Joel Bagah graduated from University of Louisville School of Medicine in 2020. He is heading to Boston Medical Center as an Internal Medicine resident. You can follow him on instagram.
As Healthcare Professionals
America has a weight problem. According to the CDC, in 2017, 35.2% of Americans were overweight, and 30.1% were obese. No matter what specialty you go into, having obesity as a comorbid condition worsens outcomes. As healthcare professionals who want to go the extra mile for our patients, we should be equipped with tools to tackle overweight and obesity. I truly believe we should have a more active role in fighting this epidemic. That comes with an understanding of fitness and health. As healthcare leaders, we should be leading by example in the domain of fitness and health, but that’s not the case. Because of our rigorous training, a lot of us succumb to this epidemic as well.
Hospitals and clinics are places where one is almost certain to find a sizeable proportion of overweight and obese individuals, not just in the beds, but in the halls as well. The epidemic can be seen amongst the clinical staff including nurses, doctors, medical students, and pharmacists. As reported in a 2007 Physicians Health Study, 40% of the 19,000 doctors were overweight and 23% were obese. One could project that a more recent estimate would be higher. In the pursuit of rigorous medical training and care for their patients, medical students, residents, and physicians neglect their personal health and succumb to this epidemic. Now it would not matter if it did not impact patient care, but unfortunately research points to the contrary. In a study about physicians’ personal health and beliefs in relation to their practices, it was shown that patients are less trustful in the counseling they receive from overweight or obese physicians. Furthermore, physicians with unhealthy personal habits are less likely to proactively address obesity and counsel patients on healthy habits. Given these findings, you now understand why we should be leaders in this field.
Why the Need to Exercise?
You’ve probably heard or know that exercise is important. Indeed, physical activity is important, extremely important I might add. The primary role of exercise is to maintain and improve health. Many of our elderly patients with beautiful lab values are active people. They are the people who come to the hospital for minor things and leave the next day. Over the past years, the reason behind the need to exercise has turned from personal health to physical appearance. This transformation is accentuated by the rise of social media and the increasing number of fitness models who primarily associate exercise with physical appearance. It is certainly true that exercise will improve one’s physical appearance and physical appearance in itself can be a powerful motivator for some people, but it is a secondary benefit of exercise. The true and primary benefit of exercise is personal health maintenance. It happens in the body when it “magically” hits almost every body system and lowers our risk for heart disease (the #1 killer in the US and worldwide), diabetes, stroke, depression, obesity, high blood pressure, osteoporosis, back pain…the list goes on. No drug does that, which explains why exercise is often called the “All-Cure” drug. Exercise is priceless to health and good outcomes in diseases. “Activity drives development” is a sentence that you will hear a lot when it comes to growth and division of old cells into new ones. We know that cell growth and division is very important as we grow and age. Just like old computers that are slow and take forever to open documents and programs, old cells in our body work the same way; they become sluggish and slow down our body systems. When our body systems slow down, we slow down. Just like new computers that are faster and more efficient than older ones, new cells in our body work the same way. They make our body systems run smoothly and efficiently. As you can imagine when these systems function at their best, we perform at our best. “Activity drives development.” Exercise drives development: It drives the formation of new cells in our body, which keeps our systems running smoothly. You now understand why physical therapy works. You now understand how exercise keeps the hippocampus (brain part involved in memory storage) fresh with new cells and protects against dementia. Health is the foundation of any individual. Without good health, the individual crumbles, the foundation crumbles, and whatever is built on that foundation might shake or crumble in some instances.
How Much Exercise Do We Need?
The current recommendation from the American Heart Association is 150 minutes/week of moderate to high-intensity exercises. That can be broken down to 30 minutes for 5 days/week. That is for the average person who wants to stay healthy. Of course, you’ll reap more benefits if you do 6-7 days/week. If you want to build lean muscle or be ripped, you will definitely need at least twice the time mentioned above. I do think it is important to start out as recommended above (5 days/week) and move up to 6-7 days/week as you get used to exercise. How do we define exercise intensity? Intensity is quantified in terms of metabolic equivalents (METs). METs define intensity as a multiple of your basal metabolic rate (BMR), the amount of energy you would spontaneously burn at rest in 24 hours. If you got out of bed and sat on the couch watching TV (MET value of 1) or playing video games (MET value of 1) all day, and then went back to bed at night, it would be a good estimate of your basal/resting metabolic rate. Running has a MET of 10 or higher depending on the pace, which essentially means running burns at least 10 times more energy than sitting on the couch per unit of time. For example if you burn 2 calories/min on the couch, you would be burning at least 20 calories/min running. The faster you run, the more calories you burn. Moderate intensity is defined by a MET of at least 3 while high-intensity requires a MET value of at least 6. Checkout the table below for various activities and their MET value.