INTRODUCTION

A disease is a particular abnormal condition that negatively affects

the structure or function of all or part of an organism, and that is not immediately
due to any external injury White, Tim (19 December 2014). Diseases are often
known to be medical conditions that are associated with specific signs and
symptoms. A disease may be caused by external factors such as pathogens or by
internal dysfunctions. For example, internal dysfunctions of the immune
system can produce a variety of different diseases, including various forms
of immunodeficiency, hypersensitivity, allergies and autoimmune disorders.
In humans, disease is often used more broadly to refer to any condition that
causes pain, dysfunction, distress, social problems, or death to the person affected,
or similar problems for those in contact with the person. In this broader sense, it
sometimes includes injuries, disabilities, disorders, syndromes, infections,
isolated symptoms, deviant behaviors, and atypical variations of structure and
function, while in other contexts and for other purposes these may be considered
distinguishable categories. Diseases can affect people not only physically, but also
mentally, as contracting and living with a disease can alter the affected person's
perspective on life.
Lifestyle disease
A disease is any disease that appears to increase in frequency as countries
become more industrialized and people live longer, especially if the risk
factors include behavioral choices like a sedentary lifestyle or a diet high in
unhealthful foods such as refined carbohydrates, trans fats, or alcoholic
beverages.
Non-communicable
A non-communicable disease is a medical condition or disease that is non-
transmissible. Non-communicable diseases cannot be spread directly from
one person to another. Heart disease and cancer are examples of non-
communicable diseases in humans.
Not enough exercise (inactive lifestyle) is defined as any waking behavior such as
sitting or leaning with an energy expenditure of 1.5 metabolic equivalent task
(MET) or less (SBRN 2017- 2020). This definition, proposed by the inactive
lifestyle Behavior Research Network in 2012, is currently the most widely used
definition of sedentary behavior. Some examples of sedentary behavior include
television viewing, playing video games, using a computer, sitting at school or
work, and sitting while commuting [JOCHEM C 2019]. According to the 2011
Compendium of Physical Activities,
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MET is defined as the ratio of work metabolic rate to the standard resting
metabolic rate (RMR) of 1 kcal/(kg/h). One MET is the RMR or energy cost for a
person at rest. When classified quantitatively based on their intensities, physical
activities can be classified into 1.0–1.5 METs (sedentary behavior), 1.6–2.9 METs
(light intensity), 3–5.9 (moderate intensity), and ≥6 METs (vigorous intensity)
[AINSWORTH BE 2009]. In the United States and around the world, people are
spending more and more time doing sedentary activities. During our leisure time,
we are often sitting: while using a computer or other device, watching TV, or
playing video games. Many of our jobs have become more sedentary, with long
days sitting at a desk. And the way most of us get around involves sitting - in cars,
on buses, and on trains.
Example of inactive lifestyle

Example of inactive lifestyle

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Exercise
Exercise is any bodily activity that enhances or log physical fittness and
overall health and wellness. It is performed for various reasons including
strengthening muscles and the cardiovascular system, honing athletic skills, weight
loss or maintenance, as well as for the purpose of enjoyment. Frequent and regular
physical exercise boosts the immune system, and helps prevent the "diseases of
affluence" such as heart disease, cardiovascular disease, Type 2
diabetes and obesity.

U.S. Navy sailors exercising in the presence of their female instructor, 2010

Physical inactivity refers to the lack of moderate-to-vigorous physical activity in a

person's lifestyle. It is distinct from sedentary behavior. As of 2008, the WHO
identified the Americas and the Eastern Mediterranean as regions with the greatest
prevalence of physical inactivity. Nearly half of all women in both of these regions
have physical inactivity, as well as 40% of men in the Americas and 36% of men
in the Eastern Mediterranean. In contrast, the region with the lowest prevalence of
physical inactivity is Southeast Asia. There, 19% of women and 15% of men are
physically inactive.

