TABLE OF CONTENTS

Title Page

Certification

Dedication

Acknowledgement

Table of Contents

List of Table

Abtract

CHAPTER ONE

Get the Basics...

 By TYLER SPRAUL AUG 25,2020


 Exercise for the purpose of training to increase strength, speed, and endurance can be traced
back to ancient Greece around 600 B.C.
 Bodybuilding first emerged a while before more structured exercise routines for the average
person.
 It was not until the mid 20th century that regular exercise as a means to improve health began to
become mainstream.

If you take the term exercise to simply mean physical tasks that may require strength or
endurance then exercise has been around since the beginning of time.

After all, carving tools out of stone or building structures with one’s bare hands must have been
very physically demanding.

When looking at a more narrow definition of exercise, however, it became normal to work out
for the sake of maintaining your own health and fitness level at a much later date.

While it is impossible to point an exact date that modern exercise was invented you can pinpoint
time periods in our history when regular fitness routines emerged in certain populations and
eventually the general population.

Science is also tied closely to this history because much of what we base our fitness routines on
today is based on studies done relating exercise to various aspects of personal health.
To find a workout routine that works for you, sign up for an Exercise.com PRO plan today. 

Table of Contents

When Was Exercise Invented as a Means of Training?

Exercise for the purpose of training to increase strength, speed, and endurance can be traced back
to ancient Greece around 600 B.C.

Greek and Spartan soldiers were among the first to engage in exercises such as lifting heavy
rocks and doing construction work to increase muscle strength, running long distances to
increase speed and endurance, and competing in wrestling matches to refine fighting skills.

Exercise for the purpose of training the military led to the idea of sports and competition with the
first Olympic Games held in ancient Greece.

Despite this, exercise was by no means seen as something the average person took part in. If you
were not part of the military there was no purpose seen in engaging in structured fitness routines.

Perhaps people in ancient times and even more modern history did not see a need for the average
person to exercise because their daily lives provided them with all the physical fitness tasks their
bodies needed. Until later in the 20th Century, people mostly walked everywhere they needed to
go whether it was a job, school, or to a local market.

They carried their belongings while they walked, and did manual labor around their homes
themselves. Formal exercise was not a necessity back then as it is today in a world of
conveniences that greatly reduce our level of physical fitness.

When Was Bodybuilding Invented?

Bodybuilding first emerged a while before more structured exercise routines for the average
person. In the early 1800s men with well-trained physiques began popping up on the carnival and
circus circuits. People began viewing toned muscles and strength for men as something to be
desired. Still, it was only a small portion of the population that this pertained to. For many,
exercise was associated with those who were lower class and was not viewed as something the
majority of people, especially women, wanted to engage in.

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When Was Exercise Invented as a Means of Improving

Health and Fitness?
It was not until the mid 20th century that regular exercise as a means to improve health began to
become mainstream. In 1949, Jerry Morris, an epidemiologist, made the first correlations
between cardiovascular health and exercise. He completed studies in London examining bus
drivers who sat for long periods every day and often suffered from heart and lung conditions. He
also studied postal workers who delivered mail through biking or walking versus those who sat
behind counters all day. These studies were published in 1953.

At roughly the same time, the treadmill was invented, initially for use by doctors for medical
testing, but soon after was used in prisons to provide daily movement for prisoners confined to
their cells for long periods of time. In the 1960s, treadmills began being marketed for use in the
home.

Throughout the 1960s, spurred by Morris’ studies, more and more people began taking part in
organized physical fitness activities. In 1968 Kenneth Cooper published the book, Aerobics,
which created an even greater desire among the general population to take part in regular
exercise. Fad diets and exercise workout routines began popping up left and right and a new
craze was born.

Today, exercise is considered necessary in order to live a healthy, productive lifestyle. As

additional studies point to increasing health benefits and more and more exercise programs gain
endorsements by medical gurus and celebrities more people see exercise as a necessary part of
daily life.

Ironically, with all the technology we now have to make our lives supposedly easier, we have
reduced our natural means of getting exercise so much so that even with today’s health clubs,
exercise fads, home equipment, and children’s programs, people have significantly more
problems with obesity than they did a hundred years ago.

Now that you know more about when exercise was invented, you can get started planning your
own fitness routine. Sign up for an Exercise.com PRO plan today to develop a program that
meets your personal needs.

References:

1. https://www.healthline.com/health/fitness-exercise/aerobic-exercise-examples
2. https://www.healthline.com/nutrition/10-benefits-of-exercise
3. https://www.cdc.gov/obesity/data/adult.html
4. https://bjsm.bmj.com/content/34/3/217
5. https://www.unm.edu/~lkravitz/Article%20folder/history.html

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in: Featured, Fitness, Health & Fitness

Guest Contributor • September 24, 2014 • Last updated: June 1, 2021

The History of Physical Fitness

Editor’s Note: This is a guest post from MovNat founder Erwan Le Corre.

Fitness, as we know it today, seems to be a relatively modern invention – something that started
vaguely in the 70s with jogging and Jazzercise. But physical exercise obviously goes back much further
than that, to a time where people wouldn’t have thought of it as working out, but rather a way of life.
Centuries and millennia ago, they did not have all the machines and weights and gyms that we have
today, and yet they were in better shape than we are. To understand why this is, how we got to our
modern fitness culture, and what we have lost along the way, it’s helpful to take a look at the history of
exercise.

In a previous article on the philosophy of “MovNat,” I briefly talked about the history of physical training
before there were modern gyms and workout programs. This article is a more detailed overview of
exercise throughout time, from its ancestral origins, to the early history of physical education in Europe
and America, to today’s plethora of fitness modalities, sports, and activities.

Primal Times: Move For Your Life!

From the dawn of humankind to around 10,000 BC, men had a constant voice in the back of their head
saying, “Run for your life!” Physical development followed a natural path that was determined by the
practical demands of life in a wild landscape as well as the vital need to avoid threats and seize
opportunities for survival.

One’s movement demands consisted of locomotion, the manipulation of tools and natural objects
(rocks, tree limbs, etc.), and defense. To survive in a harsh environment full of natural and human
obstacles and enemies, early man had to know not only how to run, but also walk, balance, jump, crawl,
climb, lift, carry, throw and catch things, and fight. We can also safely assume that playful or creative
moves like early forms of dancing were performed when bellies were full and predators weren’t around.

“Any idea how many calories we’ve burned?”

The strength and mobility of early man was not developed through structured programs, methods, or
schedules, but rather was forged by the daily, instinctive, necessity-driven practice of highly practical
and adaptable movement skills. Today, the few hunter-gatherer tribes which still exist around the world
would have no idea what “primal fitness” or a “caveman workout” is, as this kind of “exercise” remains
deeply ingrained in their everyday lives.
In hunter-gatherer tribes, everyone had to be strong — men, women, and children alike. Here we see
walking, balancing, and carrying — all at once. It doesn’t get any more “functional” than this.

Neolithic Times: Crop Culture

Starting between 10,000 and 8,000 BC, the Agricultural Revolution is often considered to be the dawn of
civilization.

Man’s transition from nomadic hunter-gatherer to farmer led to dramatic changes in his physical
activity. The numerous demands of growing food and raising cattle meant a lot of chores and a lot of
daily labor for farmers. But these tasks were largely repetitive, and required a very limited range of
movement. At the same time, the need for performing a variety of complex movements — running,
balancing, jumping, crawling, climbing — greatly diminished. Such movements were rarely performed in
a farm environment, or were performed in much simpler ways; for example, climbing a ladder is safer
and more constrained and predictable than climbing trees.

Ancient Times: Prepared for War

Between 4,000 BC and the fall of the Roman Empire in 476 AD, civilizations rose and fell through war
and conquest. Assyrians, Babylonians, Egyptians, Persians, and later on, the Greeks and Romans all
imposed physical training on boys and young men. The purpose? Preparing for battle.

Ancient military training had similarities to the movements performed in nature by our cavemen
brethren, but with more structure and a different end goal. Young men practiced fundamental skills
such as walking and running on uneven terrains, jumping, crawling, climbing, lifting and carrying heavy
things, throwing and catching, unarmed fighting, and weapons training.

Civilized populations valued physical culture for sports as well. Records of athletic competitions exist
from ancient Egypt, and of course, the ancient Greeks famously created the first Olympic games. Not
surprisingly, these early sports were all based on practical, natural movement skills and were
fundamentally related to the preparedness needed for war — the Greeks strove to best each other in
running (sometimes with armor and shield), jumping, throwing (javelin or discus), and fighting (striking
and wrestling).
The images above demonstrate the sports the Greeks trained for and competed in during their Olympics
games. The events concentrated on natural movements, like running, and martial skills, like fighting.

Outside of military training and sports, Greeks, and later the Romans, celebrated the body’s beauty and
strength and embraced physical training as a philosophical ideal and an essential part of a complete
education. They celebrated the idea of having a sound mind, in a sound body. Physical culture started to
rise beyond practical necessities to become a means to an end — an “art de vivre.”

Remains of a “gymnasia,” an early version of our modern gyms.

Antique sculpture representing ideal athleticism.

The Dark Ages: The Rejection of the Body

Lasting from the 5th to the 15th century, the Middle Ages were a chaotic period with a succession of
kingdoms and empires, waves of barbarian invasions, and devastating plagues. The teachings of
Christianity spread the belief that the primary concern of one’s lifetime was preparing for the afterlife.
The body was seen as sinful and unimportant — it was a man’s soul that was his true essence. Education
was overwhelmingly connected to the Church, and focused on cultivating the mind rather than training
the body.
Under feudalism, the dominant social system in medieval Europe, only nobles and mercenaries
underwent physical training for military service. Similarly to ancient times, their training centered
on natural movements and martial skills.

The rest of the population were mostly peasants obliged to live on their lord’s land and work extremely
hard in fields using rudimentary tools. Their “exercise” came through hard labor.

The Renaissance: A Fresh Start

The Renaissance Era (from around 1400 to 1600) prompted a much greater and open interest in the
body, anatomy, biology, health, and physical education.

In 1420, Vittorino da Feltre, an Italian humanist and one of the first modern educators, opened a very
popular school where, beyond the humanist subjects, a special emphasis was placed on physical
education.
Cristobal Mendez

In 1553, El Libro del Ejercicio Corporal y Sus Provechos, by Spaniard Cristobal Mendez, was the first book
to exclusively address physical exercise and its benefits. In the book, exercises, games, and sports are
classified, analyzed, and described from a medical standpoint, and advice is offered on how to prevent
and recover from injuries resulting from these physical pursuits. Several chapters even provide specific
advice on particular drills and games for women, children, and the elderly.
16 years later, Mercurialis, an Italian physician, published De Arte Gymnastica. It was the culmination of
his studies of classical and medical literature, particularly the ancient Greeks’ and Romans’ approach to
hygiene, diet, and exercise, and their use of natural methods for the treatment of disease. Laying out
the principles of physical therapy for the first time, and accompanied with beautiful illustrations (even
though they were largely creative speculations), it is considered the first book on sports medicine, and
strongly influenced the wave of physical education and training methods that started to emerge in
Europe two centuries later.
Climbing and balancing practice as depicted in De Arte Gymnastica.

The Old Times: Fit for the Homeland

The Industrial Revolution, marking the transition from manual production methods to machine-based
manufacturing processes, began around 1760 and quickly generated social, economic, and cultural
trends that changed the way people lived, worked, and of course, moved. As people became more
sedentary, a new movement towards intentional physical exercise arose. This movement was given a
boost in the 19th century from the rise of a nationalistic fervor in many counties in Europe. Staying
healthy, fit, and ready to serve in battle became a point of civic duty and pride.

In Europe

In 1774, Johann Bernard Basedow, influenced by Rousseau’s ideas of the “Natural Human,” opened the
Philanthropinum in Germany, with an emphasis on physical exercise and games, including wrestling,
running, riding, fencing, vaulting, and dancing. Even the school’s uniforms, which were often heavy and
constricting during this time period, were made more comfortable to allow students greater freedom of
movement. This model inspired the founding of many similar institutions, and physical training began to
become more systemized and included as an integral part of the educational curriculum.

Some of the apparatuses designed by Muths. Found in Gymnastik für die Jugend.
Climbing vertical pole or rope. In Gymnastik für die Jugend.

Twenty years later, Guts Muths, another German teacher and educator, developed the basic principles
of artistic gymnastics, for which he is regarded as the “Great Grandfather of Gymnastics.” His Gymnastik
für die Jugend (Gymnastics For the Youth), the first systematic textbook in gymnastics, was published in
1800 and became a standard reference for physical education in the English-speaking world.
Friedrich Jahn (1778-1852), known as “The father of gymnastics.”

In 1810 Friedrich Jahn came on the physical culture scene. Known as “The Father of Gymnastics,” he was
an essential pioneer of physical education, and his ideas spread throughout Europe and America. A
German gymnastics educator and ardent nationalist who had lived through Napoleon’s invasion of his
country, he felt the best way to prevent another such incursion was to help his people develop their
bodies and minds. To this end, he led young men on fresh-air expeditions and taught them gymnastics
and calisthenics to restore their physical and moral strength.

In 1811, Jahn opened the first Turnplatz, or open-air gymnasium, in Berlin. His gymnastics movement,
then called the Turnverein, spread rapidly throughout the country, and in 1816 he published Die
Deutsche Turnkunst (The German Gymnastics) dedicated to his gymnastics system.

In addition to these contributions to physical culture, Jahn invented the pommel horse and horizontal
and parallel bars, and promoted the use of gymnastic rings. The physical culture festivals he sponsored
attracted as many as 30,000 enthusiasts, but the essence and end goal of his gymnastics and calisthenics
methods were above all practical and functional, not artistic. He advocated the practice of the
traditional natural movements like running, balancing, jumping, climbing, and so on.
An early gymnastics festival in Germany.

Well-informed of this German model, as well as the ancient tradition of athletics, Swede Pehr Henrik
Ling developed principles of physical development, emphasizing the integration of perfect bodily
development with muscular beauty. By contrast with the German system, this Swedish system
promoted “light gymnastics,” employing little, if any apparatuses (Ling invented wall bars) and focusing
on calisthenics, breathing, and stretching exercises as well as massage.

Swedish gymnastics had four categories: pedagogic, military, medical, and aesthetic. All movements had
to be performed correctly and collectively in a freestanding fashion under a leader’s direction, which
differed from the predominant, more mobile, strenuous, and practical German approach. Aspects of this
method can still be traced in some modern programs of physical training.

Around the exact same time, Spaniard Francisco Amoros founded a military gymnastics school in
Madrid, then moved to Paris and established the Normal Gymnastic Civil and Military School in 1819. In
1830 he published A Guide to Physical, Gymnastic and Moral Education.
After being removed from his position as leader of the army’s physical training program, he opened a
popular civilian gymnastics hall in Paris and became the initiator of physical education in France and
Spain.

In 1847, French physical culture pioneer and strongman Hippolyte Triat founded a huge gymnasium in
Paris where the bourgeois, aristocrats, and spirited youth joined in an enthusiastic pursuit of fitness.

In the 1870s after the loss of Alsace-Lorraine to the Germans, the already budding nationalistic mood in
France exploded. Physical education became a principal focus in French schools, as battalions of young
men were trained to avenge the country.

In Scotland, the Highland Games began during the Romantic trend of the 1830s, and included traditional
physical challenges distinctive to Scottish culture such as caber tossing, hammer throwing, and the stone
shot put, along with running, wrestling, and jumping.
The exercise methods developed by German physical culturists influenced English physical education.

In England, Charles Darwin’s concept of “survival of the fittest” gave that country’s nascent physical
culture movement a boost. Englishmen wanted to be strong enough to rise to the top of nature’s
hierarchy. In 1849 the first English athletic competition was conducted at the Royal Military Academy.
Scot Archibald MacLaren opened a well-equipped gymnasium at the University of Oxford in 1858, where
he trained 12 army officers who then implemented his physical training regimen into the British Army.
University of Oxford gymnasium.

