THINGS THAT MATTER: Exercise – The pill for almost every ill

I was delighted to read in the press that Jamaica’s Prime Minister Andrew Holness “has encouraged Jamaicans to commit to 30 minutes of physical activity every day, to improve their health and reduce the risk factors associated with non-communicable diseases (NCDs)”. He went on: “I want to encourage you all to get the message out that ‘Jamaica Moves’. We are going to do our 30 minutes of exercise every day, and I hope that this will keep the doctors away”.

The Prime Minister was speaking at the awards ceremony for the CARICOM road race held last Saturday in Montego Bay. In his remarks, Minister of Health Dr Christopher Tufton said the region’s leaders are considering a CARICOM / Caribbean Moves initiative, similar to Jamaica Moves. These developments are the result of the splendid efforts of the Healthy Caribbean Coalition (HCC) which was formed after the Heads of Government Conference on Chronic Disease in Port of Spain and led by Professor Sir Trevor Hassell. Dr. Victor Matsudo, founder of the Agita São Paulo Program as a model for using physical activity to promote health, had come to our conference in Barbados to help get the HCC off the ground.

Coincidentally, I’m also delighted to have been just given a report in The Sun, Dominica’s newspaper, of the Dr. Bernard A. Sorhaindo Memorial Lecture I gave in Dominica way back in 2011. It was a splendid affair organised by the UWI Open Campus in memory of one of Dominica’s greatest sons. My topic was requested because of the concern in Dominica about their rising rates of obesity and chronic non-communicable diseases. What I said then was highly relevant for both Dominica and Jamaica, but it’s even more urgent for Barbados to take action. Hence the theme “Exercise is the pill for ALMOST every ill”. And so I shall provide a précis of what I said then in a long interview with a reporter (November 14, 2011).

Question: You said that just like the poor, the diabetic and hypertensive will always be with us. What do you mean?

Dr. Fraser: We have the genes for both of them. There’s no question that the prevalence of both is higher in our black population than in most places, just as the problems of ischaemic heart disease and abnormal blood lipids are higher in Asian populations. These are genetic facts we have to live with. But the point is we have it in our power to minimise the problem. If we can translate the knowledge we have and persuade people to be more physically active and live a healthier life style then we can keep them slim, in healthy shape, and prevent them from getting diabetes and hypertension.

These days being overweight or obese has become the norm – in other words, 70 percent of our population are “big”. Even my taxi driver told me this morning: “the ladies are “thick”. So we have to change attitudes. When we did the studies in Barbados we discovered that the younger men were turning towards slimmer ladies now, and it was the older men who thought that thick women were healthy and more desirable. That was due to the older days when thin women were described as “scrummy” and thought to be unhealthy. Perhaps the younger men are now influenced by Rihanna’s appearance.

Question: Television’s influence again?

Dr. Fraser: Television again. But television has its value if we can use it to persuade people that being slim and lithe is healthy and valuable. I’m always pleased when I see body building shows and beauty competitions on TV, but everybody can’t be like that. With due respect, neither you nor I will look like Arnold Schwarzenegger, but a slim ideal or goal is better than a fat ideal for our health.

There are doctors and others who say: “Oh, you can be fat and fit” but I assure you that in fact and in the many population studies the fittest people are the slimmest people. It’s not impossible to be fat and fit, but life expectancy and health improves for everyone if you are slimmer. So we’re just saying “Be responsible, for your and your family’s benefit, and for society and our health care costs”.

Question: How serious is the problem of non-communicable diseases in the Caribbean?

Dr. Fraser: Very serious. They say its better in the Bahamas but it’s also bigger in the Bahamas. The Bahamian people according to the survey studies are the biggest in the Caribbean and the Bahamian men are huge as well as the ladies, while in Barbados the men are much, much slimmer than the ladies. Across the Caribbean the order of magnitude, with the last figures we have, is The Bahamas, then the British Virgin Islands, Barbados, St. Lucia and Jamaica in that order. It virtually depends to what extent the society depends on tourism. With the tourist trade people have gone from physical activity to sedentary or service activity like walking around the restaurant. And when you finish serving the guests, well after all, there’s plenty of left-over food. So most chefs and waitresses are no longer the slim young people they once were. They are thick!

Dominican women are in fact the slimmest because you have maintained a more physically active life style. In summary, I believe the problem of non-communicable diseases across the Caribbean is a huge problem (pun intended), because we don’t have the support services or the funds for the treatment of the complications. But if we would invest more in health promotion, we would save a fortune down the line. A healthy diet, physical activity and weight reduction can prevent the onset of diabetes in people who have pre-diabetes or glucose intolerance. With a healthy lifestyle you can prevent diabetes progressing, and prevent complications of heart attack or stroke, which not only compromise the individual but cost partners and families, and cost our countries a fortune we simply can’t afford.

In summary, treatment and complications cost a fortune, while prevention costs a fraction. Exercise is free, it makes you feel great, and it’s the pill for ALMOST every ill. That’s my message today, tomorrow and for all of us.

(Professor Fraser is Past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine and Clinical Website:

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