Exercise & Chronic Diseases

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What is arthritis?

Arthritis is a chronic and often debilitating disease caused by inflammation in one or more joints that results in pain, swelling, stiffness and limited movement.

Why does arthritis matter?

Arthritis is one of the top chronic diseases and affects 1 in 6 Canadians. Many people with arthritis tend to be physically inactive which tends to accelerate the progression of their disease.

How can exercise help?

Exercise brings a direct benefit to those suffering with arthritis. Research shows that a properly designed exercise program can decrease your pain, increase your flexibility and overall fitness and lessen any feelings of depression or anxiety.


What is asthma?

Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath and coughing. The coughing often occurs at night or early in the morning.


How can exercise help?

Exercise can help control the frequency and severity of attacks. Most studies support the idea that people with asthma that participate in an average of 20-30 minutes of aerobic exercise 2-3 times a week will improve their breathing, exercise tolerance and resting heart rate. There is little evidence to support that idea that exercise worsens asthma symptoms or that there is any reason for people with asthma to avoid regular physical activity.


What is cancer?

Cancer is when a group of abnormal cells grow and invade healthy cells in the body.

Why does cancer matter?

1 in 2 Canadians will develop cancer in their lifetime and 1 in 4 will die from the disease. It is the leading cause of death in Canada, surpassing cardiovascular disease at 30% of all deaths.

How can exercise help?

Exercise can lower your risk of developing 13 types of cancer and lower the risk of cancer recurrence. Exercise can decrease cancer related fatigue and other symptoms while improving quality of life during and after cancer treatments. Research also links better outcomes in physically active patients diagnosed with breast, colorectal and prostate cancer.


What is diabetes?

There are 2 main forms of diabetes:

Type 1 diabetes occurs when the pancreas fails to make (or does not make sufficient) insulin. This is a problem because insulin is the hormone responsible for transporting glucose out of your blood and into the cells that need it. When insulin is not available glucose builds up in the blood leading to hyperglycemia (high blood sugar).

Type 2 diabetes typically occurs when the cells become resistant to the insulin. This means that insulin is trying to transport glucose into the cells but they are not allowing it inside also leading to high levels of blood sugar.

Why does diabetes matter?

Diabetes is a very serious metabolic disorder that, if not managed properly, can lead to complications such as blindness, heart disease, kidney disease, nerve damage and erectile dysfunction (this is not an exhaustive list!).

How can exercise help?

Exercise is considered to be an essential part of diabetes care. Exercise helps manage diabetes in the following ways:

  • Improved blood glucose control (type 2 diabetes)
  • Improved insulin sensitivity = reduction in need for medication
  • Reduction in body fat. Weight loss increases insulin sensitivity which can lead to a reduction in the need for medication
  • Exercise decreases the risk for cardiovascular disease (80% of diabetics die of a heart attack – Canadian Diabetes Association)
  • Prevention of type 2 diabetes – evidence indicates that pre-diabetes can be reversed with exercise and dietary changes

What is dyslipidemia?

Dyslipidemia refers to any of several lipid abnormalities. Lipid abnormalities can be divided into 4 categories

1. High Total Cholesterol (mg/dl)
< 200 = desirable
200-239 = boderline high
> 240 = high

2. High Triglycerides (mg/dl)
< 150 = normal
150-199 = boderline high
200-499 = high
> 500 = very high

3. High LDL Cholesterol - LDL-C (mg/dl)
< 100 = optimal
100-129 = near optimal
130-159 = borderline high
160-189 = high
> 190 = very high

4. Low HDL (mg/dl)
< 40 is low for men, < 50 is low for women
> 60 high (a good thing!)

Why does dyslipidemia matter?

All of these abnormalities put a person at increased risk of having a heart attack. Both Low HDL and High Triglycerides put a person at increased risk of developing diabetes.

How can exercise help?

Regular participation in exercise can cause beneficial results in both people with normal lipid profiles and those with dyslipidemia including:

  • lower triglyceride concentrations
  • decreased concentrations of small LDL particles (high amounts of small LDL particles are associated with heart attacks)
  • increased number of larger-sized LDL particles
  • higher HDL concentrations (particularity from high intensity exercise)
  • increased lipoprotein enzyme activity
  • improved glycemic control (important for diabetes)

What is fibromyalgia?

Fibromyalgia is a chronic pain syndrome that involves widespread musculoskeletal pain, fatigue and sleep disturbance.

Why does fibromyalgia matter?

Fibromyalgia is one of the most common chronic pain conditions – it is estimated to affect 2% of Canadians and affects more women than men. The pain and sleep disturbances caused by fibromyalgia can be life altering.

How can exercise help?

Exercise is one of the most powerful remedies in the treatment of fibromyalgia:

  • reduced number of tender points and decreased pain at tender points
  • decreased general pain
  • improved mobility

The exercise program must be slow and gradual. The goal is to improve overall health while decreasing fibromyalgia symptoms.


What is hypertension?

Hypertension, or high blood pressure, is a chronic medical condition in which the blood pressure in the arteries is elevated. This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure involves two measurements: systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole).

