Canadian doctors are increasingly turning to prescriptions of exercise as a means to prevent and treat a host of illnesses.
In Leduc, Alta., south of Edmonton, family doctors realized the authoritative impact of a physician's prescription.
For a year, they've handed out "Prescriptions to Get Active" — complete with check boxes for the intensity, duration and type of physical activity — to patients they consider healthy but at risk for obesity and chronic diseases.
"There is a sense of tangibility and authoritativeness to a prescription," said Dr. Justin Balko, a family physician and president of the Leduc Beaumont Devon Primary Care Network. "People understand what a prescription is. They know it's not just a good idea. It's a health expert telling them that they want to do this for their own health."
Balko said more than 200 individuals have taken up the recommendations by signing up with a city's recreation centre, which offers a free month-long membership as part of the program. Of those who signed up for the month free, nearly 30 per cent continued with long-term memberships. Other patients may be getting fit on their own.
Balko was inspired by researchers in New Zealand. Since 2003, they've published studies in medical journals showing how doctors' prescriptions for exercise in that country can increase physical activity in adults by 10 per cent for at least a year.
Participants in Alberta are also provided time with an exercise specialist, who gets them accustomed to the facility and its equipment and who helps reduce barriers to getting active.
For the family doctors, the printed prescription pads are quick and easy to fill out, similar to the scripts they commonly use for medications.
At Toronto Rehab hospital, doctors have found that people living with heart disease who exercise regularly have a 50 per cent lower chance of dying than cardiac patients who don't work out.
Making doctors champions of exercise
"We think that exercise is helpful in every condition that we could think of," said Dr. Paul Oh, medical director of the cardiovascular prevention and rehabilitation program. "For brain health, for heart health, for cancer, for arthritis, the benefits are so large."
For an exercise prescription to be a success, doctors need to spend a few minutes counselling patients, setting up goals and an action plan, something Oh acknowledged that doctors aren't well trained to do. He said there's a movement afoot to train physicians to be better prescribers and champions of exercise.
Kimberley Harris, 42, goes to Toronto Rehab to follow her prescription to walk an 18-minute mile twice a day and lift light weights two or three times a week, all in the hopes of delaying the heart transplant she needs.
Harris was born with a very rare heart condition. Following reconstructive heart surgery as a teen, she had a heart attack in her mid-30s and now has a mechanical valve and an implanted defibrillator.
"It is part of my recovery prescription," Harris said of the exercise routine. "It is just as good as the eight drugs that I take daily. It helps my head a lot more than the drugs do."
Harris said that without the support and accountability provided by her health-care team — which includes doctors, nurses or nurse practitioners, dietitians, exercise rehabilitation supervisors, lab technicians, a psychologist and a social worker — she wouldn't follow through.
"It keeps you on track," said Harris. "It is so easy to go home and sit in your house and say, 'Oh, I am feeling sick. I don't want to do anything.' You are not allowed to do that here. You have to keep on track, it's a much more structured program."
Harris said she wishes the health-care system that caters to people after they're sick would pay more attention to preventing illness, particularly in congenital heart patients like herself.
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Improved Sexual Function
Here's a motivating reason to get moving: regular physical activity can increase blood flow in a way that has a direct affect on sexual function, explains <a href="http://www.huffingtonpost.com/david-katz-md" target="_hplink">HuffPost blogger</a> David Katz, M.D., founding director of Yale University's Prevention Research Center At Griffin Hospital. In fact, a recent study published by Emory University researchers in the <em>Journal of Sexual Medicine</em> identified a link between physical activity and erectile function among men between the ages of 18 and 40. "The men in our study who exercised more seemed to experience a protective benefit against erectile dysfunction," study co-author Wayland Hsiao, assistant professor of urology at Emory School of Medicine, <a href="http://www.emory.edu/EMORY_REPORT/stories/2012/01/research_exercise_enhance_sexual_function_men.html" target="_hplink">said in a statement</a>. "We hope that early screening for ED may be a gateway issue to help motivate young men to live healthily on a consistent basis so that they can possibly avoid health issues associated with a sedentary lifestyle, such as diabetes and cardiovascular disease. We see this as just the beginning."
