Exercise is Medicine

This New York Times article was sent to me by a patient – Thank you!

Below are my comments on certain parts of the article, and one very important clarification.

Of all the things we as physicians can recommend for health, few provide as much benefit as physical activity.

Absolutely!  Exercise is medicine! In the article he gives a link to study that looks at all of the most powerful research on exercise as medicine.  So the results are not just from one study but looking at the trend in a group of well-designed studies.  In other words – it is good, reliable information.  What did they find?

• Improving stamina and strength is possible for those with a wide variety of different health concerns.
• Exercise training is safe for those with disease when patients are guided by exercise professionals.
• Exercise training improves the prognosis in many diseases.
• In some diseases such as arthritis, pain symptoms are reduced.

For people (mostly middle-aged men) who had a heart attack, exercise therapy reduced all causes of mortality by 27 percent and cardiac mortality by 31 percent.

That means if you have heart disease and you exercise regularly you are 27% less likely to die from ANY cause and 31% less likely to die from a heart incident!  I don’t know how that compares to the benefits of the top cardiac medication – but wow!  That is like adding another powerful heart medication, with GREAT side effects.

ATTENTION all people with diabetes and concerned about complications of the disease.  Attention all of you worried about getting diabetes.  And a special shout out to those of you  trying to lower your A1c in order to qualify for weight loss surgery:

People with diabetes who exercise have lower HbA1c values, which is the marker of blood sugar control, low enough to probably reduce the risk of complications from the disease.

Does shortness of breath limit what you do in life.  Our body is a “use it or lose it” system and this is one of the best demonstrations of that:

Twenty randomized controlled trials have showed that patients with chronic obstructive pulmonary disease can walk farther and function better if they exercise.

I could go on with the benefits but I wont because the article gives great information about how powerful exercise is as medicine.

Many people will be surprised at how little you need to do to achieve these results.

This point cannot be overstated.  In popular media the tendency is toward a “prove-yourself, exceed” mentality with exercise.  It cannot be more clear -if  your goal is health – more is not better.  After a certain point too much exercise strains the body instead of heals it!  How do you know how much?  If exercise gives you energy and you are feeling stronger, you found the right amount.  Exercise is no longer medicine when we overdo it -exercise then becomes a sport or a hobby.  This is a very important difference.   Accumulating 30 minutes of movement bouts a day can do it.  That means that even if you cannot do 30 minutes all together, split it up into shorter bouts throughout the day- it is WAY better than nothing.

Here is the important clarification:

Moderate intensity is probably much less than you think. Walking briskly, at 3 to 4 miles per hour or so, qualifies. So does bicycling slower than 10 miles an hour. Anything that gets your heart rate somewhere between 110 and 140 beats per minute is enough. Even vacuuming, mowing the lawn or walking your dog might qualify.

This is where exercise recommendations can get very confusion and sap motivation.  

When finding the right level for exercise, it is much more accurate and reliable to listen to your body than how fast you are going.  This gets mixed up in the media so often. 

Moderate intensity means your breathing is comfortable to a comfortable challenge level.  If it feels uncomfortable, it is too intense and time to slow down.  As long as the challenge is comfortable for your breathing you are generally working in the right range for improving stamina with cardiovascular exercise.*  

Breathing measures what is actually happening in the whole cardiovascular system.  Heart rate only measures one piece of that system.  The numbers he gives above are too general to be worthwhile, so please do not follow that advice. Your body does not know how fast you are going, so don’t worry about it unless you are training for a competition.  If health and wellbeing are your goal, listen to your body!

Keep Moving, Be Well

Janet

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*These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.