Medical Wellness in Action: Exercise is Medicine
Photo by Robert Collins on Unsplash
In their new book, Practical Wisdom: The Right Way to Do the Right Thing, Barry Schwartz and Kenneth Sharpe call for excellence in action: wisdom centered on human values, character strengths, moral purpose, and our and society’s positive transformations. Practical wisdom, or phronesis, is the solution-based concept Aristotle identified as “the essential human quality that combines the fruits of individual experiences with our empathy and intellect.” Practical wisdom is acting wisely, where we are guided by the proper aims (telos), or goals of a particular activity. Practical wisdom combines will with a moral skill that enables us to flourish, as individuals and a society.
Happily, important practical wisdom is part of the American College of Sportsmedicine’s (ACSM) multi-organizational, multi-national initiative, promoting moderate physical activity: Exercise is Medicine® (EIM). This global enterprise aims to prevent disease and improve health. EIM is sparking some positive changes in health and medical care. Since its launch at the first World Congress of Exercise Is Medicine last year, the momentum is building internationally.
Recognizing physical inactivity as a major life/health risk factor, the EIM intention is to recognize, validate and roll out the powerful benefits of moderate exercise in our life, health and well-being. The ACSM/EIM exercise guidelines call for a minimum of 150 minutes of moderate physical activity a week for adults, and a minimum of 420 minutes a week for children
Dr. Karim Khan: Inactivity even Worse than Smokadiabesity
The recent ACSM conference had a record number of participants with over 6,000 in attendance. Eminent professor (in departments of exercise science, epidemiology and biostatistics at Arnold School of Public Health, University of South Carolina), Dr. Steve Blair, reported a highpoint moment when Dr. Karim Khan spoke about “smokadiabesity,” (smoking, diabetes, obesity). Dr. Khan’s “creative and thought-provoking” presentation, “Supersize my Exercise: Learning from Mad Med, the Marlboro Man and Freakonomics to Promote Physical Activity,” educated and inspired people to make/find more time to be active. This keynote was aimed at those trying to influence government, health authorities, professional organizations, schools and community groups to embrace the vital physical activity message.
Dr. Kahn provided striking new findings related to the power of exercise for health domains, such as brain function, cancer prevention, and depression. Kahn showed data supporting the view that inactivity/low fitness causes more deaths than smokadiabesity! “At epidemic proportions, smoking, diabetes and obesity are major public health concern, … yet low physical fitness kills more people than all these in combination!”
Dr. Bob Sallis: Exercise as a Vital Sign
Leader and founder of the ACSM’s program, Exercise is Medicine, Dr. Bob Sallis, Kaiser Permanente, recently posted a robust editorial for the British Journal of Sports Medicine titled Developing Health Care systems to Support Exercise: Exercise as a 5th Vital Sign. At Kaiser Permanente, Dr. Sallis has instituted the idea of Exercise Vital Signs. He believes all physicians need to ask patients how many minutes of moderate exercise they perform in a week.
Dr. Sallis’ important message is that exercise as a vital sign is a “minimal standard of care.” Exercise reporting should be a part of every patient’s intake, and part of their medical chart, as much as the other vital signs of blood pressure, heart/pulse rate, respiration rate, and body temperature. In addition to documenting his patient’s exercise, he also charts their body mass index (BMI). To date he has collected exercise as a vital sign for over 3.5 million people in Southern California, with the goal of charting over 12 million people in the next year!
Dr. Sallis, a model of fitness, writes with passion and verve, “The importance of physical activity to health and wellness has been established incontrovertibly. There is a linear relationship between physical activity and health. Those who maintain an active and fit way of life live longer, healthier lives.”
He further discusses how sedentary, unfit behaviors “predictably” develop chronic diseases prematurely and die at a younger age. Asking Dr. Sallis, about moderate physical activity/exercise as a medical vital sign, he urges, “The goal is in ensuring that physical activity levels are assessed and prescribed at every visit.” This is the basic standard of care he expects.
In discussing medical school’s current standards of training, he opines, “It may be easier to change standards of care, and then medical schools will follow suit.”
U.S. National Physical Activity Plan
Dr. Blair encourages people who are interested in physical activity and health to get involved in promoting and implementing the U.S. National Physical Activity Plan, which was released in May 2010. The plan focuses on strategies and tactics in multiple sectors such as education, public health, clinical medicine, worksites, urban planning and transport, and other areas. Dr. Blair wisely acknowledges, “We have a huge public health problem of inactivity, and it will take extensive efforts by many groups over many years. Please review the Plan and find a way to get involved.”
Dan Henkel, ACSM Senior Director of Communication & Advocacy, concurs, “We can each look at the National Physical Activity Plan and see how we can help bring about changes in our own communities to make them more conducive to healthy and active lifestyles.” He discusses advocating for more bike lanes, hiking trails, pocket parks, and workplace wellness programs that reduce health care costs and absenteeism. He believes there are opportunities and rewards in helping our fellow citizens become more active and healthy.
Human Choreography and Lifestyle Medicine
In his recent presentation on passion, President-elect of International Positive Psychology Association (IPPA), Dr. Robert Vallerand discussed recent research around Harmonious Passion, where we can experience positive emotions that feed us and lead us to developing positive relationships.
I believe that we can find harmonious passion in moving well. I believe we can merge areas on Positive Psychology and Positive Physical Activity, and establish Positive Exercise Prescriptions (PEP) for flourishing individuals and communities. By developing a positive relationship with kinesiology, we can inspire others to reach for healthier, happier and richer lives. With principled doctors joining fitness professionals to help lead the reduction of the grave risks of inactivity, there is great hope in the phronesis of medical wellness in action.
Resources
Blair, S. (2009). ‘Smokadiabesity’ reaches epidemic proportions. But low fitness still kills more Americans than smoking, diabetes and obesity combined!,
Blair, 2009, British Journal of Sports Medicine, (43) pp 1-2.
Sallis, R. (2010). Editorial, Developing Healthcare Systems to Support Exercise: Exercise as the Fifth Vital Sign. British Journal of Sports Medicine, 45(6), 473.
Schwartz, B. and Sharpe, K. (2010). Practical Wisdom. New York: Penguin Group.
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