Th e He alth Ben efit s of Phy sica l

Ac tivi ty

Ch arle s B. Cor bin

Ro bert P. Pang razi 

ARI ZONA STA TE UNI VERS ITY

ORIGINALLY PUBLISHED AS SERIES 1, NUMBER 1, OF THE PCPFS RESEARCH DIGEST.

HI GHLI GHT

“I t is cl ea r t h a t m o d era t e le vels of fi t n es s of fer co n sid era b le

h e a lt h be n efi t s. Th e ke y is m o vin g fr om t h e u n fit ca t ego ry—

so m e 30 t o 40 m i llio n p e op le in t h is co u n t r y—t o t h e

m o d era t ely fi t ca t ego ry. By be gin n in g p r ogra m s of m o d era t e,

re gu la r ex erci se—h a lf a n h o u r ea ch d a y, t h ree t i m es a we ek—

a n yon e ca n jo in t h is gr ou p , a n d m a rked ly lo wer t h eir d e a t h

ra t es fr om a l l-ca u se m o rt a l it y, ca n cer , a n d ca rd io va sc u la r 

d i sea s e.”

Dr . St even Bla ir, Th e Coop er I n st i t u t e for Aer obic s Re sea r ch

In 1990, Healthy People 2000 was released by Dr. Louis Sullivan, Secretary, Department of

Health and Human Services. The document elaborated national health promotion and disease

prevention goals for the year 2000. A central goal of the document is to increase the span of

healthy life for Americans. While improved treatment of disease to prevent premature death is

an important concern, Healthy People 2000 emphasizes the importance of prevention of

illness/disease, especially lifestyle or chronic illnesses that have become the leading sources of

death in our society. But perhaps most important of all, the goals focus on efforts to promote

a quality of life and a sense of well-being associated with good health. Dr. Michael McGinnis,

Director of the Office of Disease Prevention and Health Promotion, made the following

statement.

...it is not through happenstance that the physical activity category is the first priority area of the

Healthy People 2000 effort. Physical activity is related to the health of all Americans. It has the

ability to reduce directly the risk of several major chronic diseases as well as to catalyze positive

changes with respect to other risk factors of these diseases. Dr. William Foege, former Director of

the Centers for Disease Control, suggests that physical activity may provide the shortcut we in

public health have been seeking for the control of chronic diseases, much like immunization has

facilitated progress against infectious diseases (McGinnis, 1992, p. S196).
The inclusion of physical activity as an important lifestyle for promoting good health is

now clear. But for those interested in the health benefits of physical activity, it is not easy to

find a single source that summarizes these benefits. For this reason, we have attempted to

provide a simple sum-mary of the benefits in three sections: disease prevention and treatment;

health promotion; and physical fitness development. Six principal sources are used for this

summary. Readers are encouraged to consult these references and their sources for more

complete details.

DI SEAS E PR EVEN TION AND TRE ATME NT

Prior to 1940, the leading killers in the United States were infectious diseases. Improvement in

public health practices, implementation of personal and public health education, and vaccines

have greatly reduced the incidence of these diseases. As indicated in the early statement by

Dr. Foege, “chronic diseases” are now our major health concerns. These chronic diseases are

often referred to as “lifestyle diseases” because changes in lifestyle, including increased

activity and fitness, can reduce the threat of early death and the incidence of disease. Figure

6.1 lists several of the diseases for which regular physical activity can reduce risk, either of

getting the disease or of dying from it. Also illustrated in Figure 6.1 are some of the possible

reasons why exercise reduces risk of these diseases.

FI GURE 6 .1 

Ph y sic al ac tiv i ty an d m a jor li fest y le di seas es.

Di seas e Ph ysi c al Ac t i vi t y Be nefi t

He art Di seas e He alth y he art mu scle 

■ lo wer rest ing hear t ra te

■ mo re b lood pum ped with eac h be at

■ re duce d bl ood pres sure in subm axim al w ork

He alt hy a rter ies

■ less atherosclerosis (deposits in arteries)

■ hi gher HDL (“g ood” cho lest erol )

■ be tter blo od f at p rofi le ( fewe r “b ad” fats )

■ de crea sed plat elet and les s fi brin (re late d to ath eros cler osis )

■ be tter blo od f low

Be tter wor king cap acit y

■ fe wer dema nds duri ng w ork

■ greater ability to meet work demands

Stroke Healthy arteries (see above)

■ lo wer bloo d pr essu re

Pe riph eral Im prov ed wo rkin g ca paci ty

Va scul ar Di seas e Hi gher HD L

Be tter blo od f at p rofi le

Hi gh Bl ood Re duct ion in bl ood pr essur e am ong

Pr essu re th ose wi th hi gh le vels 

Re duct ion in b ody fatn ess (ass ocia ted with hig h bl ood pres sure )
Di abet es Re duce d bo dy fa tnes s (m ay re liev e

(n on-i nsul in)sy mpto ms o f ad ult onse t di abet es)

Be tter car bohy drat e me tabo lism (im prov ed i nsul in s ensi tivi ty)

Ca ncer Le ss ri sk of co lon ca ncer (b ette r tr ansi t ti me of fo od?) 

