Tag: Chronic Disease

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Health

Exercise: An ideal "prescription" for chronic disease

“If it was a pill, exercise would be a trillion-dollar money-maker prescribed to everyone.” Dr. Scott Lear, heart disease prevention researcher at Simon Fraser University, British Columbia, Canada.

A prescription for exercise?

Exercise is so effective at preventing and treating some chronic diseases, doctors are being encouraged to write prescriptions for it… Exercise decreases the risk of many diseases, including heart disease, stroke, Type 2 diabetes, depression (as discussed in last week’s blog ), and many cancers. Here are a few statistics for lowering chronic disease risk, as quoted on the website, Moving Medicine (a beta site being developed to encourage doctors to “prescribe” exercise to their patients):

  • Type 2 diabetes -40%

  • Cardiovascular disease -35%

  • Falls -30%

  • Dementia -30%

  • Depression -30%

  • Joint and back pain -20%

Physical activity is as important for health as many medications, but without the side effects. Humans were made to move, and inactivity is believed to be as harmful to our health as cigarettes. But, the more affluent our society becomes, the less we tend to move.

Who needs this prescription?

A global study of activity found that, on average, more than one-quarter of adults worldwide are not getting enough physical activity. And high-income Western countries (like us in North America) have inactivity rates twice as high as those of poorer countries, over 50% in some areas.

And women tend to be less active than men – up to 20% less in some countries. A 2017 survey published in Health Reports found that only 2% of girls aged 12-17 met the Canadian Movement Guidelines that include adequate sleep and at least 60 minutes of moderate to vigorous activity. A Dalhousie University study noted that teenage girls are concerned about appearances when they exercise: they worry about being pretty but natural-looking, thin but not too skinny, fit but not too muscular. Their responses in the study suggest that outdoor activities can provide an important venue to feel comfortable, safe and confident doing physical activity, compared to a gym setting where, as self-conscious teenagers, they felt they needed to be more concerned about clothing and appearances.

How to get more people moving…

Community infrastructure can influence activity in the young and old. Open spaces, like parks and walking/biking paths, provide enjoyable and convenient opportunities for physical activity. A visible example is the throngs of people who use the skating oval added to the Commons in downtown Halifax. You can even borrow skates and helmets there for free!

High quality public transport and incentives to use it rather than motorized vehicles can result in an overall increased population activity being incorporated into daily routines for those who use the systems. I noticed a marked increase in my activity level when using public transit while travelling in Europe, just by walking to and from the nearest system access.

With statistical evidence that inactivity is worsening in too many areas year by year, and with a corresponding increase in chronic diseases like diabetes and heart disease, it is time to think seriously about ways to increase physical activity levels across populations.

So, if you want to reduce your chances of developing a chronic disease as you age, look for ways to incorporate more exercise into your day, and it doesn’t have to be a session at the gym. Remember that ten minutes of activity three times a day is considered equal to a single 30-minute session. Park farther away from the door when doing errands or take the stairs instead of the elevator – it all adds up. My husband and I enjoy a daily 25-minute walk to check our mailbox most days and climbing up and down the stairs in our 3-story house adds to the daily total.

How much should you exercise to benefit?

The World Health Organization guidelines for physical activity recommend a minimum of 150 minutes per week of moderate-intensity activity like brisk walking, biking or dancing… or 75 minutes a week of vigorous activity like jogging or playing an active sport. If you have a chronic disease, check with your doctor first, start slowly and increase activity gradually. You can expect a few sore muscles as you begin but stop exercising and contact your doctor right away if you experience any chest pain or other alarming symptoms. Any exercise that makes it difficult to speak is likely too intense and could be a risk to your immediate health. Specialized exercise programs are available in some areas to help those with chronic diseases, such as heart disease or back problems, to get started safely. The cardiac rehab program my husband took after his heart attack 14 years ago was a game-changer, and we’ve worked to keep up our activity level since then.

