There comes a point in everyone’s relationship with their local GP when you have the drinking chat.
This can involve a form-filling exercise, where the doctor asks how much alcohol you drink per week as you quickly try to remember the safe limits – then perform a swift mental calculation of how many pints or glasses of wine you had and divide the total by three.
They’ll also enquire whether you smoke and if so how many per day – but what the doctor tends not to ask is: “How much exercise do you take?”
The reason for this is they were never trained to ask the question – at undergraduate level where the subject of exercise is hardly touched upon, to junior doctors being trained in hospital, the subject of physical activity is rarely broached. It’s not something a GP writes a prescription for, so doesn’t form part of the normal “chat, script, take two tablets to start and off to the chemist you pop” scenario.
However, there is a paradigm shift towards the part physical activity plays in key aspects of health and in particular illness prevention. This is known as exercise medicine and has the potential to bring huge benefits to the NHS in Scotland.
Doctors from the Faculty of Sport and Exercise Medicine (FSEM) UK, including Dr Niall Elliott who was the Team GB chief medical officer at the Rio Olympics, believe all medical professionals should now be asking about the physical activity of patients at every opportunity.
They believe we should be less obsessed with size and body mass index (BMI) and should be looking at overall cardiovascular fitness as a better indicator of how healthy a person is.
Commentators have pointed out that BMI is purely a measure of weight and doesn’t distinguish between muscle and fat. There are many big athletes including Six Nations prop forwards who turn BMI on it’s head by proving you can be fat and fit. However you “can’t out-run a bad diet” and nutrition has a vital role.
Medical experts like Dr Elliott believe exercise should be prescribed as part of primary prevention which stops an illness from happening and secondary prevention which assists in treating a particular illness like diabetes, with some 600,000 Scots at risk of the condition and cardiovascular disease.
This ties in with thinking around musculoskeletal medicine that advocates regular exercise as a way of actually reducing pain and stiffness in joints and forms part of the conversation around the treatment of arthritis.
A survey out this week showed that a quarter of people have put off doing exercise because of joint pain. Arthritis Research UK found that 49,000 of respondents said they have or have had joint pain.
Of these, 51 per cent said the pain had put them off doing exercise. But the charity, backed up by health professionals, said research has shown that regular exercise can actually reduce pain and stiffness in joints.
The Scottish Government recognise the contribution physical activity can make to our personal, community and national wellbeing and are committed to delivering that vision. However, more needs to be done in Scotland where we lag behind England in having dedicated sports and exercise medicine consultants working in the NHS.
This may sound like common sense but anything that brings people together to improve their health is worth doing.