Ob esit y In crea ses le an bo dy ma ss

De crea ses body fat per cent age

Le ss c entr al f at d istr ibut ion

De pres sion Re lief fr om so me sy mpto ms

Back Pain Increased muscle strength and endurance

Im prov ed f lexi bili ty

Im prov ed p ostu re

Os teop oros is Gr eate r bo ne de nsit y as a re sult of st ress ing lo ng bo nes

In spite of the fact that deaths from heart disease have decreased in recent years, it is still

the leading cause of death. Studies by Paffenbarger and colleagues (1989) as well as others

have clearly shown that those who do regular physical activity are at less risk of dying from

this major killer. Physically inactive people have almost twice the risk of developing heart

disease as active people (Powell et al., 1987). In fact, the American Heart Association

(Fletcher et al., 1992) has recently classified inactivity (sedentary living) as a primary risk

factor for heart disease comparable to high blood pressure, high blood cholesterol, and

cigarette smoking. Both stroke (lack of blood flow and oxygen to the brain) and peripheral

vascular disease (lack of blood flow and oxygen to the limbs) have been shown (Haskell et al.,

1992) to be associated with sedentary living for many of the same reasons why inactivity is

related to heart disease (see Figure 6.1). High blood pressure or hypertension is a condition

that predisposes people to other health risks such as heart disease and diabetes. Regular

exercise has been shown to reduce blood pressure among those who have high levels though,

by itself, exercise cannot normalize high blood pressure for most people (Haskell et al.,

1992).

In the introduction of the Physical Activity and Fitness section of Healthy People 2000

(Public Health Service, p. 94), it is noted that physical activity can help to prevent and manage

non-insulin-dependent diabetes and osteoporosis. Recent evidence also has shown that

inactive people have a higher incidence of colon and breast cancer than active people. While

the evidence is less than complete, one researcher reached the following conclusion based on

a review of recent research.

Given the consistency in the direction and magnitude of the findings regarding colon cancer...the

evidence supports the conclusion that activity is protective against colon cancer. Although that

protective effect may be small, the attributable risk of colon cancer associated with inactivity may

be quite high given the prevalence of inactivity in Western societies. (Sternfeld, 1992, p. 1195)

It is generally conceded that regular muscle fitness and flexibility exercise can aid in

improving posture. Together, exercise and good posture can have a positive effect on back

problems as evidenced by less risk of back pain. In a recent review, Plowman (1992) noted

that while we do not yet know the exact amounts of muscle strength, muscle endurance, and

flexibility necessary to reduce the risk of back pain, there is support for the notion that poor

scores on these fitness measures are predictive of low back pain.
The potential benefits of regular physical activity in reducing obesity are well

documented. Regular exercise expends calories that can result in reduced fat storage in the

body’s fat cells. At the same time, exercise designed to build muscle fitness increases lean

body tissue (muscle), which can result in a lesser relative percentage of fat in the body and a

higher resting metabolism. Getting obese Americans to adopt regular exercise that would help

them achieve normal levels of body fatness is not as successful as we might hope.

Nevertheless, physical activity has great potential for reducing the incidence of obesity in our

society (Epstein et al., 1990).

Depression is a major medical problem that causes much pain and suffering. The number

of bed days and disabilities associated with depression is greater than that for the eight major

chronic health conditions (Public Health Service, 1990). A recent position statement of the

International Society of Sport Psychology (1992) states that studies on depressed patients

reveal that aerobic exercises are as effective as different forms of psychotherapy. In addition,

the Society summarizes by saying: “Exercise can have beneficial emotional effects across all

ages and for both sexes.”

HE ALTH PRO MOTI ON

The previous section dealt primarily with disease. Of course, disease treatment and prevention

are critical to good health in our society. Nevertheless, it is widely acknowledged that optimal

health is much more than freedom from disease. The challenge of Healthy People 2000

(Public Health Service, 1990) illustrates this point.

The health of people is measured by more than death rates. Good health comes from reducing

unnecessary suffering, illness, and disability. It comes as well from an improved quality of life.

