Exercise as medicine

When cardiologist Dr. Paula Harvey, director of the cardiovascular research program at Women’s College Hospital, says that exercise is medicine, it’s not just a clever reminder that physical activity is good for you. Research has shown that exercise is a powerful therapy that can help reduce blood pressure, cholesterol and blood sugar levels, among other benefits.

“For example, we know that if somebody goes through exercise training after a heart attack, that’s as effective as medication in reducing recurrence of heart attack and death,” Dr. Harvey explains. “Exercise is also one of the only things that will actually increase good cholesterol as well as decrease the bad cholesterol.”

Exercise has clear benefits for cardiovascular health, but it also benefits mental health, bone and joint health, and probably cognitive health, Dr. Harvey says.

Canadian physical activity guidelines recommend adults get 150 minutes of moderate-to-vigorous aerobic exercise per week.

“Include some resistance exercise for bone and muscle strength and protection from falls,” Dr. Harvey says. “But from the cardiovascular point of view, it’s aerobic exercise – things like walking, cycling, jogging, swimming – that are beneficial to health.”

Those benefits start almost immediately, even if you can’t see them. In her physiology lab, Dr. Harvey looked at women’s blood pressure, heart rate and blood vessel health before and after a 45-minute walk at a moderate pace on a treadmill.

“I can show that blood pressure and blood vessel health is significantly improved after 45 minutes of just walking at a moderate intensity where you could hold a conversation,” she says.

Dr. Harvey stresses that exercise doesn’t have to mean competitive sports or extreme activities. It can mean finding something that you enjoy doing and perhaps can do with your partner or your kids or with friends at lunchtime.

Overcoming barriers

For some people, things like age or chronic conditions may seem like barriers to exercise, but it is never too late to benefit from physical activity.

“We don’t want people to feel that it’s a barrier because they’re too old or they’ve got arthritis and a sore knee or a sore hip,” Dr. Harvey says. “That’s an important message because there are still so many benefits from physical activity, such as to improve your quality of life and your ability to stay in your home, to do your activities of daily living without being short of breath and having pain.”

Conditions such as osteoarthritis can actually benefit from exercise. With the right supervision, almost no condition is a barrier to exercise.

“I can’t think of any patient group, let alone healthy individuals, who shouldn’t be doing some sort of physical activity,” Dr. Harvey says. “There are patients for whom it’s not necessarily safe for them to start exercising unsupervised. For some people it should be supervised until they have reached such a point that it’s established that it’s safe.”

For example, women in the Women’s Cardiovascular Health Initiative – a cardiac rehabilitation program for women at Women’s College Hospital – do a supervised program until is it safe for them to continue exercising on their own.

In addition to regular exercise, you can add physical activity into your day by looking for opportunities to walk a little farther, or to get out of your chair instead of using email.

“So use the stairs, and get up and go and speak to your colleague. Just keep moving,” Dr. Harvey says. Even on days when it seems difficult, being more active pays off in health benefits. In fact, especially on days when it seems challenging, physical activity offers great value for the time invested: it brings more oxygen to your muscles and organs, it helps manage stress, and it promotes better sleep. Those benefits build over time, resulting in improved overall health.

“If you’re looking for a tonic for everything, it’s exercise,” Dr. Harvey says.