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VOLUME 54 , ISSUE 4 ( October-December, 2020 ) > List of Articles

REVIEW ARTICLE

Exercise as Medicine—Evidence for Prescribing Exercise for the National Health Priority Areas: An Umbrella Review

Philippa J Inge, Nirmala KP Perera, John W Orchard, Leigh Golding

Keywords : Exercise, National health priority areas, Physical activity, Review

Citation Information : Inge PJ, Perera NK, Orchard JW, Golding L. Exercise as Medicine—Evidence for Prescribing Exercise for the National Health Priority Areas: An Umbrella Review. J Postgrad Med Edu Res 2020; 54 (4):178-205.

DOI: 10.5005/jp-journals-10028-1381

License: CC BY-NC 4.0

Published Online: 25-01-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: To describe the relationship between exercise and Australia\'s nine national health priority areas (NHPAs), which are arthritis and musculoskeletal conditions, asthma, cancer control, cardiovascular health, dementia, diabetes mellitus, injury prevention and control, mental health conditions, and obesity. Materials and methods: CINAHL, Cochrane Database of Systematic Reviews, PubMed, and SPORTDiscus were searched from 2007 to 2017, inclusive. Included were systematic reviews and meta-analyses reporting the effect of exercise on development, management, and treatment of Australia\'s NHPAs. Results: A total of 74 studies were fulfilling the inclusion criteria. Moderate exercise effectively treats and manages symptoms of osteoarthritis. Exercise improves maximal oxygen uptake in patients with asthma, prevents breast cancer, and reduces hospital admissions for patients with heart failure. Exercise significantly reduces the risk of type II diabetes mellitus and assists weight control. Exercise reduces the risk of vascular dementia, delays cognitive decline, and is effective in falls prevention. Exercise reduces symptoms of anxiety and is an effective treatment for people with depression. Conclusion: Exercise had a positive/beneficial effect in all nine NHPAs. However, it doesn\'t have universal beneficial effect for every subdisease. From a clinical perspective, prescription of exercise to assist in the management and/or prevention of all of the nine NHPAs should be encouraged. Implications for public health: Exercise has a critical role in the national public health strategy for the prevention and treatment of diseases related to inactivity.


