A subversive approach?


There’s a new study out in the British Medical Journal suggesting that exercise is as good or better a treatment than drugs for heart disease and stroke.  With news this good why are we just finding it out now?  An important question but first, the meat of the study:

The BBC article Exercise ‘can be as good as pills’ covers a study published in the British Medical Journal suggesting that exercise might be just as effective as medication for treatment of some heart disease…or in the case of stroke, more effective…when it comes to preventing death.  From the article:

The findings suggest exercise should be added to prescriptions, say the researchers.

Please don’t anyone go off their medications just yet, but definitely start thinking about adding some exercise to the mix.

Now that I’ve covered that important piece of information, back to my initial question: why has it taken so long to find this out?  Since exercise is obviously a healthier, cheaper, more widely available option to drug interventions, with no side effects and ample additional benefits, why in the world hasn’t it been studied before this? To find the answer I turn to the part of the study that I personally found to be the most fascinating.

For a lot of intriguing structural reasons that I don’t have time for, medical research as a whole has been growing increasingly biased towards studying drug interventions vs. other treatment strategies.  For example, in this particular case the number of clinical trials studying exercise is dwarfed by the number of drug trials.

This overall bias means that the existing medical literature (where the research is eventually published) is also increasingly skewed towards medications vs. other options, and this then tends to constrict doctors’ treatment recommendations since they base them on said literature.  Ditto for the treatment options that insurance companies will cover.

In other words, even though drug therapies may not be the best option in every case, there’s no way to know for sure since other options aren’t really being studied much.  From the researchers: 

“Our findings reflect the bias against testing exercise interventions and highlight the changing landscape of medical research, which seems to increasingly favor drug interventions over strategies to modify lifestyle,” they wrote in the review…”The lopsided nature of modern medical research may fail to detect the most effective treatment for a given condition if that treatment is not a prescription drug.”

I’ve been sensing this shift for a while and I’m glad to see it’s being recognized and talked about, but realistically speaking it’s a complex, far reaching, structural problem and I imagine it’ll prove difficult to fix.

So instead, I think I’ll just take the research and apply it for myself.  I’ll take Dane the mangy rescue mutt out for a vigorous walk and start my heart a-pumping without even getting a doctor’s prescription first, which feels strangely subversive.

copyright Dia Osborn 2013

P.S. By the way, the little walking, armless guy above comes courtesy of Wikipedia.


Exercise could help stroke, heart disease patients just as well as drugs.

Exercise ‘can be as good as pills’