It is also worth mentioning the Czech Sokol movement. Founded in 1862, this youth sports and
gymnastics organization was inspired by the German Turnverein (Gymnastic Movement) and provided
physical, moral, and intellectual training for the nation through fitness programs (mostly centered on
marching drills, fencing, and various forms of weightlifting), lectures, group outings, and massive
gymnastics festivals. This training extended to men of all economic classes, eventually to women, and
ultimately to the entire Slavic world.

The Polish Falcons (1867) had similar aspirations. In addition to physical training and athletic contests,
such cultural groups often sponsored national or traditional dances, songs, and language revivals.
Everywhere in Europe people seemed to develop a fitness culture rooted in their ethnic or national
identity.

As Europe entered the 20th century, French navy officer and physical educator Georges Hebert played a
prominent role in moving physical culture forward – and did so by taking a cue from the cultures of the
past. Having studied the principles espoused by his predecessors, including Jahn and Amoros, he
pioneered his own “natural method.” His method was entirely based on natural movement skills such as
walking, running, balancing, jumping, crawling, climbing, manipulative skills (lifting, throwing, etc.), and
self-defense – all of which were often practiced on obstacle courses. Hebert was responsible for the
physical training of all sailors in the French navy, and then opened the largest and most modern
indoor/outdoor training center in Reims in 1913.
An excerpt from one of Hebert’s books.

Hebert published his first book, L’Education Physique ou l’Entrainement Complet par la Methode
Naturelle (Physical Education or Complete Training by the Natural Method), in 1912, followed by many
other works on the same subject. The insights modern man can glean from these seminal works will be
the subject of my next post.

In the USA

Since the threat of foreign invasion was never as great in the United States as it was in Europe, the need
to prepare for war was not as acute, and thus an emphasis on physical culture came later to this
country.

Catharine Beecher was one of the first pioneers to create an awareness of fitness in America. As a strong
advocate for the inclusion of physical education in schools as well as daily exercises for both sexes, she
developed a program of calisthenics that were performed to music. When Beecher established the
Hartford Female Seminary in 1823, it was the first major U.S. educational institution for women to
implement physical education courses as part of the program.
At the same time, European physical culture traditions started to take root in America. Many “Turners”
(German practitioners of Jahn’s gymnastic system) emigrated to the US, and in 1824, German scholar
Charles Beck opened an outdoors gymnasium in Massachusetts that was similar to Jahn’s Turnplatz. It
was the first gym in the nation and hosted the first school gymnastics program in the country.

Many other Turners became active in the American public education system and strongly influenced it
by opening clubs and teaching gymnastics in various states. One of the most notable practitioners of this
European tradition was Dudley Allen Sargent, who is considered to be the founder of physical education
in the United States. From 1879 until his retirement in 1919, he was director of the Hemenway
Gymnasium at Harvard University, where he taught the German and Swedish systems that he had
learned as a young man. Sargent also challenged the Victorian view of females as feeble and prone to
fainting, and encouraged freedom of dress and vigorous activity for girls and women.

Sargent invented multiple gymnasium apparatuses, created a Universal Test for Strength, Speed and
Endurance in 1902, wrote numerous articles and books on physical education, and warned that “without
solid physical education programs, people would become fat, deformed, and clumsy.”

Practical and cooperative physical training. Your great-grandma was training for the Spartan Race,
before there was a Spartan Race.

The big takeaway from tracing the development of physical culture both in Europe and the US during
this period is that these gymnastics systems were all very similar, and mostly based on a practical
approach. “Gymnastics” or “calisthenics” at that time did not primarily convey the idea of acrobatics,
but more utilitarian movement skills and the strength training that was essential to military
preparedness and real-life situations.

The exception to this trend was the introduction of apparatuses like the Gymnasticon. Invented in 1796,
it was the forerunner of modern machine-based fitness.
Gymnasticon

The use of fitness equipment would pick up in the 20th century, as would the weights-based, strength-
oriented strongman approach to physical culture. These two trends would lead to the modern fitness
industry as we know it.

The Rise of the Modern Fitness Industry

The 20th century marked the rise of specialized, competitive sports, as well as the emergence of a well-
organized and thriving “fitness” market and industry.

At the very beginning of the 20th century, at the same time Georges Hebert developed and promoted
his “Natural Method,” another Frenchman, Professor Edmond Desbonnet, managed to make physical
exercise and strength training fashionable through the publication of fitness journals (he used
photography to capture male and female athletes) and by opening a chain of exercise clubs. This laid a
strong foundation for physical culture in Europe, but also for “fitness” as an industry.
Desbonnet’s system was a reaction against the decadence of the Belle Epoque, during which people
lived without thinking on their physical condition and health. At the height of his popularity, he had
more than 200 fitness centers, and several of the famous early strongmen and bodybuilders were
proponents of the Desbonnet method.

Being rather expensive, his fitness centers were frequented by the high class of French and European
society before World War I. After the war, the working class also started to gain access to the physical
culture movement.

During the same period in the USA, Bernarr Macfadden came to prominence as an American physical
culture guru and healthy living advocate. He recommended a minimalist lifestyle based on time spent in
nature, daily vigorous physical exercise, and the elimination of alcohol, tea, coffee, and white bread
from one’s diet.

Macfadden started to market a wall-mounted muscle developer that he had created, and founded one
of the first muscle magazines, Physical Culture, in 1899. He staged the first physique contest in America
in 1903, and similar competitions in 1921 and 1922 fostered the rise of physical culture’s greatest icon,
Charles Atlas. By 1935, Macfadden’s publishing empire had a total of 35 million readers, and he died a
multimillionaire in 1955.

The “old school” gym that emerged in the 20th century…is not so old school after all when looked at as
part of a much longer history of physical fitness.

Desbonnet and Macfadden can be seen as the precursors of the health and fitness industry as we know
it. From there, we enter the age of confusion — the age of fitness-as-business and its many fads, with its
current aesthetics-driven, body-building approach, the use of increasingly sophisticated exercise
machines in gyms, home equipment, the huge supplement business, countless magazines, books, DVDs,
an even now the emergence of tech-based exercise with numerous fitness apps.

Over the course of a century, thousands of methods and programs have emerged, all promising to get
you in the best shape of your life in the quickest amount of time possible (with results generally being
limited to improvements in your physical appearance).
This short list is but a sampling of those methods and devices that people have given millions of dollars
to in the past century: the vibrating belt, Jack LaLanne’s TV tips and juicing, Jane Fonda’s aerobics,
Simmons’s “Sweatin’ to the Oldies” videos, the Bowflex home gyms, Thighmasters, 8 Minute Abs and Ab
Rollers, Tae Bo, Pilates, Spinning, P90X, Wii Fit, Power Plates, Sauna Suits, Power Wristbands, and many
more.

If unregulated gimmicks sit on one side of the modern fitness dichotomy, on the other resides the study
of exercise as a science. Exercise has been analyzed and quantified in laboratories, and enormous
amounts of data have been amassed on the effect of movement on the human body. The professionals
who make a career out of sifting through this data, and making recommendations based on it, are
regulated through numerous organizations, associations, councils, federations, and commissions,
including:

Academy of Applied Personal Training Education

American College of Sports Medicine

American Council on Exercise

International Fitness Professionals Association

National Academy of Sports Medicine

Any many more…

The Current State of Physical Culture: Lost in Fitness

As we reflect on the evolution of fitness over the centuries, and the different facets present in our
modern physical culture, it is well to ask ourselves: what have we lost, and what have we gained?

Obviously, much good has come out of these recent developments: there’s widespread awareness of
the importance of regular exercise, nearly every community has a gym where people can work out, and
we understand more about how the human body works and responds to physical training than we ever
have before.

Yet despite the plethora of health and fitness methods, programs, and resources, the general population
has never been so physically sedentary and out-of-shape.

A recent World Health Organization report indicates that life expectancy in the U.S. dropped for first
time since 1993. The health of modern people is declining, despite highly advanced medical
technologies, and in spite of the thriving health and fitness industry. How could that be?
Even though we have tons more devices and information about health and fitness than our ancestors
did, we are in worse shape.

A large part of it is motivation. People are simply not as motivated to move their body and get healthy as
they were in the past. We live in a society where the inability to operate one’s body in a practical and
effective manner is no longer an embarrassing condition.

In my opinion, the health and fitness industry as whole, no matter how “cutting-edge” or
“revolutionary” each new program claims to be, has failed to get the majority of people to value,
practice, and enjoy physical exercise. Aside from a few exceptions, I believe that the industry has widely
contributed to spreading a limited perception of what health and fitness are, and to people turning their
back on it.

Overwhelmingly, the most common perception of what it means to be fit, and the primary motivation
for exercising, is to look fit. It is no longer about having a healthy body that can actually do stuff that is
practical to real life.

Overwhelmingly, the most common view on how to exercise is that you need machines for cardio and to
build muscle and strength so you look good, and maybe add a bit of stretching to the mix (there is
equipment for that too). Throw in some vitamins and supplements, and you’re healthy and fit!

Overwhelmingly, exercise is a mere chore, not a pleasure; it’s something people have to force
themselves to do, not a natural expression of who they are.

Last but not least, many who try to address their fitness needs are confused as to what modality to
choose. We have lost clarity and simplicity. We have lost a sense of practicality. We have lost
naturalness.

A New Paradigm For the Future

I see two radically different paradigms of the future of exercise on the horizon.

On the one hand, we’re entering the age of ever-more advanced exercise machines that remove people
from real life, nature, and what their bodies are naturally designed to do. I see the age of fitness tech,
with connected gadgets and their apps, sensors, and wires. The age of “bio-hacking” and exercise
efficiency, offering promises like: “Get fit in 3 minutes of exercise a week!” The era of ubiquitous self-
quantification where people obsessively check out data curves on a screen, trying to manage their
health and fitness in the most scientific way possible. What I see starts to resemble a technological,
trans-humanistic approach to the body’s health. Is this really where we should be headed?

Despite everything that the health and fitness industry provides, people have never been so physically
inactive. So should we expect the answer to this predicament to come from even more varied, or more
technologically advanced programs and equipment? Or will the solution come from a different mindset,
a simpler approach and practice, and overall a new culture?

My friend and functional movement expert Gray Cook once said, “We are meant to grow strong and to
age gracefully. Reclamation of authentic movement is the starting point.”

First grade physical education in America in the 50s: walking, running, balancing, jumping, crawling,
rolling, climbing. Simple, effective, practical, enjoyable.

To become (and stay) strong and healthy, the average Joe and Jane, which most of us are, simply need
to move naturally, like all humans used to do not so long ago. We need to practice fundamental
movement skills to develop a baseline of physical competence that is useful in real-life, tangible ways.
We also need to employ a down-to-earth approach that is practical in both its practice and objectives,
which people find enjoyable, that is scalable and progressive, that doesn’t compulsorily require very
expensive custom-made equipment, and that can be done in groups.

So let me present you with the alternative paradigm that I envision for the future of physical exercise.
For thousands of years, physical development followed a natural path; we used to move naturally with
the demands of life. Tigers, bears, wild horses, gorillas, dolphins, eagles, etc. still do the same. We are
still designed to follow evolution and nature. For hundreds of years, our predecessors have trusted in a
design that provided immediate usefulness and practical benefits to their lives.
Natural movement, or practical physical performance, was at the core of exercise for centuries. It was
probably at the core of your own childhood years and play. While daddy was working out his guns with
dumbbells in the backyard, the little guy that you once were used to run, jump, balance, crawl, climb,
carry, throw, and wrestle. Did you need machines or smartphone apps? Did you need to track anything?
Were you thinking of what muscles you were exercising? The answer to all of these is no, and yet
weren’t you having an absolute blast?
Just because modern conveniences have obliterated the necessity to move (if you’re hungry, just click
and order a pizza online, right?) and just because the fitness industry has led us to believe that fitness
happens only indoors with equipment, doesn’t mean that our biological nature — our natural,
evolutionary potential and need for complex and adaptable movements — has changed.

We don’t have to accept our sedentary lifestyle and be hemmed in by the machines we have created in
order to become fit. We don’t have to maintain a false dichotomy between strength and cardio,
between the body and the mind, between fitness and health, or between exercise as something we do,
and movement and physical activity as an expression of who we are.

I believe that it is not only a biological duty, but also a moral duty for everyone to be equipped with the
movement skills, strength, conditioning, and mental fortitude that are required to respond effectively to
the physical demands of real life. I also believe that nature is what we all need — the nature outside of
us, and just as importantly, the physical nature within. Author Richard Louv puts it beautifully:

“The future will belong to the nature-smart. The more high-tech we become, the more nature we need.”
Alejandro Jodorowsky once said that “Birds born in a cage think flying is a sickness.” We have learned to
neglect, distrust, and even fear our own natural movements. The truth is, we still have a real, natural
potential for powerful, graceful, and useful movement. Move so you can be strong, and be strong so you
can be free.

Be sure to listen to my podcast interview with Erwan:

_______________________
Before starting the Natural Movement fitness trend worldwide in his late 30s, Erwan Le Corre has spent
a lifetime pursuing a true, real-life fitness, from France to Brazil. Synthesizing his studies of ancient and
modern physical training methodologies, martial arts, his experience in specialized sports and
his expertise of training in nature, he founded what is now known as the MovNat method. You can read
more about Erwan here & here.

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EFFECT OF EXERCISE ON VITAL SIGNS IN BOTH SEXES

Exercise
From Wikipedia, the free encyclopedia

Jump to navigationJump to search

"Workout" redirects here. For other uses, see Exercise (disambiguation) and Workout

(disambiguation).

Running in water
 Weight training

Exercise is any bodily activity that enhances or maintains physical fitness and

overall health and wellness.[1]
It is performed for various reasons, to aid growth and improve strength, prevent aging,
develop muscles and the cardiovascular system, hone athletic skills, weight loss or
maintenance, improve health,[2] or simply for enjoyment. Many individuals choose
to exercise outdoors where they can congregate in groups, socialize, and enhance well-
being.[3]
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. [4]

Contents

 1Classification
 2Health effects
o 2.1Fitness
o 2.2Cardiovascular system
o 2.3Immune system
o 2.4Cancer
o 2.5Neurobiological
o 2.6Sleep
o 2.7Libido
 3Mechanism of effects
o 3.1Skeletal muscle
o 3.2Other peripheral organs
o 3.3Central nervous system
 4Public health measures
 5Exercise trends
o 5.1Social and cultural variation
 6Nutrition and recovery
 7Excessive exercise
 8History
 9Other animals
 10See also
 11References
 12External links

Classification

An aerobics exercise instructor motivates her class to keep up the pace in United States.

