Exercise is Medicine
A key thing to note is that the benefits of physical activity are short- lived hence there is a need for consistency. To promote and maintain health
Majority of the health ministerial budgets world- wide is directed towards curative treatment.
Prevention is preached, however not enough attention is extended in that area, for instance, a lot is spent annually on surgical procedures, cardiovascular evaluations and medications, that is, in the pharmaceutical industry.
Despite this tremendous budget directed to health care, non- communicable diseases continue to be rampant and we tend to run out of these commonly prescribed drugs. One may attribute it to poor supply and stock control but on the flip side, are our efforts well directed?
The honest answer is NO!
Non- communicable diseases account for 40.5 million deaths globally, 86percent of which occur in the low and middle income countries according to WHO. From the 2014, Botswana STEPS survey; 30.6percent of adults are overweight or obese, 18.5percent smoke and 95percent do not eat enough fruits and vegetables.
Based on a CDC report on health outcome determinants, 20percent is determined by genetics, 20percent the environment like clean water access, pollution etc; 10percent by access to health care and 50percent by our health habits, mainly physical activity, diet and smoking.
As alluded to prior, a chunk of the budget is usually directed towards access to health care which contributes the least to the health outcome determinants as per this WHO report. It is no secret that there is need for access to good health care systems, however, efforts need to be directed on primary prevention by improving our health habits. Most prominently, improving physical activity, encouraging good nutrition and cessation of smoking.
Currently, we focus on physical activity.
Exercise
Exercise is a form of physical activity. Over the past 12 years, physical activity ( PA) has been proven to have positive outcomes in relation to preventing onset of illness ( primary prevention), improving disease control ( secondary prevention) and improving morbidity ( tertiary prevention).
All these levels of prevention are vital and can lead to improved health outcomes, quality of life and reduction of the national health expenditure.
The benefits of PA have proven to improve with increased intensity, frequency and duration. WHO has devised recommendations which have shown to be effective in achieving optimal outcomes. These outcomes are well recognized with exercise at moderate intensity; there is a dose- response relationship where greater reductions in risk are met with high intensity activity, however, a small bit of exercise done leads to improved outcome compared to no exercise at all. A key thing to note is that the benefits of physical activity are short- lived hence there is a need for consistency. To promote and maintain health, all healthy adults aged 18 to 65 years need moderate- intensity aerobic ( endurance) physical activity for a minimum of 30 minutes, five days each week or vigorous- intensity aerobic physical activity for a minimum of 20 minutes, three days each week.
Combinations of moderate and vigorous intensity activity can be performed to meet this recommendation. For example, a person can meet the recommendation by walking briskly for 30 minutes twice during the week and then jogging for 20 minutes on two other days. Moderate intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30 minute minimum by performing bouts each lasting 10 or more minutes. During moderate intensity exercise, a person should be able to talk to a companion but might be a little breathless. Vigorous intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition to the above recommendations, every adult should perform activities that maintain or increase muscular strength and endurance, a minimum of two days each week. Eight to ten different exercises using the major muscle groups of the legs, trunk, chest and shoulders; one or two sets of 8– 12 repetitions each should be performed.
How do we implement the change?
Exercise is Medicine needs to be at the forefront of health initiatives as it seems to be the single most ‘ drug’ with mostly desirable side effects; the 5 key steps include:
1. Pre- exercise screening
2. Exercise prescription
3. Promoting exercise oriented behaviour
4. Health promotions
5. Consistency
Over the next weeks, we’ll run a series covering the measures as outlined. Indeed ‘ Exercise is Medicine’; The results are worth a change in strategy incorporating exercise along with other healthy habits to improve health outcomes in the general population which can in turn, reduce the burden of expenses on the health care systems.