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Exercise ‘as potent’ as medicine

Exercise can be as effective as many frequently prescribed drugs in treating some of the leading causes of death, according to a new report. The study raises important questions about whether our health care system focuses too much on medications and too little on activity to combat physical ailments.

For the study, which was published in October in BMJ, researchers compared how well various drugs and exercise succeed in reducing deaths among people who have been diagnosed with several common and serious conditions, including heart disease and diabetes.

Comparative effectiveness studies are a staple of science, of course, especially in pharmaceutical research. Scientists often track how well one drug treats a condition compared with the outcome if they use a different drug. But few studies have directly compared drugs with exercise, and even fewer

have compared outcomes in terms of mortality or whether the intervention significantly lessens the chance that someone with a disease will die from it, despite treatment.

So Huseyin Naci, a graduate student at the London School of Economics and Political Science, and Dr John Ioannidis, the director of the Stanford Prevention Research Centre at the Stanford University School of Medicine, decided to create a comprehensive comparison of the effectiveness of drugs and exercise in lessening mortality among people who had been diagnosed with one of four diseases: heart disease, chronic heart failure, stroke or diabetes.

Naci and Ioannidis gathered all of the recent randomized controlled trials, as well as previous reviews and meta-analyses of older experiments relating to mortality among patients with those diseases, whether they had been treated with drugs or exercise.

The results consistently showed that drugs and exercise produced almost exactly the same results. People with
heart disease, for instance, who exercised but did not use commonly prescribed medications, had the same risk of dying from — or surviving — heart disease as patients taking those drugs. Similarly, people with diabetes who exercised had the same relative risk of dying from the condition as those taking the most commonly prescribed drugs.

Only in chronic heart failure were drugs noticeably more effective than exercise. Diuretics staved off mortality better than did exercise.

Overall, Ioannidis said: “our results suggest that exercise can be quite potent” in treating heart disease and the other conditions, equaling the lifesaving benefits available from most of the commonly prescribed drugs, including statins. (

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