Benefits of Exercise on Health

compiled by John G. Connor, M.Ac., L.Ac.  edited by Barbara Connor, M.Ac., L.Ac.  April 24, 2013

Table of Contents

Herbs and Nutrients and Exercise
Benefits of Acupuncture in Exercise
Risks of Specializing in One Sport and Training Intensively
Risks of 24 Hour Ultramarathons
Effects of Exercise on Blood Markers
Benefits of Exercise on Different Conditions & Groups: 
Anxiety, Cancer, Cardiovascular Disease, Chronic Disease 
Memory & Cognition 
Muscle Strength 
Old Age
Parkinson’s Disease 
Postmenopausal Women
Rheumatoid Arthritis 
Traumatic Brain Injury
Weight and Fat Loss

Barbara and I feel that exercise is not only an important part of staying fit but it contributes to our well being in so many ways.  We have put together this little compilation in hopes that it may give you a deeper appreciation of the many ways exercise can help in our quest for optimal health.The importance of physical exercises for a healthy aging process is not a groundbreaking discussion; yet, it is evermore an extremely relevant issue. Hippocrates, over 400 years BC, already suggested that the safest way to health would be the right amount of physical activity and nourishment. A long time has passed ever since, and until today studies confirm the relation between an active life style and health, demonstrating that the higher the level of physical capacity, the lower the risks of all-cause mortality. (Andrea Deslandes 2013)

Specifically, exercise contributes to the prevention of several cardiovascular and metabolic diseases. Also, recent studies have shown that exercise is not only good for the heart, lungs, vessels, muscles and bones, but it also improves the health of the brain. Physical exercise may contribute to the improvement of cognitive and behavioral functioning through neurobiological mechanisms necessary for neurogenesis, angiogenesis, synaptogenesis and plasticity. So, as aging speeds up degenerative processes, like sarcopenia, osteoporosis and cerebral atrophy, physical exercise increases lean body mass, bone mineral density and the formation of new neurons and neuroplasticity. (Andrea Deslandes 2013)

Among middle-aged and older males, specifically, physical activity has been found to be inversely associated with coronary heart disease (CHD) risk, hypertension, cancer mortality, and cardiovascular disease (CVD) mortality. Further, greater leisure time physical activity, has been associated with reduced diabetes risk, while high lifetime occupational physical activity has been shown to be protective against colon and prostate cancer in adult males. (George et al 2013) 

The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults.

The American College of Sports Medicine recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. (Garber et al 2011)

The exercise program should be modified according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. (Garber et al 2011)

Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. All older adults should engage in regular physical activity and avoid an inactive lifestyle. (American College of Sports Medicine et al 2009)

Regular exercise offers protection against all-cause mortality, primarily by protection against atherosclerosis, Type 2 diabetes, colon cancer, and breast cancer. In addition, physical training is effective in the treatment of patients with ischemic heart disease, heart failure, Type 2 diabetes, and chronic obstructive pulmonary disease. (Petersen & Pedersen 2005) An important idea that has emerged in cognitive science is that the body influences the mind. The embodied cognition approach suggests that motor output is integral to cognition, and the converging evidence of multiple avenues of research further indicate that the role of our body in memory processes may be much more prevalent than previously believed. (Madan & Singhal 2012)

Herbs and Nutrients and Exercise
American Ginseng – The major finding of this investigation was that the production of plasma creatine kinase (CK) during exercise significantly decreased for group American Ginseng  (AG) over group P (P<0.05).In conclusion, a 4-wk AG supplementation reduced the leakage of CK from skeletal sarcoplasm into blood streaming during an exhaustive treadmill run, but did not enhance aerobic work capacity. The reduction of plasma CK level may be due to AG that is effective for the decrease of skeletal muscle cell membrane damage induced by exercise during the high intensity treadmill run. (Hsu et al 2005)

Antioxidants – The beneficial effects of exercise and a healthy diet are well documented in the general population, but poorly understood in elite athletes. Previous research in sub-elite athletes suggest regular training and an antioxidant-rich diet enhances antioxidant defences, but not performance. With the exception of glutathione peroxidise GPx, there were small to moderate increases with exercise for all markers. Training status correlates more strongly with antioxidant status than diet. (Braakhuis et al 2013) Foods rich in antioxidants are cranberries, blueberries, raspberries, blackberries, beans, artichokes, Russet potatoes, prunes, apples and pecans. (

Ashwagandha (Withania somnifera) – The present study was designed and performed to assess the effects of Withania somnifera and Terminalia arjuna (Arjuna) on physical performance and cardiorespiratory endurance in healthy young adults. The authors concluded that Withania somnifera may be useful for generalized weakness and to improve speed and lower limb muscular strength and neuro-muscular co-ordination. (Sandhu et al 2010)

Bovine colostrum – There is convincing evidence that daily supplementation with bovine colostrum, for a number of weeks (and preliminary evidence for acute effects after a single dose), can maintain intestinal barrier integrity, immune function and reduce the chances of suffering URTI or URT symptoms in athletes or those undertaking heavy training. In summary, the balance of existing evidence does support the notion that bovine colostrum is beneficial for certain groups of athletes, such as those involved in strenuous training (e.g. endurance athletes), in terms of immunity and resistance to infection. (Davison G 2012)

Cholecalciferol therapy augments muscle mitochondrial maximal oxidative phosphorylation after exercise in symptomatic, vitamin D-deficient individuals. This finding suggests that changes in mitochondrial oxidative phosphorylation in skeletal muscle could at least be partly responsible for the fatigue experienced by these patients. For the first time, we demonstrate a link between vitamin D and the mitochondria in human skeletal muscle. (Sinha et al 2013)

Creatine and sodium bicarbonate supplementation independently increase exercise performance, but it remains unclear whether combining these 2 supplements is more beneficial on exercise performance. The purpose of this study was to evaluate the impact of combining creatine monohydrate and sodium bicarbonate supplementation on exercise performance. Combining creatine and sodium bicarbonate supplementation increased peak and mean power and had the greatest attenuation of decline in relative peak power over the 6 repeated sprints. These data suggest that combining these 2 supplements may be advantageous for athletes participating in high-intensity, intermittent exercise. (Barber et al 2013)

Creatine supplementation significantly increased body weights of the athletes of endurance trial. Plasma lactate concentration and ratio of f-TRP/BCAAs after recovery from endurance running were significantly decreased with creatine supplementation. Plasma purine metabolites (the sum of hypoxanthine and uric acid), glutamine, urinary 3-methylhistidine, and urea nitrogen concentrations tended to decrease before running in trials with creatine supplements. After running, urinary hydroxyproline concentration significantly increased in the power trial with creatine supplements. The findings suggest that creatine supplementation tended to decrease muscle glycogen and protein degradation, especially after endurance exercise. However, creatine supplementation might induce collagen proteolysis in athletes after sprint running. (Tang et al 2013)