Physical exercises are generally grouped into three types, depending on the overall
effect they have on the human body:[5]

 Aerobic exercise is any physical activity that uses large muscle groups and causes the
body to use more oxygen than it would while resting.[5] The goal of aerobic exercise is to
increase cardiovascular endurance.[6] Examples of aerobic exercise
include running, cycling, swimming, brisk walking, skipping rope, rowing, hiking, dancing,
playing tennis, continuous training, and long distance running.[5]
 Anaerobic exercise, which includes strength and resistance training, can firm,
strengthen, and increase muscle mass, as well as improve bone density, balance,
and coordination.[5] Examples of strength exercises are push-ups, pull-ups, lunges, squats,
bench press. Anaerobic exercise also includes weight training, functional training, eccentric
training, interval training, sprinting, and high-intensity interval training which increase short-
term muscle strength.[5][7]
 Flexibility exercises stretch and lengthen muscles.[5] Activities such as stretching help to
improve joint flexibility and keep muscles limber.[5] The goal is to improve the range of
motion which can reduce the chance of injury.[5][8]
Physical exercise can also include training that focuses on accuracy, agility, power,
and speed.[9]
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.[10]
Health effects
Main article: Exercise physiology

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.
[11]
 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.
[12]
 Moderate levels of exercise have been correlated with preventing aging by reducing
inflammatory potential.[13] 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.[14] 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.[14] 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.[15] Overall, physical inactivity causes 9% of premature
mortality worldwide.[15]

Metabolic and musculoskeletal adaptations from endurance and strength training

Endurance Strength
Type of adaptation Sources
training effects training effects

Skeletal muscle morphology and exercise performance adaptations

Muscle hypertrophy ↔ ↑↑↑ [16]

Muscle strength and power ↔↓ ↑↑↑ [16]

Muscle fiber size ↔↑ ↑↑↑ [16]

Myofibrillar protein synthesis ↔↑ ↑↑↑ [16]

Neuromuscular adaptations ↔↑ ↑↑↑ [16]

Anaerobic capacity ↑ ↑↑ [16]

Lactate tolerance ↑↑ ↔↑ [16]

Endurance capacity ↑↑↑ ↔↑ [16]

Capillary growth (angiogenesis) ↑↑ ↔ [16]

Mitochondrial biogenesis ↑↑ ↔↑ [16]

Mitochondrial density and oxidative function ↑↑↑ ↔↑ [16]

Whole-body and metabolic adaptations

Bone mineral density ↑↑ ↑↑ [16]

Inflammatory markers ↓↓ ↓ [16]

Flexibility ↑ ↑ [16]

Posture ↔ ↑ [16]

Ability in activities of daily living ↔↑ ↑↑ [16]

Basal metabolic rate ↑ ↑↑ [16]

Body composition

Percent body fat ↓↓ ↓ [16]

 Lean body mass ↔ ↑↑ [16]

Glucose metabolism

Resting insulin levels ↓ ↓ [16]

Insulin sensitivity ↑↑ ↑↑ [16]

Insulin response to glucose challenge ↓↓ ↓↓ [16]

Cardiovascular adaptations

Resting heart rate ↓↓ ↔ [16]

Stroke volume (resting and maximal) ↑↑ ↔ [16]

Systolic blood pressure (resting) ↔↓ ↔ [16]

Diastolic blood pressure (resting) ↔↓ ↔↓ [16]

Cardiovascular risk profile ↓↓↓ ↓ [16]

Show

Table legend

Fitness
Main article: Physical fitness

Individuals 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] Studies have shown
that exercising in middle age leads 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]
A 2015 meta-analysis demonstrated that high-intensity interval training improved
one's VO2 max more than lower intensity endurance training.[23]
Cardiovascular system
Main article: Cardiovascular fitness

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.[24][25]
Children who participate in physical exercise experience greater loss of body fat and
increased cardiovascular fitness.[26] 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. [27] There is a dose-response
relationship between the amount of exercise performed from approximately 700–
2000 kcal 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.[28] According to the American Heart
Association, exercise reduces the risk of cardiovascular diseases, including heart
attack and stroke.[25]
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.
[29]
 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.
[29]
 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.[30] 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.[29]
Vitamin C supplementation has been associated with a lower incidence of upper
respiratory tract infections in marathon runners.[29]
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. [31] The depression in the
immune system following acute bouts of exercise may be one of the mechanisms for
this anti-inflammatory effect.[29]
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." [32] Evidence suggests that exercise
may positively affect cancer survivors health-related quality of life, including factors such
as anxiety, self-esteem and emotional well-being.[33] 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.[34] This is likely to be more pronounced with
higher intensity exercise.[34] Although there is only limited scientific evidence on the
subject, people with cancer cachexia are encouraged to engage in physical exercise.
[35]
 Due to various factors, some individuals with cancer cachexia have a limited capacity
for physical exercise.[36][37] Compliance with prescribed exercise is low in individuals with
cachexia and clinical trials of exercise in this population often suffer from high drop-out
rates.[36][37]
The evidence is very uncertain about the effect of aerobic physical exercises on anxiety
and serious adverse events for adults with haematological malignancies.[38] Aerobic
physical exercises may result in little to no difference in the mortality, in the quality of life
and in the physical functioning.[38] These exercises may result in a slight reduction in
depression. Furthermore, aerobic physical exercises probably reduce fatigue. [38]
Neurobiological
This section is an excerpt from Neurobiological effects of physical exercise.[edit]

The neurobiological effects of physical exercise are numerous and involve a wide range

of interrelated effects on brain structure, brain function, and cognition.[39][40][41][42] A large
body of research in humans has demonstrated that consistent aerobic exercise (e.g.,
30 minutes every day) induces persistent improvements in certain cognitive functions,
healthy alterations in gene expression in the brain, and beneficial forms
of neuroplasticity and behavioral plasticity; some of these long-term effects include:
increased neuron growth, increased neurological activity (e.g., c-
Fos and BDNF signaling), improved stress coping, enhanced cognitive control of
behavior, improved declarative, spatial, and working memory, and structural and
functional improvements in brain structures and pathways associated with cognitive
control and memory.[39][40][41][42][43][44][45][46][47][48] The effects of exercise on cognition have important
implications for improving academic performance in children and college students,
improving adult productivity, preserving cognitive function in old age, preventing or
treating certain neurological disorders, and improving overall quality of life.[39][49][50][51]
In healthy adults, aerobic exercise has been shown to induce transient effects on
cognition after a single exercise session and persistent effects on cognition following
regular exercise over the course of several months. [39][48][52] People who regularly perform
aerobic exercise (e.g., running, jogging, brisk walking, swimming, and cycling) have
greater scores on neuropsychological function and performance tests that measure
certain cognitive functions, such as attentional control, inhibitory control, cognitive
flexibility, working memory updating and capacity, declarative memory, spatial memory,
and information processing speed.[39][43][45][47][48][52] The transient effects of exercise on
cognition include improvements in most executive functions (e.g., attention, working
memory, cognitive flexibility, inhibitory control, problem solving, and decision making)
and information processing speed for a period of up to 2 hours after exercising.[52]
Aerobic exercise induces short- and long-term effects on mood and emotional states by
promoting positive affect, inhibiting negative affect, and decreasing the biological
response to acute psychological stress.[52] Over the short-term, aerobic exercise
functions as both an antidepressant and euphoriant,[53][54][55][56] whereas consistent exercise
produces general improvements in mood and self-esteem.[57][58]
Regular aerobic exercise improves symptoms associated with a variety of central nervous
system disorders and may be used as an adjunct therapy for these disorders. There is clear
evidence of exercise treatment efficacy for major depressive disorder and attention deficit
hyperactivity disorder.[49][55][59][60][61] The American Academy of Neurology's clinical practice
guideline for mild cognitive impairment indicates that clinicians should recommend regular
exercise (two times per week) to individuals who have been diagnosed with this condition.
[62]
 Reviews of clinical evidence also support the use of exercise as an adjunct therapy for
certain neurodegenerative disorders, particularly Alzheimer’s disease and Parkinson's disease.
[63][64][65][66][67][68]
 Regular exercise is also associated with a lower risk of developing
neurodegenerative disorders.[66][69] A large body of preclinical evidence and emerging clinical
evidence supports the use of exercise as an adjunct therapy for the treatment and prevention
of drug addictions.[70][71][72][73][74] Regular exercise has also been proposed as an adjunct therapy
for brain cancers.[75]

Depression
This section is an excerpt from Neurobiological effects of physical exercise § Major depressive
disorder.[edit]
A number of medical reviews have indicated that exercise has a marked and
persistent antidepressant effect in humans,[43][55][56][59][76][77] an effect believed to be mediated
through enhanced BDNF signaling in the brain.[46][59] 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. [76] 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; [59] 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. [55][56] One systematic review noted
that yoga may be effective in alleviating symptoms of prenatal depression.[78] 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.[43] 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. [79]
A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life
in individuals with depression relative to controls.[49][80]

Continuous aerobic exercise can induce a transient state of euphoria, colloquially

known as a "runner's high" in distance running or a "rower's high" in crew, through the
increased biosynthesis of at least
three euphoriant neurochemicals: anandamide (an endocannabinoid),[81] β-endorphin (an 
endogenous opioid),[82] and phenethylamine (a trace amine and amphetamine analog).[83]
[84][85]

Sleep
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. [86] 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. [87] A 2018 systematic review and meta-analysis
suggested that exercise can improve sleep quality in people with insomnia. [88]
Libido
One 2013 study found that exercising improved sexual arousal problems related to
antidepressant use.[89]

Mechanism of effects
Skeletal muscle
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).[90][91] 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).[90][92] The suppression of muscle
protein breakdown following food consumption occurs primarily via increases
in plasma insulin.[90][93][94] 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.[90][93][94][95]
Aerobic exercise induces mitochondrial biogenesis and an increased capacity
for oxidative phosphorylation in the mitochondria of skeletal muscle, which is one
mechanism by which aerobic exercise enhances submaximal endurance performance.
   These effects occur via an exercise-induced increase in the
[96] [90][97]

intracellular AMP:ATP ratio, thereby triggering the activation of AMP-activated protein

kinase (AMPK) which subsequently phosphorylates peroxisome proliferator-activated
receptor gamma coactivator-1α (PGC-1α), the master regulator of mitochondrial
biogenesis.[90][97][98]

Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis

and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives
(primarily L-leucine and HMB).[90] Many amino acids derived from food protein promote the activation
of mTORC1 and increase protein synthesis by signaling through Rag GTPases.[90][99]

show

Abbreviations and representations

Resistance training stimulates muscle protein synthesis (MPS) for a period of up to 48 hours following exercise
(shown by dotted line).[91] 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). [91]

Other peripheral organs

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)[100] and maximal aerobic
capacity (VO2 max),[100][101] as well as a decrease in resting heart rate (RHR).[102][103][104] Long-term adaptations to
resistance training, the most common form of anaerobic exercise, include muscular hypertrophy,[105][106] an
increase in the physiological cross-sectional area (PCSA) of muscle(s), and an increase in neural drive,[107]
[108]
 both of which lead to increased muscular strength.[109] Neural adaptations begin more quickly and plateau
prior to the hypertrophic response.[110][111]

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. [112] Exercise reduces levels
of cortisol, which causes many health problems, both physical and mental. [113] Endurance
exercise before meals lowers blood glucose more than the same exercise after meals.
[114]
 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.[115] 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.
Central nervous system
Further information: Neurobiological effects of physical exercise §  Neuroplasticity

The effects of physical exercise on the central nervous system are mediated in part by

specific neurotrophic factor hormones that are released into the blood stream by
muscles, including BDNF, IGF-1, and VEGF.[116][117][118][119][120][121]

Public health measures

Multiple component community-wide campaigns are frequently used in an attempt to
increase a population's level of physical activity. A 2015 Cochrane review, however, did
not find evidence supporting a benefit. [122] The quality of the underlying evidence was
also poor.[122] However, there is some evidence that school-based interventions can
increase activity levels and fitness in children. [17] Another Cochrane review found some
evidence that certain types of exercise programmes, such as those involving gait,
balance, co-ordination and functional tasks, can improve balance in older adults.
[123]
 Following progressive resistance training, older adults also respond with improved
physical function.[124] Survey of brief interventions promoting physical activity found that
they are cost-effective, although there are variations between studies. [125]
Environmental approaches appear promising: signs that encourage the use of stairs, as
well as community campaigns, may increase exercise levels. [126] 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.[127]
[128]

To identify which public health strategies are effective, a Cochrane overview of reviews
is in preparation.[129]
Physical exercise was said to decrease healthcare costs, increase the rate of job
attendance, as well as increase the amount of effort women put into their jobs. [130] There
is some level of concern about additional exposure to air pollution when exercising
outdoors, especially near traffic.[131]
Children will mimic the behavior of their parents in relation to physical exercise. Parents
can thus promote physical activity and limit the amount of time children spend in front of
screens.[132]
Children who are overweight and participate in physical exercise experience a greater
loss of body fat and increased cardiovascular fitness. 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. [133] 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[134] 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.

Exercise trends
Main article: Exercise trends

Worldwide there has been a large shift toward less physically demanding work. [135] 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.[135] Personal lifestyle changes, however, can correct the lack of physical
exercise.
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. [136]

 Sports activities for exercising



Running helps in achieving physical fitness.[137]

 
 

Skateboarding is good for cardiovascular health[138]

 

Swimming as an exercise tones muscles and builds strength.[139]

 

Athletics (ex. pole vault) as a form of exercise

 

Football as an exercise

Social and cultural variation

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 utilize 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. [140]
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 utilize the public facilities, but also to organize aerobics and
dance sessions, which are open to the public.[141]
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.[142]
Exercise in some areas of China, particularly among those who are retired, seems to be
socially grounded. In the mornings, 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.[143]
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, in order to aid the body with the
recovery process following strenuous exercise.[144]
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. [145]
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.[146]
Excessive exercise
Main article: Overtraining

Excessive exercise or overtraining occurs when a person exceeds their body's ability to

recover from strenuous exercise.[147]

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)

See also: Aerobic exercise §  History, Fitness culture, and History of physical training and

fitness

Roper's gymnasium, Philadelphia, USA, circa 1831.

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." [148] 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.[149]
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.[150] 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.[151][152][153] 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.[154]
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.[155][156] Dr. 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.
[156]

Other animals
Studies of animals indicate that physical activity may be more adaptable than changes
in food intake to regulate energy balance.[157]
Mice having access to activity wheels engaged in voluntary exercise and increased their
propensity to run as adults.[158] Artificial selection of mice exhibited
significant heritability in voluntary exercise levels,[159] with "high-runner" breeds having
enhanced aerobic capacity,[160] hippocampal neurogenesis,[161] and skeletal
muscle morphology.[162]
The effects of exercise training appear to be heterogeneous across non-mammalian
species. As examples, exercise training of salmon showed minor improvements of
endurance,[163] and a forced swimming regimen of yellowtail amberjack and rainbow
trout accelerated their growth rates and altered muscle morphology favorable for
sustained swimming.[164][165] Crocodiles, alligators, and ducks showed elevated aerobic
capacity following exercise training.[166][167][168] No effect of endurance training was found in
most studies of lizards,[166][169] although one study did report a training effect. [170] In
lizards, sprint training had no effect on maximal exercise capacity, [170] and muscular
damage from over-training occurred following weeks of forced treadmill exercise. [169]

