BRUNSWICK

Physical activity can improve most, if not all, facets of your life and health. Regular activity can improve your cardiovascular function, better your mood, reduce the risk of falling if you’re in the elderly population, among many other benefits.

Heart disease, cancer, strokes and diabetes are among the top 10 causes of death in our country, all of which can be positively affected by exercise.

Managing medical issues that result either directly or indirectly from inactivity comes at a hefty price. The U.S. spent $3 trillion on healthcare in 2014. Medical costs due to inactivity have been estimated to be $24 billion annually. Eleven percent of aggregate health care expenditures in the U.S. are associated with inadequate physical activity.

Healthcare coverage has changed significantly over the past few years. Most people are paying higher deductibles and co-pays. Reducing the expenses associated with healthcare and mitigating out of pocket expenses is within everyone’s power. We all can improve our quality of life by starting or increasing our physical activity. Even small lifestyle changes can dramatically improve your health and has the potential to put more money in your wallet.

Cardiovascular disease

Generally refers to conditions causing narrowing of blood vessels leading to heart attacks and strokes.

In 2009, 22.3 million Americans 18 or older with heart disease incurred $8.5 billion in health care expenses. Frequently individuals with cardiovascular disease require treatment for high cholesterol, which comes with a steep price tag.

In the U.S. new cholesterol drugs that are entering the market are estimated to cost $23 billion a year, in addition to the $7.8-22.4 billion our country already spends on the more traditional cholesterol medications.

Increased cardio-respiratory fitness is associated with lower risk of cardiovascular disease. A six-month study of untrained individuals put through an intensive exercise program resulted in a lowering of exercising heart rate by 5- 20 beats per minute and increased stroke volume by 20 percent.

Stroke volume is the amount of blood the left ventricle pumps out with each beat. These findings mean the participants’ hearts started pumping more efficiently.

In response to exercise, all four chambers of the heart dilate and the heart muscle gets thicker, making for a more effective pump.

Exercise has been found to increase the release of nitric oxide from the inner lining of our blood vessels. Nitrous oxide decreases the formation of plaques and clots within blood vessels, thus decreasing risk of strokes and heart attacks. Studies have noted an increase in the diameter of arteries in response to exercise. Also there is no lower threshold for cardiovascular benefit when it comes to exercise.

Consistent exercise can decrease LDL (“bad” cholesterol) levels, and increase HDL (“good” cholesterol). More good news is that cardiovascular risk reduction is greatest in the least fit individuals who start exercising, signifying that even a little exercise is worthwhile.

Diabetes

Type 2 diabetes is a disease characterized by elevated blood glucose levels due to the body being insensitive to the effects of insulin. Secondary problems related to type 2 diabetes include damage to blood vessels increasing the risk of strokes, heart attacks, kidney disease and vision loss among other complications. About 29 million Americans have diabetes, each with estimated health care expenses of around $15,000 a year. 382 million people, or 8.3% of the world’s population has diabetes. In 2012 it was estimated that diabetes cost the US $245 billion, of which $176 billion went to medical expenses and the rest to lost productivity.

Diabetes is strongly correlated with obesity, physical inactivity and family history, which accounts for 90 percent of all cases.

Exercise can make the body more sensitive to insulin and decrease body fat, which counters the disease process of diabetes.

A single session of exercise has been shown to increase the body’s insulin sensitivity for up to 16 hours. Prolonged exercise produces a fall in glucose levels and normalizes insulin levels.

Physical activity also improves several parameters associated with diabetes including weight, cholesterol panels and blood pressure. Even better, physical activity and exercise can help prevent the onset of Type 2 diabetes, particularly those of us at higher risk.

Muscle, Joint, & Bone

Health

Low back pain and osteoarthritis are common musculoskeletal maladies that can be traced back to inadequate activity.

By 2030 it is projected that 25 percent of Americans will have osteoarthritis. About 8 percent of the population actively suffers from back pain.

A 2009 study showed that insurance companies paid $149.4 billion dollars for issues related to osteoarthritis. An additional $36.1 billion dollars were paid out-of-pocket by the public for the care of issues related to joint pain.

Exercise programs for the low back can decrease disability and pain, increase quality of life and strength. Resistance or aerobic exercise can help with pain control and decrease disability.

There is a study that suggests simply walking may decrease pain and increase function in individuals with chronic musculoskeletal pain. A Cochrane review found land based exercises resulted in immediate benefit for knee pain, function and quality of life comparable to medications like Ibuprofen.

The strength of bones is in part related to weight bearing activity. Osteoporosis and osteopenia are processes characterized by decreased bone density placing people at a higher risk of fractures. Osteoporosis is a leading cause of morbidity and mortality in the elderly.

Over 54 million people in the U.S. have osteopenia or osteoporosis. One in two women, and one in four men over 50 years of age will suffer a fracture due to poor bone density. Two million broken bones occur a year as a result of osteoporosis and osteopenia in the U.S., incurring $19 billion per year in medical expenses.

