Move and Stretch: Achieving Good Quality of Life and Health through Physical Activity

By Amy Lynn, BNatMed
 
In 2012, physical inactivity is the fourth leading cause of death worldwide (1). It is pandemic and a strong causative factor of the major non-communicable diseases such as cardiovascular diseases, cancer and diabetes. In children and adolescents, sedentary behavior and obesity were strongly correlated. In adults, sedentary behavior were strongly correlated with all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome (2). Among older adults, sedentary behavior is a strong element influencing the health of ageing adults and is being considered as a significant fall risk factor, such as drugs (3). Clearly, physical inactivity is one of the top four pillars of a noncommunicable disease strategy (1). 

For this reason, physical activity (PA) is a significant determinant of an individual’s predisposition to the majority of non-communicable diseases and even extends to be a chief contributor in achieving an overall good quality of life (4-6). Confirming this fact is the evidence that people who achieve total PA levels several times higher than the current recommended minimum level have significant reductions in the risk of diabetes, ischemic heart disease, ischemic stroke events, breast cancer and colon cancer (5). The physiological benefits PA, in all its intensity and elements, endows on the human body is achieved by inculcating protective and strengthening effects on various body systems and organs. To comprehensively grasp how physical activity serves as a constructive platform positively leveraging an individual’s health status, summarized below are the several beneficial impacts of PA on the overall quality of life and select body systems.

Overall quality of life
PA is associated with a better Health Related Quality of Life (HRQoL) with higher intensities of PA linked to higher HRQoL index (6). Health Related Quality of Life covers the physical and mental well-being of an individual and is an important concept in health research and helps to inform decisions on prevention and treatment of ill health (6). Similarly, yoga therapy was found to be effective in managing the distressing perimenopausal symptoms among women.  Perimenopausal-related psychological symptoms, especially menopausal anxiety, were significantly reduced; vasomotor concerns including hot flushes, night sweats and sweating were meaningfully lessened; and even sexual attitudes such as sexual desire and intimacy were profoundly increased (7).

Gastrointestinal (GI) tract health
Physical activities, in mild-to-moderate intensity, substantially decrease the onset of GI-related diseases such as diverticular diseases, constipation, cholelithiasis and can even benefit patients suffering from inflammatory bowel disease (8). Light-intensity activities include domestic or occupational task such as washing dishes, hanging, washing, ironing, cooking or eating while moderate-intensity activities are characterized by brisk walking for 10 minutes or longer, gentle swimming, social tennis, carrying light loads and cycling at a regular pace (9). The protective and positive effects of PA on the GI tract is possible since PA improves celiac and splanchnic blood flow under physical stress; decreases gastric emptying time; and lowers the relative risk for colon cancer in most populations by enhancing the body’s innate immunological response and/or preventing the production of prostaglandin E2 – known to stimulate colon cell proliferation (10).
Cardiovascular health
PA imparts numerous physiological improvements on the cardiovascular system through its constructive actions on blood coagulation, blood pressure, blood flow and blood lipid profiles. Long-term regular PA reduces the risk of ischemic cardiac events or stroke by reducing concentrations of plasma fibrinogen and decreasing the adhesion or aggregation properties of platelets (11). The lower the concentration of fibrinogen content, the lesser the risk of thrombus formation (i.e. stationary mass of, often obstructing, blood clot attached to its place of origin along a blood vessel wall) (11).
The lower time spent in sedentary activities and higher time spent in light physical activities (LPA) are associated with lower brachial and central blood pressure (BP) on hypertensive clients. Central BP includes pressure from both peripheral and central arteries and has been considered a strong predictor of cardiovascular events and target organ damage. The beneficial association observed between LPA and a reduction in central BP indicates a possible effect of physical activity, even in low intensity, in reducing cardiovascular risk even in hypertensive clients (12).
Exercise training or PA, through its beneficial actions on blood flow, is substantially promoted for application among patients with coronary artery disease. Aerobic exercise training elicits cardiovascular adaptations that can prevent or reverse the pathology of coronary artery disease without the use of pharmacological interventions. The enhanced coronary blood flow from exercise training helps prevent myocardial ischemia, reducing the incidence of myocardial infarction and angina. These improvements in coronary blood flow are due to structural and functional changes in the conduit and resistance vessels of the coronary circulation, which promote vasodilation due to enhanced endothelial and smooth muscle function. Coronary smooth muscle cells function is enhanced through improved Ca2+ (calcium ions) handling, which may promote a stabilization of coronary atherosclerotic plaques (13).
Lastly, routine PA (three to five days per week) markedly lowers the amount of LDL cholesterol and increases HDL cholesterol and exhibits a predominantly positive effect on blood lipid concentrations. Significant reductions in overall cholesterol and LDL cholesterol, as well as increases in HDL cholesterol, are consistently proven to positively impact cardiovascular health (11).
Cognitive function and mental health
Exercise and physical activity sensibly regulates brain-derived neurotrophic factor (BDNF), a neurotrophin crucial for its neurotrophic and neuroprotective properties in the central nervous system and the periphery. Apart from its specific role, neurotrophins regulate cognitive function by signaling neurons to survive, differentiate, or grow and support neuroplasticity. Neuroplasticity refers to the ability of the brain to adapt to environmental change, respond to injury, and to acquire novel information by modifying neural connectivity and function (14).
PA positively influences mental health, mostly demonstrated through its capability to improve depressive and anxiety symptoms. Regular PA has been shown to ameliorate anxiety symptoms among healthy older adults (15). The possible mechanisms explaining how this can be achieved revolves around the hypothetical psychological and physiological aspects of PA. Psychologically, PA elevates mental health either by acting as a distractive stimulus against unfavourable stimuli, serving as a self-efficacy measurement tool and/or attending as a platform for social interaction. Physiologically, PA signals the body’s release of monoamines and/or endorphins. The former’s function being likened to an antidepressive drug while the latter exerts inhibitory effects on the central nervous system leading to sensations of calm and improved mood after exercise (16).