Echinacea, Rhodiola, Ginseng – In this review we try to find out if the most common herbal supplements (Echinacea, Rhodiola, Ginseng) are effective in the empowerment of performance or in the modulation of the immune system. It seems that the prevalent effect is adaptogenic rather than ergogenic, with a better tolerance of the exercise induced stress, related to enhancement of the whole immune system and decrease of the oxidative damage. (Megna et al 2012)

Eleutherococcus senticosus  – The root of Acanthopanax senticosus (also called Eleutherococcus senticosus or Siberian ginseng) has been used extensively in China, Russia and Japan as an adaptogen to fight against stress and fatigue. This animal study was designed to ascertain the anti-fatigue property of Acanthopanax senticosus by load-weighted swimming test, sleep deprivation test, also to isolate and characterize the active constituents.  The eleutherosides possess the potent abilities to alleviate fatigue both in physical and mental fatigue. Eleutheroside E may be responsible for the pharmacological effect of anti-fatigue. Furthermore, the possible mechanisms were it reduced the level of TG by increasing fat utilization, delayed the accumulation of blood urea nitrogen (BUN), and increased the LDH to reduce the accumulation of lactic acid in muscle and then protect the muscle tissue. (Huang et al 2011) 

Eleutherococcus senticosus – This is the first well-conducted double-blind, randomized, placebo controlled and crossover study that shows that 8-week Eleutherococcus senticosus supplementation enhances endurance capacity, elevates cardiovascular functions and alters the metabolism for sparing glycogen in recreationally trained males. Subjects cycled at 75% VO2 peak until exhaustion. (Kuo et al 2010)

Eleutherococcus senticosus – We compared the effects of the water extracts (A, B, C, D and E) of five Eleutherococcus senticosus cortex on the swimming time, natural killer (NK) activity and blood corticosterone level using forced swimming stressed mice. It is suggested that eleutheroside E may be contributed to the anti-fatigue action, the recovery of the reduction of NK activity and the inhibition of corticosterone elevation induced by swimming stress. (Kimura & Sumiyoshi 2004)

 Fish oil – Our findings in this animal study suggest that fish oil supplementation, initiated from prenatal period to midlife, and physical exercise program applied throughout the life induced distinctly a better cognitive performance. (Rachetti et al 2013) 

Lactobacillus fermentum VRI-003 (PCC) – Prophylactic administration of PCC was associated with a substantial reduction in the number of days and severity of respiratory illness in a cohort of highly trained distance runners. Maintenance of IFNgamma levels may be one mechanism underpinning the positive clinical outcomes. (Cox et al 2010)

Lactobacillus casei Shirota (LcS) – Regular ingestion of LcS appears to be beneficial in reducing the frequency of upper respiratory-tract infections (URTIs) in an athletic cohort, which may be related to better maintenance of saliva IgA levels during a winter period of training and competition. (Gleeson et al 2011)Oat beta-glucan (purified from oat bran) -The results showed feeding dietary oat β-glucan to rats could significantly reduce the body weight and increase the maximum running time compared with normal control (P<0.05). Furthermore, dietary oat β-glucan decreased the levels of blood urea nitrogen, lactate acid, and creatine kinase activity in serum, and increased the levels of non-esterified fatty acids, lactic dehydrogenase activity in serum, and the content of liver glycogen. Therefore, the present study demonstrated that dietary oat β-glucan can enhance the endurance capacity of rats while facilitating their recovery from fatigue. (Xu et al 2013)

Panax notoginseng (PNG) – Based on this study, we conclude that 1,350 mg per day PNG supplement for 30 days improved endurance time to exhaustion, and lowered mean blood pressure and Vo2 during endurance exercise. (Liang et al 2005) In CorydalisQuercetin and vitamin C – Supplementation with quercetin and vitamin C for 8 weeks did not improve exercise performance but reduced muscle damage and body fat percent in healthy subjects. (Askari et al 2012)

Quercetin and Lactobacillus probiotics – Evidence is accumulating that some nutritional supplements including flavonoids such as quercetin and Lactobacillus probiotics can augment some aspects of immune function and reduce illness rates in exercise-stressed athletes. (Walsh et al 2011)

Resveratrol – In this animal study resveratrol (RES) supplementation produced dose-dependent decreases in serum lactate and ammonia levels and creatine kinase (CK) activity and also an increase in glucose levels in dose-dependent manners after the 15-min swimming test. The mechanism was related to the increased energy utilization (as blood glucose), and decreased serum levels of lactate, ammonia, and CK. Therefore, RES could be a potential agent with an anti-fatigue pharmacological effect. (Wu et al 2013)

Resveratrol – Exercise training (ET) improves endurance capacity by increasing both skeletal muscle mitochondrial number and function, as well as contributing to favourable cardiac remodeling. Interestingly, some of the benefits of regular exercise can also be mimicked by the naturally occurring polyphenol, resveratrol. However, it is not known whether resveratrol resveratrol enhances physiological adaptations to ET. Overall, the findings in this animal study provide evidence that the capacity for fatty acid oxidation is augmented by the addition of resveratrol to the diet during ET. (Dolinsky et al 2012) I

Rhaponticum carthamoides – Soviet and Russian athletes have used and still use rhaponticum to improve athletic performance, endurance, and recovery from intensive training. Regular use of this herb promotes the building of muscle tissue, enhances the excretion of uric and lactic acid, and stimulates blood flow to the muscles and brain. (Winston & Maines, Adaptogens : Herbs for Strength, Stamina, and Stress Relief; Healing Arts Press, 2007, page 189)

Rhodiola rosea – Chronic Rhodiola rosea supplementation significantly improved exhaustive swimming-induced fatigue in this animal study by the increased glycogen content, energy supply of lipogenic enzyme expressions and protective defense mechanisms. (Lee et al 2009)

Rhodiola rosea – The purpose of this double blind placebo-controlled randomized study was to investigate the effect of acute and 4-week Rhodiola rosea intake on physical capacity, muscle strength, speed of limb movement, reaction time, and attention. Acute Rhodiola rosea intake can improve endurance exercise capacity in young healthy volunteers. This response was not altered by prior daily 4-week Rhodiola intake. (De Bock et al 2004)

Sodium bicarbonate supplementation is likely to be beneficial to the performance of those competing in 2000m rowing events, particularly in the second half of the event. (Hobson et al 2013)

Taurine – Additional supplementation of Taurine with branched-chain amino acids would be a useful way to attenuate delayed-onset muscle soreness and muscle damages induced by high-intensity exercise. (Ra et al 2013)

Benefits of Acupuncture in Exercise
In addition to its curative properties in various chronic conditions, demonstrated by the number of clinical trials, acupuncture has been recently applied as an enhancer of sports performance. Reviewed studies of published literature on the use of acupuncture in resistance and endurance sports activities demonstrated the association of traditional acupuncture protocol with increase of muscular strength and power. In cases regarding endurance activities, acupuncture treatment improved hemodynamic parameters of participants but not their aerobic performance. (Ahmedov S 2010)