By 2025 it is predicted that we will see three million fractures a year at an annual cost of $25.3 billion.

Physical activity transmits mechanical loads to the skeleton, which affects bone formation. The skeleton responds positively with bone deposition primarily in response to weight bearing exercise.

So, the exciting news is that exercise is one of the strongest non-pharmacological means of developing and maintaining healthy bone mass and decreasing the risk of fractures.

Cancer

Inactivity is certainly not the sole cause of cancer, though it has been associated with an increased likelihood of colorectal, breast and prostate cancer.

Cancer overall is the second leading cause of death in our country. In 2016 it is estimated that there will be 134,490 new cases of colorectal cancer, 249,260 of breast cancer and 180,890 of prostate cancer.

Direct medical costs for all cancers was $74.8 billion in 2013.

Aside from the association of activity levels with certain cancers, individuals with cancer who exercise regularly have shown improved quality of life, self-esteem, physical function, energy levels and social functioning compared to those who do not regularly exercise.

Length of hospital stays and number of general practitioner visits were noted to decrease in cancer patients that were more active. The improvements in quality of life did not vary greatly between the various types of cancer.

Psychiatric Illness & Issues

Attention-Deficit/Hyperactivity Disorder (ADHD) afflicts 11 percent of 4-17 year olds in the U.S. It is estimated to cost $14,576 per year to provide care to individuals with ADHD, which is associated with significant disability including concurrent psychiatric issues, learning disability and substance abuse.

Medication and behavioral treatments mitigate the symptoms of ADHD, and exercise has been found to aid in management as well.

Researchers at the University of Illinois report findings indicating outdoor activity in the course of common after-school and weekend activities may be “widely effective” in reducing attention deficit symptoms in children.

Over 15 million Americans suffer from depression, costing $210 billion per year. Depression has the greatest burden of disability among mental and behavioral disorders. Medication and behavioral measures are staples in treatment, though exercise has been found to be a valuable adjunct of care.

Some data suggest that a single episode of exercise improves mood. Exercise may be as effective as psychotherapy and more effective then other behavioral intervention for the treatment of depression.

Another study demonstrated that a 10-week endurance program improved depression symptoms, where the condition was unchanged in the relaxation and control groups. Exercise has also been noted to positively affect concentrations of several hormones that influence our mood. Physical activity can also prevent further episodes of depression.

Anxiety disorders affect 40 million in the U.S., age 18 and older, and is frequently found with depression. Of the country’s $148 billion health bill one-third goes to the care of anxiety disorders. Individuals with anxiety are 3-5 times more likely to go to the doctor for physical symptoms that are related to their mood issue.

Physical inactivity is significantly associated with increased anxiety and can affect the severity of panic disorders. Aerobic and non-aerobic exercise can decrease anxiety symptoms and is an effective adjunct to standard care.

Dementia & Falls

Dementia is a condition characterized by trouble with memory, thinking, learning, understanding and completing complex tasks.

Over five million Americans, and one in nine adults, 65-and-older suffer from dementia. The U.S. spent roughly $226 billion on the care of patients with dementia.

There is also a heavy emotional and physical toll on families of dementia patients. The estimated value of unpaid care provided to dementia patients was $217.7 billion, and is primarily provided by family members.

The disease has a few different causes and there are limitations to the present medical options in terms of management. As with most disease processes, prevention is critical and exercise has a central role.

Physical activity is associated with a decrease in risk of cognitive impairment and dementia. Resistance training has been found to decrease a chemical in our bodies called homocysteine. Elevated homocysteine has been associated with impaired cognitive performance.

Resistance training increases Insulin Growth Factor-1, a protein that promotes nerve growth, survival and differentiation, and improves cognitive performance. Physical activity maintains and enhances cognition throughout life. Cognition and ability to complete complex tasks improves with exercise and a further benefit is a reduced risk of falls.

Falls are the third leading cause of chronic disability worldwide with 30 percent of individuals 65-years or older suffering one or more falls per year, 20 percent of which result in injuries requiring medical attention.

A study showed that certain exercise programs decrease falls by 35 percent. Resistance training decreases muscle loss, which reduces fall and fracture risk as well as disability.

Managing your life and health is within your power. Physical activity is associated with better quality of life, lower risk of a multitude of conditions, and better management of several medical issues.

The numbers and statistics may have a numbing effect, but the bottom line is that exercise is good for you, it will make you feel better, and it can save you and the world a lot of money. It’s not a question of whether physical activity is beneficial, but rather what is the appropriate form, intensity and volume for you.

Before undergoing any change in activity, a discussion with your doctor is recommended. It is my hope to provide readers with some more detailed guidance on activity at a future time.

BRIAN ABBOTT works at Coastal Orthopedics in Brunswick and will be providing various health stories in the future to The Times Record.