So, don’t be surprised if your doctor gives you an unusual prescription…

In addition to the Moving Medicine program in UK mentioned above, Canadian medical schools are also revising their curricula to teach future doctors about the benefits of exercise to prevent and treat chronic diseases. It’s better and less costly to prevent diseases than to treat them!

(Please note that underlined phrases above and in the references are links to the source of the information)

References:

Exercise is Medicine, and Doctors are Starting to Prescribe It, The Conversation

Prescribing Movement (UK website under development to encourage doctors to prescribe exercise)

Girls and Women Need More Time in Nature to be Healthy

Worldwide Trends in Physical Inactivity 2001-2016

Categories
Health

Yin and Yang

I’ve seen the symbol for Yin and Yang many times, but never understood what it represented beyond light and dark, male and female, strength and passivity. I was surprised to find a detailed explanation of Yin and Yang in body functions in a scientific article about chronic inflammation.

During the Yin phase, natural cell death, or apoptosis, is promoted. Growth of various tissues is slowed, inflammation is promoted and potential tumor growth would be blocked.

During the Yang phase healing of wounds is promoted, growth is stimulated, and anti-inflammatory mediators are produced, but there is a tendency toward tumorigenesis, or the growth of new tumors.

As with other Yin and Yang interpretations, the need for balance between the two opposing elements is important.

Acute inflammation, the type that occurs in response to injury or acute illness, is considered a “friend” that protects the body against harmful elements. However, chronic or persistent inflammation becomes a “foe” that eventually destroys tissue integrity and function. The immune system uses inflammation to stimulate its protective actions but this function needs to be self-terminating… stimulating acute Yin inflammation when necessary to kill off foreign invaders such as bacteria and reverting to the Yang anti-inflammatory growth and repair phase when the threat is gone.

The ability of our immune system to protect us from disease is affected by the amount of oxidative stress (quantity of damaging free radicals versus protective antioxidants) in our system, immunosenescence (the gradual deterioration of the immune system that occurs with age) and altered function of various hormones (the stress hormone, cortisol, as well as estrogen, progesterone, androgens, insulin, and thyroid).

Here are some simple ways to address each of these factors:

  • Oxidative stress – increase the amount of colored fruits and vegetables to ensure adequate intake of antioxidants.

    • Brightly coloured foods are known to contain these beneficial substances, and including five different colours on your plate is an easy way to increase intake of antioxidants.

  • Immunosenescence – ensure optimal bacterial flora in the digestive system.

    • Substances that control the amount and type of inflammation in the body are largely produced in the gut, and are controlled by the type of bacteria that resides there. Eating more fermented food, such as yogurt and sauerkraut, or taking a probiotic supplement, introduces good bacteria to the digestive system, and is especially important after taking antibiotics.

  • Altered hormone function – reduce stress, and change response to stress.

    • Stress hormones, Including cortisol, are an important anti-inflammatory factor. However, cortisol also increases blood sugar levels. While this function is important for the “fight or flight” response, with chronic stress cortisol tends to cause unhealthy weight gain around the waist. Increased levels of cortisol can also interfere with the function of reproductive hormones that are similar in structure (estrogen, progesterone and androgens) giving the effect of a lack of hormone even if levels are normal.

    • While it maybe difficult to avoid stress, you can change your response to stress. Simply pausing to do a few deep breaths, and thinking positive thoughts can induce a relaxation response, and reduce chronic production of cortisol.

    • Work to keep a positive outlook – look for the good side of every situation!

Even low-level ongoing inflammation has been associated with many chronic diseases, such as heart disease, arthritis, and dementias. Working to keep your Yin and Yang balanced, and your immune system functioning properly, may be the ideal approach to preventing chronic disease.

Reference: Inflammation, Chronic Diseases and Cancer-Cell and Molecular Biology, Immunology and Clinical Bases, Mahin Khatami. Intechweb.org