‘Take five long walks and call me next week’
Can a prescription for exercise do as much good as a bottle of pills?
Steven Blair, the author of rafts of research on the medical value of exercise, says it definitely can be as effective, and he is at the University of British Columbia this week to tell newly minted doctors that very thing.
“(Medical professionals) haven’t been trained in it, so it’s not in the forefront of their thinking. And physicians are very busy. I think they just haven’t been persuaded that this is something they have to do,” said Blair.
Blair, a professor at the University of South Carolina’s school of public health, says that despite the growing evidence that physical activity is another “vital sign” that doctors should monitor in their patients, it is still not on the radar of many health professionals.
“The major health problems around the world — certainly in North American and Europe — are non-communicable diseases. And what are the causes of non-communicable disease — diabetes, heart attack, stroke, cancer? It’s unhealthy lifestyles. That’s a major cause of our health problems,” he said in a telephone interview this week.
“We would like more physicians to pay more attention to this incredibly important health issue.”
Blair’s talks at UBC are being hosted by the Centre for Hip Health and Mobility, which conducts research on bone health and fall prevention.
Dr. Karim Khan, a researcher at the centre and a UBC professor in family practise, says part of the problem is that studies comparing the effects of exercise to the effects of medication are relatively new, and significant changes in professional approach can take a generation.
It has been 10 years since the American Heart Association declared that exercise is an effective treatment for heart disease, yet the past decade also saw a boom in prescriptions for statins, a class of medication used to reduce the cholesterol that contributes to heart disease.
Khan points to a 2004 study published in the journal Circulation that concluded exercise was as effective — and much cheaper and safer — than implanting a mesh stent in the arteries of patients with stable coronary artery disease.
Yet doctors are far more likely to hear about advancements in drug research — even if the benefits are marginal — because pharmaceutical companies have budgets to distribute positive research papers to inboxes around the world.
“It’s about who has the pulpit,” said Khan. “Data is powerful. It’s not a lack of information, it’s the proportion of information that doctors are hearing.”
Likewise, Blair says a 2002 study published in the New England Journal of Medicine should have revolutionized the treatment of pre-diabetes, yet the number of North Americans with type-2 diabetes continues to rise. Researchers concluded that a regular exercise program reduced the incidence of diabetes by 58 per cent, compared to a 31-per-cent reduction with a medication — metformin. There was no reduction in the group that took a placebo.
“When it came out, I remember physicians saying it was too complex to monitor patients,” said Blair.
Ultimately, both researchers say, the huge cost benefit of prescribing exercise over expensive drugs will win more converts.
Steven Blair and Dr. Karim Khan will speak in Abbotsford [August 28th, 2013] at the Matsqui Centennial Auditorium from 7 to 8:30 p.m. The event is sponsored by the Abbotsford Division of Family Practice along with Healthy Abbotsford.
For more information please contact David Adams, Associate Director, MobilityBC - UBC Centre for Hip Health & Mobility at 604-875-4111 x 21784