In terms of health benefits, the amount of recommended exercise depends upon the goal, the type of exercise, and the age of the person. Even doing a small amount of exercise is healthier than doing none.[5]
Classification
An aerobics exercise instructor in the United States instructs her class.
Physical exercises are generally grouped into three types, depending on the overall effect they have on the human body:[6]
Types of exercise can also be classified as dynamic or static. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly, albeit transiently, during the performance of the exercise.[11]
Physical exercise is important for maintaining physical fitness and can contribute to maintaining a healthy weight, regulating the digestive system, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system. Some studies indicate that exercise may increase life expectancy and the overall quality of life.[12] People who participate in moderate to high levels of physical exercise have a lower mortality rate compared to individuals who by comparison are not physically active.[13] Moderate levels of exercise have been correlated with preventing aging by reducing inflammatory potential.[14] The majority of the benefits from exercise are achieved with around 3500 metabolic equivalent (MET) minutes per week, with diminishing returns at higher levels of activity.[15] For example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or bicycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week.[15] A lack of physical activity causes approximately 6% of the burden of disease from coronary heart disease, 7% of type 2 diabetes, 10% of breast cancer and 10% of colon cancer worldwide.[16] Overall, physical inactivity causes 9% of premature mortality worldwide.[16]
Most people can increase fitness by increasing physical activity levels.[17] Increases in muscle size from resistance training are primarily determined by diet and testosterone.[18] This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population.[19][20] There is evidence that exercising in middle age may lead to better physical ability later in life.[21]
Early motor skills and development is also related to physical activity and performance later in life. Children who are more proficient with motor skills early on are more inclined to be physically active, and thus tend to perform well in sports and have better fitness levels. Early motor proficiency has a positive correlation to childhood physical activity and fitness levels, while less proficiency in motor skills results in a more sedentary lifestyle.[22]
The type and intensity of physical activity performed may have an effect on a person's fitness level. There is some weak evidence that high-intensity interval training may improve a person's VO2 max slightly more than lower intensity endurance training.[23] However, unscientific fitness methods could lead to sports injuries.[24]
The beneficial effect of exercise on the cardiovascular system is well documented. There is a direct correlation between physical inactivity and cardiovascular disease, and physical inactivity is an independent risk factor for the development of coronary artery disease. Low levels of physical exercise increase the risk of cardiovascular diseases mortality.[25][26]
Children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness.[27] Studies have shown that academic stress in youth increases the risk of cardiovascular disease in later years; however, these risks can be greatly decreased with regular physical exercise.[28]
There is a dose-response relationship between the amount of exercise performed from approximately 700–2000kcal of energy expenditure per week and all-cause mortality and cardiovascular disease mortality in middle-aged and elderly men. The greatest potential for reduced mortality is seen in sedentary individuals who become moderately active.
Studies have shown that since heart disease is the leading cause of death in women, regular exercise in aging women leads to healthier cardiovascular profiles.
Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate-intensity activity (40–60% of maximal oxygen uptake, depending on age). Persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival. Persons who remain sedentary have the highest risk for all-cause and cardiovascular disease mortality.[29] According to the American Heart Association, exercise reduces the risk of cardiovascular diseases, including heart attack and stroke.[26]
Some have suggested that increases in physical exercise might decrease healthcare costs, increase the rate of job attendance, as well as increase the amount of effort women put into their jobs.[30]
Immune system
Although there have been hundreds of studies on physical exercise and the immune system, there is little direct evidence on its connection to illness.[31]Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human immune system; an effect which is modeled in a J curve. Moderate exercise has been associated with a 29% decreased incidence of upper respiratory tract infections (URTI), but studies of marathon runners found that their prolonged high-intensity exercise was associated with an increased risk of infection occurrence.[31] However, another study did not find the effect. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections. Studies have shown that strenuous stress for long durations, such as training for a marathon, can suppress the immune system by decreasing the concentration of lymphocytes.[32] The immune systems of athletes and nonathletes are generally similar. Athletes may have a slightly elevated natural killer cell count and cytolytic action, but these are unlikely to be clinically significant.[31]
Biomarkers of inflammation such as C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects. In individuals with heart disease, exercise interventions lower blood levels of fibrinogen and C-reactive protein, an important cardiovascular risk marker.[33] The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti-inflammatory effect.[31]
Cancer
A systematic review evaluated 45 studies that examined the relationship between physical activity and cancer survival rates. According to the review, "[there] was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality. There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers."[34] Evidence suggests that exercise may positively affect the quality of life in cancer survivors, including factors such as anxiety, self-esteem and emotional well-being.[35] For people with cancer undergoing active treatment, exercise may also have positive effects on health-related quality of life, such as fatigue and physical functioning.[36] This is likely to be more pronounced with higher intensity exercise.[36]
Exercise may contribute to a reduction of cancer-related fatigue in survivors of breast cancer.[37] Although there is only limited scientific evidence on the subject, people with cancer cachexia are encouraged to engage in physical exercise.[38] Due to various factors, some individuals with cancer cachexia have a limited capacity for physical exercise.[39][40]Compliance with prescribed exercise is low in individuals with cachexia and clinical trials of exercise in this population often have high drop-out rates.[39][40]
There is low-quality evidence for an effect of aerobic physical exercises on anxiety and serious adverse events in adults with hematological malignancies.[41] Aerobic physical exercise may result in little to no difference in the mortality, quality of life, or physical functioning.[41] These exercises may result in a slight reduction in depression and reduction in fatigue.[41]
