Jog your way to better health

Dr S. Rohan Jayasinghe

Physical inactivity- harbinger to a public health catastrophe

Though we consider ourselves to be a sporting nation, recently released statistics show that we are increasingly becoming a community of couch potatoes. While our elite athletes perform better and better in the world scene, we are comfortable at sitting in front of the television screen watching and rejoicing in their feats. This is an alarming reality. Physical inactivity and obesity in the general population is on the increase. It brings along with itself the dreaded lifestyle diseases of high blood pressure, diabetes, hypercholesterolaemia and heart disease. Life style diseases are defined as ill health due to non-healthy life style and practices. In addition to the above, the sedentary life style and obesity has been associated with many other disease conditions such as cancer, deep vein thrombosis, osteoporosis, stroke and even depression and anxiety. Outlook for the future generations does not seem any brighter. Research reveals that obesity among the younger generation is wide spread. Childhood obesity is predictive of public health consequences in the future. It is believed that the cholesterol plaques that cause obstruction to the blood flow to heart muscle and cause heart attack, are laid down since the very early years of one’s life. Increasing prevalence of obesity and inactivity in the younger generation thus is a stark prediction of a possible epidemic of heart disease that is to come.

Phenomenon of lifestyle disease began to take shape since the time of the industrial revolution. As the development of machinery and automation started to substitute human labour, the incidence of coronary heart disease began to increase. Ischaemic heart disease was the biggest cause of disease and death at the turn of the last century. More than hundred years later the situation remains the same, if not worse. The repertoire of life style diseases has grown with the addition of many more conditions other than heart disease, added to the list. What can we do to address this dreadful situation and what can we do to avoid dire consequences in the future?

Experimental research shows that regular exercise decreases obesity, heart disease, blood pressure, diabetes and hypercholesterolaemia. It is also known to decreases platelet adhesiveness in the blood, acting in a similar manner to Aspirin in preventing heart attacks. A more recently discovered benefit of exercise is its ability to improve the body’s immune function, thus decreasing the incidence of infections, cancers and possibly the autoimmune diseases like rheumatoid arthritis and lupus. There is no denial that physical activity improves ones sense of well being, reduces psychological stress, depression, anxiety, insomnia and even the lack of libido. Much effort and finances has gone into studying the causes of physical inactivity and obesity among the general population and formulating strategies to address the issue.

Much of the above are preventative benefits that would ensure to a large extent good health in times to come. What about the therapeutic benefits of physical exercise in addressing already present disease conditions? Exercise prescription should be considered as a core component in the treatment of many conditions such as heart attack, heart failure, stroke, emphysema, nicotine addiction, osteoporosis and depression.

Since the sixties the value of regular physical exercise was made popular by public health advocates and the public media. Only a minority of the general public has absorbed this message. Demographic data show that physical inactivity and the lack of participation in leisure time exercise is more prevalent in the less affluent societies and among minority and aboriginal communities. A definite inverse relationship has been observed between regular physical exercise and the level of education. These findings should help us identify new target populations to direct resources and define strategies at popularising exercise better and more effectively.

It is important that doctors prescribe exercise readily as a preventative as well as a therapeutic modality. It is a very economical form of therapy and in the lager schema of things it will save millions to the health care budget. One expert recently viewed the opinion that exercise should be madea major part of primary care- a preventive measure similar in importance to vaccination against infectious diseases. Policy makers believe that by educating the school children in the target populations one can get the message across to the adults and at the same time invest on the health of the future generations.

What form of exercise is good

Many shun regular physical exercise due to ignorance about the level of involvement and the intensity required to obtain maximum benefits. It is not necessary to perform high intensity exercise for hours on end to exhaustion. Leisure time light activity for a fifteen to thirty minutes a day is sufficient to achieve significant health benefits in preventing heart disease, stroke, hypertension, diabetes and even some mental illnesses. A study done in the US in 1986 showed regular brisk walking reduced the death from heart attacks by 35% among a large population of women. This study also proved that it is never too late to start on regular exercise. Commencing exercise even later in life could add many more years to one's life span. The massive “Nurse's health study” conducted over many years in the US showed that the protective effect of walking increased with the cumulative distance walked and the cumulative time spent walking.

Regular, light physical exercise is a convenient, practical and economical passport to good health. But it is not to say that it is 100% safe. It is important to avoid musculo-skeletal injury as well as other more serious health hazards of blackouts, dehydration and heat stroke that can associate with exercising inappropriately. One should ensure that at least fifteen minutes is spent on gentle stretching of limb muscles as a warm-up. Wearing of comfortable and reliable gear including well fitting shoes is a must. Dehydration should be avoided at all times. Anyone over fifty intending to start on an exercise program should see the doctor to assess and address the risk of possible existing heart disease.

There has been renewed interest in alternative forms of life style measures to combat common illnesses. Tai Chi and Yoga are two such alternative forms of exercise that has shown tremendous promise in the prevention and treatment of life style diseases. Scientists have described regression of cholesterol plaques obstructing coronary arteries after completing a special form of yoga exercise. Tai- Chi has shown survival benefits among practising geriatric populations according to one European randomised controlled study.

Light exercises for a short period of time regularly should be the universal prescription to all that value and anticipate lasting good health. Renewing the interest in leisure time exercise will certainly dawn a healthier tomorrow for the whole nation.