Why you should exercise even more

More than half of the Dutch lead mainly sedentary lives and do not reach the nationally set exercise norm. This has negative consequences for body and mind. Get moving (more often) to benefit now, but also later.

We have tulips, we have windmills, we have syrup waffles and we have the Dutch exercise norm. Way back in the 1990s, when we in the Netherlands were still laughing out loud at Jim Carrey going running in a sports outfit on a treadmill in his garage in The Truman Show (the idea alone, why on earth would you do that?), the idea for this directive was conceived by a concerned government. Technology was embraced at an increasingly rapid pace; sedentary work seemed to become the new norm among Dutch people. The spectre of an obesity epidemic, already in full swing in the aforementioned America at the time, was never far away, so there had to be something that encouraged people to get out of their chairs to move more: a kind of compass for a more active life.

A standard

Scientists, health experts and policymakers joined forces and began researching and consulting. Their goal? To set a norm that would not only tell us how much exercise we need on a daily basis, but also inspire and motivate us to actually take the first step. In 1998, the Dutch Exercise Standard saw the light of day, initially advising at least 30 minutes of moderate-intensity continuous exercise daily. In 2008 this was changed to 150 minutes a week, based on the idea that for many people it is difficult to cycle, jog or, say, work out for half an hour every day. Because 150 minutes of exercise also provides considerable health benefits and is more feasible, the first adaptation of the Exercise Standard was a fact.

Cardio versus strength

In 2011, several health organisations, including the World Health Organisation (WHO), advocated including bone and muscle-strengthening exercises in the exercise norm of various countries. Until now, our so-called compass for a more active life was limited to cardiovascular activities, i.e. activities that make your heart beat faster. It has long been thought that cardio training was superior to strength training in terms of promoting your health. A myth perpetuated by the general association of cardio with improving stamina and burning - a lot of - calories. However, strength training, more and more studies have shown, has yet another very different and at least as important impact on your overall health.

Energetic and resilient

Therefore, it is that the current Dutch Movement Standard encourages not only 150 minutes a week of moderate-intensity physical activity, but also at least twice a week of muscle- and bone-strengthening activities. If you are over 65, it is additionally recommended to do balance exercises a few times a week - standing on one leg, walking in a straight line while placing the heel of one foot in front of the toe of the other - to reduce the risk of falling. Sounds simple and doable, this invitation to a lifestyle that ensures an energetic and resilient body. Nevertheless, in practice, it turns out to be disappointing, because according to the most recent official figures, the Dutch still move too little on average: only 47 per cent of adults meet the exercise guidelines. In 2020, it was 52.7 per cent, so we see a downward trend there.

Exercise poverty

Figures and studies show a global trend towards a more sedentary lifestyle, meaning we move less and less and sit more and more. At work, in our leisure time. "Since the industrial revolution, we have started spending more and more time in offices and behind computer screens," says Luc van Loon, professor of physiology of exertion at Maastricht University's Department of Human Biology. "We no longer need to hunt or flee from wild animals, which has led to so much less exercise. If you have to name one characteristic of our current society, it is exercise poverty. There are attempts to use sports and exercise as ways to counter that, but the question is whether you can compensate for a sedentary lifestyle by exercising for an hour three times a week."

'Organ crosstalk'

If you exercise little, you develop anabolic resistance," says Van Loon. "That means your muscles stop responding as well to the stimuli of training and growth, leading to reduced growth and decrease in muscle fibre size," Van Loon says. "The quality and quantity of your muscles gets worse, which reduces your ability to generate strength and move smoothly. We also now know that muscles release substances during movement that have those positive effects on organ systems. It sounds a bit crazy, but organs 'talk' to each other through the substances they get from muscles. We call this 'organ crosstalk'. The more substances organs get the better the conversations and thus the cooperation. Other tissues in our body also benefit from the substances released in the muscles when you move. If you don't move, these substances are not secreted and you don't have these benefits."

Overfilled fat cells

It is known that people who sit a lot and exercise little often have excess energy intake and thus an increased risk of obesity. "If you eat too much and you don't burn it, your body is going to store the excess energy as fat," says Van Loon. "Initially, this will happen in your fat cells, but at some point they become overcrowded. When that happens, your body starts collecting and parking the fat in other places. Initially in your muscles, a storage place that is larger in athletes than in people who don't exercise much. This is useful, because the energy from that fat can be put to good use during intensive exercise. The situation is different in people who do not exercise much, because in them the fat accumulates in the muscles without being regularly used as a source of energy. The same happens over time in the liver, heart and organs in the abdominal cavity."

These are places where you don't want fat, because accumulations of fat in these organs can lead to serious health problems. Van Loon: "Fat that accumulates in muscles can lead to insulin resistance, which means the cells no longer respond properly to insulin. That can lead to type 2 diabetes. Fat in your heart can lead to inflammation, fibrosis and disturbances in heart function and the development of heart disease. Liver fattening is also dangerous as it can result in inflammation, scarring and eventually even liver cirrhosis. Little exercise also increases a risk of many other diseases and conditions, such as high blood pressure, elevated cholesterol levels, cardiovascular disease and various types of cancer, such as breast and colon cancer."