A number of medical reviews have indicated that exercise has a marked and persistent antidepressant effect in humans,[47][61][62][65][82][83] an effect believed to be mediated through enhanced BDNF signaling in the brain.[50][65] Several systematic reviews have analyzed the potential for physical exercise in the treatment of depressive disorders. The 2013 Cochrane Collaboration review on physical exercise for depression noted that, based upon limited evidence, it is more effective than a control intervention and comparable to psychological or antidepressant drug therapies.[82] Three subsequent 2014 systematic reviews that included the Cochrane review in their analysis concluded with similar findings: one indicated that physical exercise is effective as an adjunct treatment (i.e., treatments that are used together) with antidepressant medication;[65] the other two indicated that physical exercise has marked antidepressant effects and recommended the inclusion of physical activity as an adjunct treatment for mild–moderate depression and mental illness in general.[61][62] One systematic review noted that yoga may be effective in alleviating symptoms of prenatal depression.[84] Another review asserted that evidence from clinical trials supports the efficacy of physical exercise as a treatment for depression over a 2–4 month period.[47] These benefits have also been noted in old age, with a review conducted in 2019 finding that exercise is an effective treatment for clinically diagnosed depression in older adults.[85]
A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life in individuals with depression relative to controls.[53][86]
Preliminary evidence from a 2012 review indicated that physical training for up to four months may increase sleep quality in adults over 40 years of age.[92] A 2010 review suggested that exercise generally improved sleep for most people, and may help with insomnia, but there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep.[93] A 2018 systematic review and meta-analysis suggested that exercise can improve sleep quality in people with insomnia.[94]
Libido
One 2013 study found that exercising improved sexual arousal problems related to antidepressant use.[95]
Respiratory system
People who participate in physical exercise experience increased cardiovascular fitness.[medical citation needed]
There is some level of concern about additional exposure to air pollution when exercising outdoors, especially near traffic.[96]
Resistance training and subsequent consumption of a protein-rich meal promotes muscle hypertrophy and gains in muscle strength by stimulating myofibrillar muscle protein synthesis (MPS) and inhibiting muscle protein breakdown (MPB).[97][98] The stimulation of muscle protein synthesis by resistance training occurs via phosphorylation of the mechanistic target of rapamycin (mTOR) and subsequent activation of mTORC1, which leads to protein biosynthesis in cellular ribosomes via phosphorylation of mTORC1's immediate targets (the p70S6 kinase and the translation repressor protein 4EBP1).[97][99] The suppression of muscle protein breakdown following food consumption occurs primarily via increases in plasmainsulin.[97][100][101] Similarly, increased muscle protein synthesis (via activation of mTORC1) and suppressed muscle protein breakdown (via insulin-independent mechanisms) has also been shown to occur following ingestion of β-hydroxy β-methylbutyric acid.[97][100][101][102]
Resistance training stimulates muscle protein synthesis (MPS) for a period of up to 48 hours following exercise (shown by dotted line).[98] Ingestion of a protein-rich meal at any point during this period will augment the exercise-induced increase in muscle protein synthesis (shown by solid lines).[98]
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines which promote the growth of new tissue, tissue repair, and multiple anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases.[119] Exercise reduces levels of cortisol, which causes many health problems, both physical and mental.[120] Endurance exercise before meals lowers blood glucose more than the same exercise after meals.[121] There is evidence that vigorous exercise (90–95% of VO2 max) induces a greater degree of physiological cardiac hypertrophy than moderate exercise (40 to 70% of VO2 max), but it is unknown whether this has any effects on overall morbidity and/or mortality.[122] Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Ventricular hypertrophy, the thickening of the ventricular walls, is generally beneficial and healthy if it occurs in response to exercise.
Community-wide and school campaigns are often used in an attempt to increase a population's level of physical activity. Studies to determine the effectiveness of these types of programs need to be interpreted cautiously as the results vary.[17] There is some evidence that certain types of exercise programmes for older adults, such as those involving gait, balance, co-ordination and functional tasks, can improve balance.[129] Following progressive resistance training, older adults also respond with improved physical function.[130] Brief interventions promoting physical activity may be cost-effective, however this evidence is weak and there are variations between studies.[131]
Environmental approaches appear promising: signs that encourage the use of stairs, as well as community campaigns, may increase exercise levels.[132] The city of Bogotá, Colombia, for example, blocks off 113 kilometers (70 mi) of roads on Sundays and holidays to make it easier for its citizens to get exercise. Such pedestrian zones are part of an effort to combat chronic diseases and to maintain a healthy BMI.[133][134]
Parents can promote physical activity by modelling healthy levels of physical activity or by encouraging physical activity.[135] According to the Centers for Disease Control and Prevention in the United States, children and adolescents should do 60 minutes or more of physical activity each day.[136] Implementing physical exercise in the school system and ensuring an environment in which children can reduce barriers to maintain a healthy lifestyle is essential.
The European Commission's Directorate-General for Education and Culture (DG EAC) has dedicated programs and funds for Health Enhancing Physical Activity (HEPA) projects[137] within its Horizon 2020 and Erasmus+ program, as research showed that too many Europeans are not physically active enough. Financing is available for increased collaboration between players active in this field across the EU and around the world, the promotion of HEPA in the EU and its partner countries, and the European Sports Week. The DG EAC regularly publishes a Eurobarometer on sport and physical activity.
Worldwide there has been a large shift toward less physically demanding work.[138] This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor-saving technology in the home, and fewer active recreational pursuits.[138]Personal lifestyle changes, however, can correct the lack of physical exercise.[medical citation needed]
Research published in 2015 suggests that incorporating mindfulness into physical exercise interventions increases exercise adherence and self-efficacy, and also has positive effects both psychologically and physiologically.[139]
Exercising looks different in every country, as do the motivations behind exercising.[3] In some countries, people exercise primarily indoors (such as at home or health clubs), while in others, people primarily exercise outdoors. People may exercise for personal enjoyment, health and well-being, social interactions, competition or training, etc. These differences could potentially be attributed to a variety of reasons including geographic location and social tendencies.
