The Health Benefits of

Physical Activity

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lesson topics
Physical activity and hypo kinetic
diseases
Physical activity and cardiovascular
diseases

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Physical activity and hypo kinetic diseases

Hypokinetic diseases are conditions

related to inactivity or low levels of
regular activity.

Physical inactivity is the most important

public health problem in the 21st century.

Each year at least 1.9 million people die

as a result of physical inactivity.
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Aerobics Center Longitudinal Study
(2009)
Risk factor Death Rate
Low cardio respiratory fitness 16%

Obesity 2-3%

Smoking 8-10%

High cholesterol 2-4%

Diabetes 2-4%

Hypertension 8-16%

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 Question
How much and what kind of physical
activity are needed to promote health and
reduce the risk of chronic disease ?

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Recommendations
American Heart Association (AHA) &
 American College of Sport Medicine
(ACSM )

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Cardiovascular fitness
Moderate-intensity Vigorous-intensity
aerobic activity activity
3.0-6.0 METS or 5 or 6 >6.0 METS or 7 or 8
on a 10-point perceived on a 10-point
exertion scale perceived exertion
Activity that noticeably scale
increases heart rate and Causes rapid
lasts more than 10 min breathing and
 Example, brisk
increases heart rate
walking for 15 min. substantially
Example, jogging.
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ACSM recommendations for adults
For adults (18-65 yr) and older adults (>65 yr),

minimum of 30 min or 20 min of

of moderate- vigorous-intensity
intensity aerobic aerobic exercise 3
activity 5 days per days per week.
week

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Resistance exercise
Moderate- to high-intensity (8- to 12-
repetition maximum (RM) for adults and
10- to 15-RM for older adults - resistance
training for a minimum of 2
nonconsecutive days per week.

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Adults
For substantial health benefits, adults
should engage in aerobic exercise at least
150 min per week at a moderate intensity
OR 75 min per week at a vigorous
intensity.
 In addition, adults and older adults
should do muscle-strengthening activities
at least 2 days per week.

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Children
Children should do
at least 60 min of
physical activity
every day.
Most of the 60 min
per day should be
either moderate or
vigorous aerobic
activity and should
include vigorous
aerobic activities at
least 3 days per 01/27/2024
Part of the 60 min or
more of daily
physical activity
should be muscle
strengthening
activities (at least 3
days a week) and
bone-strengthening
activities (at least 3
days a week).
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 Brainstorm
Exercise deficit disorder (EDD)
Dose-response relationship between
physical activity and health

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Balance and flexibility exercises are also
suggested for older adults.

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01/27/2024 14
Physical Activity and Cardiovascular
Diseases
Cardiovascular disease (CVD) caused
17.3 million deaths (30%) worldwide in
2008, and it is projected to cause more
than 26 million deaths by 2030. (WHO,
2011)

More than 80% of those cardiovascular

deaths occurred in low- and middle-
income countries .(WHO, 2011)
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Coronary Heart Disease (CHD)

Globally,7.6 million people dying from

CHD in 2005 (WHO 2007).

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Cause of CHD
Myocardial ischemia resulting from a
progressive, degenerative
disorder ,atherosclerosis.

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CHD Risk Factors
Age
Family History
Hypercholesterolemia
Hypertension
Tobacco use
Diabetes Mellitus
Prediabetes
Overweight
Obesity
Physical inactivity
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Physical Activity and CHD
Approximately 6% of CHD deaths
worldwide
can be attributed to a lack of physical
activity (WHO, 2010).
Physically active people have lower
incidences of myocardial infarction and
mortality from CHD and tend to develop
CHD at a later age compared to their
sedentary counterparts.
Individuals who exercise regularly reduce
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Hypertension

Hypertension( high blood pressure) is a

chronic, persistent elevation of blood
pressure.
Clinically defined as a systolic pressure
≥140 mmHg or a diastolic pressure ≥90
mmHg.
Prehypertension - a systolic pressure of
120 to 139 mmHg, a diastolic pressure of
80 to 89 mmHg, or both.
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Report on Hypertension
WHO identified hypertension as the
leading cardiovascular risk factor,
attributing 13% of deaths worldwide to
high blood pressure.
Hypertension is also the primary risk
factor for all types of stroke.

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Regular physical activity prevents
hypertension and lowers blood pressure in
younger and older adults who are
normotensive, prehypertensive, or
hypertensive.
Compared to normotensive individuals,
training-induced changes in resting systolic
and diastolic blood pressures (5-7 mmHg)
are greater for hypertensive individuals who
participate in endurance exercise.
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However, even modest reductions in
blood pressure (2-3 mmHg) by endurance
or resistance exercise training decrease
CHD risk by 5% to 9%, stroke risk by 8%
to14%, and all-cause mortality by 4% in
the general population (Pescatello et al.
2004).

