In my post, Health Benefits of Exercise: a grossly underutilised therapy, I have discussed the various health benefits associated with physical activity, as a result of which exercise is now aptly being recognised as ‘medicine’. However, to derive optimal health benefits from exercise, an exercise program needs to follow certain parameters, similar to drug prescription, such as frequency, dose (amount), time (duration) and type (of physical activity). In my post Exercise Prescription for Optimal Health Benefits, I have discussed the FITT-VP principles for exercise prescription. In this post, I shall be discussing ‘prescription for aerobic exercise’ based on the FITT-VP principles. Prescription for strength training as per FITT-VP factors will be discussed in the next post. Aerobic exercise is referred to in the literature, both scientific and lay, by various terms. In the scientific literature, it is referred to as cardiorespiratory endurance or aerobic endurance, while colloquially it is referred to as aerobic exercise or just aerobic, or cardio, or cardio exercises, or cardio workout. In this post, these terms will be used interchangeably.
Exercise is being increasingly recognised to play an important role not only in the prevention but treatment as well of multiple lifestyle diseases (chronic diseases), health conditions and risk factors associated with these. In view of the above, exercise is now aptly being recognised as medicine. It is the cornerstone of lifestyle modification to achieve Holistic Health. However, like any other medicine, exercise too has some associated risks, though benefits of exercise on health, far outweigh the risks. However, before proceeding with the benefits and risks associated with exercise, it would be pertinent to understand some important related terms. Even though physical activity and exercise are often used interchangeably, they are not synonymous. The definition of these and some closely related terms are given below:
As I begin my new blog, it would be prudent to explain the terms ‘Wellness’ and ‘Holistic Health’; both today buzzwords in the health industry. Health, as we commonly understand as a layman, is the “absence of disease.” However, even though, people may lack the physical symptoms of a disease, they may still be bored, lack energy, and never feel like doing anything or simply unhappy with their lives. Such emotional states often set the stage for physical and mental disease. You will also notice that these feelings are aggravated or mitigated by what is happening around you; you are touched by everything that happens in your surroundings.
Even celebrities who seem to HAVE IT ALL, may not be happy. We come across people who are famous, rich, successful and inspiration for many – they seem to have it all, yet many of them have talked about feeling hollow from within, suffering from panic attacks, and even about being depressed. In an interview with The Telegraph a couple of years ago, Prince Harry had said: “I’ve spent most of my life saying ‘I’m fine. I can safely say that losing my mom at the age of 12 and shutting down all my emotions for the last 20 years has had quite a serious effect on my life…I have probably been very close to a complete breakdown on numerous occasions.” The most decorated Olympian of all time, swimmer Michael Phelps, while talking about his battle with loneliness within, said he was grateful for not taking his own life. So, obviously, there is something beyond the absence of disease which is necessary to help you feel better about yourself – energetic, joyous, at peace with your own self and your surroundings and have a purpose and meaning to life.
Definition of Health
The World Health Organisation has recognised that health is multi-dimensional and has therefore defined health thus:
“Health is a state of complete physical, mental, and social well-being and not merely an absence of disease or infirmity.”
In addition to the three specific dimensions envisaged in the WHO’s definition of health, other dimensions such as spiritual, emotional, and vocational have come to be recognised as ones which have a significant impact on health and well-being. Before we proceed further, it would be prudent to understand these dimensions and how they interact with each other.
Physical health is the most visible of the various dimensions of health. The state of physical health implies the notion of “perfect functioning” of the body.
In simpler terms, mental health encompasses your thoughts, knowledge, attitudes, and beliefs – your analytical self. Thoughts may seem to be something very innocuous and we all have them all the time. However, the power of thoughts is such that “the quality of your thinking determines the quality of your life” – they act as manures for your brain. Therefore, it is important to watch the quality of your thoughts.
It’s your feelings – your range of emotions from fear to anger to love and joy.
Social well-being is the extent to which you feel a sense of belonging and social inclusion; a connected person is a supported person. Social isolation and loneliness could be a greater threat to public health than obesity, researchers say. Being connected to others socially is widely considered a fundamental human need – crucial to both social well-being and survival. “There is robust evidence that social isolation and loneliness significantly increase the risk of premature mortality, and the magnitude of the risk exceeds that of many leading health indicators.” So Lonely I Could Die. Indeed many nations around the world now suggest we are facing a ‘loneliness epidemic’ amidst a sea of humanity. Establish a respectful cooperative relationship with your family, friends, community, and the environment.
It is the intangible “something” that transcends physiology and psychology. It primarily relates to one’s own journey to discover things of importance in life: your relationship with yourself and your relationship with a Higher Power. Its main purpose is to find purpose and meaning in life.
What Makes a ‘Whole’ person?
