Why is exercise your strongest “medicine”?
If I told you there was a tablet that measurably reduced the risk of cardiovascular disease, type 2 diabetes, several types of cancer and depression, improved sleep, maintained your bones and joints, and also calmed chronic inflammation, you would probably want to take it.
Well... such a “miracle tablet” really does exist: it is called regular physical activity.
There is just one catch: you do not swallow it, you have to do it – and that is tiring. That is precisely why it is missing from most people's lives and treatment plans.
This article shows the same coin from two sides: what regular exercise gives you – and what happens in your body when it is missing. The latter is rarely stated so bluntly: lack of movement is not a neutral state (not rest), but active deterioration.
Key point
The WHO recommendation for adults is 150–300 minutes of moderate-intensity physical activity per week (or 75–150 minutes of vigorous activity), PLUS at least two muscle-strengthening sessions per week – and this amount also applies in older age and alongside chronic disease, adapted to individual abilities.1 The most important principle is that some movement is always better than none, and it is never too late to start.
What does regular exercise give you?
| Area | What do you experience? |
|---|---|
| Heart and circulation | Lower blood pressure and resting heart rate, better exercise tolerance, lower risk of heart attack and stroke |
| Metabolism | Better insulin sensitivity, easier weight control, lower risk of diabetes |
| Chronic inflammation | Working muscle produces inflammation-calming substances, while shrinking visceral fat produces fewer inflammatory substances3 |
| Mental health | Measurably less anxiety and low mood – an effect comparable to that of treatments4 |
| Bones, muscles and joints | Preserved muscle mass and bone density, more stable joints, lower risk of falls and fractures in older age |
| Sleep | Falling asleep faster, deeper and more restorative sleep |
And here is a connection I explained in detail in the article on chronic inflammation: exercise is one of the four inflammation-calming pillars of lifestyle, alongside diet, stress management and sleep.
What happens in your body?
Working muscle does more than mechanical work: it releases hormone-like messenger substances, called myokines, into the circulation. One of these is IL-6, which has a curious double life: chronically high levels signal silent inflammation, but when released from muscle during exercise, it starts an inflammation-calming chain reaction. This “IL-6 paradox” explains why every workout provides a dose of natural anti-inflammatory action – and in the long term, regular exercise also reduces abdominal fat, one of the main producers of inflammatory substances.3
Lack of movement is not “zero”, but a minus. Unused muscle breaks down at an alarming rate – with complete unloading (a cast or bed rest), measurable muscle loss becomes visible within just 2–3 weeks. Connective tissues stiffen, joint range of motion narrows, circulation slows, fluid stagnates in the limbs, bones become thinner, and metabolism shifts towards insulin resistance. That is why I tell every patient: after illness and surgery, rest only as much as your doctor prescribes – complete immobility is itself harmful.
It may be surprising, but it is true: hours spent sitting are an independent risk factor – even if you exercise otherwise. According to an analysis combining data from more than one million people, prolonged sitting increases the risk of death, but around 60–75 minutes of moderate activity a day largely neutralised this additional risk.2 The practical lesson is twofold: get enough exercise, AND break up sitting – stand up for a few minutes every hour, even if you exercised that day.
How much is enough – and what type of exercise?
The WHO recommendation can be summarised simply: 150–300 minutes of moderate-intensity aerobic activity per week (brisk walking, cycling, swimming – at a pace where you can still talk but can no longer sing), or half as much vigorous activity, plus muscle-strengthening exercise at least twice a week (bodyweight exercises, resistance bands, weights). For children, the target is 60 minutes a day; in older age and alongside chronic disease, the same principles apply, adapted to individual abilities – and research is clear here too: some movement is always better than none.1
Aerobic exercise supports the cardiovascular system, endurance and inflammatory balance. Strength training is not optional after the age of 40: from then on, muscle mass decreases year by year on its own, and muscle is not just about strength but also a metabolic organ – one of the biggest users of blood glucose and a producer of myokines. Stretching and mobility protect joint range of motion and posture – a few minutes a day is enough.
My advice for getting started
Do not start with a training plan, start by building a habit. First month: 10–15 minutes of brisk walking every day, at a fixed time – that is all, nothing more. Once you have established that, increase it: longer walks, then two short bodyweight strength circuits at home each week. The goal is not a perfect programme, but still doing it six months from now. “Give it everything” January starts die out in February; a modest but sustainable amount can last for years – and the years are what count.
