==== Front J Funct Morphol Kinesiol J Funct Morphol Kinesiol jfmk Journal of Functional Morphology and Kinesiology 2411-5142 MDPI 10.3390/jfmk5010002 jfmk-05-00002 Communication Using Physical Activity to Enhance Health Outcomes Across the Life Span https://orcid.org/0000-0003-3603-4600Roychowdhury Dev DR ACADEMY, Melbourne, VIC 3000, Australia; info@drdevroy.com 04 1 2020 3 2020 5 1 228 11 2019 02 1 2020 © 2020 by the author.2020Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Physical activity has been widely recognized as one of the primary determinants that proliferates positive psychophysiological health in individuals. Despite the numerous benefits of engaging in physical activity, a majority of the global population continues to be physically inactive or sedentary. The aim of this brief commentary is to capture the benefits of engaging in regular physical activity across the life span. In particular, this paper will highlight the benefits of engaging in regular physical activity with respect to age, gender, atypical populations, and lifestyle. Future research and recommendations have also been addressed. physical activityhealthlife spanpsychologyphysiologykinesiology ==== Body 1. Introduction Despite the well-established benefits of engaging in regular physical activity [1,2], recent trends have revealed that a large proportion of the global population is increasingly becoming sedentary [3,4], which has been associated with increased risks for several chronic conditions and mortality [5,6,7]. The global economic cost of physical inactivity has been conservatively estimated at $67.5 billion [8,9] with no improvements in the levels of physical inactivity recorded in the past decade [10]. Understandably, the emotional and psychological burden are likely to be far reaching and horrid. Physical activity has been defined as “any bodily movement produced by skeletal muscles that requires energy expenditure” [11]. The World Health Organization (WHO) has developed global recommendations on physical activity for health with the primary aim of guiding policy makers on the requisite amount of physical activity with respect to its frequency, duration, intensity, type, and total amount [12]. The recommendations that are set out address three age groups: 5–17 years old; 18–64 years old; and 65 years old and above [12]. It is primarily recommended that children and youth aged 5–17 years ought to engage in at least 60 min of moderate to vigorous intensity physical activity per day; adults aged 18–64 years ought to do at least 150 min of moderate intensity aerobic physical activity on a weekly basis or do at least 75 min of vigorous intensity aerobic physical activity in a week or an equivalent combination of moderate and vigorous intensity activity; and adults aged 65 years and above ought to do at least 150 min of moderate intensity aerobic physical activity in a week or do at least 75 min of vigorous intensity aerobic physical activity on a weekly basis or an equivalent combination of moderate and vigorous intensity activity [13]. Despite the clear practical recommendations that exist and explosion of research reporting on the benefits of engaging in regular physical activity, recent research now suggests that it is no longer sufficient to simply meet these recommendations to address health needs and lower health risks [14]. Furthermore, the conceptualization of the terms ‘physical inactivity’ and ‘sedentary behaviour’ has also been controversial [15,16], which has implications for the way research protocols are designed and policy guidelines are formulated. Future research should, therefore, attempt to focus on arriving at a clear understanding of and consensus on what these terms constitute along with their theoretical, observational, and practical distinctions. For the purpose of this paper, the terms physical inactivity and sedentary behaviours are used interchangeably. It is widely accepted that a range of factors affect individuals’ involvement in physical activity, including psychological, social, environmental, and administrative factors [17]. Given the significance of different factors and the role they play in individuals’ final decision to undertake and maintain regular physical activity [18], it is imperative to understand how motivational factors aid engagement in physical activity within such complex and multi-dimensional contexts. Research on participation motivation has clearly indicated that individuals’ involvement in specific types of physical activity may be functionally characterized by the primary participation motives they have for engaging in those activities [19,20,21]. Although motivation research pertaining to physical activity has received substantial consideration, other determinants have received scant attention. The purpose of this brief commentary, therefore, is to encapsulate the benefits of engaging in regular physical activity across the life span. More specifically, this paper will highlight the benefits of engaging in regular physical activity with respect to age, gender, atypical populations, and lifestyle. 2. Physical Activity across Age Groups Movement-based activity has been found to positively affect individuals’ psychophysiology across different life stages. Physical activity has been linked to a number of adaptive psychological, physical, and social outcomes, especially in early childhood (i.e., birth to five years), including lower cardiovascular risk factors [22,23], improved bone development [24,25], decreased fat and body mass indices [26,27,28,29], improved motor development [30], and improved emotional, cognitive, and social development [31,32]. Research with school-aged children have also reported that physical activity may improve cognitive functioning and academic performance at school [33,34,35,36,37,38,39]. Physical activity has also been found to improve psychological health and prevent mental health conditions in young people [40,41]. Furthermore, recent neuroimaging research involving children has found that those who participated in a nine-month physical activity program showed reduction in fMRI brain activation in the right anterior prefrontal cortex and improvements in performance on a task of attentional and interference control when compared to the wait-list control group [42]. Similarly, movement-based learning environments have shown to improve children’s executive functioning [43,44,45] and academic performance [46,47,48,49,50,51,52,53]. Studies have further reported that certain core executive functions, that appear to be activated through physical activity, are fundamental for children’s psychophysiological and social development [54] and may play a vital role in their overall academic success [55,56,57]. Research on physical activity with adults has revealed that higher levels of physical activity are associated with better health-related quality of life [58,59,60,61]. Physically active adults are likely to have improved cardiovascular and metabolic health; better weight maintenance strategies; reduced risk of bone fracture and better bone mass and mineral density; increased muscular mass, strength, and power; and reduced risks of breast and colon cancer, diabetes, high blood pressure, coronary heart disease, stroke, hypertension, and depression [62,63,64,65,66,67,68,69]. Additionally, research