Risks of Specializing in One Sport and Training Intensively
Young athletes who specialize in one sport and train intensively have a significantly higher risk of stress fractures and other severe overuse injuries, even when compared with other injured athletes, according to the largest clinical study of its kind. For example, young athletes who spent more hours per week than their age playing one sport – such as a 12-year-old who plays tennis 13 or more hours a week – were 70 percent more likely to experience serious overuse injuries than other injuries. (Science Daily, Apr. 19, 2013)
“We should be cautious about intense specialization in one sport before and during adolescence,” Jayanthi said. Loyola University Medical Center sports medicine physician Dr. Neeru Jayanthi presented findings during an oral podium research session April 19 at the American Medical Society for Sports Medicine (AMSSM) meeting in San Diego. The study is titled “Risks of Specialized Training and Growth in Young Athletes: A Prospective Clinical Cohort Study.” (Science Daily, Apr. 19, 2013)

Risks of 24 Hour Ultramarathons
Twenty male runners were selected for evaluation a day before and immediately after the race, where the athletes had to cover the most distance in 24 hours. Clinical, laboratory and echocardiographic data were obtained at both evaluations. Mean distance covered was 140.3 ± 18.7 km. Runners showed weight loss (p < 0.001) and decrease in systolic (p < 0.001) and diastolic (p = 0.004) blood pressure. Hematological changes were compatible with the physiological stress. Plasma levels of creatine phosphokinase strikingly increased post-race (163.4 ± 56.8 vs. 2978.4 ± 1921.9 U/L; p < 0.001) and was inversely correlated with distance covered: those who covered the longest distances showed the lowest CPK levels (Pearson r = 0.69, p = 0.02). After the race, 2 runners showed a slight increase in Troponin levels. One of them also had simultaneous decrease in left ventricular ejection fraction (coronary artery disease was subsequently ruled out). Basal echocardiography assessment had shown LV hypertrophy in one and increased left atrial volume in five runners. After the race, there was a decrease in E/A ratio (p < 0.01). Prolonged physical exercise is associated with metabolic and cardiovascular alterations. Cardiac abnormalities found in our study suggest that cardiac fatigue may occur in this specific race modality. The long-term effect of these alterations, while maintaining the routine practice of prolonged strenuous physical activity, is still unknown. (Passaglia et al 2013)

Effects of Exercise on Blood Markers
TNF-α, IL-1β, IL-6 and IL-1ra, creatine kinase – This study compared the cytokine response to exhaustive running in recreationally-active and endurance-trained men. Creatine kinase concentrations were increased (P < 0.001) throughout exercise and up to follow-up day 4, peaking at follow-up day 1, but were not associated with changes in any cytokines. Exhaustive running resulted in modest and transient increases in TNF-α and IL-1β, and more marked and prolonged increases in IL-6 and IL-1ra, but improved training status did not affect this response. Increased creatine kinase might indicate either exercise-induced muscle cell disruption or increased cell permeability, although neither appears to have contributed to the increased cytokine concentrations. (Scott et al 2013)

Regular exercise reduces CRP, IL-6, and TNF-αlevels and also increases anti-inflammatory substances such as IL-4 and IL-10. In healthy young adults, a 12-week high-intensity aerobic training program down regulates cytokine release from monocytes. In fact, even leisure time physical activity (e.g., walking, jogging, or running, etc.) reduces hs-CRP concentration in a graded manner. Subjects with higher baseline CRP levels (>3.0mg/L) will benefit more. (Golbidi & Laher 2012)

Brain-derived neurotrophic factor (BDNF) – Findings suggest that brain-derived neurotrophic factor (BDNF) signaling in specific brain regions mediates some of the beneficial effects of exercise and energy restriction on peripheral energy metabolism and the cardiovascular system. (Rothman & Mattson 2013)

Antioxidant enzymes – Exercise also resulted in an increase in mitochondrial antioxidant enzymes (copper-zinc superoxide dismutase, manganese superoxide dismutase, and glutathione peroxidase) and prevented the ischemia-reperfusion (IR)-induced release of proapoptotic proteins from the mitochondria. Collectively, these novel findings reveal that exercise-induced cardioprotection is mediated, at least in part, through mitochondrial adaptations resulting in a mitochondrial phenotype that resists IR-induced damage. (Lee et al 2012)

Glucose, HbA1c, high-density lipoprotein (HDL) cholesterol, and triglycerides – After adjusting for weight change, fitness was independently associated (p < 0.05) with improvements in R(2 )for glucose (+0.7%), HbA1c (+1.1%), high-density lipoprotein (HDL) cholesterol (+0.4%), and triglycerides (+0.2%) in intensive lifestyle intervention (ILI) and diastolic BP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in diabetes support and education (DSE). Taken together, weight and fitness changes explained from 0.1-9.3% of the variability in cardiovascular risk factor changes. Conclusion: Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. (Gibbs et al 2012)

hs-CRP, IL-6, Neutrophils, serum amyloid A –  Relative to controls, hs-CRP decreased by geometric mean (95% confidence interval, P value): 0.92 mg/L (0.53-1.31, P < 0.001) in the diet and 0.87 mg/L (0.51-1.23, P < 0.0001) in the diet + exercise groups. IL-6 decreased by 0.34 pg/mL (0.13-0.55, P = 0.001) in the diet and 0.32 pg/mL (0.15-0.49, P < 0.001) in the diet + exercise groups. Neutrophil counts decreased by 0.31 × 10(9)/L (0.09-0.54, P = 0.006) in the diet and 0.30 × 10(9)/L (0.09-0.50, P = 0.005) in the diet + exercise groups. Diet and diet + exercise participants with 5% or more weight loss reduced inflammatory biomarkers (hs-CRP, serum amyloid A (SAA), and IL-6) compared with controls. The diet and diet + exercise groups reduced hs-CRP in all subgroups of baseline BMI, waist circumference, CRP level, and fasting glucose. Our findings indicate that a caloric restriction weight loss diet with or without exercise reduces biomarkers of inflammation in postmenopausal women, with potential clinical significance for cancer risk reduction. (Imayama et al 2012)

Benefits of Exercise on Different Conditions & Groups:
To determine the short- and long-term effects of resistance training on muscle strength, psychological well-being, control-beliefs, cognitive speed and memory in normally active elderly people. An 8-week programme of resistance training lessens anxiety and self-attentiveness and improves muscle strength. (Perrig-Chiello et al 1998)

Cancer survivors experienced a positive influence of physical exercise on return to work (RtW) and work performance and a positive influence of RtW on physical exercise. By stimulating and facilitating physical exercise during and after RtW, the time to lasting RtW may be shortened, work performance may be optimized, and sustained participation in physical exercise may be achieved. The main perceived effects were “improved fitness” and “renewed energy.” Most participants thought that physical exercise had likely contributed to their ability to return to work, primarily by increasing energy levels. Some believed that physical exercise had enhanced their work performance by improving their ability to cope with demanding work. Some respondents found that a supportive work environment stimulated their continuation of physical exercise. (Groeneveld et al 2013)Cancer survival is associated with considerable physical and psychosocial burden.

