Exercise could be as effective as many drugs for common diseases, a large review study shows.
The researchers looked at four reviews of the effectiveness of exercising in reducing the risk of dying in people with heart disease, heart failure, stroke and prediabetes. They also examined 12 reviews of drug treatments for these conditions. In total, the analysis included 305 randomized controlled trials, with about 340,000 patients.
The results showed that both exercise and medication reduced people's odds of dying. However, there wasn't any difference between these interventions in terms of reducing the risk of death for people with heart disease and prediabetes.
Among stroke patients, exercise appeared more effective than drug treatment, while for people with heart failure, diuretic drugs were more effective than exercise and all other medication, according to the study, published today (Oct. 1) in journal BMJ.
The benefits of physical activity have been well documented in previous studies, but there has been little evidence for how exercise compares with drugs in reducing the risk of death from common diseases, the researchers said. [Beyond Vegetables & Exercise: 5 Ways to Be Heart Healthy]
The researchers also found that considerably more studies have looked at the effectiveness of drugs in treating common diseases than have analyzed the benefits of exercise as treatment, which may reflect a bias against testing exercise interventions and favoring medications over lifestyle changes, the researchers said.
"This blind spot in available scientific evidence prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement, but exercise could yield more profound or sustainable gains in health," the researchers wrote in their paper.
In the study, people with heart disease had reduced odds of mortality after either exercising or taking medications such as statins, beta blockers and antiplatelets, compared with people who didn't use medication or exercise.
In stroke patients, unlike any of the drug interventions compared to placebo, exercising was significantly more effective than getting no exercise in reducing the odds of mortality, and appeared to be more effective than medications in doing so.
For people with prediabetes, however, neither exercise nor drug interventions were clearly effective in reducing the odds of mortality, according to the study.
When they looked at the big picture — comparing exercise to drug interventions — the researchers didn't find a difference between the two in terms of their effectiveness in reducing the risk of mortality.
The researchers suggested that clinical trials aimed at studying drugs' efficacy should include exercise, to show whether a new medication offers more benefit than exercise.
"In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition," they said.