Regular Exercise Relieves Symptoms of Chronic Conditions

A bird at Echodale Park. (Dr. Noorali Bharwani)
A bird at Echodale Park. (Dr. Noorali Bharwani)

There is one drug that can be free, safe and readily accessible. It is called exercise. Every person should be encouraged to take this drug to be happy and healthy. That is the message in an article published in the Canadian Medical Association Journal (Prescribing exercise interventions for patients with chronic conditions, CMAJ April 19 2016)

Experts believe exercise is under prescribed and frequently overlooked often in favour of medications or surgery. Patients find taking painkillers is an easy way out than finding time for regular exercise. We are very busy making a living and raising a family. Finding time for regular exercise means making choices and sacrifices.

What are the benefits of regular exercise?

Studies have shown regular exercise plays a big role in prevention of coronary heart disease, stroke rehabilitation, treatment for heart failure and prevention of diabetes. Benefits of exercise are substantial for conditions that are not life threatening, like chronic back pain and osteoarthritis.

Outcomes for which exercise is effective

The authors of the CMAJ article reviewed evidence for the effectiveness of exercise for the following conditions: Arthritis of the hip and knee, chronic nonspecific low-back pain, prevention of falls, heart failure, coronary heart disease, chronic obstructive pulmonary disease (COPD), chronic fatigue syndrome, and type 2 diabetes.

The evidence is clear. Exercise helps.

To make sure the exercise program works for a patient the health care provider should monitor the progress in conjunction with the exercise specialist. Without appropriate guidance exercise is unlikely to achieve the desired outcomes.

Not all patients need to see an exercise specialist. Some of these exercises may be prescribed by family physicians. These are largely self-actioned by a patient (for example for falls prevention), whereas other interventions require a referral to a health care professional with expertise in exercise prescription (e.g., cardiac rehabilitation, exercise for chronic back pain or knee osteoarthritis and pulmonary rehabilitation for COPD).

For example, a person with chronic nonspecific low-back pain should see an exercise specialist to guide through a properly planned exercise therapy.

According to the CMAJ article, a typical program would comprise 20 hours of individually supervised sessions over 8–12 weeks and a home program. The type of exercise (e.g., yoga v. graded activity) seems less important than the quality of implementation (e.g., supervision, inclusion of a home program and duration of the program have been shown to improve treatment effect).

Exercise programs normally include an education component, incorporation of psychological principles, such as pacing or goal setting, and progress in functional activities, says the article.

The authors believe exercise is an effective but neglected treatment for many chronic conditions. Exercise is beneficial for many chronic conditions and can offer benefits that are comparable to taking painkillers.

Under normal circumstances how much should the average adult exercise every day?

Regular exercise is important for everyone. This is a well-known fact. Everybody knows it. But most people have trouble finding time or are confused about the type of exercise they should do.

It is recommended that adults accumulate at least 2.5 hours of moderate to vigorous physical activity each week and children and youth accumulate at least 60 minutes per day.

Regular exercise strengthens your heart, lungs, bones and muscles. Gives you more energy and strength. Helps control your weight and blood pressure. All the things we always wanted in life… besides money!

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Surgeon General of the U.S. Promotes Healthy Walking

A beach in Albufeira, Portugal. Stay active, stay healthy! (Dr. Noorai Bharwani)
A beach in Albufeira, Portugal. Stay active, stay healthy! (Dr. Noorai Bharwani)

Regular walking has physical and mental benefits.

“If you seek creative ideas go walking. Angels whisper to a man when he goes for a walk,” says writer Raymond I. Myers.

If you want to be healthy and stay healthy then take a walk, says U.S. Surgeon General Dr. Vivek Murthy. Vice Admiral Vivek Murthy is an American physician, a vice admiral in the Public Health Service Commissioned Corps, and the 19th Surgeon General of the United States. He knows what he is talking about.

Only half of adults and just over a quarter of high school students get the amount of physical activity recommended for good health. That is not good.

How much activity do we need to stay healthy?

It is recommended that adults get at least two and half-hours a week of moderately intense physical activity. Children should be active at least 60 minutes every day.

Why do we need to be physically active?

The reasons are pretty simple but very important. Regular physical activity reduces the risk of heart disease, diabetes, obesity and a list of other health problems – and can ease symptoms and improve quality of life for people already living with chronic diseases.

Murthy says your walking should be brisk enough that you can still talk but not sing. Walking should be brisk enough to get your heart rate up. To encourage walking we need to make our neighborhoods easier and safer for foot traffic. Walking is simple and affordable. Murthy encourages communities to create walkable neighborhoods. Make sidewalks safer for seniors.

November is senior’s falls prevention month. Studies have shown that walking is good for balance. A good balance does help prevent falls.

Walking is not always easy. Changing weather and flu season is a hindrance to establish consistent walking habit. Icy roads and sidewalks are dangerous. People find indoor areas like malls and indoor walking trails in places like YMCA very helpful.

You can walk leisurely 30 minutes a day for general health benefits. You can walk briskly to improve cardiovascular fitness by walking 30 minutes a day five days a week. If you are trying to lose weight then you need to walk briskly for 45 to 60 minutes a day five days a week. And make your dinner slimmer.

