EXERCISE IS MEDICINE
By Monika Tarkowska-Carter CPT, LWMC, HLC
What do YOU think about exercise? Is it fun and play or pain and suffering? Simple discomfort that needs to be endured or the necessary evil? Something boring you just go through mechanically or something you look forward to? But have you ever thought of exercise as medicine? Well, maybe you should.
Did you know that in 2005 the Centers for Disease Control and Prevention (CDC) estimated that 365,000 deaths in the US occur annually from poor diet and lack of physical activity? Two-thirds of US adults are either overweight or obese. More than half of US adults do not meet the recommended levels of physical activity. Almost one-fourth of US adults have no leisure-time physical activity at all (1). Maybe it’s time to think about prevention.
Studies repeatedly show that exercise and physical activity can help prevent obesity, diabetes, cardiovascular disease, many types of cancer and other chronic conditions. Together, sedentary lifestyle and poor diet contribute to the current obesity epidemic as well as increased morbidity and mortality. However, overweight or obese people are not universally at risk for metabolic or cardiovascular diseases and other associated chronic conditions. Many of these people (about one-third) do not show any clinical or subclinical risk factors for cardiovascular disease (CVD) such as dyslipidemia, hypertension or elevated blood sugar. The strongest predictor of CVD risk is low levels of cardiorespiratory fitness (1).
Earlier this year I attended the American College of Sports Medicine (ACSM) Health and Fitness summit in Austin, TX where Steven N. Blair, Ph.D., FACSM (past President of ACSM) gave a standing ovation lecture to fitness professionals entitled: “Fitness or Fatness: Which is more important to health?” Dr Blair has done a tremendous amount of research on the subject showing that the fitness level of an individual is a much greater predictor of disease and mortality than overweight or obesity alone. Obese individuals who are fit have much lower risk of mortality than lean individuals who are unfit, and low cardiorespiratory fitness in overweight or obese people is as hazardous as other risk factors. He went as far as suggesting that no papers should be published, nor research project funded, on obesity and any health outcome unless physical activity/fitness has been accurately measured and taken into account in the analyses (2). Dr. Blair published over 450 scientific papers, many of them on the subject of physical activity and its prevention of various diseases. One of them showed that physically fit women were less likely to die from breast cancer (3).
At the same conference, Ted Mitchell, MD, FACSM (President and CEO of the Copper Clinic) showed how many conditions were affected by the lack of fitness. Among them were: joint pain, fatigue, headaches, heartburn, snoring, decreased sex drive and sex problems, stress, anxiety and depression (4).
With all the research available on the subject why isn’t more being done about prevention? We live in a disease driven society. Disease is a lot more profitable than health. Drug companies make huge profits on medications and medical treatments. Don’t get me wrong – they are needed and often life-saving but prescribing medications for every condition that could have been easily prevented in the first place is becoming more and more prevalent. Prevention involves lifestyle changes, not just diagnostics. Everyone can and should practice prevention in the form of a healthy lifestyle. It is free and available to all. Better nutrition and higher levels of physical activity don’t increase cost but bring a huge payoff in terms of lower health-care cost, increased productivity and greater quality of life. The main keys to health, longevity and disease prevention are: getting more active, eating a little healthier and incorporating some kind of movement into your everyday life. In a very real sense, exercise is medicine. At this point, however, little is being done by organized medicine to increase physical activity among patients.
As a member of the American College of Sports Medicine (ACSM) and a professional in the health and fitness community, I am committed to encouraging physical activity for the health benefits it brings to all people. Exercise and physical activity are powerful medicine helping prevent and treat numerous chronic conditions. Significant health benefits can be achieved with at least 30 minutes of moderate physical activity most days of the week.
A recent survey by ACSM reveals that, while 4 out of 10 physicians talk to their patients about the importance of exercise, they don’t always offer suggestions on the best ways to be physically active. According to the same survey, nearly 65% of patients would be more interested in exercising to stay healthy if advised by their doctor and given additional resources.
A CALL TO PHYSICIANS
If there was a drug that could so powerfully fight America’s obesity epidemic and the health implications it brings, prevent and treat dozens of diseases would you prescribe it to your patients? Certainly.
