Diana Veneri, PT, EdD, RYT, associate professor of physical therapy in the department of physical therapy at Sacred Heart University In Fairfield, Conn. She is a researcher, a former neurology clinical specialist, and a registered yoga teacher.
Exercise is free medicine: It can cost virtually nothing, yet can improve health and prevent or even help heal many types of illnesses. Research over the past few decades has uncovered many of the ways regular exercise works its magic, including strengthening the heart and immune system and fighting off the threats from stress and inflammation. Considering that stress and inflammation can set the foundation for many diseases, exercise’s ability to tamp them down is nothing short of extraordinary.
Whether the source of inflammation is chronic stress, an inflammatory condition like arthritis or lupus, or simply getting older (chronic inflammation can speed up the aging process), many types of exercise can have a powerful effect in regulating inflammation and supporting your immune function. This is especially true of exercises that focus on the mind-body connection.
We’ve long know that exercise releases feel-good neurotransmitters called endorphins. Endorphins counteract the not-so-wonderful hormones increased by stress, like cortisol. More recently, we’ve learned that regular amounts of moderate exercise also fight cytokines, specific proteins associated with inflammatory markers. They can do this regardless of your age. Studies consistently show an inverse link between these markers and exercise: People who exercise on a frequent basis have lower levels of them.
What’s more, physical activity has a cumulative effect—the more you exercise, the more you’re able to exercise to get these benefits, no matter your starting point. One study concluded that even when people don’t benefit from medication, regular physical activity can boost their immune response and improve their overall health.
The primary goal of a cardio workout is raise your heart rate for a set period of time by exercising at a moderate or high intensity. This kind of training improves heart function along with lung capacity and muscle strength. The goal is to reach a heart rate of 55 to 70 percent of your maximum, which is 220 minus your age. So, as an example, if you’re 60 years old, your max rate is 165 beats per minute, and your target rate is between 90 and 115 beats per minute.
Just how effective can it be? A review of 11 different studies that looked at the effects of aerobic exercise on inflammatory markers in middle-aged and older adults showed that aerobic exercise significantly reduced C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-a), and interleukin 6 (IL-6).
Walking is an excellent choice and can be done anywhere by almost everybody. Swimming and water workouts also deserve special mention. If you’re in pain, working out in water makes movement easier because the buoyancy of the water cushions your body, removes gravity, and reduces stress on your joints. Other great activities are jogging, dancing, cycling, rowing, cross-country skiing, and using machines like the stair climber or elliptical. Keep in mind that weight-bearing options—those you do while upright—are particularly good for building strong muscles and bones.
A unique form of cardio is high-intensity interval training (HIIT), which alternates a few minutes of high-intensity movement with comparable minutes of low-intensity movement or simply resting. During the high-intensity minutes, the goal is for your heart rate to reach 80 percent of its max (128 beats per minute in the above example).
Studies done at Duke University showed that among older people with rheumatoid arthritis, 10 weeks of a walking-based HIIT program improved how they felt, reduced markers of inflammation and disease activity, and improved cardiovascular fitness and immune function.
These are often called meditative movements because they combine elements of meditation and elements of exercise. Yoga, tai chi, and qi gong, in particular, are especially good at relieving inflammation directly and, by reducing stress, indirectly. All three mind-body practices use very specific breathing techniques for relaxation and movements that increase range-of-motion and strength. Being conscious of your breath while moving teaches you to be present in the moment, the importance of which is just being realized in the west. They also share the philosophy of caring for the whole person: mind and body.
A 2017 study found that yoga can improve levels of biomarkers of cellular aging and result in less oxidative stress, lower levels of inflammatory biomarkers, and greater antioxidant activity.
Like yoga, tai chi and qi gong have been practiced for thousands of years. Qi gong was always focused on health and wellness, while tai chi was primarily a martial art. The philosophy behind these exercises is based around the concept of qi (pronounced chee), your vital energy. When your qi flows, your mind and body are in balance, but if it’s blocked or weak, you’re more susceptible to physical and emotional ills. Both tai chi and qi gong promote the flow of qi with slow and gentle movements linked to breaths and with meditation designed to focus your attention on the present.
They both have a physiologic impact on immune system functioning and inflammatory responses. Though tai chi might be a bit more vigorous, it can inhibit pro-inflammatory biomarkers and, with guidance, even those with medical conditions can benefit. In one study, participants reported lower stress levels and higher overall health and well-being. Separate studies have looked at how it benefits people with conditions that include arthritis, fibromyalgia, diabetes, and depression, and found similar positive results.
Having strong muscles at every age is essential for attending to activities of daily living. You can use weights, exercise bands, or your own body weight with exercises such as push-ups and squats to build strength.
Traditional weightlifting is designed to stress muscles and cause micro-tears—a temporary inflammatory response—in order to build them. Under-strengthen and you won’t improve, but over-strengthen and you can cause damage from too much inflammation. It’s important to find the balance between not doing enough and overdoing activities. Moderate exercise or vigorous exercise with appropriate rest periods brings benefits; overtraining with intense and long periods of exercise can lead to higher levels of inflammatory mediators and increase your risk for injury and chronic inflammation.
Finding your sweet spots
If you’re out of shape or are managing a chronic condition, talk to your doctor about the best exercises for you and together develop a plan that will help you get started. If you have a medical condition that makes you more prone to musculoskeletal injury or falls, work with a professional trainer, physical therapist, or a teacher certified in the discipline you’re interested in when beginning a new activity. Learn correct form and how to use any equipment correctly.
It’s important to make exercise a regular habit, and that usually requires accountability. Find a buddy to exercise with or who will check in and ask, “Did you exercise today?” If you’re motivated by visuals, use a calendar or e-journal to detail your workouts. Noting that you did 35 minutes today can motivate you to beat that time tomorrow.
And here’s one thing not to do: Don’t invest money in a fitness activity before you know that you really enjoy it. That means don’t sign up for a lengthy gym membership if you’ve never stepped into a gym before. If you don’t enjoy or feel comfortable with a form of exercise, no matter how anti-inflammatory it is, you won’t stick with it. Explore first and then get yourself any equipment and instruction needed to do your best.
Exercising core muscles, those of the abdomen and back, in particular, is important to protect the spine and keep your body in a good upright posture. Pilates is especially efficient and effective at this. Its creator, Joseph Pilates, was sick for most of his early life and developed his own exercise discipline to manage his various conditions. It’s a very specific and targeted series of exercises that can be done as floor work with no equipment needed or with machines such as the Reformer that he devised as well. Research published in the Journal of Exercise, Nutrition and Biochemistry found that Pilates may have anti-inflammatory benefits.