on senescence has indicated that physical activity may play a vital protective role against the detrimental effects of age on psychological and physical health [70,71]. Higher physical activity in the elderly population has been linked to reduced prevalence of chronic conditions [72,73,74,75], decreased cognitive deterioration [76,77], improved physical health [74,78,79,80], better mental health [78,81,82], reduced mortality rates [74,75,83,84,85], and improved quality of life [78,81,82,86,87]. Furthermore, age-related cross-sectional studies have indicated that physically fit older participants (as opposed to their sedentary counterparts) had comparable results to younger participants on a range of cognitive tasks, abilities, and processes [88,89,90,91,92]. Similarly, longitudinal studies have indicated that involvement in moderate and vigorous physical activity may buffer against cognitive degeneration in older age [93]. Finally, intervention studies reveal that older adults who participated in physical activity programs showed improved cardiorespiratory fitness [94,95], increased heart rate variability and enhanced executive control [96], and improved cognitive performance [97]. 3. Physical Activity and Gender It has been observed that there are systematic differences in the reasons males and females nominate for participating in physical activity [19,20,21]. Therefore, it is plausible to argue that gender differences exist in how individuals contrive and obtain benefits from engagement in specific physical activities, which may be functionally characterized by the benefits the activities seem to offer to those individuals. Despite this, recommended levels of physical activity around the world are more or less the same with minimal or no refinement related to gender [13]. Research has shown that males are more likely to be physically active across different life stages—through fetal and neonatal periods [98], infancy [99,100,101], childhood [102], adolescence [103], and adulthood [19,104]—as compared to their female counterparts. According to some researchers, this tilts the physical activity research and practice domains in favour of males, with health professionals often overlooking the requirements of females [105]. This is further exacerbated by the fact that females generally tend to engage less in physical activity [106], males take part in more specific sedentary behaviours [107], gender socialization and roles differ from birth onwards [108], and specific psychological, social, and environmental factors vary across lifetime [109,110], which play a significant role in mediating the relationship between gender and physical activity involvement. Although it is known that males and females tend to favour different kinds of physical activities, it is important to understand how this participation and consequent health outcomes are affected. Research indicates that level, intensity, type, and amount of physical activity involvement may have different beneficial effects for males and females. For instance, Asztalos and colleagues found that males participating in higher levels and vigorous intensity physical activity had lowered feelings of psychological distress, and females engaging in walking and moderate intensity physical activity had better emotional well-being and regulation [111]. This has also been confirmed in other studies that purport that males benefit from engaging in vigorous physical activities [112,113,114] whereas females benefit from low to moderate intensity physical activities [115]. Furthermore, studies involving differential intensity physical activity and health conditions show clear gender differences in terms of health outcomes. For instance, studies in cardiovascular disease [115,116,117,118] and diabetes [119] indicate that females are more likely than males to benefit from low to moderate intensity physical activity. In another study involving physical activity and cancer prevention, risk reduction in colon cancer in females was related to increased leisure time activity, whereas risk reduction in males was related to both leisure and occupational physical activity [120]. Gender differences in exercise habits also reveal that, with higher levels of exercise, the level of reported self-esteem increases in males and decreases in females [121]. In contrast, it has also been found that females who engage in low intensity physical activity report higher self-esteem and quality of life as compared to females who participate in high intensity physical activity [122]. This may be attributed to the different motives males and females have for engaging in physical activities. For instance, research suggests that males are more likely to participate in physical activity due to social and competitive reasons, whereas females are more likely to engage in physical activity for appearance motives [19,20,21]. 4. Physical Activity across Atypical Population While research on physical activity has established clear benefits for the healthy population [11,12,13], recent research has demonstrated that physical activity may also have positive implications for atypical conditions and population. For instance, it has been found that physical activity may aid in preventing obesity by helping individuals increase their total energy expenditure, decrease total body fat, and even build muscle mass by engaging in muscle-strengthening activities [123]. Furthermore, physical activity has been recommended as an alternative disease management strategy for individuals living with immunodeficiencies [124,125]. Additionally, research in the domain of cancer prevention suggests that physical activity may reduce the risk of a range of malignancies, including lung, colon, breast, prostate, and endometrial cancer [120,126,127,128,129,130,131,132]. Similarly, risk modeling studies indicate that physical activity may help reduce the risk of recurrent stroke [133]. Studies in diabetes have also indicated that physical activity, especially aerobic activity, is associated with lower cardiovascular and mortality risks in both type 1 and type 2 diabetes [134]. Research in different types of physical activity has also confirmed that it may play a vital role in improving overall physical health, including cardiorespiratory, musculoskeletal, and neuromotor fitness [135]. In recent years, the positive effects of physical activity on mental health have also come to the fore [136,137,138]. Physical activity has been found to be particularly effective in ameliorating the effects of stress, anxiety, and depression [139]. Asmundson and colleagues found that physical activity had positive therapeutic effects on stress and stress-related symptoms [137]. Similarly, systematic reviews of physical activity, especially aerobic and anaerobic exercise, suggest physical activity to be an efficacious transdiagnostic intervention for anxiety-related disorders [140]. Furthermore, randomized control trials have also indicated physical activity to be an effective tool in reducing symptoms of depression [141]. In addition to its psychophysiological benefits, physical activity has also been found to be positively associated with subjective health outcomes, including personal experiences of self-esteem, health behaviours, fitness, life situation, and ill-health [142,143]. A range of studies have reported that higher levels of physical activity were positively associated with higher self-esteem in children, adolescents, and young and middle-aged adults [144,145,146,147,148,149,150,151]. Finally, researchers have also found that physical activity not only fosters emotional, social, and motor skills, it also promotes personal well-being and strengthens relations between peers [152]. 