Are Fit People Healthy?

Is any exercise healthy?

Posted Oct 28, 2011

When I was asked to write a response to this question, I pondered who would even ask such a question? Of course, fit people are healthy; this is what fitness is all about, being healthy. Exercisers also know this. For example, Canadian women in Lisa McDermott's study exercised because it was good for their health and doing something for their health made them feel good about themselves.

However, upon closer inspection, I also have several very fit friends or colleagues how had injured themselves doing exercise. One has severe shoulder pain and can no longer lift any weights. Another has done so much running that her knees are ‘shot' and now she is only allowed to walk. A third one has chronic plantar fasciitis and is unable to do any exercises that involve lifting her heels up when standing. In addition, my colleagues who study sport continually demonstrate how athletes ignore pain and injuries even if they might cause permanent damage to their bodies. These researchers have questioned the assumption that sport participation is a way to improve one's health.

What is this thing called ‘health'? Is being in pain healthy if it means becoming fit? On the other hand, what does it mean to be fit? To find some answers to these questions I looked at what research had to say. When these researchers explain the health benefits of exercise they seem to talk a lot about illness.

For example, when the exercisers in McDermott's study talked about health, they referred to keeping their heart and lungs in shape to avoid heart attacks, to prevent osteoporosis, or to alleviate asthma. Indeed, there is scientific evidence that improved physical fitness can prevent coronary heart disease and related hyper tension (blood pressure), type II diabetes, some types of cancer, osteoporosis, depression, and anxiety. To obtain these benefits, one has to, however, work on one's physical fitness, which is different from just being physically active. Physical fitness has four components: cardio-vascular fitness refers to the functioning of heart and lungs; muscle strength and endurance refers to the functioning of muscles, flexibility refers to the functioning of the joints, and body composition refers to the relationship between lean body mass (muscles and organs) versus fat body mass. However, to become fit, one needs to improve all four components with very a particular way. This is called exercise.

We exercise the cardio-vascular component by running, walking, swimming, cycling, and rowing: these make the heart and lungs work and thus, will improve their fitness.

We exercise the muscles through resistance training.

We exercise flexibility through stretching exercises.

We improve our body composition if we do all the above.

Exercise classes typically have segments for these components: aerobics for cardio-vascular fitness, toning for muscles, and stretching for flexibility. Exercise prescriptions should include exercises for each component.

This is getting complicated. Wait, there is more.

Let's summarize: Research has indicated that if one wishes to prevent illness, one needs to improve one's physical fitness by exercising the four components of physical fitness. This requires careful monitoring of how often one exercises (frequency), how hard each time (intensity), and how long at each session (duration). As general rule, the American Council of Sport Medicine recommends that one exercises five days a week (frequency) according to following schedule:

Do moderately intense cardio 30 minutes a day, five days a week

Or

Do vigorously intense cardio 20 minutes a day, 3 days a week

And

Do eight to 10 strength-training exercises, eight to 12 repetitions of each exercise twice a week.

They recommend moderate-intensity (working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation). If one wants to be more specific, as a general rule, to ensure that cardio-vascular fitness improves one should exercise 50-85% of one's maximum heart capacity (intensity). One should do this at least 3 times a week. On two days a week, one should do strength training. But how much weight? According to some recommendations, one should lift weights ranging from 50-90% of one's maximum capacity.

How does one know what is 50-85% of one's maximum heart capacity? How about 50-90% of one's maximum muscle strength? Well, one could calculate it based on a special formula or take a fitness test. One also needs to change her program when one gets better at it - to continue to improve.

Wow! To prevent illness is not a simple task of doing some physical activity. To get those benefits, one really needs to exercise in very specific and measured ways. One also needs to improve and this requires that one exercises quite a lot. This can be painful. Can one get injured doing this amount of exercise?

It can be painful and one can definitely get injured, particularly if one begins with too much exercise. However, health here is not about avoiding pain or injury but to prevent certain illnesses. Obviously, science can tell us that exercising to improve physical fitness most likely helps one to prevent certain illnesses, but exercise does not necessarily alleviate discomfort, pain, or injury. That is not the meaning of exercise. One can, thus, be in pain as long as one eventually becomes fitter. Notably, if we believe that health is all about avoiding certain diseases, then one must make sure to exercise according to the correct parameters, otherwise there are no scientifically proven benefits. Only fit people can be illness free.

Or one might think of health differently. Actually, the World Health Organization (WHO), already in 1946, defined health as a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity. The WHO definition, thus, goes beyond illness prevention. Exercise, then, does not guarantee wellbeing because it is not designed for wellbeing. Based on this understanding of health as wellbeing, fit people are not necessarily healthy.

Is being healthy a matter of definition, not fitness? It seems like it is. Should we then stop worrying about exercise and do whatever makes us feel well? For some people exercise does make them feel good. When we become aware of the different meanings of health, we find we might be able to choose between following an exercise regime and being physically active. And when we have more choice of what it means to do healthy physical activity, we might even start enjoying it and doing more of it.

Certainly that's healthy.

References cited: McDermott, L. (2011). 'Doing something that is good for me': Exploring intersections of physical activity and health. In E. Kennedy & P. Markula (Eds.), Women and exercise: The Body, health, and consumerism (pp. 197-226). New York: Routledge.