Health is thus best measured by citizens’ sense of well-being. (p. 6)

Prevention of disease is a high priority and regular physical activity has been shown to

help prevent the conditions discussed in the preceding sections. But what of high-quality

living and a sense of well-being? Many of these are quite subjective. Corbin and Lindsey

(1990) summarize some of the perceived benefits of exercise based on subjective feelings of

people responding to national surveys. Some of the reported benefits are supported by

scientific evidence, including a reduction in stress levels and in symptoms of depression

(International Society of Sport Psychology, 1992), improved appearance, and increased

working capacity. Other benefits such as improved sleep habits, greater ability to enjoy

leisure, improved general sense of well-being, and improved self-esteem are less easy to

document. Nevertheless, what people think is true influences their quality of life and the

results of national opinion polls show that many Americans have positive feelings about the

benefits they receive from regular exercise (Corbin and Lindsey, 1990). Among older adults,

regular physical activity has been shown to increase independent functioning, increase the

ability to drive a car, and improve social interactions (Corbin and Lindsey, 1990). There is

similar evidence to show that physical activity can positively influence other health-related

behaviors (Blair, 1985). One survey, for example, showed that regular exercisers were 50%

more likely to quit smoking; 40% more likely to eat less red meat; 30% more likely to cut

down on caffeine; 250% more likely to eat low calorie foods and drinks; 200% more likely to

lose weight, and 25% more likely to cut down on salt and sugar than non-exercisers (Harris &

Gurin, 1985).
Physical activity’s contribution to quality of life and a personal sense of well-being is

more difficult to document than its contribution to prevention and treatment of disease. In the

long run, however, it may be equally important if the national goal of lengthening healthy life

is to be achieved. It is doubtful that most Americans would favor an extended life if “quality

of life” was lacking. The evidence suggests that humans were designed to be physically active

and that physical activity has great potential for enhancing quality of life and sense of wellbeing. Additional research is necessary to determine the full extent of activity’s contribution

to these important variables.

PH YSIC AL F ITNE SS

There is no doubt that regular physical activity builds physical fitness. What has become

increasingly clear in recent years is that physical activity and physical fitness, as evidenced by

performance on fitness tests, are independent but related phenomena. Likewise, physical

fitness is associated with good health. For example, Blair et al. (1989) have shown that those

with “good” levels of fitness have less heart disease risk than those with “low” levels of

fitness. The previously cited review by Plowman (1992) suggests that muscle fitness is

necessary to prevent back pain. Others have pointed out the importance of fitness to injury

prevention (McGinnis, 1992). Body fatness, often considered a health-related component of

physical fitness, is associated with medical problems of various kinds.

Fitness, as measured by fitness tests, is NOT solely related to regular physical activity. As

noted in Figure 6.2, there are many other factors that contribute to physical fitness. Among

children, fitness scores are influenced by chronological age and maturation (physiological

age). In some cases, children and adolescents who are inactive have higher fitness scores than

younger or more active peers (Pangrazi & Corbin, 1990; Pate, Dowda, & Ross, 1990).

Bouchard and colleagues (1992) have demonstrated that heredity plays a significant role in a

person’s ability to improve fitness as a result of exercise. Some people respond to training

more favorably than others, so it is possible that regular exercisers could sometimes have

lower fitness performance levels than those who are sedentary. Of course, other factors such

as nutrition, learned skills, and environment also play a role in fitness performances.

There is little doubt that good physical fitness is associated with reduced risk of disease.

Further, it can be stated that good fitness helps people function effectively, look better, and

have the ability to enjoy their free time. But evidence exists to support other important

statements about physical fitness.

■ Physical fitness, as measured by fitness tests, is not as meaningful to good health as

physical fitness that results from regular physical activity as part of the normal lifestyle.

■ Physical fitness, as measured by fitness tests, will ultimately improve as the result of

regular exercise to the extent that hereditary predispositions allow. The amount and rate

of change in fitness will take longer for some to achieve than for others.

■ Physical fitness is associated with good health but is not the same as good health. Regular

physical activity has positive benefits for both good health and adequate physical fitness.

■ For good health benefits to result, it is important NOT to be in a low fit category. On the

other hand, high levels of fitness test performance do NOT seem to be necessary for

attaining health benefits. All people with regular physical activity have the potential to

achieve adequate levels of fitness that are associated with good health.
FI GURE 6 .2 

Fa ctor s af f ect in g p h y sic al f i tn es s p e r f or m an c es.

Ot her Fact ors (Nut riti on, Stre ss, etc. )

He redi ty Fi tnes s Ma tura tion 

Ph ysic al A ctiv ity

S UM MA RY 

In recent years, much has been learned about regular physical activity and physical fitness.

