Exercise is Medicine! But how can we convince the sceptics?

I connected with ACSM president Bob Sallis today – he is heading up the ‘Exercise Is Medicine’ initiative through ACSM.

Bob, a family doctor in California, shared his frustration with mainstream medicine overlooking physical activity as the most powerful therapy available to physicians. The Exercise is Medicine initiative aims to have every family doctor assessing current level of physical activity by a simple questionnaire at every consultation. This question would be asked by the office assistant so that the doctor, of course 100% reliable, would not need to take up time to do that.

Patients who are doing less than 150 minutes of physical activity per week could then be readily flagged for interventions. And that is a whole new ball of wax as they say! But there is hope – more and more interventions are proving successful so combining the best of research from psychology, exercise physiology, engineering and electronics should allow us to make a difference. As Bob says, ‘we can convince patients to have their stomach stapled and take medications that sometimes make them feel awful, so promoting physical activity shouldn’t be that difficult!’.

The Exercise is Medicine initiative aims to have every family doctor assessing current level of physical activity by a simple questionnaire at every consultation. This question would be asked by the office assistant so that the doctor, of course 100% reliable, would not need to take up time to do that.

Do you have a successful way of promoting physical activity in the office? And please remember the BJSM special issue for 2009 – Integrating Physical Activity into Clinical Practice.

The April issue of BJSM has 4 papers related to physical activity and health:
check them out online first!

An active school model to promote physical activity in elementary schools: Action Schools! BC
Patti-Jean Naylor, Heather M Macdonald, Darren E. R. Warburton, Katherine E Reed, and Heather A McKay

Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomized controlled trial
Jannique G.Z. van Uffelen, Marijke J.M. Chinapaw, Willem van Mechelen, and Marijke Hopman-Rock

Effect of commercial airline travel on oxygen saturation in athletes
Celeste Geertsema, Anthony B Williams, Peter Dzendrowskyj, and Chris Hanna

Best The Practice of Primary Care Sports Medicine in the United States
Jason J Diehl, Jason J Pirozzolo, and Thomas M

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  • Ivo Janecka, MD, MBA, PhD

    Exercise is indeed medicine and one of the best ones we have had on our evolutionary journey. Skeptics should be addressed not as a single group but should be “stratified,” based on their risk factors. A well-person without strong family history of serious/fatal diseases is unlikely to be approachable, at least not at this point of time. However, high risk population is likely to be very receptive to clear and straightforward connections between health and disease and health-disease-lifespan association.
    I looked at the relationship between colon cancer and physical activity (see abstract and web link below – it’s an open-access journal). Anyone who is in a high risk category would likely “get the message.”

    Janecka IP: Colon Cancer and Physical Activity: A Content Analysis of Reciprocal Relationship. Clinical Medicine: Oncology 2007:1 81–89
    http://la-press.com/cr_data/files/f_CMO-1-Janecka-et-al_437.pdf

    Abstract
    Background: Colon cancer is among the leading causes of cancer mortality and its incidence is increasing worldwide. This is true in spite of broad basic research into colon cancer while, concurrently, physical activity has been shown to offer significant preventive potential. This background led to the formulation of the following research questions:
    • Why is physical activity so effective in decreasing the incidence of colon cancer?
    • Is there a common denominator to colon cancer and physical activity, which has a reciprocal function?
    • Knowing the potential for public health impact of physical activity on colon cancer, has physical activity-colon cancer relationship been in the forefront of research efforts?
    Methods: Content analysis of archival literature has been carried out on census of 32,822 message units, extracted from the National Library of Medicine and its PubMed database. The following search terms were used: colon cancer, physical activity, melatonin, age/genetics, diet (obesity, vitamin D, calcium), immunity/inflammation, and bioactive substances
    incorporating insulin-like growth factor 1, interleukins, and prostaglandins. The research timeframe for each category began with the first article published and ended with the last one printed in 2005.
    Results/Conclusions: The effectiveness of physical activity in decreasing the incidence of colon cancer is likely the result of its biologic activity within not one or two but all of the major known colon cancer etiologies, demonstrating a powerful reciprocal relationship. Melatonin is identified as a plausible common denominator of colon cancer and physical activity. The greatest volume of publications deals with colon cancer and genetics. A significant societal health care impact could be achieved by adopting physical activity as a major cancer control strategy.