Sedentary behavior (too much sitting) is now understood to be a health risk that is additional to, and distinct from, the hazards of too little exercise. Among colorectal cancer survivors, sedentary behavior may contribute to all-cause and disease-specific mortality, weight gain, comorbid cardiovascular disease, and diminished quality of life. (Lynch et al 2013)

Results from limited elderly-specific trials suggest that physical activity interventions are safe and effective in older cancer survivors, with prostate cancer survivors representing the best studied cohort of older persons with cancer. (Klepin et al 2013)

Our findings argue that obesity and physical inactivity are associated with a higher risk of CTNNB1-negative colorectal cancer but not with CTNNB1-positive cancer risk. (Morikawa et al 2013)

In a prospective cohort of men undergoing biopsy, increased exercise, measured as metabolic equivalent hours per week, was found to be associated with prostate cancer (CaP) risk reduction among white but not black men. Investigating race-specific mechanisms by which exercise modifies CaP risk and why these mechanisms disfavor black men in particular are warranted. (Singh et al 2012)

A 16-week Tai Chi exercise significantly diminished the magnitude of the decreased T1/T2 ratio in the natural course of recovery in a population of postsurgical non-small cell lung cancer survivors. Tai Chi may have a role in ameliorating the imbalance between humoral and cellular immunity, potentiating human immunity against tumors. (Wang et al 2012)

This systematic review indicates that exercise may have beneficial effects at varying follow-up periods on health-related quality of life (HRQoL) and certain HRQoL domains including physical functioning, role function, social functioning, and fatigue. Positive effects of exercise interventions are more pronounced with moderate- or vigorous-intensity versus mild-intensity exercise programs. The positive results must be interpreted cautiously because of the heterogeneity of exercise programs tested and measures used to assess HRQoL and HRQoL domains, and the risk of bias in many trials. Further research is required to investigate how to sustain positive effects of exercise over time and to determine essential attributes of exercise (mode, intensity, frequency, duration, timing) by cancer type and cancer treatment for optimal effects on HRQoL and its domains. (Mishra et al 2012 Cochrane Database Syst Rev)

Vigorous aerobic impact exercise training has potential to maintain bone structural strength and improve physical performance among breast cancer survivors. (Nikander et al 2012)

Combination exercise training including walking (2 sessions per week) and resistance training (2 sessions per week that was different from walking days) can improve metabolic syndrome parameters in postmenopausal women with breast cancer. (Nuri et al 2012)

Exercise is safe and has physiologic benefits for patients undergoing multiple myeloma treatment. (Coleman et al 2012)

The findings of the updated review have enabled a more precise conclusion to be made in that aerobic exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumours. Further research is required to determine the optimal type, intensity and timing of an exercise intervention. (Cochrane Database Syst Rev – Cramp et al 2012)

While the limited evidence base does not support an association of physical activity with either testicular or bladder cancers, a growing body of research suggests that physical activity results in a modest risk reduction for kidney cancer. A large number (>30) of studies suggests a probable small decrease in prostate cancer risk among those who are physically active, which is likely driven by the effect on advanced/aggressive tumors. The role of physical activity in decreasing urologic cancer risk is thus likely limited to advanced prostate and possibly kidney cancers with no association in testicular or bladder cancers. (Wolin & Stoll 2012)

Our results suggest that regular exercise prevents colon tumorigenesis, at least partly via the suppression of inducible nitric oxide synthase (iNOS) expression associated with anti-inflammation. (Aoi et al 2010)

Cardiovascular Disease
Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly coronary heart disease. (Williams & Thompson 2013)

Sprint interval training (SIT) has been proposed as a time efficient alternative to endurance training (ET) for increasing skeletal muscle oxidative capacity and improving certain cardiovascular functions. In sedentary males SIT and ET are effective in improving muscle microvascular density and eNOS protein content. (Cocks et al 2013)

Exercise regimens  – The American College of Cardiology/American Heart Association recommends at least 30 minutes of moderate (at 50–70% of maximal predicted heart rate) exercise on most days to reduce the risk of cardiovascular events. Patients with hypertension, type 2 diabetes, metabolic syndrome, stable cardiovascular disease, myocardial infarction, and congestive heart failure, all benefit from exercise training compared to those who do not participate in any training. Importantly, an exercise regimen that improves endothelial function in diabetic patients fails to benefit healthy subjects. In healthy individuals, a longer and more intense exercise protocol is needed to induce measureable changes in cardiovascular parameters, while older and sicker subjects can benefit from less intense exercise regimens. (Golbidi & Laher 2012)

Exercise training improved autonomic function, assessed by heart rate recovery, resting heart rate and systolic blood pressure, in the absence of changes in diet or medication. (Ribeiro et al 2012)

Exercise also resulted in an increase in mitochondrial antioxidant enzymes (copper-zinc superoxide dismutase, manganese superoxide dismutase, and glutathione peroxidase) and prevented the ischemia-reperfusion (IR)-induced release of proapoptotic proteins from the mitochondria. Collectively, these novel findings reveal that exercise-induced cardioprotection is mediated, at least in part, through mitochondrial adaptations resulting in a mitochondrial phenotype that resists IR-induced damage. (Lee et al 2012)

Exercise training
has beneficial effects on left ventricular remodeling in clinically stable post-MI (myocardial infarction) patients with greatest benefits occurring when training starts earlier following MI (from one week) and lasts longer than 3 months according to this meta-analysis. (Haykowsky et al 2011)

Increased fitness.
After adjusting for weight change, fitness was independently associated (p < 0.05) with improvements in R(2 )for glucose (+0.7%), HbA1c (+1.1%), high-density lipoprotein (HDL) cholesterol (+0.4%), and triglycerides (+0.2%) in intensive lifestyle intervention (ILI) and diastolic BP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in diabetes support and education (DSE). Taken together, weight and fitness changes explained from 0.1-9.3% of the variability in cardiovascular risk factor changes. Conclusion: Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. (Gibbs et al 2012)Stopping smoking, modifying one’s diet and exercise – This study found that individuals who change their behavior (quit smoking and modify diet and exercise) after acute coronary syndrome (ACS) are at substantially lower risk of repeat cardiovascular events.

