments. Moreover, we hypothesize that the main role of exercise on treatment-resistant depression is in inducing neurogenesis by increasing BDNF expression, as was demonstrated by several recent studies.
Keeping in mind that exercise shows no medication side effects such as withdrawal symptoms (20), weight gain, dry mouth or insomnia (21), but shows potential health benefits such as weight reduction, it is highly recommended to use exercise as an adjunctive treatment for depression (22). New findings confirm that exercise can be recommended as a first-line treatment for mild to moderate depression; as an adjunct to medications (23); as an alternative to cognitive behavioral therapy (11); and in preventing depression in clinical as well as healthy populations (24–26). ... Although recent findings have shown that exercise can decrease depressive symptoms, there are still many questions and limitations to wider application of exercise in depression. For instance, there are deficiencies in methodological planning such as uncontrolled nonrandomized trials, small sample sizes, inadequate allocation concealment, lack of intention-to-treat analyses, non-blinded outcome assessments, and inclusion of subjects without clinical diagnosis that limit the interpretability of research outcomes (53).
The present review summarises the impact of exercise interventions (1–10 weeks in duration with at least two sessions each week) on parameters related to ADHD in 7-to 13-year-old children. We may conclude that all different types of exercise (here yoga, active games with and without the involvement of balls, walking and athletic training) attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration and frequency of exercise is most effective in this respect and future research focusing on this question with randomised and controlled long-term interventions is warranted.
There is accelerating evidence that physical exercise is a useful treatment for preventing and reducing drug addiction ... In some individuals, exercise has its own rewarding effects, and a behavioral economic interaction may occur, such that physical and social rewards of exercise can substitute for the rewarding effects of drug abuse. ... The value of this form of treatment for drug addiction in laboratory animals and humans is that exercise, if it can substitute for the rewarding effects of drugs, could be self-maintained over an extended period of time. Work to date in [laboratory animals and humans] regarding exercise as a treatment for drug addiction supports this hypothesis. ... However, a RTC study was recently reported by Rawson et al. (226), whereby they used 8 weeks of exercise as a post-residential treatment for METH addiction, showed a significant reduction in use (confirmed by urine screens) in participants who had been using meth 18 days or less a month. ... Animal and human research on physical exercise as a treatment for stimulant addiction indicates that this is one of the most promising treatments on the horizon. [emphasis added]
Similar to environmental enrichment, studies have found that exercise reduces self-administration and relapse to drugs of abuse (Cosgrove et al., 2002; Zlebnik et al., 2010). There is also some evidence that these preclinical findings translate to human populations, as exercise reduces withdrawal symptoms and relapse in abstinent smokers (Daniel et al., 2006; Prochaska et al., 2008), and one drug recovery program has seen success in participants that train for and compete in a marathon as part of the program (Butler, 2005). ... In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs. This syndrome is characterized by a medication-induced increase in (or compulsive) engagement in non-drug rewards such as gambling, shopping, or sex (Evans et al., 2006; Aiken, 2007; Lader, 2008).
The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. ... numerous theoretical and practical reasons support exercise-based treatments for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects.
Collectively, these findings demonstrate that exercise may serve as a substitute or competition for drug abuse by changing ΔFosB or cFos immunoreactivity in the reward system to protect against later or previous drug use. ... As briefly reviewed above, a large number of human and rodent studies clearly show that there are sex differences in "drug addiction and exercise. The sex differences are also found in the effectiveness of exercise on drug addiction prevention and treatment, as well as underlying neurobiological mechanisms. The postulate that exercise serves as an ideal intervention for drug addiction has been widely recognized and used in human and animal rehabilitation. ... In particular, more studies on the neurobiological mechanism of exercise and its roles in preventing and treating drug addiction are needed.
Six RCTs were identified that exclusively considered the effect of exercise in AD patients. Exercise generally had a positive effect on rate of cognitive decline in AD. A meta-analysis found that exercise interventions have a positive effect on global cognitive function, 0.75 (95% CI = 0.32–1.17). ... The most prevalent subtype of dementia is Alzheimer’s disease (AD), accounting for up to 65.0% of all dementia cases ... Cognitive decline in AD is attributable at least in part to the buildup of amyloid and tau proteins, which promote neuronal dysfunction and death (Hardy and Selkoe, 2002; Karran et al., 2011). Evidence in transgenic mouse models of AD, in which the mice have artificially elevated amyloid load, suggests that exercise programs are able to improve cognitive function (Adlard et al., 2005; Nichol et al., 2007). Adlard and colleagues also determined that the improvement in cognitive performance occurred in conjunction with a reduced amyloid load. Research that includes direct indices of change in such biomarkers will help to determine the mechanisms by which exercise may act on cognition in AD.
Alzheimer’s disease (AD) is a progressive neurological disorder characterized by loss in cognitive function, abnormal behavior, and decreased ability to perform basic activities of daily living [(ADLs)] ... All studies included people with AD who completed an exercise program consisting of aerobic, strength, or balance training or any combination of the three. The length of the exercise programs varied from 12 weeks to 12 months. ... Six studies involving 446 participants tested the effect of exercise on ADL performance ... exercise had a large and significant effect on ADL performance (z = 4.07, p < .0001; average effect size = 0.80). ... These positive effects were apparent with programs ranging in length from 12 wk (Santana-Sosa et al., 2008; Teri et al., 2003) and intermediate length of 16 wk (Roach et al., 2011; Vreugdenhil et al., 2012) to 6 mo (Venturelli et al., 2011) and 12 mo (Rolland et al., 2007). Furthermore, the positive effects of a 3-mo intervention lasted 24 mo (Teri et al., 2003). ... No adverse effects of exercise on ADL performance were noted. ... The study with the largest effect size implemented a walking and aerobic program of only 30 min four times a week (Venturelli et al., 2011).
Longitudinal observational studies show an association between higher levels of physical activity and a reduced risk of cognitive decline and dementia. A case can be made for a causal interpretation. Future research should use objective measures of physical activity, adjust for the full range of confounders and have adequate follow-up length. Ideally, randomised controlled trials will be conducted. ... On the whole the results do, however, lend support to the notion of a causal relationship between physical activity, cognitive decline and dementia, according to the established criteria for causal inference.
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