The Role of Exercise in Some Intestinal Disorders

In 2001, Gut – An International Journal of Gastroenterology and Hepatology, published a review article from the Netherlands titled “Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract.”

It is an interesting review. It says that acute strenuous exercise may provoke gastrointestinal symptoms such as nausea, heartburn, diarrhea and gastrointestinal bleeding. This happens especially during vigorous sports such as long distance running and triathlons. About 20 – 50 per cent of endurance athletes are hampered by these symptoms. This may deter them from participation in training and competitive events. But it has no long term effect on their health.

In contrast, the article says, repetitive exercise periods at a relatively low intensity may have protective effects on the gastrointestinal tract.

There is strong evidence that physical activity reduces the risk of colon cancer by up to 50 per cent. The primary postulated mechanism, according to the article, is that physical activity reduces intestinal transit time which would limit the time of contact between the colon mucosa and cancer promoting contents.

Several studies have been published on the relationship between physical activity and gall stones. Still more work needs to be done. Regular exercise may reduce the chance of developing gall stones.

A limited number of studies have investigated the preventive effect of physical activity on inflammatory bowel disease (Crohn’s disease and ulcerative colitis). The article says, “While the preventive effect of physical activity remains inconclusive, it has become clear that physical activity is not harmful for patients with inflammatory bowel disease….”

Physical activity in patients with inflammatory bowel disease should be encouraged as these patients have muscle weakness and are at risk of osteoporosis, especially if they are on steroids for the treatment of their disease.  Exercise will improve physical health, general well being, perceived stress and quality of life.

A possible role of physical activity in reducing the risk of diverticular disease has been reported in the medical literature. It has been suggested that diverticular disease was more prevalent among people with sedentary occupations than in more active occupations. An increase in colonic motor activity via hormonal, vascular, and mechanical aspects, leading to a reduction in colonic transit time, was postulated as an underlying mechanism.

Regular physical activity and exercise has shown a positive effect on reducing constipation. The review article mentions two case control studies that showed the defecation pattern of runners was “better” (less firm stools, higher defecation frequency, higher stool weight) than in inactive controls. Further research is required to confirm these findings.

In conclusion, strenuous exercise may induce gastrointestinal symptoms such as heartburn or diarrhoea, which may deter people from participating in physical activity. These symptoms are usually transient.

Physical activity, mostly performed at a relatively low intensity, may also have protective effects on the gastrointestinal tract. There is strong evidence that physical activity reduces the risk of colon cancer. Less convincing evidence is found for gall stones and constipation.

Physical activity may reduce the risk of diverticulosis, gastrointestinal bleeding, and inflammatory bowel disease, although up to now there has been little research to substantiate this. Physical activity does not interfere with the healing process in inflammatory bowel disease and will probably not reduce the risk of rectal and gastric cancer, says the article.

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There Are Many Ways To Be Physically Active

Doing the same thing over and over can create lethargy and boredom. This applies to physical activities as well. So, most people get involved in more than one kind of physical activity to keep them healthy and happy. Besides, our muscles and joints require different kinds of challenges to keep them strong and moving.

In my collection of old articles, I found a TIME magazine (June 13, 2005) which reported on a poll of 1011 adult Americans to see how many people exercise every week and the type of exercise they do. Nearly a third of North Americans are considered obese and a quarter of Americans (22 per cent of men, 28 per cent of women) admit that they virtually spend no time getting exercise in their leisure time.

The poll found most respondents do exercise every week. But the type of exercise or physical activity they do varies from taking a brisk walk (69 per cent) to bowling (seven per cent). Half the respondents admitted to being overweight. Dr. Tim Church, medical director, Cooper Institute, a fitness research centre in Dallas, is quoted in the article saying, “We have two epidemics. One is obesity, the other is physical inactivity.”

According to the TIME poll, 69 per cent take a brisk walk, 35 per cent use exercise machine, 32 per cent lift weights, 30 per cent ride a bike, 27 per cent jog or run, 22 per cent do aerobic exercise, 21 per cent swim, 19 per cent dance, 18 per cent play some kind of sport like soccer, 18 per cent go hiking, eight per cent play golf, seven per cent do yoga, seven per cent bowl.

Make sure the physical activity you enjoy is safe for you and people around you. A lot depends on your age, health and what kind of activity you are involved in. Riding bicycles is a good example. According to the National Safety Council in the U.S., there are 57 million Americans riding bicycles that range all the way from dirt bikes up to high performance 18-speed models.

An article in the Bulletin of the American College of Surgeons (October 2007) says, cycling ranks as the seventh most popular recreational activity after exercise walking, swimming, camping, fishing, exercise with equipment and bowling. Millions of cyclists occupy the same streets, paths and sidewalks as motor vehicles and pedestrians. There are statistics to show that many pedestrians and cyclists are injured by motor vehicles. About 14 per cent of the injured end up in rehab, nursing homes or die from their injuries. Riding motor bikes can be dangerous too.

Walking is a pretty simple way to exercise. But we have the lowest percentage of trips by walking of any country. We live in a modern society which encourages laziness and lack of movement. Compare ourselves to Old Order Amish, a religious sect which does not use cars and other modern transportation methods.

