Exercise is Medicine

Doctors can be put under extreme time restrictions in the delivery of quality care to patients. In many cases, a follow up appointment can be as short as five to ten minutes. Try putting yourself in those shoes for a moment. What would you say to someone who’s desperately seeking solutions to better health? Beyond the medical jargon and pharmaceuticals, would you leave room for exercise prescription? Why or why not?

If I had a white coat on, this would be my spiel. One that is backed by science, and an understanding that exercise is far too under-utilized in the medical profession. Oh, how patients are frantically looking for remedies from a medicine bottle or surgery bed. What if they were advised that the cheapest and most sustainable pill wasn’t a pill at all? In just five minutes, you could turn the medical paradigm on its head. Here’s how.

Quick disclaimer — I’m not a physician, but I know that the practice of medicine is extremely complex. Exercise won’t be the right decision 100% of the time, at least not right away. For the majority of people though, it has a rightful place — in one form or another. In a similar fashion, the body is complex. Don’t view this as a complete list, but rather as a tool to starting the conversation around exercise as medicine. Read on.

5 minutes (and five points) to convince a patient that exercise is the medication they need.

1. It’s a natural drug.

Exercise boosts neurotransmitters (signalling molecules) in the nervous system. ‘Happy brain chemicals’ such as serotonin, dopamine, and oxytocin have all been proven to increase after a bout of physical activity — more so in aerobic exercise than resistance training, according to the literature. This can cause a variety of positive outcomes from enhanced emotional regulation and mood, to improved digestion and motivation.

On a study by Yüksel et. al, it was found that high blood and brain oxytocin levels positively correlated with low anxiety levels and increased empathy-like behaviours in mice. Similar findings have also been confirmed in humans.

On the ‘runners high’… that appears to not be linked to endorphins, despite popular belief. It is more correlated to increased endocannabinoids in the bloodstream which activate the same receptor that various psychoactive drugs do (yes, like marijuana). This can provide pain relief and an elevated sense of calm, somewhat of a natural opioid — but much, much safer than the real stuff.

2. It’s a badass body armor kit.

It’s hard to name a disease that isn’t at least somewhat prevented through consistent exercise. Atherosclerosis, diabetes, cancer, osteoarthritis, mental health disorders, heck even incontinence can be considerably reduced through moving your body. Want to have better control over your blood glucose? What about the idea of less back pain? Exercise is frequently the panacea to these issues.

The statistics show that we desperately need this armor too. The CDC reports that 80% of cardiovascular diseases alone are preventable through lifestyle changes, yet CVD remains the deadliest killer — costing America a staggering one billion dollars a day (or very close). That’s not all. Emerging research shows that 20% of cancers are modifiable based on behaviour. Again, exercise is a big part of the solution, and must be a go-to remedy.

3. It’s an architect.

Not only does physical activity protect the body, but it also builds it up. First off, physical activity does a great job at constructing muscle if the musculoskeletal system is challenged. Perhaps less commonly known, exercise boosts vascular endothelial growth factor and insulin-like growth factor 1. VEGF can build new blood vessels (reducing CVD risk), while IGF-1 has a growth-promoting effect on many tissues, even down to the regulation of cellular DNA synthesis.

If you’re under thirty, impact exercise assists in building your bone mineral density (BMD), summating enough to form a bank that will prevent accidents in the senior years. If you’re a little further along in life — don’t worry. Exercise is proven to prevent further bone degeneration, a welcome thought for anyone who has suffered from a fracture. Ah, and we can’t forget about the miracle that is neuroplasticity. Exercise induces growth factors in the brain that lead to development of new neural synapses (connections), an appropriate lead up to the next point.

4. It’s a teacher.

Moderate to vigorous activity boosts the release of brain derived neurotrophic factor. Not only does BDNF help neurons mature and survive, but it has a primary role in neuroplasticity and the enhancement of learning and memory. Additionally, exercise increases the function and size of the hippocampus — the brain center responsible for consolidating new information and storing them as long-term memories. Think of it like boosting the storage capacity of your SD card to log more data onto the hard drive (your cerebral cortex).

These adaptations aren’t reserved for ‘healthy’ populations either. Studies on mental disorders, such as ADHD, have found exercise to be a proven catalyst for improved attention, cognition, and overall executive control.

5. It’s a blanket and a warm cup of tea.

And finally, moving your body reduces stress. It does so by lowering cortisol through the slowing of the HPA axis, and by decreasing the activity of the amygdala, the fear center of the brain (just to name a couple of mechanisms).

Essentially, you have the power to turn off those internal sirens… or at least lower the decibel volume of their wail. It’s no mistake that “Take a walk!” is such common advise for angry or stressed-out individuals. All this to say, exercise may be the most accessible, cheapest version of Prozac out there.

Well done! All of this in less than five minutes…you may even have time to do a patellar tendon reflex test on your patient! Mind you, talk on nutrition and sleep wouldn’t be a bad proposition either.

Now we’re not all doctors. Nor does everyone have a platform of such influence. Fortunately, we all have a role to play by sharing the conversation, and starting the turnaround. North America needs this more than ever — a shift from pills to prevention. A shift from hospital beds to chip trails. A shift from hurting patients to healthy people. Everyone has a voice, and everyone can say…

“Exercise is medicine!”