What if you currently cannot exercise?
After surgery, injury or illness comes the difficult period: you want to move, but you must not, or you cannot. I have two messages for this situation. First: “rest” almost never means complete immobility – ask your doctor what is allowed, and do it, because the breakdown processes described above start within weeks. Second: muscle stimulation (EMS) may help passively work muscles that cannot be used – the electrical impulse contracts the muscle even when you cannot. I wrote about how this works in the article on neuromuscular stimulation; you can find the devices in the muscle stimulator category. Even then, EMS is not a substitute for exercise, but a bridge – as soon as possible, active movement should take centre stage.
When should you seek medical clearance first?
If you have known heart disease; if you have experienced chest pain, unusual shortness of breath, dizziness or fainting on exertion; if you live with untreated high blood pressure or diabetes; or if you are over 40 and want to start intensive exercise after decades without it – speak to your doctor first and start gradually. Moderate activity (walking, easy cycling) is safe for most people without prior clearance – if in doubt, start with this and consult your doctor along the way.
Frequently asked questions
Yes. Research and the WHO recommendation send the same clear message: there is no minimum “entry threshold”; every minute of movement is better than none, and health benefits begin even with small amounts. Ten minutes of brisk walking a day adds up to 70 minutes a week – half of the recommendation is already covered. Start where your life allows, and increase it when you can.
The one you keep doing in the long term. Research has not identified one clear winner – consistency beats the method. The complete package requires aerobic activity AND two strength sessions a week; within that, choose what you enjoy: if you hate running, walk, swim, dance or garden.
Yes – in fact, the WHO recommendation specifically highlights regular physical activity as fundamental for older people and those living with chronic disease, adapted to individual condition. In older age, strength and balance exercises deserve special emphasis because they are the most effective tools for preventing falls. With chronic disease, starting in consultation with your doctor is the rule – exercise is part of treatment, not a risk.
It is better than nothing – concentrating the weekly amount at the weekend still brings health benefits. But sitting is a separate issue: long, uninterrupted sitting increases risk even if you exercise at the weekend. The answer is therefore twofold: keep your weekend sport, AND stand up for a few minutes every hour on weekdays and take short walks – together, these provide the protection.
No. EMS works the muscles, but most cardiovascular, metabolic and mental benefits are linked to active, whole-body movement. Muscle stimulation is valuable in two situations: when you temporarily cannot move (after injury or surgery, during immobilisation), and when a weakened muscle group needs targeted work during rehabilitation. It is an adjunct – not a replacement.
What does the research say?
“How much should I exercise according to science?”
The WHO formulated its recommendation based on the full body of available evidence: adults should do 150–300 minutes of moderate-intensity activity and two muscle-strengthening sessions per week – extended to all age groups, from pregnant women to older people and those living with chronic disease. Its two most important messages are that some movement is always better than none, and that time spent sitting should be reduced in its own right.1
“Can a whole day of sitting be worked off?”
To a large extent, yes – but only with a substantial amount of activity. An analysis combining data from more than one million people found that sitting for 8+ hours a day substantially increased the risk of death compared with active people who sat little – but among those doing around 60–75 minutes of moderate activity a day, the additional risk from prolonged sitting virtually disappeared. Long hours in front of the television proved more persistent: there, risk was only reduced even among the most active people.2
“Does exercise really help my mind too?”
Measurably. A combined analysis of more than one thousand studies found that regular physical activity produces moderate, consistent improvements in anxiety and low mood – in healthy people and those with chronic disease alike – and that the effect size is comparable to established treatments. The researchers concluded that exercise should also be a cornerstone in the treatment of mental health complaints.4
Summary – Quick overview
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Scientific sources
- Bull FC, Al-Ansari SS, Biddle S, et al. (2020).World Health Organization 2020 guidelines on physical activity and sedentary behaviour.British Journal of Sports Medicine, 54(24), 1451–1462.DOI: 10.1136/bjsports-2020-102955
- Ekelund U, Steene-Johannessen J, Brown WJ, et al. (2016).Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women.The Lancet, 388(10051), 1302–1310.DOI: 10.1016/S0140-6736(16)30370-1
- Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA (2011).The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease.Nature Reviews Immunology, 11(9), 607–615.DOI: 10.1038/nri3041
- Singh B, Olds T, Curtis R, et al. (2023).Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews.British Journal of Sports Medicine, 57(18), 1203–1209.DOI: 10.1136/bjsports-2022-106195
