Here are some tips regarding health, medicine, and fitness. Here are also some solutions from which you can also take benefit.

1. Health and fitness
Introduction
Exercise is known to be a beneficial factor for health . This is because it proves protective
against numerous pathologies, promoting longevity but also a greater quality of life.
Training and Health: Scientific EvidenceShutterstock
However, few people disclose the most significant medical (statistical-scientific) evidence,
without which certain conjectures would remain so.
Therefore, in this article we will propose the most important information on the role that
motor inactivity plays in the development of chronic diseases and in the manifestation of
early death - that is, caused by non-hereditary pathologies and indeed acquired through an
incorrect lifestyle.
Note : primary literature reference: Health benefits of physical activity: the evidence . Darren
ER Warburton, Crystal Whitney Nicol and Shannon SD Bredin. For more information on the
attached bibliography, consult the study in question.

3. Premise
Exercising improves the health of the body and mind
We anticipate that:
<< The scientific evidence on the effectiveness of regular physical activity in the primary and
secondary prevention of various diseases and early death is totally irrefutable . >>.
What diseases can be countered by training the body?
Below we will summarize the diseases that can be countered directly - in preventive and,
often, also therapeutic terms - thanks to the practice of regular motor activity .
Mostly:
Obesity, insulin resistance and type 2 diabetes mellitus , hypertension , dyslipidemia
(differently on triglycerides and cholesterol ), cardiovascular disease , osteoporosis , some
joint degeneration ( osteoarthritis ), colon and breast cancer, senile decline and dementia,
depression *.
Recall on the other hand that, by counteracting obesity, physical exercise indirectly fights
many other conditions.

5. * Did You Know That ...
Motor therapy is progressively assuming a pivotal role in the treatment of various psychiatric
conditions and psychological distress, such as mood disorders (e.g. major depression,
seasonal affective disorder or even more serious conditions), non-pathological depressive
and anxiety symptoms , drug addiction and other abuse syndromes (gambling) etc.
Already from these few lines, however, the first doubts emerge; what does regular physical
activity mean?
Several competent authorities have thought of answering, such as national research
institutes, which have drawn up specific guidelines on training designed for health purposes.
Those of "Health Canada", for example, have proved to be adequate in obtaining the much
desired benefits, especially in subjects who were sedentary in the past .
In these circumstances, a linear correlation between motor activity and state of health seems
to be evident, so much so that a further increase in sports physical activity or fitness ,
associated with an improvement in general functionality, seems to lead to greater general
psycho-physical benefits.
Sedentary lifestyle
How much does a sedentary lifestyle hurt?
It is a question that few ask themselves; usually, in fact, we focus more on the beneficial
effect of movement.
It is a subconscious omission, with a logically self-protective purpose, since the answer is
very uncomfortable: " a sedentary lifestyle is very bad for your health. ".
Admitting with no room for misunderstanding that one's inactivity can harm, as any other risk
factor would do ( smoking , alcohol abuse , overnutrition and overweight , etc.) is not easy.
Psychologically, it is much more "comfortable" to convince oneself that: " yes, training is
good, but by not doing it I simply remain at a normal level ". Unfortunately this is not the
case.
A sedentary lifestyle is neither natural nor normal for the human being, and is responsible for
a real reduction in the state of health, as it constitutes a modifiable risk factor for all the
uncomfortable conditions mentioned above.
The prevalence of physical inactivity is very important in percentage terms, in some states
even higher than that of all other modifiable risk factors (linked to lifestyle, such as diet).
Further below, in addition to developing the correlation between training or pathologies, we
will also describe the data relating to general and muscular fitness , and we will deal with the
independent effects of frequency (strictly linked to volume )