See also

 Medicine portal

 Society portal

 Sports portal
Main article: Outline of exercise

 Active living
 Behavioural change theories
 Bodybuilding
 Exercise hypertension
 Exercise-induced nausea
 Exercise intensity
 Exercise intolerance
 Exercise-induced anaphylaxis
 Exercise-induced asthma
 Kinesiology
 Metabolic equivalent
 Non-exercise associated thermogenesis
 Neurobiological effects of physical exercise
 Supercompensation
 Warming up
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50. ^ Pratali L, Mastorci F, Vitiello N, Sironi A, Gastaldelli A, Gemignani A (November
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257248. doi:10.1155/2014/257248. PMC  4897547.  PMID  27351018. Research investigating the
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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].
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Cognition, Neurophysiology, and Neurochemical Pathways: A Review". Brain Plasticity. 2(2): 127–
 152.  doi:10.3233/BPL-160040. PMC  5928534.  PMID  29765853. Lay summary –  Can A Single
Exercise Session Benefit Your Brain?  (12 June 2017).  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
[28]. These effects have been reported to persist for up to 24 hours after exercise cessation [28, 29,
53]. 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 [9]. These positive changes have
been demonstrated to occur with very low to very high exercise intensities [9], with effects lasting for
up to two hours after the end of the exercise bout (Fig. 1A) [27]. 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 [17]. 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 [9].
53. ^ Cunha GS, Ribeiro JL, Oliveira AR (June 2008).  "[Levels of beta-endorphin in response to
exercise and overtraining]".  Arq Bras Endocrinol Metabol  (in Portuguese). 52 (4): 589–
598.  doi:10.1590/S0004-27302008000400004.  PMID  18604371. Interestingly, some symptoms of
OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia,
increasing lactate tolerance, and exercise-induced euphoria, are important for training.
54. ^ Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M,
Berthele A, Tolle TR (2008).  "The runner's high: opioidergic mechanisms in the human brain". Cereb.
Cortex. 18 (11): 2523–2531.  doi:10.1093/cercor/bhn013.  PMID  18296435. The runner's high
describes a euphoric state resulting from long-distance running.
55. ^ Jump up to:a b c d Josefsson 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.  PMID  23362828. S2CID  29351791.
56. ^ Jump up to:a b c Rosenbaum 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.  PMID  24813261. 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.  ...
Conclusion
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.
57. ^ 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.  PMC 4314337. PMID 25455510.  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.
58. ^ 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.  PMC 3809922. PMID 24157077.  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, 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.
59. ^ Jump up to:a b c d Mura 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. PMID 24589012.  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.41,51,73,92,93 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.
60. ^ Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O
(July 2016). "Sweat it out? The effects of physical exercise on cognition and behavior in children and
adults with ADHD: a systematic literature review". J. Neural Transm. (Vienna).  124  (Suppl 1): 3–
26.  doi:10.1007/s00702-016-1593-7. PMC  5281644.  PMID  27400928.
61. ^ 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. PMID 24612421.  S2CID 45881887.  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.
62. ^ Petersen RC, Lopez O, Armstrong MJ, Getchius T, Ganguli M, Gloss D, Gronseth GS,
Marson D, Pringsheim T, Day GS, Sager M, Stevens J, Rae-Grant A (January 2018). "Practice
guideline update summary: Mild cognitive impairment  – Report of the Guideline Development,
Dissemination, and Implementation Subcommittee of the American Academy of
Neurology". Neurology. Special article. 90 (3): 126–
135.  doi:10.1212/WNL.0000000000004826.  PMC 5772157. PMID 29282327.  Lay
summary –  Exercise may improve thinking ability and memory (27 December 2017).  In patients with
MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may
improve cognitive measures. ... Clinicians should recommend regular exercise (Level B).  ...
Recommendation
 For patients diagnosed with MCI, clinicians should recommend regular exercise (twice/week) as part
of an overall approach to management (Level B).
63. ^ 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.  PMID  23962667. Six RCTs were identified that exclusively
considered the effect of exercise in AD patients. Exercise generally had a positive effect on 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 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.
64. ^ 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. PMC  5360200.  PMID  24367955. 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).
65. ^ Mattson MP (2014). "Interventions that improve body and brain bioenergetics for
Parkinson's disease risk reduction and therapy".  J Parkinsons Dis. 4  (1): 1–13. doi:10.3233/JPD-
130335. PMID 24473219.
66. ^ Jump up to:a b Grazina R, Massano J (2013). "Physical exercise and Parkinson's disease:
influence on symptoms, disease course and prevention". Rev Neurosci. 24 (2): 139–
152.  doi:10.1515/revneuro-2012-0087. PMID 23492553.  S2CID 33890283.
67. ^ 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. PMID 24132847.  S2CID 22822120.
68. ^ Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley CM,
Deane KH, Wheatley K, Ives N (September 2013). "Physiotherapy versus placebo or no intervention
in Parkinson's disease". Cochrane Database Syst Rev.  9 (9):
CD002817. doi:10.1002/14651858.CD002817.pub4.  PMC 7120224. PMID 24018704.
69. ^ 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.  PMC 4064273. PMID 24885250.  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.
70. ^ 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. PMC  4745113.  PMID  26903885. 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. (226), 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]
71. ^ Lynch WJ, Peterson AB, Sanchez V, Abel J, Smith MA (September 2013). "Exercise as a
novel treatment for drug addiction: a neurobiological and stage-dependent hypothesis".  Neurosci
Biobehav Rev.  37  (8): 1622–
1644.  doi:10.1016/j.neubiorev.2013.06.011.  PMC 3788047. PMID 23806439.
72. ^ Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug
addictions".  Neuropharmacology. 61 (7): 1109–
1122.  doi:10.1016/j.neuropharm.2011.03.010.  PMC 3139704. PMID 21459101.  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).
73. ^ 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.  PMC 4831948. PMID 25397661.  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.
74. ^ 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.  PMC 4712120. PMID 26182835.  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.
75. ^ Cormie P, Nowak AK, Chambers SK, Galvão DA, Newton RU (April 2015).  "The potential
role of exercise in neuro-oncology".  Front. Oncol. 5:
85.  doi:10.3389/fonc.2015.00085. PMC  4389372.  PMID  25905043.
76. ^ Jump up to:a b Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M,
Mead GE (September 2013). "Exercise for depression".  Cochrane Database Syst. Rev.  9 (9):
CD004366. doi:10.1002/14651858.CD004366.pub6.  PMID  24026850. 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.
77. ^ Brené S, Bjørnebekk A, Aberg E, Mathé AA, Olson L, Werme M (2007). "Running is
rewarding and antidepressive". Physiol. Behav.  92  (1–2): 136–
140.  doi:10.1016/j.physbeh.2007.05.015.  PMC 2040025. PMID 17561174.
78. ^ Gong H, Ni C, Shen X, Wu T, Jiang C (February 2015).  "Yoga for prenatal depression: a
systematic review and meta-analysis". BMC Psychiatry.  15: 14.  doi:10.1186/s12888-015-0393-
1. PMC  4323231.  PMID  25652267.
79. ^ Miller KJ, Gonçalves-Bradley DC, Areerob P, Hennessy D, Mesagno C, Grace F
(2020).  "Comparative effectiveness of three exercise types to treat clinical depression in older adults:
A systematic review and network meta-analysis of randomised controlled trials".  Ageing Research
Reviews. 58: 100999.  doi:10.1016/j.arr.2019.100999.  PMID  31837462. S2CID  209179889.
80. ^ 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.
81. ^ Tantimonaco M, Ceci R, Sabatini S, Catani MV, Rossi A, Gasperi V, Maccarrone M (2014).
"Physical activity and the endocannabinoid system: an overview".  Cell. Mol. Life Sci.  71  (14): 2681–
98.  doi:10.1007/s00018-014-1575-6. PMID 24526057.  S2CID 14531019.
82. ^ Dinas PC, Koutedakis Y, Flouris AD (2011). "Effects of exercise and physical activity on
depression".  Ir J Med Sci. 180 (2): 319–25. doi:10.1007/s11845-010-0633-
9. PMID 21076975.  S2CID 40951545.
83. ^ Szabo A, Billett E, Turner J (2001).  "Phenylethylamine, a possible link to the antidepressant
effects of exercise?".  Br J Sports Med.  35  (5): 342–
43.  doi:10.1136/bjsm.35.5.342.  PMC 1724404. PMID 11579070.
84. ^ Lindemann L, Hoener MC (2005). "A renaissance in trace amines inspired by a novel GPCR
family". Trends Pharmacol. Sci. 26 (5): 274–81. doi:10.1016/j.tips.2005.03.007.  PMID  15860375.
85. ^ Berry MD (2007). "The potential of trace amines and their receptors for treating neurological
and psychiatric diseases".  Rev Recent Clin Trials.  2 (1): 3–
19.  doi:10.2174/157488707779318107. PMID 18473983.  S2CID 7127324.
86. ^ Yang, PY; Ho, KH; Chen, HC; Chien, MY (2012).  "Exercise training improves sleep quality
in middle-aged and older adults with sleep problems: A systematic review".  Journal of
Physiotherapy. 58 (3): 157–63. doi:10.1016/S1836-9553(12)70106-6.  PMID  22884182.
87. ^ Buman, M.P.; King, A.C. (2010). "Exercise as a Treatment to Enhance Sleep". American
Journal of Lifestyle Medicine.  31  (5): 514. doi:10.1177/1559827610375532.  S2CID 73314918.
88. ^ Banno, M; Harada, Y; Taniguchi, M; Tobita, R; Tsujimoto, H; Tsujimoto, Y; Kataoka, Y;
Noda, A (2018).  "Exercise can improve sleep quality: a systematic review and meta-
analysis". PeerJ. 6: e5172. doi:10.7717/peerj.5172.  PMC 6045928. PMID 30018855.
89. ^ Lorenz, TA; Meston, CM (2013).  "Acute Exercise Improves Physical Sexual Arousal in
Women Taking Antidepressants".  Annals of Behavioral Medicine.  43  (3): 352–
361.  doi:10.1007/s12160-011-9338-1. PMC  3422071.  PMID  22403029.
90. ^ Jump up to:a b c d e f g h Brook MS, Wilkinson DJ, Phillips BE, Perez-Schindler J, Philp A, Smith K,
Atherton PJ (January 2016). "Skeletal muscle homeostasis and plasticity in youth and ageing: impact
of nutrition and exercise".  Acta Physiologica. 216 (1): 15–
41.  doi:10.1111/apha.12532. PMC  4843955.  PMID  26010896.
91. ^ Jump up to:a b c Phillips SM (May 2014). "A brief review of critical processes in exercise-induced
muscular hypertrophy".  Sports Med. 44 Suppl 1: S71–S77. doi:10.1007/s40279-014-0152-
3. PMC  4008813.  PMID  24791918.
92. ^ Brioche T, Pagano AF, Py G, Chopard A (April 2016). "Muscle wasting and aging:
Experimental models, fatty infiltrations, and prevention"  (PDF).  Molecular Aspects of Medicine. 50:
56–87. doi:10.1016/j.mam.2016.04.006. PMID 27106402.
93. ^ Jump up to:a b Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, Loughna
P, Churchward-Venne TA, Breen L, Phillips SM, Etheridge T, Rathmacher JA, Smith K, Szewczyk NJ,
 Atherton PJ (June 2013). "Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human
skeletal muscle protein metabolism".  J. Physiol. 591 (11): 2911–
23.  doi:10.1113/jphysiol.2013.253203. PMC  3690694.  PMID  23551944.
94. ^ Jump up to:a b Wilkinson DJ, Hossain T, Limb MC, Phillips BE, Lund J, Williams JP, Brook MS,
Cegielski J, Philp A, Ashcroft S, Rathmacher JA, Szewczyk NJ, Smith K, Atherton PJ (2018). "Impact
of the calcium form of β-hydroxy-β-methylbutyrate upon human skeletal muscle protein
metabolism".  Clinical Nutrition (Edinburgh, Scotland). 37 (6): 2068–
2075.  doi:10.1016/j.clnu.2017.09.024.  PMC 6295980. PMID 29097038.  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).
95. ^ Phillips SM (July 2015). "Nutritional supplements in support of resistance exercise to
counter age-related sarcopenia". Adv. Nutr. 6  (4): 452–
60.  doi:10.3945/an.115.008367. PMC  4496741.  PMID  26178029.
96. ^ Adaptation of mitochondrial ATP-production in human skeletal muscle to endurance training
and detraining
97. ^ Jump up to:a b Boushel R, Lundby C, Qvortrup K, Sahlin K (October 2014). "Mitochondrial
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levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N
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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
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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
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one of the strongest promoters of neurogenesis in the brain of adult rodents (97, 102) and humans
(1,61), 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
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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
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What are vital signs?

Vital signs are measurements of the body's most basic functions. The four main vital
signs routinely monitored by medical professionals and health care providers include
the following:

 Body temperature
 Pulse rate
 Respiration rate (rate of breathing)
 Blood pressure (Blood pressure is not considered a vital sign, but is often
measured along with the vital signs.)

Vital signs are useful in detecting or monitoring medical problems. Vital signs can be
measured in a medical setting, at home, at the site of a medical emergency, or
elsewhere.

What is body temperature?

The normal body temperature of a person varies depending on gender, recent activity,
food and fluid consumption, time of day, and, in women, the stage of the menstrual
cycle. Normal body temperature can range from 97.8 degrees F (or Fahrenheit,
equivalent to 36.5 degrees C, or Celsius) to 99 degrees F (37.2 degrees C) for a healthy
adult. A person's body temperature can be taken in any of the following ways:

 Orally. Temperature can be taken by mouth using either the classic glass

thermometer, or the more modern digital thermometers that use an electronic
probe to measure body temperature.
 Rectally. Temperatures taken rectally (using a glass or digital thermometer)
tend to be 0.5 to 0.7 degrees F higher than when taken by mouth.
 Axillary. Temperatures can be taken under the arm using a glass or digital
thermometer. Temperatures taken by this route tend to be 0.3 to 0.4 degrees F
lower than those temperatures taken by mouth.
 By ear. A special thermometer can quickly measure the temperature of the ear
drum, which reflects the body's core temperature (the temperature of the internal
organs).
 By skin. A special thermometer can quickly measure the temperature of the
skin on the forehead.

Body temperature may be abnormal due to fever (high temperature)

or hypothermia (low temperature). A fever is indicated when body temperature rises
about one degree or more over the normal temperature of 98.6 degrees Fahrenheit,
according to the American Academy of Family Physicians. Hypothermia is defined as a
drop in body temperature below 95 degrees Fahrenheit.

About glass thermometers containing mercury

According to the Environmental Protection Agency, mercury is a toxic substance that
poses a threat to the health of humans, as well as to the environment. Because of the
risk of breaking, glass thermometers containing mercury should be removed from use
and disposed of properly in accordance with local, state, and federal laws. Contact your
local health department, waste disposal authority, or fire department for information on
how to properly dispose of mercury thermometers.

What is the pulse rate?

The pulse rate is a measurement of the heart rate, or the number of times the heart
beats per minute. As the heart pushes blood through the arteries, the arteries expand
and contract with the flow of the blood. Taking a pulse not only measures the heart rate,
but also can indicate the following:

 Heart rhythm
 Strength of the pulse

The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse
rate may fluctuate and increase with exercise, illness, injury, and emotions. Females
ages 12 and older, in general, tend to have faster heart rates than do males. Athletes,
such as runners, who do a lot of cardiovascular conditioning, may have heart rates near
40 beats per minute and experience no problems.

How to check your pulse

As the heart forces blood through the arteries, you feel the beats by firmly pressing on
the arteries, which are located close to the surface of the skin at certain points of the
body. The pulse can be found on the side of the neck, on the inside of the elbow, or at
the wrist. For most people, it is easiest to take the pulse at the wrist. If you use the lower
neck, be sure not to press too hard, and never press on the pulses on both sides of the
lower neck at the same time to prevent blocking blood flow to the brain. When taking
your pulse:

 Using the first and second fingertips, press firmly but gently on the arteries until
you feel a pulse.
 Begin counting the pulse when the clock's second hand is on the 12.
 Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to
calculate beats per minute).
 When counting, do not watch the clock continuously, but concentrate on the
beats of the pulse.
 If unsure about your results, ask another person to count for you.

If your doctor has ordered you to check your own pulse and you are having difficulty
finding it, consult your doctor or nurse for additional instruction.

What is the respiration rate?

The respiration rate is the number of breaths a person takes per minute. The rate is
usually measured when a person is at rest and simply involves counting the number of
breaths for one minute by counting how many times the chest rises. Respiration rates
may increase with fever, illness, and other medical conditions. When checking
respiration, it is important to also note whether a person has any difficulty breathing.
Normal respiration rates for an adult person at rest range from 12 to 16 breaths per
minute.

What is blood pressure?

Blood pressure is the force of the blood pushing against the artery walls during
contraction and relaxation of the heart. Each time the heart beats, it pumps blood into
the arteries, resulting in the highest blood pressure as the heart contracts. When the
heart relaxes, the blood pressure falls.

Two numbers are recorded when measuring blood pressure. The higher number, or
systolic pressure, refers to the pressure inside the artery when the heart contracts and
pumps blood through the body. The lower number, or diastolic pressure, refers to the
pressure inside the artery when the heart is at rest and is filling with blood. Both the
systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This
recording represents how high the mercury column in an old-fashioned manual blood
pressure device (called a mercury manometer or sphygmomanometer) is raised by the
pressure of the blood. Today, your doctor's office is more likely to use a simple dial for
this measurement.

High blood pressure, or hypertension, directly increases the risk of heart attack, heart
failure, and stroke. With high blood pressure, the arteries may have an increased
resistance against the flow of blood, causing the heart to pump harder to circulate the
blood.

Blood pressure is categorized as normal, elevated, or stage 1 or stage 2 high blood

pressure:

 Normal blood pressure is systolic of less than 120 and diastolic of less than 80
(120/80)
 Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80
 Stage 1 high blood pressure is systolic is 130 to 139 or diastolic between 80 to
89
 Stage 2 high blood pressure is when systolic is 140 or higher or the diastolic is
90 or higher

These numbers should be used as a guide only. A single blood pressure measurement
that is higher than normal is not necessarily an indication of a problem. Your doctor will
want to see multiple blood pressure measurements over several days or weeks before
making a diagnosis of high blood pressure and starting treatment. Ask your provider
when to contact him or her if your blood pressure readings are not within the normal
range.

Why should I monitor my blood pressure at home?