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Exercise Prescription for Individuals with Hypertension (ACSM, 2013)

Mode:  Duration: 30-60 min or

Primarily
more of continuous or
endurance activities
accumulated aerobic
supplemented by physical activity per day,
resistance exercises and a minimum of one set
Intensity: Moderate- (8-12 reps) of resistance
training exercises for each
intensity endurance major muscle group.
(40-60% VO2R) and  Frequency: Most,
Resistance training preferably all days of the
(60-80% 1- RM) week for aerobic exercise;
2 or 3 days/wk for
resistance raining.

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Precautions during exercise
In the presence of uncontrolled HTN (>180/110
mm Hg), exercise is only engaged after
initiating drug therapy
 For resting SBP greater than 180 mm Hg or
resting DBP greater than 110 mm Hg, even if
blood pressure medications are being taken,
exercise is contraindicated and is not engaged
until blood pressure is under control.
During exercise, if SBP becomes greater than
220 mm Hg or DBP greater than 105 mm Hg,
exercise is stopped, and blood pressure is
allowed to return toward resting values
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Hyper-cholesterolemia & Dyslipidemia

Hypercholesterolemia- an elevation of
total cholesterol (TC) in the blood.

Hyperlipidemia- an increase in blood

lipid levels

 Dyslipidemia - an abnormal blood

lipid profile.

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Standards for blood lipids

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Risk factors for hypercholesterolemia
Age
Gender
Family history
Alcohol
Smoking

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Physical Activity and Lipid Profiles
 Regular physical activity positively
affects lipid metabolism and lipid profiles.
Cross-sectional comparisons of
lipid profiles in physically active and
sedentary women and men suggest that
physical fitness is inversely related to TC
and the TC/HDL-C ratio (Shoenhair and
Wells 1995).

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 Diabetes Mellitus
• Characterized by high blood glucose
concentrations
• Type 1: inability of the -cells in the
pancreas to produce insulin
– 5-10% of all diabetes cases
• Type 2: ineffectiveness of insulin to
facilitate the transport of glucose into the
cells (insulin resistance)
– 90-95% of all diabetes cases
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• Gestational: diabetes that develops
during pregnancy
– 4% of all pregnancies
• Prediabetes: impaired fasting glucose
and/or impaired glucose tolerance

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Diabetes

A fasting plasma glucose ≥126 mg / dL

(7.0 mmol /L ) or
 2 h plasma glucose values in oral glucose
tolerance test (OGTT) ≥200 mg / dL (11.1
mmol/∙ L) or
 HbA1C (glycated hemoglobin test)
≥6.5%.

There must be at least two separate

abnormal results for the risk factor to be
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What's a Normal Hemoglobin A1c Test?

For people without diabetes, the normal

range for the hemoglobin A1c level is
between 4% and 5.6%.
Hemoglobin A1c levels between 5.7%
and 6.4% mean you have a higher chance
of getting diabetes.
Levels of 6.5% or higher mean you have
diabetes

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Symptoms of Diabetes
 Frequent urination  Tingling or numbness
 Excessive thirst in hands or feet
 Unexplained weight  Feeling very tired

loss much of the time

 Extreme hunger  Irritability

 Sudden vision  Sores that are slow to

changes heal
 More infections than
normal

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Etiology of Diabetes
• Type 1: • Type 2: Delayed insulin
Destruction of secretion or impaired
insulin-secreting insulin reaction, insulin
-cells (heredity) resistance, excessive
glucose output from the
liver
• Type 2: -cells become
less responsive to
increased blood glucose,
target cells have a
reduction in the number
and/or activation of the 35
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Health Problems and Diabetes
• Coronary artery and peripheral vascular
disease
• Cerebrovascular disease and stroke
• Hypertension
• Peripheral vascular disease
• Kidney disease
• Eye disorders, including blindness

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Treating Diabetes
• Individualized insulin administration and
monitoring (if needed)
• Well-balanced diet
• Regular exercise and physical training
• Drugs: sulfonylureas, biguanides
• Weight loss

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Physical Activity and Type 1 Diabetes

• In people with type 1 diabetes, exercise

may or may not improve their glycemic
control but will help lower their risk for
coronary artery disease
• Blood glucose concentration must be
carefully monitored during exercise in
people with type 1 diabetes so that they
can alter their insulin dosage
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Physical Activity and Type 2 Diabetes

• Type 2 diabetes responds well to exercise

• Membrane permeability to glucose
improves with exercise.

