If you're looking for a New Year's resolution that could pay you back countless times, it's this: I promise to do a little exercise every week. It could be the difference between having a healthy, disease-free older age and joining the millions who regularly pop pills
Once we reach our mid-50s or so, most of us seem to accept that we will need a pharmaceutical either as a just-in-case remedy against conditions like raised cholesterol and high blood pressure or to help keep us going when we do develop a chronic health condition.
To do otherwise would be irresponsible and a course of action reserved only for those with a death wish-or so doctors tell us (who in turn are told so by drug manufacturers). And many of us agree: in fact, Britons are now taking an average of 17 prescription drugs each. And it's a rising trend: in 2000, we were each taking an average of 11 drugs.
But an astonishing piece of new research-prepared by three of the world's leading universities-dares to suggest otherwise. People with chronic, life-threatening health problems can live just as long-and possibly longer-if they instead introduce regular exercise into their lifestyles.1
Another recent study has found that just a little exercise once a week could be all we have to do to enjoy a healthy old age.2And of course, unlike drugs, there're no dangerous side-effects to make your life unpleasant or intolerable.
Yet despite this, far too few of us are choosing the exercise option. In fact, a mere14 per cent of Britons do any
exercise at all.
This is all good news for the pharmaceutical industry. Its profits come from lifelong prescriptions for the treatment of symptoms of chronic disease. One such example is simvastatin, the most widely prescribed drug in the UK, designed to reduce levels of 'bad' LDL (low-density lipoprotein) cholesterol, a supposed precursor of heart disease.
The drugs industry also happens to be responsible for funding the vast majority of medical research that seeks to determine the effectiveness of its products.
At best, these medical trials may pitch the drug against a placebo, a 'sugar pill' with no active chemical properties-but almost never are the scientists commissioned to test the drug against a lifestyle change such as improved diet or regular exercise.
A small minority of research gets its funding from agencies that don't have pharmaceutical ties, and this is where lifestyle changes may be assessed. Although these studies are pretty thin on the ground, there's still enough that's been published to give us a good idea of how we can live better, and longer, without drugs.
Finding the evidence
A team from Harvard and Stanford universities and London School of Economics Health found just 57 trials involving 14,716 people that looked at the benefits of exercise.1
Not a single trial compared exercise directly with a drug but, by using special statistical analyses, they were able to evaluate the benefits against 248 drug trials that examined the effect of major pharmaceuticals on chronic conditions such as heart disease, stroke recovery, heart failure and diabetes prevention.
What the researchers discovered wasn't just important-it was revelatory. Plenty of trials have already confirmed that exercise is good for us even when we're suffering from cancer, arthritis, asthma or heart disease, but none had demonstrated we could actually throw away the pills.
Those pills form the bedrock of the drugs industry: statins, beta-blockers, ACE inhibitors, anticoagulants and antiplatelet agents were all assessed against regular exercise, and only diuretics, or 'water pills', helped patients with heart failure live longer than they would have by just exercising. For people recovering from stroke, exercise was more beneficial than any drug, while exercise was as good as a drug for every other condition.
Tantalizingly, the researchers didn't explore the sort of exercise or how long the participants exercised. They don't know what exercise or intensity would most benefit a given patient, although they do confirm that whatever exercise is used, there's no downside.
One Cochrane Collaboration review they cite found no bad reactions to exercise, not even among heart
patients who had been exercising for 10 years or more.
What's exercise ever done for us?
We all know that exercise is good for us (even if we don't do it), but probably don't realize how good. Here are some of the health problems that regular exercise can help improve, and by how much.
Depression by 30%
Breast cancer by 20%
Premature death by 30%
Colon cancer by 50%
Osteoarthritis by 83%
Falls in the elderly by 30%
Hip fracture by 68%
Type 2 diabetes by 50%
Coronary heart disease by 35%
Dementia by 30%
It's never too late
Another new research paper throws more light on the type of exercise and its benefits-and the take-home message is a positive one: it's never too late to start.
The study, carried out by researchers from University College London, assessed the health of 3,454 adults with an average age of 64 over an eight-year follow-up period.2 They found that sustained and frequent physical activity for four years increased by seven times the chances of a healthy, disease-free, old age compared with being inactive.
Exercse doesn't just help ward off the usual chronic diseases of old age, it also keeps us mentally sharp too. Regular exercisers maintained a good memory and were able to lead active social lives.
The exercise doesn't have to be particularly onerous or regular. Those who indulged in either moderate or vigorous exercise at least once a week at the start of the study were four times more likely to be classified as 'healthy agers' eight years later.
It doesn't seem to matter when you start exercising either. The participants who started exercising only at the start of the study-and who'd been inactive before-were still three times more likely to be 'healthy agers' by the end of the study compared with those who did no exercise for the duration of the trial.
The key, say the researchers, is little and often when it comes to exercise.
Your exercise options
What exercise you do, and how vigorously you do it, depends on your age and your mobility. If you're in your late 50s and can still get around reasonably well, here are some of your exercise options:
Walking.Walk at a good pace for 150 minutes a week, or just over 20 minutes a day. If that's too difficult, walk at a gentler pace for eight to 14 hours every week-that's between 68 minutes and two hours every day.
Cycling.Another option is to cycle for two and a half hours once a week, or halve the time and do it twice a week.
Jogging/tennis. You need to do one of these more vigorous options for around 75 minutes per week.
Ballroom dancing.You don't have to be a Strictly Celeb to get exercise benefits from dancing, as long as you do it for at least two hours every week.
Mowing the lawn.It's good for you, but you do need a very large lawn and grass that grows quickly if mowing is the only exercise you do. And it has to be the old-fashioned sort of lawnmower that you push around for two hours each week.
Carrying the groceries.Lifting anything a little heavy is a good muscle-strengthening exercise and also good for balance and coordination. But remember to lift properly: keep the back straight, flex the knees and use the legs, not the back. Alternative muscle-strengthening exercises include yoga and serious gardening.
Swimming.A fast swim for 150 minutes (or 30 minutes five times) per week provides vigorous exercise that makes the heart work a little faster and leaves you a little breathless.
Many of us may be put off by the idea of exercise because it conjures up images of sweating suffering bodies in a gym, but it doesn't have to be so punishing, a third new study reveals.3
This study-the subject of our Every Picture feature this month (see pages 22-3)-has discovered that older people who do even a moderate amount of exercise, such as a walk around the block, are far less likely to suffer a stroke. The key is the length of time you do the exercise rather than how strenuously you exercise.
People who walk for eight to 14 hours a week-and the pace doesn't matter at all-nearly halved their risk of a stroke, while those who walked 22 hours a week, or more than three hours every day, had only a third of the risk of stroke compared with those of a similar age who stayed in their armchairs.
So just walking around the block several times a day is a New Year's resolution we all can keep, and it may keep you healthy and drug-free into
BMJ, 2013; 347: f5577
Br J Sports Med, 2013; doi: 1136/bjsports-2013-092993
Stroke, 2013; doi: 10.1161/STROKEAHA.113.002246