Scientific literature suggests that regular, brisk exercise of any kind can improve confidence, stamina, energy, weight control and life expectancy and reduce stress. It can also reduce the risk of coronary heart disease, strokes, diabetes, high blood pressure, osteoporosis and other health problems. And Friedrich Nietzsche, author of Twilight of the Idols says, “All truly great thoughts are conceived while walking.” What more can you ask for?

Now lets get cracking!

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Regular Physical Exercise Makes You Smart and Healthy

One step at a time. (Dr. Noorali Bharwani)
One step at a time. (Dr. Noorali Bharwani)

Who wouldn’t like to be smart and healthy?

An article in the Scientific American Mind (July/August 2009), titled “Fit Body, Fit Mind?” says your workout makes you smarter and you stay sharp into old age.

“We are used to thinking of intelligence as largely a matter of genetic inheritance, but that is not the whole picture. What you do affects your mental wellbeing: staying physically and mentally active helps us stay sharp as we age,” says the article. Your brain and body – either use it or lose it.

A review of dozens of studies shows that maintaining a mental edge requires more. Other things you do – including participating in activities that make you think, getting regular exercise, staying socially engaged and even having a positive attitude – have a meaningful influence on how effective your cognitive functioning will be in old age, says the article.

Sometime ago, researchers from Denver presented their research at the annual meeting of the Pediatric Academic Societies. Their conclusion: being more physically fit means kids will do better in school. They found that this can be achieved by increasing school’s physical education program to 40 minutes a day, five days a week, from 40 minutes once a week. The performance improved by about 70 per cent. Amazing!

A healthy and smart child will one day become a parent and hopefully instill the same kind of healthy attitude to the future generations. A person can workout at school, at a public or private gym or at home.

To be smart and healthy one has to have enough sleep everyday. Sleep scientists say that we need one hour of sleep for every two we stay alert. This allows the brain to regenerate and repair itself. A student needs that to stay fresh and study more. A good night’s sleep also makes driving safe.

To be smart, a student has to study. Without studying you don’t get the grades. So how many hours should one study? That requires time management skills. We all have 168 hours in a week to use as we wish. Common sense says that more time you spend studying better your academic performance will be.

Most universities recommend that students study at least two hours outside of class for every hour spent in class, although some recommend even more.

Finally, boost your memory and brainpower with healthy food like fruits, vegetables and fish.

It is not difficult to be healthy, happy and smart. Mental and physical power depends on how much time and effort we put into it. Have fun.

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How Schools Teach our Children to be Fat

A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)
A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)

“Our children are getting fatter. They eat more and move less,” says Diane Kelsall, MD, deputy editor, Canadian Medical Association Journal (CMAJ April 7, 2015), in an editorial titled, “How schools teach our children to be fat.”

The editorial goes on to say that nearly 85 per cent of children aged three to four years meet activity levels recommended in Canadian guidelines, but this falls to only four per cent in teens.

Unfortunately, most of our overweight or obese children will not outgrow their weight problem. That means they develop adult diseases like hypertension and diabetes. And our schools hinder the fight against obesity in our youth, says the editorial.

If you look at a typical day for our children when they are at school then you will understand why Dr. Kelsall feels our schools are doing a poor job of preventing obesity. She makes the following points:

  • Our children’s school day starts early, often well before 9 am.
  • They are likely driven or take the bus to school.
  • They are tired when they arrive and sit for most of the day.
  • Physical education classes are usually not required after grade nine.
  • Lunch may be rushed, and food options available in the school may be high in fat or sugar.
  • At lunch or after classes, some students may participate in sports, but most don’t.
  • Students have hours of homework resulting in extended screen time.
  • They go to bed late, and the cycle starts all over again.

No wonder nearly one-third of our school-aged children are overweight or obese. Our schools should be helping our children to be healthy and that should lead to healthy adulthood. How can schools do that? Dr. Kelsall suggests the following:

  • Daily exercise should be mandatory for all school children. It should become part of daily life. Classes should include enough sustained, vigorous exercise to help students meet recommended activity levels, rather than the 20-minute requirement in some jurisdictions.
  • Walking or cycling to school is a good start.
  • Taking public transportation affords more opportunity for exercise than being driven by parents.

Lengthy sitting time has been shown to be a risk factor for early death in adults. The editorial says that a peek into most high school classrooms will show rows of students sitting for classes that are often 75 minutes in length, among the longest in the world. This sends the message that being sedentary is acceptable. Beyond physical education classes, getting students moving during school hours takes creativity.

We should do what Japan does. Make food education a part of the compulsory curriculum. We should encourage our kids to sleep early and get up early. Like adults, tired adolescents are at increased risk of obesity.

“Obesity is a complex disease and prevention requires multilevel intervention,” says Dr. Kelsall. It starts with the individual and family making good choices around exercise and food intake, but broader societal support is necessary. Our battle against smoking is slowly winning and message to people is clear – if you smoke then you kill yourself and hurt others. The message for obesity and overeating is the same – stop hurting yourself and the people you love.

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