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ADVANTAGE OF PHYSICAL HEALTH

ROMEO FERNON C. STO. DOMINGO

1ST YEAR, BSBA

ALEXIS F. NATURALES
 INRODUCTION

Physical health prior to the onset of modern medicine would have considered someone
physically healthy if he or she was not stricken with a serious illness. With modern
medical innovations came longer life spans, which changed the way we define physical
health. Today's definition can consider everything ranging from the absence of disease
to fitness level.

While physical health consists of many components, here is a brief list of the key areas
that should be addressed:

Physical activity - includes strength, flexibility, and endurance

Nutrition and diet - includes nutrient intake, fluid intake, and healthy digestion

Alcohol and drugs - includes the abstinence from or reduced consumption of these
substances

Medical self-care - includes addressing minor ailments or injuries and seeking

emergency care as necessary

Rest and sleep - includes periodic rest and relaxation, along with high quality sleep
The Benefit s of Physical Health and Activity

HIGHLIGHT

“It is clear that moderate levels of fitness offer considerable health benefits. The key is
moving from the unfit category, some 30 to 40 million people in this country to the
moderately fit category. By beginning programs of moderate, regular exercise half an
hour each day, three times a week anyone can join this group, and markedly lower their
death rates from all-cause mortality, cancer, and cardiovascular disease.”

Dr. Steven Blair, the Cooper Institute for Aerobics Research

In 1990, Healthy People 2000 was released by Dr. Louis Sullivan, Secretary,
Department of Health and Human Services. The document elaborated national health
promotion and disease prevention goals for the year 2000. A central goal of the
document is to increase the span of healthy life for Americans. While improved
treatment of disease to prevent premature death is an important concern, Healthy
People 2000 emphasizes the importance of prevention of illness/disease, especially
lifestyle or chronic illnesses that have become the leading sources of death in our
society. But perhaps most important of all, the goals focus on efforts to promote quality
of life and a sense of well-being associated with good health. Dr. Michael McGinnis,
Director of the Office of Disease Prevention and Health Promotion, made the following
statement.

...it is not through happenstance that the physical activity category is the first priority
area of the Healthy People 2000 effort. Physical activity is related to the health of all
people. It has the ability to reduce directly the risk of several major chronic diseases as
well as to catalyse positive changes with respect to other risk fac Control, suggests that
physical activity may provide the shortcut we in public health have been seeking for the
control of chronic diseases. Much like immunization has facilitated progress against
infectious diseases (McGinnis, 1992, p. S196).

The inclusion of physical activity as an important lifestyle for promoting good health is
now clear. But for those interested in the health benefits of physical activity, it is not
easy to find a single source that summarizes these benefits. For this reason, we have
attempted to provide a simple sum-mary of the benefits in three sections: disease
prevention and treatment; health promotion; and physical fitness development. Six
principal sources are used for this summary. Readers are encouraged to consult these
references and their sources for more complete details.

DISEASE PREVENTION AND TREATMENT

Prior to 1940, the leading killers in the United States were infectious diseases.
Improvement in public health practices, implementation of personal and public health
education, and vaccines have greatly reduced the incidence of these diseases. As
indicated in the early statement by Dr. Foege, “chronic diseases” are now our major
health concerns. These chronic diseases are often referred to as “lifestyle diseases”
because changes in lifestyle, including increased activity and fitness, can reduce the
threat of early death and the incidence of disease. Figure 6.1 lists several of the
diseases for which regular physical activity can reduce risk, either of getting the disease
or of dying from it. Also illustrated in Figure 6.1 are some of the possible reasons why
exercise reduces risk of these diseases.

Physical health activity and major lifestyle diseases.

