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Writer's pictureDr. Fredrick Peters

THE IMPORTANCE OF CARDIOVASCULAR EXERCISE - AN EVIDENCE BASED ANALYSIS

Spring is almost here, so lace up those shoes and get moving!

Consistent cardiovascular exercise can result in lower resting blood pressure, lower resting heart rate, and has a multitude of other benefits. The American Heart Association recommends achieving at least 150 minutes of moderate-intensity exercise, or 75 minutes of vigorous-intensity exercise, at least 5 days per week.

The goal: at least 30-minutes, five or more days per week, and it must raise your heart rate for the duration of the activity.

Cardio has a multitude of benefits

1. Cognitive health

There are many ways exercise improves cognitive health. Aerobic exercise raises your heart rate and increases blood flow to your brain. Your increased heart rate is accompanied by harder and faster breathing depending on the intensity of your workout. As your increased breathing pumps more oxygen into your bloodstream, more oxygen is delivered to your brain. This leads to neurogenesis—or the production of neurons—in certain parts of your brain that control memory and thinking. Neurogenesis increases brain volume, and this cognitive reserve is believed to help buffer against the effects of dementia.


Another factor mediating the link between cognition and exercise is neurotrophins, which are proteins that aid neuron survival and function. It has been noted that exercise promotes the production of neurotrophins, leading to greater brain plasticity, and therefore, better memory and learning. In addition to neurotrophins, exercise also results in an increase in neurotransmitters in the brain, specifically serotonin and norepinephrine, which boost information processing and mood.


Exercise’s Lasting Effects on Cognition

In 2017, the Lancet released its landmark research commission on dementia prevention, intervention, and care that demonstrated that 35 percent of risk factors for developing dementia can be attributed to modifiable lifestyle traits. A significant component: exercise.


In a longitudinal study conducted by Dr. Zhu from the University of Minnesota, exercise tests were administered to a group of participants to determine their fitness levels. Those who were the most active in 1985 tended to still be on the fit side of the spectrum decades later. That same “fit” cohort also performed better on cognitive tests decades later.


Furthermore, exercise gives hope to people with a rare genetic mutation that programs them for early-onset Alzheimer’s disease. Although exercise cannot completely counteract their genetic predisposition, people who exercised for at least 150 minutes per week had better cognitive outcomes compared to those who did not.


Incredibly, exercise could potentially delay their dementia onset by up to 15 years.


2. Skin

Getting the heart rate up and improving blood circulation, can help to deliver oxygen and nutrients to the skin which keeps the skin healthy, promotes collagen production, and promotes new skin cells which keeps the skin looking glowing and is also helpful for anti-aging,


3. Muscle and Joints

Synovial fluid lubricates the joint.

The joint is surrounded by soft tissue called the synovial membrane, which produces a fluid that acts like oil in an engine, allowing your bones to move past one another more smoothly. Physical activity encourages circulation of the fluid.


Blood flow increases.

Exercise gets the heart pumping, which increases blood circulation throughout your body – including your joints. As a result, the synovial membrane is exposed to a steady supply of nourishing oxygen and nutrients.


Nutrients circulate to the joint.

The weight that bears down on your joints when you exercise forces water molecules out of the cartilage like a sponge. When the weight is lifted, the water molecules return, bringing oxygen and nutrients the joints need.


Joint-repair genes are switched on.

Research shows that joint movement activates genes associated with rebuilding cartilage. Overdoing exercise can have the opposite effect, though, so listen to your body.


Cellular waste is removed.

Exercise triggers a biological process called autophagy, where damaged cells in the joint are broken down and removed.


Muscle is built.

Exercise strengthens the muscles, ligaments and tendons surrounding the joints. When these tissues are strong, they act like a brace to protect the joint, and lessen pressure on weakened joints.


4. Weight Loss Aerobic exercise alone results in clinically significant weight loss for men and women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630467/

Abstract Exercise is recommended by public health agencies for weight management; however, the role of exercise is generally considered secondary to energy restriction. Few studies exist that have verified completion of exercise, measured the energy expenditure of exercise, and prescribed exercise with equivalent energy expenditure across individuals and genders.

Objective The objective of this study was to evaluate aerobic exercise, without energy restriction, on weight loss in sedentary overweight and obese men and women.

Design and Methods This investigation was a randomized, controlled, efficacy trial in 141 overweight and obese participants (body mass index, 31.0 ± 4.6 kg/m2; age 22.6 ± 3.9 years). Participants were randomized (2:2:1 ratio) to exercise at either 400 kcal/session or 600 kcal/session or to a non-exercise control. Exercise was supervised, 5 days/week, for 10 months. All participants were instructed to maintain usual ad libitum diets. Due to the efficacy design, completion of ≥ 90% of exercise sessions was an a priori definition of per protocol, and these participants were included in the analysis.

Results Weight loss from baseline to 10 months for the 400 and 600 kcal/session groups was 3.9 ± 4.9kg (4.3%) and 5.2 ± 5.6kg (5.7%), respectively compared to weight gain for controls of 0.5 ± 3.5kg (0.5%) (p<0.05). Differences for weight loss from baseline to 10 months between the exercise groups and differences between men and women within groups were not statistically significant.

