What began as a catchphrase has evolved into a phenomenon that can no longer ignore. Doctors are increasingly recommending physical activity as a preventive measure for heart disease, high blood pressure, stroke, depression, Type 2 diabetes, and breast and colon cancer. And a report published in the British Journal of Sports Medicine in April provided another significant example of why exercise is medicine.
“We discovered that following physical activity requirements was strongly correlated with a lower risk of extreme COVID-19 among infected adults”, said a team of researchers led by Robert Sallis of the Kaiser Permanente Medical Center in California.
Is exercise good for the immune system?
It is well known that exercise increases immunity and that physically active people are less prone to viral infections and inflammation, all of which are hallmarks of COVID-19. However, until recently, there was no evidence linking the positive effects of exercise to a lower risk of the life-threatening consequences of COVID-19. In search of answers, Sallis and his colleagues examined the medical histories of 48,440 people who tested positive for COVID-19 and were also patients of a southern California healthcare system that regularly collected data on exercise patterns.
The researchers used previously collected exercise data to categorise each COVID-positive patient’s level of physical activity into one of three categories: consistently meeting physical activity requirements (150 minutes or more of exercise per week), consistently inactive (zero to 10 minutes per week), or any activity (11 to 149 minutes per week). They were able to take a novel look at the effect of exercise on the severity of COVID-19 symptoms by comparing exercise volume to hospitalisation, admission to the intensive care unit, and death and considering all patients’ age, race, gender, and medical background.
“People who met physical activity requirements (150 minutes or more of exercise per week) were less likely to be hospitalised, admitted to the ICU, or die as a result of COVID-19 than those who were inactive or did any activity”, the researchers wrote.
Further breaking it down, the chances of hospitalisation increased 2.26 times for those who were chronically inactive and those who exercised 150 minutes a week. Those who engaged in any operation had a higher likelihood of requiring care than the most active but a lower likelihood than the least active. Their odds of being hospitalised were 1.89 times higher than the study’s most involved patients.
“Notably, being chronically inactive was a stronger risk factor for extreme COVID-19 outcomes than any of the underlying medical conditions and risk factors reported by the CDC (Centers for Disease Control and Prevention),” said Sallis and his colleagues. “In reality, as compared to the widely cited modifiable risk factors, such as smoking, obesity, diabetes, hypertension, cardiovascular disease, and cancer, physical inactivity was the strongest risk factor for all outcomes.”
Just 6.4% of study participants exercised for 150 minutes or more a week daily, while 14.4% exercised for 10 minutes or less weekly—the majority of the community assigned themselves to the “some activity” category. The group’s average BMI was 31.2, which is at the low end of the overweight range, and the average age was 47. 69% of the study participants were female. In terms of how many people have COVID-19 severe cases, 8.6% were hospitalised, 2.4% were admitted to the intensive care unit, and 1.6% died.
In light of these ground-breaking findings, it’s ironic that physical exercise is one of the lifestyle patterns that has changed the most since the pandemic began. With gyms and fitness centres closed worldwide for several weeks to months during all three waves of the pandemic, and outdoor activity heavily limited, several reports have shown that fewer people than ever are getting 150 minutes of exercise a week. Moreover, despite prioritising the opening of certain fitness opportunities after the first wave last spring, very few public health and government leaders have reaffirmed the health benefits of having 150 minutes of exercise a week, which the researchers say could improve.
“We suggest that public health officials warn all communities that, short of vaccination and following public health protection recommendations such as social distancing and mask usage, engaging in routine physical activity could be the single most important action individuals may take to avoid extreme COVID-19 and its complications, including death,” the researchers wrote.
Also lacking are wholesale improvements in how communities provide entertainment to residents to find healthy ways. Based on the evidence provided by Sallis and his team, the lesson for all of us is that when it comes to your wellbeing before, during, and after a pandemic, it’s time to think of exercise as medicine.