Many policy makers and other individuals in our communities focus only on two solutions to the corona virus infection pandemic: a vaccine and an antiviral agent.
The pharmaceutical industry, academia and governments have redirected their resources to this challenge, but we do not know how long this will take. In the meantime, months of isolation at home have an immense deconditioning effect of epidemic proportions, affecting millions of people. Lockdown policy decisions were aimed at people over 70, and people under 70 with long-term conditions, but we now know that the older you are, the more activity you need, and the more long-term conditions you have, the more activity you need.
As we wait for the vaccine and treatment for a coronavirus infection, getting more active and being physically fitter is the best thing we can do to improve our health reserve to enable us to withstand ‘insults’ such as viruses or trauma from a motor vehicle crash or risk of developing or making things worse if we have long-term health conditions, including heart disease, stroke, cancer, dementia and depression.
Physical activity has been called a miracle cure by the Academy of Medical Sciences (http://bit.ly/2lTqDvc).
Physical activity research reveals that any level of activity is better than none, and more is better still. Furthermore, the evidence that activity is good for both body and mind is impressive.
Physical activity keeps arteries healthy, both directly and indirectly. The direct effect is only now being understood, but it does appear that physical activity can prevent inflammation in the arteries, and inflammation leads to atherosclerosis and the furring up of the arteries with atheroma, a porridge-like substance made up of fat and inflammatory tissue. The fatty charges come from several reasons, all of which have the same cause, intake of excessive calories from food and under expenditure of calories through lack of activity.
These conditions, hypercholesterolaemia and pre-diabetes for example, have names that sound as though they are real diseases, like rheumatoid arthritis or tuberculosis. However, they are just the consequence of our modern environment dominated by cars, the internet, the computer screen, the desk job, and high-calorie food, which is universally available and cheap. No one would want to return to the days in which backbreaking work was the norm for the poorer people in society. Even the man digging up the road performs less physical activity, through sitting on his bottom and using his thumbs to control a mechanical excavator. The sedentary lifestyle is now almost universal, but it does influence blood pressure, blood sugar and blood lipids.
Everyone has cholesterol, lipids and sugar in their blood stream, and everyone has a blood pressure. They are all essential for life. However, when inactivity, often aggravated by consuming more calories than are needed, increases the levels of these chemicals, they change from being essential for life to becoming a risk to health and life. They are risk factors not diseases, but the medical profession has given them names as though they were diseases like severe acute respiratory syndrome (SARS), hypercholesterolemia, type 2 diabetes and high blood pressure.
These increase the risk of vascular dementia, but evidence that physical activity can reduce the risk of or prevent atherosclerosis by modifying these factors is strong. Most of the studies so far have looked at the impact on heart disease, but increasingly there is evidence of an impact on dementia also. Even more exciting, perhaps, is the more recent research on the direct impact of exercise on the brain. In 2015, Harvard Medical School, one of the world’s top medical schools, published a special health report on Walking for Health, and included a fascinating section on the benefits of walking on the brain.
So how can we be more active? Any contact communication opportunity, newspapers, social media and person-to-person conversations are opportunities to raise the issue, discuss it, and pass on information about our weekly physical activity. The following physical activity check list outlines how much activity, benefits and sample exercises for each of the three essential types of physical activity: flexibility, strength and endurance.
Flexibility activities: How much? Four to seven times a week.
Benefits: gentle reaching, bending and stretching, keep your muscles relaxed and joints mobile.
Sample exercises: Stretching, dancing, yoga, martial arts, and other activities that make you bend and stretch.
Strength activities: How much? Two to four days per week.
Benefits: Activities against resistance strengthen muscles and bones and improves posture.
Sample exercises: Lifting weights, carrying supplies, climbing stairs, moving furniture.
Endurance activities: How much? Four to seven times a week.
Benefits: Continuous activities benefit your heart, lungs, and circulatory system.
Sample activities: Active commuting, brisk walking, cycling, jogging, swimming, racquet sports, skating.
Physical activity is safe and beneficial for almost everyone. People should start slow and build up to avoid injury, and those with long term conditions may need to seek advice for a tailored exercise prescription.
What are the drawbacks of physical activity? There seem to be far fewer than for other widely-used preventives and cures. Indeed, physical activity is one of the alternatives to antidepressants and painkillers that we need for people struggling with physical or psychological pain. It seems to have few, if any, side effects, and unlike some prescription drugs, it is not generally addictive, although exercise addiction does occur.
Physicians now recognize that another benefit of physical activity is that it does not prompt over-diagnosis, unlike intensive precision screening looking for disease. Proponents of this type of screening are referring to the use of new technologies, such as genome analysis, and other ‘big data’ and machine-learning technologies. The proponents argue that these technologies enable unprecedented monitoring of the human body. The proponents of these plans, which are still largely theoretical, ignore accumulating evidence that they come with a high risk of over-medicalization and over-diagnosis – taking another pill is not always the best prevention or treatment solution for what ails us.
“Living is not merely living, but living in health.” Marital wrote this epigram in the first century.
The understanding of the importance of physical activity to increase health reserve will lead people to rethink what is happening to them as they live longer, and take action in this new coronavirus infection era. It will reduce their risk of dementia, frailty and the need for social care.
Larry W. Chambers has authored articles and books on disease prevention, improvements in long-term care homes, and innovative approaches for continuing professional development. He is research director of the Niagara Regional Campus, School of Medicine, McMaster University. Eva Liu and Hanna Levy are medical students at the Niagara Regional Campus of the McMaster University School of Medicine.