Immune function
PA has anti-inflammatory effects. Habitually physically active individuals possess reduced levels of systemic inflammation biomarkers. This is corroborated by a study where chronic exercise induced positive effects on the immune system and sleep in patients with chronic primary insomnia (17). It is well proven that higher levels of habitual physical activity are associated with lower skeletal muscle inflammatory protein content, lower adipokine (circulating hormones) production, and lower serum levels of C-reactive protein (CRP). Although extreme exercise stress may impair immune function and increase susceptibility to infection, this may not be entirely detrimental to the host and may, by reducing immune activation and subsequent inflammation, be one of the mechanisms through which regular exercise benefits long-term health (18).

Musculoskeletal function
PA, as well as stretching, enhances musculoskeletal integrity and function. Some of the established physiological effects of stretching are: range of motion gain, short-term relief of discomfort/pain, viscoelastic changes in the tendon-muscle unit, and impaired muscle contraction with decreased peak force (19). Given the justifications of the abovementioned, stretching has been perceived as a doable and easily administered intervention in preventing the onset of work-related musculoskeletal disorders, provided that stretching programs should be appropriately tailored to the nature of the job and its immediate working environment (19).

Renal function
PA may decrease the risk of renal cancer by 22% (20). PA, especially in high intensity, significantly reduces factors positively associated with the development of renal carcinoma which includes adiposity, insulin resistance and lipid peroxidation. Further potential cancer-preventing mechanisms include the beneficial effects of PA on chronic inflammation (partly manifested by preventing adiposity) and immune function (by increasing the number of natural immune cells) (20). Similarly, various exercise interventions benefitted CKD patients on aspects of physical fitness, muscular functioning, walking capacity, cardiovascular function and HRQoL, with stronger evidence for dialysis patients and aerobic exercise programs (21).
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In conclusion, the collective evidence compiled within this article supports the incontrovertible fact that physical activity confers benefits not only on the physiological aspect of our health but positively influences the psychological and sociological facets of our individuality as well. It is in this regard that PA serves both as a strong driving agent towards achieving an overall good quality of life and an effective, inexpensive deterrent against the onset of the majority of non-communicable diseases. Hence, thoroughly and comprehensively understanding the important role PA plays on our overall health and quality of life, would most likely lead towards attaining a successful and noncommunicable disease-free aging throughout the life stages.

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