New Year’s is a time of resolution, renewal and rejuvenation. People resolve to stop smoking, lose weight and exercise. More gym memberships are sold in January than any other time of the year, and many go unused. We all have this sense that we should exercise more – but have you ever wondered why that is such a universal sentiment? What is it about exercise that makes it hard to maintain but remain so high on our wish lists? What does exercise do for us?
Exercise impacts not only our muscles but almost every body function we have – it changes multiple hormone levels, insulin sensitivity, pain perception, hunger, sex drive and mood. Exercise gives you the power to heal yourself. Regular exercise promotes the following changes in the body:
increases the development of new blood vessels (can help in heart disease)
improves the functioning of multiple immune system aspects
decreases anxiety and depression
decreases pain in osteoarthritis
improves blood pressure
improves diabetes beyond weight loss
decreases the cravings for cigarettes
strengthens muscle fibers as well as promotes the development of more muscle tissue
stimulates the reward centers in the brain with substances called endorphins
and many other functions
These effects are separate from and in addition to the usual weight loss that accompanies exercise.
So what is exercise?
Exercise is any activity that maintains or improves physical fitness, health and wellness. Studies have shown moderate activity will begin to show the benefits of exercise. Moderate exercise is defined as 150 minutes per week (30 minutes/5 days per week) of brisk walking or similar activity. The more intense your activity, the less total time you need – 75 minutes per week of intense activity will give similar benefits to the 150 minutes of moderate activity.
A recent study in the journal Lancet showed that in people with a high risk of heart disease and pre-diabetes decreased their risk of a heart attack by 10% just by increasing their walking by 2000 steps per day. Another study in the British Medical Journal demonstrated that regular exercise was as effective as medication in preventing death from second heart attacks, rehabilitation from a stroke, improving heart failure and preventing diabetes.
The trick is maintaining the activity to continue reaping the benefits – if you don’t use it, you lose it. Another way of looking at it is stated very well by Jim Rohn, an author and self development coach. “Motivation is what gets you started, habit is what keeps you going.”
What do I recommend in my practice?
So, should everyone stop their medications if they exercise? No, and certainly not without discussing your plans with your doctor. Not every condition can be controlled with exercise, and not every medication can be safely stopped abruptly. What I try to emphasize with my patients is that medication begins to correct a problem immediately – for example – lowering cardiovascular risk with a statin; adding an exercise program helps manage the long term risk. We can then decide if immediate action is necessary, and set a goal – say losing a certain amount of weight. When the goal is reached, stop the medication and reassess the condition.
By re-evaluating your diagnosis the effect of medication and the effect of your actions on your diagnosis can be measured, and your treatment plan revised. You become an equal partner on your journey to wellness by revising your diagnosis!
Personally, I reconnected with running about 3 years ago. While there have been some ups and downs, I’ve managed to keep about 20 pounds off, and will be running my 7th half marathon next weekend. If you’d like to read about my own story on how I started maintaining a program, see this post – Exercise for a Cause, originally posted on TheVisualMD.com in 2011.
The path to wellness begins with a proper diagnosis
I am a Board Certified Internal Medicine physician. I currently practice at and am the Medical Director of NYU Langone Internal Medicine Associates. Posts are my opinion and not medical advice or an official position of NYU Langone Medical Center.
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