Exercise is Medicine! By Cindy Binkley, FLT Columnist

by Cindy Binkley, FLT Columnist

What if there was ONE prescription that could prevent and treat dozens of diseases, such as diabetes, hypertension and obesity? Exercise is that prescription!

Recent studies estimate that half of all adults in the U.S. will be obese by the year 2030. The health and financial consequences related to that number are staggering. Increasing rates of obesity would mean 7.8 million additional cases of diabetes, 6.8 million extra cases of coronary heart disease and stroke, and 539,000 extra cancer cases. That’s not to mention a $66 billion per year increase in health care costs by 2030.

The underlying causes of the obesity epidemic are many. Our understanding of obesity is expanding, yet our success in moving the population in the right direction has been limited. Reducing obesity will require a comprehensive, “whole society” approach. Meaning that individuals, health care providers, fitness professionals, health systems, community leaders, schools and even employers will need to have a little skin in the game, to have an impact on containing and dialing back obesity.

One organization has already got the ball rolling; we just need to join the game. Exercise is Medicine (EIM) was started by the American College of Sports Medicine (ACSM), to improve the role that health care providers and health care systems play in promoting physical activity in patients and communities. Started back in 2008 under the leadership of former ACSM President Robert Sallis, M.D., EIM has been enormously successful in highlighting the critical role health care provider’s play in promoting a healthy lifestyle and physical activity. EIM now has a global presence and is working with partners on several continents to spread a worldwide message about the importance of physical activity in promoting health and preventing disease.

EIM recommends that physical activity to be considered by all health care providers as a vital sign in every patient visit.  In order to accomplish this goal, it is necessary for EIM to:

  1. Create a broad awareness that Exercise is Medicine.
  2. Make “level of physical activity” a standard vital sign question at each patient visit.
  3. Educate physicians and other health care providers on effective counseling strategies and provide them the tools to refer patients appropriately to healthcare providers if needed.
  4. Work with legislators to make changes in public policy and in the private sector to support the EIM mission.
  5. Encourage physicians and other health care providers to be physically active themselves.

Exercise is like medicine in so many ways. Exercise should be prescribed, in a specific dosage and formulation to each individual patient diagnosed with a disease.

The prescription must be very specific regarding exercise modality, intensity, frequency and duration. It is not enough to have providers tell patients “you should exercise for your disease” without giving them these specifics. It would be equivalent to telling a patient to “just take some pills.” No provider would do that! Clearly, there is much work to be done in this area. The basic guideline for adults over the age of 18 is to engage in 150 minutes a week of moderate-intensity activity (or 75 minutes a week of vigorous-intensity aerobics).  Also, muscle-strengthening activities that involve all major muscle groups performed should be included.

The dosage of a medicine is also very important. A drug must be in a therapeutic range in order to have the desired effect. Too much, and you risk side effects, too little and there is no benefit. With regard to exercise, it is important to know how much exercise the individual needs to perform to have the most benefit. Measurement of the key areas both at baseline and after the prescription is critical to understanding how to prescribe exercise. On the other hand, it is important to know that exercise can also have side effects. Musculoskeletal injuries, cardiac events, shortness of breath, blood glucose changes, and electrolyte abnormalities are many of the known side effects. So, just as a provider would not dream of telling a patient “just take as many pills as you can” to treat a disease, similarly, telling a patient “just exercise regularly” does not provide for safety in avoiding complications.

Formulation of a drug affects its impact, and the same applies to exercise. In this case, it is important to determine if general physical activity or specific goal-directed exercise is most appropriate for an individual patient. In this arena, we must consider each patient’s stage of readiness to increase physical activity/exercise. Prescribing exercise that a patient perceives as impossible to perform is like prescribing a pill for a patient who cannot swallow. We must match the delivery method of activity to what the patient can accomplish successfully. If a patient will not “take the medicine,” no benefits can be seen. One good option is to prescribe physical therapy. A physical therapist has the skills to create an exercise program specific to the individual and the disease and the ability to motivate the individual to achieve their exercise goals.

For more information on Exercise is Medicine go to http://exerciseismedicine.org or contact Cindy directly at cbinkley@cpwhc.com. Be the solution to the obesity epidemic and join the EIM team. Exercise…the only prescription with unlimited refills.