The
stay-at-home measures used to reduce the spread of COVID-19 may have
impacted your exercise habits, which can result in unanticipated health
concerns
Inactivity can
reduce insulin sensitivity and lower protein synthesis in your body; not
all older adults can recover after returning to normal activity levels
Inactivity is
associated with an increased risk of noncommunicable conditions
including cardiovascular disease, Type 2 diabetes, low back pain and
mental health disorders
Regular
exercise and physical activity also reduce your risk of infections due
to anti-inflammatory influence and immune regulation
Develop a healthy at-home activity routine including short activity "snacks," nonexercise movement and the Nitric Oxide Dump
Decades of fitness research remind us
that physical activity is one of the best preventive measures available.
It's one of the pillars of good health alongside nutrition, sleep and
hydration. Evidence has demonstrated the effect that exercise has on
sleep quality, mental health, heart disease and metabolic conditions.
For example, in one meta-analysis1
of 305 randomized controlled trials including 339,274 participants,
researchers compared exercise with drug interventions on mortality in
diabetes and heart disease.
They found there was no statistically detectable difference in those
who used exercise or who took medication in the prevention of coronary
heart disease and diabetes. In fact, exercise was found to be more
helpful than prescription drugs for those who’d had a stroke.
Physical activity is also a key factor for longevity. Those who
engage in regular exercise have a reduced risk from all-cause mortality.2 As discussed in another study published in JAMA,3
researchers concluded "cardiorespiratory fitness was inversely
associated with all-cause mortality" and it "is a modifiable indicator
of long-term mortality."
Pursue Active Stay-at-Home Measures
In a recent paper published in the Journal of Sport and Health
Science, scientists caution that the official recommendations to
restrict movement do not mean physical activity should also be limited.4
The clear health benefits associated with activity ought to encourage
people to get at least 30 minutes of moderate exercise each day.
Stuart Phillips, Ph.D., is a professor at McMaster University in the
department of kinesiology. He is raising a concern that the prolonged
stay-in-place orders during the COVID-19 pandemic may result in unanticipated health issues related to inactivity.5
He recently shared information with Canadian Olympic athletes on how
to reduce the impact of the lockdown on performance and how to avoid
injury as they return to intense training after the restrictions are
lifted. In a press release, he commented:6
“As we protect ourselves against the risks of COVID-19, we are
spending more time sitting and less time walking, or being physically
active. Extended periods of inactivity have a really detrimental effect
on our health. Our physical health has never been more important than
now."
Phillips led a team that recently published a paper in The Journals of Gerontology7 in which they evaluated the effect of two weeks of inactivity on insulin sensitivity.
The team engaged 22 overweight, prediabetic adults who were between the
ages of 65 and 73 years and asked them to limit their activity to 1,000
steps per day.
This was done to mimic the level of activity a hospitalized person or someone who is housebound may experience after an illness.8
They found that the two-week period of reduced activity led to a lower
rate of protein synthesis and deteriorating control over their blood
sugar.
However, unlike younger adults, some of the older individuals’
parameters did not recover after returning to their normal activity
levels. Phillips explained the implications of this data during the
pandemic:9
“The reduced steps experimental model demonstrates what an older
person who got the flu might experience if they were hospitalized for
three or four days with respiratory issues and then convalesced at home
for two weeks. The vast majority of people are at home during this
pandemic. For older people, a decline in health may be compounded by
both physical deconditioning and social isolation."
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Inactivity Increases Several Health Risks
If staying at home has reduced your activity level and raised the
number of hours you’re sitting, then you may be placing your health at
risk; this comes with long-term effects.
The World Health Organization believes that their data show physical
inactivity as a leading cause of disability and disease throughout the
world.10 It is estimated 3.2 million deaths each year could be linked to physical inactivity.
Much of the research on fitness and exercise has been on the impact it has on noncommunicable diseases and longevity.11
In one assessment of the associated risks, researchers estimated that
by getting rid of inactivity, 6% to 10% of all major noncommunicable
diseases could be eliminated.
These results prompted headlines comparing inactivity to smoking, as the number of deaths is nearly the same.12 People who are less active have a higher potential risk of high blood pressure, Type 2 diabetes, coronary heart disease, depression and anxiety.13 Other effects from inactivity include:14
Fewer calories being burned
Muscle weakness
Poor aerobic fitness
Bone loss
Reduction in metabolism
Poor blood circulation
Increasing inflammation
Potential hormonal imbalance
Avoid Back Pain or Worsening Medical Conditions
Another risk of inactivity is lower back pain, one of the more common health complaints and a major cause of disability.15
It is also one of the more common triggers for an opioid pain
prescription that may lead to dependence. Exercise and nonexercise
movement are two foundational treatments for lower back pain.
In a systematic review of the literature,16
researchers found that those who exercised lowered their risk of
developing back pain by 33%. They also found that exercise reduced the
severity in those who had back pain at the start of an intervention. The
researchers concluded that a combination of strength training with
stretching or aerobic exercises done two to three times a week is
recommended for the prevention of lower back pain.
During periods of self-isolation, people with underlying medical
conditions may experience a worsening of their health with inactivity.
In a commentary in Nature Reviews Rheumatology,17 the authors warn of the potential dangers for those who have rheumatic diseases.