5. Physical Activity and Lifestyle An individual’s capacity to undertake physical tasks of everyday living plays a vital role in their physical well-being and overall welfare. While higher physical functioning in individuals is associated with valued tasks and independent living, poor physical functioning has been found to be associated with poorer quality of life, inhibited social participation, and higher risk of death [153,154]. Other studies have also confirmed longitudinal and cross-sectional associations between physical functioning and physical activity [155]. Studies have indicated that physical functioning of individuals depends on a range of lifestyle and socio-economic factors and as such it is reasonable to believe that these factors may also play an important role in regulating involvement in physical activity. For instance, socio-economic status has been found to be one of the strongest predictors of physical functioning [156,157], with adults with lower socio-economic status found to be less likely to engage in healthy behaviours [158]. Furthermore, research indicates that higher levels of education, higher income, and living in affluent areas were positively associated with better physical functioning [159,160,161,162,163]. Additionally, a number of lifestyle-related behavioural risk factors, including smoking, excess alcohol consumption, and poor nutrition, have been found to negatively affect physical functioning [164,165,166,167,168,169,170]. 6. Discussion A review of the literature suggests that the benefits of engaging in regular physical activity has been consistently associated with a range of positive psychological and physical health outcomes for individuals across the life span. Research in the active living, sport, and exercise literature has reliably demonstrated that individuals may have different reasons for engaging in different forms of physical activities and as such may gain different benefits from engaging in those activities. For instance, it is vital for toddlers, pre-school, and school-aged children to engage in active play that fosters their movement, communication, confidence, social, and interaction skills. Therefore, in addition to the evident kinesiological benefits that they would obtain from engaging in physical activity, it would also be reasonable to state that while, on one hand, structured play can nurture their movement, intellectual, and problem-solving skills, unstructured play can also, on the other hand, cultivate their creative, imaginative, and social skills. Similarly, other studies have also indicated that older adults tend to engage in leisure time physical activities in order to relax, maintain independence, flexibility, and mobility, and reduce muscle atrophy, amongst other reasons. Despite this, majority of research in the sport and exercise domain has focused exclusively on the type, intensity, frequency, and/or amount of physical activity with no or very little regard given to the saliency of other influences which may play an equivale role in underscoring individuals’ primary participation in those activities. Health professionals and policy makers should, therefore, focus on developing targeted interventions that not only accentuate physiological benefits in physical activity participation, but also emphasize on the motivational and enjoyable aspects of physical activity involvement with especial attention given to individual-activity fit. Designing novel and tailored evidence-based interventions specific to participants would ensure that those individuals engage in appropriate forms of physical activities, which would maximize satisfaction and reduce drop-out rates. Furthermore, creating smart and innovative campaigns will not only promote the uptake of physical activity, but will also aid professionals in understanding and addressing barriers in an effective and efficient manner. Physical activity is a complex behaviour which often has personal, social, and public antecedents and consequences. Individuals may engage in physical activity in many ways, with multiple combinations of dose-responses, motives, contexts, and outcomes. It is, therefore, imperative to understand what constitutes physical activity engagement, how it is perceived by individuals, and how it gets manifested in everyday life. Future research in this domain must focus on ethnographic, narrative, intervention, and longitudinal studies to complement quantitative experiments in order to arrive at a comprehensive conceptualization of physical activity involvement along with its practical implications. This must also include how much physical activity is adequate, sufficient, or recommended for individuals with specific needs or goals. Physical activity may also have varied meanings for different individuals depending on the context, lifestyle choices, religious and spiritual practices, and local customs and traditions, in which the activities are being carried out. Given the multivariate nature of physical activity, exploratory and cross-sectional studies ought to focus on social, linguistically-diverse, and communal components of physical activity involvement. This may, for instance, include school-based physical education programs, or slow body-movement intervention programs in aged care setting, or appropriate diet-exercise awareness campaigns to enable better decision-making in clients. Similarly, public health announcements, messages, and campaigns should be clear, updated regularly, and modernized. Given the efficaciousness of physical activity across the life span, another area that would particularly benefit is the health care sector. There is an insistent need for researchers, practitioners, consultants, and policy makers to formulate a unified diagnostic and prescriptive code by incorporating physical activity across a variety of settings, whereby physicians could potentially counsel and recommend clients appropriate physical activity as part of their treatment plans to further therapeutic goals. This would not only help clients gain valuable kinesiological benefits but also address excessive dependence on medications that is prevalent across numerous health care settings and conditions. This also means that appropriate training and study modules must be incorporated in educational and professional settings to equip future practitioners with relevant and necessary skills and knowledge. With the advent and excessive use of technology in everyday life, future research could also focus on utilizing mobile applications, web-based platforms, and virtual or augmented reality wearables to help individuals keep track of their physical activity goals, maintain adherence, and gain desired health outcomes. This could also be used to understand pertinent shifts in generational differences, social and community trends, and personal preferences. Finally, utilizing both traditional and novel methodologies may ultimately assist us in understanding why individuals engage in different forms of physical activity and the myriad benefits they could achieve from such engagement. This will undoubtedly have huge implications for the psychological and kinesiological health of individuals. 