In Colombia, for example, citizens value and celebrate the outdoor environments of their country. In many instances, they use outdoor activities as social gatherings to enjoy nature and their communities. In Bogotá, Colombia, a 70-mile stretch of road known as the Ciclovía is shut down each Sunday for bicyclists, runners, rollerbladers, skateboarders and other exercisers to work out and enjoy their surroundings.[143]
Similarly to Colombia, citizens of Cambodia tend to exercise socially outside. In this country, public gyms have become quite popular. People will congregate at these outdoor gyms not only to use the public facilities, but also to organize aerobics and dance sessions, which are open to the public.[144]
Sweden has also begun developing outdoor gyms, called utegym. These gyms are free to the public and are often placed in beautiful, picturesque environments. People will swim in rivers, use boats, and run through forests to stay healthy and enjoy the natural world around them. This works particularly well in Sweden due to its geographical location.[145]
Exercise in some areas of China, particularly among those who are retired, seems to be socially grounded. In the mornings, square dances are held in public parks; these gatherings may include Latin dancing, ballroom dancing, tango, or even the jitterbug. Dancing in public allows people to interact with those with whom they would not normally interact, allowing for both health and social benefits.[146]
These sociocultural variations in physical exercise show how people in different geographic locations and social climates have varying motivations and methods of exercising. Physical exercise can improve health and well-being, as well as enhance community ties and appreciation of natural beauty.[3]
Nutrition and recovery
Proper nutrition is as important to health as exercise. When exercising, it becomes even more important to have a good diet to ensure that the body has the correct ratio of macronutrients while providing ample micronutrients, to aid the body with the recovery process following strenuous exercise.[147]
Active recovery is recommended after participating in physical exercise because it removes lactate from the blood more quickly than inactive recovery. Removing lactate from circulation allows for an easy decline in body temperature, which can also benefit the immune system, as an individual may be vulnerable to minor illnesses if the body temperature drops too abruptly after physical exercise.[148]
Exercise has an effect on appetite, but whether it increases or decreases appetite varies from individual to individual, and is affected by the intensity and duration of the exercise.[149]
Excessive exercise or overtraining occurs when a person exceeds their body's ability to recover from strenuous exercise.[150]
History
This article is missing information about times and places when exercise was viewed negatively. Please expand the article to include this information. Further details may exist on the talk page. (August 2021)
The benefits of exercise have been known since antiquity. Dating back to 65 BCE, it was Marcus Cicero, Roman politician and lawyer, who stated: "It is exercise alone that supports the spirits, and keeps the mind in vigor."[151] Exercise was also seen to be valued later in history during the Early Middle Ages as a means of survival by the Germanic peoples of Northern Europe.[152]
More recently, exercise was regarded as a beneficial force in the 19th century. In 1858 Archibald MacLaren opened a gymnasium at the University of Oxford and instituted a training regimen for Major Frederick Hammersley and 12 non-commissioned officers.[153] This regimen was assimilated into the training of the British Army, which formed the Army Gymnastic Staff in 1860 and made sport an important part of military life.[154][155][156] Several mass exercise movements were started in the early twentieth century as well. The first and most significant of these in the UK was the Women's League of Health and Beauty, founded in 1930 by Mary Bagot Stack, that had 166,000 members in 1937.[157]
The link between physical health and exercise (or lack of it) was further established in 1949 and reported in 1953 by a team led by Jerry Morris.[158][159] Morris noted that men of similar social class and occupation (bus conductors versus bus drivers) had markedly different rates of heart attacks, depending on the level of exercise they got: bus drivers had a sedentary occupation and a higher incidence of heart disease, while bus conductors were forced to move continually and had a lower incidence of heart disease.[159]
Other animals
Studies of animals indicate that physical activity may be more adaptable than changes in food intake to regulate energy balance.[160]
The effects of exercise training appear to be heterogeneous across non-mammalian species. As examples, exercise training of salmon showed minor improvements of endurance,[166] and a forced swimming regimen of yellowtail amberjack and rainbow trout accelerated their growth rates and altered muscle morphology favorable for sustained swimming.[167][168] Crocodiles, alligators, and ducks showed elevated aerobic capacity following exercise training.[169][170][171] No effect of endurance training was found in most studies of lizards,[169][172] although one study did report a training effect.[173] In lizards, sprint training had no effect on maximal exercise capacity,[173] and muscular damage from over-training occurred following weeks of forced treadmill exercise.[172]
^Kylasov A, Gavrov S (2011). Diversity Of Sport: non-destructive evaluation. Paris: UNESCO: Encyclopedia of Life Support Systems. pp. 462–91. ISBN978-5-89317-227-0.
^O'Connor DM, Crowe MJ, Spinks WL (March 2006). "Effects of static stretching on leg power during cycling". The Journal of Sports Medicine and Physical Fitness. 46 (1): 52–56. PMID16596099.
^"What Is Fitness?"(PDF). The CrossFit Journal. October 2002. p. 4. Retrieved 12 September 2010.
^Hubal MJ, Gordish-Dressman H, Thompson PD, Price TB, Hoffman EP, Angelopoulos TJ, et al. (June 2005). "Variability in muscle size and strength gain after unilateral resistance training". Medicine and Science in Sports and Exercise. 37 (6): 964–972. PMID15947721.
^Brutsaert TD, Parra EJ (April 2006). "What makes a champion? Explaining variation in human athletic performance". Respiratory Physiology & Neurobiology. 151 (2–3): 109–123. doi:10.1016/j.resp.2005.12.013. PMID16448865. S2CID13711090.
^Geddes L (28 July 2007). "Superhuman". New Scientist. pp. 35–41.
^Wrotniak BH, Epstein LH, Dorn JM, Jones KE, Kondilis VA (December 2006). "The relationship between motor proficiency and physical activity in children". Pediatrics. 118 (6): e1758–e1765. doi:10.1542/peds.2006-0742. PMID17142498. S2CID41653923.
^Lumeng JC (March 2006). "Small-group physical education classes result in important health benefits". The Journal of Pediatrics. 148 (3): 418–419. doi:10.1016/j.jpeds.2006.02.025. PMID17243298.
^Fletcher GF, Balady G, Blair SN, Blumenthal J, Caspersen C, Chaitman B, et al. (August 1996). "Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association". Circulation. 94 (4): 857–862. doi:10.1161/01.CIR.94.4.857. PMID8772712. S2CID2392781.
^ abSadeghi M, Keshavarz-Fathi M, Baracos V, Arends J, Mahmoudi M, Rezaei N (July 2018). "Cancer cachexia: Diagnosis, assessment, and treatment". Critical Reviews in Oncology/Hematology. 127: 91–104. doi:10.1016/j.critrevonc.2018.05.006. PMID29891116. S2CID48363786.
^ abcdeErickson KI, Hillman CH, Kramer AF (August 2015). "Physical activity, brain, and cognition". Current Opinion in Behavioral Sciences. 4: 27–32. doi:10.1016/j.cobeha.2015.01.005. S2CID54301951.
^ abPaillard T, Rolland Y, de Souto Barreto P (July 2015). "Protective Effects of Physical Exercise in Alzheimer's Disease and Parkinson's Disease: A Narrative Review". J Clin Neurol. 11 (3): 212–219. doi:10.3988/jcn.2015.11.3.212. PMC4507374. PMID26174783. Aerobic physical exercise (PE) activates the release of neurotrophic factors and promotes angiogenesis, thereby facilitating neurogenesis and synaptogenesis, which in turn improve memory and cognitive functions. ... Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission.