Disease : Physical Activity Benefit :

Heart Disease Healthy heart muscle
■ Lower resting heart rate
■ Blood pumped with each beat
■ reduced blood pressure in submaximal work Healthy arteries
 ■ less atherosclerosis (deposits in arteries)
■ Higher HDL (“good” Cholesterol)
■ Better blood f at profile (fewer “bad” fats)
■ decreased platelet and less fibrin (related to atherosclerosis)
■ Better blood f low Better working capacity
■ fewer demands during work
■ Greater ability to meet work demands

Stroke Healthy arteries (see above)

■ Lower blood pressure

Peripheral Improved working capacity

Vascular Disease Higher HDL
Better blood fat profile

High Blood Reduction in blood pressure among those with high levels Reduction
Pressure in body fatness (associated with high blood pressure)

Diabetes Reduced body fatness (may relieve (non-insulin)

symptoms of adult onset diabetes)
Better carbohydrate metabolism (improved insulin sensitivity)

Cancer Less risk of colon cancer (Better transit time of food?)

Obesity Increases lean body mass, Decreases body fat percentage

Less central fat distribution

Depression Relief from some symptoms

Back Pain Increased muscle strength and endurance

 Improved flexibility
Improved posture

Osteoporosis Greater bone density as a result of stressing long bones

In spite of the fact that deaths from heart disease have decreased in recent years, it is
still the leading cause of death. Studies by Paffenbarger and colleagues (1989) as well
as others have clearly shown that those who do regular physical health activity are at
less risk of dying from this major killer. Physically inactive people have almost twice the
risk of developing heart disease as active people (Powell et al., 1987).

In fact, the American Heart Association (Fletcher et al., 1992) has recently classified
inactivity (sedentary living) as a primary risk factor for heart disease comparable to high
blood pressure, high blood cholesterol, and cigarette smoking. Both stroke (lack of
blood flow and oxygen to the brain) and peripheral vascular disease (lack of blood flow
and oxygen to the limbs) have been shown (Haskell et al., 1992) to be associated with
sedentary living for many of the same reasons why inactivity is related to heart disease
High blood pressure or hypertension is a condition that predisposes people to other
health risks such as heart disease and diabetes. Regular exercise has been shown to
reduce blood pressure among those who have high levels though, by itself, exercise
cannot normalize high blood pressure for most people (Haskell et al., 1992).

In the introduction of the Physical Activity and Fitness section of Healthy People 2000
(Public Health Service, p. 94), it is noted that physical activity can help to prevent and
manage non-insulin-dependent diabetes and osteoporosis. Recent evidence also has
shown that inactive people have a higher incidence of colon and breast cancer than
active people. While the evidence is less than complete, one researcher reached the
following conclusion based on a review of recent research.

Given the consistency in the direction and magnitude of the findings regarding colon
cancer… the evidence supports the conclusion that activity is protective against colon
cancer. Although that protective effect may be small, the attributable risk of colon
cancer associated with inactivity may be quite high given the prevalence of inactivity in
Western societies. (Sternfeld, 1992, p. 1195)

It is generally conceded that regular muscle fitness and flexibility exercise can aid in
improving posture. Together, exercise and good posture can have a positive effect on
back problems as evidenced by less risk of back pain. In a recent review, Plowman
(1992) noted that while we do not yet know the exact amounts of muscle strength,
muscle endurance, and flexibility necessary to reduce the risk of back pain, there is
support for the notion that poor scores on these fitness measures are predictive of low
back pain.

The potential benefits of regular physical health activity in reducing obesity are well
documented. Regular exercise expends calories that can result in reduced fat storage in
the body’s fat cells. At the same time, exercise designed to build muscle fitness
increases lean body tissue (muscle), which can result in a lesser relative percentage of
fat in the body and a higher resting metabolism. Getting obese Americans to adopt
regular exercise that would help them achieve normal levels of body fatness is not as
successful as we might hope. Nevertheless, physical activity has great potential for
reducing the incidence of obesity in our society (Epstein et al., 1990).

Depression is a major medical problem that causes much pain and suffering. The
number of bed days and disabilities associated with depression is greater than that for
the eight major chronic health conditions (Public Health Service, 1990). A recent
position statement of the International Society of Sport Psychology (1992) states that
studies on depressed patients reveal that aerobic exercises are as effective as different
forms of psychotherapy. In addition, the Society summarizes by saying: “Exercise can
have beneficial emotional effects across all ages and for both sexes.”
PHYSICAL FITNESS
There is no doubt that regular physical activity builds physical fitness. What has become
increasingly clear in recent years is that physical activity and physical fitness, as
evidenced by performance on fitness tests, are independent but related phenomena.
Likewise, physical fitness is associated with good health. For example, Blair et al.
(1989) have shown that those with “good” levels of fitness have less heart disease risk
than those with “low” levels of fitness. The previously cited review by Plowman (1992)
suggests that muscle fitness is necessary to prevent back pain. Others have pointed out
the importance of fitness to injury prevention (McGinnis, 1992). Body fatness, often
considered a health-related component of physical fitness, is associated with medical
problems of various kinds.