For people with hypertension, home monitoring allows your doctor to monitor how much
your blood pressure changes during the day, and from day to day. This may also help
your doctor determine how effectively your blood pressure medication is working.

What special equipment is needed to measure blood pressure?

Either an aneroid monitor, which has a dial gauge and is read by looking at a pointer, or
a digital monitor, in which the blood pressure reading flashes on a small screen, can be
used to measure blood pressure.

About the aneroid monitor

The aneroid monitor is less expensive than the digital monitor. The cuff is inflated by
hand by squeezing a rubber bulb. Some units even have a special feature to make it
easier to put the cuff on with one hand. However, the unit can be easily damaged and
become less accurate. Because the person using it must listen for heartbeats with the
stethoscope, it may not be appropriate for the hearing-impaired.

About the digital monitor

The digital monitor is automatic, with the measurements appearing on a small screen.
Because the recordings are easy to read, this is the most popular blood pressure
measuring device. It is also easier to use than the aneroid unit, and since there is no
need to listen to heartbeats through the stethoscope, this is a good device for hearing-
impaired patients. One disadvantage is that body movement or an irregular heart rate
can change the accuracy. These units are also more expensive than the aneroid
monitors.

About finger and wrist blood pressure monitors

Tests have shown that finger and/or wrist blood pressure devices are not as accurate in
measuring blood pressure as other types of monitors. In addition, they are more
expensive than other monitors.

Before you measure your blood pressure:

The American Heart Association recommends the following guidelines for home blood
pressure monitoring:

 Don't smoke or drink coffee for 30 minutes before taking your blood pressure.
 Go to the bathroom before the test.
 Relax for 5 minutes before taking the measurement.
 Sit with your back supported (don't sit on a couch or soft chair). Keep your feet
on the floor uncrossed. Place your arm on a solid flat surface (like a table) with
 the upper part of the arm at heart level. Place the middle of the cuff directly
above the bend of the elbow. Check the monitor's instruction manual for an
illustration.
 Take multiple readings. When you measure, take 2 to 3 readings one minute
apart and record all the results.
 Take your blood pressure at the same time every day, or as your healthcare
provider recommends.
 Record the date, time, and blood pressure reading.
 Take the record with you to your next medical appointment. If your blood
pressure monitor has a built-in memory, simply take the monitor with you to your
next appointment.
 Call your provider if you have several high readings. Don't be frightened by a
single high blood pressure reading, but if you get several high readings, check in
with your healthcare provider.
 When blood pressure reaches a systolic (top number) of 180 or higher OR
diastolic (bottom number) of 110 or higher, seek emergency medical treatment.

Ask your doctor or another healthcare professional to teach you how to use your blood
pressure monitor correctly. Have the monitor routinely checked for accuracy by taking it
with you to your doctor's office. It is also important to make sure the tubing is not twisted
when you store it and keep it away from heat to prevent cracks and leaks.

Proper use of your blood pressure monitor will help you and your doctor in monitoring
your blood pressure.

Exercise
From Wikipedia, the free encyclopedia

Jump to navigationJump to search

"Workout" redirects here. For other uses, see Exercise (disambiguation) and Workout

(disambiguation).
Running in water

Weight training

Exercise is any bodily activity that enhances or maintains physical fitness and

overall health and wellness.[1]
It is performed for various reasons, to aid growth and improve strength, prevent aging,
develop muscles and the cardiovascular system, hone athletic skills, weight loss or
maintenance, improve health,[2] or simply for enjoyment. Many individuals choose
to exercise outdoors where they can congregate in groups, socialize, and enhance well-
being.[3]
 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. [4]

Contents

 1Classification
 2Health effects
o 2.1Fitness
o 2.2Cardiovascular system
o 2.3Immune system
o 2.4Cancer
o 2.5Neurobiological
o 2.6Sleep
o 2.7Libido
 3Mechanism of effects
o 3.1Skeletal muscle
o 3.2Other peripheral organs
o 3.3Central nervous system
 4Public health measures
 5Exercise trends
o 5.1Social and cultural variation
 6Nutrition and recovery
 7Excessive exercise
 8History
 9Other animals
 10See also
 11References
 12External links

Classification

An aerobics exercise instructor motivates her class to keep up the pace in United States.
Physical exercises are generally grouped into three types, depending on the overall
effect they have on the human body:[5]

 Aerobic exercise is any physical activity that uses large muscle groups and causes the
body to use more oxygen than it would while resting.[5] The goal of aerobic exercise is to
increase cardiovascular endurance.[6] Examples of aerobic exercise
include running, cycling, swimming, brisk walking, skipping rope, rowing, hiking, dancing,
playing tennis, continuous training, and long distance running.[5]
 Anaerobic exercise, which includes strength and resistance training, can firm,
strengthen, and increase muscle mass, as well as improve bone density, balance,
and coordination.[5] Examples of strength exercises are push-ups, pull-ups, lunges, squats,
bench press. Anaerobic exercise also includes weight training, functional training, eccentric
training, interval training, sprinting, and high-intensity interval training which increase short-
term muscle strength.[5][7]
 Flexibility exercises stretch and lengthen muscles.[5] Activities such as stretching help to
improve joint flexibility and keep muscles limber.[5] The goal is to improve the range of
motion which can reduce the chance of injury.[5][8]
Physical exercise can also include training that focuses on accuracy, agility, power,
and speed.[9]
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.[10]

Health effects
Main article: Exercise physiology

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.
[11]
 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.
[12]
 Moderate levels of exercise have been correlated with preventing aging by reducing
inflammatory potential.[13] 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.[14] 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.[14] 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.[15] Overall, physical inactivity causes 9% of premature
mortality worldwide.[15]
 Metabolic and musculoskeletal adaptations from endurance and strength training

Endurance Strength
Type of adaptation Sources
training effects training effects

Skeletal muscle morphology and exercise performance adaptations

Muscle hypertrophy ↔ ↑↑↑ [16]

Muscle strength and power ↔↓ ↑↑↑ [16]

Muscle fiber size ↔↑ ↑↑↑ [16]

Myofibrillar protein synthesis ↔↑ ↑↑↑ [16]

Neuromuscular adaptations ↔↑ ↑↑↑ [16]

Anaerobic capacity ↑ ↑↑ [16]

Lactate tolerance ↑↑ ↔↑ [16]

Endurance capacity ↑↑↑ ↔↑ [16]

Capillary growth (angiogenesis) ↑↑ ↔ [16]

Mitochondrial biogenesis ↑↑ ↔↑ [16]

Mitochondrial density and oxidative function ↑↑↑ ↔↑ [16]

Whole-body and metabolic adaptations

Bone mineral density ↑↑ ↑↑ [16]

Inflammatory markers ↓↓ ↓ [16]

Flexibility ↑ ↑ [16]

Posture ↔ ↑ [16]

Ability in activities of daily living ↔↑ ↑↑ [16]

Basal metabolic rate ↑ ↑↑ [16]

Body composition

Percent body fat ↓↓ ↓ [16]

Lean body mass ↔ ↑↑ [16]

Glucose metabolism

Resting insulin levels ↓ ↓ [16]

Insulin sensitivity ↑↑ ↑↑ [16]

Insulin response to glucose challenge ↓↓ ↓↓ [16]

Cardiovascular adaptations
 Resting heart rate ↓↓ ↔ [16]

Stroke volume (resting and maximal) ↑↑ ↔ [16]

Systolic blood pressure (resting) ↔↓ ↔ [16]

Diastolic blood pressure (resting) ↔↓ ↔↓ [16]

Cardiovascular risk profile ↓↓↓ ↓ [16]

Show

Table legend

Fitness
Main article: Physical fitness

Individuals 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] Studies have shown
that exercising in middle age leads 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]
A 2015 meta-analysis demonstrated that high-intensity interval training improved
one's VO2 max more than lower intensity endurance training.[23]
Cardiovascular system
Main article: Cardiovascular fitness

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.[24][25]
Children who participate in physical exercise experience greater loss of body fat and
increased cardiovascular fitness.[26] 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. [27] There is a dose-response
relationship between the amount of exercise performed from approximately 700–
2000 kcal 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.[28] According to the American Heart
Association, exercise reduces the risk of cardiovascular diseases, including heart
attack and stroke.[25]
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.
[29]
 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.
[29]
 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.[30] 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.[29]
Vitamin C supplementation has been associated with a lower incidence of upper
respiratory tract infections in marathon runners.[29]
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. [31] The depression in the
immune system following acute bouts of exercise may be one of the mechanisms for
this anti-inflammatory effect.[29]
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." [32] Evidence suggests that exercise
may positively affect cancer survivors health-related quality of life, including factors such
as anxiety, self-esteem and emotional well-being.[33] 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.[34] This is likely to be more pronounced with
higher intensity exercise.[34] Although there is only limited scientific evidence on the
subject, people with cancer cachexia are encouraged to engage in physical exercise.
[35]
 Due to various factors, some individuals with cancer cachexia have a limited capacity
for physical exercise.[36][37] Compliance with prescribed exercise is low in individuals with
cachexia and clinical trials of exercise in this population often suffer from high drop-out
rates.[36][37]
The evidence is very uncertain about the effect of aerobic physical exercises on anxiety
and serious adverse events for adults with haematological malignancies.[38] Aerobic
physical exercises may result in little to no difference in the mortality, in the quality of life
and in the physical functioning.[38] These exercises may result in a slight reduction in
depression. Furthermore, aerobic physical exercises probably reduce fatigue. [38]
Neurobiological
This section is an excerpt from Neurobiological effects of physical exercise.[edit]

The neurobiological effects of physical exercise are numerous and involve a wide range

of interrelated effects on brain structure, brain function, and cognition.[39][40][41][42] A large
body of research in humans has demonstrated that consistent aerobic exercise (e.g.,
30 minutes every day) induces persistent improvements in certain cognitive functions,
healthy alterations in gene expression in the brain, and beneficial forms
of neuroplasticity and behavioral plasticity; some of these long-term effects include:
increased neuron growth, increased neurological activity (e.g., c-
Fos and BDNF signaling), improved stress coping, enhanced cognitive control of
behavior, improved declarative, spatial, and working memory, and structural and
functional improvements in brain structures and pathways associated with cognitive
control and memory.[39][40][41][42][43][44][45][46][47][48] The effects of exercise on cognition have important
implications for improving academic performance in children and college students,
improving adult productivity, preserving cognitive function in old age, preventing or
treating certain neurological disorders, and improving overall quality of life.[39][49][50][51]
In healthy adults, aerobic exercise has been shown to induce transient effects on
cognition after a single exercise session and persistent effects on cognition following
regular exercise over the course of several months. [39][48][52] People who regularly perform
aerobic exercise (e.g., running, jogging, brisk walking, swimming, and cycling) have
greater scores on neuropsychological function and performance tests that measure
certain cognitive functions, such as attentional control, inhibitory control, cognitive
flexibility, working memory updating and capacity, declarative memory, spatial memory,
and information processing speed.[39][43][45][47][48][52] The transient effects of exercise on
cognition include improvements in most executive functions (e.g., attention, working
memory, cognitive flexibility, inhibitory control, problem solving, and decision making)
and information processing speed for a period of up to 2 hours after exercising.[52]
Aerobic exercise induces short- and long-term effects on mood and emotional states by
promoting positive affect, inhibiting negative affect, and decreasing the biological
response to acute psychological stress.[52] Over the short-term, aerobic exercise
functions as both an antidepressant and euphoriant,[53][54][55][56] whereas consistent exercise
produces general improvements in mood and self-esteem.[57][58]
Regular aerobic exercise improves symptoms associated with a variety of central nervous
system disorders and may be used as an adjunct therapy for these disorders. There is clear
evidence of exercise treatment efficacy for major depressive disorder and attention deficit
hyperactivity disorder.[49][55][59][60][61] The American Academy of Neurology's clinical practice
guideline for mild cognitive impairment indicates that clinicians should recommend regular
exercise (two times per week) to individuals who have been diagnosed with this condition.
[62]
 Reviews of clinical evidence also support the use of exercise as an adjunct therapy for
certain neurodegenerative disorders, particularly Alzheimer’s disease and Parkinson's disease.
[63][64][65][66][67][68]
 Regular exercise is also associated with a lower risk of developing
neurodegenerative disorders.[66][69] A large body of preclinical evidence and emerging clinical
evidence supports the use of exercise as an adjunct therapy for the treatment and prevention
of drug addictions.[70][71][72][73][74] Regular exercise has also been proposed as an adjunct therapy
for brain cancers.[75]

Depression
This section is an excerpt from Neurobiological effects of physical exercise § Major depressive
disorder.[edit]

A number of medical reviews have indicated that exercise has a marked and
persistent antidepressant effect in humans,[43][55][56][59][76][77] an effect believed to be mediated
through enhanced BDNF signaling in the brain.[46][59] 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. [76] 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; [59] 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. [55][56] One systematic review noted
that yoga may be effective in alleviating symptoms of prenatal depression.[78] 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.[43] 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. [79]
A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life
in individuals with depression relative to controls.[49][80]

Continuous aerobic exercise can induce a transient state of euphoria, colloquially

known as a "runner's high" in distance running or a "rower's high" in crew, through the
increased biosynthesis of at least
three euphoriant neurochemicals: anandamide (an endocannabinoid),[81] β-endorphin (an 
endogenous opioid),[82] and phenethylamine (a trace amine and amphetamine analog).[83]
[84][85]

Sleep
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. [86] 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. [87] A 2018 systematic review and meta-analysis
suggested that exercise can improve sleep quality in people with insomnia. [88]
Libido
One 2013 study found that exercising improved sexual arousal problems related to
antidepressant use.[89]

Mechanism of effects
Skeletal muscle
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).[90][91] 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).[90][92] The suppression of muscle
protein breakdown following food consumption occurs primarily via increases
in plasma insulin.[90][93][94] 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.[90][93][94][95]
Aerobic exercise induces mitochondrial biogenesis and an increased capacity
for oxidative phosphorylation in the mitochondria of skeletal muscle, which is one
mechanism by which aerobic exercise enhances submaximal endurance performance.
   These effects occur via an exercise-induced increase in the
[96] [90][97]

intracellular AMP:ATP ratio, thereby triggering the activation of AMP-activated protein

kinase (AMPK) which subsequently phosphorylates peroxisome proliferator-activated
receptor gamma coactivator-1α (PGC-1α), the master regulator of mitochondrial
biogenesis.[90][97][98]
Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis
and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives
(primarily L-leucine and HMB).[90] Many amino acids derived from food protein promote the activation
of mTORC1 and increase protein synthesis by signaling through Rag GTPases.[90][99]

show

Abbreviations and representations

Resistance training stimulates muscle protein synthesis (MPS) for a period of up to 48 hours following exercise
(shown by dotted line).[91] 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). [91]

Other peripheral organs

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)[100] and maximal aerobic
capacity (VO2 max),[100][101] as well as a decrease in resting heart rate (RHR).[102][103][104] Long-term adaptations to
resistance training, the most common form of anaerobic exercise, include muscular hypertrophy,[105][106] an
increase in the physiological cross-sectional area (PCSA) of muscle(s), and an increase in neural drive,[107]
[108]
 both of which lead to increased muscular strength.[109] Neural adaptations begin more quickly and plateau
prior to the hypertrophic response.[110][111]

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. [112] Exercise reduces levels
of cortisol, which causes many health problems, both physical and mental. [113] Endurance
exercise before meals lowers blood glucose more than the same exercise after meals.
[114]
 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.[115] 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.
Central nervous system
Further information: Neurobiological effects of physical exercise §  Neuroplasticity

The effects of physical exercise on the central nervous system are mediated in part by

specific neurotrophic factor hormones that are released into the blood stream by
muscles, including BDNF, IGF-1, and VEGF.[116][117][118][119][120][121]
Public health measures
Multiple component community-wide campaigns are frequently used in an attempt to
increase a population's level of physical activity. A 2015 Cochrane review, however, did
not find evidence supporting a benefit. [122] The quality of the underlying evidence was
also poor.[122] However, there is some evidence that school-based interventions can
increase activity levels and fitness in children. [17] Another Cochrane review found some
evidence that certain types of exercise programmes, such as those involving gait,
balance, co-ordination and functional tasks, can improve balance in older adults.
[123]
 Following progressive resistance training, older adults also respond with improved
physical function.[124] Survey of brief interventions promoting physical activity found that
they are cost-effective, although there are variations between studies. [125]
Environmental approaches appear promising: signs that encourage the use of stairs, as
well as community campaigns, may increase exercise levels. [126] 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.[127]
[128]

To identify which public health strategies are effective, a Cochrane overview of reviews
is in preparation.[129]
Physical exercise was said to decrease healthcare costs, increase the rate of job
attendance, as well as increase the amount of effort women put into their jobs. [130] There
is some level of concern about additional exposure to air pollution when exercising
outdoors, especially near traffic.[131]
Children will mimic the behavior of their parents in relation to physical exercise. Parents
can thus promote physical activity and limit the amount of time children spend in front of
screens.[132]
Children who are overweight and participate in physical exercise experience a greater
loss of body fat and increased cardiovascular fitness. 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. [133] 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[134] 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.