6. and intensity of physical activity.
Life expectation
Primary prevention of early mortality
From the work of Morris and colleagues dating back to the mid-20th century and the early
work of Paffenbarger and colleagues in the 1970s, a number of long-term prospective
follow-up studies have been conducted - primarily involving men but, more recently, women
as well - who assessed the risk of death from any cause and from specific diseases (e.g.
cardiovascular disease) associated with physical inactivity.
Both men and women with increased levels of sports training and fitness found a reduction
in the relative risk of death of approximately 20-35% .
For example, in a study involving healthy middle-aged men and women followed for 8 years,
lower levels of physical performance , measured on a treadmill , were associated with an
increased risk of death from any cause compared to taller.
More recent investigations have shown even greater reductions in the risk of death from any
cause and from cardiovascular disease. For example, good fitness and activity were
associated with a risk reduction of > 50% .
In addition, an increase in energy expenditure from physical activity of 1000 kcal (4200 kJ )
per week or an increase in fitness of 1 MET ( metabolism equivalent) was associated with a
mortality benefit of approximately 20% .
Physically inactive middle-aged women (engaged in < 1 hour of exercise per week )
experienced a 52% increase in all-cause mortality, a doubling of cardiovascular -related

7. mortality , and a 29% increase in cardiovascular- related mortality. cancer than physically
active ones.
These risk indices are similar to those for hypertension, hypercholesterolemia and obesity
and approach those associated with moderate cigarette smoking . Furthermore, it appears
that people who are fitter but with other risk factors for cardiovascular disease show a lower
risk of premature death than sedentary people without risk factors for cardiovascular
disease.
An increase in physical fitness reduces the risk of premature death and a decrease in it
increases it.
The effect appears to be gradual, so that even small improvements in physical fitness are
associated with a significant reduction in risk.
In one study, 35 participants with the highest levels of fitness at baseline and who
maintained or improved their fitness for an extended period had the lowest risk of premature
death.
In previously sedentary people, modest improvements in fitness have been associated with
large improvements in health status. For example, subjects who went from sedentary to
active over a 5-year period showed a 44% reduction in relative risk of death compared with
those who remained inactive.
A recent systematic review of the literature on primary prevention in women revealed that
there was a gradual inverse relationship between physical activity and the risk of
cardiovascular death, with a relative risk of 0.67 for the more active women compared to the
less active group. These protective effects were seen with just 1 hour of walking per week .
In summary, observational studies provide compelling evidence that regular physical activity
and a high level of fitness are associated with a reduced risk of premature death from any
cause and from cardiovascular disease, particularly among asymptomatic men and women .
There also appears to be a dose-response relationship, such that people with the highest
levels of activity and fitness show a lower risk of premature death.
Secondary prevention on early mortality
The benefits of activity and physical fitness also extend to patients with established
cardiovascular diseases .
This is very important because, for a long time, patients with heart disease have been
recommended total rest and inactivity.
Unlike the primary prevention insights, many secondary prevention studies are clinical
controlled and randomized (RCT).
Several systematic reviews have clearly demonstrated the importance of regular exercise to
alleviate or reverse the disease process in patients with cardiovascular disea

8. se. For example, a systematic review and meta-analysis of 48 clinical studies revealed that,
compared to usual treatments, cardiac rehabilitation is capable of significantly reducing the
incidence of premature death from any cause and in particular from cardiovascular disease.
An additional energy expenditure of approximately 1600 kcal (6720 kJ) per week has been
shown to be effective in halting the progression of coronary heart disease , and it has been
shown that an energy expenditure of approximately 2200 kcal (9240 kJ) per week can be
associated with the reduction of plaque in patients with heart disease.
Low-intensity training [eg, less than 45% of maximum aerobic power ( VO2max )] has also
been associated with improved health status among patients with cardiovascular disease .
However, the recommended training intensity for heart disease patients is generally 45% of
the reserve heart rate - that is, the difference between maximum heart rate (HRmax) and
resting heart rate .
In summary, regular physical activity is clearly effective in the secondary prevention of
cardiovascular disease and is effective in mitigating the risk of premature death among men
and women.
Type 2 Diabetes Mellitus
Primary prevention of type 2 diabetes mellitus
Both aerobic and strength exercise have been shown to be associated with a reduced risk of
type 2 diabetes .

