Exercise is Medicine™ as A Sustainable Vision

Editor’s note: This is the second of two articles (first article is here) about the Exercise is Medicine™ World Congress that took place in Baltimore, Maryland, June 1-5, 2010. The first article focused on the keynote speaker, Dr. Regina Benjamin. This article discusses the congress as a whole.

Live in rooms full of light
Avoid heavy food
Be moderate in the drinking of wine
Take massage, baths, exercise, and gymnastics
Fight insomnia with gentle rocking or the sound of running water
Change surroundings and take long journeys
Strictly avoid frightening ideas
Indulge in cheerful conversation and amusements
Listen to music. ~A. Cornelius Celsus, (ca 25 BCE—ca 50)

Life is not merely to be alive, but to be well. ~Marcus Valerius Martialis (40 AD – ca. 103)

Exercise is Medicine™ World Congress

Delegates from more than 50 countries joined forces at the inaugural Exercise is Medicine™ World Congress with two goals: Unite with others across borders to build a healthier world and globalize Exercise is Medicine™ as a positive movement. Chairman Dr. Bob Sallis, M.D. reasoned, “Exercise and Physical Activity are critical to health and necessary for the prevention and treatment of virtually ALL chronic disease. The goal is to make exercise the most widely prescribed drug in the world! The world needs it.” Sallis, himself a model of health and vigor, expressed refreshing candor, “Exercise is indeed medicine. As a family physician, why am I not prescribing this to every patient?”

An idea sparked by the 2007 Health and Fitness Summit, Exercise is Medicine™ (EIM) is a “scientific merging of the Health Care and Fitness industry.” A new collaboration created by the American Medical Association (AMA) and American College of Sports Medicine (ACSM), EIM has been designed to:

• Promote public health
• Build public and social responsibility
• Help people live happier, healthier lives
• Foster public policy that gets people moving more and well
• Build healthier communities

The Need for EIM

As EIM stakeholders, the AMA and ACSM are promoting evidence-based research and practices extolling the many virtues and benefits of exercise. Because of lifestyle and technological changes, we are reaching what they call an “an epidemic of inactivity.” Inactivity has been proven to lead to earlier incidences of heart disease, diabetes, and depression.

According to Michael O. Leavitt, U.S. Secretary of Health and Human Services (2005-2009), “We know that sedentary behavior contributes to a host of chronic diseases, and regular physical activity is an important component of an overall healthy lifestyle. There is strong evidence that physically active people have better health-related physical fitness and are at lower risk of developing many disabling medical conditions than inactive people.”

Physical Activity Assessment
Sallis recommended a physical activity assessment (PAA) as a paradigm for all patients.
Exercise is Medicine proposes a model where fitness professionals, working together with the medical community, would proffer “activity prescriptions” to people. Working in concert with physicians, evaluations including:

• Health & exercise history
• Anthropomorphic measurements
• Weight/fat analysis with bioelectrical impedance and BMI calculations
• Postural and balance evaluation
• Range-of-motion evaluation
• Exercise experience
• Aerobic capacity (submaximal testing, including vo2 maximum uptake)
• Muscle strength
• Muscular endurance
• Balance testing

After an evaluation, the client will receive an exercise program designed to include both cardiovascular and resistance training, as well as monitor the client’s progress and provide progress reports and follow-up information to the client and physician.

The Influence of Dr. Blair
Dr. Sallis credits Dr. Steve Blair for his influence and determination in promoting Physical Activity and Public Health. An Epidemiologist, Exercise Science icon and fitness devotee, Blair is a former president of ACSM. Blair believes we should “add exercise to the list of medical treatments, just as we apply cognitive behavioral therapy or drugs.” He passionately believes that, “There is not one, single medication that benefits as many things as exercise. “

Blair talked about the many benefits of exercise and how they have a profoundly positive effect on the quality of our lives. He added, “Exercise has an effect on reducing depression.” He spoke about the benefits of prescribing physical activity/exercise in combination with drug therapy and other therapies.”

