Exercise is Statistically as Good as Pharmaceuticals to Treat Diseases

A recent study published in BMJ found that physical activity is as effective as drug interventions for patients with existing cardiovascular diseases and other chronic conditions such as diabetes.

In the few conditions where the life-saving benefits of exercise have been studied, physical activity was often found to be as effective as drugs at reducing the risk of death, according to the first study to aggregate and assess the comparative benefits of drugs and exercise for reducing mortality in a wide range of illnesses.

"We were surprised to find that exercise seems to have such powerful life-saving effects for people with serious chronic conditions," said Huseyin Naci, an HMS visiting fellow in population medicine at the Harvard Pilgrim Health Care Institute, and a graduate student at the London School of Economics. "It was also surprising to find that so little is known about the potential benefits of physical activity for health in so many other illnesses."

Regular physical activity has been shown to reduce the morbidity and mortality from many chronic diseases. Millions suffer from chronic illnesses that can be prevented or improved through regular physical activity. This include heart disease, heart attack, type 2 diabetes, obesity, colon cancer, hip fractures, stroke and high blood pressure. On average, people who are physically active outlive those who are inactive.

Despite the well-known benefits of physical activity, most adults and many children lead a relatively sedentary lifestyle and are not active enough to achieve these health benefits. A sedentary lifestyle is defined as engaging in no leisure-time physical activity (exercises, sports, physically active hobbies) in a two-week period.

Study Details

In addition to providing guidance for patients and clinicians about the importance of discussing the potential benefits of exercise, the researchers highlighted the importance of continuing to research the value of exercise for health.

The researchers argue that more trials comparing the effectiveness of exercise and drugs are urgently needed to help doctors and patients make the best treatment decisions. In the meantime, they say exercise "should be considered as a viable alternative to, or alongside, drug therapy."

"We're not saying people who have had a stroke should go off their medication and head to the gym," Naci said, "but having a conversation with their physician about incorporating exercise into their treatment might be beneficial in many cases."

Preventable illness makes up approximately 80% percent of the burden of illness and 90% of all healthcare costs. Preventable illness accounts for eight of the nine leading categories of death.

In the United States, 80 percent of people 18 and older failed to meet the recommended levels of aerobic and muscle-strengthening physical activity in 2011, according to the CDC. What's more, the average number of retail prescriptions per capita for calendar year 2011 was 12.1, according to the Kaiser Family Foundation.

For people with chronic ailments, exercise used to be viewed as asking for trouble. However, current evidence suggests that in both health and disease, the overall prognosis is better for the exerciser than for the sedentary. For example, a recent study showed that intensive workouts can not only slow the progress of coronary disease, but actually restore lost coronary function when the disease is still stable.

"We've yet to find a disease state where exercise isn't helpful." said Miriam Nelson, Ph.D, from Tufts University. 

For the current study, the researchers analyzed the results of 305 randomized controlled trials involving 339,274 individuals and found no statistically detectable differences between exercise and drug interventions for secondary prevention of heart disease and prevention of diabetes.

Exercise Often More Effective Than Drugs

Among stroke patients, exercise was more effective than drug treatment.

The authors point out that the amount of trial evidence on the mortality benefits of exercise is considerably smaller than that on the benefits of drugs, and this may have had an impact on their results. Of the nearly 340,000 cases analyzed, only 15,000 patients had had exercise-based interventions.

For chronically ill individuals, the psychological as well as physical benefits of exercise can be profound. Even ten minutes of light exercise a day, can help most chronically ill patients feel more vibrant, energetic and alert.

"Exercise is empowering and energizing, and it increases your sense of control over the situation. You're never too sick or too old to get started exercising," stated Bess Marcus, Ph.D, of Brown's University. 

The researchers argue in the paper that this "blind spot" in available scientific evidence "prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement but exercise could yield more profound or sustainable gains in health."

Participation in regular physical activity-- at least 30 minutes of moderate activity on at least five days per week, or 20 minutes of vigorous physical activity at least three times per week--is critical to sustaining good health. Youth should strive for at least one hour of exercise a day. Regular physical activity has beneficial effects on most (if not all) organ systems, and consequently it helps to prevent a broad range of health problems and diseases. People of all ages, both male and female, derive substantial health benefits from physical activity.

Regular physical activity reduces the risk of developing or dying from some of the leading causes of illness in the United States. Regular physical activity improves health in the following ways:

• Reduces the risk of dying prematurely from heart disease and other conditions;
• Reduces the risk of developing diabetes;
• Reduces the risk of developing high blood pressure;
• Reduces blood pressure in people who already have high blood pressure;
• Reduces the risk of developing colon and breast cancer5;
• Helps to maintain a healthy weight;
• Helps build and maintain healthy bones, muscles, and joints;
• Helps older adults to become stronger and better able to move about without falling;
• Reduces feelings of depression and anxiety; and
• Promotes psychological well-being. 

Exercise v.s. Diet v.s. Drugs

Exercise v.s. diet v.s. drugs is often the debate that many health professionals evaluate. By examining each disease through clinical trials, we can better determine the efficacy of both exercise and diet in the treatment of many common ailments. Diet, for example, is the cornerstone of diabetes care, but if diet is combined with exercise, diabetics dramatically improve their condition by more than 45% than with diet alone. 

CONDITION	TYPE OF EXERCISE	MAXIMUM IMPROVEMENT WITH EXERCISE	MAXIMUM IMPROVEMENT WITH DRUGS	MAXIMUM IMPROVEMENT WITH DIET
High Blood Pressure	Aerobic	15%	9%	11%
Diabetes	Strength training, flexibility, low-impact aerobic	52%	5%	38%
Stroke	Strength training, flexibility, low-impact aerobic	28%	7%	--
Heart Disease	Aerobic	33%	11%	26%
High LDL cholesterol	--	--	13%	20%
Low HDL cholesterol	Aerobic	15%	--	--
High Blood Sugar	Aerobic	15%	11%	30%
Arthritis Pain	Strength training, flexibility, low-impact aerobic	40%	12%	--
Low Bone Density	Weight bearing	3%	--	2%

Regular physical activity is associated with lower mortality rates for both older and younger adults. Even those who are moderately active on a regular basis have lower mortality rates than those who are least active. Regular physical activity leads to cardiovascular fitness, which decreases the risk of cardiovascular disease mortality in general and coronary artery disease mortality in particular. High blood pressure is a major underlying cause of cardiovascular complications and mortality. Regular physical activity can prevent or delay the development of high blood pressure, and reduces blood pressure in persons with hypertension.

Despite this uncertainty, the authors claim that based on the available data physical activity is potentially as effective as many drug interventions and more trials to address the disparity between exercise and drug-based treatment evidence are needed.

"What we don't know about the benefits of exercise may be hurting us," Naci said.

Sources:
bmj.com
nlm.nih.gov
preventdisease.com
medicalnewstoday.com

Dr. Marianna Pochelli is a Doctor of Naturopathic Medicine specializing in the treatment of disease through superfoods and herbal strategies. She actively promotes detoxification, colon cleansing, and a vegetarian lifestyle using living foods as a platform to health.