9. In a large prospective study, every 500 kcal (2100 kJ) increase in weekly energy expenditure
is associated with a 6% reduction in the incidence of type 2 diabetes. This benefit was
particularly evident among people at high risk of diabetes - that is, those with a high body
mass index ( BMI ) - a finding supported by many other researchers.
For example, among 21,271 male doctors, those who reported enough physical activity
weekly to cause sweating had a low incidence of type 2 diabetes.
Moderately intense (≥ 5.5 MET for at least 40 minutes per week) and cardiovascular (> 31
mL of oxygen per kilogram per minute) physical activity levels have also been shown to be
protective against the development of type 2 diabetes in men middle-aged, with an even
greater effect among those at high risk of diabetes.
Several investigators have reported a reduced incidence of type 2 diabetes among high-risk
people (e.g. those who are overweight) following certain lifestyle interventions. An RCT
review on the subject concluded that modest weight loss with diet and exercise can reduce
the incidence of the disease among high-risk people by approximately 40-60% over 3-4
years.
In one of the RCTs, a lifestyle intervention that included moderate physical activity for at
least 150 minutes per week was found to be more effective than metformin alone in reducing
the incidence of diabetes.
In summary, research supports the importance of regular physical activity for the primary
prevention of type 2 diabetes. More research is needed to discover ideal methods (for
example, muscle -strengthening training or aerobic training ) and intensity levels. of the
exercise.

10. Secondary prevention of type 2 diabetes mellitus

11. Physical training interventions are also effective in managing diabetes.
A prospective cohort study showed that walking for at least 2 hours per week was
associated with a 39-54% reduction in the incidence of premature death from any cause and
a 34-53% reduction in cardiovascular disease among diabetics .
Furthermore, the act of walking that led to moderate increases in heart and respiratory rates
was associated with significant reductions in all-cause mortality and cardiovascular mortality.
In another cohort study, 54 physically inactive men with established type 2 diabetes had a
1.7 times higher risk of premature death than physically active men with type 2 diabetes.
This difference was also seen among people with the syndrome . metabolic .
Both aerobic and muscle strengthening training have been shown to be beneficial for
diabetes control; however, strength training may have greater benefits for glycemic control
than aerobic training.
A meta-analysis of 14 controlled trials (11 randomized) revealed that exercise protocols
produced a modest but clinically and statistically significant reduction in glycosylated
hemoglobin (0.66%) compared to control; in most of the studies, participants were treated
with oral hypoglycemic agents .
This level of change is similar to that seen in studies comparing intensive hypoglycemic
therapy with conventional treatments, known to be associated with a 42% reduction in
diabetes-related mortality .
In summary, interventions on motor practice in patients with diabetes are useful in improving
glucose homeostasis . Prospective studies with adequate follow-up show a strong
association between exercise and reduced rates of death from any cause, and in particular
from diabetes . Future research will need to focus on examining the effects of dose (intensity
and frequency of exercise).
Cancer
Primary cancer prevention
Reviews of the relationship between cancer and motor exercise are numerous.
From the available literature (which includes over 100 epidemiological studies), it seems that
routine physical activity , both as part of a real protocol and as a recreational activity, is
associated with a reduction in the incidence of specific cancers , in particular cancer . to the
colon and breast .
A systematic review of epidemiological studies revealed that moderate physical activity (>
4.5 MET, which would be equivalent to "mowing the lawn") would be associated with a
greater protective effect than less intense activity .

12. Physically active men and women showed a 3

13. 0–40% reduction in colon cancer risk; only physically active women showed a 20-30%
reduction in breast cancer risk compared to their sedentary counterparts.
In summary, there is compelling evidence that routine physical activity can be associated
with decreases in the incidence of specific cancers, particularly breast and colon cancer .
Secondary cancer prevention
There is little information on the effectiveness of physical activity in preventing death from
cancer or from any cause in cancer patients .
An initial follow-up study (5.5 years) in women with breast cancer revealed a poor
association between total recreational physical activity and the risk of death from breast
cancer . However, the study showed some important limitations.
Two recent follow-up studies in cancer patients (breast and colon cancer) revealed that
increased self-reported physical activity was associated with decreased cancer recurrence
and risk of cancer death.
One study found a 26–40% reduction in the relative risk of cancer death and breast cancer
recurrence among more active women versus less active women . Other studies have
shown similar associations.
We are currently seeking to understand the mechanism of this increased survival effect,
including the effects of exercise on the efficacy of chemotherapy .
Regular physical activity has also been shown to be associated with an improvement in the
overall quality of life and health status of cancer patients.
In summary, regular physical activity appears to confer a health benefit to patients with
established cancer . However, more research is needed to examine its role in secondary
cancer prevention.
In particular, large RCTs evaluating the effectiveness of motor exercise are needed to fully
elucidate the importance of regular physical activity on the health status of cancer patients.
Osteoporosis
Primary prevention of osteoporosis
Exercise involving continuous support of the skeleton against gravity appears to have
positive effects on bone mineral density - swimming would therefore be excluded.
In a review, 10 different cross-sectional reports revealed that people who went through such
a workout had higher bone mineral density than those who didn't and compared to athletes
who played low - impact sports .
Numerous longitudinal studies have examined the effects of physical training on bone health
in children, adolescents and young adults, middle-aged and older adults . Although the
number of studies and the total number of participants surveyed are relatively small

