The purpose of this article is to provide information on the benefits, disadvantages, risks, and side effects of different types of exercise and physical activities, as well as how an individual can choose from a variety of options available. Individuals should be aware that the following information could not be presented in detail for those who are at risk of injury or are new to exercising or fitness. If you have questions regarding your medical condition, consult your physician before beginning an activity. You must continue to follow all instructions given by your doctor and local recreation center/health club.
Benefits of Exercise to Physical Well-Being
Exercise has many benefits to physical health, including reducing the risk of heart disease, lung cancer, and diabetes ( 1, 2 ). Any type of exercise has been shown to benefit people with diabetes ( 1 ). Many studies have also demonstrated that regular exercise may lower blood pressure and decrease the need for medication to treat high blood pressure ( 3, 4 ). This may occur especially if it's done for long periods ( 5 ). The American Heart Association recommends adults engage in aerobic exercise at least two days a week for five minutes or more, with one or more sessions per week ( 6 ). In addition to improved cardiovascular health, regular aerobic exercise may help reduce body fat ( 7, 8 ).
Physical exercise also helps improve strength, flexibility, coordination, and balance ( 9). These benefits may include improving the ability to lift weights, performing basic archery and sports such as football, and building muscle and bone strength. Research suggests that the combination of aerobic exercise and resistance training may even decrease the risk of diabetes ( 10, 11 ).
Additional benefits include:
Improved mood and energy levels
Improved sleep
More energy during the day
Increased self-confidence
Less frustration than in other situations
Fewer headaches including when participating in weight training ( 12, 13 )
Healthy Weight Loss Options
Weight loss surgery is not recommended for overweight adults with type 2 diabetes because there is currently no scientific evidence to support its health risks ( 14 ). As most types of weight loss surgeries are safe and effective ( 15, 16 ), research has demonstrated that moderate-intensity weight loss has been shown to result in reduced disease risk and better quality of life ( 17 ). For older people, lifestyle changes and exercise are more important for managing obesity than surgery to lose weight ( 18 ). However, individuals who would prefer surgical weight loss surgery are encouraged to consider alternative therapies such as low-calorie diets and bariatric surgery to manage their individualized weight loss goals ( 19 ).
Cardiovascular Benefits of Workouts
Cardiovascular diseases usually develop when fats accumulate in the arteries. Exercising has been shown to reduce the amount of cholesterol ( 20, 21 ) and increase the number of healthier LDL cholesterol ( 22 ). Some evidence also shows that regular aerobic exercise may help prevent stroke ( 23 ). Other studies suggest that regular aerobics may play an important role in helping increase HDL cholesterol levels ( 24 ).
As important as the overall reduction of LDL cholesterol, research consistently indicates that maintaining a healthy level of serum cholesterol is the top public health priority ( 25 ). Studies have observed improvements in the symptoms of major artery damage such as coronary heart disease, atherosclerosis, and peripheral artery disease when an individual engages regularly in vigorous exercise at an increased level of intensity for 30 minutes or more ( 26 ). Moreover, moderate-intensity brisk walking or biking for about 10 minutes at a time significantly increases HDL levels ( 27, 28 ). Moderate-intensity aerobic activity such as swimming also increases higher-density lipoproteins (29 ). A study of women over 50 years old with elevated blood cholesterol found that engaging in a 150-minute swim per week for 3 years resulted in significant decreases in total cholesterol levels and total triglycerides levels ( 30 ).
Weight Training and Cardiovascular Risk Reduction Program
A comprehensive cardiovascular risk prevention program designed for individuals at risk for future cardiovascular events and cardiovascular benefits should focus on increasing physical activity and preventing overweight and obesity. At any age, a person may be subject to certain factors that make them predisposed to hypertension or other conditions and therefore to some degree more susceptible to the development of cardiovascular disease ( 31 ). For example, a sedentary lifestyle,
unhealthy eating habits, stress, lack of physical activity, smoking, and excessive alcohol consumption are risk factors for heart attack and stroke ( 32, 33, 34 ). It has been estimated that nearly half a million Americans die each year of CVD alone ( 35 ). Even among individuals who do not have a history of heart conditions or other risk factors for heart attack or blood clotting disorders, some types of exercise have been shown to significantly reduce CVD risk compared to others ( 36 ). Evidence suggests that any type of exercise may be beneficial in reducing cardiovascular risk factors ( 37, 38, 39 ). There is also compelling evidence that increasing physical activity during adolescence may positively impact adult obesity ( 40 ). Furthermore, researchers suggest that consistent participation in moderate to intense aerobic exercise may lead to reductions in cardiovascular risk factors and ultimately to improved vascular function and longevity in later life ( 41, 42 ). These findings are supported by studies showing improvements in glucose tolerance, fasting serum insulin levels, and dyslipidemia after frequent aerobic exercise ( 43, 44, 45 ).