^ abMcKee AC, Daneshvar DH, Alvarez VE, Stein TD (January 2014). "The neuropathology of sport". Acta Neuropathol. 127 (1): 29–51. doi:10.1007/s00401-013-1230-6. PMC4255282. PMID24366527. The benefits of regular exercise, physical fitness and sports participation on cardiovascular and brain health are undeniable ... Exercise also enhances psychological health, reduces age-related loss of brain volume, improves cognition, reduces the risk of developing dementia, and impedes neurodegeneration.
^ abDenham J, Marques FZ, O'Brien BJ, Charchar FJ (February 2014). "Exercise: putting action into our epigenome". Sports Med. 44 (2): 189–209. doi:10.1007/s40279-013-0114-1. PMID24163284. S2CID30210091. Aerobic physical exercise produces numerous health benefits in the brain. Regular engagement in physical exercise enhances cognitive functioning, increases brain neurotrophic proteins, such as brain-derived neurotrophic factor (BDNF), and prevents cognitive diseases. Recent findings highlight the role of aerobic exercise in modulating chromatin remodelers. ... These results were the first to demonstrate that acute and relatively short aerobic exercise modulates epigenetic modifications. The transient epigenetic modifications observed due to chronic running training have also been associated with improved learning and stress-coping strategies, epigenetic changes, and increased c-Fos-positive neurons ... Nonetheless, these studies demonstrate the existence of epigenetic changes after acute and chronic exercise and show they are associated with improved cognitive function and elevated markers of neurotrophic factors and neuronal activity (BDNF and c-Fos). ... The aerobic exercise training-induced changes to miRNA profile in the brain seem to be intensity-dependent. These few studies provide a basis for further exploration into potential miRNAs involved in brain and neuronal development and recovery via aerobic exercise.
^ abcCox EP, O'Dwyer N, Cook R, Vetter M, Cheng HL, Rooney K, O'Connor H (August 2016). "Relationship between physical activity and cognitive function in apparently healthy young to middle-aged adults: A systematic review". J. Sci. Med. Sport. 19 (8): 616–628. doi:10.1016/j.jsams.2015.09.003. PMID26552574. A range of validated platforms assessed CF across three domains: executive function (12 studies), memory (four studies) and processing speed (seven studies). ... In studies of executive function, five found a significant ES in favour of higher PA, ranging from small to large. Although three of four studies in the memory domain reported a significant benefit of higher PA, there was only one significant ES, which favoured low PA. Only one study examining processing speed had a significant ES, favouring higher PA. CONCLUSIONS: A limited body of evidence supports a positive effect of PA on CF in young to middle-aged adults. Further research into this relationship at this age stage is warranted. ... Significant positive effects of PA on cognitive function were found in 12 of the 14 included manuscripts, the relationship being most consistent for executive function, intermediate for memory, and weak for processing speed.
^Pratali L, Mastorci F, Vitiello N, Sironi A, Gastaldelli A, Gemignani A (November 2014). "Motor Activity in Aging: An Integrated Approach for Better Quality of Life". International Scholarly Research Notices. 2014: 257248. doi:10.1155/2014/257248. PMC4897547. PMID27351018. Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement. In particular, several cross-sectional and intervention studies have shown a positive association between physical activity and cognition in older persons [86] and an inverse correlation with cognitive decline and dementia [87]. Older adults enrolled in a 6-month aerobic fitness intervention increased brain volume in both gray matter (anterior cingulate cortex, supplementary motor area, posterior middle frontal gyrus, and left superior temporal lobe) and white matter (anterior third of corpus callosum) [88]. In addition, Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources, including decreased activation of the anterior cingulated cortex. One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity increases brain volume, stimulates neurogenesis and synaptogenesis, and increases neurotrophic factors in different areas of the brain, possibly providing reserve against later cognitive decline and dementia [89, 90].
^ abcdBasso JC, Suzuki WA (March 2017). "The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review". Brain Plasticity. 2 (2): 127–152. doi:10.3233/BPL-160040. PMC5928534. PMID29765853. A large collection of research in humans has shown that a single bout of exercise alters behavior at the level of affective state and cognitive functioning in several key ways. In terms of affective state, acute exercise decreases negative affect, increases positive affect, and decreases the psychological and physiological response to acute stress. These effects have been reported to persist for up to 24 hours after exercise cessation. In terms of cognitive functioning, acute exercise primarily enhances executive functions dependent on the prefrontal cortex including attention, working memory, problem-solving, cognitive flexibility, verbal fluency, decision-making, and inhibitory control. These positive changes have been demonstrated to occur with very low to very high exercise intensities, with effects lasting for up to two hours after the end of the exercise bout (Fig. 1A). Moreover, many of these neuropsychological assessments measure several aspects of behavior including both accuracy of performance and speed of processing. McMorris and Hale performed a meta-analysis examining the effects of acute exercise on both accuracy and speed of processing, revealing that speed significantly improved post-exercise, with minimal or no effect on accuracy. These authors concluded that increasing task difficulty or complexity may help to augment the effect of acute exercise on accuracy. ... However, in a comprehensive meta-analysis, Chang and colleagues found that exercise intensities ranging from very light (<50% MHR) to very hard (>93% MHR) have all been reported to improve cognitive functioning.
^Services, Department of Health & Human. "Exercise and mental health". betterhealth.vic.gov.au. Retrieved 19 November 2022.
^ abcdJosefsson T, Lindwall M, Archer T (2014). "Physical exercise intervention in depressive disorders: meta-analysis and systematic review". Scand J Med Sci Sports. 24 (2): 259–272. doi:10.1111/sms.12050. PMID23362828. S2CID29351791.
^ abcRosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB (2014). "Physical activity interventions for people with mental illness: a systematic review and meta-analysis". J Clin Psychiatry. 75 (9): 964–974. doi:10.4088/JCP.13r08765. PMID24813261. This systematic review and meta-analysis found that physical activity reduced depressive symptoms among people with a psychiatric illness. The current meta-analysis differs from previous studies, as it included participants with depressive symptoms with a variety of psychiatric diagnoses (except dysthymia and eating disorders). ... This review provides strong evidence for the antidepressant effect of physical activity; however, the optimal exercise modality, volume, and intensity remain to be determined. ... Few interventions exist whereby patients can hope to achieve improvements in both psychiatric symptoms and physical health simultaneously without significant risks of adverse effects. Physical activity offers substantial promise for improving outcomes for people living with mental illness, and the inclusion of physical activity and exercise programs within treatment facilities is warranted given the results of this review.
