A New Approach to Physical Activity

By Mia Taylor posted on on Fri 06th Aug, 2010 07:57 pm

Editor's note: The following paper was originally submitted as part of Mrs. Taylor's Master's degree studies. Though the piece does not concern yoga directly, many yoga students and those interested in the effects of movement on the body may be intrigued by the findings.

There is a surging need for preventive measures that can help combat the rise in overweight and obese individuals and the correlating rise in disease and health problems.  It is no surprise that exercise decreases the likelihood of certain diseases; innumerable studies have shown this to be true (Warburton et al. 2006).  The preponderance of research focuses on high-intensity or other strenuous measures to promote physical activity and disease prevention but leaves a gap between the benefit and how to reasonably attain it for the most at risk population (Wannamethee & Shaper, 2001).  Often, these populations lack the means, knowledge and capacity to make the transition into a lifestyle that incorporates vigorous physical activity or fitness (Wang & Beydoun, 2007).  By broadening the scope of what constitutes exercise and physical activity a valuable opportunity opens up to bridge that gap.  There are ways to promote the adoption of physical activity with measures that are accessible, affordable, and attainable for the public.  A significant part of this strategy is removing obstacles for the most at risk, be them mental, environmental, or societal (Granner et al., 2007) and help them to understand that physical activity can be as simple as taking everyday activities and making them more active.  I call this “movement promotion.”  Movement promotion brings us back to a time before technology and convenience, where people simply moved more doing every day activities to expend energy.  This awareness offers an ideal, accessible, and more importantly an easy option to give the most at-risk a new perspective when considering how to begin healthful living and engage in movement promotion.

By creating interventions that promote physical activity in terms of movement such as walking, gardening, dancing, house cleaning, and even stair climbing, we can desensitize the public’s understanding that physical activity does not necessarily mean high intensity or vigorous “fitness” (Casperson et al. 1985).  By recreating the standards as accessible and possible the risks associated with cardiovascular vulnerability are reduced (Wannamethee & Shaper, 2001).  The accumulation effect of movement through every day activities can help meet daily expenditure requirements, promote physical activity and overall well being for positive health outcomes. 

Studies have shown there are many health benefits attained by including a simple walking program into daily life.  The Morabia and Costanza (2004) study suggests that a brisk 15 minute walk or a slow 30 minute walk can significantly contribute to increased physical activity levels, higher calorie expenditure and an inverse relationship for health risks at the population level.  Ideally, the longer the walk at a brisk pace the higher physical activity levels, the greater calorie expenditure and health outcomes.  A broadening body of research supports their conclusion.

In a related study, Jackson and Howton (2008) utilized a pedometer intervention on walking outcomes in a group of college students categorized by body mass index (BMI).  They found that more participants in overweight and normal weight groups, when compared to the underweight group, increased the number of steps each week throughout the 12 week intervention.  This suggests that the presence of a recording instrument provides the stimulus or motivation to walk more and it also highlights an increased awareness or intrinsic motivation to continue the benefit.  This study focused on increasing participation in walking as opposed to particular physiological measurements, however by nature of increased movement benefits can be realized.

When comparing walking and vigorous physical activity to the risk of Type 2 diabetes in women, Hu et al. (1999) found similar metabolic equivalent (MET) hours per week between moderate-intensity walking and forms of more vigorous activity in female nurses.  This massive, longitudal study (n=70,000+; 8 years in length) showed a strong inverse relationship between a brisk walking pace and risks associated with Type 2 diabetes.  Both forms of movement showed equivalent energy expenditure even after adjusting for BMI and other confounding variables, correlating with equivalent reductions in risk.  The study supports that greater physical activity substantiates greater reductions in risk, however most importantly reflects walking as equal to more intense forms of exercise.