In the US, physical inactivity prevalence varies by state and ethnicity. All states
and territories had prevalence rates of more than 15% of adults. Colorado, Utah,
Oregon, and Washington were the only states with physical inactivity prevalence
less than 20%. Seven states and two territories had prevalence greater than 30%:
Tennessee, Oklahoma, Louisiana, Alabama, Kentucky, Arkansas, and Mississippi,
Guam, and Puerto Rico. Hispanics have the highest rate of physical inactivity
(31.7%), followed by African-Americans (30.3%), and then non-Hispanic whites
(23.4%).
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Causes

Several factors have been identified as part of the rising prevalence of physical
inactivity. People are participating less in physical activity during leisure time.
Additionally, they are increasingly likely to use sedentary behaviors during work
and domestic activities. Also, instead of walking or cycling, many now use passive
transportation. Urbanization may also increase physical inactivity: factors such as
violence, lack of greenspace, poor air quality, and dense traffic may discourage
physical activity.

DISEASE CAUSE BY LACK OF PHYSICAL EXERCISE

Lack of physical exercise can lead to heart disease—even for people who have no
other risk factors. It can also increase the likelihood of developing other heart
disease risk factors, including obesity, high blood pressure, high blood cholesterol,
and type 2 diabetes.

Lack of exercise can be one of the causes of many chronic diseases. By not getting
regular exercise, you raise your risk of:

1 Obesity

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2 Heart diseases, including coronary artery disease and heart attack

3 High blood pressure

4 High cholesterol

Stroke

5 Metabolic syndrome

6 Type 2 diabetes

7 Certain cancers, including colon, breast, and uterine cancers

8 Osteoporosis and falls

9 Increased feelings of depression and anxiety

10 lack of exercise can also raise your risk of premature death. And the less
exercises you do, the higher your health risks are.

Heart Disease
Not getting enough physical activity can lead to heart disease—even for people
who have no other risk factors. It can also increase the likelihood of developing
other heart disease risk factors, including obesity, high blood pressure, high blood
cholesterol, and type 2 diabetes.

Type 2 Diabetes
Not getting enough physical activity can raise a person’s risk of developing type 2
diabetes. Physical activity helps control blood sugar (glucose), weight, and blood
pressure and helps raise “good” cholesterol and lower “bad” cholesterol. Adequate
physical activity—at least 150 minutes of moderate activity a week—can also help
reduce the risk of heart disease and nerve damage, which are often problems for
people with diabetes.

Cancer
Getting the recommended amount of physical activity can lower the risk of many
cancers, including cancers of the breast, colon, and uterus. Regular physical
activity is one of the most important things people can do to improve their health.

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Moving more and sitting less have tremendous benefits for everyone, regardless of
age, sex, race, ethnicity, or current fitness level.
The total daily sedentarytime and television viewing time were correlated with an
increased all-cause mortality risk [KATZMARZYK 2019]. In a study analyzing
the mortality rates of people with >10 hours and <5 hours of sitting times a day,
the sitting time was significantly correlated with all-cause mortality (odds ratio
[OR], 1.16; 95% CI, 1.04– 1.29; P<0.05) [Rillamas-Sun E, 2018]]. In a study that
examined the correlation between the television viewing time and all-cause
mortality, the people who watched television for ≥6 hours a day had a two-fold
higher all-cause mortality risk compared to the people who watched television for
<2 hours a day (hazard ratio [HR], 1.98; 95% CI, 1.25–3.15) [Hamer M, 2017]

hereas the people who watched television for ≥4 hours a day had a 1.5 times higher
all-cause mortality risk compared to the people who watched TV for <2 hours a
day (HR, 1.48; 95% CI, 1.19–1.83) [TF, Ommerborn M 2018].