Fitness, as measured by fitness tests, is NOT solely related to regular physical activity.
There are many other factors that contribute to physical fitness. Among children, fitness
scores are influenced by chronological age and maturation (physiological age). In some
cases, children and adolescents who are inactive have higher fitness scores than
younger or more active peers (Pangrazi & Corbin, 1990; Pate, Dowda, & Ross, 1990).
Bouchard and colleagues (1992) have demonstrated that heredity plays a significant
role in a person’s ability to improve fitness as a result of exercise. Some people respond
to training more favorably than others, so it is possible that regular exercisers could
sometimes have lower fitness performance levels than those who are sedentary.

Of course, other factors such as nutrition, learned skills, and environment also play a
role in fitness performances. There is little doubt that good physical fitness is associated
with reduced risk of disease. Further, it can be stated that good fitness helps people
function effectively, look better, and have the ability to enjoy their free time. But
evidence exists to support other important statements about physical fitness.

■ Physical fitness, as measured by fitness tests, is not as meaningful to good health as

physical fitness that results from regular physical activity as part of the normal lifestyle.
■ Physical fitness, as measured by fitness tests, will ultimately improve as the result of
regular exercise to the extent that hereditary predispositions allow. The amount and rate
of change in fitness will take longer for some to achieve than for others.

■ Physical fitness is associated with good health but is not the same as good health.
Regular physical activity has positive benefits for both good health and adequate
physical fitness.

■ For good health benefits to result, it is important NOT to be in a low fit category. On
the other hand, high levels of fitness test performance do NOT seem to be necessary
for attaining health benefits. All people with regular physical activity have the potential to
achieve adequate levels of fitness that are associated with good health.

Nutrition and diet

Eating a balanced diet and being physically active are two of the most important things
you can do to be and stay physically healthy at any age.
A balanced diet includes eating the right amount of calories and nutrients to maintain a
healthy weight. ChooseMyPlate and the US Dietary Guidelines for Americans provide
recommendations for most Americans and people on what and how much to eat to
nourish your body.

Physical activity is any form of movement that uses energy. People of all shapes and
sizes and abilities can benefit from being physically active. Some physical activity is
better than none and the more you do the more benefits you gain. The US Physical
Activity Guidelines provide guidance for most Americans on types and amounts of
physical activity that are linked to health benefits.
Eating smart and being active have similar effects on our health. These include:
Reduce the risk of chronic diseases, such as diabetes, heart disease, high blood
pressure, stroke, and some cancers and associated disabilities
Prevent weight gain and/or promote weight loss
Improve overall well-being.
Being active can also improve your personal appearance, encourage fun with family
and friends, maintain the ability to live independently, and enhance fitness for sports.

Eating a healthy balanced diet accompanied by regular exercise is essential in

maintaining physical and mental health and well-being. Not only are these effective in
preventing excess weight gain or in maintaining weight loss, but healthier lifestyles are
also associated with improved sleep and mood. Physical activity particularly improves
brain-related function and outcomes.
Obesity levels remain worryingly high, with nearly 30% of the global population being
overweight or obese. This figure is set to rise to almost half of the world’s adult
population by 2030, according to the McKinsey Global Institute. The fundamental cause
of excess weight and obesity is an imbalance between energy intake and energy
expenditure. Globally, the intake of energy-dense foods that are high in saturated fat,
salt and sugar has increased. We also consume insufficient amounts of fruit,
vegetables, dairy, whole grains and oily fish, 3 which has an additive effect on the health
impact of a poor diet. Our modes of work continue to remain sedentary and we work the
longest hours compared to many other European countries.