Exercise trends
Main article: Exercise trends
Worldwide there has been a large shift toward less physically demanding work. [135] 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.[135] Personal lifestyle changes, however, can correct the lack of physical
exercise.
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. [136]

 Sports activities for exercising



Running helps in achieving physical fitness.[137]

 

Skateboarding is good for cardiovascular health[138]

 

Swimming as an exercise tones muscles and builds strength.[139]

 
 

Athletics (ex. pole vault) as a form of exercise

 

Football as an exercise

Social and cultural variation

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 utilize 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. [140]
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 utilize the public facilities, but also to organize aerobics and
dance sessions, which are open to the public.[141]
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.[142]
Exercise in some areas of China, particularly among those who are retired, seems to be
socially grounded. In the mornings, 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.[143]
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, in order to aid the body with the
recovery process following strenuous exercise.[144]
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. [145]
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.[146]

Excessive exercise
Main article: Overtraining

Excessive exercise or overtraining occurs when a person exceeds their body's ability to

recover from strenuous exercise.[147]

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)

See also: Aerobic exercise §  History, Fitness culture, and History of physical training and

fitness
Roper's gymnasium, Philadelphia, USA, circa 1831.

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." [148] 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.[149]
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.[150] 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.[151][152][153] 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.[154]
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.[155][156] Dr. 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.
[156]

Other animals
Studies of animals indicate that physical activity may be more adaptable than changes
in food intake to regulate energy balance.[157]
Mice having access to activity wheels engaged in voluntary exercise and increased their
propensity to run as adults.[158] Artificial selection of mice exhibited
significant heritability in voluntary exercise levels,[159] with "high-runner" breeds having
enhanced aerobic capacity,[160] hippocampal neurogenesis,[161] and skeletal
muscle morphology.[162]
The effects of exercise training appear to be heterogeneous across non-mammalian
species. As examples, exercise training of salmon showed minor improvements of
 endurance,[163] and a forced swimming regimen of yellowtail amberjack and rainbow
trout accelerated their growth rates and altered muscle morphology favorable for
sustained swimming.[164][165] Crocodiles, alligators, and ducks showed elevated aerobic
capacity following exercise training.[166][167][168] No effect of endurance training was found in
most studies of lizards,[166][169] although one study did report a training effect. [170] In
lizards, sprint training had no effect on maximal exercise capacity, [170] and muscular
damage from over-training occurred following weeks of forced treadmill exercise. [169]

See also

 Medicine portal

 Society portal

 Sports portal
Main article: Outline of exercise

 Active living
 Behavioural change theories
 Bodybuilding
 Exercise hypertension
 Exercise-induced nausea
 Exercise intensity
 Exercise intolerance
 Exercise-induced anaphylaxis
 Exercise-induced asthma
 Kinesiology
 Metabolic equivalent
 Non-exercise associated thermogenesis
 Neurobiological effects of physical exercise
 Supercompensation
 Warming up

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2016). "Exercise improves physical and psychological quality of life in people with depression: A
meta-analysis including the evaluation of control group response". Psychiatry Res.  241: 47–
54.  doi:10.1016/j.psychres.2016.04.054.  PMID  27155287. S2CID  4787287.  Exercise has
established efficacy as an antidepressant in people with depression. ... Exercise significantly
improved physical and psychological domains and overall QoL.  ... The lack of improvement among
control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
50. ^ 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. PMC  4897547.  PMID  27351018. 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].
51. ^ Mandolesi, Laura; Polverino, Arianna; Montuori, Simone; Foti, Francesca; Ferraioli,
Giampaolo; Sorrentino, Pierpaolo; Sorrentino, Giuseppe (27 April 2018). "Effects of Physical Exercise
on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits". Frontiers in
Psychology.  9: 509. doi:10.3389/fpsyg.2018.00509. PMC  5934999.  PMID  29755380.
52. ^ Jump up to:a b c d Basso 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. PMC  5928534.  PMID  29765853. Lay summary –  Can A Single
Exercise Session Benefit Your Brain?  (12 June 2017).  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
[28]. These effects have been reported to persist for up to 24 hours after exercise cessation [28, 29,
53]. 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 [9]. These positive changes have
been demonstrated to occur with very low to very high exercise intensities [9], with effects lasting for
up to two hours after the end of the exercise bout (Fig. 1A) [27]. 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 [17]. 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 [9].
53. ^ Cunha GS, Ribeiro JL, Oliveira AR (June 2008).  "[Levels of beta-endorphin in response to
exercise and overtraining]".  Arq Bras Endocrinol Metabol  (in Portuguese). 52 (4): 589–
598.  doi:10.1590/S0004-27302008000400004.  PMID  18604371. Interestingly, some symptoms of
OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia,
increasing lactate tolerance, and exercise-induced euphoria, are important for training.
54. ^ Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M,
Berthele A, Tolle TR (2008).  "The runner's high: opioidergic mechanisms in the human brain". Cereb.
Cortex. 18 (11): 2523–2531.  doi:10.1093/cercor/bhn013.  PMID  18296435. The runner's high
describes a euphoric state resulting from long-distance running.
55. ^ Jump up to:a b c d Josefsson 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.  PMID  23362828. S2CID  29351791.
56. ^ Jump up to:a b c Rosenbaum 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.  PMID  24813261. 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.  ...
Conclusion
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.
57. ^ 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.  PMC 4314337. PMID 25455510.  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.
58. ^ 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.  PMC 3809922. PMID 24157077.  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, 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.
59. ^ Jump up to:a b c d Mura 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. PMID 24589012.  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.41,51,73,92,93 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.
60. ^ Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O
(July 2016). "Sweat it out? The effects of physical exercise on cognition and behavior in children and
adults with ADHD: a systematic literature review". J. Neural Transm. (Vienna).  124  (Suppl 1): 3–
26.  doi:10.1007/s00702-016-1593-7. PMC  5281644.  PMID  27400928.
61. ^ 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. PMID 24612421.  S2CID 45881887.  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.
62. ^ Petersen RC, Lopez O, Armstrong MJ, Getchius T, Ganguli M, Gloss D, Gronseth GS,
Marson D, Pringsheim T, Day GS, Sager M, Stevens J, Rae-Grant A (January 2018). "Practice
guideline update summary: Mild cognitive impairment  – Report of the Guideline Development,
Dissemination, and Implementation Subcommittee of the American Academy of
Neurology". Neurology. Special article. 90 (3): 126–
135.  doi:10.1212/WNL.0000000000004826.  PMC 5772157. PMID 29282327.  Lay
summary –  Exercise may improve thinking ability and memory (27 December 2017).  In patients with
MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may
improve cognitive measures. ... Clinicians should recommend regular exercise (Level B).  ...
Recommendation
For patients diagnosed with MCI, clinicians should recommend regular exercise (twice/week) as part
of an overall approach to management (Level B).
63. ^ 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.  PMID  23962667. Six RCTs were identified that exclusively
considered the effect of exercise in AD patients. Exercise generally had a positive effect on 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 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.
64. ^ 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. PMC  5360200.  PMID  24367955. 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).
65. ^ Mattson MP (2014). "Interventions that improve body and brain bioenergetics for
Parkinson's disease risk reduction and therapy".  J Parkinsons Dis. 4  (1): 1–13. doi:10.3233/JPD-
130335. PMID 24473219.
66. ^ Jump up to:a b Grazina R, Massano J (2013). "Physical exercise and Parkinson's disease:
influence on symptoms, disease course and prevention". Rev Neurosci. 24 (2): 139–
152.  doi:10.1515/revneuro-2012-0087. PMID 23492553.  S2CID 33890283.
67. ^ 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. PMID 24132847.  S2CID 22822120.
68. ^ Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley CM,
Deane KH, Wheatley K, Ives N (September 2013). "Physiotherapy versus placebo or no intervention
in Parkinson's disease". Cochrane Database Syst Rev.  9 (9):
CD002817. doi:10.1002/14651858.CD002817.pub4.  PMC 7120224. PMID 24018704.
69. ^ 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.  PMC 4064273. PMID 24885250.  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.
70. ^ 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. PMC  4745113.  PMID  26903885. 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. (226), 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]
71. ^ Lynch WJ, Peterson AB, Sanchez V, Abel J, Smith MA (September 2013). "Exercise as a
novel treatment for drug addiction: a neurobiological and stage-dependent hypothesis".  Neurosci
Biobehav Rev.  37  (8): 1622–
1644.  doi:10.1016/j.neubiorev.2013.06.011.  PMC 3788047. PMID 23806439.
72. ^ Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug
addictions".  Neuropharmacology. 61 (7): 1109–
 1122.  doi:10.1016/j.neuropharm.2011.03.010.  PMC 3139704. PMID 21459101.  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).
73. ^ 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.  PMC 4831948. PMID 25397661.  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.
74. ^ 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.  PMC 4712120. PMID 26182835.  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.
75. ^ Cormie P, Nowak AK, Chambers SK, Galvão DA, Newton RU (April 2015).  "The potential
role of exercise in neuro-oncology".  Front. Oncol. 5:
85.  doi:10.3389/fonc.2015.00085. PMC  4389372.  PMID  25905043.
76. ^ Jump up to:a b Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M,
Mead GE (September 2013). "Exercise for depression".  Cochrane Database Syst. Rev.  9 (9):
CD004366. doi:10.1002/14651858.CD004366.pub6.  PMID  24026850. 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.
77. ^ Brené S, Bjørnebekk A, Aberg E, Mathé AA, Olson L, Werme M (2007). "Running is
rewarding and antidepressive". Physiol. Behav.  92  (1–2): 136–
140.  doi:10.1016/j.physbeh.2007.05.015.  PMC 2040025. PMID 17561174.
78. ^ Gong H, Ni C, Shen X, Wu T, Jiang C (February 2015).  "Yoga for prenatal depression: a
systematic review and meta-analysis". BMC Psychiatry.  15: 14.  doi:10.1186/s12888-015-0393-
1. PMC  4323231.  PMID  25652267.
79. ^ Miller KJ, Gonçalves-Bradley DC, Areerob P, Hennessy D, Mesagno C, Grace F
(2020).  "Comparative effectiveness of three exercise types to treat clinical depression in older adults:
A systematic review and network meta-analysis of randomised controlled trials".  Ageing Research
Reviews. 58: 100999.  doi:10.1016/j.arr.2019.100999.  PMID  31837462. S2CID  209179889.
80. ^ 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.
81. ^ Tantimonaco M, Ceci R, Sabatini S, Catani MV, Rossi A, Gasperi V, Maccarrone M (2014).
"Physical activity and the endocannabinoid system: an overview".  Cell. Mol. Life Sci.  71  (14): 2681–
98.  doi:10.1007/s00018-014-1575-6. PMID 24526057.  S2CID 14531019.
82. ^ Dinas PC, Koutedakis Y, Flouris AD (2011). "Effects of exercise and physical activity on
depression".  Ir J Med Sci. 180 (2): 319–25. doi:10.1007/s11845-010-0633-
9. PMID 21076975.  S2CID 40951545.
83. ^ Szabo A, Billett E, Turner J (2001).  "Phenylethylamine, a possible link to the antidepressant
effects of exercise?".  Br J Sports Med.  35  (5): 342–
43.  doi:10.1136/bjsm.35.5.342.  PMC 1724404. PMID 11579070.
84. ^ Lindemann L, Hoener MC (2005). "A renaissance in trace amines inspired by a novel GPCR
family". Trends Pharmacol. Sci. 26 (5): 274–81. doi:10.1016/j.tips.2005.03.007.  PMID  15860375.
85. ^ Berry MD (2007). "The potential of trace amines and their receptors for treating neurological
and psychiatric diseases".  Rev Recent Clin Trials.  2 (1): 3–
19.  doi:10.2174/157488707779318107. PMID 18473983.  S2CID 7127324.
86. ^ Yang, PY; Ho, KH; Chen, HC; Chien, MY (2012).  "Exercise training improves sleep quality
in middle-aged and older adults with sleep problems: A systematic review".  Journal of
Physiotherapy. 58 (3): 157–63. doi:10.1016/S1836-9553(12)70106-6.  PMID  22884182.
87. ^ Buman, M.P.; King, A.C. (2010). "Exercise as a Treatment to Enhance Sleep". American
Journal of Lifestyle Medicine.  31  (5): 514. doi:10.1177/1559827610375532.  S2CID 73314918.
88. ^ Banno, M; Harada, Y; Taniguchi, M; Tobita, R; Tsujimoto, H; Tsujimoto, Y; Kataoka, Y;
Noda, A (2018).  "Exercise can improve sleep quality: a systematic review and meta-
analysis". PeerJ. 6: e5172. doi:10.7717/peerj.5172.  PMC 6045928. PMID 30018855.
89. ^ Lorenz, TA; Meston, CM (2013).  "Acute Exercise Improves Physical Sexual Arousal in
Women Taking Antidepressants".  Annals of Behavioral Medicine.  43  (3): 352–
361.  doi:10.1007/s12160-011-9338-1. PMC  3422071.  PMID  22403029.
90. ^ Jump up to:a b c d e f g h Brook MS, Wilkinson DJ, Phillips BE, Perez-Schindler J, Philp A, Smith K,
Atherton PJ (January 2016). "Skeletal muscle homeostasis and plasticity in youth and ageing: impact
of nutrition and exercise".  Acta Physiologica. 216 (1): 15–
41.  doi:10.1111/apha.12532. PMC  4843955.  PMID  26010896.
91. ^ Jump up to:a b c Phillips SM (May 2014). "A brief review of critical processes in exercise-induced
muscular hypertrophy".  Sports Med. 44 Suppl 1: S71–S77. doi:10.1007/s40279-014-0152-
3. PMC  4008813.  PMID  24791918.
92. ^ Brioche T, Pagano AF, Py G, Chopard A (April 2016). "Muscle wasting and aging:
Experimental models, fatty infiltrations, and prevention"  (PDF).  Molecular Aspects of Medicine. 50:
56–87. doi:10.1016/j.mam.2016.04.006. PMID 27106402.
93. ^ Jump up to:a b Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, Loughna
P, Churchward-Venne TA, Breen L, Phillips SM, Etheridge T, Rathmacher JA, Smith K, Szewczyk NJ,
Atherton PJ (June 2013). "Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human
skeletal muscle protein metabolism".  J. Physiol. 591 (11): 2911–
23.  doi:10.1113/jphysiol.2013.253203. PMC  3690694.  PMID  23551944.
94. ^ Jump up to:a b Wilkinson DJ, Hossain T, Limb MC, Phillips BE, Lund J, Williams JP, Brook MS,
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metabolism".  Clinical Nutrition (Edinburgh, Scotland). 37 (6): 2068–
2075.  doi:10.1016/j.clnu.2017.09.024.  PMC 6295980. PMID 29097038.  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).
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central cardiovascular plasticity".  Age (Dordrecht, Netherlands).  36  (2): 665–76.  doi:10.1007/s11357-
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(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.
117. ^ 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.  PMC 4314337. PMID 25455510.  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
118. ^ Bouchard J, Villeda SA (2015).  "Aging and brain rejuvenation as systemic events".  J.
Neurochem. 132 (1): 5–19.  doi:10.1111/jnc.12969. PMC  4301186.  PMID  25327899. 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).
119. ^ 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.  PMC 4142018. PMID 25285199.  Importantly, physical
exercise can improve growth factor signalling directly or indirectly by reducing pro-inflammatory
signalling [33]. 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 [33,172,190,192], as well as
exerting neuroprotective effects of their own [33,214,215], thereby contributing to the beneficial effects
of exercise on brain health.
120. ^ Gomez-Pinilla F, Hillman C (January 2013).  "The influence of exercise on cognitive
abilities".  Compr. Physiol.  3 (1): 403–28. doi:10.1002/cphy.c110063. ISBN 978-0-470-65071-
4. PMC  3951958.  PMID  23720292. Abundant research in the last decade has shown that exercise is
one of the strongest promoters of neurogenesis in the brain of adult rodents (97, 102) and humans
(1,61), 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).
121. ^ Tarumi T, Zhang R (January 2014).  "Cerebral hemodynamics of the aging brain: risk of
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6. doi:10.3389/fphys.2014.00006. PMC  3896879.  PMID  24478719. 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
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Exercise
From Wikipedia, the free encyclopedia

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"Workout" redirects here. For other uses, see Exercise (disambiguation) and Workout

(disambiguation).

