Skip to main content

Exercise as effective as drugs for treatment of many diseases?

Coronary heart disease now costs the NHS £1.6bn a year to treat and costs the UK economy around £10bn. Yet when was the last time your doctor told you to take more physical exercise? 

Your GP may weigh you, take your blood pressure and pulse. You might be on repeat prescriptions for drugs. But a new review of evidence published today on bmj.com suggests that physical activity is potentially as effective as many drug interventions for patients with existing coronary heart disease and stroke.

Are we overdependent on drugs?

The researchers argue that more trials comparing the effectiveness of exercise and drugs are urgently needed to help doctors and patients make the best treatment decisions. In the meantime, they say exercise “should be considered as a viable alternative to, or alongside, drug therapy.”

Physical activity has well documented health benefits. Our sedentary lifestyles may be killing us, yet statistics from the British Heart Foundation show that in the UK only 14% of adults exercise regularly, with roughly one third of adults in England meeting recommended levels of physical activity.  

In contrast, prescription drug rates continue to skyrocket sharply rising to an average of 17.7 prescriptions for every person in England in 2010, compared with 11.2 in 2000.  We are becoming a nation on medication when exercise might be the best 'treatment'.

But there is still very little evidence on how exercise compares with drugs in reducing the risk of death for common diseases.

In the current analysis researchers based at the London School of Economics, Harvard Pilgrim Health Care Institute at Harvard Medical School and Stanford University School of Medicine set out to compare the effectiveness of exercise versus drugs on mortality across four conditions (secondary prevention of coronary heart disease, rehabilitation of stroke, treatment of heart failure and prevention of diabetes).

Secondary prevention refers to treating patients with existing disease before it causes significant illness.

They analysed the results of 305 randomised controlled trials involving 339,274 individuals and found no statistically detectable differences between exercise and drug interventions for secondary prevention of heart disease and prevention of diabetes.

Among stroke patients, exercise was more effective than drug treatment, while for heart failure, diuretic drugs were more effective than exercise and all other types of drug treatment.

The need for more evidence

So is exercise as effective as drugs in treatment of diseases? It is probably too early to say with certainty. The authors point out that the amount of trial evidence on the mortality benefits of exercise is considerably smaller than that on drugs, and this may have had an impact on their results.

They argue that this “blind spot” in available scientific evidence “prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement but exercise could yield more profound or sustainable gains in health.”

Physical activity potentially as effective as many drugs

Despite this uncertainty, they say that, based on the available data, physical activity is potentially as effective as many drug interventions – and call for more trials to address the disparity between exercise and drug-based treatment evidence.

“In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition,” they conclude.

Changing lifestyle may be more effective at treating and preventing diseases. But experience demonstrates it is more difficult to achieve than it seems. We have known for decades that regular exercise is beneficial yet so few of us do it. We live increasingly sedentary lives. Increasing awareness of the importance of exercise is insufficient to bring about an effective change.

Read also:

Something isn't right in the world of pharmaceuticals. Alarm bells are ringing.
Hilary and Steven Rose lift the lid on modern biomedical science.

Comments

Popular posts from this blog

Palm Oil production killing the planet

Bad trade and bad products are killing our planet. We have said this before on The Thin End. There is no better example than that of palm oil. It is used ubiquitously in so many products, and its production is a major factor destroying rainforests and threatening precious species.

Demand for palm oil is 'skyrocketing worldwide'. It is used in packaging and in so much of our snack foods, cookies, crackers, chocolate products, instant noodles, cereals, and doughnuts, and the list goes on.
Bad for the planet So, why is this so bad for the planet?

The oil is extracted from the fruit of the oil palms native to Africa. It is now grown primarily in Indonesia and Malaysia, but is also expanding across Central and West Africa and Latin America.

Palm oil production is now one of the world's leading causes of rainforest destruction, and this is impacting adversely some of the world's most culturally and biologically diverse ecosystems. Irreplaceable wildlife species like t…

Nicotine exposure in pregnancy linked to cot death

Nicotine exposure during pregnancy, whether from smoking cigarettes, or nicotine patches and e-cigarettes, increases risk of sudden infant death syndrome – sometimes known as “cot death” – according to new research published in The Journal of Physiology.

Sudden infant death syndrome (SIDS) is the sudden and unexpected death of an infant under 12 months of age occuring typically while sleeping. Failure of auto resuscitation, the ability to recover normal heart rate and breathing following gasping caused by lack of oxygen in the brain, has been recorded in human SIDS cases.



Smoking increases risk for SIDS Over the last decade, use of cigarettes has declined significantly, however, over 10% of pregnant women still smoke during pregnancy. Over recent years nicotine replacement therapies, such as nicotine patches or e-cigarettes, have been prescribed to women who wish to quit smoking during their pregnancy. However, nicotine replacement therapies may not protect infants from SIDS. 
With inc…

Maternal depression can impact child mental and physical health

Maternal depression has been repeatedly linked with negative childhood outcomes, including increased psychopathology.  Now, a new study shows that depression in mothers may impact on their children's stress levels,  as well as their physical and mental well-being throughout life.

In the study, published in the journal  Depression & Anxiety,  the researchers followed 125 children from birth to 10 years.

At 10 years old, the mothers’ and children’s cortisol (CT) and secretory immunoglobulin (s-IgA)—markers of stress and the immune system (see below)—were measured, and mother-child interaction were observed.
Psychiatric assessment  The mothers and children also had psychiatric diagnoses, and the children's externalising and internalising symptoms were reported.



Internalising disorders include depression, withdrawal, anxiety, and loneliness. They are often how we 'feel inside', such as  anger, pain, fear or hurt, but may not show it.  In contrast, externalising symptom…