With what is happening, it is natural that the covid-19 and its grave consequences are on everyone’s lips. However, today more than ever, it was good to remind us that the physical inactivity and the sedentary lifestyle they also spend a lot of time doing theirs.
the own World Health Organization (WHO) has acknowledged that the lack of physical activity is an important risk factor for increasing the number of people who they get sick and the premature mortality. In fact, the 2020 estimates indicated that it did not meet the recommendations of physical activity is responsible worldwide for more than 5 million deaths each year. dimensions of pandemic, Certainly.
Recently, a study based on data from more than a million people indicated that if the physical activity practice was sufficient -equivalent to 60-75 minutes a day of moderate-intensity physical activity-, would serve to counteract the increase in risk of mortality which means staying more than four hours sitting a day.
We must not forget that to be sitting for a long time is a dangerous practice and res sana, Especially if combined with little physical activity. In fact, this combination increases the risk of mortality the same as the tobacco o la obesity.
However, despite the evidence, only 18% of adults aged 65 to 74 and 15% of adults over 75 years meet the minimum exercise guidelines cardiovascular and muscle strength established by the WHO. That is, do more than 150 minutes of moderate-vigorous aerobic physical activity per week and muscle strengthening exercises at least 2 times a week.
Moreover, even if they did, it would also be insufficient. Because these levels of physical activity they can attenuate but not eliminate the risk associated with watching television more than 3 hours a day.
Physical inactivity and sedentary lifestyle, two old known public health problems
In the elderly, if the physical inactivity is combined with a style of sedentary lifestyle, Muscle mass and physical function are reduced. As a result, the ability to perform decreases daily activities, Increases the risk of falls and independence and quality of life are lost. In addition, sedentary living also worsens chronic health problems, including hypertension, Cardiovascular and cerebrovascular diseases, the diabetes, the depression and the dementia.
Not to be taken lightly. Staying immobilized for periods as short as 5 days, even in young people, reduces muscle mass by up to 4%, strength by 9% and our strength by up to 10%. cardiovascular capacity. In the event of being hospitalized, only three weeks of absolute rest would be similar to a deterioration in functional capacity equivalent to 30 years of aging.
In addition, it has been shown that it is sufficient to reduce the number of daily steps for 14 days to increase the risk of metabolic disease future and resistance to the insulin, Typical of type II diabetes and obesity. It is confirmed that we are designed to move. And that, if we don’t, the burden of disease and mortality skyrocket exponentially.
Despite the great advances in science, at the moment there are no drugs that can improve the physical capacity to the elderly. It doesn’t even seem likely that any will develop in the immediate future. The only “vaccine” we have is exercise. With the advantage that it is cheap, efficient and safe and there is no problem of supply or queues or shifts: everyone could start taking it from that very moment.
Confined and inactive
Globally, the SARS-CoV-2 has had a major impact on regular physical activity practice. In the specific case of Spain, it was the European country that reduced the number of daily steps of the population – 38% less – during the first weeks of confinement. Less physical activity practice than was already considered insufficient.
In the time we are living, we must maintain the levels of physical activity the highest possible. Among other things because, in case of illness or even of hospitalization, The functional capacity we have will act as a real life insurance to face more successfully the disease itself or the side effects of aggressive treatments pharmacological that they can prescribe us. In other words, the better we are at the time of getting sick, the more likely we are to overcome the disease.
Walking is not enough
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the physical exercise improves physical function and quality of life. But it also reduces the burden of noncommunicable diseases and general mortality premature, Including mortality from specific causes of cardiovascular disease, cancer, and chronic diseases of the lower respiratory tract. And while it’s better than nothing, walking isn’t enough.
In 2020, the World Health Organization publish the new guidelines on physical activity and sedentary behavior in which he recommended heavily the practice of multicomponent physical activity of moderate or intense intensity three or more days a week. This includes performing exercises to improve cardiovascular endurance (such as walking) with strength training and balance.
from the Public University of Navarre we have launched a multi-component individualized exercise program for the prevention of fragility and the risk of falls called VIVIFRAIL. It includes walking exercises for cardiovascular endurance training, as well as moving moderate weights to increase limb strength, as well as balance and mobility exercises.
It has been shown that, applied to over 70 years, The VIVIFRAIL program fulfills its goal of combating the fragility (Low body mass, strength, mobility, level of physical activity, energy). Or what is the same, it optimizes and prevents the loss of functional capacity during aging.
To make matters worse, in phospitalized acute patients, Supervised exercise interventions based on the VIVIFRAIL methodology have also been shown to be safe and effective in alleviating functional impairment and even in preventing cognitive impairment.
The importance of prescribing exercise
Is it ethical not to prescribe exercise? Despite all that has been said so far, the exercise has not yet been fully integrated into the usual practice of primary or geriatric medicine. Moreover, it is virtually absent from the basic training of most doctors and other health professionals. However, doctors should be the first “prescribers of exercise,” and medical schools should teach that skeletal muscle is still a plastic fabric and adaptable throughout human life.
As for the physical educators, Should play a more active role in the direction, monitoring and evaluation of the exercise practice in people of any age who have a health problem, those with functional diversity or with different abilities, especially in the health environment.
On the other hand, we must not forget a message as simple as it is important: exercise is not just for children and young adults. Older people can adapt at the exercise and deserve to benefit from it. It’s never too late – and it’s never too old – to contract muscles.
What it looks like indisputable is that more research is needed on exercise interventions for older adults, the “forgotten big ones” in medical studies. Especially to clarify doubts about safety, efficacy and the inherent variability among people in response to exercise.
Understanding this variability is essential to identifying the best method of treatment (Simple exercises or multicomponent exercises) and decide the intensity (low, moderate or high intensity resistance exercises). The global idea that “exercise is medicineBut just as not all drugs cure cancer, not all types of exercise (cardiovascular, muscle strengthening, balance) have the same effects on disease and functional capacity.
Either way, the aphysical activity it should be considered, with and without a pandemic, as an essential activity with an impact on public health. This should be one of the great challenges of public health and health policies in the coming years.
* This article was published in The Conversation and reproduced here under the Creative Commons license. Click here to read the original version.
* Mikel Izquierdo, Professor and Director of the Department of Health Sciences, Public University of Navarra.