Running in water
 Weight training

Exercise is any bodily activity that enhances or maintains physical fitness and

overall health and wellness.[1]
It is performed for various reasons, to aid growth and improve strength, prevent aging,
develop muscles and the cardiovascular system, hone athletic skills, weight loss or
maintenance, improve health,[2] or simply for enjoyment. Many individuals choose
to exercise outdoors where they can congregate in groups, socialize, and enhance well-
being.[3]
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. [4]

Contents

 1Classification
 2Health effects
o 2.1Fitness
o 2.2Cardiovascular system
o 2.3Immune system
o 2.4Cancer
o 2.5Neurobiological
o 2.6Sleep
o 2.7Libido
 3Mechanism of effects
o 3.1Skeletal muscle
o 3.2Other peripheral organs
o 3.3Central nervous system
 4Public health measures
 5Exercise trends
o 5.1Social and cultural variation
 6Nutrition and recovery
 7Excessive exercise
 8History
 9Other animals
 10See also
 11References
 12External links

Classification

An aerobics exercise instructor motivates her class to keep up the pace in United States.

Physical exercises are generally grouped into three types, depending on the overall
effect they have on the human body:[5]

 Aerobic exercise is any physical activity that uses large muscle groups and causes the
body to use more oxygen than it would while resting.[5] The goal of aerobic exercise is to
increase cardiovascular endurance.[6] Examples of aerobic exercise
include running, cycling, swimming, brisk walking, skipping rope, rowing, hiking, dancing,
playing tennis, continuous training, and long distance running.[5]
 Anaerobic exercise, which includes strength and resistance training, can firm,
strengthen, and increase muscle mass, as well as improve bone density, balance,
and coordination.[5] Examples of strength exercises are push-ups, pull-ups, lunges, squats,
bench press. Anaerobic exercise also includes weight training, functional training, eccentric
training, interval training, sprinting, and high-intensity interval training which increase short-
term muscle strength.[5][7]
 Flexibility exercises stretch and lengthen muscles.[5] Activities such as stretching help to
improve joint flexibility and keep muscles limber.[5] The goal is to improve the range of
motion which can reduce the chance of injury.[5][8]
Physical exercise can also include training that focuses on accuracy, agility, power,
and speed.[9]
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.[10]
Health effects
Main article: Exercise physiology

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.
[11]
 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.
[12]
 Moderate levels of exercise have been correlated with preventing aging by reducing
inflammatory potential.[13] 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.[14] 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.[14] 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.[15] Overall, physical inactivity causes 9% of premature
mortality worldwide.[15]

Metabolic and musculoskeletal adaptations from endurance and strength training

Endurance Strength
Type of adaptation Sources
training effects training effects

Skeletal muscle morphology and exercise performance adaptations

Muscle hypertrophy ↔ ↑↑↑ [16]

Muscle strength and power ↔↓ ↑↑↑ [16]

Muscle fiber size ↔↑ ↑↑↑ [16]

Myofibrillar protein synthesis ↔↑ ↑↑↑ [16]

Neuromuscular adaptations ↔↑ ↑↑↑ [16]

Anaerobic capacity ↑ ↑↑ [16]

Lactate tolerance ↑↑ ↔↑ [16]

Endurance capacity ↑↑↑ ↔↑ [16]

Capillary growth (angiogenesis) ↑↑ ↔ [16]

Mitochondrial biogenesis ↑↑ ↔↑ [16]

Mitochondrial density and oxidative function ↑↑↑ ↔↑ [16]

Whole-body and metabolic adaptations

Bone mineral density ↑↑ ↑↑ [16]

Inflammatory markers ↓↓ ↓ [16]

Flexibility ↑ ↑ [16]

Posture ↔ ↑ [16]

Ability in activities of daily living ↔↑ ↑↑ [16]

Basal metabolic rate ↑ ↑↑ [16]

Body composition

Percent body fat ↓↓ ↓ [16]

 Lean body mass ↔ ↑↑ [16]

Glucose metabolism

Resting insulin levels ↓ ↓ [16]

Insulin sensitivity ↑↑ ↑↑ [16]

Insulin response to glucose challenge ↓↓ ↓↓ [16]

Cardiovascular adaptations

Resting heart rate ↓↓ ↔ [16]

Stroke volume (resting and maximal) ↑↑ ↔ [16]

Systolic blood pressure (resting) ↔↓ ↔ [16]

Diastolic blood pressure (resting) ↔↓ ↔↓ [16]

Cardiovascular risk profile ↓↓↓ ↓ [16]

Show

Table legend

Fitness
Main article: Physical fitness

Individuals 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] Studies have shown
that exercising in middle age leads 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]
A 2015 meta-analysis demonstrated that high-intensity interval training improved
one's VO2 max more than lower intensity endurance training.[23]
Cardiovascular system
Main article: Cardiovascular fitness

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.[24][25]
Children who participate in physical exercise experience greater loss of body fat and
increased cardiovascular fitness.[26] 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. [27] There is a dose-response
relationship between the amount of exercise performed from approximately 700–
2000 kcal 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.[28] According to the American Heart
Association, exercise reduces the risk of cardiovascular diseases, including heart
attack and stroke.[25]
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.
[29]
 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.
[29]
 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.[30] 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.[29]
Vitamin C supplementation has been associated with a lower incidence of upper
respiratory tract infections in marathon runners.[29]
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. [31] The depression in the
immune system following acute bouts of exercise may be one of the mechanisms for
this anti-inflammatory effect.[29]
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." [32] Evidence suggests that exercise
may positively affect cancer survivors health-related quality of life, including factors such
as anxiety, self-esteem and emotional well-being.[33] 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.[34] This is likely to be more pronounced with
higher intensity exercise.[34] Although there is only limited scientific evidence on the
subject, people with cancer cachexia are encouraged to engage in physical exercise.
[35]
 Due to various factors, some individuals with cancer cachexia have a limited capacity
for physical exercise.[36][37] Compliance with prescribed exercise is low in individuals with
cachexia and clinical trials of exercise in this population often suffer from high drop-out
rates.[36][37]
The evidence is very uncertain about the effect of aerobic physical exercises on anxiety
and serious adverse events for adults with haematological malignancies.[38] Aerobic
physical exercises may result in little to no difference in the mortality, in the quality of life
and in the physical functioning.[38] These exercises may result in a slight reduction in
depression. Furthermore, aerobic physical exercises probably reduce fatigue. [38]
Neurobiological
This section is an excerpt from Neurobiological effects of physical exercise.[edit]

The neurobiological effects of physical exercise are numerous and involve a wide range

of interrelated effects on brain structure, brain function, and cognition.[39][40][41][42] A large
body of research in humans has demonstrated that consistent aerobic exercise (e.g.,
30 minutes every day) induces persistent improvements in certain cognitive functions,
healthy alterations in gene expression in the brain, and beneficial forms
of neuroplasticity and behavioral plasticity; some of these long-term effects include:
increased neuron growth, increased neurological activity (e.g., c-
Fos and BDNF signaling), improved stress coping, enhanced cognitive control of
behavior, improved declarative, spatial, and working memory, and structural and
functional improvements in brain structures and pathways associated with cognitive
control and memory.[39][40][41][42][43][44][45][46][47][48] The effects of exercise on cognition have important
implications for improving academic performance in children and college students,
improving adult productivity, preserving cognitive function in old age, preventing or
treating certain neurological disorders, and improving overall quality of life.[39][49][50][51]
In healthy adults, aerobic exercise has been shown to induce transient effects on
cognition after a single exercise session and persistent effects on cognition following
regular exercise over the course of several months. [39][48][52] People who regularly perform
aerobic exercise (e.g., running, jogging, brisk walking, swimming, and cycling) have
greater scores on neuropsychological function and performance tests that measure
certain cognitive functions, such as attentional control, inhibitory control, cognitive
flexibility, working memory updating and capacity, declarative memory, spatial memory,
and information processing speed.[39][43][45][47][48][52] The transient effects of exercise on
cognition include improvements in most executive functions (e.g., attention, working
memory, cognitive flexibility, inhibitory control, problem solving, and decision making)
and information processing speed for a period of up to 2 hours after exercising.[52]
Aerobic exercise induces short- and long-term effects on mood and emotional states by
promoting positive affect, inhibiting negative affect, and decreasing the biological
response to acute psychological stress.[52] Over the short-term, aerobic exercise
functions as both an antidepressant and euphoriant,[53][54][55][56] whereas consistent exercise
produces general improvements in mood and self-esteem.[57][58]
Regular aerobic exercise improves symptoms associated with a variety of central nervous
system disorders and may be used as an adjunct therapy for these disorders. There is clear
evidence of exercise treatment efficacy for major depressive disorder and attention deficit
hyperactivity disorder.[49][55][59][60][61] The American Academy of Neurology's clinical practice
guideline for mild cognitive impairment indicates that clinicians should recommend regular
exercise (two times per week) to individuals who have been diagnosed with this condition.
[62]
 Reviews of clinical evidence also support the use of exercise as an adjunct therapy for
certain neurodegenerative disorders, particularly Alzheimer’s disease and Parkinson's disease.
[63][64][65][66][67][68]
 Regular exercise is also associated with a lower risk of developing
neurodegenerative disorders.[66][69] A large body of preclinical evidence and emerging clinical
evidence supports the use of exercise as an adjunct therapy for the treatment and prevention
of drug addictions.[70][71][72][73][74] Regular exercise has also been proposed as an adjunct therapy
for brain cancers.[75]

Depression
This section is an excerpt from Neurobiological effects of physical exercise § Major depressive
disorder.[edit]
A number of medical reviews have indicated that exercise has a marked and
persistent antidepressant effect in humans,[43][55][56][59][76][77] an effect believed to be mediated
through enhanced BDNF signaling in the brain.[46][59] 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. [76] 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; [59] 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. [55][56] One systematic review noted
that yoga may be effective in alleviating symptoms of prenatal depression.[78] 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.[43] 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. [79]
A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life
in individuals with depression relative to controls.[49][80]

Continuous aerobic exercise can induce a transient state of euphoria, colloquially

known as a "runner's high" in distance running or a "rower's high" in crew, through the
increased biosynthesis of at least
three euphoriant neurochemicals: anandamide (an endocannabinoid),[81] β-endorphin (an 
endogenous opioid),[82] and phenethylamine (a trace amine and amphetamine analog).[83]
[84][85]

Sleep
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. [86] 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. [87] A 2018 systematic review and meta-analysis
suggested that exercise can improve sleep quality in people with insomnia. [88]
Libido
One 2013 study found that exercising improved sexual arousal problems related to
antidepressant use.[89]

Mechanism of effects
Skeletal muscle
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).[90][91] 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).[90][92] The suppression of muscle
protein breakdown following food consumption occurs primarily via increases
in plasma insulin.[90][93][94] 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.[90][93][94][95]
Aerobic exercise induces mitochondrial biogenesis and an increased capacity
for oxidative phosphorylation in the mitochondria of skeletal muscle, which is one
mechanism by which aerobic exercise enhances submaximal endurance performance.
   These effects occur via an exercise-induced increase in the
[96] [90][97]

intracellular AMP:ATP ratio, thereby triggering the activation of AMP-activated protein

kinase (AMPK) which subsequently phosphorylates peroxisome proliferator-activated
receptor gamma coactivator-1α (PGC-1α), the master regulator of mitochondrial
biogenesis.[90][97][98]

Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis

and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives
(primarily L-leucine and HMB).[90] Many amino acids derived from food protein promote the activation
of mTORC1 and increase protein synthesis by signaling through Rag GTPases.[90][99]

show

Abbreviations and representations

Resistance training stimulates muscle protein synthesis (MPS) for a period of up to 48 hours following exercise
(shown by dotted line).[91] 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). [91]

Other peripheral organs

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)[100] and maximal aerobic
capacity (VO2 max),[100][101] as well as a decrease in resting heart rate (RHR).[102][103][104] Long-term adaptations to
resistance training, the most common form of anaerobic exercise, include muscular hypertrophy,[105][106] an
increase in the physiological cross-sectional area (PCSA) of muscle(s), and an increase in neural drive,[107]
[108]
 both of which lead to increased muscular strength.[109] Neural adaptations begin more quickly and plateau
prior to the hypertrophic response.[110][111]

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. [112] Exercise reduces levels
of cortisol, which causes many health problems, both physical and mental. [113] Endurance
exercise before meals lowers blood glucose more than the same exercise after meals.
[114]
 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.[115] 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.
Central nervous system
Further information: Neurobiological effects of physical exercise §  Neuroplasticity

The effects of physical exercise on the central nervous system are mediated in part by

specific neurotrophic factor hormones that are released into the blood stream by
muscles, including BDNF, IGF-1, and VEGF.[116][117][118][119][120][121]

Public health measures

Multiple component community-wide campaigns are frequently used in an attempt to
increase a population's level of physical activity. A 2015 Cochrane review, however, did
not find evidence supporting a benefit. [122] The quality of the underlying evidence was
also poor.[122] However, there is some evidence that school-based interventions can
increase activity levels and fitness in children. [17] Another Cochrane review found some
evidence that certain types of exercise programmes, such as those involving gait,
balance, co-ordination and functional tasks, can improve balance in older adults.
[123]
 Following progressive resistance training, older adults also respond with improved
physical function.[124] Survey of brief interventions promoting physical activity found that
they are cost-effective, although there are variations between studies. [125]
Environmental approaches appear promising: signs that encourage the use of stairs, as
well as community campaigns, may increase exercise levels. [126] 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.[127]
[128]

To identify which public health strategies are effective, a Cochrane overview of reviews
is in preparation.[129]
Physical exercise was said to decrease healthcare costs, increase the rate of job
attendance, as well as increase the amount of effort women put into their jobs. [130] There
is some level of concern about additional exposure to air pollution when exercising
outdoors, especially near traffic.[131]
Children will mimic the behavior of their parents in relation to physical exercise. Parents
can thus promote physical activity and limit the amount of time children spend in front of
screens.[132]
Children who are overweight and participate in physical exercise experience a greater
loss of body fat and increased cardiovascular fitness. 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. [133] 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[134] 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.

Exercise trends
Main article: Exercise trends

Worldwide there has been a large shift toward less physically demanding work. [135] 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.[135] Personal lifestyle changes, however, can correct the lack of physical
exercise.
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. [136]

 Sports activities for exercising



Running helps in achieving physical fitness.[137]

 
 

Skateboarding is good for cardiovascular health[138]

 

Swimming as an exercise tones muscles and builds strength.[139]

 

Athletics (ex. pole vault) as a form of exercise

 

Football as an exercise

Social and cultural variation

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 utilize 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. [140]
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 utilize the public facilities, but also to organize aerobics and
dance sessions, which are open to the public.[141]
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.[142]
Exercise in some areas of China, particularly among those who are retired, seems to be
socially grounded. In the mornings, 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.[143]
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, in order to aid the body with the
recovery process following strenuous exercise.[144]
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. [145]
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.[146]
Excessive exercise
Main article: Overtraining

Excessive exercise or overtraining occurs when a person exceeds their body's ability to

recover from strenuous exercise.[147]

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)

See also: Aerobic exercise §  History, Fitness culture, and History of physical training and

fitness

Roper's gymnasium, Philadelphia, USA, circa 1831.