A study conducted by the Tennessee’s Department of Health and Exercise Science found that an average Amish man takes 18,425 steps a day, and the average Amish woman takes 14,196 steps. A typical American takes about 5,000 steps a day.

This shows what modernisation has done to us. It has made us lazy. Vagaries of the weather further encourage our laziness. Now that summer is over and weather is starting to get nasty for outdoor activities, we must start thinking of physical activities we can do indoors or safely outdoors. Make sure you are fit to do what you want to do. Then build your stamina slowly. There are numerous activities you can pick from. Keep it simple and start slowly. Talk to a professional trainer.

Have fun.

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Regular Physical Activity Can Reduce Your Blood Pressure and Prevent Stroke

When was the last time you had your blood pressure checked?

There are many things you can do to prevent stroke. One of the most important things you can do is to keep your blood pressure under control. It is also important to learn to recognize early signs of stroke because if you receive clot busting medications within three to 4.5 hours then your chance of survival and living without disability is considerably improved.

Stress and anxiety can raise your blood pressure. We know that anxiety does not cause permanent high blood pressure but it can cause dramatic temporary spikes of high blood pressure which can cause damage to our blood vessels and vital organs like heart and kidneys. It can damage the brain and retina. Persistent or recurrent anxiety can make us prone to picking up bad habits like smoking, drinking or eating too much unhealthy food. Combination of these factors can increase our risk of high blood pressure.

Nearly two-thirds of all cases of stroke and one-half of all cases of coronary heart disease are directly related to hypertension. What is scarier is that most cases of hypertension either go undiagnosed or untreated. That is why it is called a silent killer. You may have high blood pressure but may not have any symptoms.

World Health Organization says that hypertension causes seven million premature deaths worldwide each year. Hypertension affects 22 percent of Canadians. It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension. It is a ticking but silent time bomb ready to explode any time.

The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension. This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders.

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Hypertension can be prevented and treated with lifestyle changes – with or without medication. Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

If your doctor wants you take pills to control your blood pressure then make sure you take it regularly. Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

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What’s the role of exercise in preventing cancer?

Heavy weight and large size have been associated with increased risk of breast cancer. There is evidence to suggest that regular exercise is associated with a reduced incidence of breast cancer.

The relationship between physical activity and breast cancer incidence has been extensively studied, with over 60 studies published in North America, Europe, Asia, and Australia. Most studies indicate that physically active women have a lower risk of developing breast cancer than inactive women.

In the Women’s Health Initiative Observational Study published in 2001, it was reported that current exercise and exercise after menopause are both associated with a decreased risk of breast cancer. Even a small amount of exercise (1.25 to 2.5 hours per week of brisk walking) is beneficial. Women who had engaged in regular strenuous exercise at age 35 had a 14 per cent decreased risk of breast cancer compared with less active women (CMAJ 2004).

Evidence from population based studies suggests that occupational, leisure, and household activities are associated with about 30 per cent reduction in breast cancer rates – more you exercise, better the results (BMJ editorial 2000).

There is evidence to support potentially important protective effect of physical activity against colon cancer but not against rectal cancer. And there is no evidence that exercise increases the risk of any cancer. Colorectal cancer has been one of the most extensively studied cancers in relation to physical activity, with more than 50 studies examining this association (www.cancer.gov).

Many studies in the United States and around the world have consistently found that adults who increase their physical activity, either in intensity, duration, or frequency, can reduce their risk of developing colon cancer by 30 to 40 per cent relative to those who are sedentary regardless of body mass index (BMI), with the greatest risk reduction seen among those who are most active.

The risk of colorectal cancer begins to increase after age 40 and continues to increase as you get older. Obesity is linked to an increased risk of colorectal cancer. A lifestyle that does not include regular exercise may also be linked to an increased risk of colorectal cancer.

Research findings are less consistent about the effect of physical activity on prostate cancer, with at least 36 studies in North America, Europe, and Asia. Overall, the epidemiologic research does not indicate that there is an inverse relationship between physical activity and prostate cancer.

About 20 studies have examined the role of physical activity on endometrial cancer risk. These studies suggest that women who are physically active have a 20 per cent to 40 per cent reduced risk of endometrial cancer, with the greatest reduction in risk among those with the highest levels of physical activity. Risk does not appear to vary by age.

At least 21 studies have examined the impact of physical activity on the risk of lung cancer. Overall, these studies suggest that the most physically active individuals experience about a 20 per cent reduction in risk.

In conclusion, there is convincing evidence that physical activity is associated with a reduced risk of cancers of the colon and breast. Several studies also have reported links between physical activity and a reduced risk of cancers of the prostate, lung, and lining of the uterus (endometrial cancer).

Despite these health benefits, recent studies have shown that more than 50 per cent of the population do not engage in enough regular physical activity.

National Cancer Institute (NCI) funded studies are exploring the ways in which physical activity may improve the prognosis and quality of life of cancer patients and survivors. For more information about current research in this area, please visit NCI’s Cancer Survivorship Research Web site at http://cancercontrol.cancer.gov/ocs on the Internet.

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