Sedentary time (sitting time, television or screen viewing time, leisure time while
sitting in a day) is independently associated with allcause mortality, CVD
incidence or mortality, incidence or mortality of certain cancers (breast, colon,
colorectal, endometrial, and epithelial ovarian cancer), and type 2 DM. In
particular, the adverse effect of sedentary time was more evident among people
who engaged in little physical activity compared to those who engaged in frequent
physical activity. The relative risk (RR) for all-cause mortality was 30% higher
with high physical activity (HR, 1.16; 95% CI, 0.84–1.59) compared to that with
low physical activity (HR, 1.46; 95% CI, 1.22–1.75) [Biswas A, 2015].

The fact that the prevalence of type 2 DM increases with increasing sedentary time
has been consistently documented in various studies (HR, 1.91; 95% CI, 1.64–
2.22) [Biswas A, 2015].

In an assessment of DM risk considering both sedentary time and physical activity,

the DM risk increased with the increasing daily sedentary time (HR, 1.13; 95% CI,
1.04–1.22; P<0.001), and the effect was not offset by the level of physical activity
(HR, 1.11; 95% CI, 1.01–1.19; P<0.001). The risk for CVD also increased with the
increasing daily sedentary time (HR, 1.29; 95% CI, 1.27–1.30; P<0.001), and

6
although the physical activity level slightly offset this effect, sedentary time still
significantly increased the risk (HR, 1.11; 95% CI, 1.01–1.19; P<0.001). This
shows that the level of physical activity does not influence the impact of prolonged
sedentary time on the risk for CVD and DM.

A few biological mechanisms can explain the impact of the total daily sedentary
time on CVD and DM risk. Prolonged sitting is known to affect the content and
activity of muscle glucose transporter proteins. An animal study observed that
prolonged muscle inactivity reduces the LPL activity, which regulates blood lipid
concentration and carbohydrate metabolism through cellular pathways that differ
from the normal motor response; however, additional verification is required by
human studies [DWMPSY DW 2010].

ADVERSE EFFECT OF LACK OF PHYSICAL EXERCISE

Not getting enough exercise can increases all-cause mortality and the risks for
cardiovascular diseases (CVD), diabetes mellitus (DM), hypertension (HTN), and
cancers (breast, colon, colorectal, endometrial, and epithelial ovarian cancer). This
has been consistently documented in the literature [PATTERSON R, 2018]. There
is no disagreement on the fact that prolonged total sedentary behavior times are
associated with poor disease outcomes. However, the patterns of sedentary time
may differ even within the same total amount of time, and not much is known
about the particular patterns of prolonged sedentary time that pose more significant
health hazards (for example, continuous sedentary behavior without a break or
intermittent sedentary behavior) [DIAZ KM 2019]. One study reported that even if
the total active life style time was equal, having short sedentary bouts and
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engaging in physical activities intermittently can have relative health benefits. The
total inactive lifestyle time and moderate-to-vigorous physical activity (MVPA)
have been reported to be negatively correlated, where the waist circumference
(standardized β, -0.16; 95% confidence interval [CI], -0.31 to -0.02; P=0.026),
body mass index (β, -0.19; 95% CI, -0.35 to -0.02; P=0.026), triglyceride level (β, -
0.18; 95% CI, -0.34 to -0.02; P=0.029), and 2-hour postprandial plasma glucose
level (β, -0.18; 95% CI, -0.34 to -0.02; P=0.025) decreased with increasing the
number of breaks in the sedentary time [HEALY GN 2008]. Furthermore, when
the sedentary time was interrupted with light- or moderate-intensity physical
activity, the systolic and diastolic blood pressures dropped by 2–3 mm Hg whereas
interrupting the sedentary time with light-intensity physical activity (LIPA) or
simple muscle training in patients with diabetes (88% of the population had HTN)
decreased the systolic pressure by 14–16 mm Hg and the diastolic pressure by 8–
10 mm Hg [DEMPSEY PC 2018].
Physiological Features

The exact mechanisms of the various adverse effects of sedentary behavior on the
human body are currently unknown. However, several hypotheses have been
proposed for the overall understanding of the impact of inactive lifestyle behavior
on the human body, which are described below.