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  1. Australian Institute of Health and Welfare (AU). National Health Priority areas 2013 2013 Available from: https://www.aihw.gov.au/reports/health-care-quality-performance/national-health-priority-areas-first-report/related-material.
  2. Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380(9838):219–229. DOI: 10.1016/S0140-6736(12)61031-9.
  3. National Preventative Health Task Force. Taking Preventative Action, a response to Australia: the healthiest country by 2020, the report of the National Preventative Taskforce. Canberra: Commonwealth of Australia; 2010.
  4. Australian Bureau of Statistics. 4364.0.55.001—National Health Survey: First Results, 2014–15 Canberra Australian Bureau of Statistics; 2016.
  5. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. DOI: 10.1371/journal.pmed.1000097.
  6. JBI Reviewers manual 2014.
  7. Moher D, Tricco A. Issues related to the conduct of systematic reviews: a focus on the nutrition field. Am J Clin Nutr 2008;88(5): 1191–1199.
  8. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 2007;7:10. DOI: 10.1186/1471-2288-7-10.
  9. Baillet A, Zeboulon N, Gossec L, et al. Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken) 2010;62(7):984–992. DOI: 10.1002/acr.20146.
  10. Bartels EM, Juhl CB, Christensen R, et al. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev 2016(3):CD005523. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005523.pub3/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD005523.pub3/asset/CD005523pdf?v=1&t=j5hs83id&s=baece127ab0c88b0ab6778ff54531a90d34596e3.
  11. Cairns AP, McVeigh JG. A systematic review of the effects of dynamic exercise in rheumatoid arthritis. Rheumatol Int 2009;30(2):147–158. DOI: 10.1007/s00296-009-1090-5.
  12. Choi BK, Verbeek JH, Tam WW-S, et al. Exercises for prevention of recurrences of low-back pain. Cochrane Database Syst Rev 2010(1):CD006555. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006555.pub2/abstract.
  13. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2015(1):CD004376. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004376.pub3/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD004376.pub3/asset/CD004376.pdf?v=1&t=j5hstv8f&s=1a078ccbfaab65a881079c3296f2c2cf4def31e9.
  14. Fransen M, McConnell S, Hernandez-Molina G, et al. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev 2014(4):CD007912. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007912.pub2/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD007912.pub2/asset/CD007912.pdf?v=1&t=j5hsut34&s=ad6ed5ed6c1ea0005a1251fa273e857df9a45de9.
  15. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 2011(7):Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000333.pub2/abstract.
  16. Hurkmans E, van der Giesen FJ, Vliet VTP, et al. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database Syst Rev 2009(4):CD006853. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006853.pub2/abstract.
  17. Nikander R, Sievanen H, Heinonen A, et al. Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life. BMC Med 2010;8:47. DOI: 10.1186/1741-7015-8-47.
  18. Oesch P, Kool J, Hagen KB, et al. Effectiveness of exercise on work disability in patients with non-acute non-specific low back pain: systematic review and meta-analysis of randomised controlled trials. J Rehabil Med 2010;42(3):193–205. DOI: 10.2340/16501977-0524.
  19. Waller B, Ogonowska-Slodownik A, Vitor M, et al. Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis. Phys Ther 2014;94(10):1383–1395. DOI: 10.2522/ptj.20130417.
  20. Beggs S, Foong YC, Le HCT, et al. Swimming training for asthma in children and adolescents aged 18 years and Under. Cochrane Database Syst Rev 2013(4):CD009607. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009607.pub2/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD009607.pub2/asset/CD009607.pdf?v=1&t=j5hw1a43&s=89359d5a373d9680e08a5f2e670f92efbc5d5cff.
  21. Carson KV, Chandratilleke MG, Picot J, et al. Physical training for asthma. Cochrane Database Syst Rev 2013(9):CD001116. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001116.pub4/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD001116.pub4/asset/CD001116.pdf?v=1&t=j5hw27vn&s=2ac6ed4ab577cb79f949800a94e440b21c326863.
  22. Crosbie A. The effect of physical training in children with asthma on pulmonary function, aerobic capacity and health-related quality of life: a systematic review of randomized control trials. Pediatr Exerc Sci 2012;24(3):472–489. DOI: 10.1123/pes.24.3.472.
  23. Eichenberger PA, Diener SN, Kofmehl R, et al. Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med 2013;43(11):1157–1170. DOI: 10.1007/s40279-013-0077-2.
