Physical Activity as Medicine: How Movement Shapes Metabolism, Health, and Longevity

Physical activity—and particularly structured exercise—may be considered the most powerful and complete tool we have for wellness and health promotion. Its effects are truly systemic, producing positive changes across virtually all tissues, organs, and body systems, including the gastrointestinal system, adrenal glands, immune system, and beyond. Regular physical activity conditions the body to better handle stress, inflammation, and a wide range of metabolic challenges.

Importantly, physical activity is more than just exercise. It encompasses a broad range of movements that are part of our daily lives. I like to think of it as a spectrum, where different activities contribute differently to energy expenditure, metabolic health, and overall resilience.

The Physical Activity Spectrum

1. Activities of Daily Living (ADLs)

These include the basic movements we perform every day, such as walking around the house, showering, cooking, cleaning, and other household chores. While often overlooked, ADLs contribute to baseline energy expenditure and functional independence.

2. Work-Related Activities and Transportation

This category varies greatly from person to person. Some occupations are highly sedentary (office work, administrative roles, security desks), while others require substantial physical effort and muscular strength (construction workers, farmers, manual laborers).

In addition, transportation plays a role—some individuals walk or bike to work, while others rely on cars or public transportation. For certain people, this can represent a significant portion of daily energy expenditure, while for others it is minimal. These factors should always be considered when prescribing exercise for disease prevention, health promotion, or weight control.

3. Lifestyle Activities

These activities usually involve low intensity and often do not produce a measurable caloric expenditure. Examples include leisurely walks in the park or neighborhood, walking the dog, light gardening, mild yard work, or fishing. While beneficial for well-being and stress reduction, they generally have limited impact on metabolic health unless combined with more structured activity.

4. Structured Physical Activity (Exercise)

This is the portion of physical activity most reliably associated with measurable health benefits. It includes planned and intentional exercise such as brisk walking, jogging, running, and muscle-strengthening activities. This is the type of activity we most often rely on to produce consistent effects on cardiovascular health, metabolic function, and disease prevention.

Intensity Levels of Structured Physical Activity

Structured exercise can be divided into three levels based on the effort required:

Light-Intensity Activity

Examples include easy walking, stretching, yoga, bowling, or gentle mobility exercises. Although not typically prescribed as a primary strategy for health improvement, light activity can be very useful during initial stages for individuals with physical limitations or medical conditions that contraindicate higher intensity exercise.

Light activity is still better than no activity.

Moderate-Intensity Activity

This includes brisk walking, doubles tennis, pickleball, cycling, and similar activities. Moderate intensity exercise is the most commonly prescribed, as it is attainable for most individuals and has consistently demonstrated significant health benefits.

Vigorous-Intensity Activity

This is the highest level of exertion and includes running, jogging, basketball, soccer, singles tennis, skiing, inline skating, and other high-energy sports. These activities demand greater energy expenditure and cardiorespiratory capacity and offer robust fitness gains for those who can safely perform them.

Key Components of Physical Activity

Physical activity and exercise also differ according to the type of movement and their impact on the body. There are five main components:

1. Aerobic Exercise (“Cardio”)

Whole-body activities that use large muscle groups and stress the cardiorespiratory system. Aerobic exercise is strongly recommended for weight management and cardiovascular disease prevention.

2. Musculoskeletal Fitness

These activities target specific muscle groups to improve strength, power, and muscle mass, contributing to metabolic resilience. Examples include body-weight exercises (push-ups, squats, pull-ups), weight lifting, and resistance band training.

3. Flexibility

Focused on improving joint range of motion and stretching muscles and ligaments. Examples include yoga and Pilates.

4. Balance

Balance exercises improve stability during movement and daily activities, helping reduce injuries and falls. Yoga, Pilates, and Tai-Chi are common examples.

5. Speed and Power

Typically part of advanced training programs for athletes or individuals pursuing higher levels of performance. High-Intensity Interval Training (HIIT) is a common example.

Current Recommendations for Health Promotion

For cardiovascular prevention and weight management, the most widely accepted recommendations include:

• At least 150 minutes per week of accumulated moderate to vigorous physical activity

• At least 2 days per week of muscle-strengthening activities

Key Elements of an Exercise Prescription

When prescribing physical activity for health promotion and prevention of overweight and obesity, I focus on five essential parameters:

1. Frequency – typically 3–5 times per week

2. Intensity – moderate to vigorous, as tolerated

3. Time – about 30–35 minutes per session (or 150–200 minutes per week)

4. Type – brisk walking, jogging, running, or other modalities, personalized to the individual

5. Enjoyment – tailored to personal preferences and real-life capacity to improve long-term adherence

A Holistic and Flexible Approach

I strongly emphasize a holistic and flexible approach to physical activity. Ideally, this includes a combination of different modalities, such as:

• 3 days of 30 minutes of aerobic exercise

• 2 days of 30 minutes of muscle-strengthening activities

• 1 day of 60 minutes of Qi Gong, Tai-Chi, or Yoga

Whenever possible, this should be complemented with fun and social activities like dancing, pickleball, Zumba, or recreational sports, which significantly increase enjoyment and sustainability.

Some of the Many Benefits of Physical Activity

Regular physical activity and exercise provide countless benefits, including:

1. Increased body temperature regulation

2. Enhanced brain activity and cognitive function

3. Improved liver function

4. Increased bone mass and strength

5. Improved overall metabolism

6. Normalization of blood pressure

7. Lower total cholesterol, LDL cholesterol, and triglycerides, with increased HDL cholesterol

8. Improved blood circulation

9. Enhanced cardiorespiratory fitness and oxygen utilization

10. Improved sexual health

11. Better mental health and emotional well-being

12. Enhanced immune function

In my experience, when approached thoughtfully and personalized appropriately, physical activity truly functions as medicine—one that is accessible, powerful, and transformative across the entire lifespan.