CW: Regular Exercise: An amazingly effective elixir

It’s Wednesday, so I would like to tell you about some cool things I learned this past week about the science of how exercise can be used as a treatment for three common ailments.

First, some background about exercise: The great thing about exercising every day that you eat is that this magic potion is not a shot or a pill. It does not involve a doctor burning or squishing anything in your body. There are no HIPAA forms, no insurance pre-certifications, and not even a co-pay. It’s as we say, easy and free. And drum roll please…exercise is active—not passive.

Here’s the Mandrola take on how exercise might treat three specific medical conditions:

Let’s start with young people. I have written before about how regular exercise in children can increase the size of the hippocampus–a part of the brain involved in intelligence. It seems striking that educators feel that schools don’t have time for gym class. Well now, the famous NYTimes exercise writer, Gretchen Reynolds, tells us about a study of Italian youngsters that scored better on concentration tests after a period of endurance exercise. Ms Reynolds goes on to tie this research into the broader implications of using endurance exercise as an antidote for the ADHD epidemic. Here’s a study that would be nifty: 50 minutes of daily exercise versus any adrenaline-spiking. tachycardia-inducing ADHD pill.

Now on to an older group of patients. Besides heart disease, one of the greatest health scourges of older humans is arthritis. As a bike racer who has suffered from sudden deceleration injuries, I feel empathy for those whose skeletons ache. Creakiness is a bummer. I get that. So what are arthritis patients and their doctors to do? Reflexively, many reach for an NSAID. But that’s a bad idea, given these drugs’ tremendous cardiac, renal and GI side effects.

Enter exercise. The paradox is that the very thing that hurts, movement, actually helps arthritis patients the most. Study after study shows that exercise trumps pills and arthroscopy. But this is tough sell to the typical heart patient who is accustomed to having a procedure or taking a pill as a solution.

Finally, let’s finish with how endurance exercise might help Cancer patients. The idea comes form the Basic Science for Clinicians Series published regularly in the journal Circulation. The review article, written by six doctors (three PhDs), explained how aerobic exercise might modulate the cardio-toxicity of anthracyclines. I know this sounds complicated, and the article was indeed heavy on weighty words like apoptosis, but let me offer a translation:

Anthracyclines, like doxorubicin, are commonly-used and highly effective cancer drugs; they are especially effective in treating breast cancer. The problem with these drugs is that they can damage heart muscle, leaving the cancer-free patient with irreversible heart failure. Thus far the only way around this vexing problem is to either reduce the dose of the drug or stop it entirely.

What I learned from the review article is that the very way that anthracyclines damage the heart (inducing muscle death by free radicals, preventing of protein synthesis, disturbing cellular energy metabolism and causing calcium overload in the heart cells) are all things that aerobic exercise may blunt. And multiple studies (mostly in animal models) show that intense exercise mitigates the cardiac toxicity of these helpful cancer drugs.

The authors point out the earliness of the research by saying:

“Evidence reviewed here indicates that aerobic exercise is a promising strategy to prevent and/or treat doxorubicin-induced cardiac injury. Future studies are required to further elucidate the molecular mechanisms underlying the cardioprotective properties of exercise before, during, and after doxorubicin exposure.”

Imagine the implications here: What if science supported that a person felled with cancer can actually do something active (not passive) to directly improve their survival? Working out regularly might allow the cancer patient to tolerate a life-saving medicine. Those with cancer would be like heart patients: exercise could save their life. That’s a pretty cool concept! Why don’t more doctors talk about the benefits of exercise?

So there you have it. In addition to preventing and treating heart disease, our number one killer, exercise can also be used to safely treat arthritis, ADHD and perhaps even Cancer.

Ride on. Your body will love you for it.

JMM

Comments

  1. says

    Hello Dr. John – okay, I’m convinced! After my knee surgery (following one of those cycling sudden deceleration injuries) I was surprised that exercise-exercise-exercise was the best physiotherapy advice for helping me to heal. Plus those stronger muscles around the knee would help stabilize the wonky joint in the future! MRI also revealed osteoarthritis of that knee (who knew?) but once again, exercise is recommended for this, too.

    Your ‘exercise only on the days you plan to eat’ advice is brilliant and I have borrowed (stolen?) it frequently for my own blog posts and when I do presentations about women’s heart disease.

    Thanks!!
    cheers,
    C.

  2. Don says

    Does exercise have any beneficial impact on AFIB?

    I try to exercise in between my intermittent episodes in the hope that being in shape will help me cope with them better.

  3. Thomas Byrnes says

    Hello, Dr. John,
    Thank you very much for your informative articles and blogs.

    Although there may be several variables that prevent you from make a generalized rule or statement, if a cyclist racing goes into AFIB (irregular heartbeats, but not necessarily tachycardia) while cycling, what, if any, are the risks of continuing to ride within himself or herself, instead of stopping immediately? This situation came for me doing my 83-mile relay leg of the Furnace Creek 508. Thank you.

    • says

      In the absence of shortness of breath, chest pain or dizziness there is little risk to continuing on, albeit at a lower wattage. But isn’t riding, walking, running, or living, for that matter, within oneself, always healthy?