Cardiopulmonary fitness may be a protective factor for cognition in patients with CAD. (Swardfager et al 2010)Epidemiological studies indicate that the risk of hypertension increases by being overweight. Modest increases in exercise intensity and frequency have hypotensive effects in sedentary hypertensive patients. (Yung et al 2009)There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that cardiovascular disease (CVD) is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD. (Leung et al 2008)

We suggest that regular exercise induces suppression of TNF-α and thereby offers protection against TNF-α-induced insulin resistance. Recently, IL-6 was introduced as the first myokine, defined as a cytokine that is produced and released by contracting skeletal muscle fibers, exerting its effects in other organs of the body. Here we suggest that myokines may be involved in mediating the health-beneficial effects of exercise and that these in particular are involved in the protection against chronic diseases associated with low-grade inflammation such as diabetes and cardiovascular diseases. (Petersen & Pedersen 2005)

Chronic Disease
Our findings suggest that higher volumes of sitting time are significantly associated with diabetes and overall chronic disease, independent of physical activity and other potentially confounding factors. (George et al 2013)

Aerobic exercise has been shown to improve renal and cardiac function in individuals with chronic kidney disease (CKD), and exercise has gained more attention as a possible tool for preventing, reducing or delaying CKD progression. It has been suggested that appropriate exercise may improve a patient’s physical strength and quality of life. Swimming has been increasingly prescribed as a non-pharmacological treatment for arterial hypertension, obesity and coronary heart disease. (Luiz et al 2013)

In conclusion, sprint interval training (SIT) and endurance training (ET) both increase net intramuscular triglyceride (IMTG) breakdown during exercise and increase in perilipin 2 (PLIN2) and perilipin 5 (PLIN5) protein expression. The data are consistent with the hypothesis that increases in PLIN2 and PLIN5 are related to the mechanisms that promote increased intramuscular triglyceride utilization during exercise and improve insulin sensitivity following 6 weeks of SIT and ET. (Shepherd et al 2013)

Delayed secondary biochemical and cellular changes after traumatic brain injury continue for months to years, and are associated with chronic neuroinflammation and progressive neurodegeneration. Physical activity can reduce inflammation and facilitate recovery after brain injury. Here, we investigated the time-dependent effects, and underlying mechanisms of post-traumatic exercise initiation on outcome after moderate traumatic brain injury using a well-characterized mouse controlled cortical impact model. Cognitive recovery was associated with attenuation of classical inflammatory pathways, activation of alternative inflammatory responses and enhancement of neurogenesis. In contrast, early initiation of exercise failed to alter behavioral recovery or lesion size, while increasing the neurotoxic pro-inflammatory responses. These data underscore the critical importance of timing of exercise initiation after trauma and its relation to neuroinflammation, and challenge the widely held view that effective neuroprotection requires early intervention. (Piao et al 2013)

Both exercise regimens (60-min running and 60-min swimming) were beneficial by rescuing cardiac function in chronic kidney disease victims in this animal study. Its action mechanism was by way of inhibiting myocyte death and rescuing cardiac hypertrophy. (Chen et al 2012)There is evidence for significant beneficial effects of regular exercise on physical fitness, walking capacity, cardiovascular dimensions (e.g. blood pressure and heart rate), health-related quality of life and some nutritional parameters in adults with chronic kidney disease. (Cochrane Database Syst Rev – Heiwe & Jacobson 2011)

Higher midlife fitness levels seem to be associated with lower hazards of developing all-cause dementia later in life. The magnitude and direction of the association were similar with or without previous stroke, suggesting that higher fitness levels earlier in life may lower risk for dementia later in life, independent of cerebrovascular disease. (Defina et al 2013)

There is growing interest in the use of exercise in the treatment of depression. A number of randomized controlled trials (RCTs) have demonstrated a reduction in depressive symptoms with both aerobic and non-aerobic exercise interventions. This has been supported in a number of systematic reviews and meta-analyses. (Stanton & Reabum 2013)

In this review article, literature is critically analyzed and reinterpreted for a new energy-based concept of insulin resistance, in which insulin resistance is a result of energy surplus in cells. The energy surplus signal is mediated by ATP and sensed by adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. Decreasing ATP level by suppression of production or stimulation of utilization is a promising approach in the treatment of insulin resistance. In support, many of existing insulin sensitizing medicines inhibit ATP production in mitochondria. The effective therapies such as weight loss, exercise, and caloric restriction all reduce ATP in insulin sensitive cells. (Ye J 2013)

This animal study demonstrates that previous exercise training (ET) improves the functional damage that affects diabetes mellitus (DM). Additionally, our findings suggest that the development of renal and cardiac dysfunction can be minimized by 4 weeks of ET before the induction of DM by streptozotocin. (Silva et al 2012)

 High intensity intervals and resistance training improve glycemic control and insulin sensitivity in females with a high metabolic risk. (Alvarez et al 2012)

We suggest that regular exercise induces suppression of TNF-α and thereby offers protection against TNF-α-induced insulin resistance. Recently, IL-6 was introduced as the first myokine, defined as a cytokine that is produced and released by contracting skeletal muscle fibers, exerting its effects in other organs of the body. Here we suggest that myokines may be involved in mediating the health-beneficial effects of exercise and that these in particular are involved in the protection against chronic diseases associated with low-grade inflammation such as diabetes and cardiovascular diseases. (Petersen & Pedersen 2005

)Regular physical activity mends insulin function and glucose tolerance in healthy individuals, patients with obesity, insulin resistance, and diabetics. (Golbidi et al 2012)

These data show that exercise training improves resting substrate oxidation and creates a metabolic milieu that appears to promote lipid utilization in skeletal muscle, thus facilitating a reversal of insulin resistance. We also demonstrate that leptin sensitivity is improved but that such a trend may rely on reducing caloric intake in addition to exercise training. (Solomon et al 2008)

Aerobic exercise training improves oxidative capacity and insulin sensitivity in younger and older obese and/or impaired glucose tolerant/Type 2 diabetes individuals. (Solomon et al 2008)

Overall, we conclude that physical or sport activities represent an exciting intervention that should be integrated with conventional therapy for the improvement of brain function and resistance to neurodegenerative diseases as well as a complementary non-pharmacological treatment of epilepsy. (Arida et al 2013)These data suggest that the ability of physical exercise to reduce the fluid percussion injury (FPI)-induced seizures is not related to its protection against neuronal damage; however, the effective protection of selected targets, such as Na+,K+-ATPase elicited by physical exercise, may represent a new line of treatment for post-traumatic seizure susceptibility. (Silva et al 2013)Our study demonstrated that a strength exercise program exerted a significant influence on the seizure frequency in animals with epilepsy and strengthens the observed beneficial effect of exercise on epilepsy that has been demonstrated in animal studies. (Peixinho-Pena et al 2012)

Physiological responses during rest, acute physical effort, and a recovery period were studied. Twenty-four subjects (12 with juvenile myoclonic epilepsy (JME) and 12 controls) participated in this study. Compared with the control group, the JME group had a significantly lower V˙O(2) at rest (13.3%) and resting metabolic rate (15.6%). The number of epileptiform discharges in the JME group was significantly reduced during the recovery period (72%) compared with the resting state. There were no significant differences between the JME and control groups in behavioral outcomes and sleep parameters evaluated by actigraphy monitoring. The positive findings of our study strengthen the evidence for the benefits of physical exercise for people with JME. (de Lima et al 2011)Although not statistically significant, a decrease in the number of epileptiform discharges was observed between the rest state and exercise (82%) and between the rest state and recovery period (74%). In conclusion, the lower aerobic fitness in people with epilepsy observed may be associated with their sedentary habits. Moreover, our findings reinforce the hypothesis that exhaustive exercise is not a seizure-inducing factor. (Vancini et al 2010)