  24. Grande AJ, Silva V, Andriolo BN, et al. Water-based exercise for adults with asthma. Cochrane Database Syst Rev 2014(7):CD010456. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010456.pub2/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD010456.pub2/asset/CD010456.pdf?v=1&t=j5hw4wvt&s=e10ea6e84fca9fea24b11dbe718ed39170bce089.
  25. Wanrooij VH, Willeboordse M, Dompeling E, et al. Exercise training in children with asthma: a systematic review. Br J Sports Med 2014;48(13):1024–1031. DOI: 10.1136/bjsports-2012-091347.
  26. Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients: a systematic review of randomized controlled trials. Support Care Cancer 2012;20(2):221–233. DOI: 10.1007/s00520-011-1271-0.
  27. Bicego D, Brown K, Ruddick M, et al. Effects of exercise on quality of life in women living with breast cancer: a systematic review. Breast J 2009;15(1):45–51. DOI: 10.1111/j.1524-4741.2008.00670.x.
  28. Bourke L, Smith D, Steed L, et al. Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol 2016;69(4):693–703. DOI: 10.1016/j.eururo.2015.10.047.
  29. Buffart LM, Kalter J, Sweegers MG, et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev 2017;52:91–104. DOI: 10.1016/j.ctrv.2016.11.010.
  30. Cramer H, Lauche R, Klose P, et al. A systematic review and meta-analysis of exercise interventions for colorectal cancer patients. Eur J Cancer Care (Engl) 2014;23(1):3–14. DOI: 10.1111/ecc.12093.
  31. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012(11):CD006145. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006145.pub3/abstract.
  32. Furmaniak AC, Menig M, Markes MH. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2016(9):CD005001. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005001.pub3/abstract.
  33. Gerritsen JK, Vincent AJ. Exercise improves quality of life in patients with cancer: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2016;50(13):796–803. DOI: 10.1136/bjsports-2015-094787.
  34. Granger CL, McDonald CF, Berney S, et al. Exercise intervention to improve exercise capacity and health related quality of life for patients with non-small cell lung cancer: a systematic review. Lung Cancer 2011;72(2):139–153. DOI: 10.1016/j.lungcan.2011. 01.006.
  35. Keogh JW, MacLeod RD. Body composition, physical fitness, functional performance, quality of life, and fatigue benefits of exercise for prostate cancer patients: a systematic review. J Pain and Symptom Manage 2012;43(1):96–110. DOI: 10.1016/j.jpainsymman.2011. 03.006.
  36. Mishra SI, Scherer RW, Geigle PM, et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 2012(8):CD007566. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007566.pub2/abstract.
  37. Monninkhof EM, Elias SG, Vlems FA, et al. Physical activity and breast cancer: a systematic review. Epidemiology 2007;18(1):137–157. DOI: 10.1097/01.ede.0000251167.75581.98.
  38. Winzer BM, Whiteman DC, Reeves MM, et al. Physical activity and cancer prevention: a systematic review of clinical trials. Cancer Causes Control 2011;22(6):811–826. DOI: 10.1007/s10552-011-9761-4.
  39. Adsett JA, Mudge AM, Morris N, et al. Aquatic exercise training and stable heart failure: a systematic review and meta-analysis. Int J Cardiol 2015;186:22–28. DOI: 10.1016/j.ijcard.2015.03.095.
  40. Anderson L, Thompson DR, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2016(1):CD001800. DOI: 10.1002/14651858.CD001800.pub3.
  41. Davies EJ, Moxham T, Rees K, et al. Exercise training for systolic heart failure: cochrane systematic review and meta-analysis. Eur J Heart Fail 2010;12(7):706–715. DOI: 10.1093/eurjhf/hfq056.
  42. Lewinter C, Doherty P, Gale CP, et al. Exercise-based cardiac rehabilitation in patients with heart failure: a meta-analysis of randomised controlled trials between 1999 and 2013. Eur J Prev Cardiol 2015;22(12):1504–1512. DOI: 10.1177/2047487314559853.
  43. Risom SS, Zwisler A-D, Johansen PP, et al. Exercise-based cardiac rehabilitation for adults with atrial fibrillation. Cochrane Database Syst Rev 2017(2):CD011197. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011197.pub2/abstract.
  44. Saunders DH, Sanderson M, Hayes S, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev 2016;3:CD003316. DOI: 10.1002/14651858.CD003316.pub6.
  45. Taylor RS, Sagar VA, Davies EJ, et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev 2014(4):CD003331. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003331.pub4/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD003331.pub4/asset/CD003331.pdf?v=1&t=j5i0t2g8&s=5846669d3f9a89825b980dc3b04811dcf177bea9.
  46. Aarsland D, Sardahaee FS, Anderssen S, et al. Is physical activity a potential preventive factor for vascular dementia? A systematic review. Aging Ment Health 2010;14(4):386–395. DOI: 10.1080/13607860903586136.
  47. Barreto Pde S, Demougeot L, Pillard F, et al. Exercise training for managing behavioral and psychological symptoms in people with dementia: a systematic review and meta-analysis. Ageing Res Rev 2015;24(Pt B):274–285. DOI: 10.1016/j.arr.2015.09.001.