In the UK we spend more time sat on public transport, watching television and indoors.
Excess weight and obesity are major risk factors for a number of chronic, non-
communicable diseases (NCD) including type 2 diabetes, cardiovascular diseases,
musculoskeletal disorders (particularly osteoarthritis) and some cancers. 5 The risk for
these NCD’s also rises with an increase in body mass index (BMI) and age. To
summarise:

1. The UK has one of the highest levels of obesity in western Europe: 67% of men and
57% of women are either overweight or obese.

2. More than half of men and women are at an increased risk of multiple health
problems caused by poor diet.
3. The level of childhood obesity is a huge concern. In the UK, one in 10 children are
obese when they start school. By the time they leave primary school, nearly 20% of
children are obese with a 75-80% risk of obese adolescents becoming obese adults.
Childhood obesity is associated with a higher chance of obesity, premature death and
disability in adulthood.

4. According to the latest diet surveys, children and teenagers consume around 40%
more added sugar than the recommended daily allowance; much of this coming from
snacks and sweets.3 We are now seeing type 2 diabetes, hypertension, early markers of
heart disease, breathing difficulties, increased risk of fractures and psychological effects
in young children.

5. In 2014 Public Health England reported that 12% of children under three have tooth
decay and an average of three teeth in these children are decayed, missing or filled. 6

6. Obesity can reduce life expectancy by eight to 10 years. This is equivalent to the
effects of life-long smoking.7

Obesity is preventable and is the result of a complex, multifactorial integration of

environmental and social factors that influence our dietary and physical activity patterns.
Lack of supportive policies has led to the creation of an obesogenic environment that
simply does not enable the public to make healthy choices easily. The UK are now
behind many other western industrialised countries in reducing premature mortality
rates.8 This increases the financial burden on local authority and health resources.
Those working in primary care are required to work much more through a reactive
approach to healthcare as opposed to the more desired proactive approach.

Over and under nutrition

Most recently, attention has been given to the overconsumption of energy and the
resulting obesity crisis. however under nutrition is still a growing concern. Malnutrition,
meaning poor nutrition, affects over three million people in the UK, 9 93% of these live in
the community. It has also been identified in one in four adults on admission to hospital.
A poor quality diet consumed in inadequate amounts or in excess both contribute to
malnutrition, as nutrients are not supplied in sufficient or appropriate proportions.
Despite an excess of dietary calorie intake, obese individuals have relatively high rates
of micronutrient deficiencies.
One in five people in the UK live below the poverty line and are unable to afford
sufficient food to meet their nutritional requirements. Just £2.10 per person per day is
spent on groceries by low-income families. The increase in nutritional requirements as a
result of illness or injury is often underestimated. Upon admission, additional stress and
the impact of interventions, surgical procedures and opportunistic infections can all
significantly increase energy expenditure. Nutrient requirements develop further,
increasing the likelihood of malnutrition occurring while in a care setting if these
demands are not met.

Consequences of poor PHYSICAL HEALTH lifestyle choices

All malnutrition is inevitably accompanied by increased susceptibility to illness and
clinical complications.
However, these risks can be significantly reduced if it is recognised early and
specifically treated with relatively simple measures. Clinical complications associated
with malnutrition can be decreased by as much as 70% and mortality reduced by
around 40%. Poor nutrition and physical inactivity can contribute to the following:
- Constipation.
– Anaemia.
– Type 2 diabetes.
– Heart disease.
– Stroke.
– Declining mental health.
– Neurological disorders.
– Muscle atrophy.
– Vision problems.
– Increased risk of falls.
– Poor immune response.
– Increased risk of pressure sores.
– Higher risk of infection.
– Prolonged hospital stays.
– Increased dependency and medications.
– Increased prescription costs.
– More GP visits.
– Readmissions and recurrent hospital stays.

Alcohol and drugs

The negative physical and mental effects of the use of alcohol and other drugs are well
documented. Use of these drugs may cause: blackouts, poisoning, overdose and death;
physical and psychological dependence; damage to vital organs such as the brain,
heart, and liver; inability to learn and remember information; and psychological
problems including depression, psychosis, and severe anxiety. Risks associated with
specific drugs are described later in this section.

