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Associations of various exercise types with self-rated health status and health-related physical fitness in Japanese adults

王, 震男 WANG, Zhennan 筑波大学 DOI:10.15068/00160603

2020.07.27

概要

Participation in regular physical activity or exercise benefits many parts of the body: heart, skeletal muscles, bones, blood, the immune system and the nervous system, and reduces many of the risk factors for non-communicable diseases including reducing blood pressure, improving blood cholesterol levels, and lowering body mass index (BMI) (Haskell et al., 2007). In addition to the above benefits on improving health status and reducing risk factors for chronic disease, it has been confirmed to be effective in improving mental health: improved mood, reducing symptoms of stress, anger and depression, alleviating anxiety, and slowing cognitive decline (Babyak et al., 2000; Pate et al., 1995; Penedo & Dahn, 2005; Taylor et al., 1985; Warburton et al., 2006).

　Since more than 20 years ago, the American College of Sports Medicine (ACSM) in conjunction with the Centers for Disease Control and Prevention (CDC) (Pate et al., 1995), the U.S. Surgeon General (Hootman, 2009), and the National Institutes of Health (1996) issued landmark publications on physical activity (PA) and health. An important goal of these reports was to clarify for exercise professionals and the public the amount and intensity of PA needed to improve health status. The ACSM and American Heart Association (AHA) (Haskell et al., 2007) issued updated recommendations for PA and health in 2007 as follows:

1) All healthy adults aged 18–65 years should participate in moderate intensity aerobic PA for a minimum of 30 min on 5 d·wk−1 or vigorous intensity aerobic activity for a minimum of 20 min on 3 d·wk−1.
2) Combinations of moderate and vigorous intensity exercise can be performed to meet this recommendation.
3) Moderate intensity aerobic activity can be accumulated to total the 30 min minimum by performing bouts each lasting ≥10 min.
4) Every adult should perform activities that maintain or increase muscular strength and endurance for a minimum of 2 d·wk−1.
5) Because of the dose-response relationship between PA and health, individuals who wish to further improve their fitness, reduce their risk for chronic diseases and disabilities, and/or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of PA.

　Due to the importance of the amount of PA, most previous studies have focused primarily on the optimal “volume” (frequency, time and intensity of PA or exercise) and the minimum volume for health benefits, in particular the effects of intensity (e.g., moderate vs. vigorous) on health status (Warburton et al., 2006).

　Although the health benefits of PA or exercise are widely confirmed, worldwide, 31.1% (95% CI: 30.9–31.2) of adults (aged 15 years or older) did not reach public health guidelines for recommended levels of physical activity (Hallal et al., 2012). Regular leisure time physical activity (LTPA) was undertaken by only 22.2% (95% CI, 21.8%-22.6%) among adults in the United States (Reeves & Rafferty, 2005). According to the China national survey on the status of physical activities, the percentage of people who regularly participated in physical exercise was 33.9% (General Administration of Sport of China, 2015). In Japan, the proportion of habitual exercisers was 35.9% for men and 28.6% for women, and there had been no significant increase or decrease in both men and women over the last 10 years (Ministry of Health Labour and Welfare, 2018). It seems that only understanding the health benefits of physical activity or exercise does not effectively increase people's daily physical activities and habitual exercise.

　Apart from the amount of exercise, mode or type has been considered as another unique characteristic of exercise or sports. American College of Sports Medicine (2009) emphasized that an assortment of exercise modalities is recommended to avoid the potential for overuse syndromes; a variety of exercises to improve the components of physical fitness is recommended for all adults.

　Exercise continuance requires a feeling of enjoyment during the activity (Ito et al., 2019). “Pleasure” and “physical competence” are considered as important factors for affecting the adherence volition of physical exercise (Nakamura & Furukawa, 2004). With different exercise types or modes, exercise practitioners are capable of learning unique exercise skills that could affect exercise motivation (Schunk, 1989). There are differences in the preferences of exercise type among people of different ages and genders (Nakamura & Furukawa, 2004), and personal motivation and preferences are likely gradually changed with aging, lower physical strength and motor function.

　A few studies have reported that exercise types are associated with various health conditions. Walking, as one of the most common type of exercise, is often included in studies of exercise in relation to disease (Morris & Hardman, 1997). Edwards et al. (2005) found that hockey (a team sport) players perceived themselves as having more positive relations and sport competence with resistance trainers and runners by compared psychological wellbeing and physical self-perception. Duncan et al. (2002) confirmed that runners had significantly higher total body, femoral neck, and leg bone mineral density than swimmers, and greater leg bone mineral density than cyclists. King et al. (2003) proved that compared to non-exercisers with respect to a specific exercise type, people who regularly engaged in jogging and aerobic dancing were significantly less likely to have elevated cardiovascular markers but not those who engaged in gardening swimming, cycling, calisthenics, and weight lifting were not, after controlling for age, race, sex, body mass index, smoking, and health status.

　In the studies of the association between exercise type and health, Tsujimoto et al. (2017) found that participation in multiple exercises showed better self-reported health (SRH) and self-assessment of physical fitness than those participation in single exercise. Among numerous health related indicators, SRH is simple, easy to administer measure of general health. It is a valid and reliable measure among those without cognitive impairment. Initially, it replaced clinical assessments in survey research (Strawbridge & Wallhagen, 1999). It is commonly used in psychological research, clinical settings, and in general population surveys (Bombak, 2013). Early studies using SRH involved assessing the relationship between SRH with sociodemographic, physical health, and psychosocial variables (Garrity et al., 1978; Maddox, 1962). Additional uses of SRH involved investigating relationships between health constructs, sociodemographic, physical, and psychosocial variables, clarifying measurement issues, attempting to explain health and illness behavior, or describing populations’ health (Ware et al., 1980). SRH was found to be at least moderately associated with physicians’ assessments of health (Idler et al., 1999).

　With commonly being treated as a more accurate measure of physical activity than self-report, physical fitness is often used in large epidemiologic investigations (Williams, 2001). A high level of physical fitness usually is associated with good health. Health-related physical fitness involves the components of physical fitness related to health status, including cardiovascular fitness, musculoskeletal fitness, body composition and metabolism (Williams, 2001) . The health-related components of physical fitness are more important for public health than are the components related to athletic ability (Caspersen et al., 1985).

　Health benefits are associated with physical activity and regular exercise or sports, not only with the volume (frequency, time and intensity), but also with the exercise mode or type. It is certainly not easy to classify all exercise or sports, as there are over 3,000 sport disciplines and sporting games and more than 8,000 indigenous sports worldwide (Lipoński et al., 2003). Classification of exercise or sports is considered important. In order to clear the general characteristics of exercise or sports, it is considered important to study the exercise type by means of classification. As far as the author knows, there has been no systematic study on the association of health with exercise type.

　Therefore, the purposes of this thesis were to explore the associations of various exercise types with both subjective (self-rated health) and objective health indicators (health-related physical fitness).

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