Monday 11 December 2017

How exercise is the latest 'wonder drug' that all doctors should prescribe

Instructor Mark Holland with his client Lynne Davies at FlyeFit Gym, Baggot Street, Dublin Photo: Caroline Quinn
Instructor Mark Holland with his client Lynne Davies at FlyeFit Gym, Baggot Street, Dublin Photo: Caroline Quinn
Eilish O'Regan

Eilish O'Regan

It's hailed as the "wonder drug" of 2017 that all doctors should prescribe - and it's free.

Exercise is hard to beat for its power to not just prevent but also treat illness.

It is possible to walk your way to better health, according a group of experts on the physical activity policy group of the Royal College of Physicians.

Co-chair of the group, Professor Sean Gaine, a specialist in the Mater Hospital, Dublin, said they were urging fellow doctors to "engage with patients to increase their levels of physical activity, through advice, prescription and referral".

The impressive long-term benefits include:

- A 30pc risk reduction in deaths from any cause;

- Reduced chance of heart disease, stroke and cardiovascular disease, type 2 diabetes, breast and colon cancer;

- 29pc-30pc less risk of depression;

- 30pc lower risk of falls in elderly;

- 36pc-68pc reduced risk of hip fracture.

The guideline for adults is at least 30 minutes of moderate activity five days a week or 150 minutes weekly.

However, two-thirds of adults are not meeting the guidelines and more than one in 10 is sedentary. "Some exercise is better than none," said Prof Gaine.

The group found that lack of time is often cited as a reason for not exercising, but they point out that there are many small opportunities to work it into our daily lives.

It's possible to accumulate time spent in light activity - getting up from the chair and moving during ad breaks on television; pacing while on the phone; adding gentle five-minute breaks during the day; and walking rather than driving on short trips.

Prof Gaine said he often found older patients were frail but the way to reduce the chance of this was to start exercising when you were still young.

Active

Responding to the call to prescribe exercise, Dr Brendan O'Shea of the Irish College of General Practitioners, who is a family doctor in Kildare, said most GPs had experience of prescribing the 'wonder drug'.

"GPs are well placed to prescribe exercise, as we know our patients well, they usually attend us for many years. We understand what options might work for them and we know about the exercise facilities in the community," he said.

"Because of the personal medical care we provide over the years, we can approach the topic at a good time, and in a tailored way suited to the individual concerned.

"Many of us were active in our adolescence, playing on teams or pursuing particular sports, often with dedication, and to a high degree of accomplishment. But life intervenes, and a combination of the mortgage, a busy career, two children and a long commute often combine to make the adolescent exercise habit impossible.

"There is a job of work to do, to nudge and assist people to devise a more sustainable but effective exercise habit, for their middle and later years, rather than simply opting out, and allowing the middle aged spread to take over. The middle aged spread often comes with diabetes and blood pressure."

Dr O'Shea said that people did not often attend GPs asking for advice on exercise.

"But we can find moments in our consulting where we can usefully put it on the agenda," he said. "Several years ago, an exercise referral scheme introduced by the HSE was trialled, and was the subject of a major review in 2016.

"From a GP perspective, extent of the administration required when referring the individual to the fitness instructor was an added challenge.

"Most GPs are having more conversations about exercise with patients than previously.

"In addition to the prevention benefits, both GPs and increasing numbers of patients understand that developing a good exercise habit is very helpful in reducing anxiety, improving sleep patterns and alleviating depression.

"For people who are troubled by these symptoms, use of exercise definitely enables reduced use of medication."

Irish Independent

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