A Prescription for Exercise

May 26, 2016

The belief that “exercise is medicine” is nothing new. It is thousands of years old, even within the Western medical tradition. Hippocrates (circa 400 BC) is quoted with “walking is man’s best medicine.” Centuries later (in 1769) the Scottish physician William Buchan wrote “exercise alone would prevent many of those diseases which cannot be cured, and would remove others where medicine proves ineffectual.” Such sentiments ring true today as they did then, and are even touted at times as new and innovative. More recently, the phrase “Exercise is Medicine” has actually been trademarked in a joint project between the American Medical Association and the American College of Sports Medicine, emphasizing the recognition and importance of this simple truth.

The negative health consequences of an inactive lifestyle are multiple, including increased risks of overweight and obesity, heart disease, frailty, falls, and many other maladies. The health benefits of regular physical activity are similarly myriad: regular physical activity combats many chronic diseases, improves mood, boosts energy levels, improves sleep, along with many other health benefits. To borrow a phrase, the benefits of exercise are “priceless.”

Hopefully, therefore, we can all answer the question of whether or not we should be physically active with an affirmative nod. The next likely questions then become what should we do to be more physically active and how much should we do?

The best responses to these questions need to be given in context for each individual. Where are you now? Where do you want to be tomorrow, next year, in 10 years? For example, for individuals who are currently not particularly physically active, I would answer: Do something, even if it is only 5 minutes each day. Then, after a week, add another five minutes each day. Continue this process for 6 weeks, building up to “something” for 30 minutes most days, if not each day, of the week.

For individuals that are already active, they may want to consider a tune up to their routine. Ideally, each of us, almost regardless of age, should be striving for 60 minutes of physical activity / exercise each day. By the end of the week, that would hopefully include 3-4 hours of moderate aerobic activity, 1-2 hours of strengthening exercises, and 1-2 hours of activities that promote flexibility and balance.

Don’t have an hour to dedicate each day? Then work on it in smaller, bite sized doses throughout the day. Aim for 10-15 minutes as a minimum for each session.

Looking to know “how hard” your efforts should be? Again, this needs to be answered in context for each individual.

First, let’s review some terms that are often used when discussing physical activity and exercise. The phrase “physical activity” would be our most inclusive concept, and would include everything from the moving about from room to room with simple daily activities, shopping, cleaning, etc., to the more formal idea of “exercise.” “Exercise” would then refer to purposeful physical activity with some general goal toward benefiting one’s health or enjoyment. This may include going for a walk after a meal, going to the gym to “work out” or taking an exercise class at the fitness center or even at your local library. The goals of “exercise” may be a general “because it’s good for me” or “because I like it,” or may be more specific, such as “to help lower my blood pressure.” The concept of “training” typically refers to more focused exercise, with such specific goals as “to run a 5k this summer” or “to lift so many pounds.” We should all be physically active, and with few exceptions, we should all be exercising to some extent. Most of us, however, do not need to “train,” per se.

These concepts reflect the intent of the activity, but also imply the intensity needed to achieve the goals. Daily physical activity can generally be considered of “light to moderate” intensity for most individuals. Exercise should generally fall in to the “moderate” range, with some in the “light” zone and perhaps some in the “vigorous” zone. Training often entails more time spent in the “vigorous” zone.

Now, we’ve introduced a few additional terms, relating to intensity of exercise. Perhaps the easiest way to interpret the different levels of exercise intensity as “light,” “moderate,” or “vigorous” is the traditional “talk test.” If you can easily hold a conversation while you are physically active, you are in the “light” intensity zone. If you can speak in clear phrases, but need to limit the phrases to catch your breath, then this is the “moderate” intensity zone. Finally, if speaking much beyond a single word is difficult, you are more likely in the “vigorous” intensity zone. While there are several other more sophisticated ways to measure exercise intensity, the “talk test” is simple and requires no specialized equipment or know-how beyond the above descriptions.

If we follow our analogy of exercise as medicine, can we run the risk of an overdose? Certainly. Just as in most aspects of life, even good things can be done to excess. Overdoing it with exercise may lead to injury, and perhaps just as problematic, may lead to a decision to stop exercise altogether. If you have questions about the safety of an exercise program, or need more specific guidance to get started, seek the advice of a knowledgeable health care provider to get you on your way. Exercise is a tool, like any other. Learn to use it wisely, and it will help you throughout your life.



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