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If there was a treatment that could lead to the following;

  • up to a 35% lower risk of coronary heart disease and stroke
  • up to a 50% lower risk of type 2 diabetes
  • up to a 50% lower risk of colon cancer
  • up to a 20% lower risk of breast cancer
  • a 30% lower risk of early death
  • up to an 83% lower risk of osteoarthritis
  • up to a 68% lower risk of hip fracture
  • a 30% lower risk of falls (among older adults)
  • up to a 30% lower risk of depression
  • up to a 30% lower risk of dementia

We would all be taking it, wouldn’t we? Well there is and it is called exercise. These figures were correct when people were randomised to 150 min a week of aerobic exercise [so they got sweaty and out of breath] or continued to do nothing. And this was true even if people did NOT LOSE WEIGHT. Most people generally know that exercise is good for the heart but few realise it has an effect on the immune system and leads to a decreased risk of some cancers such as cancer of the breast, colon, womb and even possibly lung cancer.

It is as good for depression or anxiety as counselling or anti depressants. When you exercise you ‘burn off stress hormones’ and get an endorphin [‘feel good’ chemical] boost. Feeling fitter, stronger and more attractive obviously wards off and prevents depressive feelings. http://www.rcpsych.ac.uk/expertadvice/treatments/exerciseandmentalhealth.aspx

We are all likely to live longer and the incidence of dementia will increase. How do we try and prevent this – with ‘brain training’ games? There is no evidence that these work – however the general maxim ‘What is good for the heart is good for the brain’ does hold. Much dementia is caused by atherosclerosis – furring up of the blood vessels to organs such as the heart and the brain. As the blood supply to the organs reduces they can not work so well and cells may die – in the case of the brain this leads to dementia. Alzheimers involves the formation of amyloid plaques in the brain. Cholesterol promotes the formation of these plaques.

Half an hour of exercise a day is probably more beneficial for my type 2 diabetic patients than all the multiple, expensive medication [with side effects] that they are on!

Figures published a few days ago by the NHS’s Health and Social Care Information Centre suggested that two thirds of men and half of all women are now overweight or obese. Only a third of adults manage 30 minutes of exercise once a week. It seems that the British are now the fattest in Europe!

What can we do about it? This week the BMA demanded a tax on sugary drinks and a ban on unhealthy food adverts targeted at children. This of course raises questions about the infringement of personal liberties. But in this country and others such as the USA and Denmark, which have introduced similar legislation, there is the growing realisation that unless we do some thing and try and tackle our unfit, overweight population our health systems might not be able to afford the consequences.

As a GP I promote exercise for it seems most disorders – from diabetes, menopausal hot flushes [helps temperature regulation and maintains bone density], to insomnia [promotes natural relaxation and sleep]. I often write a very simple exercise plan on a prescription to emphasise its value as a treatment. I refer the overweight to dieticians and gyms [they can attend for free – courtesy of the NHS] but doctors and dieticians get notoriously bad results – hence the rise in gastric bypass operations. Many have argued that we should pay people to lose weight and exercise, give them a monetary incentive and this would be far cheaper in the long run for the NHS. Some health bodies have already tried this. What do you think? Is this a step to far?

May be you agree instead with the solution in the cartoon below. -please feel free to comment.

http://blog.practicalethics.ox.ac.uk/2010/06/paying-people-to-lose-weight

obesity cartoon

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