Changes In Gene Expression
In the burgeoning field of epigenetics, scientists are discovering how <a href="http://www.time.com/time/magazine/article/0,9171,1952313,00.html" target="_hplink">environmental factors</a>, including diet, stress and toxins, can change the way our genes are expressed, essentially turning certain genes on or off, and affecting which are passed down from generation to generation. One factor that can play a role? Exercise. Two recent studies have illustrated just how regular physical activity can affect gene expression. The first study, conducted by Swedish researchers illustrated how inactive young adults demonstrated an immediate shift in their muscle cells' genetic material after just a few minutes on a stationary bicycle, <a href="http://www.huffingtonpost.com/2012/03/06/exercise-changes-your-dna_n_1324452.html" target="_hplink">HuffPost reported</a> when the findings were released. The second study, conducted by researchers from the Harvard School Of Public Health, found that walking an hour a day can <a href="http://www.huffingtonpost.com/2012/03/15/walking-obesity-genetic_n_1345224.html" target="_hplink">slash genetic tendencies toward obesity</a>. We'll walk to that!
Sweating it out could help you get your glow on post-workout, too. As Dr. Katz explains, your skin is the largest organ in your body. And as we slough off tons of skin cells each day, we need to give our body the right construction materials -- healthy foods, regular exercise, plenty of oxygen -- to rebuild. " If you've got good construction material," he says, "you can build healthy skin cells and you have good skin." Skin also tells the story of what's going on inside your body. "The skin is the window dressing. It's really reflective of overall health," Katz says. And that means if your body's natural detoxification system is healthy, including the kidneys, liver and spleen, it'll translate into a healthy looking glow. Those body-sculpting benefits of working out don't hurt either. "Skin draped over muscle looks great, skin draped over an excess of subcutaneous fat, not so much," Katz says.
Here's a health shocker: moving your feet may have health benefits all the way up to your eyes. According to a recent paper published in the journal <em>Investigative Ophthalmology & Visual Science</em>, <a href="http://www.sciencedaily.com/releases/2011/10/111024133028.htm" target="_hplink">regular exercise may be linked</a> to a lowered risk of developing glaucoma. Researchers, evaluating 5,650 men and women between the ages of 48 and 90, found that people who engaged in moderate physical exercise 15 years prior had a <a href="http://www.ahaf.org/glaucoma/newsupdates/physical-fitness-could-have-a.html" target="_hplink">25 percent reduced risk</a> of low ocular perfusion pressure, a risk factor for glaucoma. "It appears that OPP is largely determined by cardiovascular fitness," author Paul J. Foster, M.D. Ph.D., of the University College London Institute of Ophthalmology <a href="http://www.sciencedaily.com/releases/2011/10/111024133028.htm" target="_hplink">said in a statement</a>. "We cannot comment on the cause, but there is certainly an association between a sedentary lifestyle and factors which increase glaucoma risk."
Breaking a sweat during the day may just mean better beauty sleep at night. According to a large study published last year in the journal <em>Mental Health and Physical activity</em>, people who exercised at a moderate or vigorous level for at least 150 minutes a week (that's just over 20 minutes a day) <a href="http://www.sciencedirect.com/science/article/pii/S1755296611000317" target="_hplink">reported 65 percent better sleep quality</a> than their more sedentary peers. "Increasingly, the scientific evidence is encouraging as regular physical activity may serve as a non-pharmaceutical alternative to improve sleep," study author Brad Cardinal, a professor of exercise science at Oregon State University <a href="http://www.sciencedaily.com/releases/2011/11/111122143354.htm" target="_hplink">said in a statement</a> when the findings were released. And that, in turn, could have a whole host of additional benefits, as <a href="http://www.huffingtonpost.com/2011/11/28/exercise-sleep-quality-moderate-weekly_n_1116315.html" target="_hplink">poor quality sleep</a> has been linked to increases in inflammation, high blood pressure, and increased blood glucose levels in people diagnosed with Type 2 Diabetes.
A Sharper Brain
Looking at your body holistically, what's healthy for the whole body -- good nutrition, plenty of rest, supportive relationships -- is also good for the brain, explains Katz. And the same goes for regular exercise. "If something is good for your brain, it's probably good for you," he told The Huffington Post. "And if it's not good for you, it's probably not good for your brain." In the short term, exercise means increased blood flow to the brain, which can help you stay sharper. So instead of taking that coffee break, which provides an artificial stimulant to help you focus in the short-term, consider a walk instead. "Exercise does the same thing and it confers a lasting benefit into the bargain," he says. (Added bonus: <a href="http://www.huffingtonpost.com/2012/01/13/sitting_n_1202800.html#s608680&title=It_Ups_Diabetes" target="_hplink">sitting for too long</a> has been associated with a host of health problems, including increased diabetes and cancer risk.) In fact, one Swedish study published last year in the <em>Journal of Occupational and Environmental Medicine</em> found that taking exercise breaks at work for two-and-a-half hours a week was associated with improvements in productivity. Physical fitness also has brain benefits in the long term, as well. Studies have linked regular activity to <a href="http://www.sciencedaily.com/releases/2011/09/110907163919.htm" target="_hplink">decreased risk of dementia</a> and <a href="http://www.webmd.com/fitness-exercise/news/20070313/get-fit-improve-memory" target="_hplink">improved memory</a>.
