Exercise as Medicine

Diet and exercise have long been touted as a way to reverse heart disease. Can exercise be as good as medications for heart disease?

Everyone understands medications. A pill is prescribed in a fixed dose and taken at a specified time.  How can exercise be prescribed? How can we “dose” exercise? One way to “dose” exercise is by measuring the intensity of exercise using the metabolic equivalent, or MET, level. The MET is an estimate of the amount of oxygen used by the body during physical activity. One MET is the energy the body uses while sitting quietly at rest. The harder you work, the higher the MET. An activity that burns 3 to 6 METs is considered moderate, while one that burns more than 6 METs is vigorous. Walking is great exercise. For example, walking on level ground at 2.5 mph requires 3 METs, backpacking is 7 METs and climbing hills with a heavy pack uses 9 METs. Tables are available that outline the METs for various activities.

A person who wants to start an exercise program should be given an exercise prescription by their doctor. This prescription should have the frequency of exercise (typically 3-5 times per week), the intensity (usually moderate or 6 METs), the time per session (20-30 minutes), the target heart rate and the type of exercise. The target heart rate can be easily calculated by the formula: (220-age) x 0.85.

What type of exercise is best? The answer is the one you will actually do. If you like an exercise, then you will be more likely to follow through with it. One does not need to spend lots of money on gym memberships to gain the benefit of exercise. Walking is an excellent exercise which is easy to do, requires no extra equipment, is generally safe to do, is easy on the joints and has the lowest drop out rate.

Once a person has their exercise prescription and begins their exercise program, what kind of health benefits can they expect?  A daily regimen of walking reduces the risk for heart attack, stroke, atrial fibrillation, colon cancer, hypertension, diabetes, depression, obesity and Alzheimer’s disease. Walking lowers total cholesterol levels, raises good cholesterol levels (HDL), maintains healthy bones and lowers stress levels. Walking can even help you live longer (one and one half more years for walking daily at 3 METs). More strenuous daily activity can extend your life by three years.

Despite all of the benefits of exercise and government campaigns to promote physical activity, many people remain sedentary. One way to promote and sustain walking behaviors is through walking groups. Walking groups are short walks scheduled weekly or monthly. Walking groups, especially those targeted at older adults, have supportive effects that encourage adherence and positive attitudes toward physical activity, companionship and a shared experience of wellness, providing both physical and psychological health benefits. Walk with a Doc (www.walkwithadoc.org) is a national walking group where local physicians walk side by side with their patients.  The informal setting makes participants comfortable interacting with their doctor, questions or health topics can be discussed while walking and, most importantly, patients witness their physicians practicing what they preach. A Walk with a Doc walking group has been established in the central New Jersey area. The first walk will take place in the Bridgewater Commons Mall on Saturday February 28 2015 at 8:30 AM. The meeting place for the walk is the mall’s food court. For future walks look for information on www.medicor.com.

So to help your heart, start walking today. For the best benefit, take a walk for 30 to 60 minutes each day. Alternatively you can join us at Walk with a Doc. If you really want to challenge yourself, take a hike.