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Sloth Kills: Should Doctors Prescribe Exercise?

Posted By Prucia Buscell, Thursday, August 16, 2012

Physical inertia is unnatural and unhealthy, a Mayo Clinic physiologist asserts, and physicians need to combat what The Lancet recently called an "inactivity pandemic.”

Mayo Physiologist Michael Joyner writing in this month’s Journal of Physiology suggests physical inactivity should be recognized as a mainstream medical diagnosis and doctors should prescribe exercise.

"The entire medical research industrial complex is oriented towards inactivity,” Dr. Joyner told NPR. "Physicians really need to start defining the physically active state as normal.”

In an NPR health blog Eliza Barclay notes that insurance companies will reimburse patients for medicines for diseases related to inactivity, but rarely for gym membership. Barclay says Joyner figures about 30 percent of the responsibility to fight inactivity should fall on the medical community. He says the two greatest public health triumphs of the last century were improved traffic safety and reduced smoking. Doctors and the public health community influenced those achievements, he argues, and the same model could be used for widespread behavior change to reduce destructive sedentary habits.

The World Health Organization estimates that 3.2 million people die each year, including 2.6 million in low and middle income countries, because of physical inactivity.

I-Min Lee, a professor of medicine at Harvard Medical School, says inactivity will contribute to 5.3 million premature deaths this year, about the same number of premature deaths caused by smoking. Dr. Lee is the lead author of a study on physical activity, non-communicable disease and life expectancy published in The Lancet. The article reports that worldwide, inactivity causes from six to eight percent of the burden of disease from coronary heart disease; seven percent of type 2 diabetes, 10 percent of breast cancer, 10 percent of colon cancer, and nine percent of deaths before age 60. A MedicalDaily story by Nikki Tucker notes inactivity also increases susceptibility for fibromyalgia, chronic fatigue syndrome, and postural orthostatic tachycardia syndrome, also known as POTS, in which a person experiences dizziness or flu-like symptoms when standing or exercising. Joyner says in his article that exercise training has been shown to reduce or reverse POTS.

A NewScientist story by Andy Coghlin cites a study by Gregory Heath of the University of Tennessee who examined interventions around the work that worked to promote physical activity. Among them are more than 100 cities in South America and some in the U.S. that periodically close certain roads to vehicular traffic to make way for bikers, skaters, runners and pedestrians. The movement, called Ciclovia, which translates as bike path, started 30 years ago in Bogota, Colombia, where traffic is banned on certain streets 72 days out of the year.

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