The Importance of Physical Activity on Outcomes of Health

Defining Physical Activity (PA)

Terms such as fitness, exercise, sports, physical activity, etc are often used interchangeably but refer to different concepts. This article primarily focuses on the implications of physical activity for health. Therefore, it is important to distinguish this concept from other commonly used terms like fitness and exercise. Physical activity is defined as “as any bodily movement produced by skeletal muscles that results in energy expenditure” (Singh, 2013). Hence, it includes sports, household, occupational, conditioning, and other activities. Exercise is a branch of physical activity which is mainly defined by its intentional, repetitive, and goal-oriented nature. Lastly, being physically “fit” is an attribute that is assigned to an individual on the basis of their skill, health, and the context in which they are being labelled “fit”.

Low PA Levels in Indian Youth

In 2016, a collaborative effort between researchers and educators from Canada and India led to the development of the first Indian Report Card on Physical Activity for Children and Youth. It was a measure designed to serve a two-fold purpose - 1. To evaluate and appraise the current state of active living in India, and 2. To use data obtained to inform policies surrounding active lifestyles. The results from the nationwide survey highlighted the serious public health problem of physical inactivity in Indian Youth (Katapally et al., 2016). The report revealed most Indian children, both from rural and urban demographics, do not achieve recommended levels of physical activity. Researchers were also unable to find significant evidence with respect to the implementation of organizational or government efforts to increase physical activity. However, it must be noted that due to the lack of clear data on various variables, a complete picture that encompasses the diversity of the nation could not be captured by the report. Therefore, while physical activity is low, more data needs to be collected to help inform policies and strategies to improve the current condition.

Implications for Physical Health

The ancient philosophy of a “sound body-sound mind” has been consistently supported by empirical research on the effect of physical activity on psychological well being (Silvestri, 1997). Therefore, it is a known fact that physical activity has a positive impact on the physical and mental aspects of one's health.

Warburton and colleagues (2014) provide supporting evidence for the role of physical activity in preventing chronic diseases. They find that regular physical activity can be used as a primary and secondary preventive technique for cardiovascular disease, diabetes, cancer, hypertension, obesity, and osteoporosis. Pengpid and colleagues (2021) found that, in Indians, moderate and/or high physical activity was negatively associated with diabetes, heart diseases, stroke, hypertension, chronic lung diseases, vision impairment, chronic renal failure and Alzheimer’s disease. They noted that higher PA levels protected individuals from 9 out of 12 chronic conditions.

The carry-over effect or transferability of early habituation of physical activity on adult lifestyle has also been well-documented. An article reviewing the short- and long-term effects of adolescent physical activity found four different pathways by which it may improve or maintain health. Findings suggested that 1. Adult physical activity indirectly results in a health benefit when it begins from childhood, 2. Adolescent physical activity directly influences adult morbidity by providing long term benefits on bone health, breast cancer and sedentary behaviours, 3. It decreases adolescent morbidity, and 4. It promotes short term benefits like muscular and bone health in adolescents (Hallal, 2006).

Domain-Specific Evidence for Mental Health Outcomes

A longitudinal study on the Indian population found that higher PA levels were associated with 10 out 11 mental health and well-being indicators. They presented robust evidence for the association between high PA levels and lesser insomnia symptoms, lesser depressive symptoms, lesser loneliness, and better cognitive functioning. Furthermore, they found that individuals engaging in high PA rated themselves better on well-being measures, life satisfaction, happiness, and functional ability.