Public Policy

In a compelling keynote, Dr. Jeffrey P. Koplan spoke about Physical Activity, Health, Health Care Reform and Lifestyle Reform Revisited. Koplan discussed many ways our society and communities put up barriers to prevent us from moving more saying, “Public policy can design better systems and prevent disease.” He embraces a public policy of flourishing and thriving, that:

• Builds healthy communities
• Cultivates green spaces
• Is pedestrian friendly
• Offers user-friendly bike paths, sidewalks, open attractive stairways
• Is about safety, and where schools encourage students to cycle
• Using schools after hours for recreation, sports and play
• Offers work place encouragement to move more
• Encourages Public transportation

Dr. Koplan discussed U.S. Health Care policy – Patient Protection and Affordable Care Act HR 3590. Though ungainly, this plan could have a bearing on disease prevention and health promotion. He recommends line clarification and a dose of positive behavioral economics, which “could set in motion coverage of preventative health services.” He is concerned because, “It remains to be seen how Physical Activity will be incorporated as an exercise prescription. Effective programming is key if there is going to be a serious attempt to improve the gap in health care.”

Changing Social Norms: Making Exercise Cool

Koplan discussed changing norms as a society, including how we as a culture now look at tobacco usage, underage drinking, highway safety, seat belts, child car seats, air bags, fluoride, and vaccines. He talked about tobacco regulations, secondhand smoke, no smoking bans, and taxes, saying, “The idea of smoking changed from cool and sophisticated to stupid and dangerous.”

He acknowledged that prevention encourages a healthy alternative decision, but often at first, “there is lots of opposition, like it’s a communist plot.” Koplan believes, “Physical Activity as a preventative intervention can have a profoundly positive effect in our changing world. Right here and now, we are facing an epidemic of inactivity in our homes, communities and around the world. He also talked about places in the world that are successful in encouraging physical activity like Copenhagen, China and Brazil, and U.S. programs in Arkansas, Oregon, and Wisconsin.

A Positive Call to Action

Each day has 1440 minutes. Adding daily exercise, especially enjoyable physical activities, for a minimum of 30 minutes every day is “beneficial and necessary,” in the words of Dr. Tait McKenzie, who served as the first director of Physical Education at the University of Pennsylvania back in 1909.

Positive emotions via motion is a concept that fosters greater well-being and positive engagement, while promoting autonomy, meaning, and a better quality of life. We as individuals and communities can benefit from the power of moving our bodies well. That’s a prescription we can all live with.

 

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References

The Exercise Time Finder from the American College of Sports Medicine

See PPND articles by Marie-Josée Salvas Shaar for ideas about exercise:

• How Physical Activity Enhances Productivity
• Why Couch Potatoes are Tired
• Personal Hygience, Einstein, and Your Like-o-meter
• Top 10 Stimuli to Exercise Your Body
  

Csiksentmihalyi, M. (1990). Flow: The psychology of optimal experience.. New York: Harper Perennial.

Elkind, D. (2007). The Power of Play: Learning What Comes Naturally. Da Capo Press.

McGill, J. S. (1980). The joy of effort: A biography of R. Tait McKenzie. Clay Publishing Company.

Mutrie, N. & Faulkner, G. (2004). Physical activity: Positive psychology in motion. In In P. A. Linley & S. Joseph (Eds.). Positive Psychology in Practice. pp. 146-164. Hoboken, NJ: John Wiley & Sons.

President’s Council on Physical Fitness and Sports (1999). Physical activity promotion and school physical education. Physical Activity and Fitness Research Digest.

Ratey, J. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. New York: Little, Brown and Company.

Ryff, C. D., & Singer, B. (2002). From social structure to biology: Integrative science in pursuit of human health and well-being. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of Positive Psychology. (pp. 541-555). New York: Oxford University Press.

Shusterman, R. (2006). Thinking through the body, educating for the humanities: A plea for somaesthetics. Journal of Aesthetic Education, 40, 1-21.

Image Credits
Prescription sign courtesy of Ano Lobb
Playing skip rope courtesy of Mike Baird
Travel by bike courtesy of Polly Heninger
Make it cool to move courtesy of wraggy