Unit Two

2. The Health Benefits of Physical Activity

2.1. Physical Activity and Hypokinetic Diseases/Conditions
 Hypokinetic diseases are conditions related to inactivity or low levels of
habitual activity.
 Hypokinetic diseases are conditions that occur from a sedentary lifestyle.
 "Hypo" means less and "kinetic" means movement.
 Hypo Kinetic Diseases-a diseases or conditions caused by less or lack of
regular physical activity.
 The human body is designed for movement and strenuous physical activity,
exercise is not a part of the average lifestyle.
 Physical inactivity has led to a rise in chronic diseases.

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 Individuals who do not exercise regularly are at a greater risk for developing chronic diseases
such as:
o coronary heart disease (CHD),
o hypertension,
o hypercholesterolemia,
o cancer,
o obesity, and musculoskeletal disorders.
o One of the most significant harmful effects of modern-day technology has been an increase in
chronic diseases that related to a lack of physical activity.

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 Physical activity lowers the risk of hypokinetic conditions including:
 dying prematurely,
 coronary artery disease,
 stroke,
 type 2 diabetes,
 metabolic syndrome,
 high blood lipid profile,
 cancers (colon, breast, lung, and endometrial), and hip fractures.
 It also reduces abdominal obesity and feeling of depression and anxiety.
Physical activity helps in:
 weight loss,
 weight maintenance and prevention of weight gain,
 prevention of fails, and improved functional health,
 improved cognitive function, increased bone density, and improved quality of sleep.

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 The Exercise and Physical Activity Pyramid illustrates a balanced plan of
physical activity and exercise to promote health and to improve physical fitness,
 You should encourage your clients to engage in physical activities around the
home and workplace on a daily basis to establish a foundation (base of pyramid)
for an active lifestyle.
 They should perform aerobic activities a minimum of 3 days/week;
 They should do weight-resistance exercises and flexibility or balance exercises at
least 2 days per week.
 Recreational sport activities (middle levels of pyramid) are recommended to add
variety to the exercise plan.
 High-intensity training and competitive sport (top of pyramid) require a solid
fitness base and proper preparation to prevent injury; most adults should engage
in these activities sparingly or carefully.
 So, daily physical activity is the base for physical fitness
 Try to be active for at least 30 min every day

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 2.2. Physical Activity and Cardiovascular Diseases
1) Coronary Heart Disease (CHD)
• Coronary Heart Disease (CHD) is disease of heart muscle and blood vessels inside the
heart.
• CHD is caused by a lack of blood supply to the heart muscle (myocardial ischemia)
resulting from a progressive, degenerative or worsening disorder known as
atherosclerosis.
• The Atherosclerosis (sometimes is called “hardening” or “clogging” of the arteries) is
the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the
arteries.
• The human heart is an organ that pumps blood throughout the body via the circulatory system, supplying
oxygen and nutrients to the tissues and removing carbon dioxide and other wastes
• The heart has four chambers: two atria and two ventricles.
• The right atrium receives oxygen-poor blood from the body and pumps it to the right ventricle.
• The right ventricle pumps the oxygen-poor blood to the lungs.
• The left atrium receives oxygen-rich blood from the lungs and pumps it to the left ventricle.
• The left ventricle pumps the oxygen-rich blood to the body

systemic vessels are arteries that carry oxygen-rich blood from the heart's left ventricle to the
tissues in all parts of the body
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• These plaques(signs) can restrict blood flow to the heart muscle by physically
clogging(blocking) the artery or by causing abnormal artery tone and function)
 The coronary heart diseases include: Coronary occlusion (heart attack), atherosclerosis,
arteriosclerosis, and angina pectoris. ( for chest pain or discomfort due to coronary
heart disease.)
The positive risk factors for CHD are:
1) Age,
2) Family History,
3) Hypercholesterolemia,
4) Hypertension,
5) Tobacco use,
6) Diabetes Mellitus or Prediabetes,
7) Overweight and Obesity, and
8) Physical Inactivity.