Adverse effect of lack of exercise are associated with metabolic dysfunctions, such
as elevated plasma triglycerides and high-density lipoprotein (HDL) cholesterol
and reduced insulin sensitivity [Yanagibori 1998]. Lipoprotein lipase (LPL) is a
protein that interacts at the cellular level, and a low LPL concentration is known to
decrease the plasma HDL cholesterol level, while affecting the prevalence of
severe HTN, diabetes-induced dyslipidemia, metabolic disorders caused by aging,
metabolic syndrome, and coronary artery diseases. Moreover, LPL activity is
diminished by physical inactivity. Additionally, physical inactivity inhibits LPL
activity in skeletal muscles and rapidly signals for impaired lipid metabolism. In an
experiment based on a rat model, the reduction of LPL activity in rats that engaged
in light walking was only about 10% of the LPL activity in rats that were only
placed in their cages [HAMILTON MT 2007]. The fact that muscle LPL activity is
highly sensitive to physical inactivity and low-intensity muscular contractile
activity can serve as evidence supporting the theory that sedentary behavior is a
risk factor for various metabolic disorders [BEY L, 2003].

Physical inactivity reduces bone mineral density [ZERWEKH JE 1998]. In a study

on healthy adult men and women, 12 weeks of bed rest decreased the mineral
8
density of the lumbar spine, femoral neck, and greater trochanter by 1%–4%
[ZERWEKH JE 1998]. The balance between bone resorption and bone deposition
mediates the relationship between sedentary behavior and the reduction of bone
mineral density. According to some studies, bed rest elevates bone resorption
markers and does not influence bone formation markers [KIM H 2003].

Some studies have provided limited evidence that physical inactive lifestyle
behavior has a negative impact on vascular health. A study on healthy women
reported that 56 days of head-down bed rest decreased the endothelium-dependent
vasodilation while increasing the endothelial cell damage. Such alterations in
vascular function were prevented through aerobic exercise and muscle training
[DEMIOT C 2005].

BENEFIT OF EXERCISE AGAINST DISEASE

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.[ J Am Coll Cardiol. 2019]
Physical activity can improve health now and in the future. People of all ages,
races and ethnicities, shapes, sizes, and abilities can benefit from more physical
activity.
Physical activity:

 Helps prevent unhealthy weight gain.

 Reduces the risk of many chronic diseases, such as heart disease, cancer, and
type 2 diabetes.
 Helps reduce feelings of anxiety and improves sleep quality.

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  Improves cognitive ability and reduces risk of dementia.
 Improves bone and musculoskeletal health.

Not everyone has the same opportunity to be physically active. Many people live
in neighborhoods with poor sidewalk and street infrastructure, few safe spaces for
physical activity, and few destinations (including transit stops) within walking or
biking distance from their home. Creating activity-friendly communities can
provide safe and convenient places for people to be active. It can also support local
economies by increasing retail activity and employment.

An aerobics exercise instructor in the United States instructs her class.

10
Physical exercises are generally grouped into three types, depending on the overall
effect they have on the human body:[ White, Tim 2014]
 Aerobic exercise is any physical activity that uses large muscle groups and
causes the body to use more oxygen than it would while resting.[ White,
Tim 2014] The goal of aerobic exercise is to
increase cardiovascular endurance. Examples of aerobic exercise
include running, cycling, swimming, brisk walking, skipping
rope, rowing, hiking, dancing, playing tennis, continuous training, and long
distance running.[ White, Tim 2014]
 Anaerobic exercise, which includes strength and resistance training, can
firm, strengthen, and increase muscle mass, as well as improve bone
density, balance, and coordination.[ White, Tim 2014] 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.[ White, Tim 2014]
[DOCHEM C 2019]
 Flexibility exercises stretch and lengthen muscles.[ White, Tim
2014] Activities such as stretching help to improve joint flexibility and keep
muscles limber.[ White, Tim 2014] The goal is to improve the range of
motion which can reduce the chance of injury.[ White, Tim 2014]
[AINSWORTS BE 2011]

