Exercise as Medicine

screenshotAlthough Hippocrates was first credited with the observation that exercise keeps a man well, the evidence for the benefits of exercise in the prevention and treatment of disease has been clearly established.  There is in fact a linear relationship between physical activity and health status, and therefore inactivity is considered a powerful and modifiable risk factor for chronic disease, disability and premature death.  Given the unprecedented levels of sedentary lifestyles, should physicians not consider it an ethical obligation to assess and prescribe exercise?

Exercise represents one of the highest levels of physiologic stress to the body; for example, while a high fever can increase metabolism by 100%, a marathon race can increase metabolism by 2000%.  While the primary systems involved in exercise are cardiac, pulmonary, nervous, muscular, and metabolic, all systems benefit; exercise reduces both morbidity and mortality from most common illnesses, and a wide variety of symptoms are usually improved—anxiety, depression, headaches, heartburn, decreased libido, impotency, poor sleep, fatigue, decreased memory, joint pains, poor self esteem, to name a few. And so, regular exercise builds strength and reserve to withstand the everyday challenges to health, at the same time it improves blood flow and metabolic efficiency.

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screenshotAs our patients age, they want to preserve their functional capacity as long as possible.  Our goal as clinicians then is to “square off the screenshotgeriatric curve”.  And of course, there is no age where exercise ceases to be a benefit.  Ask 100 year old  marathoner Fauja Singh, who only started running at age 80 after his wife died.  Or sister Madonna Buder, who started her triathlon career at age 54, and who recently completed her 45th Ironman race at age 80.  You are only as old as you think you are.

Finally, it has been shown that physicians with healthy personal habits are more likely to counsel patients to adopt such habits; such physicians are more credible and motivating to their patients as well.  A healthy doc equals a healthy patient!  We need only start in our own back yard, and share what you know.

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