Exercise Is A Prescription
Posted in Education, Exercise & Fitness, Lifestyle, Sports on Jul 01, 2013
Author: Dr. Gary Huber, DO
Is exercise as effective as drugs?
So why are we called health care providers if we are not in fact going to prescribe health? Interesting question and I don’t intend for this to be a thorn in anyone’s side but simply a question of logic. In a study from the British Medical Journal by Naci et al, they reviewed 305 different randomized controlled trials that looked at 339,274 participants and found that exercise in most settings was equal to drug therapy in preventing heart disease, recurrent heart attacks, heart failure, diabetes and preventing recurrent strokes. This is in fact not shocking. What is shocking is that only one third of primary care physicians prescribed exercise to their patients and the numbers get worse when you ascend up the ladder of specialists. In fact the US national cholesterol education program guidelines advises the use of statins (cholesterol drugs) “only after exhausting interventions for intensive lifestyle modification”. Most physicians, though well intended, have no knowledge of how to modify lifestyle for their patients as this is not taught in medical schools.
Medical schools teach us how to use drugs and our entire focus, sadly, is often centered around drug use to modify disease risk. In an editorial by Dr. Moynihan from 2002 that appeared in the British Medical Journal, “The current body of medical literature largely constricts clinicians to drug options”. He was referencing the lack of adequate study of other modalities in treating disease. That's because we have allowed our medical system to be guided by pharmaceutical companies that sponsor mega million dollar studies of their drugs, and our governmental support has sadly stepped aside. Our own FDA is paid for by the pharmaceutical industry in real hard cash. Money talks in this country and if you are promoting broccoli and exercise there is no money for you.
In Naci’s study he revealed that exercise was on par with drugs effects in reducing mortality from coronary heart disease. A quote from the study states, “when compared head to head in network meta-analysis, all interventions (drugs and exercise) were not different beyond chance. There was no statistical detectable difference among any of the drug and exercise interventions in terms of their effect on mortality outcomes.” Stated simply – drug therapy offered no advantage over simple exercise.
Now I would not go as far as to say that everyone should chuck their medications in the trash and just go for a jog, but this is real evidence and it makes “sense” that when we do good things to the body, the body wants to heal. We typically get heart disease, diabetes and stroke from engaging in poor habits and bad food. It only makes sense that the disease process is reversed when we alter our lifestyle.
Going one step further, in the Naci study they found that exercise was significantly MORE effective than drugs in the case of stroke rehabilitation.
So what are we to do? I prescribe drug therapy for my patients when appropriate but I also prescribe exercise therapy to everyone. I talk with my patients about the virtues of exercise and continuously promote it as a tool that is relatively free, far less expensive than drugs, can be done anywhere with very little if any equipment and modified to suit anyone’s limitations or desire. Here is a short list of benefits from the simple act of exercise:
Manage your weight. Intense exercise can raise our anaerobic threshold, which improves our ability to burn fat at rest.
This list is just a broad overview of the benefits and is not even close to being a complete summary. I encourage everyone to find his or her own version of exercise. I personally don't like treadmills so if you asked me to get on one I would hate it. But I love exercise of all sorts and you have to find the format that suits YOU. There are endless ways to get aerobic and resistance exercise and I encourage everyone, even people with prior heart attacks and in fact ESPECIALLY people with heart attacks and strokes to find an avenue into exercise that you like and are willing to involve yourself in 3 to 4 times per week or more.
A few simple rules:
Enough talk. Start now. Exercise is one of the best tools for reducing your pharmaceutical bill each month.