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Massachusetts Medical Society's Physician Focus

Doctor's Rx: Exercise

PROGRAM HIGHLIGHTS:

  • Physical exercise can reduce the risk of chronic illness such as heart disease, diabetes, obesity, and even depression.

  • Less than half of all adults get the recommend amount of physical activity, and less than one-third of high-school students attend physical education classes.

  • Two things – a diet high in calories and a lifestyle so much more sedentary than ever before – have conspired to make obesity and overweight huge problems.

  • Losing weight should not be thought of as the main benefit of exercise; from a health perspective, the effects on such areas as cholesterol, blood pressure, sugar, and the circulatory system are much greater.

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Physical exercise has been called the closest thing to a “fountain of youth,” with benefits that reduce the risk of chronic illnesses and enhance mood and self-esteem. Yet most Americans don’t exercise. Findings from the Centers for Disease Prevention and Control indicate that fewer than two in 10 get the recommended levels of exercise and more than a quarter of adults don’t give any time to exercising.

So the obvious question is this: If it’s so good for you, why don’t more people do it?

“We’re living in a society in which we are physically doing less and less,” says Stuart Chipkin, M.D. “We’re in an unfortunate ‘perfect storm” – with a diet high in calories and a lifestyle so much more sedentary than we’ve ever been, and those two things have conspired to make the weight problem we face in America and the world such a concern.”

Dr. Chipkin, an endocrinologist at Valley Medical Group in Amherst, Mass. and a research professor in the Department of Kinesiology at the University of Massachusetts School of Public Health and Health Sciences, along with his colleague, Barry Braun, Ph.D., an associate professor in the Department of Kinesiology at UMass, are the guests on the December edition of Physician Focus to discuss the health benefits of physical exercise. Hosting this edition is Frederick Buckley Jr., M.D., a general surgeon and Vice Chair of the Massachusetts Medical Society’s Committee on Nutrition and Physical Activity.

Both Dr. Chipkin and Dr. Braun agree that, while physical activity is good for you, people should recognize that losing weight should not be most important goal of exercise. From a health perspective, its greatest benefits accrue far beyond the waistline - on the heart, lungs, muscles, and circulatory system, as well as on cholesterol, blood pressure, and blood sugar levels. People who are more active are also more productive and spend less time being sick.

As ardent advocates of exercise, what do they recommend for activity? “The best exercise is the one you like to do,” says Dr. Chipkin, and Dr. Braun agrees. “Whatever people enjoy doing and continue doing,” he says, “that’s the right exercise for them.”

Is there a difference between exercise and physical activity? And are the health benefits different? Dr. Braun makes the distinction. “Anything that involves expending energy – running, walking, mowing the lawn, or gardening – is physical activity. Exercise can be defined as the purposeful activity to improve health.”

But both are good for you he says: “No matter how you do it, no matter how you slice it or break it up, the energy you expend regardless of what size the chunks are is going to be beneficial.”

Both men, however, believe that experts and health providers need to get better at tailoring what people need to do for their particular needs, whether it be improving muscle mass, bone density, or lung function. A person’s individual situation is critical in trying to match the physical activity prescription with the person’s situation.

“We need to think of exercise as a prescription drug,” says Dr. Chipkin, “with the dosage based on the individual.” The intensity - vigorous or moderate - and the frequency - how many times a week – will vary, he says, with the individual. Most of all, he says, “Patients need to understand how important it is.”

And to those folks who use the age-old, oft-used reason of ‘I don’t have the time,’ Dr. Braun is clear and to the point. “I recognize that people are busy,” he says, “but if the president of the United States has the time to exercise, then the rest of us should as well. People need to make time. There’s never going to be time.”

Watch the accompanying program for the full discussion, including conversation about ways to keep people interested and motivated in exercising, the importance of setting realistic goals, different prescriptions for different age groups, and how exercise can benefit and be adapted for those with disabilities.

Text:
MMS/Richard Gulla

ADDITIONAL RESOURCES
Centers for Disease Control

U.S. Department of Health and Human Services Physical Activity Guidelines for Americans

American Academy of Pediatrics

National Institute on Aging, GoForLife

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"Doctor's Rx: Exercise" PSA


From left, Frederick Buckley Jr., M.D., Barry Braun, Ph.D.; Stuart Chipkin, M.D.
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