The Exercise Prescription

This post is part of the series exercise

Other posts in this series:

  1. Let’s talk about exercise
  2. The Exercise Prescription (Current)

We all know that we need to get more exercise. In today’s technologically driven world we sit too much and move too little. Being a working mom, I am well aware of how I am always rushing around, but not physically moving very much. It is hard to find the time (and inclination) to exercise with dedication.

Doctors have been telling their patients to exercise more since  Hippocrates said: “walking is man’s best medicine”.  A medical prescription is very clear as to the dosage, duration and frequency that is needed. The recommendations on how much and how often to exercise have been vague. Perhaps, not surprisingly, patient compliance has been equally “vague”.

We are now beginning to realise that the amount of exercise needed is different for different goals.

  • Exercise for depression

We have known for some time that exercise is as effective as antidepressants in the treatment of mild and moderate depression and is a useful add-on to medication in the treatment of more severe depressions.  The recommendation is one of moderate exercise three times a week for this antidepressant effect.

We have become aware that exercise is helpful not only in the treatment of depression but can also reduce the incidence of depression. The Norwegians recently completed an extensive study of over 75000 people over a period of 13 years and discovered that only an hour of light exercise a week could reduce the incidence of depression by 12%. That is an amazing benefit for little effort. A 12% reduction in incidence does not sound like much, but as anyone suffering from depression will tell you, prevention is better than cure.

If all parents were to make weekend walks the new family norm, then the next generation should reap the benefits of lower depression rates.

Another study, this time by the Germans, found that people who were in regular contact with nature, like people who lived near forests, had healthier amygdalas. The amygdala is a little structure deep in the brain which is very involved with processing danger and our responses to it. A healthier amygdala means being better able to deal with stress.

Armed with this knowledge, the script for my family reads: “weekly walks in nature”.

  • Exercise for cardiovascular health

The cardiologists were the first speciality to start accessing the benefits of exercise. They recommend that to reduce the risk of cardiovascular disease; you need 150 minutes moderate exercise a week, or 75 minutes rigorous exercise a week. So both the regimes of 2-3 times a week or a long session on weekends meet this recommendation.

  • Exercise for weight loss

Exercise for weight loss takes the most commitment. Weight loss is all about calories in vs calories out. If you want to burn off a 300 calorie doughnut, you will need to run for about 40 minutes, so that is not the easiest way to lose weight. The trick is to try to boost your daily metabolism, thus increasing how many calories you burn in a day. What this translates to is at least 30 minutes of moderate exercise 6 out of 7 days.

For some of my patients, depression makes getting out of bed difficult. Giving them a directive to exercise for 30 minutes every day is an impossible task and just gives them another reason to beat themselves up. Rather I explain that they could reduce the risk of their children getting depression by merely going for a family walk each week. I suspect that this attainable intervention could have benefits the trials have not even mentioned.


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