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Can more push-ups mean fewer pills?

  • Article by: KATY READ
  • Star Tribune
  • January 10, 2012 - 3:52 PM

Exercise may be the single most effective thing you can do to stay healthy, but many people never hear their doctors mention it.

Regular, moderate exercise has been shown to protect against conditions ranging from diabetes to depression, from cancer to cardiovascular disease. Yet about half of Americans don't do it. Studies suggest that people are more likely to exercise -- to at least try it -- if following doctors' orders. But health-care providers maintain no established tradition of discussing these benefits with their patients, have no framework for assessing patients' fitness or recommending regimens and specialists.

Exercise Is Medicine is working to change that. The four-year-old initiative, organized by the Indianapolis-based American College of Sports Medicine (ACSM) along with the American Medical Association, aims to make exercise assessments and advice as standard a part of doctor's office visits as weigh-ins and blood-pressure checks.

"Hopefully at some time in the not too distant future, every time a patient goes to see a health-care provider ... they will get some sort of physical activity assessment, or be referred to health and fitness professional for counseling," said Adrian Hutber, vice president of Exercise Is Medicine.

Dr. Robert Sallis, then president of the ACSM, developed the program out of frustration "that he, as a physician, could refer patients for bariatric surgery but could not refer patients for physical activity counseling," Hutber said. Exercise Is Medicine has since spread to about 25 other countries, each with a task force of local doctors, fitness experts, government officials and other authorities who tailor the program to the local culture.

The Exercise Is Medicine website (www.exerciseismedicine.org) provides information for the public, fitness professionals and others, including tips and handouts to help health-care providers integrate fitness discussions into examinations. It even offers a standardized "Exercise Prescription and Referral Form" on which doctors can write their patients individualized recommendations for aerobic and strength exercise.

The eventual goal is to create referral networks of fitness professionals trained to work with patients with specific medical issues, such as cardiovascular disease or Alzheimer's. The possibility that insurance plans will someday cover such services is "the holy grail," Hutber said.

Patients are generally willing to discuss exercise with their doctors, said Dr. Steven Stovitz, an associate professor at the University of Minnesota who works with college athletes as well as sedentary folks. A member of the Exercise Is Medicine's education committee, Stovitz recommends pedometers and other strategies to help his patients with sedentary jobs get moving.

"People, I think, are aware that more physical activity makes them feel better, and they tend to be open about discussing different strategies for increasing their own levels," Stovitz said. "Of course, it should not be done in a lecturing tone, it should be done in more of an assessment of where the patient's at."

Although people tend to use weight as a gauge for fitness, it's possible to be both fat and fit, and it's far healthier than being thin and inactive, said Steven N. Blair, professor in the Department of Exercise Science at the University of South Carolina, in an email. Inactivity causes more deaths than obesity, more than hypertension or high cholesterol; it even gives smoking a run for its money as a hazardous lifestyle choice.

"We have published many papers on this topic, and the findings are quite consistent: Obese individuals who are fit have a lower risk of dying during the next several years than normal weight people who are unfit," said Blair, whose research has informed Exercise Is Medicine's mission. "This pattern also holds for the development of many chronic diseases."

The good news is, getting active is easier than you might think. Federal guidelines for minimal fitness call for just 150 minutes a week of moderate-intensity physical activity, the equivalent of five brisk half-hour walks. That probably won't prepare you for a marathon or chisel your abs into a six-pack, but it's enough to reduce your risk of some chronic and deadly diseases.

"You're not going to turn into an athlete," Hutber said. "And the good news is, you don't need to ... if you're not interested in that. You can just be fit enough."

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