Conclusions Supervised exercise, with equivalent energy expenditure, results in clinically significant weight loss with no significant difference between men and women.


5. Lung Health Regular exercise leads to numerous and varied physiological changes that are beneficial from a health standpoint. They include improved cardio-respiratory function and skeletal muscle function; higher levels of high-density lipoprotein cholesterol; improved blood pressure, body composition, and bone density; decreased insulin need and improved glucose tolerance; enhanced performance of work, and many positive psychological benefits. These changes, in turn, help lower death rates from illnesses such as cardiovascular disease (including heart attack and stroke); type-2 diabetes; and certain cancers, including colon, breast and lung; and lower disease rates for high blood pressure, obesity, osteoarthritis and osteoporosis.


Improvement in cardio-respiratory function does not result from changes in the lung's ability to expand, however. In general regular exercise does not substantially change measures of pulmonary function such as total lung capacity, the volume of air in the lungs after taking the largest breath possible (TLC), and forced vital capacity, the amount of air able to be blown out after taking the largest breath possible (FVC). Studies comparing TLC and FVC show little difference between regular exercisers and nonexercisers, in fact. So even though people often report feeling out of breath or winded during exercise, it is unlikely that pulmonary function limits their ability to exercise, unless they have a disease that specifically impairs lung function such as asthma, bronchitis or emphysema.


One of the largest differences between an exerciser and a nonexerciser concerns the heart's ability to pump blood and consequently deliver oxygen to working muscles. Cardiac output is a major limiting factor for prolonged exercise. In addition, an exerciser typically has a larger blood volume, is better able to extract oxygen from the air in the lungs and is better able to extract oxygen from the blood at the working muscles than a sedentary individual is. Gas exchange involves not only oxygen delivery but also the removal of carbon dioxide, which is a byproduct of energy metabolism, and this process is also more efficient in an exerciser.

6. Sexual function

An investigation of the relationship between physical fitness, self-concept, and sexual functioning https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963213/


Obesity and inactivity have led to an increasing number of individuals with sexual dysfunctions (43% of women; 31% of men). Small bouts of exercise can drastically improve sexual functioning. Thus, the present study is designed to examine the effects of physical fitness and self-concept on sexual functioning.

Fitness assessments and questionnaires were administered to 133 participants between the ages of 18 and 50 years. Physical fitness was assessed through body composition, cardiovascular endurance, muscular strength, and muscular endurance. Self-concept was presented as a total self-concept score and as six individual concepts of self. Sexual function was presented as both an aggregate score and five separate constructs of sexual functioning – fantasy/cognition, arousal, orgasm, behavior/experience, and drive/desire.

The results indicated that sexual behavior/experience was predicted by body fat percentage. In men, fantasy was related to total self-concept; sexual behavior/experience was related to likeability. In women, arousal was predicted by cardiovascular endurance. Total self-concept was related to both orgasm and sex drive/desire. Power and muscular strength were significantly related to number of sexual partners in women but not men.

The present study adds to the growing body of evidence indicating a positive relationship between physical fitness and sexual health. Individuals with sexual dysfunctions, particularly women, who are not persuaded by the currently publicized benefits of physical activity, may be inclined to exercise to improve sexual functioning. 7. Mood, Sleep, and Energy Researchers don’t completely understand how physical activity improves sleep. Moderate aerobic exercise increases the amount of deep REM sleep, where the brain and body have a chance to rejuvenate. Exercise can also help to stabilize your mood and decompress the mind, a cognitive process that is important for naturally transitioning to sleep.

The Timing of Exercise May Matter

  • Aerobic exercise causes the body to release endorphins. These chemicals can create a level of activity in the brain that keeps some people awake. These individuals should exercise at least 1 to 2 hours before going to bed, giving endorphin levels time to wash out and the brain time to wind down.

  • Exercise also raises your core body temperature. The effect of exercise in some people is like taking a hot shower that wakes you up in the morning. Elevation in core body temperature signals the body clock that it’s time to be awake. After about 30 to 90 minutes, the core body temperature starts to fall. The decline helps to facilitate sleepiness.

Despite these biological responses to exercise, other people find that the time of day they exercise doesn’t make a difference.


How Much Exercise You Need for Better Sleep The good news: People who engage in at least 30 minutes of moderate aerobic exercise may see a difference in sleep quality that same night. Take Advantage!

The Fitness Doctor offers a private cardiovascular area just for your convenience! Be sure to take advantage of this amenity (before or after) your training session. You’ll not only boost your immune system, but by improving your cardiorespiratory fitness, you can also increase your chance of living a long, healthy life!


When all is said and done, regular exercise produces numerous favorable changes that collectively result in the body being able to work in a far more efficient manner. All of us are born with the ability to increase our physical fitness levels through regular exercise so it is unfortunate that many peoples' sedentary lifestyles and lack of exercise result in unfavorable outcomes in terms of disease. Perhaps one of the greatest challenges we face in developed societies is how to facilitate and encourage healthier lifestyles that include regular physical activity. Left unchecked, this problem will contribute to ever-increasing health care costs and higher disease rates. Regular exercise is not the magic bullet in terms of disease prevention, but, when combined with a healthy diet, it may be the best intervention currently available to any one who is willing to get up off the couch.


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