  48. Forbes D, Forbes SC, Blake CM, et al. Exercise programs for people with dementia. Cochrane Database Syst Rev 2015(4):CD00648. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006489.pub4/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD006489.pub4/asset/CD006489.pdf?v=1&t=j5i0zsjx&s=01151693f3c14e59ce4f8f27dcfe448634b5618f.
  49. Groot C, Hooghiemstra AM, Raijmakers PG, et al. The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Ageing Res Rev 2016;25:13–23. DOI: 10.1016/j.arr.2015.11.005.
  50. Laver K, Dyer S, Whitehead C, et al. Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews. BMJ Open 2016;6(4):e010767. DOI: 10.1136/bmjopen-2015-010767.
  51. Law LL, Barnett F, Yau MK, et al. Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: a systematic review. Ageing Res Rev 2014;15:61–75. DOI: 10.1016/j.arr.2014.02.008.
  52. Littbrand H, Stenvall M, Rosendahl E. Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: a systematic review. Am J Phys Med Rehabil 2011;90(6):495–518. DOI: 10.1097/PHM.0b013e318214de26.
  53. Ohman H, Savikko N, Strandberg TE, et al. Effect of physical exercise on cognitive performance in older adults with mild cognitive impairment or dementia: a systematic review. Dement Geriatr Cogn Disord 2014;38(5-6):347–365. DOI: 10.1159/000365388.
  54. Pitkala K, Savikko N, Poysti M, et al. Efficacy of physical exercise intervention on mobility and physical functioning in older people with dementia: a systematic review. Exp Gerontol 2013;48(1):85–93. DOI: 10.1016/j.exger.2012.08.008.
  55. Young J, Angevaren M, Rusted J, et al. Aerobic exercise to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2015(4):CD005381. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005381.pub4/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD005381.pub4/asset/CD005381.pdf?v=1&t=j5i1ddyp&s=d7d9421ea5bd3e124d0eb1fcc8dd56b0c20ba1e9.
  56. Aguiar EJ, Morgan PJ, Collins CE, et al. Efficacy of interventions that include diet, aerobic and resistance training components for type II diabetes prevention: a systematic review with meta-analysis. Int J Behav Nutr Phys Act 2014;11:2. DOI: 10.1186/1479-5868-11-2.
  57. Aune D, Norat T, Leitzmann M, et al. Physical activity and the risk of type II diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 2015;30(7):529–542. DOI: 10.1007/s10654-015-0056-z.
  58. Bain E, Crane M, Tieu J, et al. Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 2015(4):Cd010443. DOI: 10.1002/14651858.CD010443.pub2.
  59. Han S, Middleton P, Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 2012(7):CD009021. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009021.pub2/abstract.
  60. Orozco LJ, Buchleitner AM, Gimenez-Perez G, et al. Exercise or exercise and diet for preventing type II diabetes mellitus. Cochrane Database Syst Rev 2008(3):CD003054. DOI: 10.1002/14651858.CD003054.pub3.
  61. Arnold CM, Sran MM, Harrison EL. Exercise for fall risk reduction in community-dwelling older adults: a systematic review. Physiother Can 2008;60(4):358–372. DOI: 10.3138/physio.60.4.358.
  62. El-Khoury F, Cassou B, Charles MA, et al. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ 2013;347:f6234.
  63. Kendrick D, Kumar A, Carpenter H, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst Rev 2014(11):CD009848. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009848.pub2/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD009848.pub2/asset/CD009848.pdf?v=1&t=j5i32t6p&s=db5e4befae355ed88871a517e0f6bd474a72f971.
  64. Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2014;48(11):1306–1315. DOI: 10.1136/bjsports-2013-092538.
  65. Rössler R, Donath L, Verhagen E, et al. Exercise-based injury prevention in child and adolescent sport: a systematic review and meta-analysis. Sports Med 2014;44(12):1733–1748. DOI: 10.1007/s40279-014-0234-2.
  66. Sherrington C, Whitney JC, Lord SR, et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008;56(12):2234–2243. DOI: 10.1111/j.1532-5415.2008.02014.x.
  67. Cooney GM, Dwan K, Greig CA, et al. Exercise for depression. Cochrane Database Syst Rev 2013(9):CD004366. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004366.pub6/abstract http://onlinelibrary.wiley.com/store/10.1002/14651858.CD004366.pub6/asset/CD004366.pdf?v=1&t=j5i3b8hf&s=fc5eaf1322c811bfcf1ac0f7a1e361d42b8bdb85.
  68. Daley A, Jolly K, MacArthur C. The effectiveness of exercise in the management of post-natal depression: systematic review and meta-analysis. Family Pract 2009;26(2):154–162. DOI: 10.1093/fampra/cmn101.
  69. de Souza Moura AM, Lamego MK, Paes F, et al. Effects of aerobic exercise on anxiety disorders: a systematic review. CNS Neurol Disord Drug Targets 2015;14(9):1184–1193. DOI: 10.2174/1871527315666151111121259.