Impaired judgment and coordination resulting from the use of alcohol and other drugs
are associated with acquaintance assault and rape; DUI/DWI arrests; hazing; falls,
drowning and other injuries; contracting sexually-transmitted infections including AIDS;
and unwanted or unplanned sexual experiences and pregnancy.
The substance abuse of family members and friends may also be of concern to
individuals. Patterns of risk-taking behavior and dependency not only interfere in the
lives of the abusers, but can also have a negative impact on the affected students'
academic work, emotional wellbeing and adjustment to college life.

ALCOHOL - Alcohol abuse is a progressive disorder in which physical dependency can

develop. Even low doses of alcohol impair brain function, judgment, alertness,
coordination and reflexes. Very high doses cause suppression of respiration and death.
Chronic alcohol abuse can produce dementia, sexual impotence, cirrhosis of the liver,
and heart disease; and sudden withdrawal can produce severe anxiety, tremors,
hallucinations, and life-threatening convulsions.

SOME OF THE NEGATIVE CONSEQUENCES THAT DRINKING ALCOHOL CAN

HAVE, BOTH AS ARESULT OF YOUR DRINKING AND OTHERS' DRINKING:
hangovers
academic problems--missed classes, getting behind in school work
arguing with friends
engaging in unwanted and/or unprotected sexual activity
weight gain-the "Freshman 15" isn't all due to campus dining!
getting injured / assaulted / sexually assaulted
damaging property or having your property damaged
requiring treatment for alcohol poisoning
trouble on campus or with police
being insulted or humiliated
having your study or sleep interrupted
developing tolerance, dependence or addiction
death from alcohol poisoning or alcohol-related injury

All of these things have happened to W&L students. Neuroscience research shows that
alcohol impairs the formation of new memories and learning, especially in the
developing brain--and as college-aged students, your brains are still developing. Alcohol
use can cause both short term and long-term problems for those who choose to use it.
Alcohol is a central nervous system depressant whose effects depend on how much
you drink. These effects may range from loss of inhibition with only one drink to making
someone "stumbling drunk" to acute alcohol poisoning with loss of consciousness and
difficulty breathing. Acute alcohol poisoning usually occurs in situations of rapid alcohol
intake such as shots, funneling, keg stands and drinking games. Even after someone
passes out their BAC (blood alcohol concentration) can continue to rise from the alcohol
still in their stomach. Medical attention is critical to prevent serious injury or death.
Women are affected by alcohol to a greater degree than men. They become more
impaired than men when drinking the same amount of alcohol due to their higher
percentage of body fat--alcohol is water soluble, so there is a greater concentration of
alcohol in a woman's bloodstream after drinking. Because women tend to be smaller
than men, alcohol is less diluted upon reaching the brain than in larger individuals.
Women also become intoxicated more easily 1-3 days before their menstrual periods.
Finally, women absorb more alcohol into their bloodstreams because they lack the
enzyme alcohol dehydrogenase in their stomach, which in men breaks down some
alcohol before it is absorbed.

How can drugs and alcohol affect PHYSICAL HEALTH?

People use drugs and drink alcohol for lots of different reasons. Whatever your reason,
using drugs or alcohol may have a long-term negative effect on you. The possible long-
term effects include the following.
Needing to take more to get the same effect.
High blood pressure and strokes.
Problems with your liver and pancreas.
Development of certain cancers e.g. liver cancer, bowel cancer and mouth cancer.
Difficulty obtaining or maintaining an erection.
Problems with orgasms.
Difficulties becoming pregnant.
Feeling like you must use the drug or alcohol. This is known as being dependent.
Withdrawal symptoms including feeling sick, cold, sweaty or shaky when you don’t take
them.
Having sudden mood changes.
Having a negative outlook on life.
Loss of motivation.
Depression.
Anxiety.
Problems with relationships.
Being secretive.
Having episodes of drug-induced psychosis.
If you use alcohol or drugs for a long time it can cause serious issues for your mental
well-being. Drugs can make you more unwell and more likely to try and harm yourself or
take your own life.

How does physical activity and fitness lead to improved health outcomes?

