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Exercise is Medicine: does your GP prescribe it?

Since the term was coined in the first decade of the 21st century, much has been written on the subject in the scientific literature especially the Sports Medicine publications, but I am not sure how much this has filtered down to the GPs and the general public since that time. I have written about this in the past when we had a clinic in Surbiton but I thought it was worth a revisit to emphasise the incredible benefits of exercise and activity on health.

Our health is influenced by genetics, environment and behaviour. The latter two of these are easily modifiable. The environmental factors influencing disease have come through medicines, vaccines, hygiene and safety regulations but has much been done to target behaviours such as physical inactivity In 2009 RE Sallis believed that physical inactivity was the greatest public health problem of the time and the British Journal of Sports Medicine dedicated an entire issue to the topic under the editorship of Dr Steven Blair.

Activity as a benefit to health has been known about since the 5th Century when Hippocrates said ‘Eating alone may not keep a man well; he must also take exercise. For food and exercise….work together to produce health’. Years of scientific research has shown a clear correlation between activity and health, namely the fit and healthy live longer and healthier lives, and this is regardless of age, sex, race or environment.

So what are the details? In a nutshell, scientific evidence clearly shows that regular activity has benefits for primary and secondary prevention of diabetes, high blood pressure, cancer (especially breast and colon), depression, osteoporosis and dementia. There is a clear correlation also between physical activity and all-cause mortality. It cannot be overstated that, given the above, activity and exercise are the magic bullets of health management. It could almost be seen as a ‘vaccine’ to prevent chronic disease and premature death.

However, at the time Sallis was writing this, and even now, medicine was and still has not really climbed onboard. If it had been a pill that conferred all these health benefits, anyone and everyone would be taking it. It would be the most prescribed and effective pill ever produced. One answer to the question why more has not been done: the pharmaceutical industry. Need I say more on that topic.

Simply put, the cost of healthcare in in the US the first decade of the 21st century, would have been over $1500 more per year for a sedentary person. In 2005, the estimated medical costs of inactivity in California were estimated at $29billion, a 32% increase from 2000.

The real issue is that modern medicine is not really interested in prevention. The pharmaceutical industry is not in the business of disease prevention and thus this particular tanker is taking and will continue to take years to turn around.

Ideally the fitness industry and the healthcare industry need to merge in some way. In the US, healthcare insurance covers medical intervention but does not cover gym membership or even an appointment with a fitness professional. Even this needs to change.

So it is down to those medical professionals who are aware of this issue, those in the sports medicine world and those allied alongside, to promote, emphasise, preach from the pulpit the need for patients to understand the risks of being sedentary and the importance of exercise in treating and preventing chronic disease, improve health and increase longevity.

Exercise is Medicine: we prescribe it.

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