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1.
Physical inactivity is a major risk factor for CVD [37,38].
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2.
Increased physical activity and routine physical exercise often improve metabolic parameters that otherwise increase CVD risk (e.g., hyperglycemia, hyperinsulinemia, high blood pressure, hypertriglyceridemia, and reduced high-density lipoprotein cholesterol levels) [37,39,40].
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3.
Beyond improvements in CVD risk factors, increased physical activity and routine physical exercise may benefit the cardiovascular system via enhanced myocardial muscle function (with amelioration of age-related loss of skeletal and cardiac muscle mass and strength). Increased physical activity may reduce inflammation, improve endothelial function, provide cardioprotection against ischemia-reperfusion injury via increased myocardial oxygen utilization, promote myocardial regeneration, facilitate blood vessel dilatation capacity, enhance fibrinolysis, improve autonomic balance, decrease sympathetic tone, reduce cardiac dysrhythmias, reduce resting heart rate, and may possibly help generate a more healthful gut microbiota [38,[41], [42], [43]].
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4.
Routine physical activity and exercise may help with weight loss maintenance (and possibly weight loss itself), with favorable effects on adiposopathic endocrine and immune abnormalities that promote CVD. An essential principle is that even modest physical activity has health benefits, compared to physical inactivity [3,44].
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5.
Routine physical activity and exercise may improve body composition through increased muscle mass and decreased visceral and android fat. For the same body mass index, an individual with decreased physical activity and decreased muscle mass will have a higher percent body fat, and often an increase in visceral fat and android fat (i.e., abdominal subcutaneous adipose tissue plus visceral adipose tissue), which is a body composition profile associated with increased risk for CVD [3,45].
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6.
Provided the guidance is patient-appropriate, a balance of both dynamic (aerobic) and resistance (weightlifting) exercise training are recommended to improve myocardial function and reduce CVD risk [39].
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7.
In addition to physical exercise, physical activity that increases energy expenditure is dependent upon non-exercise activity thermogenesis (NEAT), which is physical activity beyond volitional sporting-like exercise. NEAT often represents the highest percent of daily energy expenditure beyond resting metabolic rate, and helps account for much of the variance in body weight between individuals having similar caloric intake [3], [46].
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8.
A physical exercise prescription may help facilitate adherence to physical exercise program, and often includes frequency, intensity, time spent, type, and enjoyment (FITTE) [3], [39].
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9.
For adults aged 18–64 years without health-related contraindications, common physical exercise recommendations include ≥150 min of moderate-intensity physical activity per week, or ≥75 min of vigorous-intensity physical activity per week [4]. Additional health benefits may be derived from increase moderate-intensity physical activity to 300 min per week, or equivalent. Muscle-strengthening activities are also recommended involving major muscle groups ≥2 days per week [35,39].
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10.
A common physical activity is walking. Less than 5000 steps per day is considered sedentary; ≥10,000 steps per day is considered active. While ≥10,000 steps per day may be optimal, advancing from minimal to some physical activity (incremental steps >2000 steps per day) may have CVD benefits [47]. Most cardiometabolic markers may especially be improved at > 7500 steps per day [48].
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