Fitness Guidelines
The Committee on Active Recreation recommends that individuals maintain an exercise goal of 75 to 85 percent of their maximum heart rate (MHR) during continuous moderate-intensity aerobic and 30 minutes or more of vigorous physical performance per week. In addition, they recommend that individuals maintain a caloric expenditure of 500–600 kcal/day per MHR with at least 25 percent of calories being at “moderate” intensity and 60–75 percent of calories being at “vigorous” intensity, at least three times per week. Overall, these guidelines were developed on a fairly narrow sample of individuals, primarily males, ages 65 years and older. However, these guidelines should be applied to individuals at greater risk for developing chronic diseases such as obesity, metabolic syndrome, and cardiovascular disease, as well as pre-exercise tension-type headache disorder ( 46, 47 ). The American College of Sports Medicine (ACSM) and the International Society for Sport and Exercise Medicine (ISSE) further recommends that individuals engage in moderate-intensity aerobic training at least twice weekly, with 1 session per week for children. Additional recommendations issued by ACSM and ISSE include adding exercises for strengthening muscles and bones; increasing the total daily calorie intake when possible; limiting time spent sitting and sleeping; and adjusting the target intensity of exercise for older individuals with poor balance and low mobility ( 48, 49 ). Unfortunately, these recommendations do not cover specific exercise modalities that can be used to meet the guidelines outlined above ( 50 ). Additionally, although the guidelines emphasize the importance of an active lifestyle, there is no mention of the difference between steady state and interval training.
Interval Training versus Steady State Training
Intermittent, brief bouts of endurance training may help keep metabolism healthy by burning excess carbs and giving more energy to work muscles and oxygen to cells, which may be more sustainable than prolonged steady-state exercises ( 51, 52, 53, 54). According to the Centers for Disease Control, only less than half of U.S. citizens participate in any form of cardiovascular exercise once a month, although a large portion can sustain moderate-intensity endurance training sessions that offer benefits in keeping blood sugar stable while remaining physically fit ( 55 ). In general, interval training is associated with stronger gains in cardiorespiratory fitness, muscular mass, lean body mass, and lean body mass ( 56, 57 ). On the other hand, steady-state exercise is seen as superior to interval training for promoting musculoskeletal strength, muscular power, muscle and bone growth, and increased stamina and endurance. Due to the small sample size and cross-sectional design of the current review, it is difficult to determine whether interval training is better than steady-state exercise. While both programs are beneficial, participants on either are likely to differ based on factors such as fitness level, sex, diet, the presence of chronic ailments such as cancer or heart failure, and genetic predisposition. Based on what we know today, it appears to be best for athletes to incorporate both forms of exercise in various phases of competition. However, for average-to-high-intensity exercise, it appears that alternating between sprinting and holding a plank is optimal. Interval training offers another option for individuals whose exercise schedule cannot accommodate the higher intensity required for steady-state training. Regarding the timing of implementation and duration of exercise, the recommendation for beginners is, to begin with, simple short intervals followed by longer repetitions of the same length. As the training progresses, the athlete needs to adjust for slower recovery times in between exercises. Because short-term intermingling of movements does not allow for a complete warm-up period, many experts suggest using shorter but slightly faster sets. Another advantage of alternating between short, quick bursts of activity and medium or longer durations is the opportunity to create more variability in response to training stimuli. When using slow-tempo drills, the athlete can also avoid sudden stopping and give himself the breathing room he needs for longer and smarter exercises.
Protein Shakes: Advantages and Disadvantages for Athletes
Several studies have demonstrated that protein shakes are a viable alternative to shakes in terms of convenience of preparation and cost. Protein shakes have been shown to contain sufficient amounts of high-quality protein from varied sources, which has been shown to promote weight loss ( 59, 60 ). This review states that studies show a marked improvement in protein shake consumption when consumed before meals with meal replacement bars providing only around 0.5–1.0 grams of sugar per serving (61). However, recent studies indicate that consuming too much protein can cause water retention, constipation, bloating, cramping, gastrointestinal discomfort, and abdominal pain (62). To address these concerns, manufacturers often add electrolytes to the protein powder to counterbalance the water retention caused by the liquid protein and other added nutrients. More
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