Roughly 36 million people in the United States suffer from migraines, <a href="http://www.migraineresearchfoundation.org/about-migraine.html" target="_hplink">according to the Migraine Research Foundation</a> -- and the oftentimes debilitating headaches take their toll in more than 113 million lost work days each year. Characterized by <a href="http://www.mayoclinic.com/health/migraine-headache/DS00120" target="_hplink">intense pain in one side of the head</a> and often joined by symptoms of nausea, vomiting and sensitivity to light and sound, migraines tend to run in families and are <a href="http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=causes" target="_hplink">triggered by a variety of factors</a>, from foods to stress to environmental changes, according to the Mayo Clinic. Treatments can include drugs taken at the onset of an attack and preventive medications -- and a recent, small study suggests that exercise may be just as effective at the latter. The findings, published in the journal, <em>Cephalalgia</em>, suggest that <a href="http://www.huffingtonpost.com/2011/10/11/exercise-migraines-prevention_n_1003794.html" target="_hplink">regular physical activity may be able to prevent migraines</a> as well as drugs or relaxation therapy, The Huffington Post reported when the study was released last year.
The brunt of flu season may be behind us, but regular, moderate exercise may help us to stave off a springtime cold by <a href="http://www.msnbc.msn.com/id/10894093/ns/health-cold_and_flu/t/working-out-may-help-prevent-colds-flu/#.T2vztWJAaOF" target="_hplink">upping the body's defenses against viruses and bacteria</a>. A sedentary person is likely to catch two to three upper respiratory tract infections each year, <a href="http://www.huffingtonpost.com/2012/01/07/exercise-immunity_n_1190296.html" target="_hplink">HuffPost reported earlier this year</a>, but a moderately active person can cut that number by close to a third. But the effect reverses in the case of intense exercise -- marathoners, for instance, may have a <a href="http://www.huffingtonpost.com/2012/01/07/exercise-immunity_n_1190296.html" target="_hplink">two-to-six-fold increase in contracting an upper respiratory tract infection</a> in the weeks following a race.
A Sunnier Disposition
As much as we all sometimes dread the prospect of working out, the truth is that you'll actually <em>feel</em> better after you're done. Physical activity triggers the release of endorphins, those feel-good chemicals that produce a sense of euphoria in the brain. (Who can forget the <a href="http://www.imdb.com/title/tt0250494/quotes" target="_hplink">famous <em>Legally Blonde</em> quote</a>: "Exercise gives you endorphins. Endorphins make you happy. Happy people just don't shoot their husbands, they just don't." Just us?) Recent research has further confirmed the link between working out and happiness -- last month, Penn State researchers published findings suggesting that <a href="http://journals.humankinetics.com/jsep-current-issue/jsep-volume-33-issue-6-december/the-dynamic-nature-of-physical-activity-intentions-a-within-person-perspective-on-intention-behavior-coupling" target="_hplink">people who are more physically active</a> reported greater general feelings of excitements and enthusiasm, The Huffington Post reported when the study was published. "Our results suggest that not only are there chronic benefits of physical activity, but there are discrete benefits as well," study researcher Amanda Hyde, a kinesiology graduate student at Penn State, <a href="http://www.eurekalert.org/pub_releases/2012-02/ps-pay020812.php" target="_hplink">said in a statement</a>. "Doing more exercise than you typically do can give you a burst of pleasant-activated feelings. So today, if you want a boost, go do some moderate-to-vigorous intensity exercise."
Could daily workouts be the real fountain of youth? Maybe so. A Taiwanese study published last year in The Lancet suggests that even just 15 minutes of physical activity a day can <a href="http://www.huffingtonpost.com/2011/08/16/15-minutes-daily-exercise-live-longer_n_928137.html" target="_hplink">extend life expectancy by three years</a>, compared to people who didn't exercise.