Findings from animal studies indicate that exercise can modulate neuronal vulnerability to epileptic insults. Exercise treatment before a precipitating brain insult demonstrates a reduced brain susceptibility in the kindling or the pilocarpine model of epilepsy. In view of the beneficial effect of exercise during the epileptogenesis process, studies analyzed the influence of exercise after the development of chronic epilepsy. Behavioral analysis showed a reduced frequency of seizures during physical exercise program. Metabolic, electrophysiologic, and immunohistochemical studies have confirmed the positive influence of exercise on epilepsy. Taken into account that exercise can exert beneficial actions such as reduction of seizure susceptibility as observed in animal studies, and improvement of quality of life and reduction of anxiety and depression of individuals with epilepsy, physical exercise can be a potential candidate to be integrated with conventional therapy for epilepsy. (Arida et al 2010)

Acute exercise has been found to affect lymphocyte subsets, immunoglobulin levels, the activity of mononuclear phagocytic system, polymorphonuclear leukocytes and cytokine levels, especially IL-1, IL-2, IL-6 and TNF. The extreme type of immune deficiency in sportsmen, in which there are not determine different isotypes of immunoglobulins, there are described as phenomenon of Ig disappearance. The immune suppression is associated with an increased risk of subclinical and clinical infection in athletes. (Trushna et al 2012)

Aging is associated with a decline in the normal functioning of the immune system that is described by the canopy term “immunosenescence”. This contributes to poorer vaccine responses and the increased incidence of infection and malignancy seen in the elderly. Regular exercise has been associated with enhanced vaccination responses, lower numbers of exhausted/senescent T-cells, increased T-cell proliferative capacity, lower circulatory levels of inflammatory cytokines (“inflamm-aging”), increased neutrophil phagocytic activity, lowered inflammatory response to bacterial challenge, greater NK-cell cytotoxic activity and longer leukocyte telomere lengths in aging humans, all of which indicate that habitual exercise is capable of regulating the immune system and delaying the onset of immunosenescence. This contention is supported by the majority of animal studies that report improved immune responses and outcomes to viral infections and malignancies due to exercise training. However, whether or not exercise can reverse, as well as prevent, immunosenescence is a contentious issue, particularly because most longitudinal exercise training studies do not report the same positive effects of exercise on immunity that have been widely reported in studies with a cross-sectional design. (Simpson et al 2012)

Multiple components of the immune systems in athletes exhibit transient dysfunction after prolonged, heavy exertion. During this “open window” of impaired immunity, pathogens may gain a foothold, increasing infection risk. (Nieman DC 2008)Prolonged strenuous exercise is followed by a temporary functional immune impairment. Low numbers of CD4+ T helper (Th) and CD8+ T cytotoxic (Tc) cells are found in the circulation. These cells can be divided according to their cytokine profile into type 1 (Th1 and Tc1), which produce interferon-gamma and interleukin (IL)-2, and type 2 (Th2 and Tc2) cells, which produce IL-4. The question addressed in the present study was whether exercise affected the relative balance between the circulating levels of these cytokine-producing T cells. In conclusion, the postexercise decrease in T lymphocyte number is accompanied by a more pronounced decrease in type 1 T cells, which may be linked to high plasma epinephrine. Furthermore, IL-6 may stimulate type 2 T cells, thereby maintaining a relatively unaltered percentage of these cells in the circulation compared with total circulating lymphocyte number. (Steensberg et al 2001)

In obesity, circulating levels of inflammatory markers are elevated, possibly due to increased production of pro-inflammatory cytokines from several tissues/cells, including macrophages within adipose tissue, vascular endothelial cells and peripheral blood mononuclear cells. Recent evidence supports that adipose tissue hypoxia may be an important mechanism through which enlarged adipose tissue elicits local tissue inflammation and further contributes to systemic inflammation. Current evidence supports that exercise training, such as aerobic and resistance exercise, reduces chronic inflammation, especially in obese individuals with high levels of inflammatory biomarkers undergoing a longer-term intervention. Several studies have reported that this effect is independent of the exercise-induced weight loss. (You et al 2013)

Obesity and sedentary lifestyle are associated with increased oxidative stress, inflammation and vessel dysfunction. Previous research has shown that an encapsulated fruit/berry/vegetable juice powder (FBV) supplement or controlled exercise training improve the markers of redox biology, low-grade inflammation and circulation. Following 8 weeks of supplementation, compared with placebo, the FBV group had a significant (P< 0·05) reduction in carbonyl proteins* (CP), ox-LDL, total oxidation status (TOS) and TNF-α, and a significant increase in blood flow, O2 saturation of hemoglobin (SO2Hb) and relative concentration of hemoglobin (rHb). Independent of supplementation, moderate exercise significantly increased blood flow and rHb, with a trend towards increased SO2Hb. Compared with placebo, 8 weeks of supplementation with FBV decreased the markers of systemic oxidation and inflammation. Both FBV supplementation and a single walking bout improved the markers of the microcirculation in these obese women. (Lamprecht et al 2013) * Protein carbonyl content is the most widely used marker of oxidative modification of proteins. (Chevion et al 2000)

The present research was designed to evaluate the adaptive responses to oxidative stress and inflammation in handball players subjected to well-controlled training intervals over one-year of competition. Seven blood samples were collected over the season of the study, approximately one a month. Plasma lipid peroxidation, nitrite, cytokines (IL-1β, IL-6, INFγ and TNFα), and the glutathione cycle in erythrocytes, were measured. Exercise intensity, measured with the Borg’s scale, increased significantly up to the middle of the competition season, coinciding with maximal creatine kinase and lactate dehydrogenase values, and then decreased at the end of the study. The inflammatory markers including nitrite, IL-1β, IL-6, and, to a lesser extent INFγ, increased early in the training season, and remained elevated until the end of the study. TNFα, however, remained low during the season. (Concepcion-Huertas et al 2013)

The oxidative stress response included a transient increase of the glutathione disulphide/glutathione ratio and glutathione reductase activity at the beginning of the study, returning to basal values somewhat later. Glutathione peroxidase also increased at the end of the training season, and lipid peroxidation levels remained low during the athletic season. These results suggest that well-trained athletes were best adapted to the oxidative response, although the beneficial effects of some of the inflammatory cytokines on skeletal muscle myogenesis and repair cannot be ruled out. (Concepcion-Huertas et al 2013)

Chronic inflammation is involved in the pathogenesis of insulin resistance, atherosclerosis, neurodegeneration, and tumour growth. Evidence suggests that the prophylactic effect of exercise may, to some extent, be ascribed to the anti-inflammatory effect of regular exercise mediated via a reduction in visceral fat mass and/or by induction of an anti-inflammatory environment with each bout of exercise (e.g. via increases in circulating anti-inflammatory cytokines including interleukin (IL)-1 receptor antagonist and IL-10). To understand the mechanism(s) of the protective, anti-inflammatory effect of exercise fully, we need to focus on the nature of exercise that is most efficient at allieviating the effects of chronic inflammation in disease. (Walsh et al 2011)