^Szuhany KL, Bugatti M, Otto MW (October 2014). "A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor". J Psychiatr Res. 60C: 56–64. doi:10.1016/j.jpsychires.2014.10.003. PMC4314337. PMID25455510. Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). ... Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans.
^Lees C, Hopkins J (2013). "Effect of aerobic exercise on cognition, academic achievement, and psychosocial function in children: a systematic review of randomized control trials". Prev Chronic Dis. 10: E174. doi:10.5888/pcd10.130010. PMC3809922. PMID24157077. This omission is relevant, given the evidence that aerobic-based physical activity generates structural changes in the brain, such as neurogenesis, angiogenesis, increased hippocampal volume, and connectivity (12,13). In children, a positive relationship between aerobic fitness, hippocampal volume, and memory has been found (12,13). ... Mental health outcomes included reduced depression and increased self-esteem, although no change was found in anxiety levels (18). ... This systematic review of the literature found that [aerobic physical activity (APA)] is positively associated with cognition, academic achievement, behavior, and psychosocial functioning outcomes. Importantly, Shephard also showed that curriculum time reassigned to APA still results in a measurable, albeit small, improvement in academic performance (24). ... The actual aerobic-based activity does not appear to be a major factor; interventions used many different types of APA and found similar associations. In positive association studies, the intensity of the aerobic activity was moderate to vigorous. The amount of time spent in APA varied significantly between studies; however, even as little as 45 minutes per week appeared to have a benefit.
^ abcdMura G, Moro MF, Patten SB, Carta MG (2014). "Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review". CNS Spectr. 19 (6): 496–508. doi:10.1017/S1092852913000953. PMID24589012. S2CID32304140. Considered overall, the studies included in the present review showed a strong effectiveness of exercise combined with antidepressants. ... Conclusions This is the first review to have focused on exercise as an add-on strategy in the treatment of MDD. Our findings corroborate some previous observations that were based on few studies and which were difficult to generalize. Given the results of the present article, it seems that exercise might be an effective strategy to enhance the antidepressant effect of medication treatments. Moreover, we hypothesize that the main role of exercise on treatment-resistant depression is in inducing neurogenesis by increasing BDNF expression, as was demonstrated by several recent studies.
^Kamp CF, Sperlich B, Holmberg HC (July 2014). "Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters". Acta Paediatr. 103 (7): 709–14. doi:10.1111/apa.12628. PMID24612421. S2CID45881887. The present review summarises the impact of exercise interventions (1–10 weeks in duration with at least two sessions each week) on parameters related to ADHD in 7-to 13-year-old children. We may conclude that all different types of exercise (here yoga, active games with and without the involvement of balls, walking, and athletic training) attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration, and frequency of exercise is most effective in this respect, and future research focusing on this question with randomised and controlled long-term interventions is warranted.
^Farina N, Rusted J, Tabet N (January 2014). "The effect of exercise interventions on cognitive outcome in Alzheimer's disease: a systematic review". Int Psychogeriatr. 26 (1): 9–18. doi:10.1017/S1041610213001385. PMID23962667. S2CID24936334. Six RCTs were identified that exclusively considered the effect of exercise in AD patients. Exercise generally had a positive effect on the rate of cognitive decline in AD. A meta-analysis found that exercise interventions have a positive effect on global cognitive function, 0.75 (95% CI = 0.32–1.17). ... The most prevalent subtype of dementia is Alzheimer's disease (AD), accounting for up to 65.0% of all dementia cases ... Cognitive decline in AD is attributable at least in part to the buildup of amyloid and tau proteins, which promote neuronal dysfunction and death (Hardy and Selkoe, 2002; Karran et al., 2011). Evidence in transgenic mouse models of AD, in which the mice have an artificially elevated amyloid load, suggests that exercise programs are able to improve cognitive function (Adlard et al., 2005; Nichol et al., 2007). Adlard and colleagues also determined that the improvement in cognitive performance occurred in conjunction with a reduced amyloid load. Research that includes direct indices of change in such biomarkers will help to determine the mechanisms by which exercise may act on cognition in AD.
^Rao AK, Chou A, Bursley B, Smulofsky J, Jezequel J (January 2014). "Systematic review of the effects of exercise on activities of daily living in people with Alzheimer's disease". Am J Occup Ther. 68 (1): 50–56. doi:10.5014/ajot.2014.009035. PMC5360200. PMID24367955. Alzheimer's disease (AD) is a progressive neurological disorder characterized by loss in cognitive function, abnormal behavior, and decreased ability to perform basic activities of daily living [(ADLs)] ... All studies included people with AD who completed an exercise program consisting of aerobic, strength, or balance training or any combination of the three. The length of the exercise programs varied from 12 weeks to 12 months. ... Six studies involving 446 participants tested the effect of exercise on ADL performance ... exercise had a large and significant effect on ADL performance (z = 4.07, p < .0001; average effect size = 0.80). ... These positive effects were apparent with programs ranging in length from 12 wk (Santana-Sosa et al., 2008; Teri et al., 2003) and intermediate length of 16 wk (Roach et al., 2011; Vreugdenhil et al., 2012) to 6 mo (Venturelli et al., 2011) and 12 mo (Rolland et al., 2007). Furthermore, the positive effects of a 3-mo intervention lasted 24 mo (Teri et al., 2003). ... No adverse effects of exercise on ADL performance were noted. ... The study with the largest effect size implemented a walking and aerobic program of only 30 min four times a week (Venturelli et al., 2011).
^van der Kolk NM, King LA (September 2013). "Effects of exercise on mobility in people with Parkinson's disease". Mov. Disord. 28 (11): 1587–1596. doi:10.1002/mds.25658. PMID24132847. S2CID22822120.
^Blondell SJ, Hammersley-Mather R, Veerman JL (May 2014). "Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies". BMC Public Health. 14: 510. doi:10.1186/1471-2458-14-510. PMC4064273. PMID24885250. Longitudinal observational studies show an association between higher levels of physical activity and a reduced risk of cognitive decline and dementia. A case can be made for a causal interpretation. Future research should use objective measures of physical activity, adjust for the full range of confounders, and have adequate follow-up length. Ideally, randomised controlled trials will be conducted. ... On the whole, the results do, however, lend support to the notion of a causal relationship between physical activity, cognitive decline, and dementia, according to the established criteria for causal inference.