People with these conditions have an increased risk of infection or
complications from respiratory illnesses, such as COVID-19. Sedentary
behavior was prevalent before the stay-at-home orders. The negative
clinical effects in the pediatric population with rheumatoid diseases
include muscle atrophy, weakness, fatigue, insulin resistance and
reduced physical capacity.
Although bedrest was a treatment used in the past, data show this
leads to joint destruction. Since inactivity may increase with social
distancing and quarantining, those with rheumatoid disease who were
hypoactive before the pandemic may risk worsening of their disease,
symptoms and comorbidities if they don’t become more active.
How Exercise Improves Your Immune System
There is strong epidemiological evidence that regular exercise and
physical activity reduce the number of infectious diseases older adults
will experience.18 While there is ample evidence of its long-term benefits on health, the effect of a single session continues to be analyzed.
One study was conducted to explore the assertion that after
exercising just once, the body has a heightened immune surveillance and
regulation function. The authors of this investigation also believe
there is a physiological limitation to or delay in aging of the immune
system with regular physical activity.
In a second review19
scientists summarized research evidence including the results of acute
and chronic exercise on the immune system and the effect on
immunosenescence (immune system aging). The data show a logical and
inverse relationship in the risk of illness for those who exercise
moderately.
Leading physiologists James Turner and John Campbell recently
published an analysis in which they argued that a higher number of
infections are more likely to be linked to20
"inadequate diet, psychological stress, insufficient sleep, travel and,
importantly, pathogen exposure at social gathering events like
marathons — rather than the act of exercising itself." Turner commented:21
"But people should not overlook the importance of staying fit,
active and healthy during this period. Provided it is carried out in
isolation — away from others — then regular, daily exercise will help
better maintain the way the immune system works — not suppress it."
Writing in the American College of Sports Medicine, Richard Simpson,
Ph.D., believes exercise during the COVID-19 pandemic is necessary to
positively impact the immune system and counter the stressful effects of
isolation. Simpson writes of the importance to seniors, saying:22
"Exercise is especially beneficial for older adults who are more
susceptible to infection in general and have also been identified as a
particularly vulnerable population during this COVID-19 outbreak."
Lack of Exercise Jeopardizes Older Adults
Unfortunately, the trend for inactivity rises with age.23
In addition to the health risks and immune compromise associated with
physical inactivity in seniors, it also increases the risk for balance
problems, broken bones and disability.
In older adults with arthritis,
a lack of physical activity has been associated with a measurable
decline in the ability to do activities of daily living such as meal
preparation, grocery shopping, taking medications and managing money.24
In this study, functional ability deteriorated more in women and
minorities, which the researchers attributed to a higher number of
comorbidities such as diabetes, stroke, depression and cognitive
impairment. In another study of older adults, scientists found that at
the end of a 10-year follow-up period, those who were sedentary were
more likely to have trouble walking.25
Develop a Healthy At-Home Activity Routine
Working or staying home can open the door for poor movement routines.
If you previously had to get out of your chair at the office every 30
minutes or if you had a job that required you to spend hours on your
feet every day, binge watching television or playing games on your
computer can throw a wrench in those habits.
As a rule, getting even a little bit of exercise is better than
nothing. Avoid sitting as much as possible, as the simple act of bearing
weight on your legs helps reduce your risk of unwanted health
conditions.
There are a variety of ways to use safe, simple and easy exercises at
home that also reduce your potential for exposure to airborne viral
infections such as COVID-19. Here are several suggestions to help you
improve the amount of time you’re out of your chair so you get at least
30 minutes of exercise each day:
• Activity snacks — Phillips suggested26 "Prolonged periods of sitting
should be broken up with 'activity snacks' like a little walk or going
up and down a flight of stairs. A short daily walk has amazing
properties from not just a physical but a psychological perspective. We
don’t have to run a marathon.”
In other words, small movements may have big benefits. Consider
taking a walk in the morning and another in the afternoon as the weather
permits. Getting outdoors has additional benefits for your immune
system, specifically from your exposure to the sun that may boost your vitamin D production. • Nonexercise Movement —
This type of activity may be as important as exercise. Make it a point
to get up from your chair at least every 30 minutes or more to stretch
and move around. If you are working from home or spending more time in
front of a computer or television screen than what is considered
healthy, opt for using a Swiss ball.
These large, inflatable balls can be ordered online and most come
with a pump. Sitting on one at your desk or while watching television
encourages movement and helps strengthen your core muscles. • Strengthening — With
inactivity you can lose muscle mass and strength. You don't need a gym
or fancy equipment to get a workout. In fact, you don't even have to
leave home. For more on how to get a strength training workout at home,
see "No Time for the Gym Today? Try This at Home." • Indoor Exercise —
Getting some aerobic activity and exercise at home is not nearly as
challenging as you might imagine. If you don’t have a favorite aerobic
workout video, consider climbing the stairs or purchasing a stationary
bike, which can be delivered straight to your door. • Nitric Oxide Dump —
Your home exercise routine wouldn’t be complete without the Nitric Oxide
Dump developed by Dr. Zach Bush. The routine I demonstrate in the video
below works best if you complete it three times a day, waiting at least
two hours between sessions, which is how long it takes for nitric oxide
to synthesize in your body for subsequent release.
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