Several biological mechanisms may be responsible for the reduction in the risk of
chronic disease and premature death associated with routine physical activity. For
instance, routine physical activity has been shown to improve body composition (e.g.,
through reduced abdominal adiposity and improved weight control) enhance lipid
lipoprotein profiles (e.g., through reduced triglyceride levels, increased high-density
lipoprotein [HDL] cholesterol levels and decreased low-density lipoprotein [LDL]-to-HDL
ratios), improve glucose homeostasis and insulin sensitivity, reduce blood
pressure, improve autonomic tone, reduce systemic inflammation; decrease blood
coagulation, improve coronary blood flow, augment cardiac function and enhance
endothelial function.

Chronic inflammation, as indicated by elevated circulating levels of inflammatory

mediators such as C-reactive protein, has been shown to be strongly associated with
most of the chronic diseases whose prevention has benefited from exercise. Recent
RCTs have shown that exercise training may cause marked reductions in C-reactive
protein levels. Each of these factors may explain directly or indirectly the reduced
incidence of chronic disease and premature death among people who engage in routine
physical activity.

Routine physical activity is also associated with improved psychological well-being (e.g.,
through reduced stress, anxiety and depression). Psychological well-being is particularly
important for the prevention and management of cardiovascular disease, but it also has
important implications for the prevention and management of other chronic diseases
such as diabetes, osteoporosis, hypertension, obesity, cancer and depression.
Changes in endothelial function may be a particularly important adaptation to routine
physical activity.

Endothelial dysfunction has been observed with aging, smoking and multiple chronic
disease states, including coronary artery disease, congestive heart failure, stroke, type
2 diabetes, hypertension, hypercholesterolemia and obesity. Regular aerobic activity
has been found to improve vascular function in adults independent of changes in other
risk factors and has been said to result in a shear-stress–mediated improvement in
endothelial function, which confers a health benefit to a number of disease states.

Although most research into the mechanisms of how physical activity and fitness
improve health outcomes has dealt with the relation between cardiovascular disease
and physical activity, researchers have also evaluated the primary mechanisms
responsible for decreases in the risk and severity of individual disease states. In fact,
despite the adaptations that are of global benefit for multiple disease states, physical
activity also results in specific adaptations that affect individual disease states.

For instance, in type 2 diabetes, adaptations that affect glucose homeostasis are of
great importance. As reviewed by Ivy, a series of changes (independent of changes in
body mass) occur as a result of regular physical activity, including increased glycogen
synthase and hexokinase activity, increased GLUT-4 protein and mRNA expression, and
improved muscle capillary density (resulting in improved glucose delivery to the
muscle). A series of mechanisms may explain the 46% reduction in cancer rates
observed with regular physical activity, including reductions in fat stores, increased
energy expenditure offsetting a high-fat diet, activity-related changes in sex hormone
levels, immune function, insulin and insulin-like growth factors, free-radical generation,
and direct effects on the tumour.

The majority of proposed mechanisms have been discussed in the context of chronic
adaptations brought about by routine physical activity. However, researchers have
recently examined the importance of acute changes in risk factors for chronic
disease. An excellent review of the topic by Thompson and colleagues revealed that
acute, dynamic exercise may result in transient changes in the form of reductions in
triglyceride levels, increases in HDL cholesterol level, decreases in blood pressure (for
12–16 hours), reductions in insulin resistance and improvements in glucose control.
These acute changes indicate the important role individual exercise sessions have on
health status.

HEALTH PROMOTION
The previous section dealt primarily with disease. Of course, disease treatment and
prevention are critical to good health in our society. Nevertheless, it is widely
acknowledged that optimal health is much more than freedom from disease. The
challenge of Healthy People 2000 (Public Health Service, 1990) illustrates this point.

The health of people is measured by more than death rates. Good health comes from
reducing unnecessary suffering, illness, and disability. It comes as well from an
improved quality of life. Health is thus best measured by citizens’ sense of well-being.

Prevention of disease is a high priority and regular physical activity has been shown to
help prevent the conditions discussed in the preceding sections. But what of high-quality
living and a sense of well-being? Many of these are quite subjective.