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Physical Activity and Coronary Heart Disease
 Leading a physically active lifestyle may prevent 20% to 35% of cardiovascular
diseases.
 Physical activity exerts its effect independently of smoking, hypertension,
hypercholesterolemia, obesity, diabetes, and family history of CHD.
 example:- Brisk walking, running, swimming, cycling, playing tennis and jumping
rope. Heart-pumping aerobic exercise is the kind that recommend at least 150 minutes
per week of moderate activity.
2) Hypertension
 Hypertension, or high blood pressure,
 A condition in which the force of the blood against the artery walls is too high.
 Blood pressure is measured using two numbers: The first number, called
 systolic blood pressure,
 measures the pressure in your arteries when your heart beats.
 diastolic blood pressure,
 measures the pressure in your arteries when your heart rests between beats
 A clear link exists between hypertension and cardiovascular disease.
 Hypertension is also the primary risk factor for all types of stroke.
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• Stress related habits such as using tobacco or drink alcohol
can lead to further increase in blood pressure.
• Diastole is defined by the following characteristics:
• Diastole is when the heart muscle relaxes.
• When the heart relaxes, the chambers of the heart fill with blood, and
a person’s blood pressure decreases.
• Systole is defined by the following characteristics:
• Systole is when the heart muscle contracts.
• When the heart contracts, it pushes the blood out of the heart and into
the large blood vessels of the circulatory system. From here, the blood
goes to all of the organs and tissues of the body.
• During systole, a person’s blood pressure increases.

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• Diastole and systole affect a person’s blood pressure differently, as follows:
• When the heart pushes blood around the body during systole, the pressure
placed on the vessels increases. This is called systolic pressure.
• When the heart relaxes between beats and refills with blood, the blood
pressure drops. This is called diastolic pressure.

• If your systolic blood pressure is higher than 130 but your diastolic blood
pressure is under 80, that's called isolated systolic hypertension. It's the
most common kind of high blood pressure in older people.

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 Blood Pressure Levels

systolic: less than 120

Normal mm Hg diastolic: less
than 80 mm Hg

systolic: 120–139 mm Hg
At Risk (prehypertension)
diastolic: 80–89 mm Hg

systolic: 140 mm Hg or
High Blood Pressure
higher diastolic: 90 mm
(hypertension)
Hg or high

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 Regular physical activity prevents hypertension and lowers blood pressure in younger and older
adults who are normotensive, pre-hypertensive, 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.
 The ACSM endorsed or recommend the following exercise prescription to lower blood pressure in
adults with hypertension.

Exercise Prescription for Individuals with Hypertension

Mode: Primarily endurance activities supplemented by resistance exercises.

Intensity: Moderate-intensity endurance (40–60% VO2R)* and resistance training (60–80% 1-RM)
Duration: 30–60 min or more of continuous or accumulated aerobic physical activity per day, and a
minimum of one set (8–12 reps) of resistance training exercises for each major muscle group.
Frequency: Most, preferably all, days of the week for aerobic exercise; 2 or 3 days/week for resistance
raining. *VO2R is the difference between the maximum and the resting rate of oxygen consumption.

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3) Hyper-Cholesterolemia and Dyslipidemia
 Hypercholesterolemia, is an elevation of total cholesterol (TC)
in the blood, is associated with increased risk for CVD.
 Hypercholesterolemia is also referred to as:-
hyperlipidemia, which is an increase in blood lipid levels;
dyslipidemia refers to an abnormal blood lipid profile.
 The two major types of lipids found in the blood are
triglycerides and cholesterol.
 Triglycerides are made when your body stores the extra calories
it doesn't need for energy. store unused calories and provide your
body with energy
 Approximately 18% of strokes and 56% of heart attacks are
caused by high blood cholesterol.
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 Age,
 gender,
 family history,
 alcohol,
 smoking are risk factors for hypercholesterolemia and regular activity
reduced the chance of getting hypercholesterolemia and dyslipidemia.
 Cholesterol is a waxy, fatlike substance found in all animal products (meats,
dairy products, and eggs).
 The body can make cholesterol in the liver and absorb it from the diet.

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 Cholesterol is essential to the body, and it is used to
 build cell membranes,
 to produce sex hormones, and
 to form bile acids necessary for fat digestion.
 Total cholesterol levels less than 200 milligrams per deciliter
(mg/dL) are considered desirable for adults.
 A reading between 200 and 239 mg/dL is considered borderline high and a
reading of 240 mg/dL and above is considered high

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 Lipoproteins are an essential part of the complex transport
system that exchanges lipids among the liver, intestine, and
peripheral tissues.
 Lipoproteins are classified by the thickness of the protein
shell that surrounds the cholesterol. They are: LDLs, HDLs,
and TC:
 There are two types of lipoprotiens: high-density lipoprotein (HDL) and
low-density lipoprotein (LDL).

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 As a general rule, HDL is considered “good” cholesterol, while LDL is
considered “bad.” This is because:-
 HDL carries cholesterol to your liver, where it can be removed from your
bloodstream before it builds up in your arteries.
 LDL, on the other hand, takes cholesterol directly to your arteries. This
can result in atherosclerosis, a plaque build-up that can even cause heart
attack and stroke
 Physical Activity and Lipid Profiles:
 Regular physical activity, especially habitual aerobic exercise,
positively affects lipid metabolism and lipid profiles.

