Roll out of bed, mozy on into the kitchen, get a cup of coffee, park myself on the couch, and proceed to barely move for the rest of the day.

Essentially the standard course of my current life.

There’s going to be intermittent breaks to eat, play with my daughter, go to the bathroom, but outside of that, not a ton happening. Relegated to not leaving the house, I’ve found my mood change, my focus change, my physical activity change.

Pre-quarantine you’d be hard pressed to see a day where I didn’t leave the house. Whether going out to work with patients or clients, running errands, doing activities with my daughter & wife, or getting a workout in, I was not laying around for much of the day.

This change in lifestyle has definitely taken its toll on my physique; usually I feel on the fitter side of things, whereas now I’ve started to feel puffy and chubby.

Being the guy who gets a sheet cake at Costco to just have around for a snack because I normally burn enough calories moving & training, isn’t very conducive to chillaxing all day.

Before this last week, I could have easily gone the whole day with under a thousand steps, but after implementing the changes that I mentioned last week I’ve increased them back up and found myself more consistent with training.

These things were a game changer for me and I’ve noticed not only an improvement in my physique, but a change in a lot of other things, such as my anxiety, mood, and sleep.

Physical activity – not just “working out” but the entire spectrum of being physically active – has a ton of benefits that span across much more than just having washboard abs or toned triceps.

Most of the time people really focus on the aesthetic side of things; I get it, our external appearance is pretty impactful on how we are viewed by others, but how we actually feel has arguably a bigger impact on our lives.

Through physical activity we challenge just about every major system in our body (such as our cardiovascular and respiratory systems) to work more effectively. Physical activity has been shown to be an effective intervention for a wide range of chronic disease, improving the health of the person overall.

With quarantine, we take away most people’s average forms of physical activity: gyms to lift weights in, roads & tracks to run on, parks to walk in, and much more. By losing out on your standard option to exercise, it can be very challenging for people. Most of our research on exercise adherence indicates that the more blocks in the way for someone to do their preferred form of activity, the less likely they are to do them.

I was struggling with this and took a few steps to get back in my groove, which has admittedly been challenging, not feeling quite like what I would hope for, and not a real replacement for my usual training – but has a been a huge step in the right direction.

Being physically active during quarantine is a very important thing. Normally being active is pretty damn important – as I outlined above, it’s got tons of benefits – but during this time it’s arguably more important.

A recent study from Jimenez-Pavon 2020 discusses how people in quarantine often struggle with significant mental challenges and progressive deconditioning. These things can compound and lead to serious health complications and possibly severe mental health issues.

Physical exercise may not jump to people’s minds as an intervention for this, but it provides a plethora of benefits that can help mitigate these things.

Firstly, it helps in keeping people busy. Boredom leads to restlessness, which can lead to anxiety and many more problems. Working out gives you something positive to do which can combat this and give you the feeling of increased control.

Secondly, it fights deconditioning and progressive health loss. Whether or not you think you’re at risk of getting sick from the Corona Virus, being deconditioned and generally more frail puts you at risk of tons of other health issues.

If we look at the research on bed rest, it highlights the changes in our functioning when we have a drastic reduction in physical activity.

*Before we get into the effects we see with bed rest, this is extrapolated data, but it holds some merit.

Mental health

Physical activity has been associated with a range of different factors for mental health. There is growing research showing how physical activity can be very beneficial for managing depression, anxiety, and other similar conditions. One reason for this is likely the affect physical activity has on our neurotransmitters – such as dopamine and serotonin (which regulate our mood).

It’s been found that with reduced physical activity there is a reduction in dopamine and serotonin, which can impact our mood and cognition. It’s common to see people become more restlessness, more likely to experience insomnia, and possibly have more aggression/agitation. When people are forced into bedrest, these people often have increased anxiety and depression.

Hormonal effects

Most people know that being physically active encourages muscle mass to either build or maintain. The reason for this is multifactorial and there are a range of things like mechanical tension driving for mTOR signaling, but there is also other factors like impacting the production of cortisol.

Cortisol is a hormone that is produced in your adrenal glands and is highly associated with our current stress state. It impacts what substrates our body uses (such as carbs, fats or protein), impacts inflammation, and affects our retention of muscle mass.

When we are confined to bed rest, there is a large increase in cortisol levels. It’s believed that this increased level is one major contributor to the reduced muscle mass we see with bed rest.

Our metabolism is driven through movement. Low level movement, often attributed as NEAT, has a huge impact on our metabolic rate. It does this through the general act of moving, through retention of muscle mass, through hormone responses like for that of cortisol, but also for thyroid hormones. We start to see a change in metabolic rate with as little as 10 hours of immobility.

Collectively this can start a vicious cycle where we are inactive, our metabolism drops, it causes muscle loss, our metabolism drops further, we continue to be inactive, and repeats. For anyone who has seen the research on longer term bed rest, or looking at what happens to astronauts after space ventures, our bodies can have severe adaptations to prolonged bouts of reduced challenge.

Motility

No, not mobility – motility, particularly bowel motility. We see with decreased physical activity there is a reduced amount of motion occurring within the bowels, and with less peristalsis we are at more risk of constipation. As we move around, it encourages abdominal motion, which impacts the movement of our bowel content. So less physical activity, less bowel movement (as a general rule).

Gastric Reflux

Spending more time laying on your back increases the time it takes for food to pass through your digestive system. This combined with the reclined position increasing the gastric fluid pushing back up increases your likelihood of having some kind of reflux.

These issues are not something we should down play. For the majority of the people in the world, we are looking at this quarantine lasting quite a while and these things are likely to start popping up in people who were relatively healthy prior. Finding some strategies to maintain your health is critical.

In our next blog we are going to tackle some of the research on that – how to be active, how much you need to do to maintain, and more.

Stay healthy everybody!

References:

Jimenez-Pavon D, et al. Physical exercise as a therapy to fight against the mental and physical consequences of COVID-19 quarantine: special focus in older people. Prog Cardiovasc Dis. 2020. doi:10.1016/j.pcad.2020.03.009.

Kortebein P, et al. Functional impact of 10 days of bed rest in healthy older adults. Journal of gerontology: Medical sciences. 2008;64A(10):1076-1081.

Fitts RH, et al. The deleterious effects of bed rest on human skeletal muscle fibers are exacerbated by hypercortisolemia and ameliorated by dietary supplementation. American Journal Of Physiology, Cell Physiology. 2007;293(1):C313-320.

Kramer A, et al. How to prevent the detrimental effects of two months of bed-rest on muscle, bone and cardiovascular system: an RCT. Scientific Reports. 2017;7:13177.

Stubbs RJ, et al. A decrease in physical activity affects appetite, energy, and nutrient balance in lean men feeding ad libitum. American Journal of Clinical Nutrition. 2004;79(1):62-69.

Corcoran PJ. Use it or lose it – the hazards of bedrest and inactivity. Western Journal of medicine. 1991;154(5):536-538.