7. Conclusions In summary, it is now widely recognized that engagement in appropriate forms of physical activity may have numerous psychological, kinesiological, and social benefits. It has been noted in the literature that people tend to engage in diverse forms of physical activity for primary participation reasons by virtue of their age, gender, condition, and context. Understanding the influences of these variables and tailoring appropriate programs and interventions will greatly assist individuals maximize their physical activity needs and goals. Acknowledgments I would like to thank the Journal Guest Editors of this special issue, Marianna Alesi and Sebastiano Costa, for inviting me to contribute this paper. I would also like to thank the Assistant Managing Editors, Molly Lu and Sydney Tang, for their assistance and administrative correspondences regarding this special journal issue. Funding This research received no external funding. Conflicts of Interest The author declares no conflict of interest. ==== Refs References 1. Frederick-Recascino C. Morris T. Intrinsic and extrinsic motivation in sport and exercise Sport Psychology: Theory, Applications and Issues Morris T. Summers J. John Wiley & Sons Melbourne, Australia 2004 121 151 2. Lloyd-Jones D.M. Yuling H. Labarthe D. Mozaffarian L.J. Appel L. Van Horn K. Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association’s strategic impact goal, through 2020 and beyond Circulation 2010 121 586 613 10.1161/CIRCULATIONAHA.109.192703 20089546 3. Matthews C.E. Chen K.Y. Freedson P.S. Buchowski M.S. Beech B.M. Pate R.R. Troiano R.P. Amount of time spent in sedentary behaviors in the United States, 2003–2004 Am. J. Epidemiol. 2008 167 875 881 10.1093/aje/kwm390 18303006 4. Hansen B.H. Kolle E. Dyrstad S.M. Holme I. Anderssen S.A. Accelerometer-determined physical activity in adults and older people Med. Sci. Sports Exerc. 2012 44 266 272 10.1249/MSS.0b013e31822cb354 21796052 5. Grøntved A. Hu F.B. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: A meta-analysis JAMA 2011 305 2448 2455 10.1001/jama.2011.812 21673296 6. Chau J.Y. Grunseit A.C. Chey T. Stamatakis E. Brown W.J. Matthews C.E. Bauman A.E. van der Ploeg H.P. Daily sitting time and all-cause mortality: A meta-analysis PLoS ONE 2013 8 80000 10.1371/journal.pone.0080000 7. Biswas A. Oh P.I. Faulkner G.E. Bajaj R.R. Silver M.A. Mitchell M.S. Alter D.A. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: A systematic review and meta-analysis Ann. Intern. Med. 2015 162 123 132 10.7326/M14-1651 25599350 8. Ding D. Lawson K.D. Kolbe-Alexander T.L. Finkelstein E.A. Katzmarzyk P.T. van Mechelen W. Pratt M. The economic burden of physical inactivity: A global analysis of major non-communicable diseases Lancet 2016 388 1311 1324 10.1016/S0140-6736(16)30383-X 27475266 9. Torjesen I. Global cost of physical inactivity is estimated at $67.5bn a year BMJ 2016 354 i4187 10.1136/bmj.i4187 27469609 10. Prevalence of Insufficient Physical Activity Available online: https://www.who.int/gho/ncd/risk_factors/physical_activity_text/en/ (accessed on 20 November 2019) 11. Physical Activity Available online: https://www.who.int/dietphysicalactivity/pa/en/ (accessed on 20 November 2019) 12. Global Recommendations on Physical Activity for Health Available online: https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/ (accessed on 20 November 2019) 13. Global Recommezndations on Physical Activity for Health Available online: https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf;jsessionid=DE9AB06EE6639F7F13089681CD5D7298?sequence=1 (accessed on 20 November 2019) 14. González K. Fuentes J. Márquez J.L. Physical inactivity, sedentary behavior and chronic diseases Korean J. Fam. Med. 2017 38 111 10.4082/kjfm.2017.38.3.111 28572885 15. Yates T. Wilmot E.G. Davies M.J. Gorely T. Edwardson C. Biddle S. Khunti K. Sedentary behavior Am. J. Prev. Med. 2011 40 e33 e34 10.1016/j.amepre.2011.02.017 21565646 16. Pate R.R. O’Neill J.R. Lobelo F. The evolving definition of “sedentary” Exerc. Sport Sci. Rev. 2008 36 173 178 10.1097/JES.0b013e3181877d1a 18815485 17. Biddle S.J. Mutrie N. Psychology of Physical Activity: Determinants, Well-Being and Interventions Routledge London, UK 2007 18. Hoare E. Stavreski B. Jennings G. Kingwell B. Exploring motivation and barriers to physical activity among active and inactive Australian adults Sports 2017 5 47 10.3390/sports5030047 29910407 19. Roychowdhury D. Examining Reasons for Participation in Sport and Exercise Using the Physical Activity and Leisure Motivation Scale (PALMS) Ph.D. Thesis Victoria University Melbourne, Australia 2012 20. Roychowdhury D. A comprehensive measure of participation motivation: Examining and validating the Physical Activity and Leisure Motivation Scale J. Hum. Sport Exerc. 2018 13 231 247 10.14198/jhse.2018.131.20 21. Roychowdhury D. Functional significance of participation motivation on physical activity involvement Psychol. Thought 2018 11 9 17 10.5964/psyct.v11i1.255 22. Saakslahti A. Numminen P. Niinikoski H. Rask-Nissila L. Viikari J. Tuominen J. Välimäki I. Is physical activity related to body size, fundamental motor skills, and CHD risk factors in early childhood? Pediatric Exerc. Sci. 1999 11 327 340 10.1123/pes.11.4.327 23. Sääkslahti A. Numminen P. Varstala V. Helenius H. Tammi A. Viikari J. Välimäki I. Physical activity as a preventive measure for coronary heart disease risk factors in early childhood Scand. J. Med. Sci. Sports 2004 14 143 149 10.1111/j.1600-0838.2004.00347.x 15144353 24. Binkley T. Specker B. Increased periosteal circumference remains present 12 months after an exercise intervention in preschool children Bone 2004 35 1383 1388 10.1016/j.bone.2004.08.012 15589220 25. Janz K.F. Burns T.L. Torner J.C. Levy S.M. Paulos R. Willing M.C. Warren J.J. Physical activity and bone measures in young children: The Iowa bone development study Pediatrics 2001 107 1387 1393 10.1542/peds.107.6.1387 11389262 26. Metallinos-Katsaras E.S. Freedson P.S. Fulton J.E. Sherry B. The association between an objective measure of physical activity and weight status in preschoolers Obesity 2007 15 686 694 10.1038/oby.2007.571 17372319 27. Trost S.G. Sirard J.R. Dowda M. Pfeiffer K.A. Pate R.R. Physical activity in overweight and non-overweight preschool children Int. J. Obes. Relat. Metab. Disord. 