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4) Diabetes Mellitus
 Diabetes mellitus (sugar diabetes) refers to a
group of metabolic disorders characterized by
chronic hyperglycaemia (elevated blood glucose
concentrations).
 Factors linked to this epidemic (widespread)
include:
 aging, physical inactivity,
 unhealthy diet, and obesity.
 Early warning signs of diabetes mellitus are
excessive thirst and frequent urination.
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 This is due to glucose being filtered out of the blood
in the kidneys and then excreted in urine.
 Hence the term ‘diabetes’ (meaning ‘siphon’ (draw
off)) ‘mellitus’ (meaning ‘sweet’).
 There are two main forms of diabetes, termed: Type
1 and Type 2 Diabetes.

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i. Type 1 Diabetes
 Type 1 diabetes is also known as juvenile onset diabetes because it usually
begins in youth.
 Type 1 diabetes is formerly referred/known to as insulin-dependent
diabetes mellitus (IDDM), usually occurs before age 30 but can develop
at any age.
 Type 1 diabetes involves an insulin deficiency/lack, due to an autoimmune
destruction of the insulin producing b-cells in the pancreas.
 Insulin:- it helps your body turn food into energy and control your blood
sugar level.
 The pancreas doesn’t make insulin because the body immune system
attacks the cells in the pancreas that makes insulin.
 Beta cells are cells that makes insulin a hormon that control the level of
glucose (type of sugar) in the blood.so in type 1 diyabets the bodys
immune system mistakenly destroys the beta cell.

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 The only way to prevent hyper-glycaemia (having too high a level of blood
sugar) in type 1 diabetes is by using insulin injections.
 Type 1 diabetes may be caused by autoimmune, genetic, or environmental
factors, but the specific cause is unknown. Unfortunately, there is no known
way to prevent type-1 diabetes.

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ii. Type 2 diabetes
 Type 2 diabetes is sometimes referred to as adult (or
maturity) onset diabetes because it usually (though not
always) begins in adulthood.
 Type 2 diabetes is characterized by insulin resistance
(although insulin production may also be impaired or
decreased).
 Insulin deficiency and insulin resistance are a problem
because insulin acts as a signal for liver cells, muscle
cells and adipocytes to take up and store glucose.
 The pancreas makes less insulin than used to and your
body becomes resistant to insulin.
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 An important determinant of type 2 diabetes risk is
obesity.
 Nearly 90% of cases of type 2 diabetes may be
related to obesity.
 Left untreated, insulin deficiency and insulin
resistance or opposition will lead to hyper-glycaemia
(too much sugar in the blood) which is associated
with damage to blood vessel walls and to nerves.
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• Insulin Resistance Treatment and Prevention
1. Exercise. Go for at least 30 minutes a day of moderate activity (like brisk
walking) Get to a healthy weight. If you're not sure what you should
weigh or how to reach a weight loss goal, ask your doctor.
2. Eat a healthy diet.
3. Take medications..
.

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o Also, diabetes is among the leading causes of kidney failure; 10% to
20% of people with diabetes die of kidney failure
 Age,
 gender,
 family history,
 calorie intake,
 physical inactivity are risk factors for developing diabetes.
 healthy nutrition and increased physical activity, can reduce the risk of
type 2 diabetes by as much as 67% in high-risk individuals.
 Both resistance and aerobic exercise alone or in combination improve
HbA1c values in people with type 2 diabetes.

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 A blood sugar level less than 140 mg/dL (7.8 mmol/L) is
normal.
 A reading of more than 200 mg/dL (11.1 mmol/L) indicates
diabetes.
 A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0
mmol/L) indicates prediabetes

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5) Obesity and Overweight
 Obesity is a condition involving an excessive
accumulation of body fat such that health is endangered.
 Obesity is often defined using the body mass index (BMI),
which is calculated by dividing weight (in kilograms) by
height (in meters) squared, i.e. kg/m2.
 below 18.5 – you're in the underweight range.
 between 18.5 and 24.9 – you're in the healthy weight
range.
 between 25 and 29.9 – you're in the overweight range.
 between 30 and 39.9 – you're in the obese range.

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• Obese individuals have a shorter life expectancy and greater risks of CHD,
• stroke,
• dyslipidemia, hypertension, diabetes mellitus, certain cancers,, sleep apnea,
abnormal menses, and infertility.
• It is generally accepted that obesity is caused by an imbalance between
energy intake (food) and energy expenditure (physical activity).
• Thus, if energy consumption exceeds energy expenditure weight gain will
occur and if this pattern continues over months and years then obesity will
follow.
• obesity is due to too much food and too little exercise.
So, restricting caloric intake and increasing caloric expenditure through
physical activity and exercise are effective ways of reducing body weight
and fatness while normalizing blood pressure and blood lipid profiles.

