Regular Exercise: Roadmaps toward aging gracefully among growing adults in Nigeria

By

Fasoranti, Afolabi Joseph

The goal of every individual is to attain optimal health and growth. The average life expectancy for men and women in developing countries has gradually been dropping from 60yrs to 55 years and the healthy life expectancy – Disability Adjusted Life Expectancy (DALE) has reached 45-51years (World Health Organization, 2015). The drop in this life expectancy has been as a result of ravaging non communicable diseases such as heart attack, hypertension., stroke, diabetes, cancer, kidney diseases brought about by physical inactivity and poor nutrition (Adegboye, 2013).

During the twentieth century, effective public health strategies and advances in medical treatment contributed to a dramatic increase in life expectancy in Nigeria. Many of the diseases that claimed our ancestors including tuberculosis, diarrhea and enteritis, malaria and small pox no longer carry the much threats they once were. Although they may still present significant health challenges in Nigeria, these diseases are no longer the leading killers of Nigerian adults. However, other diseases such as heart diseases, cancer and diabetes have continued to be the leading causes of death every year since the late nineties (Kolawole, 2011). Heart diseases and cancer pose their greatest risks on people health, as do other chronic diseases and conditions such as stroke, chronic lower respiratory diseases and diabetes.

Fries (2009) defined aging as irreversible biological changes that occur in all living things with the passage of time eventually resulting in death. He further stated that aging is a progressive functional decline or a gradual deterioration of physiological function, including a decrease in health and increase in vulnerability. Center for Diseases Control (CDC, 2011) also defined aging as the continuous wearing away and repair or replacement of body tissue to a stage where tear of the body consequently decline in functions of body tissues. Francis (2015) theorized that aging occurred as a result of many factors such as genes, environment, disease, lifestyles and dietary habits. How and when this occurs is unique to every individual. Aging is a process which commences at birth and continues through infancy, childhood, adolescence and adulthood to death.

Growing adults are seeking ways to maximize their physical, mental, and social wellbeing to remain independent and active as they age. Aging gracefully means living a long, productive, meaningful life and enjoying a high quality of life (Wilson, 2009). Glen and Floss (2014) also conceptualized aging gracefully as living to an advanced age, having good physical health, a positive mental outlook, being cognitively alert, having a good memory and being socially involved. WHO (2014) also defined aging gracefully as active aging which is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. Growing adult can do a number of things to promote good health and prevent disease and injury. Healthy behaviours such as exercising regularly, good nutrition, and getting recommended health screenings can contribute to longer, healthier lives.

Exercise is one of the best ways Nigerians can prevent disease and injury. It reduces the risk of many negative health outcomes in growing adults, including early death (WHO, 2007), cardiovascular disease (Otinwa, 2014). Stroke, diabetes, several forms of cancer, depression, cognitive decline and falls (CDC, 2012). Exercise reduces pain and improves function for those with arthritis and other chronic conditions. physical activity at all ages can improve health and well being, helping to reduce the likelihood of obesity and delaying functional decline and the onset of chronic diseases. It can also reduce the severity of disability associated with chronic diseases, improve mental health, promote social contracts, prolong independent living and reduce the risk of falls. (Seaward, 2009). Maintaining muscle strength and mass in growing adults helps retain function and independence, weight management and prevention of injuries.

Good nutrition can also play a prominent role towards aging gracefully. Adequate and safe supply of food is required throughout the different life stages to maintain functional capacity and enable health aging. (WHO, 2011). Adequate and good nutrition helps to combats communicable and non communicable diseases which can hinder individuals towards aging gracefully (Adebayo, 2011)

A growth in the numbers of older people inevitably has brought an increase in the range and intensity of their problems and needs. Growing adults in Nigeria suffer a lot of hardship in an increasingly hostile, competitive and intolerant society (Ajomale, 2007). The inability of government to cope with the regular payment of salaries, pensions, the inadequate social services and health facilities to cater for the needs of an aging population all pose new threats to the growing adult health.

Therefore, the purpose of this paper is to examine the importance of good nutrition and exercise as reliable strategies in achieving productive and meaningful adults.

Typical Changes with Age and Its Effect

The body changes with aging in many ways which affect the function of both individual cell, and organ systems. These changes occur little by little and progress inevitably overtime which can result in changes in function and in appearance. Besdine (2014) identified various changes in the body as a result of aging which includes the under listed as discussed.