Stress is necessary

Another concern is that you need exercise to maintain your muscles and bones. "The protein that makes up your muscles, bones and other tissues in your body is constantly being made and broken down," van Loon explains. "This happens under the influence of diet, as well as exercise. For your bones and muscles to maintain the same quality, they need load. Especially because as you get older, the breakdown seems to slowly win out over production. So you then need more exercise to maintain the same amount of muscle and bone. If this does not happen, for instance because you are bedridden or mainly sit due to illness, your bones and muscles become thinner and more brittle. This eventually results in reduced muscle strength and osteoporosis, making you more prone to falls and (bone) fractures." 

Research is currently conducted on professional cyclists. Van Loon: "They eat relatively little - compared to their high energy requirements - because it is beneficial for their performance to keep their body weight as low as possible. At the same time, they use a lot of energy, because they are on the bike for hours every day. You would think that they would then still have strong bones, because they move a huge amount. But because the bicycle carries their weight, there is little strain on their bones. As a result, they often have very brittle bones, which is not nice when they fall off their bikes. Within their training schedule, bone and muscle strengthening exercises are therefore increasingly integrated, which we also see in the renewed Exercise Standard. Swimming does not fit in there, but rope skipping, for example, works very well. As does running or exercises where you use your own body weight."

More mentally resilient

Besides for your body, exercise is also much needed for your mind. "Exercise is increasingly used as a treatment for people with depression," says Van Loon. "We also know that exercise helps make people more mentally resilient. This is due to the signalling substances released when you exercise, such as endorphins, serotonin, dopamine and adrenaline. These 'happy substances' have a positive effect on your mood. Also, exercise distracts, you can do it together and ... it has hardly any side effects, except maybe some muscle pain."

In addition, according to Van Loon, there is evidence that physical activity plays a role in preventing and treating diseases at the brain level. For example, a lot of research has been done on the link between exercise and dementia. During a study in Groningen, one group of elderly people with dementia went for half an hour's walk four times a week, another group received social visits a few times a week, the last group went for half an hour's walk twice a week ánd did half an hour's muscle-strengthening exercises twice a week. After nine weeks, the group that had to make do with social visits appeared to have fallen behind, while the walking group had made a little progress. The group of elderly people who did both walking and strength training improved considerably in terms of thinking, memory and physical fitness.

A fit brain

Research into the link between exercise and brain function is still in its infancy, but it is known that your brain produces a stimulating substance when you exercise brain-derived neurotrophic factor, or BDNF. BDNF ensures that existing connections between cells become stronger and that new connections between cells are formed. If you do not move or move little, the networks of cells will eventually deteriorate. Everyone loses brain connections as we age. If you do not compensate for this by moving enough, the networks will become weaker. This makes it harder and harder to move smoothly, but also makes it harder to think well, quickly and efficiently. Therefore, it is a trade-off: you keep your brain fit by moving and you can move because your brain is in shape. In other words, exercise should be for the preservation of both body and mind, but what is the best form of exercise? Should we all start running marathons?

Hit the strength room every day? Or is 'just' walking good enough too? "You have in your muscles type 1 and type 2 fibres, the so-called red and white fibres," Van Loon explains. "You can think of the type 1 fibres as marathon fibres: they can burn fat well and have great endurance capacity. The type 2 fibres are the bodybuild fibres: they use much less oxygen and fat and you can use them to generate a lot of power quickly and for short periods of time."

Type 2 fibres

It is these fast, strong and thick type 2 fibres in particular that diminish greatly in size with age and under the influence of bed rest. Van Loon: "If you want to grow old healthily, it is therefore important to maintain precisely these type 2 fibres. You don't do that by leisurely walking the dog or cycling, but with short, intensive exercise: jumping, climbing stairs ánd strength training." For those who now think you can't do strength training without a gym membership, or need a home gym with at least a dumbbell bench, a set of dumbbells and a barbell: you don't have to make it that difficult for yourself at all. Strength training means training with resistance. You can do this with weights, but also with a bottle of water or your own body weight, such as push-ups, squats and plank exercises.

Exercise in different ways

"If you have little time, High Intensity Interval Training (HITT) is a good idea," Van Loon advises. "This is thought to get you to a certain level faster, but the best tip is: do a bit of everything. Work on your fitness, coordination, strength and balance, for example by alternating jogging and fitness with yoga and occasionally brushing your teeth on one leg. When you alternate different ways of moving, you work on your whole body rather than one specific part. That is the best thing you can do for your health. I also know people who say: I don't exercise, but they cycle ten kilometers to and from work every day, for example. Or they are busy every day gardening, walking the dog and remodeling their house. That's fine too. If you are doing something you can sustain, you are already a long way on the right track."

Why you should exercise even more Read the article in Dutch here Waarom je nog meer moet bewegen - Santé (sante.nl)

Interview Luc van Loo