Physical exercise can also include training that focuses on accuracy, agility, power,

and speed.[KATZMARZYK PT 2019]
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.[DUNSKEN DW 2010]
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.[DAIZ TM 2011] People who participate in moderate to high
levels of physical exercise have a lower mortality rate compared to individuals

11
who by comparison are not physically active.[YANAGIBORI 1998] Moderate
levels of exercise have been correlated with preventing aging by reducing
inflammatory potential.[DEMPSEY PC 2018] 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.[YANAGIBORI
1998] 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.
[YAKAGIBORI 1998] 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.[HAMILTON TNT
2OO7] Overall, physical inactivity causes 9% of premature mortality worldwide.
[HAMILTON TNT 2007]
Fitness
Main article: Physical fitness
Most people can increase fitness by increasing physical
activity levels[HAMILYON TNT 2007]. Increases in muscle size from resistance
training are primarily determined by diet and testosterone [BEJ L, 2003]. This
genetic variation in improvement from training is one of the key physiological
differences between elite athletes and the larger population.[ZER WELH JE 1998]
[OZZ KIMIH 2003] There is evidence that exercising in middle age may lead to
better physical ability later in life.[ZWORT SR 2007]
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.[ZWORT SR 2007]
The type and intensity of physical activity performed may have an effect on a
person's fitness level. There is some weak evidence that high-intensity interval
training may improve a person's VO2 max slightly more than lower intensity
endurance training. However, unscientific fitness methods could lead to sports
injuries.

12
 WAY FORWARD
Tip for becoming physically active;
Most of us sit when we are working, often in front of a computer. In fact, less than
20% of Americans have physically active jobs. It can be challenging to fit physical
activity into your busy workday, but here are some tips to help you get moving:
Get up from your chair and move around at least once an hour
Stand when you are talking on the phone
Find out whether your company can get you a stand-up or treadmill desk
Take the stairs instead of the elevator
Use your break or part of your lunch hour to walk around the building
Stand up and walk to a colleague's office instead of sending an email
Have "walking" or standing meetings with co-workers instead of sitting in a
conference room
Engaging oneself into physical actives like e.g housework, gardening, and yard
work are all physical work. To increase the intensity, you could try doing them at a
more vigorous pace.
Keep moving while you watch TV. Lift hand weights, do some gentle yoga
stretches, or pedal an exercise bike. Instead of using the TV remote, get up and
change the channels yourself.
Work out at home with a workout video (on your TV or on the internet)

13
Go for a walk in your neighborhood. It can be more fun if you walk your dog, walk
your kids to school, or walk with a friend.
Stand up when talking on the phone
Get some exercise equipment for your home. Treadmills and elliptical trainers are
great, but not everyone has the money or space for one. Less expensive equipment
such as yoga balls, exercise mats, stretch bands, and hand weights can help you get
a workout at home too.
Most of us sit when we are working, often in front of a computer. In fact, less than
20% of Americans have physically active jobs. It can be challenging to fit physical
activity into your busy workday, but here are some tips to help you get moving:
Get up from your chair and move around at least once an hour
Stand when you are talking on the phone
Find out whether your company can get you a stand-up or treadmill desk
Take the stairs instead of the elevator

CONCLUSION

Since the beginning of the coronavirus pandemic, social distancing has become
important, and engaging in physical activity in the postcorona era is difficult.
Therefore, a study of the problems of sedentary lifestyle is considered more
valuable at this point.

A sedentary lifestyle has an array of adverse health effects, including elevated all-
cause mortality, CVD mortality, cancer risk, risks for metabolic diseases such as
DM, HTN, dyslipidemia, and musculoskeletal diseases such as knee pain and
osteoporosis.

It is indisputable that the negative health impacts intensify with increases in the
total daily sedentary times. For this reason, it is important to reduce the sedentary
time as much as possible.

14
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