Memory and Cognition
Taken together, the results of this 6-month randomized controlled trial provide support for the prevailing notion that exercise can positively impact cognitive functioning and may represent an effective strategy to improve memory in those who have begun to experience cognitive decline. (Nagtamatsu et al 2013)Our findings in this animal study suggest that fish oil supplementation, initiated from prenatal period to midlife, and physical exercise program applied throughout the life induced distinctly a better cognitive performance. (Rachetti et al 2013)

Results suggest that acute physical exercise enhances executive functioning. The number of studies on chronic physical exercise is limited and it should be investigated whether chronic physical exercise shows effects on executive functions comparable to acute physical exercise. This is highly relevant in preadolescent children and adolescents, given the importance of well-developed executive functions for daily life functioning and the current increase in sedentary behaviour in these age groups.  (Verburgh et al 2013) *

Executive function is the cognitive process that regulates an individual’s ability to organize thoughts and activities, prioritize tasks, manage time efficiently, and make decisions. ( the idea that physical exercise could increase memory recall ability is recent focus of research, it has been shown several decades ago in older adults (Powell, 1974; Diesfeldt and Diesfeldt-Groenendijk, 1977), and has even been shown to lead to enhanced memory abilities as much as one year later (Perrig-Chiello et al., 1998).

More recently, daily physical exercise has been shown to reduce the cognitive decline associated with aging as well as reduce the risk of developing Alzheimer’s disease (Buchman et al., 2012). (Madan & Singhal 2012)While it appears clear that exercise has beneficial effects on memory and hippocampal neurogenesis, it should also be noted that the benefits of exercise on cognition are not confined to only memory or the hippocampus, but also extend to a wider range of cognitive processes, particularly executive function and the prefrontal cortex and anterior cingulate cortex (see Hillman et al., 2008, for a review). (Madan & Singhal 2012)

Exercise significantly elevated endogenous norepinephrine (measured via the biomarker, salivary alpha-amylase) in both amnestic mild cognitive impairment (aMCI) patients and controls. Additionally, exercise retrogradely enhanced memory in both aMCI patients and controls. Acute exercise that activates the noradrenergic system may serve as a beneficial, natural, and practical therapeutic intervention for cognitive decline in the aging population. (Segal et al 2012)

Muscle Strength
To determine the short- and long-term effects of resistance training on muscle strength, psychological well-being, control-beliefs, cognitive speed and memory in normally active elderly people. An 8-week programme of resistance training lessens anxiety and self-attentiveness and improves muscle strength. (Perrig-Chiello et al 1998)

Old Age
The data from this animal study suggests that exercise may be an effective therapy for alleviating learning and memory decline due to aging or the onset of neurodegenerative diseases. (Yu et al 2013)I

t is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. (Forbes et al 2012)

Even after age 75 lifestyle behaviours such as not smoking and physical activity are associated with longer survival. A low risk profile can add five years to women’s lives and six years to men’s. These associations, although attenuated, were also present among the oldest old (≥85 years) and in people with chronic conditions. (Rizzuto et al 2012)Both caloric restriction and exercise can stimulate adult neurogenesis and enhance synaptic plasticity, which may enhance cognitive function and the ability of the brain to resist aging. (Cheng et al 2010)

Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women. (Liu-Ambrose et al 2010)

A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. (Colcombe & Kramer 2003)

Parkinson’s Disease
Physical exercise (PE) has been associated with a lower risk of developing a neurodegenerative disease. The literature has been searched, and results have been systematized and interpreted with regard to the effects of physical exercise in Parkinson’s disease (PD). Published data show the following: 1) Physical exercise has been associated with a lower risk of developing PD; 2) Physical exercise has been shown to improve disease symptoms, mobility, balance, gait and quality of life (in this regard, walking training, tai-chi and tango dancing have demonstrated the highest level of evidence of efficacy); and 3) neuroprotective effects from physical exercise could be expected in PD, although this has been suggested in animal studies only. (Grazina & Massano 2013)

Postmenopausal Women
The conclusions of this randomized study of overweight/obese postmenopausal women (n = 439) were as follows: Weight loss through diet or diet + exercise increased adiponectin concentrations. Leptin concentrations decreased in all of the intervention groups, but the greatest reduction occurred with diet + exercise. Weight loss and exercise exerted some beneficial effects on chronic diseases via effects on adiponectin and leptin. (Abbenhardt et al 2013)

Exercise training can improve muscle tissue strength, function and quality in sedentary postmenopausal women. Isoflavones, irrespective of exercise, did not produce changes in these variables. From a clinical perspective, these results suggest that overweight women could reduce the risks of mobility impairments, even in the absence of weight loss, by following a sound exercise intervention that includes both resistance and aerobic training at a high intensity. (Choquette et al 2013)A total of 48 post-menopausal women (54-73 years of age) were enrolled. Ex-elite athletes with long-term (>20 years) histories of significant training and performance were divided into two groups: weight-bearing sports (runners, n=12) and non-weight-bearing sports (swimmers, n=12). The athletes were age matched with sedentary controls (n=24). The high level of physical activity observed in female athletes is associated with improved muscle mass, bone mineral density (BMD), bone mineral content (BMC), and physical activity during youth seems to have a beneficial effect on bone mass and helps to prevent bone loss due to aging. (Andreoli et al 2012)

This 12-month aerobic jumping and circuit training intervention completely prevented femoral neck bone loss in premenopausal breast cancer patients, whereas no effect on BMD was seen in postmenopausal women. (Saarto et al 2012)The combined associations of leisure-time physical activity and sleep suggest that cardiovascular risk factors are more favorable in highly active women relative to less active women regardless of sleep. (Casas et al 2012)Combination exercise training including walking (2 sessions per week) and resistance training (2 sessions per week that was different from walking days) can improve metabolic syndrome parameters in postmenopausal women with breast cancer. (Nuri et al 2012)

This study was a randomized controlled trial involving 118 overweight/obese postmenopausal women. The authors concluded that a combined diet and exercise intervention has positive effects on health-related quality of life (HRQOL) and psychological health, which may be greater than that from exercise or diet alone. Improvements in weight, aerobic fitness and psychosocial factors may mediate intervention effects on HRQOL. (Imayama et al 2011)

Rheumatoid Arthritis
To assess the effectiveness and safety of short-term (< three months) and long-term (> three months) dynamic exercise therapy programs (aerobic capacity and/or muscle strength training), either land or water-based, for people with rheumatoid arthritis. Based on the evidence, aerobic capacity training combined with muscle strength training is recommended as routine practice in patients with rheumatoid arthritis. (Cochrane Database Syst Rev. Hurkmans et al 2009)

