Let’s move for health!Regular exercise and a healthy diet are great ways to keep at bay lifestyle-related non-communicable diseases.
I am an ophthalmologist practising in a tertiary eye care centre. My job keeps me busy, and I mean hold-your-urine-kind-of-busy, but I am not writing this article to complain about my job.
Despite the organised chaos that reigns my professional life, I stay motivated. I meditate twice a day and make an effort to do some form of physical activity at least twice a week. And no one has to tell me to do these things. I am already convinced that making an effort to take care of my mind and body (my software and hardware) is worth it.
Given the positive changes I have experienced since I started exercising and meditating regularly, I would like my community—the one I am growing with and the one that continues to push me to overcome my weaknesses and applaud the smallest of my achievements—to do the same.
The people I work with are all people of science. We practice medicine, an art that is almost always evidence-based. Evidence-based medicine shows that regular physical activity benefits the human body. A higher fitness level is associated with a lower chance of premature cardiovascular death. Just two sessions of resistance training per week can improve glycemic control in people with diabetes. Moderate to high-intensity exercise has been shown to improve levels of depression.
A person with a non-medical background would assume that people practising medicine know these facts and hence have a more or less consistent practice of doing some form of physical activity. But it’s not usually the case. I asked physicians from different fields if they engage in any form of physical activity at least twice a week? Only 39 percent answered yes.
This finding bothers me, both for the sake of the medical community and the general public at large.
Firstly, the lack of physical activity is a risk factor for disease. Being diseased literally means your body is not at ease. The disease may or may not have a name. You may not have hypertension, diabetes, or thyroid disorder, but you may feel suboptimal. You might have a sore back, constipation, insomnia, or mild depression. I am not trying to argue that exercise solves them all, but it is an integral part of the prevention and management of most medical conditions.
Secondly, when we, as caretakers of people’s health, do not prioritise physical fitness, we are disseminating skewed information regarding health and wellbeing. Suppose a physician prescribes physical activity to a patient, but s/he is not very convincing about it, based on their own life experiences and priorities. In that case, patients are less likely to be convinced of exercise’s benefits.
So, despite the ample evidence of the proven benefits of physical activity, why do we physicians not prioritise it in our personal lives and that of our patients? I guess it is because of the way we have been trained in medical school. Most of our training focuses on treating diseases with drugs and surgeries. Only a very few hours are invested in learning how to prevent and control diet and lifestyle-related non-communicable diseases (NCDs) like diabetes, hypertension, and cardiovascular diseases, among others. A study by Shiva Raj Mishra and colleagues on the prevalence of modifiable risk factors of major NCDs among medical students in three medical colleges in the Kathmandu Valley found a high prevalence of risk factors of major NCDs among medical students.
The medical community and public health policymakers can no longer ignore the shifting tides of diseases in Nepal. With rising purchasing power, changing lifestyles, and increased urbanisation, NCDs are on the rise. In 2019, NCDs accounted for 71 percent of total deaths in Nepal. Given the state of things, most of us are primed to suffer from a chronic disease as we age. Childhood obesity is on the rise. NCDs not only lead to death but also degrade the quality of the years we have to live.
Modern medicine has severely undervalued the importance of nutrition and physical activity. As a result, we have become too comfortable consuming medical drugs to fix ourselves. Although medication helps, for someone living with a chronic condition, the aim should be to control the disease with the least number of drugs.
In hindsight, I recall the answers I would write down on tests in medical school. For instance, if asked about the ways to manage diabetes, I would fill pages with a long list of medicines but never elaborate on the diet and lifestyle aspects. Since modern medicine is much more attuned to treatment than prevention, the cultural norms and institutions around treatment compel us to promote drugs subconsciously.
This is not to say that exercise is the be-all and end-all. It has to be supported by a healthy and diverse diet with an equal emphasis on activities that help us be mindful and calm. Any measure of prevention is way simpler than treatment.
But here is the catch. Humans confuse simplicity for weakness. Exercising and meditating regularly and eating a healthy diet are simpler and cheaper lifestyle interventions we can make to minimise our chances of falling ill and then waiting in line for the doctor’s appointment, investing in pricey medicines and medical tests. But the latter seems like an effort that pays off as it will give immediate relief from pain. On the contrary, the former requires you to commit some time, and it takes a while before you see any visible result. It all comes down to choosing what we value as individuals and as a society.
So, does this article motivate you to grab your running shoes or a yoga mat? Changing lifelong habits and learning a new habit can be challenging. Sometimes motivation is not enough. It runs out on you. At some point in life, we have all promised to exercise regularly and make good on that promise. But soon, we give up, and then we are left with this terrible feeling of being a quitter. The trick is to start small. James Clear, the author of ‘Atomic Habits’, suggests several techniques like reducing friction between you and a behaviour change and habit stacking.
Having said all this, it all comes down to the individual’s decision to make or not make physical activity a part of personal care. Fifty years ago, an individual’s health probably depended on access to health care, basic sanitation, and health education. But that is not the case today. Information is at your fingertips. We just need to commit to ourselves and carve out some me time.