2003 27 834 839 10.1038/sj.ijo.0802311 12821970 28. Janz K.F. Levy S.M. Burns T.L. Torner J.C. Willing M.C. Warren J.J. Fatness, physical activity, and television viewing in children during the adiposity rebound period: The Iowa bone development study Prev. Med. 2002 35 563 571 10.1006/pmed.2002.1113 12460524 29. Atkin L.M. Davies P.S. Diet composition and body composition in preschool children Am. J. Clin. Nutr. 2000 72 15 21 10.1093/ajcn/72.1.15 10871555 30. Cliff D.P. Okely A.D. Smith L.M. Kim M. Relationships between fundamental movement skills and objectively measured physical activity in preschool children Pediatric Exerc. Sci. 2009 21 436 449 10.1123/pes.21.4.436 20128363 31. Colwell M. Lindsey E. Preschool children’s pretend and physical play and sex of play partner: Connections to peer competence Sex Roles 2005 52 497 509 10.1007/s11199-005-3716-8 32. Lindsey E.W. Colwell M.J. Preschoolers’ emotional competence: Links to pretend and physical play Child Study J. 2003 33 39 52 33. Tomporowski P. McCullick B. Pesce C. Enhancing Children’s Cognition with Physical Activity Games Human Kinetics Champaign, IL, USA 2015 34. Tomporowski P.D. McCullick B. Pendleton D.M. Pesce C. Exercise and children’s cognition: The role of exercise characteristics and a place for metacognition J. Sport Health Sci. 2015 4 47 55 10.1016/j.jshs.2014.09.003 35. Khan N.A. Hillman C.H. The relation of childhood physical activity and aerobic fitness to brain function and cognition: A review Pediatric Exerc. Sci. 2014 26 138 146 10.1123/pes.2013-0125 36. Singh A. Uijtdewilligen L. Twisk J.R. van Mechelen W. Chinapaw M.M. Physical activity and performance at school: A systematic review of the literature including a methodological quality assessment Arch. Pediatrics Adolesc. Med. 2012 166 49 55 10.1001/archpediatrics.2011.716 37. Álvarez-Bueno C. Pesce C. Cavero-Redondo I. Sánchez-López M. Garrido-Miguel M. Martínez-Vizcaíno V. Academic achievement and physical activity: A meta-analysis Pediatrics 2017 140 e20171498 10.1542/peds.2017-1498 29175972 38. Santana C.A. Azevedo L.B. Cattuzzo M.T. Hill J.O. Andrade L.P. Prado W.L. Physical fitness and academic performance in youth: A systematic review Scand. J. Med. Sci. Sports 2017 27 579 603 10.1111/sms.12773 27714852 39. Owen K.B. Parker P.D. Van Zanden B. MacMillan F. Astell-Burt T. Lonsdale C. Physical activity and school engagement in youth: A systematic review and meta-analysis Educ. Psychol. 2016 51 129 145 10.1080/00461520.2016.1151793 40. Biddle S.J. Asare M. Physical activity and mental health in children and adolescents: A review of reviews Br. J. Sports Med. 2011 45 886 895 10.1136/bjsports-2011-090185 21807669 41. Babic M. Morgan P.J. Plotnikoff R.C. Lonsdale C. White R.L. Lubans D.R. Physical activity and physical self-concept in youth: Systematic review and meta-analysis Sports Med. 2014 44 1589 1601 10.1007/s40279-014-0229-z 25053012 42. Chaddock-Heyman L. Erickson K.I. Voss M. Knecht A. Pontifex M.B. Castelli D. Hillman C. Kramer A. The effects of physical activity on functional MRI activation associated with cognitive control in children: A randomized controlled intervention Front. Hum. Neurosci. 2013 7 1 13 10.3389/fnhum.2013.00072 23355817 43. Egger F. Conzelmann A. Schmidt M. The effect of acute cognitively engaging physical activity breaks on children’s executive functions: Too much of a good thing? Psychol. Sport Exerc. 2018 36 178 186 10.1016/j.psychsport.2018.02.014 44. Schmidt M. Jäger K. Egger F. Roebers C.M. Conzelmann A. Cognitively engaging chronic physical activity, but not aerobic exercise, affects executive functions in primary school children: A group-randomized controlled trial J. Sport Exerc. Psychol. 2015 37 575 591 10.1123/jsep.2015-0069 26866766 45. Hillman C.H. Pontifex M.B. Raine L.B. Castelli D.M. Hall E.E. Kramer A.F. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children Neuroscience 2009 159 1044 1054 10.1016/j.neuroscience.2009.01.057 19356688 46. Mavilidi M.F. Okely A. Chandler P. Domazet S.L. Paas F. Immediate and delayed effects of integrating physical activity into preschool children’s learning of numeracy skills J. Exp. Child Psychol. 2018 166 502 519 10.1016/j.jecp.2017.09.009 29096234 47. Mavilidi M.F. Ruiter M. Schmidt M. Okely A.D. Loyens S. Chandler P. Paas F. A narrative review of school-based physical activity for enhancing cognition and learning: The importance of relevancy and integration Front. Psychol. 2018 9 2079 10.3389/fpsyg.2018.02079 30464752 48. Mavilidi M.F. Okely A.D. Chandler P. Cliff D.P. Paas F. Effects of integrated physical exercises and gestures on preschool children’s foreign language vocabulary learning Educ. Psychol. Rev. 2015 27 413 426 10.1007/s10648-015-9337-z 49. Mavilidi M.F. Okely A.D. Chandler P. Paas F. Effects of integrating physical activities into a science lesson on preschool children’s learning and enjoyment Mind Brain Educ. 2017 31 281 290 10.1002/acp.3325 50. Mavilidi M.F. Okely A.D. Chandler P. Paas F. Infusing physical activities into the classroom: Effects on preschool children’s geography learning Appl. Cogn. Psychol. 2016 10 256 263 10.1111/mbe.12131 51. Toumpaniari K. Loyens S. Mavilidi M.F. Paas F. Preschool children’s foreign language vocabulary learning by embodying words through physical activity and gesturing Educ. Psychol. Rev. 2015 27 445 456 10.1007/s10648-015-9316-4 52. Riley N. Lubans D.R. Holmes K. Gore J. Hansen V. Morgan P.J. Movement-based mathematics: Enjoyment and engagement without compromising learning through the EASY Minds program Eurasia J. Math Sci. Technol. Educ. 2017 13 1653 1673 10.12973/eurasia.2017.00690a 53. Riley N. Lubans D.R. Holmes K. Morgan P.J. Findings from the EASY Minds cluster randomized controlled trial: Evaluation of a physical activity integration program for mathematics in primary schools J. Phys. Act. Health 2016 13 198 206 10.1123/jpah.2015-0046 26107532 54. Miyake A. Friedman N.P. Emerson M.J. Witzki A.H. Howerter A. Wager T.D. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis Cogn. Psychol. 2000 41 49 100 10.1006/cogp.1999.0734 10945922 55. Schmidt M. Egger F. Benzing V. Jäger K. Conzelmann A. Roebers C.M. Pesce C. Disentangling the relationship between children’s motor ability, executive function and academic achievement PLoS ONE 2017 12 e0182845 10.1371/journal.pone.0182845 28817625 56. Diamond A. Executive functions Annu. Rev. Psychol. 2013 64 135 168 10.1146/annurev-psych-113011-143750 23020641 57. Diamond A. Lee K. Interventions shown to aid executive function development in children 4 to 12 years old Science 2011 333 959 964 10.1126/science.1204529 21852486 58. Anokye N.K. Trueman P. Green C. Physical activity and health related quality of life BMC Public Health 2012 12 624 10.1186/1471-2458-12-624 22871153 59. Bize R. Johnson J.A. Plotnikoff R.C. Physical activity level and health-related quality of life in the general adult population: A systematic review Prev. Med. 2007 45 401 415 10.1016/j.ypmed.2007.07.017 17707498 60. Vuillemin A. Boini S. Bertrais S. Tessier S. Oppert J.M. Hercber. S. Guillemin F. Briançon S. Leisure time physical activity and health-related quality of life Prev. Med. 2005 41 562 569 10.1016/j.ypmed.2005.01.006 15917053 61. Wendel-Vos G. Schuit A. Tijhuis. M. Kromhout D. Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations Qual. Life Res. 2004 13 667 677 10.1023/B:QURE.0000021313.51397.33 15130029 62. Warburton D.E. Charlesworth S. Ivey A. Nettlefold L. Bredin S.S. A systematic review of the evidence for Canada’s physical activity guidelines for adults Int. J. Behav. Nutr. Phys. Act. 2010 7 39 10.1186/1479-5868-7-39 20459783 63. Physical Activity Guidelines Advisory Committee (PAGAC) Physical Activity Guidelines Advisory Committee Report US Department of Health and Human Services Washington, DC, USA 2008 64. Cook I. Alberts M. Lambert E.V. Relationship between adiposity and pedometer-assessed ambulatory activity in adult, rural African women Int. J. Obes. 2008 32 1327 1330 10.1038/ijo.2008.26 65. Nocon M. Hiemann T. Müller-Riemenschneider F. Thalau F. Roll S. Willich S.N. Association of physical activity with all-cause and cardiovascular mortality: A systematic review and meta-analysis Eur. J. Cardiovasc. Prev. Rehabil. 