Another accessible approach to increasing movement is through activity associated with gardening.  Gardening has multiple benefits including the moderate physical demand of daily maintenance, psychological enhancement, as well as a supply of fresh fruit and vegetables which are known to promote overall health management (Lombard, Forster-Cox, Smeal & O’Neill, 2006).  The study cited found promising results when investigating gardening and agriculture as a means of physical activity for the Navajo Nation that has experienced an increasing rate of diabetes.  Overall, Native Americans who participated in individual gardens or community gardens had increased levels of HDL cholesterol and less need for insulin or oral medications.  In addition, the gardeners’ diets changed in correlation with their gardening activity; the tendency to consume a healthier diet was evident, contributing to a change in mentality about food and choices, as well as leading to greater overall health and well-being.

A study by Wannamethee and Shaper (2001) also examined the effects of walking and gardening on cardiovascular health and found that accumulated light-to-moderate walking or gardening activities during the week conferred similar reductions on cardiovascular risks when compared to a once-a-week vigorous activity for the older adult population.  The study emphasizes that continued moderate activity is an ideal option for those in the older adult population that may fear or dislike vigorous activities.  The quality of movement with more moderate activity lends to a much more enjoyable experience, which then leads to further participation. 

The idea of accumulated bouts of exercise is now getting considerable attention as a way to influence participation in physical activity.  Murphy, Blair and Murtagh (2009) performed a review of 16 comparable studies each designed to determine the effects of equal amounts of exercise performed in both an accumulated or continuous manner.  Although the studies measured varying physiological parameters, common ground indicated that the majority of prescribed accumulated bouts of movement had equal results in cardiovascular measurements compared with groups who performed continuous bouts of exercise.  In detail of the 16 studies included in the review, 12 focused primarily on walking as the form of exercise, three on running or jogging, and one on aerobic dance.

Kruk’s (2009) study on 858 Polish women and breast cancer risk found a natural protective element for women who participated in lifetime household and occupational activity.  Specifically, results showed that groups classified into low-to-moderate intensity, long-lasting household activities and moderate-to-vigorous recreational activities were both linked to a 44% reduced risk for breast cancer in pre- and post-menopausal women.  The study also revealed that the greater intensity of the activity the greater the risk reductions in breast cancer.

Dancing is a form of movement and physical activity that has positive outcomes as well.  Keogh and colleagues (2009) evaluated the effects of a variety of dancing styles in older adults in a review of 18 studies.  Analysis revealed that participants in all studies significantly benefited by a dance program in lower BMI, greater aerobic power, lower body strength, flexibility, and endurance, increased static and dynamic balance and improved gait speed.  Of importance is the effect on aerobic capacity and economy as a component to reduce cardiovascular disease risk.

Stair climbing is another option of movement that may offer accessibility and ease to inactive individuals.  Surprisingly little research has been done in this area to determine health benefits, but certainly affordability of this form of physical activity is of interest.  Two similarly designed studies conducted by Boreham and colleagues (2000;2005) studied the effects of stair climbing on cardiorespiratory fitness, blood lipids, cholesterol levels, blood lactate, and homocysteine in experimental groups of young women.  Prescribed accumulated short bouts of stair climbing were assigned to the experimental groups with bouts interspersed throughout the day.  Researchers found significant improvements in oxygen uptake, heart rate and end lactate measurements when compared to control groups.  No change was found in homocysteine, total cholesterol, or triglycerides however, a rise in HDL-cholesterol and a reduction in LDL-cholesterol were recorded.

The research reviewed points to a common theme for the concept of movement promotion: that every day activities like walking, gardening, dancing and stair-climbing confer benefits previously not emphasized as a tool for preventing diseases.   These types of activities offer a welcomed alternative approach to attaining physical activity recommended levels for most adults.   The evidence supports the theory that shorter, accumulated bouts of low-to-moderate exercise intensity can be equivalent to continuous bouts of vigorous exercise intensity for positive health outcomes.  The appeal of this research is simultaneously comforting and advantageous to all people, inactive and active as well.  As perhaps expected, additional bouts of exercise lead to greater benefits in cardiovascular health, aerobic power, BMI, blood lipids, muscle strength, psychological well being and overall fitness levels.

