There is NO doubt in all medical literature that being active is beneficial for health. It is the single most significant factor you have control of to change, followed by nutrition and sleep.
( family walk with the kids - aerobic cardiovascular exercise and social connection)
We are not all made to be marathon runners, and I am not urging you all to become marathon runners. I am asking you to consider whether you can get more active, even if you think you are active there may be more you can do.
There are specific recommendations for individuals with certain health conditions, and please do not hesitate to discuss these with your GP or specialist or book an appointment with me to discuss this, but the majority of people even those with heart disease, COPD, inflammatory joint conditions and mental health disorders will benefit from getting more active.
Only 2 weeks ago I had a second consult with a 77 yr old man, who I have renamed for this blog as Brian, who had seen a cardiologist who told him he had mild angina ( coronary artery disease) and to come back and review with him in 1 year. The cardiologist had said to Brian to wait until he has a further review before continuing to play golf with his friends. When I saw him 6 months after his appointment with the cardiologist, he had lost muscle mass, lost cognitive function, and most importantly lost his joy in life as he had lost his social connection and sense of purpose, his wife brought him back worried about his health. He had stopped golf and stopped gardening on his allotment scared for his heart health; his two joys; connecting with friends and growing food for his family. We had a holistic conversation reflecting what is health and what is wellbeing, both of which he desired and hoped to improve by consulting with medical professionals. HIs response was; to be able to enjoy time with my wife, enjoy time with my family doing things I enjoy, without being a burden on them physically or mentally. He reflected on what wellbeing and happiness for him looked like , Brian stated; ‘feeling connected in his community and having a sense of purpose within his family unit’. He had lost a lot of this in 6 months by becoming inactive. After a pause and time to reflect on his beliefs and my expertise as a medical doctor we were able to together create a realistic safe plan to get him cardiovascularly and muscularly fit again over the next 16 weeks I am due to see him next week and I look forward to it. He left the consult with hope. Increasing his plant intake, reducing his red meat intake and ensuring he was getting adequate vitamins and minerals and protein in his diet, good quality sleep and daily exercise including golf twice a week and gardening 4 times a week for short bursts with rests I am certain he will have a sense of wellbeing and health back.
Reducing his activity had caused his BP to increase, and therefore his risk of heart attack ( the thing he was trying to avoid) to increase. His muscle mass had decreased making him more prone to falls due to decreased balance and decreased exercise had reduced blood flow to the brain reducing his memory. All of this knocked his self esteem and confidence affecting his mental health. This gentleman is a reminder that taking a holistic approach to each individual patient is crucial and to consider what is trying to be fixed, and the impact of the intervention. Modern medicine is excellent but it does not reverse disease or prevent disease, lifestyle is the only proven modifiable factor that can do this. Working with your doctor using modern medicine ( tablets and technology) alongside lifestyle modification is the key to longevity and well being. There is no one tablet that can offer what physical activity and good nutrition can. Ofcourse I support evidence based medicine including medications for certain conditions where the benefits outweigh the risks and the patient is fully informed of the side effects, whilst being counselled on lifestyle modifications.
Being active saves lives. It can reduce your risk of major illnesses, such as coronary heart disease, stroke, type 2 diabetes and cancer and lower your risk of early death by up to 30%.
But its not what everyone wants to hear, and some people believe they are active enough if they go for a dog walk each day then sit at the desk for the next 8-10hours. Or some of my patients tell me their job is really active as they stack shelves or work in a school. I am sure it is active, but is there anything else you can do to increase your activity further, or add in some flexibility training for your back, or strength training for your muscles and joints.
I would urge you to read and and just reflect is there any way you can increase your activity in every single day. Now for some that increase may be using the stairs rather than the elevator, or getting off the bus 2 steps sooner than your stop, or parking a few streets away from work, for others it means getting out of your chair each hour to walk to the kitchen sink, or the tea room at work and back rather than just when you need a wee and for some it means adding in an extra walk at the end of the day , starting gardening, taking up a new hobbie such as tennis, doing housework. Please just consider how you can be more active and how you can therefore encourage others around you to be more active.
Print these infographics and place them in your work place to remind you and your colleagues of your minimum commitment; being moderately active for 150 minutes a week – means getting out of breath.
Some resources I share with my patients that are really supportive include;
ParkRUN – find your local FREE Parkrun and walk it first and try to decrease your time over the year. Take a friend, take your toddler in their buggy or take your neighbour. https://www.parkrun.org.uk/
Step counting
Exercise on referral to your local gym – ask you GP if there is a scheme like this in your area. For PLymouth and Ivybridge patients you need to collect a form from the gym and hand it in to be signed by your GP.
NHS Weight management services. To qualify you need a BMI greater than 30 , diabetes, high BP or both . https://www.england.nhs.uk/digital-weight-management/
Create a personalised monthly schedule diary to plan when you are going to be active to hold yourself accountable – consider apps like Strava, or step counting
There are very disease specific statistics and bits of medical literature on the evidence of physical activity that I'd be more than happy to share with you and will do in coming months through the blog. In the meantime if you have questions please email me, or specific topics you want me to cover . I may take up to 10 working days to reply at present but hold fire I will get back to you.
Finally for me personally being active keeps my mental health in check with high workload and a busy family life, with three kids. I am fully aware if I have neglected the importance of activity in my day or week thinking I do not have time for it today or tomorrow, my mood dips, my sleep suffers and my concentration and enjoyment at work declines. Being active has to be a priority the same as brushing your teeth.
Direct health benefits include;
Improved mental wellbeing and health
Decreased anxiety
Improved self esteem , self confidence
Clarity of mind for organising thoughts – a walk or jog can be an act of mindfulness
Increased bone density ( especially important in peri-menopausal and menopausal women)
Sense of purpose; cleaning/ housework, gardening
Improved heart health
Lower BP, Lower cholesterol
Increased muscle strength and tone, improved balance and coordination
Decreased asthma attacks, improved respiratory fitness
Social connection when attending groups or training with others – lifelong friendships
As a busy NHS GP and health coach for women, making time for exercise is a priority for me. But sometime I let it slip and always regret it. Heres what I do to ensure there is adequate activity for me in a week;
Walk or run before leaving for work; often taking the kids out with me for 20 minutes minimum
Try to get up from desk every hour and walk to coffee room and back
Aim to run 3 times a week for at least 30 minutes, 1 time with girlfriends to connect and laugh
Do house work at least twice a week and try to make it strenuous
Garden, digging, lifting once or twice a week
I aim to do yoga three times a week using a free app at home to fit around kids and work.
I fail some weeks, some weeks I do more and some I do less, but when I create a routine I am more likely to stick to it and even more so if I do it with someone else and therefore am held accountable. The last few weeks it's been with my middle daughter ( 13 years) 5 km a day until Easter. We didn't achieve each day but we did most days and it felt great, we always felt better and we as a bonus had some quality time together.
Exploring the coast path - wearing a back pack counts as 'weight bearing exercise' and supports a strong spine, reducing osteoporosis/osteopenia ( bone thinning) that occurs as we age more pronounced post menopausally due to lack of oestrogen.
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