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." [148] 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.[149]
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.[150] 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.[151][152][153] 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.[154]
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.[155][156] Dr. 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.
[156]

Other animals
Studies of animals indicate that physical activity may be more adaptable than changes
in food intake to regulate energy balance.[157]
Mice having access to activity wheels engaged in voluntary exercise and increased their
propensity to run as adults.[158] Artificial selection of mice exhibited
significant heritability in voluntary exercise levels,[159] with "high-runner" breeds having
enhanced aerobic capacity,[160] hippocampal neurogenesis,[161] and skeletal
muscle morphology.[162]
The effects of exercise training appear to be heterogeneous across non-mammalian
species. As examples, exercise training of salmon showed minor improvements of
endurance,[163] and a forced swimming regimen of yellowtail amberjack and rainbow
trout accelerated their growth rates and altered muscle morphology favorable for
sustained swimming.[164][165] Crocodiles, alligators, and ducks showed elevated aerobic
capacity following exercise training.[166][167][168] No effect of endurance training was found in
most studies of lizards,[166][169] although one study did report a training effect. [170] In
lizards, sprint training had no effect on maximal exercise capacity, [170] and muscular
damage from over-training occurred following weeks of forced treadmill exercise. [169]

See also

 Medicine portal

 Society portal

 Sports portal
Main article: Outline of exercise

 Active living
 Behavioural change theories
 Bodybuilding
 Exercise hypertension
 Exercise-induced nausea
 Exercise intensity
 Exercise intolerance
 Exercise-induced anaphylaxis
 Exercise-induced asthma
 Kinesiology
 Metabolic equivalent
 Non-exercise associated thermogenesis
 Neurobiological effects of physical exercise
 Supercompensation
 Warming up
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Physical Exercise in Alzheimer's Disease and Parkinson's Disease: A Narrative Review".  J Clin
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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.
41. ^ Jump up to:a b McKee AC, Daneshvar DH, Alvarez VE, Stein TD (January 2014).  "The
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6. PMC  4255282.  PMID  24366527. 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.
42. ^ Jump up to:a b Denham J, Marques FZ, O'Brien BJ, Charchar FJ (February 2014). "Exercise:
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1. PMID 24163284.  S2CID 30210091.  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 [76–78]. Recent findings highlight a role for aerobic exercise in modulating chromatin
remodelers [21, 79–82]. ... 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 [164]. These few studies provide a basis for further
exploration into potential miRNAs involved in brain and neuronal development and recovery via
aerobic exercise.
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47. ^ Jump up to:a b Buckley J, Cohen JD, Kramer AF, McAuley E, Mullen SP (2014).  "Cognitive
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48. ^ Jump up to:a b c Cox EP, O'Dwyer N, Cook R, Vetter M, Cheng HL, Rooney K, O'Connor H
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628.  doi:10.1016/j.jsams.2015.09.003. PMID 26552574.  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.
49. ^ Jump up to:a b c Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Stubbs B (July
2016). "Exercise improves physical and psychological quality of life in people with depression: A
meta-analysis including the evaluation of control group response". Psychiatry Res.  241: 47–
54.  doi:10.1016/j.psychres.2016.04.054.  PMID  27155287. S2CID  4787287.  Exercise has
established efficacy as an antidepressant in people with depression. ... Exercise significantly
improved physical and psychological domains and overall QoL.  ... The lack of improvement among
control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
50. ^ 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. PMC  4897547.  PMID  27351018. 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].
51. ^ Mandolesi, Laura; Polverino, Arianna; Montuori, Simone; Foti, Francesca; Ferraioli,
Giampaolo; Sorrentino, Pierpaolo; Sorrentino, Giuseppe (27 April 2018). "Effects of Physical Exercise
on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits". Frontiers in
Psychology.  9: 509. doi:10.3389/fpsyg.2018.00509. PMC  5934999.  PMID  29755380.
52. ^ Jump up to:a b c d Basso 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. PMC  5928534.  PMID  29765853. Lay summary –  Can A Single
Exercise Session Benefit Your Brain?  (12 June 2017).  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
[28]. These effects have been reported to persist for up to 24 hours after exercise cessation [28, 29,
53]. 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 [9]. These positive changes have
been demonstrated to occur with very low to very high exercise intensities [9], with effects lasting for
up to two hours after the end of the exercise bout (Fig. 1A) [27]. 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 [17]. 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 [9].
53. ^ Cunha GS, Ribeiro JL, Oliveira AR (June 2008).  "[Levels of beta-endorphin in response to
exercise and overtraining]".  Arq Bras Endocrinol Metabol  (in Portuguese). 52 (4): 589–
598.  doi:10.1590/S0004-27302008000400004.  PMID  18604371. Interestingly, some symptoms of
OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia,
increasing lactate tolerance, and exercise-induced euphoria, are important for training.
54. ^ Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M,
Berthele A, Tolle TR (2008).  "The runner's high: opioidergic mechanisms in the human brain". Cereb.
Cortex. 18 (11): 2523–2531.  doi:10.1093/cercor/bhn013.  PMID  18296435. The runner's high
describes a euphoric state resulting from long-distance running.
55. ^ Jump up to:a b c d Josefsson 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.  PMID  23362828. S2CID  29351791.
56. ^ Jump up to:a b c Rosenbaum 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.  PMID  24813261. 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.  ...
Conclusion
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.
57. ^ 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.  PMC 4314337. PMID 25455510.  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.
58. ^ 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.  PMC 3809922. PMID 24157077.  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, 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.
59. ^ Jump up to:a b c d Mura 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. PMID 24589012.  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.41,51,73,92,93 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.
60. ^ Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O
(July 2016). "Sweat it out? The effects of physical exercise on cognition and behavior in children and
adults with ADHD: a systematic literature review". J. Neural Transm. (Vienna).  124  (Suppl 1): 3–
26.  doi:10.1007/s00702-016-1593-7. PMC  5281644.  PMID  27400928.
61. ^ 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. PMID 24612421.  S2CID 45881887.  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.
62. ^ Petersen RC, Lopez O, Armstrong MJ, Getchius T, Ganguli M, Gloss D, Gronseth GS,
Marson D, Pringsheim T, Day GS, Sager M, Stevens J, Rae-Grant A (January 2018). "Practice
guideline update summary: Mild cognitive impairment  – Report of the Guideline Development,
Dissemination, and Implementation Subcommittee of the American Academy of
Neurology". Neurology. Special article. 90 (3): 126–
135.  doi:10.1212/WNL.0000000000004826.  PMC 5772157. PMID 29282327.  Lay
summary –  Exercise may improve thinking ability and memory (27 December 2017).  In patients with
MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may
improve cognitive measures. ... Clinicians should recommend regular exercise (Level B).  ...
Recommendation
 For patients diagnosed with MCI, clinicians should recommend regular exercise (twice/week) as part
of an overall approach to management (Level B).
63. ^ 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.  PMID  23962667. Six RCTs were identified that exclusively
considered the effect of exercise in AD patients. Exercise generally had a positive effect on 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 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.
64. ^ 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. PMC  5360200.  PMID  24367955. 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).
65. ^ Mattson MP (2014). "Interventions that improve body and brain bioenergetics for
Parkinson's disease risk reduction and therapy".  J Parkinsons Dis. 4  (1): 1–13. doi:10.3233/JPD-
130335. PMID 24473219.
66. ^ Jump up to:a b Grazina R, Massano J (2013). "Physical exercise and Parkinson's disease:
influence on symptoms, disease course and prevention". Rev Neurosci. 24 (2): 139–
152.  doi:10.1515/revneuro-2012-0087. PMID 23492553.  S2CID 33890283.
67. ^ 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. PMID 24132847.  S2CID 22822120.
68. ^ Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley CM,
Deane KH, Wheatley K, Ives N (September 2013). "Physiotherapy versus placebo or no intervention
in Parkinson's disease". Cochrane Database Syst Rev.  9 (9):
CD002817. doi:10.1002/14651858.CD002817.pub4.  PMC 7120224. PMID 24018704.
69. ^ 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.  PMC 4064273. PMID 24885250.  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.
70. ^ 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. PMC  4745113.  PMID  26903885. 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. (226), 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]
71. ^ Lynch WJ, Peterson AB, Sanchez V, Abel J, Smith MA (September 2013). "Exercise as a
novel treatment for drug addiction: a neurobiological and stage-dependent hypothesis".  Neurosci
Biobehav Rev.  37  (8): 1622–
1644.  doi:10.1016/j.neubiorev.2013.06.011.  PMC 3788047. PMID 23806439.
72. ^ Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug
addictions".  Neuropharmacology. 61 (7): 1109–
1122.  doi:10.1016/j.neuropharm.2011.03.010.  PMC 3139704. PMID 21459101.  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).
73. ^ 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.  PMC 4831948. PMID 25397661.  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.
74. ^ 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.  PMC 4712120. PMID 26182835.  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.
75. ^ Cormie P, Nowak AK, Chambers SK, Galvão DA, Newton RU (April 2015).  "The potential
role of exercise in neuro-oncology".  Front. Oncol. 5:
85.  doi:10.3389/fonc.2015.00085. PMC  4389372.  PMID  25905043.
76. ^ Jump up to:a b Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M,
Mead GE (September 2013). "Exercise for depression".  Cochrane Database Syst. Rev.  9 (9):
CD004366. doi:10.1002/14651858.CD004366.pub6.  PMID  24026850. 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.
77. ^ Brené S, Bjørnebekk A, Aberg E, Mathé AA, Olson L, Werme M (2007). "Running is
rewarding and antidepressive". Physiol. Behav.  92  (1–2): 136–
140.  doi:10.1016/j.physbeh.2007.05.015.  PMC 2040025. PMID 17561174.
78. ^ Gong H, Ni C, Shen X, Wu T, Jiang C (February 2015).  "Yoga for prenatal depression: a
systematic review and meta-analysis". BMC Psychiatry.  15: 14.  doi:10.1186/s12888-015-0393-
1. PMC  4323231.  PMID  25652267.
79. ^ Miller KJ, Gonçalves-Bradley DC, Areerob P, Hennessy D, Mesagno C, Grace F
(2020).  "Comparative effectiveness of three exercise types to treat clinical depression in older adults:
A systematic review and network meta-analysis of randomised controlled trials".  Ageing Research
Reviews. 58: 100999.  doi:10.1016/j.arr.2019.100999.  PMID  31837462. S2CID  209179889.
80. ^ 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.
81. ^ Tantimonaco M, Ceci R, Sabatini S, Catani MV, Rossi A, Gasperi V, Maccarrone M (2014).
"Physical activity and the endocannabinoid system: an overview".  Cell. Mol. Life Sci.  71  (14): 2681–
98.  doi:10.1007/s00018-014-1575-6. PMID 24526057.  S2CID 14531019.
82. ^ Dinas PC, Koutedakis Y, Flouris AD (2011). "Effects of exercise and physical activity on
depression".  Ir J Med Sci. 180 (2): 319–25. doi:10.1007/s11845-010-0633-
9. PMID 21076975.  S2CID 40951545.
83. ^ Szabo A, Billett E, Turner J (2001).  "Phenylethylamine, a possible link to the antidepressant
effects of exercise?".  Br J Sports Med.  35  (5): 342–
43.  doi:10.1136/bjsm.35.5.342.  PMC 1724404. PMID 11579070.
84. ^ Lindemann L, Hoener MC (2005). "A renaissance in trace amines inspired by a novel GPCR
family". Trends Pharmacol. Sci. 26 (5): 274–81. doi:10.1016/j.tips.2005.03.007.  PMID  15860375.
85. ^ Berry MD (2007). "The potential of trace amines and their receptors for treating neurological
and psychiatric diseases".  Rev Recent Clin Trials.  2 (1): 3–
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86. ^ Yang, PY; Ho, KH; Chen, HC; Chien, MY (2012).  "Exercise training improves sleep quality
in middle-aged and older adults with sleep problems: A systematic review".  Journal of
Physiotherapy. 58 (3): 157–63. doi:10.1016/S1836-9553(12)70106-6.  PMID  22884182.
87. ^ Buman, M.P.; King, A.C. (2010). "Exercise as a Treatment to Enhance Sleep". American
Journal of Lifestyle Medicine.  31  (5): 514. doi:10.1177/1559827610375532.  S2CID 73314918.
88. ^ Banno, M; Harada, Y; Taniguchi, M; Tobita, R; Tsujimoto, H; Tsujimoto, Y; Kataoka, Y;
Noda, A (2018).  "Exercise can improve sleep quality: a systematic review and meta-
analysis". PeerJ. 6: e5172. doi:10.7717/peerj.5172.  PMC 6045928. PMID 30018855.
89. ^ Lorenz, TA; Meston, CM (2013).  "Acute Exercise Improves Physical Sexual Arousal in
Women Taking Antidepressants".  Annals of Behavioral Medicine.  43  (3): 352–
361.  doi:10.1007/s12160-011-9338-1. PMC  3422071.  PMID  22403029.
90. ^ Jump up to:a b c d e f g h Brook MS, Wilkinson DJ, Phillips BE, Perez-Schindler J, Philp A, Smith K,
Atherton PJ (January 2016). "Skeletal muscle homeostasis and plasticity in youth and ageing: impact
of nutrition and exercise".  Acta Physiologica. 216 (1): 15–
41.  doi:10.1111/apha.12532. PMC  4843955.  PMID  26010896.
91. ^ Jump up to:a b c Phillips SM (May 2014). "A brief review of critical processes in exercise-induced
muscular hypertrophy".  Sports Med. 44 Suppl 1: S71–S77. doi:10.1007/s40279-014-0152-
3. PMC  4008813.  PMID  24791918.
92. ^ Brioche T, Pagano AF, Py G, Chopard A (April 2016). "Muscle wasting and aging:
Experimental models, fatty infiltrations, and prevention"  (PDF).  Molecular Aspects of Medicine. 50:
56–87. doi:10.1016/j.mam.2016.04.006. PMID 27106402.
93. ^ Jump up to:a b Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, Loughna
P, Churchward-Venne TA, Breen L, Phillips SM, Etheridge T, Rathmacher JA, Smith K, Szewczyk NJ,
 Atherton PJ (June 2013). "Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human
skeletal muscle protein metabolism".  J. Physiol. 591 (11): 2911–
23.  doi:10.1113/jphysiol.2013.253203. PMC  3690694.  PMID  23551944.
94. ^ Jump up to:a b Wilkinson DJ, Hossain T, Limb MC, Phillips BE, Lund J, Williams JP, Brook MS,
Cegielski J, Philp A, Ashcroft S, Rathmacher JA, Szewczyk NJ, Smith K, Atherton PJ (2018). "Impact
of the calcium form of β-hydroxy-β-methylbutyrate upon human skeletal muscle protein
metabolism".  Clinical Nutrition (Edinburgh, Scotland). 37 (6): 2068–
2075.  doi:10.1016/j.clnu.2017.09.024.  PMC 6295980. PMID 29097038.  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).
95. ^ Phillips SM (July 2015). "Nutritional supplements in support of resistance exercise to
counter age-related sarcopenia". Adv. Nutr. 6  (4): 452–
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Figure 2: The mTOR Signaling Pathway
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(16 November 2013).  "Exercise-training-induced changes in metabolic capacity with age: the role of
central cardiovascular plasticity".  Age (Dordrecht, Netherlands).  36  (2): 665–76.  doi:10.1007/s11357-
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105. ^ 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
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106. ^ Schoenfeld, BJ (June 2013). "Postexercise hypertrophic adaptations: a reexamination of the
hormone hypothesis and its applicability to resistance training program design".  Journal of Strength
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with multiple sclerosis".  Journal of Neurology. 260 (7): 1822–32. doi:10.1007/s00415-013-6884-
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Hikida, RS (March 1994). "Skeletal muscle adaptations during early phase of heavy-resistance
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