14. compared to those in the cardiov
ascular literature, there is compelling evidence that physical activity that requires continued
skeletal support against gravity prevents bone loss associated with aging .
In an RCT meta-analysis it was found that physical training programs prevent or reverse
lumbar spine and femoral neck bone loss in both pre-menopausal and post-menopausal
women by nearly 1 % per year . Physical training appears to significantly reduce the risk of
falls .
The risk and incidence of fractures appear to decrease even among active people. Among
3262 healthy men (mean age 44 years) followed for 21 years, intense physical activity was
associated with a reduced incidence of hip fractures . This observation supports the findings
of a previous survey in which fracture rates were lower among people who performed more
activities than people who were sedentary.
In summary, routine physical activity appears to prevent bone mineral density loss and
osteoporosis, particularly in postmenopausal women . The benefits clearly outweigh the
potential risks , particularly in older people .
Secondary prevention of osteoporosis
bone density in elderly women (75-85 years of age) already suffering from low bone mineral
density
In this 6-month RCT, 98 women were randomly assigned to participate in resistance training
(n = 32), for agility (n = 34) or stretching (shame exercise, n = 32).

15. Agility training resulted in a significant 0.5 % increase in cortical bone density at the tibial
shaft and resistance training resulted in a significant 1.4% increase in cortical bone density
at the shaft . radial ; the stretching group experienced losses in cortical bone density .
Furthermore, a study of osteopenic women in early postmenopause revealed that a 2-year
intensive training program was effective in mitigating the rate of bone loss .
In summary, preliminary evidence indicates that regular physical activity is an effective
secondary prevention strategy for maintaining bone health and fighting osteoporosis .
Physical Activity and General Fitness
General fitness is a physiological state of full and total functionality (essential or basal) that
allows you to meet the needs of daily life and is able to provide the basis for sports
progression.
General fitness includes all components of health, including cardiovascular fitness,
respiratory fitness, muscle fitness , bone and joint fitness , body composition , and metabolic
fitness .
The only way to achieve or maintain general fitness is by physical activity . Furthermore,
both are inversely related to both morbidity and mortality.
This is why these two factors are often used as interchangeable criteria; but in reality they
are not.
Most analyzes showed a reduction of at least 50% in mortality among people with good
general fitness compared to those with low values ​
​
- therefore it is considered a more
predictive value of physical activity.
To obtain accurate estimates of physical activity, some rely on measurements , which would
provide a quantitative assessment of the same. Among the most interesting criteria we find
energy expenditure, heart rate evaluation or performance estimation (time, distance,
strength, etc.) etc.
However, the general fitness assessment is often not applicable in larger, general
population-based surveys.
Also for this reason, from the point of view of public health, Blair and colleagues argue that it
is preferable to encourage people to become physically more active rather than reach
greater levels of general fitness, because it is a more easily understandable and apparently
simple concept compared to essential functionality. (which, on the other hand, remains the
ultimate goal) .
Musculoskeletal Fitness
Musculoskeletal Fitness: A Paradigm Shift
Contrary to what many believe, improvements in health indicators - due to increased
physical activity - can occur even in the absence of changes in aerobic capacity .

