Exercise Is A Prescription

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.

•  Reduce cortisol which contributes to weight gain
  • Exercise reduces stress hormones helping us to feel more calm. It actually makes our brain more resilient to the effects of stress.
• Prevent and manage diabetes
  • Exercise helps our insulin receptor work more efficiently thus reducing our chances of developing diabetes.
  • I use it in our diet program to reverse type 2 diabetes and reduce the need for medication in type 1 diabetes.
• Ease depression and help manage pain and stress
• Keep bones and muscles strong
  • Exercise stimulates bone health by triggering osteoblast activity to make bones stronger thus preventing osteoporosis 
• Strengthen your cardiovascular and respiratory systems
• Removes toxins from fat stores
  • Exercise with intensity induces sweat, which clears toxins from our body through the skin.
• Reduce the risk of cancer. Studies show that exercise reduces risk for cancer and increases survival for those with cancer.
•  Sleep better
  • Lack of sleep is directly correlated to risk of weight gain.
•  Cognitive improvement
  • Exercise increases oxygen delivery to brain tissue allowing us to have greater mental stamina, more creativity of thought and promote greater problem solving ability.
  • Exercise stimulates the production of an important brain protein called brain derived neurotrophic factor that helps repair our brain from oxidative stress and reduce the risk of degenerative brain diseases.

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:

1. Start slow if you are new to exercise. Obtain proper guidance and instruction and slowly progress over time.

2. Find JOY! If you hate it you wont do it so find the type of exercise that you like and do it in a way that suits you. Alone, in a group, with a goal in mind, or simply as a peaceful respite from your day. Play with the multitude of options out there.

3. Make it a habit you engage in a minimum of three times per week. It doesn't have to be overly strenuous or time consuming. Most people can gain great benefit from just 20 to 30 minutes per day.

Enough talk. Start now. Exercise is one of the best tools for reducing your pharmaceutical bill each month.