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6) Metabolic Syndrome
 Metabolic syndrome refers to a combination of CVD risk factors
associated with hypertension, dyslipidemia, insulin resistance, and
abdominal obesity.
 Age and BMI directly relate to metabolic syndrome.
 Lifestyle must be modified in order to manage metabolic syndrome.
 The combination of healthy nutrition and increased physical activity is an
effective way to
 increase HDL-C and
 to reduce blood pressure,
 body weight,
 triglycerides, and blood glucose levels.

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7) Aging
o A sedentary lifestyle and lack of physical activity reduce life expectancy
by predisposing the individual to aging-related diseases and by
influencing the aging process itself.
o With aging, a progressive loss of physiological and metabolic functions
occurs; however, biological aging may differ considerably among
individuals due to variability in genetic and environmental factors that
affect oxidative stress and inflammation.
o Telomeres are repeated DNA sequences that determine the structure and
function of chromosomes. With aging and diseases associated with
increased oxidative stress (e.g., CHD, diabetes mellitus, osteoporosis, and
heart failure), telomere length decreases. Thus, regular exercise benefits in
retarding the aging process and diminishing the risk of aging-related
diseases.

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i. Musculoskeletal Diseases and Disorders
 Diseases and disorders of the musculoskeletal system, such as
 osteoporosis,( loss of BONE mass)
 osteoarthritis,( deterioration, joint degeneration, joint narrowing, bone-on-
bone, calcium deposits, bone spurs, joint diminishment )
 bone fractures,
 connective tissue tears, and
 low back syndrome, are also related to physical inactivity and a sedentary
lifestyle.
 Osteoporosis is a disease characterized by the loss of bone mineral content
and bone mineral density due to factors such as aging, amenorrhea,
malnutrition, menopause, and physical inactivity.
 Osteopenia, or low bone mineral mass, is a precursor to osteoporosis.
 More than one of every two adults aged 50 or older has either osteoporosis
or osteopenia.
 Adequate calcium intake, vitamin D intake, and regular physical activity
help counteract age-related bone loss.
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ACSM suggests the following exercise prescription to help counteract bone
loss due to aging and preserve bone health during adulthood:
i. Mode: Weight-bearing endurance activities (e.g., stair climbing, jogging),
activities that involve jumping (e.g., basketball, plyometric), and
resistance training
ii. Intensity: Moderate to high, in terms of bone-loading forces
iii. Frequency: 3–5 times per week for weight-bearing endurance activities;
2 or 3 times per week for resistance exercise
iv. 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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ii. Low back pain afflicts millions of people each year.
 More than 80% of all low back problems are produced by muscular
weakness or imbalance caused by a lack of physical activity.
 If the muscles are not strong enough to support the vertebral column in
proper alignment, poor posture results and low back pain develops.
 Excessive weight,
 poor flexibility, and
 improper lifting habits also contribute to low back problems.
 While some risks of associated with low back pain are not modifiable,
such as
 gender and age,
 lifestyle behavior such as smoking, physical inactivity,
flexibility, and muscular strength and endurance can all be
improved.
 Low back problem can be corrected through an exercise program that
develops strength and flexibility in the appropriate muscle groups.

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Unit Summary
• Major chronic diseases associated with a lack of physical activity are CVDs, diabetes, obesity, and
musculoskeletal disorders.
• Cardiovascular diseases are responsible for 30% of all deaths worldwide.
• The positive risk factors for CHD are the following: age, family history, dyslipidemia, hypertension,
tobacco use, pre-diabetes or glucose intolerance, obesity, and physical inactivity.
• The prevalence of obesity is on the rise, especially in developed countries; two of every three adults
and more than one of every three adolescents and children are overweight or obese.
• BMI is used to identify and classify individuals as overweight or obese. Cutoff values for obesity,
however, may vary depending on ethnicity.
• Metabolic syndrome is a term used to describe individuals who have three or more cardiovascular
disease risk factors.
• Osteoporosis and low back syndrome are musculoskeletal disorders afflicting millions of people
each year.
 To benefit health and prevent disease, every adult should accumulate a minimum of 150 min/week of
moderate-intensity physical activity or 75 min/week of vigorous-intensity physical activity.
 For additional health benefits, increase physical activity to 300 min/week and 150 min/week,
respectively, for moderate- and vigorous-intensity exercise.

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