16. This is particularly evident in older populations , where regular physical activity can lead to
reductions in risk factors for chronic disease and disability without modifying traditional ,
typically aerobic, physiological markers of performance (e.g. cardiac output and oxidative
potential) . .
What happens instead is an improvement in musculoskeletal fitness .
There is growing evidence that improved musculoskeletal fitness is associated with an
increase in general health and a reduction in the risk of chronic disease and disability .
This research has led to a shift in research into the health benefits of activities to the
musculoskeletal system.
Musculoskeletal fitness appears to be particularly important for older people and their ability
to maintain functional independence .
Indeed, many activities of daily life do not require a large aerobic production but instead
depend on one or more components of the musculoskeletal fitness.
Many healthy older people may find themselves at or near the functional threshold of
addiction , risking losing the ability to carry out daily activities. With musculoskeletal decline,
an individual may lose the ability to get up from a chair or climb stairs .
This represents a vicious cycle, in which the musculoskeletal form continues to deteriorate,
leading to inactivity and further addiction.
Improvements in musculoskeletal function have enormous potential in delaying or
eliminating the onset of disability , addiction and chronic disease.
For example, previous longitudinal investigations have revealed that people with high levels
of muscle strength have fewer functional limitations and a lower incidence of chronic
diseases such as diabetes, stroke , arthritis , coronary heart disease and lung disorders.
Two recent systematic reviews revealed that improved musculoskeletal form is positively
associated with functional independence, mobility, glucose homeostasis, bone health,
psychological well -being, and overall quality of life , and is negatively associated with the
risk of falls, illness and premature death .
Interventions that improve musculoskeletal fitness appear to be particularly important for
improving the health status of frail elderly people who have low musculoskeletal reserve.
This research has clearly revealed the importance of engaging in activities that engage the
musculoskeletal system and is supported by the results of a recent epidemiological survey.
This evidence provides direct support to the recent recommendation that muscle
strengthening and muscle flexibility training be performed at least twice a week to maintain

17. physiological functional status, promote long-term high levels of general physical activity,
and improve overall quality of life . life .
How Much Physical Activity
How much physical activity is considered sufficient?
It is evident that physical activity is essential in the prevention of chronic disease and early
death .
However, doubts remain about the identification of the " training load " (duration and intensity
of exercise, frequency of sessions, stimulus density, etc.), both optimal and minimum
necessary, to obtain the aforementioned health benefits.
In particular, the choice of the intensity parameter (low, medium or moderate, intense or
vigorous) would raise more doubts . However, there is interesting evidence that this is
inversely and linearly associated with mortality .
Early work by Paffenbarger and associates revealed that regular physical activity
(consuming> 2000 kcal [8400 kJ] per week) could correlate with an average 1 to 2 year
increase in life expectancy at the age of 80 years, and that, even at lower levels of energy
expenditure, the benefits were still linear.
Subsequent studies have shown that an average energy expenditure of approximately 1000
kcal (4200 kJ) per week is associated with a 20-30 % reduction in all - cause mortality .
Currently, most organizations, health and fitness professionals advocate a minimum exercise
volume of 1000 kcal (4200 kJ) per week and recognize the additional benefits of increased
energy expenditure .
More recently, it has been speculated that even lower levels of weekly energy expenditure
may be associated with health benefits.
An exercise volume of approximately half the currently recommended volume may be
sufficient , particularly for individuals who are extremely deconditioned and / or frail and / or
elderly . Further research is needed to determine whether consuming as little as 500 kcal
(2100 kJ) per week offers relevant health benefits. If so, previously sedentary people may be
more likely to engage in physical activity and maintain an active lifestyle.
The dose-response relationship between physical activity and health outlined above
generally refers to cardiovascular disease and premature death from any cause. However,
the same may apply to other benefits associated with the activity.
For example, as previously mentioned, moderately intense exercise levels (≥ 5.5 MET for at
least 40 minutes per week) of cardiovascular fitness (> 31ml of oxygen per kilogram per
minute) are considered effective preventive strategies against type diabetes. 2. Walking
more than 2 hours per week has also been shown to reduce the risk of premature death in
patients with type 2 diabetes mellitus .