This is the impetus behind Exercise is Medicine, an initiative from ACSM. One objective is to encourage YOU, the physician, to “prescribe” exercise during patient visits. Please, talk to your patients about exercise and, as appropriate, refer them to qualified fitness professionals. Counseling patients on the benefits of physical activity in their long-term health and well-being is critical and should be a standard part of your practice.
On November 5, 2007 the American Medical Association (AMA) partnered with ACSM to bring the above initiative into fruition. However, this is just the beginning. A lot more needs to be done and we rely on you for help and active participation. There is a great need to merge the fitness industry with the healthcare industry. Why do these two worlds so seldom interact? All healthcare practitioners “…must insist that the world healthcare systems make as big (or bigger) commitment to getting patients active as they make to getting them to take medications or submit to various procedures that have less scientific evidence supporting their benefit. With a wealth of evidence in hand, it is time for organized medicine to join with fitness professionals to ensure that patients around the world take their exercise pill. There is no better way to improve health and longevity” (5).
You can find additional resources about the initiative at: http://exerciseismedicine.org/physicians.htm. Additional information about the American College of Sports Medicine is available at: http://www.acsm.org/. On May 3, 2010 the National Physical Activity Plan was launched in Washington DC as a result of cooperation between many health organizations. More information about the plan can be found at: http://physicalactivityplan.org/index.htm. To find a qualified fitness professional in your area please go to: http://www.ideafit.com/fitnessconnect?gclid=CMPR2cOpoaUCFQoBbAodJxvlKA. IDEA Health and Fitness Association is the biggest educational body in the fitness industry and has recently published an online listing of certified professionals. Their certifications, insurance status and CPR/AED skills have been verified so you can be assured that they are qualified. You can search either by zip code and a type of professional you are looking for or check a particular professional by their last name.The highest rated ones appear at the top. If you would rather contact the certifying organization directly here are a few most reputable ones:
1. ACSM (American College of Sports Medicine) - http://www.acsm.org/
2. NASM (National Academy of Sports Medicine) - http://www.nasm.org/
3. NSCA (National Strength and Conditioning Association) - http://www.nsca-lift.org/
4. ACE (American Council on Exercise) - http://www.acefitness.org/
A CALL TO PATIENTS
Please, ask a few questions about your health status the next time you visit your doctor. Are you at a healthy weight? Taking your current health status into consideration, what types of exercise are best and safest for you? Is there a certified trainer you should hire to improve your health?
*For more information on what to look for when hiring a personal trainer, please refer to my article from November 8, 2010: “Personal Trainers – The Good, The Bad and The Ugly”.
A CALL TO PARENTS
Please, give your children the gift of lifelong wellness by being a role model and supporting them in establishing a habit of lifelong physical activity. Have fun being active as a family.
DON’T UNDERESTIMATE EXERCISE – IT’S A POWERFUL DRUG!
1. Jan Warren-Findlow, PhD and Steven P. Hooker, PhD. Disentangling the Risks Associated With Weight Status, Diet and Physical Activity. Prev Chronic Dis. 2009 October; 6 (4): A 135
2. Steven N. Blair, MS, PED; Dept of Exercise Science and Epidemiology/Biostatistics, Arnold School of Public Health, Univ. of South Carolina. “Fitness or Fatness: Which is More Important for Health?” – a lecture presented at the ACSM’s 14th Health and Fitness Summit and Exposition, April 2010, Austin, TX.
3. Peel, J .Brent; Sui, Xuemei; Adams, Swann A.; Herbert, James R.; Hardin, James W.; Blair, Steven N. A Prospective Study of Cardiorespiratory Fitness and Breast Cancer Mortality. Medicine and Science in Sports and Exercise. 41(4):742-748, April 2009
4. Ted Mitchell, MD, FACSM; President and CEO, Copper Clinic. “Aging with Attitude: The Impact of Exercise on Quality of Life” – a lecture presented at the ACSM’s 14th Health and Fitness Summit and Exposition, April 2010, Austin, TX.
5. Sallis, Robert J, MD. Exercise is medicine and physicians need to prescribe it! Br. J. Sports. Med; 2009; 43; 3-4.