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Physical Activity and Type 2
Diabetes…
Healthy nutrition and increased physical
activity, can reduce the risk of type 2
diabetes by as much as 67% in high-risk
individuals (Sanz, Gautier, and Hanaire
2010).
Exercise (30-120 min, 3 days/wk for 8 wk)
produced clinically significant
improvements in HbA1c and reduced
visceral and subcutaneous adipose tissue
stores in people with type 2 diabetes
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Physical Activity and Type 2
Diabetes…

 Both resistance and aerobic exercise

alone or in combination improve HbA1c
values in people with type 2 diabetes.

 If daily exercise is not possible, it should

not be skipped 2 days in a row.

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Metabolic Syndrome
Metabolic syndrome - combination of
CVD risk factors associated with
hypertension, dyslipidemia, insulin
resistance, and abdominal obesity.

According to clinical criteria adopted by

the National Cholesterol Education
Program (2001), individuals with three or
more CVD risk factors are classified as
having metabolic syndrome
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Factors for Metabolic Syndrome
Age
BMI

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Metabolic syndrome is higher (>40%) for
older (>60 yr) adults than for younger
(20–29 yr) adults (7%).
Also, the prevalence of metabolic
syndrome is much higher for obese (BMI
> 30 kg/m2) individuals (~50%) than for
normal weight (BMI ≤ 25 kg/m2)
individuals (6.2%)

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Obesity and Overweight
(The World Health Organization report (2012)
Globally, more than 1 in every 10 adults
is obese
About 35 million children living in
developing countries are overweight .
Overweight adolescents have a 70%
chance of becoming overweight adults;
this increases to 80% if one or both
parents are overweight or obese (AHA,
2012).
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01/27/2024 46
Etiology of Obesity
Genetic factors
Decreased physical activity
Overconsumption of calories
Hormonal imbalances
Emotional trauma
Homeostatic imbalances
Cultural influences

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Health Risks Associated With Excessive
Weight and Obesity
Increased mortality rates of the following
diseases:
• Heart disease
• Hypertension
• Type 2 diabetes
• Certain types of cancer
• Gall bladder disease
• Osteoarthritis
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 The Relationship of BMI to Excess
Mortality

Bray, G.A. “Obesity: Definition, diagnosis and disadvantages.” MJA 1985; 142: S2-S8. © Copyright 1985. The
Medical Journal of Australia—reproduced with permission.
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Obesity-Induced Changes in Normal
Body Function
Respiratory problems including sleep
apnea
Polycythemia
Thrombosis
Hypertrophic cardiomyopathy
Congestive heart failure
Decreased exercise tolerance

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General Treatment of Obesity
Not everyone responds to the same
intervention in the same way
Weight loss should not exceed 0.45-0.9
kg (1-2 lb) per week
Weight loss should be considered a long-
term project
Extreme weight loss measures
◦ Very low calorie diets (350-400 kcal per day)
◦ Weight-loss drugs
◦ Surgery
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Role of Physical Activity in Weight
Control

• Altered body composition

–↓ Total weight
–↓ Fat mass and relative body fat
–Either maintain or ↑ FFM
• Increases metabolism after exercise
(EPOC)
• Decreases visceral fat stores

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Risk factors for obesity
Age
Gender
Family history
Cholesterol intake
Physical inactivity

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Physical Activity and Postural
Deformity
Posture is the position from which
movement begins and ends.
It is the alignment of different body
segments.
Proper postural alignment enables the
body to perform movements quicker with
less joint and muscular strain.

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Poor Posture

Decreased circulation
Leading to varicose veins
Muscle pain
Joint pain

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Physical inactivity and a sedentary
lifestyle.
Osteoporosis (aging, amenorrhea,
malnutrition, menopause, and physical
inactivity)
Osteoarthritis
Bone fractures
Connective tissue tears
Low back syndrome

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Exercise Prescription for Preserving
Bone Health of Adults
Mode: Weight-bearing endurance
activities (e.g., stair climbing, jogging),
activities that involve jumping (e.g.,
basketball,plyometrics), and resistance
training
 Intensity: Moderate to high
 Frequency:
3–5 times / week for weight-bearing
endurance activities;
2 or 3 times / week for resistance
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Exercise Prescription for Preserving
Bone Health of Adults …
Duration: 30–60 min/day of a
combination of weight-bearing endurance
activities, activities that involve jumping,
and resistance training that targets all
major muscle groups

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Low back pain
More than 80% of all low back problems
are produced by muscular weakness or
imbalance caused by a lack of physical
activity

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Risks factors of low back pain
Modifiable Non modifiable
Excessive weight Age
Improper lifting Gender
habits
Smoking
Physical inactivity
Poor flexibility
Poor muscular
strength
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?
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