2008 15 239 246 10.1097/HJR.0b013e3282f55e09 18525377 66. Sofi F. Capalbo A. Cesari F. Abbate R. Gensini G.F. Physical activity during leisure time and primary prevention of coronary heart disease: An updated meta-analysis of cohort studies Eur. J. Cardiovasc. Prev. Rehabil. 2008 15 247 257 10.1097/HJR.0b013e3282f232ac 18525378 67. Warburton D. Katzmarzyk P.T. Rhodes R.E. Shephard R.J. Evidence-informed physical activity guidelines for Canadian adults Can. J. Public Health 2007 98 S16 S68 18213940 68. Bauman A. Lewicka M. Schöppe S. The Health Benefits of Physical Activity in Developing Countries World Health Organization Geneva, Switzerland 2005 69. Steyn K. Sliwa K. Hawken S. Commerford P. Onen C. Damasceno A. Ounpuu S. Yusuf S. Risk factors associated with myocardial infarction in Africa: The INTERHEART Africa study Circulation 2005 112 3554 3561 10.1161/CIRCULATIONAHA.105.563452 16330696 70. Hertzog C. Kramer A.F. Wilson R.S. Lindenberger U. Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychol. Sci. Public Interest 2008 9 1 65 10.1111/j.1539-6053.2009.01034.x 26162004 71. Kramer A.F. Bherer L. Colcombe S.J. Dong W. Greenough W.T. Environmental influences on cognitive and brain plasticity during aging J. Gerontol. A Biol. Sci. Med. Sci. 2004 59 940 957 10.1093/gerona/59.9.M940 15472160 72. Soares-Miranda L. Siscovick D.S. Psaty B.M. Longstreth W.T. Mozaffarian D. Physical activity and risk of coronary heart disease and stroke in older adults. The Cardiovascular Health Study Circulation 2016 133 147 155 10.1161/CIRCULATIONAHA.115.018323 26538582 73. Lacey B. Golledge J. Yeap B.B. Lewington S. Norman P.E. Flicker L. Almeida O.P. Hankey G.J. Physical activity and vascular disease in a prospective cohort study of older men: The Health in Men Study (HIMS) BMC Geriatr. 2015 9 15 164 10.1186/s12877-015-0157-2 26652285 74. Almeida O.P. Khan K.M. Hankey G.J. Yeap B.B. Golledge J. Flicker L. 150 Minutes of vigorous physical activity per week predicts survival and successful aging: A population based 11-year longitudinal study of 12,201 older Australian men Br. J. Sports Med. 2014 48 220 225 10.1136/bjsports-2013-092814 24002240 75. Hamer M. de Oliveira C. Demakakos P. Non-exercise physical activity and survival Am. J. Prev. Med. 2014 47 452 460 10.1016/j.amepre.2014.05.044 25049216 76. Sofi F. Valecchi D. Bacci D. Abbate R. Gensini G.F. Casini A. Macchi C. Physical activity and risk of cognitive decline: A meta-analysis of prospective studies J. Intern. Med. 2011 269 107 117 10.1111/j.1365-2796.2010.02281.x 20831630 77. Laurin D. Verreauli R. Lindsay J. MacPherson K. Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons Arch. Neurol. 2001 58 498 504 10.1001/archneur.58.3.498 11255456 78. Varma V.R. Tan E.J. Wang T. Xue Q.L. Fried L.P. Seplaki C.L. King A.C. Seeman T.E. Rebok G.W. Carlson M.C. Low-intensity walking activity is associated with better health J. Appl. Gerontol. 2014 33 870 887 10.1177/0733464813512896 24652915 79. Loprinzi P.D. Brosky J.A. Objectively measured physical activity and balance among US adults J. Strength Cond. Res. 2014 28 2290 2298 10.1519/JSC.0000000000000402 24513627 80. Hillsdon M.M. Brunner E.J. Guralnik J.M. Marmot M.G. Prospective study of physical activity and physical function in early old age Am. J. Prev. Med. 2005 28 245 250 10.1016/j.amepre.2004.12.008 15766611 81. Mummery K. Schofield G. Caperchione C. Physical activity dose-response effects on mental health status in older adults Aust. N. Z. J. Public Health 2004 28 188 192 10.1111/j.1467-842X.2004.tb00934.x 15233360 82. Becofsky K. Baruth M. Wilcox S. Physical activity mediates the relationship between program participation and improved mental health in older adults Public Health 2016 132 64 71 10.1016/j.puhe.2015.07.040 26318601 83. Gebel K. Ding D. Chey T. Stanatakis E. Brown W.J. Bauman A.E. Effect of moderate to vigorous physical activity on all-cause mortality in -age and older Australians JAMA Intern. Med. 2015 175 970 977 10.1001/jamainternmed.2015.0541 25844882 84. Hupin D. Roche F. Gremeau V. Chatard J.C. Oriol M. Gaspoz J.M. Barthélémy J.C. Edouard P. Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged 60 years: A systematic review and meta-analysis Br. J. Sports Med. 2015 49 1262 1267 10.1136/bjsports-2014-094306 26238869 85. Nagai M. Kuriyama S. Kakizaki M. Ohmori-Matsuda K. Sone T. Hozawa A. Kawado M. Hashimoto S. Tsuji I. Impact of walking on life expectance and lifetime medical expenditure: The Ohsaki Cohort Study BMJ Open 2011 1 10.1136/bmjopen-2011-000240 86. Brown D.R. Carroll D.D. Workman L.M. Carlson S.A. Brown D.W. Physical activity and health-related quality of life: US adults with and without limitations Qual. Life Res. 2014 23 2673 2680 10.1007/s11136-014-0739-z 24952110 87. Heesch K.C. van Uffelen J.G. van Gellecum Y.R. Brown W.J. Dose-response relationships between physical activity, walking and health-related quality of life in mid-age and older women J. Epidemiol. Community Health 2012 66 670 677 10.1136/jech-2011-200850 22544920 88. Renaud M. Bherer L. Maquestiaux F. A high level of physical fitness is associated with more efficient response preparation in older adults J. Gerontol. B Psychol. Sci. Soc. Sci. 2010 65 317 322 10.1093/geronb/gbq004 89. Hillman C.H. Weiss E.P. Hagberg J.M. Hatfield B.D. The relationship of age and cardiovascular fitness to cognitive and motor processes Psychophysiology 2002 39 303 312 10.1017/S0048577201393058 12212649 90. Abourezk T. Toole T. Effect of task complexity on the relationship between physical fitness and reaction time in older women J. Aging Phys. Act. 1995 3 251 260 10.1123/japa.3.3.251 91. Clarkson-Smith L. Hartley A.A. Relationships between physical exercise and cognitive abilities in older adults Psychol. Aging 1989 4 183 189 10.1037/0882-7974.4.2.183 2789745 92. Spirduso W.W. Reaction and movement time as a function of age and physical activity level J. Gerontol. 1975 30 435 440 10.1093/geronj/30.4.435 1141674 93. Aichberger M.C. Busch M.A. Reischies F.M. Ströhle A. Heinz A. Rapp M.A. Effect of physical inactivity on cognitive performance after 2.5 years of follow-up: Longitudinal results from the survey of health, ageing, and retirement (SHARE) GeroPsych 2010 23 7 15 10.1024/1662-9647/a000003 94. Rikli R.E. Edwards D.J. Effects of a three-year exercise program on motor function and cognitive processing speed in older women Res. Q. Exerc. Sport 1991 62 61 67 10.1080/02701367.1991.10607519 2028094 95. Dustman R.E. Ruhling R.O. Russell E.M. Shearer D.E. Bonekat H.W. Shigeoka J.W. Wood J.S. Bradford D.C. Aerobic exercise training and improved neuropsychological function of older individuals Neurobiol. Aging 1984 5 35 42 10.1016/0197-4580(84)90083-6 6738784 96. Albinet C.T. Boucard G. Bouquet C.A. Audiffren M. Increased heart rate variability and executive performance after aerobic training in the elderly Eur. J. Appl. Physiol. 2010 109 617 624 10.1007/s00421-010-1393-y 20186426 97. Kramer A.F. Hahn S. Cohen N.J. Banich M.T. McAuley E. Harrison C.R. Chason J. Vakil E. Bardell L. Boileau R.A. Ageing, fitness and neurocognitive function Nature 1999 400 418 419 10.1038/22682 10440369 98. Almli C.R. Ball R.H. Wheeler M.E. Human fetal and neonatal movement patterns: Gender differences and fetal-to-neonatal continuity Dev. Psychobiol. 