Corbin and Lindsey (1990) summarize some of the perceived benefits of exercise based
on subjective feelings of people responding to national surveys. Some of the reported
benefits are supported by scientific evidence, including a reduction in stress levels and
in symptoms of depression (International Society of Sport Psychology, 1992), improved
appearance, and increased working capacity. Other benefits such as improved sleep
habits, greater ability to enjoy leisure, improved general sense of well-being, and
improved self-esteem are less easy to document.

Nevertheless, what people think is true influences their quality of life and the results of
national opinion polls show that many Americans have positive feelings about the
benefits they receive from regular exercise (Corbin and Lindsey, 1990). Among older
adults, regular physical activity has been shown to increase independent functioning,
increase the ability to drive a car, and improve social interactions (Corbin and Lindsey,
1990). There is similar evidence to show that physical activity can positively influence
other health-related behaviors (Blair, 1985).

One survey, for example, showed that regular exercisers were 50% more likely to quit
smoking; 40% more likely to eat less red meat; 30% more likely to cut down on caffeine;
250% more likely to eat low calorie foods and drinks; 200% more likely to lose weight,
and 25% more likely to cut down on salt and sugar than non-exercisers (Harris & Gurin,
1985).

Physical health and activity’s contribution to quality of life and a personal sense of well-
being is more difficult to document than its contribution to prevention and treatment of
disease. In the long run, however, it may be equally important if the national goal of
lengthening healthy life is to be achieved. It is doubtful that most Americans would favor
an extended life if “quality of life” was lacking.

The evidence suggests that humans were designed to be physically active and that
physical activity has great potential for enhancing quality of life and sense of wellbeing.
Additional research is necessary to determine the full extent of activity’s contribution to
these important variables.

Nonetheless, physical HEALTH activity and fitness are strong predictors of risk of death.
To obtain accurate estimates of physical activity, many fitness consultants rely on
primary standards for the measurement of energy expenditure, such as direct
observation of movement or, in the laboratory, the doubly labelled water technique or
indirect calorimetry. On a practical basis, however, measures of physical activity and
energy expenditure are obtained by using heart rate monitors and motion sensors
(pedometers and accelerometers). These devices will be briefly reviewed in the
companion article.
SUMMARY
There is incontrovertible evidence that ADVANTAGE OF PHYSICAL HEALTH
contributes to the primary and secondary prevention of several chronic diseases and is
associated with a reduced risk of premature death. There appears to be a graded linear
relation between the volume of physical activity and health status, such that the most
physically active people are at the lowest risk. However, the greatest improvements in
health status are seen when people who are least fit become physically active. The
current activity guidelines promoted by Health Canada appear to be sufficient to reduce
health risk. People who engage in exercise at levels above those recommended in the
guidelines are likely to gain further health benefits. Health promotion programs should
target people of all ages, since the risk of chronic disease starts in childhood and
increases with age.

In recent years, much has been learned about regular physical activity and physical
fitness. Many of the health benefits of exercise and physical fitness are now well
documented. Other potential benefits require much more research. In the meantime, the
following quotes seem to best summarize our knowledge. From leading researchers
Paffenbarger and Hyde (1980):
Evidence mounts that the relationship between exercise and good health is more than
circumstantial. If some questions are not yet answered, they are far less important than
those that have been.

From Edward Cooper during a news conference for the American Heart Association,
July 1, 1992:

Now I’d like to say to those who are not engaged in “exercise training” that any physical
health activity is better than none. According to our panel, housework, gardening,
shuffleboard—anything that causes us to move—is beneficial. Maybe you don’t have
time or ability to attain “cardiovascular fitness,” that is, to enable your heart to function at
its most efficient level... maybe you don’t have the money to join a health club or buy a
bicycle... still there are activities you can perform as a part of your daily life that will
benefit your heart. I encourage you to make activity a part of your routine every day—
just as much a part of your day as brushing your teeth or enjoying breakfast.

From John Dryden, spoken several hundred years ago, as cited by Paffenbarger and
Hyde (1980):

Better to hunt in fields, for health unbought, than fee the doctor for nauseous draught;
the wise, for cure, on exercise depend; God never made his work for man to mend.