JOHN DOHERTY: Exercise is medicine when Thanksgiving leftovers not left alone

The longstanding theme of The Physician and Sportsmedicine journal has been “exercise is medicine.” As we enter the holiday season, gatherings with co-workers, friends, and family will bring extra calories.

The resultant additional pounds are the reason why so many New Year’s resolutions include starting an exercise program.

Sadly, too many of us won’t stick with it and, over the years, as we age and our metabolisms slow, the number on the bathroom scale keeps climbing.

Rather than waiting until January, though, the better strategy would be to start burning more calories now.

The American diet is tailor-made to cause type 2 diabetes, thanks to all its high fat and processed sugar. That disease in turn contributes to heart disease, higher blood pressure, a greater likelihood of stroke, kidney disease, diabetic neuropathy, and even dementia.

However, a new literature review in the British Journal of Sports Medicine shows a regular dose of moderate exercise, 150 minutes per week, prevents type 2 diabetes and even will reverse it. As we age, we become more resistant to insulin which we need to burn sugar for energy. The more resistant we become to insulin, the more our pancreas has to make to help burn the sugar. Eventually, the pancreas is unable to keep up and even burns itself out.

Exercise works because it builds muscle, which burns sugar more easily than other tissues -- even while we sleep – and ultimately results in less resistance to insulin. Unfortunately, the authors of the review also wonder if exercise will ever be an effectively widespread cure because so few people – not even a quarter – will stick with it.

That’s too bad.

Consider the benefits of an exercise program, that includes an aerobic as well as a strengthening component, before trying it or – worse – giving it up.

Aerobic fitness is directly correlated with overall heart health, including lower blood pressure. Yet, so is strength training.

A study published online in February 2019 by the Journal of the American Medical Association’s Open Network revealed a simple measure and goal for middle-aged men: more than 40 push-ups. Yes, the good old-fashioned push-up which requires little room and no equipment. It strengthens the pectoralis, triceps, anterior deltoid and serratus anterior muscles

Firefighters from 10 Indiana fire departments, 1,104 in all, were evaluated periodically by researchers from Harvard between 2000 and 2007 via cardia stress testing and determination of push-up capacity. Only 75 completed 0-10 push-ups; 200 reached 11-20; 389 ranged between 21 and 30; 285 achieved 31-40; and 155 topped 40 push-ups in 60 seconds or less. The health of those firefighters was then followed until the end of 2010.

Ultimately, push-up capacity was slightly better at predicting the likelihood of a cardiovascular event than a cardiac stress test. Push-up testing was much less expensive, too.

Those unable to perform more than 10 push-ups were significantly more likely to end up with a heart issue than those who were able to perform more than 10. However, those “able to complete more than 40 push-ups had a 96% reduction in (cardiac) incidents compared with those completing fewer than 10 push-ups.” Only one of 37 cardiac events occurred among those who topped 40 push-ups. The other 36 were spread out fairly evenly among the other four groups.

Strength training not only builds muscle, but bone, too. So does an aerobic program that includes walking or running. Balance improves, as well. The result is fewer falls and, even if you do experience a fall, you are less likely to suffer a fracture or other serious injury.

Riding a bike or swimming do not build bone but the latter does build strength.

Exercise slows the development of arthritis – because you end up weighing less, putting less pressure on the joints in your legs. Then, even when arthritis is present, regular exercise decreases the pain associated with the affliction.

The physically fit have lower cancer rates but the greatest benefit – aside from heart health – may be that experienced by the brain. Benefit is undoubtedly derived from improved circulation and overall heart health. No organ – other than the heart – is more sensitive to blood supply, and the oxygen that comes with it, than the brain. The increased socialization that comes with regular exercise probably helps, too. Whatever the reason, exercise prevents the onset of age-related dementia and likely slows its progress.

Even absent the presence of dementia, faithful exercise adherence improves mental health, lowering rates of depression and anxiety.

Committing to exercise with a friend or group of friends also makes it more likely that you will stick with it.

For those with chronic back pain, exercise helps them, too, ultimately reducing reliance on pain medication.

Best of all, compared to medications, exercise has no side effects and is far less expensive. Joining a health club or buying equipment for home use involves some cost. However, proper footwear is the only expense associated with walking. Weight machines and dumb bells are nice for building strength but your own body weight offers excellent resistance for host of exercises such as the above-mentioned push-ups.

Consequently, cost should not be a barrier. Neither should time. Those who say they do not have time to exercise need to make the time. If you have time to sit down and watch television every day, you have time to do something that will truly improve your health.

The holiday season may be for celebrating and with celebrations comes food but it is also for giving gifts. Consequently, start with yourself and give the gift of better health with a consistent exercise program. Find something you like. Find somebody who will do it with you. And stick with it before poor health sticks you.