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Dr. Michael Greger: Survival of the Fittest — Exercise as Medicine

Physical inactivity has been called the biggest public health problem of the 21st century. Of course just because someone calls it that doesn’t mean it’s true, in fact physical inactivity ranks down at #5 in terms of risk factors for death, and #6 in terms of risk factors for disability. Diet is by far our greatest killer, followed by smoking.

But, there is irrefutable evidence of the effectiveness of regular physical activity in the prevention of several chronic diseases—cardiovascular disease, diabetes, cancer, hypertension, obesity, depression, osteoporosis, and premature death—helping to add years to our life, and above all, life to our years. It truly may be survival of the fittest.

How much exercise do we need? In general, the answer is the more the better. Currently, most health and fitness organizations advocate a minimum of a thousand calories of exercise a week, which is equivalent to walking an hour a day five days a week. Seven days a week, though, may be even better in terms of extending one’s lifespan.

Exercise is so important that not walking an hour a day is considered a high risk behavior, alongside smoking, excess drinking, and being obese. Having any one of these effectively ages us three to five years in terms of risk of dying prematurely, though interestingly those who ate green vegetables on a daily basis did not appear to have that same bump in risk. Even if broccoli-eating couch potatoes live as long as walkers, there are a multitude of ancillary health benefits to physical activity that doctors are encouraged to prescribe it, to signal to the patient that exercise is medicine.

Researchers at the London School, Harvard, and Stanford compared exercise to drug interventions and found that exercise often worked just as well as drugs for the treatment of heart disease, stroke, and diabetes. There’s not a lot of money to fund exercise studies, so one option would be to require drug companies to compare any new drug to exercise. In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition.

Copyright 2015 Michael Greger. First published in NutritionFacts.


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