  70. Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: a systematic review and meta-analysis. Schizophr Bull 2017;43(3):546–556.
  71. Gorczynski P, Faulkner G. Exercise therapy for schizophrenia. Cochrane Database Syst Rev 2010(5):Cd004412. DOI: 10.1002/14651858.CD004412.pub2.
  72. Herring MP, O'Connor PJ, Dishman RK. The effect of exercise training on anxiety symptoms among patients: a systematic review. Arch Intern Med 2010;170(4):321–331. DOI: 10.1001/archinternmed. 2009.530.
  73. Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med 2014;48(3):187–196. DOI: 10.1136/bjsports-2012-091287.
  74. Josefsson T, Lindwall M, Archer T. Physical exercise intervention in depressive disorders: meta-analysis and systematic review. Scand J Med Sci Sports 2014;24(2):259–272. DOI: 10.1111/sms.12050.
  75. McCurdy AP, Boule NG, Sivak A, et al. Effects of exercise on mild-to-moderate depressive symptoms in the postpartum period: a meta-analysis. Obstet Gynecol 2017;129(6):1087–1097. DOI: 10.1097/AOG.0000000000002053.
  76. Mochcovitch MD, Deslandes AC, Freire RC, et al. The effects of regular physical activity on anxiety symptoms in healthy older adults: a systematic review. Braz J Psychiatry 2016;38(3):255–261. DOI: 10.1590/1516-4446-2015-1893.
  77. Stonerock GL, Hoffman BM, Smith PJ, et al. Exercise as treatment for anxiety: systematic review and analysis. Ann Behav Med 2015;49(4):542–556. DOI: 10.1007/s12160-014-9685-9.
  78. Garcia-Hermoso A, Sanchez-Lopez M, Martinez-Vizcaino V. Effects of aerobic plus resistance exercise on body composition related variables in pediatric obesity: a systematic review and meta-analysis of randomized controlled trials. Pediatr Exerc Sci 2015;27(4):431–440. DOI: 10.1123/pes.2014-0132.
  79. Ho M, Garnett SP, Baur LA, et al. Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA Pediatr 2013;167(8):759–768. DOI: 10.1001/jamapediatrics.2013.1453.
  80. Kelley GA, Kelley KS. Effects of exercise in the treatment of overweight and obese children and adolescents: a systematic review of meta-analyses. J Obes 2013;2013:783103. DOI: 10.1155/2013/783103.
  81. Kelley GA, Kelley KS, Pate RR. Exercise and BMI in overweight and obese children and adolescents: a systematic review and trial sequential meta-analysis. Biomed Res Int 2015;2015:704539. DOI: 10.1155/2015/704539.
  82. Södlerlund A, Fischer A, Johansson T, et al. Physical activity, diet and behaviour modification in the treatment of overweight and obese adults: a systematic review. Perspect Public Health 2009;129(3): 132–142. DOI: 10.1177/1757913908094805.
  83. Drawer S, Fuller CW. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med 2001;35(6):402–408. DOI: 10.1136/bjsm.35.6.402.
  84. Gouttebarge V, Inklaar H, Frings-Dresen MH. Risk and consequences of osteoarthritis after a professional football career: a systematic review of the recent literature. J Sports Med Phys Fitness 2014;54(4): 494–504.
  85. Tran G, Smith TO, Grice A, et al. Does sports participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis. Br J Sports Med 2016;50(23):1459–1466. DOI: 10.1136/bjsports-2016-096142.
  86. Lavie CJ, O'Keefe JH, Sallis RE. Exercise and the heart—the harm of too little and too much. Curr Sports Med Rep 2015;14(2):104–109. DOI: 10.1249/JSR.0000000000000134.
  87. McCrory P, Meeuwisse WH, Kutcher JS, et al. What is the evidence for chronic concussion-related changes in retired athletes: behavioural, pathological and clinical outcomes? Br J Sports Med 2013;47(5):327–330. DOI: 10.1136/bjsports-2013-092248.
  88. Janssen KW, Orchard JW, Driscoll TR, et al. High incidence and costs for anterior cruciate ligament reconstructions performed in Australia from 2003–2004 to 2007–2008: time for an anterior cruciate ligament register by Scandinavian model? Scand J Med Sci Sports 2012;22(4):495–501. DOI: 10.1111/j.1600-0838.2010.01253.x.
  89. Sharma S, Merghani A, Mont L. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J 2015;36(23):1445–1453. DOI: 10.1093/eurheartj/ehv090.
  90. Regnaux JP, Lefevre-Colau MM, Trinquart L, et al. High-intensity vs low-intensity physical activity or exercise in people with hip or knee osteoarthritis. Cochrane Database Syst Rev 2015;10:Cd010203. DOI: 10.1002/14651858.CD010203.pub2.
  91. Lee IM, Paffenbarger Jr RS. Physical activity and stroke incidence: the Harvard Alumni health study. Stroke 1998;29(10):2049–2054. DOI: 10.1161/01.STR.29.10.2049.
  92. Australian Bureau of Statistics (AU). Dementia and deaths in Australia Canberra: Australian Bureau of Statistics; 2017 Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main%20Features~Dementia~10002.
  93. National preventative taskforce.
  94. Department of Health (AU). Tobacco Control key facts and figures Canberra Department of Health 2017 Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/tobacco-kff.
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