1. Cardiovascular system: The heart muscle thickens with age and are not able to pump blood as efficiently as before especially in the absence of physical inactivity and nutrition (Francis, 2015). The heart and other valves around the heart need extra work to pump the required blood for effective functioning of the body. Blood vessels losses its elasticity and fat deposits build up around the walls of the arteries causing arteriosclerosis overtime and sometimes high blood pressure is inevitable.
2. Skeletal system: Bones tend to become less dense. Thus, bones become weaker and more likely to break. In women, loss of bone density speeds up after menopause because less estrogen is produced (Hill, 2011). Estrogen helps prevent too much bone from being broken down during the body’s normal process of forming. Bones become less dense partly because they contain less calcium (which gives bones strength). The amount of calcium decreases because the body absorbs less calcium from foods. Also levels of vitamin which helps the body use calcium, decrease slightly. As a result, individual may become more prone to fracture. Certain bones are weakened than others. Those most affected include the end of the thigh bone (femur) at the hip, the ends of the arm bones (radius and ulna) at the wrist, and the bones of the spine (vertebrae)
3. Skin, muscles and body fat changes: Aging can be noticeably seen on skin which becomes less elastic and made fragile. The skin appears dry and wrinkled due to the decreased production of natural oil. Age spots can also occur and how fast the skin ages depend on various factors like exposure to sun, dietary, lifestyles, stress and infection. The amount of muscle tissue (muscle mass) and muscle strength tend to decrease beginning around age 30 and continuing throughout life. Regular exercise to strengthen muscle (resistance training) can partially overcome or significantly delay loss of muscle mass and strength. By age 75, the percentage of body fat typically doubles compared with what it was during young adulthood (CDC, 2005). Too much body fat can increase the risk of health problems such as hypertension (Hill, 2011). A healthy diet and regular exercise can help older people minimize increase in body fat.
4. Vision and hearing changes: As people age, the lens stiffens, making focusing on close objects harder. The pupils react more slowly to changes in light, the eyes produce less fluid, making them feel dry (CDC, 2011). This change in vision, called presbyopia, occurs because the lens and retina stiffens. Hearing loss is one of the most common conditions as one age due to the thickening of the ear drums which makes it difficult to hear sound of high intensity.
5. Nervous System: The number of nerve cells in the brain typically decreases with age. Levels of the chemical substances involved in sending messages in the brain change. Blood flow to the brain decreases because of the age-related changes in the brain may function slightly less well and causing the memory to become less efficient (kluff, 2012). Older people may react and do tasks somewhat more slowly, but given time, they do these things accurately. Some mental functions such as vocabulary, short term memory, the ability to learn new material, and the ability to recall words – may be subtly reduced after age 70. Exercise and good nutrition can slow all these attributes if properly implemented and followed.
6. Sexual and reproductive system: The effects of aging on sex hormone level are more obvious in women than in men. In women, most of these effects are related to menopause, when the levels of female hormones decrease dramatically, menstrual periods ends permanently. The decrease in female hormone levels causes the ovaries and uterus to shrink. The tissue of the vagina becomes thinner, drier, and less elastic (a condition called atropic vaginitis). In severe cases, these changes can lead to itching, bleeding, pain during intercourse. The breast becomes less firm and more fibrous and tends to sag (Health & Welfare, 2014). In men, changes in sex hormone levels are less sudden. Levels of the male hormone testosterone decrease, resulting in fewer sperm and a decreased sex drive (libido). Erectile dysfunction (impotence) become more common as men age and is often due to a disorder, usually a disorder that affects blood vessels or diabetes.

Exercise and Aging Gracefully

The interaction of physical activity, exercise and physical fitness with health and biologic aging is complex and multifaceted, but there is general acknowledgment of its importance to major public health outcomes. (American College of Sports Medicine, 2008). Stampfer et al, (2000) defined exercise as any bodily activity that enhances or maintains physical fitness and overall health and wellness. Flinch (2003) also defined exercise as series of activities that are planned and structured which involves duration, intensity and frequency aimed at improving well-being and promoting health.

The sedentary nature of modern man brought about as a result of technological innovations and advancement had exposed men to all manner of preventable and avoidable diseases and illness. Heart diseases and chronic diseases accounted for over 1.2million death per year (WHO, 2014). Being physically active plays an essential role in ensuring health and well-being. Exercise benefits many parts of the body such as the heart, skeletal muscles, bone,s blood, the immune system and the nervous system (CDC, 2011) and can also reduce the risk factors for non communicable diseases. These risk factors include: reducing blood pressure, improving blood cholesterol level and lowering body mass index (BMI). Physical inactivity is the fourth leading risk factor for global mortality (WHO, 2014). WHO also stated that physical inactivity is responsible for 6% of deaths globally and around 3.2 million deaths per year, including 2.6 million in low and middle income countries and 670,000 of these deaths are premature among the growing adults.

