Exercise—The Best Prescription

Harold Elrick, MD

The human body thrives on movement, which brings pleasure and stimulates creativity. Medically, exercise stimulates blood flow and tissue growth in muscle and bone. It also relieves the fatigue of nervous tension and sedentary activity. And the benefits extend even further: Exercise is also a potent tool for preventing and treating disease.

Convincing Evidence

In recent years researchers have learned a lot about the benefits of exercise. More physicians are asking about their patients' fitness levels and making specific exercise recommendations because exercise has proven to give patients an extra edge when it comes to avoiding or minimizing diseases:

• Heart disease. Exercise helps reverse established disease and helps control the risk factors for heart disease (high blood pressure, high cholesterol, obesity). Exercise also lowers triglycerides and raises high-density lipoproteins (HDL)—the "good" fats.
• Stroke. Exercise prevents strokes and helps restore function after a stroke.
• High blood pressure. Exercise is a nondrug therapy for treating mild-to-moderate high blood pressure, and it helps patients who are on drug therapy for severe high blood pressure.
• Diabetes. Exercise can prevent or delay the serious vascular complications of diabetes; regular exercise can reduce the need for insulin.
• Arthritis. Exercise improves endurance, strengthens muscles, and increases joint flexibility and range of motion.
• Osteoporosis. Exercise can prevent and reverse bone loss, which can stave off the disabling effects of fractures and bone degeneration.
• Excess body weight. Exercise helps patients achieve and maintain healthy body fat levels.
• Depression. Exercise reduces depression and anxiety, increases feelings of well-being, improves the ability to handle stress, and improves self-image.
• Cancer. Exercise reduces the risk of colon and breast cancer.
• Chronic obstructive pulmonary disease. Exercise is an effective rehabilitation component that provides physiologic and psychological benefits—even for those who have severe air-flow obstruction.

Getting Started

Your doctor will help you plan an exercise routine that you can comfortably accommodate (see back for prescription form). You'll find it's easier to stick with your routine if the activities you choose are (1) fun and (2) accessible—meaning safe, nearby, and inexpensive.

The bulk of your exercise program will focus on aerobic activities that are moderately strenuous—for example, walking, running, cycling, or swimming. The objective is to get the lowest possible heart rate at rest (40 to 50 beats per minute) and to get 120 to 150 beats per minute during exercise. To spice up your weekly routine, your doctor will advise you to vary your program to include nonaerobic activities such as golf, bowling, gardening, or strength training.

It is important to perform stretching exercises before and after any physical activity; their purpose is to prevent muscle strains, and when performed regularly, they also increase flexibility, strength, and circulation.

Earn Extra Activity Points

Staying active throughout the day can add to your daily exercise totals. Simple ways to achieve this are to:

• Walk briskly during chores, shopping, or errands.
• Restrict sitting to activities that require it, such as eating, learning, writing or keyboarding, and essential driving.
• Contract and relax all muscle groups (upper body, abdomen, leg) during sitting activities.
• Get up and move for 5 to 10 minutes of each hour of sitting activities, or use breaks to walk or stretch.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Elrick was a lecturer on preventive medicine at Harvard Medical School in Boston and is now director of the Foundation for Optimal Health and Longevity in Bonita, California. He is a fellow of the American College of Physicians.

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