^Carroll ME, Smethells JR (February 2016). "Sex Differences in Behavioral Dyscontrol: Role in Drug Addiction and Novel Treatments". Front. Psychiatry. 6: 175. doi:10.3389/fpsyt.2015.00175. PMC4745113. PMID26903885. There is accelerating evidence that physical exercise is a useful treatment for preventing and reducing drug addiction ... In some individuals, exercise has its own rewarding effects, and a behavioral-economic interaction may occur, such that physical and social rewards of exercise can substitute for the rewarding effects of drug abuse. ... The value of this form of treatment for drug addiction in laboratory animals and humans is that exercise, if it can substitute for the rewarding effects of drugs, could be self-maintained over an extended period of time. Work to date in [laboratory animals and humans] regarding exercise as a treatment for drug addiction supports this hypothesis. ... However, a RTC study was recently reported by Rawson et al., whereby they used 8 weeks of exercise as a post-residential treatment for METH addiction, showed a significant reduction in use (confirmed by urine screens) in participants who had been using meth 18 days or less a month. ... Animal and human research on physical exercise as a treatment for stimulant addiction indicates that this is one of the most promising treatments on the horizon. [emphasis added]
^Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug addictions". Neuropharmacology. 61 (7): 1109–1122. doi:10.1016/j.neuropharm.2011.03.010. PMC3139704. PMID21459101. Similar to environmental enrichment, studies have found that exercise reduces self-administration and relapse to drugs of abuse (Cosgrove et al., 2002; Zlebnik et al., 2010). There is also some evidence that these preclinical findings translate to human populations, as exercise reduces withdrawal symptoms and relapse in abstinent smokers (Daniel et al., 2006; Prochaska et al., 2008), and one drug recovery program has seen success in participants that train for and compete in a marathon as part of the program (Butler, 2005). ... In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs. This syndrome is characterized by a medication-induced increase in (or compulsive) engagement in non-drug rewards such as gambling, shopping, or sex (Evans et al., 2006; Aiken, 2007; Lader, 2008).
^Linke SE, Ussher M (2015). "Exercise-based treatments for substance use disorders: evidence, theory, and practicality". Am J Drug Alcohol Abuse. 41 (1): 7–15. doi:10.3109/00952990.2014.976708. PMC4831948. PMID25397661. The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. ... numerous theoretical and practical reasons support exercise-based treatments for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects.
^Zhou Y, Zhao M, Zhou C, Li R (July 2015). "Sex differences in drug addiction and response to exercise intervention: From human to animal studies". Front. Neuroendocrinol. 40: 24–41. doi:10.1016/j.yfrne.2015.07.001. PMC4712120. PMID26182835. Collectively, these findings demonstrate that exercise may serve as a substitute or competition for drug abuse by changing ΔFosB or cFos immunoreactivity in the reward system to protect against later or previous drug use. ... As briefly reviewed above, a large number of human and rodent studies clearly show that there are sex differences in drug addiction and exercise. The sex differences are also found in the effectiveness of exercise on drug addiction prevention and treatment, as well as underlying neurobiological mechanisms. The postulate that exercise serves as an ideal intervention for drug addiction has been widely recognized and used in human and animal rehabilitation. ... In particular, more studies on the neurobiological mechanism of exercise and its roles in preventing and treating drug addiction are needed.
^ abCooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE (September 2013). "Exercise for depression". Cochrane Database Syst. Rev. 2013 (9): CD004366. doi:10.1002/14651858.CD004366.pub6. PMC9721454. PMID24026850. Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.
^Chaturvedi, Santosh K.; Chandra, Prabha S.; Issac, Mohan K.; Sudarshan, C. Y. (1 September 1993). "Somatization misattributed to non-pathological vaginal discharge". Journal of Psychosomatic Research. 37 (6): 575–579. doi:10.1016/0022-3999(93)90051-G. PMID8410743.
^Tantimonaco M, Ceci R, Sabatini S, Catani MV, Rossi A, Gasperi V, Maccarrone M (July 2014). "Physical activity and the endocannabinoid system: an overview". Cellular and Molecular Life Sciences. 71 (14): 2681–2698. doi:10.1007/s00018-014-1575-6. PMID24526057. S2CID14531019.
^Dinas PC, Koutedakis Y, Flouris AD (June 2011). "Effects of exercise and physical activity on depression". Irish Journal of Medical Science. 180 (2): 319–325. doi:10.1007/s11845-010-0633-9. PMID21076975. S2CID40951545.
^Lindemann L, Hoener MC (May 2005). "A renaissance in trace amines inspired by a novel GPCR family". Trends in Pharmacological Sciences. 26 (5): 274–281. doi:10.1016/j.tips.2005.03.007. PMID15860375.
^Berry MD (January 2007). "The potential of trace amines and their receptors for treating neurological and psychiatric diseases". Reviews on Recent Clinical Trials. 2 (1): 3–19. doi:10.2174/157488707779318107. PMID18473983. S2CID7127324.
^Buman MP, King AC (2010). "Exercise as a Treatment to Enhance Sleep". American Journal of Lifestyle Medicine. 31 (5): 514. doi:10.1177/1559827610375532. S2CID73314918.
^Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Orjuela-Mendoza JP, Anaya-Boig E, et al. (September 2018). "Black Carbon Reduces the Beneficial Effect of Physical Activity on Lung Function". Medicine and Science in Sports and Exercise. 50 (9): 1875–1881. doi:10.1249/MSS.0000000000001632. hdl:10044/1/63478. PMID29634643. S2CID207183760.
^ abWilkinson DJ, Hossain T, Limb MC, Phillips BE, Lund J, Williams JP, et al. (December 2018). "Impact of the calcium form of β-hydroxy-β-methylbutyrate upon human skeletal muscle protein metabolism". Clinical Nutrition. 37 (6 Pt A): 2068–2075. doi:10.1016/j.clnu.2017.09.024. PMC6295980. PMID29097038. Ca-HMB led a significant and rapid (<60 min) peak in plasma HMB concentrations (483.6 ± 14.2 μM, p < 0.0001). This rise in plasma HMB was accompanied by increases in MPS (PA: 0.046 ± 0.004%/h, CaHMB: 0.072 ± 0.004%/h, p < [0.001]) and suppressions in MPB (PA: 7.6 ± 1.2 μmol Phe per leg min−1, Ca-HMB: 5.2 ± 0.8 μmol Phe per leg min−1, p < 0.01). ... During the first 2.5 h period we gathered postabsorptive/fasted measurements, the volunteers then consumed 3.42 g of Ca-HMB (equivalent to 2.74 g of FA-HMB) ... It may seem difficult for one to reconcile that acute provision of CaHMB, in the absence of exogenous nutrition (i.e. EAA's) and following an overnight fast, is still able to elicit a robust, perhaps near maximal stimulation of MPS, i.e. raising the question as to where the additional AA's substrates required for supporting this MPS response are coming from. It would appear that the AA's to support this response are derived from endogenous intracellular/plasma pools and/or protein breakdown (which will increase in fasted periods). ... To conclude, a large single oral dose (~3 g) of Ca-HMB robustly (near maximally) stimulates skeletal muscle anabolism, in the absence of additional nutrient intake; the anabolic effects of Ca-HMB are equivalent to FA-HMB, despite purported differences in bioavailability (Fig. 4).