Table 2: Ranking of selected risk factors: 10 leading risk factor causes of death

Source: WHO (2014) Global Health Risk

Benefits of Exercise

There are clearly many benefits that can be derived from participation in an exercise programme for the growing adult. It is well recognized that many deleterious physical and psychological conditions that commonly occur during aging can be prevented or delayed in asymptomatic persons with regular physical actively (Katan, 2010).

Exercise has been linked to playing a role in the prevention of some cancers (Kravitz, 2010) as well as reduced risk to heart disease, hypertension, osteoporosis, obesity, type II diabetes, osteoarthritis and abnormal cholesterol (Barry & Eathrone, 2004). Improved strength also helps individual function independently, with improved gait and bodily control.

Additionally, exercise is associated with effective stress management, fewer sleep disorders, enlightened mental outlook, reduced loneliness, and lowered depression and anxiety (Adeyeye, 2012). Maria and Fiatrone (2004) also asserted that exercise can be of benefit in the following ways:

1. It minimize the physiologic changes associated with typical aging
2. It contributes to psychological health and well-being
3. Increase longevity and decrease the risk of chronic diseases
4. Assist in the prevention and treatment of disability.

Categories of Exercise

Exercises according to health (2004), Stempfer, et al (2000) and Gleeson (2007) are generally grouped into four categories depending on the overall effect they have on the human body. These are aerobic, strength, flexibility and balance

1. Aerobic exercise is any physical activity that uses large muscle groups and causes the body to use more oxygen than it would while resting. Aerobic or endurance exercise involves activities that increase breathing and heart rate. These activities help to keep the body healthy, improve fitness and help individual to meet up with daily task. They also help to prevent or delay many diseases that are common in older adults (Otinwa, 2010). It involves Physical activities that build endurance. It includes brisk walking, dancing, jogging, swimming, playing tennis biking etc.
2. Strength exercise: Is any physical activity that increases the muscle and body strength, firmness and toning. It helps to improve bone strength, weight training, interval training and sprinting. It includes push- ups, lunges and biceps curls using dumb bells.
3. Balance exercise help to prevent falls, a common problem in older adults. Many lower body strength exercises also help to prevent balance. Exercise to improve balance include: standing on one foot, heel-to-toe walk.
4. Flexibility or stretching exercise is another important part of overall fitness (Esan & Omojola, 2015). It helps to improve joint flexibility and mobility which gives individual freedom of movement for regular physical activity as well as for everyday activities. It includes shoulder and upper arm stretch, calf stretch etc.

Exercise Precautions

Exercise is wonderful for health, but to get gain without pain, you must do it wisely, using restraint and judgment every step of the way. Before embarking on exercise, the following precautions must be taken into consideration.

• Check-up before you begin a moderate to vigorous exercise programme particularly if you are older than 40, if you have medical problem, or if you have not exercised previously.
• Eat and drink appropriately. Don’t eat for two hours before you exercise but drink plenty of water before, during and after exercise, particularly in warm weather.
• Warm up before you exercise and cool down afterward stroll before you walk and walk before you jog. Stretches and light aerobics are ideal warm-up and cool down activities.
• Dress simply, aiming for comfort, conveniences, and safety rather than styles.
• Exercise regularly unless you are ill or injured. Give yourself enough time to recover from injuries and illness. Remember that recovery may take longer as you age.
• Listen to your body. Learn warning signal of heart disease including chest pain or pressure, disproportionate shortness of breath, fatigue or sweating, erratic pulse. Do not ignore aches and pain that may signify injury.

Conclusion

Aging is inevitable, but it has an undeservedly fearsome reputation. No man can stop the clock, but most can slow its tick and enjoy life as they age with grace and vigour. Every man desires to live to an advanced age, having a good physical health, positive mental outlook, being cognitively alert, having a good memory and being socially involved, all these can be achieved with number of activities to promote good health. Healthy behaviours such as exercising regularly, good nutrition and getting recommended health screening can contribute to longer and healthier lives.

Recommendations

To age gracefully using exercise as a parameter, the following recommendations are drawn.

1. Individuals should involve in regular exercise and good nutrition, thus improving the chances of living longer and healthier.
2. Health education, information and awareness on importance of exercise and nutrition as the key towards aging gracefully should be made available.

Fasoranti Afolabi is a PhD student at the prestigious University of Lagos. His major area of research is disease control and prevention.