most of these risk factors and physical deteriorations from ever developing in the first place.11 High blood pressure and high choles- terol are not diseases but rather symp- toms of underlying pathology usually secondary to obesity and/or poor lipid profiles that progress to become risk fac- tors for cardiovascular disease. While medications may lower the absolute val- ues of these factors the associated adverse reactions can be extreme.12,13 There is mounting evidence to suggest that in the absence of other risk factors, the phar- maceutical treatment of any one of these conditions exposes an otherwise healthy patient to a myriad of adverse reactions including irreversible muscle damage and even death.14,15 Indeed, even as the parameters for these risk factors have been progressively broadened; hat is, lowered to include an ever-expanding patient base, the inci- dence of obesity, cardiovascular disease and degenerative conditions continues to rise16. Evidence abounds to support in- creased physical activity and better nutri- tion – or even a return to levels we rou- tinely experienced more than 30 years ago.17, 18, 19 A PLACE WHERE DCS SHOULD BE All health-care practitioners but particu- larly chiropractors can, and should, be taking a leadership role in the education of our patients, and the public at large, regarding the benefi ts of physical activity and adequate nutrition. 20 At a time when governments are looking at cost effective- ness and the essential nature of various health professions, chiropractors could be positioning themselves as the prevail- ing experts in this scientifically support- ed, effective, conservative and preventive approach to many of these chronic con- ditions.21 Indeed it completely comple- ments the chiropractic philosophy and science initiated and developed over the past 100 years or so. Our colleges should develop more educational units with a greater emphasis on physical activity and increased hours on nutritional science so new graduates are better equipped and qualifi ed to be leaders in this field. Our professional bodies need to be actively lobbying the educational systems, gov- ernments at all levels and the media. We should take a leadership role in this and 40 • CANADIAN CHIROPRACTOR | SEPTEMBER 2008 drive it to where it needs to be. If we do not lead, we will be forced to sit back and watch while others lay claim to it. REGULAR PHYSICAL ACTIVITY Regular physical activity offers an effec- tive solution for lowering the risk factors associated with cardiovascular disease, and can reduce the signs and symptoms of many musculoskeletal conditions in- cluding various types of arthritis and os- teoporosis. When introduced at a young age – i.e., daily in the schools – it would provide a preventive approach to these same risks and conditions.22 This would result in a positive change of lifestyle for many and would be inexpensive but ex- tremely benefi cial for virtually the entire population. Health-care costs would be reduced – the British Heart foundation reports that a fi ve per cent reduction of the sedentary population could realize more than 200 million dollars saved in health-care costs and more than 120 lives saved.23 Phar- maceutical dependence – and influence – could be reduced for all but the ex- tremely ill, and the health and well-being of the majority would be increased. Interestingly the terms “conservative” and “preventive” are also oft used in the description of chiropractic philosophy and its holistic approach to health care. So, if not us, then who?• References: 1. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, and Ludwig DS, “A Potential Decline in Life Expectancy in the United States in the 21st Cen- tury,” New England Journal of Medicine, 352:11, pp. 1138-1145 2. Dr. William Dietz, Director of Nutrition and Physical Activity Centers for Disease Control and Prevention, Atlanta, GA 3. Canadian Community Health survey: Obesity among children and adults – Statistics Canada 4. Northwestern University (2006, January 12). Obesity In Middle Age Raises Heart Disease, Diabetes Risk In Older Age. ScienceDaily. 5. Després JP, Lemieux I. Abdominal obe- sity and metabolic syndrome. Nature. 2006;444:881-887 6. Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006;119:812-819 7. Boule, N.G., Bouchard, C., and Tremblay, A. 2005. Physical fi tness and the meta- bolic syndrome in adults from the Quebec Family Study. Can. J. Appl. Physiol. 30: 140–156. 8. Physical activity and the metabolic syn- drome in Canada. Susan E. Brien and Peter T. Katzmarzyk Appl. Physiol. Nutr. Metab. 31: 40–47 (2006) 9. Is the association between dietary fat intake and insulin resistance modified by physical activity? Metabolism 2001 Oct; 50(10):1186-92 Harding AH, Williams DE, Hennings SH, Mitchell J, Wareham NJ 10. The Effect of Metformin and Intensive Lifestyle Intervention on the Meta- bolic Syndrome: The Diabetes Prevention Program Randomized Trial.” April 2005 Annals of Internal Medicine (volume 142, pages 611-619). T.J. Orchard, M. Tem- prosa, R. Goldberg, S. Haffner, R. Ratner, S. Marcovina, S. Fowler 11. Pediatric Exercise Medicine, Oded Bar-Or, Thomas Rowland 2004: 117- 131 pub- lisher Human Kinetics 12. Cohen, JS, Adverse drug effects, compli- ance, and the initial doses of antihyper- tensive drugs recommended by the Joint National Committee vs. the Physicians’ desk reference, Archives of Internal Medi- cine, 2001: 161:880-85 13. American Heart Association (2005, May 24). Side Effects Of Cholesterol-lowering Drugs. ScienceDaily. 14. Worstpills.org 15. Willcox SM, Himmelstein DU, Woolhan- dler S. Inappropriate drug prescribing for the community-dwelling elderly. Journal of the American Medical Association Jul 27, 1994; 272: 292 – 296 16. Patel P, Zed PJ. Drug-related visits to the emergency department: How big is the problem?. Pharmacotherapy Jul 2002; 22: 915 - 923 17. Cardiovascular disease, World Health Organization http://www.who.int/topics/ cardiovascular_diseases/en/ 18. Physical activity, nutrition and health, PACE Canada, http://www.pace-canada. org/physact.htm 19. Healthy living, Health Canada, http:// www.hc-sc.gc.ca/hl-vs/physactiv/ index_e.html 20. Commission on the Future of Health Care in Canada 2002, Roy Romanow, recom- mendations 22,23 21. U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Washing- ton DC: Department of Health and Hu- man Services, Centers for Disease Control and Prevention, 1996 22. World Health Organization (2005). Preventing chronic diseases: a vital invest- ment. Geneva: WHO 23. Economic costs of physical inactivity, British Heart Foundation www.canadianchiropractor.ca
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