Why does hypertension matter?

Hypertension is a major risk factor for stroke, myocardial infarction (heart attacks), heart failure, aneurysms of the arteries (e.g. aortic aneurysm), peripheral arterial disease and is a cause of chronic kidney disease. Even moderate elevation of arterial blood pressure is associated with a shortened life expectancy.

Normal: 110 / 70
Prehypertension: 120-139 / 80-89
Hypertension Stage 1: 140-159 / 90-99
Hypertension Stage 2: > 160 / > 100

How can exercise help?

Studies have documented a consistent 10-20mmHg reduction in systolic BP during the initial 1-3 hours following 30-45 minutes of moderate-intensity exercise in people with hypertension. Longitudinal studies further show that endurance training may elicit an average reduction of 5-7mmHg in both systolic and diastolic BP in people with stage 1 or 2 hypertension. Furthermore, physically active people with hypertension and those with higher levels of cardiorespiratory fitness have been shown to have lower mortality rates than sedentary or less fit persons. When exercise is combined with healthy lifestyle modifications, it may be possible to reduce or discontinue medications.

Low Back Pain

What is low back pain?

Low back pain (LBP) is one of the most widely experienced health-related problems in the world. Non-specific LBP is pain and discomfort that is not attributed to recognizable pathology (such as a tumor, fracture, spondylitis ect.).

Why does it matter?

LBP has a high rate of reoccurring episodes that, while varying in severity, can lead to disability, loss of work, increased use of health-care services and reduced health-related quality of life.

How can exercise help?

Most low back pain can get better if you stay active while avoiding positions and activities that increase your back pain. Using exercise to strengthen the appropriate muscles and stretch others cannot only help to decrease your pain, but it can also help you recover faster and prevent re-injury. Stopping activity due to non specific low back pain can actually lead to loss of flexibility and muscular strength and endurance and in turn create increased pain.

Metabolic Syndrome

What is metabolic syndrome?

Metabolic syndrome is the name of a group of risk factors that raises your risk for heart disease, diabetes and stroke. A person must have 3 of the 5 risk factors to be diagnosed with metabolic syndrome:

  • High waist circumference ( > 35” for women, > 40” for men)
  • High triglyceride level ( > 200mg/dc)
  • Low HDL cholesterol ( < 50mg/dl for women, < 40mg/dl for men)
  • High blood pressure ( > 130 / >85) or on blood pressure medication
  • High fasting blood sugar ( > 100mg/dl) or high HBA1C (5.7%-6.4% is considered to be pre-diabetes, > 6.5% equals diabetes)

Why does metabolic syndrome matter?

It is estimated that 1 in 5 of adult Canadians can be classified as having metabolic syndrome, putting them at an increased risk for heart disease, diabetes and stroke.

How can exercise help?

Exercise can have a great impact at reducing all of the above risk factors. Exercise frequency and consistency combined with lifestyle changes are most effective in reversing the adverse health outcomes associated with metabolic syndrome.


What is obesity?

Obesity is an excessive accumulation of body fat. It is clinically defined by body mass index, waist circumference and body fat percentage:


Overweight 25.0-29.9 = increased risk for disease
Class 1 Obese 30.0-34.9 = high risk
Class 2 Obese 35.0-39.9 = very high risk
Class 3 Obese > 40.0 (also known as clinical obesity) = very high risk

Waist Circumference

100-120cm (39.5”-47”) = high risk
> 120cm (47”) = very high risk

90-109cm (35.5”-43.0”) = high risk
> 110cm (>43.5”) = very high risk

Body Fat Percentage

16-25% = above average
> 25% = at risk

24-32% = above average
> 32% = at risk

Why does obesity matter?

Obesity is associated with numerous comorbidities including (but not limited to) heart disease, hypertension, dyslipidemia, diabetes, stroke, depression, sleep apnea, gallbladder disease and some types of cancer.

How can exercise help?

Exercise is an effective intervention for reducing body weight and favourably altering body composition – especially in mild to moderate obese people. In addition exercise helps to preserve lean body mass while reducing calories for weight loss, improved insulin sensitivity, increased metabolic rate (ability to burn more calories – even at rest), improved blood lipid profiles, decreased blood pressure, improved mood and decrease risk for other diseases associated with obesity.


What is it?

Osteoporosis is a condition in which the bones become weak and can break from a minor fall or, in severe cases, even a simple sneeze or cough.

Osteopenia is the precursor to osteoporosis and means decreased bone density.

Why does it matter?

Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined. At least 1 in 3 women and 1 in 5 men will suffer an osteoporotic fracture in their lifetime. Most common bones fractured are the hip, spine and wrist.

How can exercise help?

Evidence suggests that regular exercise training can significantly lower the age-related decline in bone loss, thereby delaying the time at which low-bone mass progresses to osteopenia and osteoporosis. For people who have already acquired osteopenia or osteoporosis, exercise training can greatly improve muscular strength, mobility and balance which can improve quality of life and minimize the risk of falling, therefore minimizing the risk of fracture.

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