We might think of promoting an intervention that includes these activities to appeal to those in the population who are at most risk or in danger of health problems associated with inactivity and obesity.  The approach is a bottom-up style.  It lowers the barriers to entry, by “re-packaging” physical activity and fitness as something more palatable for the public: more simply as movement promotion.   The value of accumulated shorter bouts of movement accomplished throughout the day can be the impetus to greater activity participation in the future.  This satiates critics that may argue that low-intensity activity is not enough to attain maximum potential for health outcomes, however for those individuals with multiple risk issues such as obesity with hypertension this is a safe alternative as this method protects against cardiac hazards.   Getting people to move and become more engaged I believe is the greater goal.

As a yoga and meditation teacher for over 10 years, primarily of adults and many older adults, I have come to understand more deeply that people’s abilities vary greatly and the idea that we can reduce risks for health issues such as heart disease, by simply doing what we normally do but in a more active and conscious manner, is appealing on many levels.  Yoga is not known for cardiovascular benefits, but according to this research, it contributes to the overall amount of activity needed to attain levels of benefit.  I have always encouraged walking as a way to move and stay active for all my students.  It thrills me to know that there are verifiable benefits for the prescription of walking.

The potential for reversing the trend of obesity and other preventable health concerns with movement promotion is massive.  If those at risk can begin to see the possibilities of taking control of their health through everyday activities, we can begin to prevent chronic disease and enhance individual wellbeing.  Movement promotion simplifies the process and the notion of exercise making it accessible to all.

References:

Warburton, D.E.R., Nicol, C.W., Brendin, S.S.D. Health benefits of physical activity: the evidence.Can Med Assoc J. 2006;174(6):801-809

Wannamethee S, Shaper A. Physical activity in the prevention of cardiovascular disease: an epidemiological perspective.  Sports Med [serial online]. 2001;31(2):101-114.

Wang, Y., & Beydoun, M.A. The obesity epidemic in the United States – Gender, age, socioeconomic, racial/ethnic, and geographic characteristics: A systematic review and meta-regression analysis. Epidemiol Rev. May 2007;29:6-28.

Granner ML, Shaper PA, Hutto B, Wilcox S, & Addy CL. Perceived individual, social and environmental factors for physical activity and walking. J Phys Act and health. 2007;4:278-293.

Casperson CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: Definitions and Distinctions for health-related research. Public Health Rep. 1985;100(2):126-131.

Morabia A, Costanza M. (2004). Does walking 15 minutes per day keep the obesity epidemic away? Simulation of the efficacy of a populationwide campaign. Am J Public Health. March 2004;94(3):437-440.

Jackson E, Howton A. Increasing walking in college students using a pedometer intervention: differences according to body mass index. J Am Coll Health [serial online]. 2008;57(2):159-164.

Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA. October 1999;282(15):1433-9.

Lombard KA, Forster-Cox S, Smeal D, O’Neill MK. Diabetes on the Navajo nation: what role can gardening and agriculture extension play to reduce it?  Rural Remote Health. 2006;6:1-16.

Murphy M. Accumulated versus continuous exercise for health benefit: a review of empirical studies. Sports Med [serial online]. 2009;39(1):29-43.

Kruk J. Intensity of lifetime physical activity and breast cancer risk among Polish women. J Sports Sci [serial online]. March 2009;27(5):437-445.

Keogh, J.W., Kilding, A., Pidgeon, P., Ashley, L., Gillis, D. Physical benefits of dancing for healthy older adults: a review.J Aging Phys Act. October 2009;17(4):479-500

Boreham C, Wallace W, Nevill A. Training effects of accumulated daily stair-climbing exercise in previously sedentary young women. Prev Med [serial online]. 2000;30(4):277-281. Available from: E-Journals, Ipswich, MA.

Boreham CAG, Kennedy RA, Murphy MH, Tully M, Wallace WFM, Young I. Training effects of short bouts of stair climbing on cardiorespiratory fitness, blood lipids, and homocysteine in sedentary young women. Bri J Sports Med, 2005;39(9):590-593.

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