18. Regarding cancer, a review of the literature rev

19. ealed that moderate physical activity (> 4.5 MET) for approximately 30-60 minutes per day
has a greater protective effect against colon and breast cancer than activities of low intensity.
The greatest benefit for reducing the incidence of breast cancer was seen among women
who had 7 or more hours of moderate to vigorous activity per week. Among patients with
established cancer, walking 1 or more hours per week did not bring significant benefits. The
biggest advantage, however, was observed among cancer survivors who performed physical
exercises equivalent to 3-5 hours per weekat medium intensity.
Regarding osteoporosis, the dose-response relationship of physical activity seems less
clear. However, osteogenic adaptations appear to be training load - dependent and
site-specific . Consequently, for optimal bone health , physical activities that require an
impact or in any case a significant mechanism stimulus are more recommended.
Running distances of up to 15-20 miles ( 24-32 km ) per week have been associated with the
accumulation or maintenance of bone mineral density, but longer distances may be
associated with a reduction in bone mineral density .
Mechanism
How does physical activity and general fitness lead to better health?
Several biological mechanisms may be responsible for reducing the risk of chronic disease
and premature death associated with routine physical activity. For example, routine physical
activity has been shown to:
improves body composition (e.g. through reduced abdominal fat and better weight control );
improves lipoprotein profiles (eg through reduced levels of triglycerides , increase in
high-density lipoproteins [ HDL ] and reduction in low-density lipoproteins [ LDL ],
optimization of the ratio between them);
improves glucose homeostasis and insulin sensitivity ; _ _
reduces blood pressure ;
improves autonomic tone ;
reduces systemic inflammation ;
decreases blood coagulability ; _
improve coronary blood flow ;
increases heart function ;
improves endothelial function .
High circulating levels of chronic inflammatory mediators (e.g. C -reactive protein) are
strongly associated with most chronic diseases, the prevention of which appears to benefit
from exercise. Recent RCTs have shown that physical training can reduce C-reactive protein
levels .
Each of these factors can directly or indirectly explain the reduced incidence of chronic
disease and premature death among people who engage in routine physical activity.
Routine physical activity may also be associated with an improvement in psychological
well-being (for example, through the reduction of stress , anxiety and depression), which is

20. particularly important in the prevention and management of cardiovascular disease, but with
important implications for prevention and management. other chronic diseases such as
diabetes, osteoporosis, hypertension, obesity, cancer and major depression.
Changes in endothelial function can be a particularly important adaptation . Endothelial
dysfunction appears to increase with aging, smoking and multiple chronic disease states,
including coronary heart disease, congestive heart failure, stroke, type 2 diabetes,
hypertension, hypercholesterolemia and obesity. Regular aerobic activity has been found to
improve vascular function in adults independently of other risk factors, resulting in improved
endothelial function, which confers a health benefit to a number of disease states.
Although most research on the mechanisms involved addresses the relationship between
cardiovascular disease and physical activity, the researchers also evaluated the primary
mechanisms responsible for decreasing the risk and severity of individual disease states.
In fact, although adaptations are globally beneficial for multiple disease states, physical
activity also translates into specific adaptations that influence individual disease states. For
example, in type 2 diabetes, adaptations that affect glucose homeostasis are of great
importance.
According to Ivy, as a result of regular physical activity, there would be a series of changes (
independent of body composition) including: increased activity of glycogen synthase and
hexokinase , increase in GLUT-4 protein and expression of mRNA , and improvement in the
density of muscle capillaries (with consequent improvement in the supply of glucose to the
muscle).
The 46% reduction in cancer rates associated with regular physical activity can be explained
by a number of mechanisms, including reduced fat stores , increased energy expenditure ,
changes related to sex hormone activity , immune function , insulin and insulin-like growth
factors, free radical generation and direct effects on the tumor.
Most of the proposed mechanisms have been discussed in the context of chronic
adaptations caused by routine physical activity. However, researchers have also recently
examined the importance of changes in acute risk factors related to chronic diseases.
An excellent review of the topic by Thompson and colleagues revealed that, in acute form,
exercise can cause transient changes in the form of decreased triglycerides, increased HDL,
decreased blood pressure (for 12-16 hours), reduction of insulin resistance and improvement
in glucose control.
These acute changes indicate the fundamental role that training sessions have on overall
health.
Conclusions
There is incontrovertible evidence that regular physical activity contributes to the primary and
secondary prevention of many chronic diseases, and that it is associated with a reduced risk
of premature death .

21. There appears to be a gradual linear relationship between physical activity load and health
status , i.e. the risk decreases as training increases.
However, the greatest health benefits are seen when less fit people become physically
active .
Health Canada's current business guidelines appear to be sufficient to reduce health risk.
People who exercise at higher levels than recommended are likely to reap additional health
benefits .
Health promotion programs should be aimed at people of all ages, as the risk of chronic
disease begins in childhood and increases over the years.