Many of the health benefits of exercise and physical fitness are now well documented. Other

potential benefits require much more research. In the meantime, the following quotes seem to

best summarize our knowledge. From leading researchers Paffenbarger and Hyde (1980):

Evidence mounts that the relationship between exercise and good health is more than circumstantial.

If some questions are not yet answered, they are far less important than those that have been.

From Edward Cooper during a news conference for the American Heart Association, July

1, 1992:

Now I’d like to say to those who are not engaged in “exercise training” that any physical activity is

better than none. According to our panel, housework, gardening, shuffleboard—anything that causes

us to move—is beneficial. Maybe you don’t have time or ability to attain “cardiovascular fitness,”

that is, to enable your heart to function at its most efficient level...maybe you don’t have the money

to join a health club or buy a bicycle...still there are activities you can perform as a part of your

daily life that will benefit your heart. I encourage you to make activity a part of your routine every

day—just as much a part of your day as brushing your teeth or enjoying breakfast.

From John Dryden, spoken several hundred years ago, as cited by Paffenbarger and Hyde

(1980):

Better to hunt in fields, for health unbought, than fee the doctor for nauseous draught; the wise, for

cure, on exercise depend; God never made his work for man to mend.

R EF ER EN CE S

Blair, S.N. (1985). Relationship between exercise or physical activity and other health behaviors. Public Health

Reports, 100, 172–180.

Blair, S.N., Kohl, H.W., Paffenbarger, R.S., Clarke, D.G., Cooper, K.H., & Gibbons, L.W. (1989). Journal of the

American Medical Association, 262, 2395–2401.

Bouchard, C., Dionne, F.T., Simoneau, J., & Boulay, M.R. (1992). Genetics of aerobic performances. In J.O.

Holloszy (Ed.), Exercise and sport sciences reviews: Vol. 20 (pp. 27–58). Baltimore: Williams and Wilkins.

Corbin, C.B., & Lindsey, R. (1990). Concepts of physical fitness. (7th ed.). Dubuque, IA: Wm. C. Brown Co.

Epstein, L.H., McCurley, M., Wing, R.R., Valoski, A. (1990). Five-year follow-up of family-based behavioral

treatments for childhood obesity. Journal of Consulting Clinical Psychology, 58, 661–664.
Fletcher, G.F., Blair, S.N., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., Falls, H., Froelicher, E.,

Froelicher, V., & Pina, I. (1992). Statement on exercise: Benefits and recommendations for physical activity

for all Americans. Circulation, 86, 2726–2730.

Harris, T.G., & Gurin, J. (1985). Look who’s getting it all together. American Health, 4 (2), 42–47.

Haskell, W.L., Leon, A.S., Caspersen, C., Froelicher, V.F., Hagberg, J.M., Harlan, W., Holloszy, J.O.,

Regensteiner, J.G., Thompson, P.D., Washburn, R.A., & Wilson, P. W.F. (1 992) . Ca rdio vasc ular be nefi ts

an d as sess ment of ph ysic al ac tivi ty an d ph ysic al fi tnes s in ad ults . Me dici ne an d Sc ienc e in Sp orts an d

Ex erci se, 24 , S2 01–S 220. 

International Society of Sport Psychology. (1992). Physical activity and psychological benefits. Physician and

Sportsmedicine, 20, 179–184.

McGinnis, J.M. (1992). The public health burden of a sedentary lifestyle. Medicine and

Science in Sports and Exercise, 24, S196–S200.

Paffenbarger, R.S., & Hyde, R.T. (1980). Exercise as protection against heart attack. New England Journal of

Medicine, 302, 1026–1027.

Paffenbarger, R.S., Hyde, R.T., Wing, A.L., & Hsieh, C. (1986). Physical activity, all-cause mortality, and

longevity of college alumni. New England Journal of Medicine, 314, 605–614.

Pangrazi, R.P., & Corbin, C. B. (1990). Age as a factor relating to physical fitness test performance. Research

Quarterly for Exercise and Sport, 61, 410–414.

Pate, R.R., Dowda, M., & Ross, J.G. (1990). Association between physical activity and physical fitness of

children. American Journal of Diseases in Children, 144, 1123–1129.

Powell, K.E., Thompson, K.D., Caspersen, C.J., & Kendrick, J.S. (1987). Physical activity and the incidence of

coronary heart disease. Annual Review of Public Health, 8, 253–287.

Public Health Service. (1990). Healthy People 2000. Washington, DC: U.S. Government Printing Office.

Sternfeld, B. (1992). Cancer and the protective effect of physical activity: The

epidemiological evidence. Medicine and Science in Sports and Exercise, 24, 1195–

1209.