The above five key aspects make you a WHOLE PERSON. The concept is based on the law of nature that a ‘whole’ is made up of interdependent parts. The ecosystem (ecological system) of which we are a part, includes all of the living things (plants, animals, and organisms) in a given area and the non-living components (air, water, sun, soil etc.). Both the living and non-living components have a complex interaction and depend on each other; the absence of one member or one non-living factor can affect all parties of the ecosystem. Similarly, the various dimensions which constitute a ‘whole’ person constantly interact and affect each other; when one of these aspects is out of balance, it can impact all the other aspects. For example, if we are nervous or anxious, this may result in a physical reaction such as a headache; when we are angry and stressed over a long period of time, we could possibly develop gastric ulcer or migraine. This relationship between your different aspects is often referred to as a mind-body connection.
WELLNESS is a state in which ‘needs’ of each of the five key aspects are met and all aspects of your WHOLE SELF are able to work in harmony with each other.
The basic needs of each aspect of whole you, which need your attention and care to perform optimally as follows:
The Physical You (your body)
Regular optimal exercise – both aerobic and muscular fitness; healthy, balanced diet; healthy body weight; and adequate rest.
Mental You (your thoughts)
Inculcate positive thoughts and viewpoints, a positive self-image and self-supporting attitudes.
Emotional You (your feelings)
Ability to forgive and ‘let go’ is the mainstay of your emotional health. Equally important, let your feelings be heard. Share love and compassion; laugh and experience happiness; establish joyful relationships, including with your own-self.
Social You (your interpersonal relationships)
Connect with family, friends, neighbours, and colleagues at the workplace.
Spiritual You (your spirit)
Take time to reflect, meditate and pray for inner calmness, and trust in your inner knowing.
Holistic Health Spectrum
Health and disease lie along a continuum, where premature death is the lowest point on the spectrum and as you move rightwards, the highest point corresponds to optimum wellness described above.
Fig. Health Spectrum
The centre or the neutral point represents a point where there is no ‘apparent’ illness. Thus, it is obvious from the above health spectrum that health is not a static state, rather it’s a dynamic process that fluctuates within a range of optimum well-being to various levels of illness, including premature death. There are degrees or ‘levels of wellness’ as there are degrees of severity of illness. Being in a state of optimum wellness does not preclude periods of illness, nor does it attempt to deny that death is a natural part of life. Therefore, what this implies is that health is a state not to be attained once and for all, but instead, it requires constant care – you don’t just get well and stay well.
The sick-care model
The conventional medicine (the ‘sick-care’ model) typically treats illness, injuries, and symptoms to bring the individual to a ‘neutral point’, where there is no longer any apparent illness. However, the wellness paradigm directs you beyond the neutral point, further along the health spectrum, towards optimum wellness. The right half of the Health Spectrum, thus, shows that even if a person is not suffering from any apparent disease, there is still a lot to be gained by attempting to reach the state of maximum well-being, where a person is not only free from any illness but everything will function at the very best that is possible.
Holistic Health meaning
The term ‘Holistic’ was coined in 1926 by a South African soldier and statesman Gen JC Smuts, as a philosophical term. Viewing the universe in terms of ‘wholes’ – that is, organisms and systems instead of molecules and atoms – he derived holism from the Greek word holos, meaning ‘whole’. Holistic Health is a concept that goes beyond curing of illness to one of achieving optimum wellness. It goes beyond just eliminating symptoms and strives to achieve maximum well-being, where everything is functioning at the highest level possible. This broader (w)holistic approach to health, promotes wellness by integrating and balancing the various aspects which constitute the ‘whole person’. It’s an ongoing process and a way of life.
History of Holistic Health
Though this concept of Holistic Health has been integrated into modern medicine only in the recent past, ancient healing traditions, as far back as 5000 years ago, in India and China, stressed living a healthy way of life in harmony with nature. Socrates (4th century BC), a Greek philosopher, warned against treating only one part of the body “for the part can never be well unless the whole is well.” The significance of treating the body as a whole’ and need for balance between the various aspects of a person to maintain health, can be traced back to Ayurveda, a medical system of Indian origin, which originated about 5000 BC. In Ayurveda, there is a ‘tridosha theory of disease’. The doshas or humors are: vata (wind), pitta (gall), and kapha (mucous). The disease was explained as a disturbance in the equilibrium of the three humors; when these were in perfect balance and harmony, a person is said to be healthy.
The significance of preventive treatment
The health spectrum has been viewed as promoting preventive treatment, which improves well-being before an individual presents with signs or symptoms of illness. This concept of ‘preventive’ medicine is also not new. In the Chinese system of medicine, considered one of the world’s oldest systems of medicine, “the great doctor is one who treats not someone who is already ill but someone not yet ill”. Galen (130-205 AD), the physician to the Roman emperor, Marcus Aurelius, and a great teacher and author, stated about health: “Since both in importance and in time, health precedes disease, so we ought to consider first how health may be preserved, and then how one may best cure diseases.”
In conclusion, by adopting the principles of holistic health you can enjoy better health, have increased energy, greater enthusiasm, an enhanced sense of well-being and a greater sense of joy; it can help find purpose and meaning to life and promotes inner calmness. This can be achieved by exercising your ‘power of choice’: choose wellness-oriented lifestyles, positive thoughts, and attitudes, love and compassion, time to be quiet and reflect, forgive and let go.