The results of this study indicate that the sedentary population who participated in this 12 week Pilates program experienced improvements in sleep quality and quality of life. (Leopoldino et al 2013)Exercise has been recommended for enhancing sleep; a claim linked to the belief that sleep need – defined by sleep duration and depth – is increased post-exercise to allow tissue recovery. We investigated the role of exercise on the sleep need of sedentary adults, after controlling for exercise mode, timing and duration. Two findings emerged: vigorous exercise did not increase sleep need; however, this level of exercise increased light sleep. (Wong et al 2013)Thirty minutes of running in the morning during weekdays for 3 consecutive weeks impacted positively on sleep and psychological functioning in healthy adolescents compared with control subjects. Running is inexpensive and easy to implement during school schedules, and as both objective and subjective improvements were observed within 3 weeks, regular physical exercise should be promoted. (Kalak et al 2012)Findings suggest that chronic vigorous exercising is positively related to adolescents’ sleep and psychological functioning. Results also indicate that males with low exercise levels are at risk for increased sleep complaints and poorer psychological functioning. (Brand et al 2010)

Aerobic cycling training can favorably modify heart rate recovery (HRR) in stroke survivors. Rapid HRR, as an indicator of enhanced autonomic function, is useful for predicting gains in cardiovascular fitness. These findings indicate the underlying importance of autonomic modulation on cardiovascular adaptations to stroke exercise rehabilitation. (Jin et al 2013)

Aerobic walking improves the physical health component of quality of life and endurance in persons with chronic stroke. It should form part of a comprehensive health promotion strategy. (Gordon et al 2013)

Traumatic Brain Injury
Delayed secondary biochemical and cellular changes after traumatic brain injury continue for months to years, and are associated with chronic neuroinflammation and progressive neurodegeneration. Physical activity can reduce inflammation and facilitate recovery after brain injury.  Late exercise initiation beginning at 5 weeks after trauma, but not early initiation of exercise at 1week, significantly reduced working and retention memory impairment at 3 months, and decreased lesion volume compared to non-exercise injury controls. Cognitive recovery was associated with attenuation of classical inflammatory pathways, activation of alternative inflammatory responses and enhancement of neurogenesis. (Piao et al 2013)

Weight and Fat Loss
One proposed mechanism linking obesity to chronic diseases is an alteration in adipose-derived adiponectin and leptin levels. We investigated the effects of 12-month reduced calorie, weight loss and exercise interventions on adiponectin and leptin concentrations. The reduced calorie diet had a 10% weight-loss goal. The exercise intervention consisted of 45 min of moderate-to-vigorous aerobic activity 5 days per week. Adiponectin increased by 9.5% in the diet group and 6.6% in the diet + exercise group (both P ≤ 0.0001 vs. control). Compared with controls, leptin decreased with all interventions (diet + exercise, -40.1%, P < 0.0001; diet, -27.1%, P < 0.0001; exercise, -12.7%, P = 0.005). Weight loss through diet or diet + exercise increased adiponectin concentrations. Leptin concentrations decreased in all of the intervention groups, but the greatest reduction occurred with diet + exercise. (Abbenhardt et al 2013)

Plasma adiponectin levels have also been reported to be reduced in obese humans, particularly those with visceral obesity, and to correlate inversely with insulin resistance. Prospective and longitudinal studies have shown that lower adiponectin levels are associated with a higher incidence of diabetes. Reduced plasma adiponectin levels are also commonly observed in a variety of states frequently associated with insulin resistance, such as cardiovascular disease and hypertension. (Kadowaki et al 2006)

Leptin is a mediator of long-term regulation of energy balance, suppressing food intake and thereby inducing weight loss. (Klok et al 2007)

Minority breast cancer survivors were recruited and retained in a weight loss study. Six months of the Curves program resulted in moderate weight loss, but weight loss was not maintained postintervention. (Greenlee et al 2013)In many interventions that are based on an exercise program intended to induce weight loss, the mean weight loss observed is modest and sometimes far less than the individual expected. The individual responses are also widely variable, with some individuals losing a substantial amount of weight, others maintaining weight, and a few actually gaining weight. The media have focused on the sub-population that loses little weight, contributing to a public perception that exercise has limited utility to cause weight loss. The purpose of the symposium was to present recent, novel data that help explain how compensatory behaviors contribute to a wide discrepancy in exercise-induced weight loss. The presentations provide evidence that some individuals adopt compensatory behaviors, i.e. increased energy intake and/or reduced activity, that offset the exercise energy expenditure and limit weight loss. (Melanson et al 2013)

We evaluated the individual and combined effects of a reduced-calorie weight loss diet and exercise on serum sex hormones in overweight and obese postmenopausal women. Compared with controls, estrone decreased 9.6% (P = .001) with diet, 5.5% (P = .01) with exercise, and 11.1% (P < .001) with diet + exercise. Estradiol decreased 16.2% (P < .001) with diet, 4.9% (P = .10) with exercise, and 20.3% (P < .001) with diet + exercise. SHBG increased 22.4% (P < .001) with diet and 25.8% (P < .001) with diet + exercise. Free estradiol decreased 21.4% (P < .001) with diet and 26.0% (P < .001) with diet + exercise. Free testosterone decreased 10.0% (P < .001) with diet and 15.6% (P < .001) with diet + exercise. Greater weight loss produced stronger effects on estrogens and SHBG. Weight loss significantly lowered serum estrogens and free testosterone, supporting weight loss for risk reduction through lowering exposure to breast cancer biomarkers. (Campbell et al 2012)

Recent guidelines on exercise for weight loss and weight maintenance include resistance training as part of the exercise prescription. Yet few studies have compared the effects of similar amounts of aerobic and resistance training on body mass and fat mass in overweight adults. Balancing time commitments against health benefits, it appears that aerobic training is the optimal mode of exercise for reducing fat mass and body mass, while a program including resistance training is needed for increasing lean mass in middle-aged, overweight/obese individuals. (Willis et al 2012)One of the basic effects of exercise training is augmenting oxidative capacity of skeletal muscles, which results in an improvement in the rate of whole body fat oxidation. Exercise also activates AMP kinase, which stimulates fatty acid oxidation, glucose uptake, and mitochondrial biogenesis. (Golbidi et al 2012)Recent findings suggest obesity is associated with reduced memory performance in older adults. The present study examined whether similar deficits also exist in younger adults. Results showed obese individuals had poorer memory performance when comparing persons across the adult lifespan (age 21-82 yr), but also when examining only younger and middle-aged adults (age 21-50 yr). (Gunstad et al 2006)

Using a prospective design, male (n=551) and female (n=872) participants of the Framingham Heart Study were classified by presence or absence of obesity and hypertension based on data collected over an 18-y surveillance period. All subjects were free from dementia, stroke, and clinically diagnosed cardiovascular disease up to the time of cognitive testing. Adverse effects of obesity and hypertension on cognitive performance were observed for men only. Obese and hypertensive men performed more poorly than men classified as either obese or hypertensive, and the best performance was observed in nonobese, normotensive men. (Elias et al 2003)

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