Exercise is medicine for chronic disease management

Abstract

We have now accumulated extensive evidence, both research and clinical, demonstrating physical exercise as a powerful medicine for the prevention and management of all chronic diseases. As a result a multi-organisational, multi-national initiative was launched by the American College of Sports Medicine and the American Medical Association in 2007 to promote integration of exercise prescription into mainstream medical care. In 2011, Exercise is Medicine® was launched in Australia by Exercise and Sports Science Australia. This presentation details current knowledge and practice of exercise medicine in a range of diseases. For example, being physically active results in a 20%, 30%, 50%, and 70% reduction in risk of lung cancer, breast cancer, colon cancer and prostate cancer respectively. Up to 50% of patients could be prevented from progressing to Type II diabetes if they met physical activity guidelines. Dementia and in particular Alzheimer's disease progression is markedly slowed by appropriate exercise. Exercise is now deemed a critical adjuvant treatment in the management of cancer. Breast cancer survivors halve their risk of dying if they can meet a relatively modest exercise dosage and colorectal cancer patients can increase their disease free survival by 55%. Researchers recently reported 61% lower risk of prostate cancer death if men completed more than three hours per week of vigorous activity. It is now well established that cardiorespiratory fitness is the principal predictor of all-cause mortality and that neuromuscular fitness (strength) is an important predictor of metabolic syndrome and functional ability. The current focus on overweight and obesity by government and the health professions is misguided and not supported by the research evidence. Physical inactivity and the resulting low fitness should be our greatest concern and the target of our research and clinical efforts to stem the increasing incidence of chronic disease. “Fitness not fatness” should be our mantra as rigorous research clearly demonstrates that normal weight people who are sedentary are at far greater risk of morbidity and mortality than overweight people who are physically active and fit. We will explore these research studies and their implications in depth.