Exercise just as good as drugs in war on major disease

Those who "enrolled on exercise programmes" may have been healthier to start with

Exercise could be as effective as some of the best drugs which protect against major diseases, research has found.

A study of more than 300 trials has found that physical activity was better than medication in helping patients recovering from strokes - and just as good as drugs in protecting against diabetes and in stopping heart disease worsening.

The research, published in the British Medical Journal, analysed data about studies on 340,000 patients diagnosed with one of four diseases: heart disease, chronic heart failure, stroke or diabetes.

Researchers said the findings suggested that regular exercise could be "quite potent" in improving survival chances, but said that until more studies are done, patients should not stop taking their tablets without taking medical advice.

The landmark research compared the mortality rates of those prescribed medication for common serious health conditions, with those who were instead enrolled on exercise programmes.

Most of the 305 studies examined involved patients had been given drugs to treat their condition. But 57 of the trials - involving 15,000 volunteers - examined the impact of exercise as a treatment.

The research found that while medication worked best for those who had suffered heart failure, in all the other groups of patients, exercise was at least as effective as the drugs which are normally prescribed.

People with heart disease who exercised but did not use commonly prescribed medications, including statins, and drugs given to reduce blood clots had the same risk of dying as patients taking the medication.

Similarly, people with borderline diabetes who exercised had the same survival chances as those taking the most commonly prescribed drugs.

Drugs compared with exercise included statins, which are given to around five million patients suffering from heart disease, or an increased risk of the condition.

The study was carried out by researcher Huseyin Naci of LSE Health, London School of Economics and Political Science and Harvard Medical School, with US colleagues at Stanford University School of Medicine.

He said prescription drug rates are soaring but activity levels are falling, with only 14 per cent of British adults exercising regularly.

In 2010 an average of 17.7 prescriptions was issued for every person in England, compared with 11.2 in 2000.

Mr Naci said: “Exercise should be considered as a viable alternative to, or alongside, drug therapy.”

Dr John Ioannidis, the director of the Stanford Prevention Research Center at the Stanford University School of Medicine, said: “Our results suggest that exercise can be quite potent.”

Other medications compared with exercise included blood-clotting medicines given to patients recovering from stroke, and alpha-glucosidase inhibitors given to patients on the cusp of developing diabetes.

Only the patients who were recovering from heart failure fared best when prescribed drugs, where anti-diuretic medication was most effective.

However, they said their analysis found far more trials examining drugs, than those which measured the impact of exercise.

They said there was a need for more research into the benefits of exercise for those suffering from serious health problems.

Researchers stressed that they were not suggesting that anyone should stop taking medications they had been prescribed, but suggested patients should think “long and hard” about their lifestyles, and talk to their doctors about incorporating more exercise into their daily routines.

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Four hours of light gardening each week could cut kidney stones

Weak effects; correlational study;  Interesting that "Intensity of activity was not associated with stone formation".  Just doing SOMETHING had an apparent effect.  Strongly indicative of a class effect

Four hours of light gardening a week is enough to lower the chance of developing kidney stones by nearly one third, researchers have found.  A study has shown that even small amounts of exercise can radically reduce the risk.

Previous research has shown that being overweight almost doubles the chance of developing kidney stones.  The condition can be incredibly painful and even require surgery.

Now Washington School of Medicine has found that keeping physically active can stop kidneys stones from forming.

They recommend three hours of average walking at 2-3 mph, four hours of light gardening, or one hour of moderate jogging at 6 mph.

The team also discovered that consuming more than 2200 calories per day increased the risk of developing kidney stones by up to 42 per cent.

Mathew Sorensen at the Washington School of Medicine and his colleagues conducted a study to evaluate whether energy intake and energy expenditure related to kidney stone formation.

They studied 84,225 women participating in the Women's Health Initiative, which has been gathering information such as dietary intake and physical activity in women since the 1990s.

"Even small amounts of exercise may decrease the risk of kidney stones—it does not need to be marathons, as the intensity of the exercise does not seem to matter," said Dr. Sorensen

"Being aware of calorie intake, watching their weight, and making efforts to exercise are important factors for improving the health of our patients overall, and as it relates to kidney stones.”

Although the study was only carried out on women, exercise is likely to have a similar effect on men.

In an accompanying editorial, Dr John Lieske of Mayo Clinic said: “Counselling for patients with stones often centers almost exclusively on diet, stressing increased fluid intake, normal dietary calcium, lower sodium, moderate protein, and reduced dietary oxalate.

“The results of Sorensen et al. suggest that a recommendation for moderate physical activity might reasonably be added to the mix," he wrote.

The study appearing in an upcoming issue of the Journal of the American Society of Nephrology

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Activity, Energy Intake, Obesity, and the Risk of Incident Kidney Stones in Postmenopausal Women: A Report from the Women’s Health Initiative

By Mathew D. Sorensen et al.

Abstract

Obesity is a strong risk factor for nephrolithiasis, but the role of physical activity and caloric intake remains poorly understood. We evaluated this relationship in 84,225 women with no history of stones as part of the Women’s Health Initiative Observational Study, a longitudinal, prospective cohort of postmenopausal women enrolled from 1993 to 1998 with 8 years’ median follow-up. The independent association of physical activity (metabolic equivalents [METs]/wk), calibrated dietary energy intake, and body mass index (BMI) with incident kidney stone development was evaluated after adjustment for nephrolithiasis risk factors. Activity intensity was evaluated in stratified analyses. Compared with the risk in inactive women, the risk of incident stones decreased by 16% in women with the lowest physical activity level (adjusted hazard ratio [aHR], 0.84; 95% confidence interval [95% CI], 0.74 to 0.97). As activity increased, the risk of incident stones continued to decline until plateauing at a decrease of approximately 31% for activity levels ≥10 METs/wk (aHR, 0.69; 95% CI, 0.60 to 0.79). Intensity of activity was not associated with stone formation. As dietary energy intake increased, the risk of incident stones increased by up to 42% (aHR, 1.42; 95% CI, 1.02 to 1.98). However, intake <1800 kcal/d did not protect against stone formation. Higher BMI category was associated with increased risk of incident stones. In summary, physical activity may reduce the risk of incident kidney stones in postmenopausal women independent of caloric intake and BMI, primarily because of the amount of activity rather than exercise intensity. Higher caloric intake further increases the risk of incident stones.

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