2001 38 252 273 10.1002/dev.1019 11319731 99. Campbell D.W. Eaton W.O. Sex differences in the activity level of infants Infant Child Dev. 1999 8 1 17 10.1002/(SICI)1522-7219(199903)8:1<1::AID-ICD186>3.0.CO;2-O 100. Goldberg S. Lewis M. Play behaviour in the year-old infant: Early sex differences Child Dev. 1969 40 21 31 10.2307/1127152 5787704 101. Hutt C. Sex differences in human development Hum. Dev. 1972 15 153 170 10.1159/000271239 5042947 102. Pate R.R. McIver K. Dowda M. Brown W.H. Addy C. Directly observed physical activity levels in preschool children J. Sch. Health 2008 78 438 444 10.1111/j.1746-1561.2008.00327.x 18651931 103. Trost S.G. Pate R. Sallis J.F. Freedson P.S. Taylor W.C. Dowda M. Sirard J. Age and gender differences in objectively measured physical activity in youth Med. Sci. Sports Exerc. 2002 34 350 355 10.1097/00005768-200202000-00025 11828247 104. Trost S.G. Owen N. Bauman A.E. Sallis J.F. Brown W. Correlates of adults’ participation in physical activity: Review and update Med. Sci. Sports Exerc. 2002 34 1996 2001 10.1097/00005768-200212000-00020 12471307 105. Yeats B. Women and Physical Activity Gender Impact Assessment 12 Women’s Health Victoria Melbourne, Australia 2010 106. Guthold R. Stevens G.A. Riley L.M. Bull F.C. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1·9 million participants Lancet Glob. Health 2018 6 e1077 e1086 10.1016/S2214-109X(18)30357-7 30193830 107. Rhodes R.E. Mark R.S. Temmel C.P. Adult sedentary behavior: A systematic review Am. J. Prev. Med. 2012 42 e3 e28 10.1016/j.amepre.2011.10.020 22341176 108. Chalabaev A. Sarrazin P. Fontayne P. Boiché J. Clément-Guillotin C. The influence of sex stereotypes and gender roles on participation and performance in sport and exercise: Review and future directions Psychol. Sport Exerc. 2013 14 136 144 10.1016/j.psychsport.2012.10.005 109. Edwards E. Sackett S. Psychosocial variables related to why women are less active than men and related health implications Clin. Med. Insights Women’s Health 2016 9 47 56 10.4137/CMWH.S34668 27398045 110. Bengoechea E.G. Spence J.C. McGannon K.R. Gender differences in perceived environmental correlates of physical activity Int. J. Behav. Nutr. Phys. Act. 2005 2 12 10.1186/1479-5868-2-12 16159404 111. Asztalos M. De Bourdeaudhuij I. Cardon G. The relationship between physical activity and mental health varies across activity intensity levels and dimensions of mental health among women and men Public Health Nutr. 2010 13 1207 1214 10.1017/S1368980009992825 20018121 112. Woodcock J. Franco O.H. Orsini N. Roberts I. Non-vigorous physical activity and all-cause mortality: Systematic review and meta-analysis of cohort studies Int. J. Epidemiol. 2011 40 121 138 10.1093/ije/dyq104 20630992 113. Tanasescu M. Leitzmann M.F. Rimm E.B. Hu F.B. Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes Circulation 2003 107 2435 2439 10.1161/01.CIR.0000066906.11109.1F 12719277 114. Tanasescu M. Leitzmann M.F. Rimm E.B. Willett W.C. Stampfer M.J. Hu F.B. Exercise type and intensity in relation to coronary heart disease in men JAMA 2002 288 1994 2000 10.1001/jama.288.16.1994 12387651 115. Sattelmair J. Pertman J. Ding E.L. Kohl H.W. Haskell W. Lee I.M. Dose response between physical activity and risk of coronary heart disease Circulation 2011 124 789 795 10.1161/CIRCULATIONAHA.110.010710 21810663 116. Bassuk S.S. Manson J.E. Physical activity and cardiovascular disease Nutr. Metab. Cardiovasc. Dis. 2010 20 467 473 10.1016/j.numecd.2009.12.015 20399084 117. Manson J.E. Greenland P. LaCroix A.Z. Stefanick M.L. Mouton C.P. Oberman A. Perri M.G. Sheps D.S. Pettinger M.B. Siscovick D.S. Walking compared with vigorous exercise for the prevention of cardiovascular events in women N. Engl. J. Med. 2002 347 716 724 10.1056/NEJMoa021067 12213942 118. Lee I.M. Rexrode K.M. Cook N.R. Manson J.E. Buring J.E. Physical activity and coronary heart disease in women: Is "no pain, no gain: Passe? JAMA 2001 285 1447 1454 10.1001/jama.285.11.1447 11255420 119. Hu F.B. Sigal R.J. Rich-Edwards J.W. Colditz G.A. Solomon C.G. Willett W.C. Speizer F.E. Manson J.E. Waking compared with vigorous physical activity and risk of type 2 diabetes in women JAMA 1999 282 1433 1439 10.1001/jama.282.15.1433 10535433 120. Friedenreich C.M. Neilson H.K. Lynch B.M. State of the epidemiological evidence on physical activity and cancer prevention Eur. J. Cancer 2010 46 2593 2604 10.1016/j.ejca.2010.07.028 20843488 121. Tiggemann M. Williamson S. The effect of exercise on body satisfaction and self-esteem as a function of gender and age Sex Roles 2000 43 119 127 10.1023/A:1007095830095 122. Lustyk M.K. Widman L. Paschane A.A. Olson K.C. Physical Activity and Quality of Life: Assessing the Influence of Activity Frequency, Intensity, Volume, and Motives Behav. Med. 2004 30 124 132 10.3200/BMED.30.3.124-132 15816315 123. Hu F.B. Physical activity, sedentary behaviors, and obesity Obesity Epidemiology Hu F.B. Oxford University Press New York, NY, USA 2008 301 319 124. Jaggers J.R. Hand G.A. Health benefits of exercise for people living with HIV: A review of the literature Am. J. Lifestyle Med. 2016 10 184 192 10.1177/1559827614538750 30202273 125. Lundgren J.D. Battegay M. Behrens G. De Wit S. Guaraldi G. Katlama C. Martinez E. Nair D. Powderly W.G. Reiss P. European AIDS clinical society (EACS) guidelines on the prevention and management of metabolic diseases in HIV HIV Med. 2008 9 72 81 10.1111/j.1468-1293.2007.00534.x 18257770 126. Friedenreich C.M. Physical activity and cancer prevention: From observational to intervention research. Cancer Epidemiol Biomark. Prev. 2001 10 287 301 127. Friedenreich C.M. Orenstein M.R. Physical activity and cancer prevention: Etiologic evidence and biological mechanisms J. Nutr. 2002 132 3456S 3464S 10.1093/jn/132.11.3456S 12421870 128. Tamakoshi K. Tokudome S. Kuriki K. Takekuma K. Toyoshima H. Epidemiology and primary prevention of colorectal cancer Gan To Kagaku Ryoho 2001 28 146 150 11242636 129. Thune I. Furberg A.S. Physical activity and cancer risk: Dose-response and cancer, all sites and site-specific Med. Sci. Sports Exerc. 2001 33 S530 S550 10.1097/00005768-200106001-00025 11427781 130. Shephard R.J. Exercise in the prevention and treatment of cancer. An update Sports Med. 1993 15 258 280 10.2165/00007256-199315040-00004 8460289 131. Shephard R.J. Physical activity and cancer Int. J. Sports Med. 1990 11 413 420 10.1055/s-2007-1024830 2286478 132. Moore S.C. Gierach G.L. Schatzkin A. Matthews C.E. Physical activity, sedentary behaviours, and the prevention of endometrial cancer Br. J. Cancer 2010 103 933 938 10.1038/sj.bjc.6605902 20877336 133. Hackam D.G. Spence J.D. Combining multiple approaches for the secondary prevention of vascular events after stroke: A quantitative modeling study Stroke 2007 38 1881 1885 10.1161/STROKEAHA.106.475525 17431209 134. Sluik D. Buijsse B. Muckelbauer R. Kaaks R. Teucher B. Tj A. Overvad K. Amiano P. Ardanaz E. Bendinelli B. Physical activity and mortality in individuals with diabetes mellitus: A prospective study and meta-analysis Arch. Intern. Med. 2012 172 1285 1295 10.1001/archinternmed.2012.3130 22868663 135. Garber C.E. Blissmer B. Deschenes M.R. Franklin B.A. Lamonte M.J. Lee I.M. Nieman D.C. Swain D.P. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise Med. Sci. Sports Exerc. 2011 43 1334 1359 21694556 136. Mikkelsen K. Stojanovska L. Polenakovic M. Bosevski M. Apostolopoulos V. Exercise and mental health Maturitas 2017 106 48 56 10.1016/j.maturitas.2017.09.003 29150166 137. Asmundson G.J. Fetzner M.G. DeBoer L.B. Powers M.B. Otto M.W. Smits J.A. Let’s get physical: A contemporary review of the anxiolytic effects of exercise for anxiety and its disorders Depress. Anxiety 2013 30 362 373 10.1002/da.22043 23300122 138. Warburton D.E. Bredin S.S. Health benefits of physical activity: A systematic review of current systematic reviews Curr. Opin. Cardiol. 2017 32 541 556 10.1097/HCO.0000000000000437 28708630 139. Helgadóttir B. Forsell Y. Ekblom Ö. Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: A cross-sectional study PLoS ONE 2015 10 e0115894 10.1371/journal.pone.0115894 25585123 140. LeBouthillier D.M. Asmundson G.J. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial J. Anxiety Disord. 2017 52 43 52 10.1016/j.janxdis.2017.09.005 29049901 141. Hallgren M. Herring M.P. Owen N. Dunstan D. Ekblom Ö. Helgadottir B. Nakitanda O.A. Forsell Y. Exercise, physical activity, and sedentary behavior in the treatment of depression: Broadening the scientific perspectives and clinical opportunities Front. Psychiatry 2016 7 36 10.3389/fpsyt.2016.00036 27014101 142. Abu-Omar K. Rutten A. Robine J.M. Self-rated health and physical activity in the European Union Soz. Prav. 2004 49 235 242 10.1007/s00038-004-3107-x 143. Manderbacka K. Examining what self-rated health question is understood to mean by respondents Scand. J. Soc. Med. 1998 26 145 153 10.1177/14034948980260020301 9658515 144. Noordstar J.J. Van der Net J. Jak S. Helders P.J. Jongmans M.J. Global self-esteem, perceived athletic competence, and physical activity in children: A longitudinal cohort study Psychol. Sport Exerc. 2016 22 83 90 10.1016/j.psychsport.2015.06.009 145. Gruber J. Physical activity and self-esteem development in children: A meta-analysis Effects of Physical Activity on Children Stull G. Eckern H. Human Kinetics Champaign, IL, USA 1986 330 348 146. Alfermann D. Stoll O. Effects of physical exercise on self-concept and well-being Int. J. Sport Psychol. 2000 31 47 65 147. Guinn B. Semper T. Jorgensen L. Mexican American female adolescent self-esteem: The effect of body image, exercise behaviour and body fatness Hispanic J. Behav. Sci. 1997 19 517 526 10.1177/07399863970194009 148. Calfas K.J. Taylor W.C. Effects of physical activity on psychological variables in adolescents Pediatric Exerc. Sci. 1994 6 406 423 10.1123/pes.6.4.406 149. Sonstroem R.J. Harlow L.L. Josephs L. Exercise and self-esteem: Validity of model expansion and exercise associations J. Sport Exerc. Psychol. 1994 16 29 42 10.1123/jsep.16.1.29 150. Barton J. Griffin M. Pretty J. Exercise-, nature-and socially interactive-based initiatives improve mood and self-esteem in the clinical population Perspect Public Health 2012 132 89 96 10.1177/1757913910393862 22616429 151. Legrand F.D. Effects of exercise on physical self-concept, global self-esteem, and depression in women of low socioeconomic status with elevated depressive symptoms J. Sport Exerc. 2014 36 357 365 10.1123/jsep.2013-0253 152. Cañabate D. Martínez G. Rodríguez D. Colomer J. Analysing Emotions and Social Skills in Physical Education Sustainability 2018 10 1585 10.3390/su10051585 153. Melzer D. Lan T.Y. Guralnik J.M. The predictive validity for mortality of the index of mobility-related limitation–Results from the EPESE Study Age Ageing 2003 32 619 625 10.1093/ageing/afg107 14600003 154. Verbrugge L.M. Jette A.M. The disablement process Soc. Sci. Med. 1994 38 1 14 10.1016/0277-9536(94)90294-1 8146699 155. Peeters G. Lips P. Brown W.J. Changes in physical functioning over 6 years in older women: Effects of sitting time and physical activity Eur. J. Ageing 2014 11 205 212 10.1007/s10433-013-0300-x 28804326 156. Gorman B.K. Read J.G. Gender disparities in adult health: An examination of three measures of morbidity J. Health Soc. Behav. 2006 47 95 110 10.1177/002214650604700201 16821505 157. Montez J.K. The socioeconomic origins of physical functioning among older U.S. adults Adv. Life Course Res. 2013 18 244 256 10.1016/j.alcr.2013.08.001 24796709 158. Meader N. King K. Moe-Byrne T. Wright K. Graham H. Petticrew M. Power C. White M. Sowden A.J. A systematic review on the clustering and co-occurrence of multiple risk behaviours BMC Public Health 2016 16 657 10.1186/s12889-016-3373-6 27473458 159. Hurst L. Stafford M. Cooper R. Hardy R. Richards M. Kuh D. Lifetime socioeconomic inequalities in physical and cognitive aging Am. J. Public Health 2013 103 1641 1648 10.2105/AJPH.2013.301240 23865666 160. Feng X. Astell-Burt T. Neighborhood socioeconomic circumstances and the co-occurrence of unhealthy lifestyles: Evidence from 206,457 Australians in the 45 and up study PLoS ONE 2013 8 e72643 10.1371/journal.pone.0072643 23977335 161. Strand B.H. Cooper R. Hardy R. Kuh D. Guralnik J. Lifelong socioeconomic position and physical performance in midlife: Results from the British 1946 birth cohort Eur. J. Epidemiol. 2011 26 475 483 10.1007/s10654-011-9562-9 21416275 162. Broese van Groenou M.I. Deeg D.J. Penninx B.W. Income differentials in functional disability in old age: Relative risks of onset, recovery, decline, attrition and mortality Aging Clin. Exp. Res. 2003 15 174 183 10.1007/BF03324497 12889850 163. Freedman V.A. Martin L.G. Schoeni R.F. Cornman J.C. Declines in late-life disability: The role of early- and mid-life factors Soc. Sci. Med. 2008 66 1588 1602 10.1016/j.socscimed.2007.11.037 18222580 164. Bernaards C.M. Twisk J.W. Van Mechelen W. Snel J. Kemper H.C. A longitudinal study on smoking in relationship to fitness and heart rate response Med. Sci. Sports Exerc. 2003 35 793 800 10.1249/01.MSS.0000064955.31005.E0 12750589 165. Leyk D. Ruther T. Witzki A. Sievert A. Moedl A. Blettner M. Hackfort D. Löllgen H. Physical fitness, weight, smoking, and exercise patterns in young adults Dtsch. Arztebl. Int. 2012 109 737 745 10.3238/arztebl.2012.0737 23189107 166. Rapuri P.B. Gallagher J.C. Smith L.M. Smoking is a risk factor for decreased physical performance in elderly women J. Gerontol. A Biol. Sci. Med. Sci. 2007 62 93 100 10.1093/gerona/62.1.93 17301045 167. Strand B.H. Mishra G. Kuh D. Guralnik J.M. Patel K.V. Smoking history and physical performance in midlife: Results from the British 1946 birth cohort J. Gerontol. A Biol. Sci. Med. Sci. 2011 66 142 149 10.1093/gerona/glq199 21071620 168. Maraldi C. Harris T.B. Newman A.B. Kritchevsky S.B. Pahor M. Koster A. Satterfield S. Ayonayon H.N. Fellin R. Volpato S. Moderate alcohol intake and risk of functional decline: The health, aging, and body composition study J. Am. Geriatr. Soc. 2009 57 1767 1775 10.1111/j.1532-5415.2009.02479.x 19737328 169. O’Keefe J.H. Bhatti S.K. Bajwa A. DiNicolantonio J.J. Lavie C.J. Alcohol and cardiovascular health: The dose makes the poison…or the remedy Mayo Clin. Proc. 2014 89 382 393 10.1016/j.mayocp.2013.11.005 24582196 170. Lafortune L. Martin S. Kelly S. Kuhn I. Remes O. Cowan A. Brayne C. Behavioural risk factors in mid-life associated with successful ageing, disability, dementia and frailty in later life: A rapid systematic review PLoS ONE 2016 11 e0144405 10.1371/journal.pone.0144405 26845035