^ abBoushel R, Lundby C, Qvortrup K, Sahlin K (October 2014). "Mitochondrial plasticity with exercise training and extreme environments". Exercise and Sport Sciences Reviews. 42 (4): 169–174. doi:10.1249/JES.0000000000000025. PMID25062000. S2CID39267910.
^Chen CY, Dicarlo SE (January 1998). "Endurance exercise training-induced resting Bradycardia: A brief review". Sports Medicine, Training and Rehabilitation. 8 (1): 37–77. doi:10.1080/15438629709512518.
^Crewther BT, Heke TL, Keogh JW (February 2013). "The effects of a resistance-training program on strength, body composition and baseline hormones in male athletes training concurrently for rugby union 7's". The Journal of Sports Medicine and Physical Fitness. 53 (1): 34–41. PMID23470909.
^Schoenfeld BJ (June 2013). "Postexercise hypertrophic adaptations: a reexamination of the hormone hypothesis and its applicability to resistance training program design". Journal of Strength and Conditioning Research. 27 (6): 1720–1730. doi:10.1519/JSC.0b013e31828ddd53. PMID23442269. S2CID25068522.
^Dalgas U, Stenager E, Lund C, Rasmussen C, Petersen T, Sørensen H, et al. (July 2013). "Neural drive increases following resistance training in patients with multiple sclerosis". Journal of Neurology. 260 (7): 1822–1832. doi:10.1007/s00415-013-6884-4. PMID23483214. S2CID848583.
^Staron RS, Karapondo DL, Kraemer WJ, Fry AC, Gordon SE, Falkel JE, et al. (March 1994). "Skeletal muscle adaptations during early phase of heavy-resistance training in men and women". Journal of Applied Physiology. 76 (3): 1247–1255. doi:10.1152/jappl.1994.76.3.1247. PMID8005869. S2CID24328546.
^Folland JP, Williams AG (2007). "The adaptations to strength training : morphological and neurological contributions to increased strength". Sports Medicine. 37 (2): 145–168. doi:10.2165/00007256-200737020-00004. PMID17241104. S2CID9070800.
^Moritani T, deVries HA (June 1979). "Neural factors versus hypertrophy in the time course of muscle strength gain". American Journal of Physical Medicine. 58 (3): 115–130. PMID453338.
^Narici MV, Roi GS, Landoni L, Minetti AE, Cerretelli P (1989). "Changes in force, cross-sectional area and neural activation during strength training and detraining of the human quadriceps". European Journal of Applied Physiology and Occupational Physiology. 59 (4): 310–319. doi:10.1007/bf02388334. PMID2583179. S2CID2231992.
^Wisløff U, Ellingsen Ø, Kemi OJ (July 2009). "High-intensity interval training to maximize cardiac benefits of exercise training?". Exercise and Sport Sciences Reviews. 37 (3): 139–146. doi:10.1097/JES.0b013e3181aa65fc. PMID19550205. S2CID25057561.
^Paillard T, Rolland Y, de Souto Barreto P (July 2015). "Protective Effects of Physical Exercise in Alzheimer's Disease and Parkinson's Disease: A Narrative Review". Journal of Clinical Neurology. 11 (3): 212–219. doi:10.3988/jcn.2015.11.3.212. PMC4507374. PMID26174783. Aerobic physical exercise (PE) activates the release of neurotrophic factors and promotes angiogenesis, thereby facilitating neurogenesis and synaptogenesis, which in turn improve memory and cognitive functions. ... Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission.
^Szuhany KL, Bugatti M, Otto MW (January 2015). "A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor". Journal of Psychiatric Research. 60: 56–64. doi:10.1016/j.jpsychires.2014.10.003. PMC4314337. PMID25455510. Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). ... Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans
^Bouchard J, Villeda SA (January 2015). "Aging and brain rejuvenation as systemic events". Journal of Neurochemistry. 132 (1): 5–19. doi:10.1111/jnc.12969. PMC4301186. PMID25327899. From a molecular perspective, elevated systemic levels of circulating growth factors such as vascular endothelial growth factor and insulin-like growth factor 1 (IGF-1) in blood elicited by increased exercise have been shown to mediate, in part, enhancements in neurogenesis (Trejo et al. 2001; Fabel et al. 2003).
^Silverman MN, Deuster PA (October 2014). "Biological mechanisms underlying the role of physical fitness in health and resilience". Interface Focus. 4 (5): 20140040. doi:10.1098/rsfs.2014.0040. PMC4142018. PMID25285199. Importantly, physical exercise can improve growth factor signalling directly or indirectly by reducing pro-inflammatory signalling…. Exercise-induced increases in brain monoamines (norepinephrine and serotonin) may also contribute to increased expression of hippocampal BDNF [194]. In addition, other growth factors—insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor—have been shown to play an important role in BDNF-induced effects on neuroplasticity …, as well as exerting neuroprotective effects of their own …, thereby contributing to the beneficial effects of exercise on brain health.
^Gomez-Pinilla F, Hillman C (January 2013). "The influence of exercise on cognitive abilities". Comprehensive Physiology. 3 (1): 403–428. doi:10.1002/cphy.c110063. ISBN978-0-470-65071-4. PMC3951958. PMID23720292. Abundant research in the last decade has shown that exercise is one of the strongest promoters of neurogenesis in the brain of adult rodents … and humans …, and this has introduced the possibility that proliferating neurons could contribute to the cognitive enhancement observed with exercise. In addition to BDNF, the actions of IGF-1 and vascular endothelial growth factor (VEGF) (54) are considered essential for the angiogenic and neurogenic effects of exercise in the brain. Although the action of exercise on brain angiogenesis has been known for many years (10), it is not until recently that neurovascular adaptations in the hippocampus have been associated with cognitive function (29). Exercise enhances the proliferation of brain endothelial cells throughout the brain (113), hippocampal IGF gene expression (47), and serum levels of both IGF (178) and VEGF (63). IGF-1 and VEGF, apparently produced in the periphery, support exercise induced neurogenesis and angiogenesis, as corroborated by blocking the effects of exercise using antibodies against IGF-1 (47) or VEGF (63).