A recent study suggested that the context in which physical activity occurs dictates the benefit it has on outcomes of mental health. In their study, White and colleagues (2017) noted the abundance of systematic reviews showing the association between - 1. Physical activity and greater mental health, and 2. Reduced risk of mental illness in the presence of physical activity. However, these reviews did not account for the context in which physical activity was conducted. For example, whether it was a leisurely activity, job-related movement, or a planned exercise routine. The meta-analysis conducted by White and colleagues (2017) addressed this limitation using a search methodology that accounted for the domain in which PA was taking place. They report that physical activity is much more effective for mental health and prevention of mental illness when performed during leisure time. Although, this is difficult as individuals with poor mental health are less likely to engage in leisure PA (White, et. al., 2016). The authors explain that there are multiple mechanisms by which physical activity enhances mental health. One likely pathway is by increasing self-efficacy and confidence. Additionally, they suggest that it may serve as a distraction or constructive outlet from stressful situations in one's life. This is known as the distraction hypothesis. It posits that PA diverts one’s attention from life stressors and therefore improves mental well-being (Leith, 2010). Furthermore, physical activity increases motivation. PA during leisure is likely to be fun and pleasuresome. This provides incentive due to the perceived benefit of enjoyment. Hence, the individual is more likely to engage in it. The more choice, freedom, and autonomy one derives from engaging in a particular physical activity, the more likely they are to repeat and enjoy it.

Recommendations

On studying the relationship between activity and physical health, numerous researchers have determined a dose-response relationship. This means that there seems to be a certain amount of physical activity that is objectively beneficial for improving health outcomes. However, there is a lack of consensus regarding the nature of this relationship. Researchers are divided on whether more PA is objectively better than relatively moderate or lesser PA. While some studies show a linear relationship, others report curvilinearity.

Depending on the research methodology used, some recommend that there is a threshold of 150min/week and 420min/week of activity that must be surpassed by adults and children respectively to improve health. This research is in line with and has informed the World Health Organization’s recommendations as well. However, some findings also suggest improvements in health conditions at much lower (even half) doses than the aforementioned recommendations.

Conclusion

The current status of physical activity levels in India is concerning and must be worked towards. There is significant, robust and solid evidence for the negative implications of low PA and positive health benefits, both mental and physical for moderate to high PA levels. In essence, it is highly recommended that individuals make it a priority to simply “move more” as it is highly likely to aid their well-being.

References

An, H. Y., Chen, W., Wang, C. W., Yang, H. F., Huang, W. T., & Fan, S. Y. (2020). The Relationships between Physical Activity and Life Satisfaction and Happiness among Young, Middle-Aged, and Older Adults. International Journal of Environmental Research and Public Health, 17(13), 4817. https://doi.org/10.3390/ijerph17134817

Katapally, T. R., Goenka, S., Bhawra, J., Mani, S., Krishnaveni, G. V., Kehoe, S. H., Lamkang, A. S., Raj, M., & McNutt, K. (2016a). Results From India’s 2016 Report Card on Physical Activity for Children and Youth. Journal of Physical Activity and Health, 13(s2), S176–S182. https://doi.org/10.1123/jpah.2016-0393

Lotan, M., Merrick, J., & Carmeli, E. (2005). Physical activity in adolescence. A review with clinical suggestions. International Journal of Adolescent Medicine and Health, 17(1). https://doi.org/10.1515/ijamh.2005.17.1.13

Paluska, S. A., & Schwenk, T. L. (2000). Physical Activity and Mental Health. Sports Medicine, 29(3), 167–180. https://doi.org/10.2165/00007256-200029030-00003

Physical activity, health and well-being among a nationally representative population-based sample of middle-aged and older adults in India, 2017–2018. (2021, December 1). ScienceDirect. https://linkinghub.elsevier.com/retrieve/pii/S2405844021027389

SINGH, K. (2013). A STUDY OF PHYSICALACTIVITY, EXERCISE, AND PHYSICAL FITNESS: DEFINITIONS AND BIFURCATION FOR PHYSICAL RELATED RESEARCH. Academic Sports Scholar, II(III), 1–5. https://doi.org/10.9780/2277-3665/1112013/37

White, R. L., Babic, M. J., Parker, P. D., Lubans, D. R., Astell-Burt, T., & Lonsdale, C. (2017). Domain-Specific Physical Activity and Mental Health: A Meta-analysis. American Journal of Preventive Medicine, 52(5), 653–666. https://doi.org/10.1016/j.amepre.2016.12.008