By Dr Raj Chandok
“If physical activity were a drug, we would refer to it as a miracle cure, due to the great many illnesses it can prevent and help treat.” UK Chief Medical Officers’ Physical Activity Guidelines*
As the winter skiing season arrives and we look forward to our family ski holiday in St. Moritz in mid December, I remember my apprehensiveness the first time I was en route to ski some twenty years ago when I was in my mid-twenties. I was on a train journey, a gentleman sitting next to me in his late 60s told me how he took up skiing for the first time at the age of 55; I remember this vividly as he described how he loved this challenge now and although he too had been worried about the physical demands, in the end all went well for him and he continued to ski every year since his first skiing experience. I was grateful for him sharing his anxieties, but also he was an exemplar of how age should not be a barrier to exploring new demanding physical challenges and activities.
The importance of physical activity at all ages has been re-stated in the recently published guidance by the UK Chief Medical Officers. In adults, there is strong evidence to demonstrate the protective effect of physical activity on the following : coronary heart disease, obesity and type 2 diabetes, mental health problems and social isolation amongst other conditions. The guidance specifies the volume, duration, frequency and type of physical activity required across the various stages of our lives to attain health benefits. Any amount of physical activity attains benefits, hence even if you have had a particularly sedentary lifestyle, an effort to achieve any activity will be beneficial.
Physical activity falls into following principal domains: cardiovascular, strengthening and balance training.
Cardiovascular exercise is also known as aerobic exercise, examples are swimming, walking, hiking, running, ball games, racquet sports, dancing, water aerobics, gymnastics, martial arts and cycling. The guidances state that each week adults should aim to accumulate 150 minutes of moderate intensity aerobic activity such as brisk walking or cycling, building up gradually from current levels. Those who are already regularly active can achieve these benefits through 75 minutes of vigorous intensity aerobic activity such as running or sports each week. Or a combination of moderate and vigorous intensity activities is also fine, moderate intensity activity occurs when the breathing rate is increased, but you are still able to talk, and vigorous intensity activity occurs when the breathing rate is increased to such an extent that you are not able to talk.
Strengthening activities, in particular, delay the natural decline in muscle mass and bone density which occurs in later life. Examples include exercises such as yoga, pilates, tai chi, gardening, lifting weights, push-ups, sit-ups, and wheeling a wheeling chair.*** Muscle strengthening activities should be done at least two times a week.
Balance training involves a combination of movements that challenge balance and reduce the likelihood of falling; the website www.nhs.uk shows how to do simple balance exercises that can be done at home, examples include sideways walking, heel-to-toe walk, one-leg stand and step-ups.
Balance exercises should be done at least two times a week.
Susruta 600 B.C. of India and Hippocrates 400 B.C. of Greece are two Physicians who long ago advocated the importance of exercise for good health, our increasingly sedentary lifestyles require us, now more than ever to engage in daily physical activities at all ages, as the benefits are absolutely in no doubt. To achieve healthy ageing, a pillar is regular physical activity, a combination of activity types as outlined in this article provides a holistic approach and achieves the optimal benefits.
*UK Chief Medical Officers’ Physical Activity Guidelines, published 7 September, 2019
Dr Raj Chandok, is a General Practitioner and Commissioner working to deliver patient-centred, high quality Long Term Conditions care across North West London.
Dr Raj S. Chandok
FRCGP FRSA MSc MBBS DC DRCOG DFFP D Med Ed.
Principal, Dr G Singh & Partners
Vice Chair NHS Ealing CCG
Honorary Professor Buckinghamshire New University
Photo Caption Dr Raj Chandok engaging in vigorous intensity aerobic activity