^Tarumi T, Zhang R (January 2014). "Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise". Frontiers in Physiology. 5: 6. doi:10.3389/fphys.2014.00006. PMC3896879. PMID24478719. Exercise-related improvements in brain function and structure may be conferred by the concurrent adaptations in vascular function and structure. Aerobic exercise increases the peripheral levels of growth factors (e.g., BDNF, IFG-1, and VEGF) which cross the blood-brain barrier (BBB) and stimulate neurogenesis and angiogenesis (Trejo et al., 2001; Lee et al., 2002; Fabel et al., 2003; Lopez-Lopez et al., 2004). Consistent with this, exercise-related enlargement of hippocampus was accompanied by increases in cerebral blood volume and capillary densities (Pereira et al., 2007). Enhanced cerebral perfusion may not only facilitate the delivery of energy substrates, but also lower the risk of vascular-related brain damages, including WMH and silent infarct (Tseng et al., 2013). Furthermore, regular aerobic exercise is associated with lower levels of Aβ deposition in individuals with APOE4 positive (Head et al., 2012), which may also reduce the risk of cerebral amyloid angiopathy and microbleeds (Poels et al., 2010).
^Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C (November 2011). "Exercise for improving balance in older people". The Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd (11): CD004963. doi:10.1002/14651858.cd004963.pub3. PMID22071817. S2CID205176433.
^Swallow JG, Carter PA, Garland T (May 1998). "Artificial selection for increased wheel-running behavior in house mice". Behavior Genetics. 28 (3): 227–237. doi:10.1023/A:1021479331779. PMID9670598. S2CID18336243.
^Swallow JG, Garland T, Carter PA, Zhan WZ, Sieck GC (January 1998). "Effects of voluntary activity and genetic selection on aerobic capacity in house mice (Mus domesticus)". Journal of Applied Physiology. 84 (1): 69–76. doi:10.1152/jappl.1998.84.1.69. PMID9451619.
^Rhodes JS, van Praag H, Jeffrey S, Girard I, Mitchell GS, Garland T, Gage FH (October 2003). "Exercise increases hippocampal neurogenesis to high levels but does not improve spatial learning in mice bred for increased voluntary wheel running". Behavioral Neuroscience. 117 (5): 1006–1016. doi:10.1037/0735-7044.117.5.1006. PMID14570550.
^Garland T, Morgan MT, Swallow JG, Rhodes JS, Girard I, Belter JG, Carter PA (June 2002). "Evolution of a small-muscle polymorphism in lines of house mice selected for high activity levels". Evolution; International Journal of Organic Evolution. 56 (6): 1267–1275. doi:10.1554/0014-3820(2002)056[1267:EOASMP]2.0.CO;2. PMID12144025. S2CID198158847.
^Gallaugher PE, Thorarensen H, Kiessling A, Farrell AP (August 2001). "Effects of high intensity exercise training on cardiovascular function, oxygen uptake, internal oxygen transport and osmotic balance in chinook salmon (Oncorhynchus tshawytscha) during critical speed swimming". The Journal of Experimental Biology. 204 (Pt 16): 2861–2872. doi:10.1242/jeb.204.16.2861. PMID11683441.
^Magnoni LJ, Crespo D, Ibarz A, Blasco J, Fernández-Borràs J, Planas JV (November 2013). "Effects of sustained swimming on the red and white muscle transcriptome of rainbow trout (Oncorhynchus mykiss) fed a carbohydrate-rich diet". Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology. 166 (3): 510–521. doi:10.1016/j.cbpa.2013.08.005. PMID23968867.
^ abOwerkowicz T, Baudinette RV (June 2008). "Exercise training enhances aerobic capacity in juvenile estuarine crocodiles (Crocodylus porosus)". Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology. 150 (2): 211–216. doi:10.1016/j.cbpa.2008.04.594. PMID18504156.
^ abGarland T, Else PL, Hulbert AJ, Tap P (March 1987). "Effects of endurance training and captivity on activity metabolism of lizards". The American Journal of Physiology. 252 (3 Pt 2): R450–R456. doi:10.1152/ajpregu.1987.252.3.R450. PMID3826409. S2CID8771310.
Physical activity and the environment – guidance on the promotion and creation of physical environments that support increased levels of physical activity.
![Summary of long-term adaptations to regular aerobic and anaerobic exercise. Aerobic exercise can cause several central cardiovascular adaptations, including an increase in stroke volume (SV)[107] and maximal aerobic capacity (VO2 max),[107][108] as well as a decrease in resting heart rate (RHR).[109][110][111] Long-term adaptations to resistance training, the most common form of anaerobic exercise, include muscular hypertrophy,[112][113] an increase in the physiological cross-sectional area (PCSA) of muscle(s), and an increase in neural drive,[114][115] both of which lead to increased muscular strength.[116] Neural adaptations begin more quickly and plateau prior to the hypertrophic response.[117][118]](http://upload.wikimedia.org/wikipedia/commons/f/f6/Aerobic_Anaerobic_Exercise_Adaptations.jpg)
![Running helps in achieving physical fitness.[140]](http://upload.wikimedia.org/wikipedia/commons/thumb/9/9a/Woman_running_barefoot_on_beach.jpg/225px-Woman_running_barefoot_on_beach.jpg)
![Skateboarding is good for cardiovascular health[141][better source needed]](http://upload.wikimedia.org/wikipedia/commons/thumb/2/22/Cruising_on_a_Board.jpg/300px-Cruising_on_a_Board.jpg)
![Swimming as an exercise tones muscles and builds strength.[142]](http://upload.wikimedia.org/wikipedia/commons/thumb/1/10/IDHM_Wasserspringen_2018-02-18_3m_mixed_Vorkampf_Sprung_3_18.jpg/207px-IDHM_Wasserspringen_2018-02-18_3m_mixed_Vorkampf_Sprung_3_18.jpg)
