Addiction IS a
Chronic Disease

Addiction IS a Chronic Disease

What every doctor tells their patients.

“Fix Your Diet and Exercise” is the adage every primary care physician says when they see a high blood pressure or lab value in your chart.  Reducing calories and increasing nutritional intake has obvious benefits in controlling one’s weight.  But what about exercise?  Hippocrates stated “All parts of the body, if used in moderation and exercised in labors to which each is accustomed, become thereby healthy and well developed and age slowly; but if they are unused and left idle, they become liable to disease, defective in growth and age quickly.”  Hippocrates was one of the most forward-thinking health professionals of his time as an understanding of the benefits of exercise faded time until the 20th century.  Jeremy Morris and colleagues conducted an epidemiological study in 1953 which showed that physical inactivity led to development of chronic diseases.  Since then, a plethora of studies have been conducted better understand the benefits of exercise and physical activity.  Studies now show that participation in regular moderate to vigorous physical activity has many health benefits.

Reducing All-Cause Mortality

Physical activity will help to reduce mortality as a whole.

Several studies are now showing that physical activity delays death from a variety of causes including heart disease and some cancers.  People who are physically active for 150 minutes a week have a 33 percent lower risk of all cause mortality than those who are not physically active.  Increasing one’s levels of physical activity is one of the only lifestyle choices that have such a large effect on mortality.  The benefits of physical activity at moderate to vigorous levels have a cumulative effect.  One does not need to perform large amounts of vigorous activity in order to reduce mortality risk.

Since Morris’ study, several others demonstrated the importance of avoiding inactivity.  Moore and Matthews (2012) compiled data showing that a significant decrease in all-cause mortality could be achieved when a person becomes more active from being inactive.  Continuing to increase one’s levels of activity will continue to decrease mortality significantly, until 150 – 300 minutes of moderate physical activity is reached.  There is no added risk for performing physical activity beyond this range, but diminishing returns are seen for reducing mortality.  Regardless of age, sex, race, ethnicity, or body weight, benefits can be seen with increased levels of physical activity.

The health-related benefits of regular moderate to vigorous levels of physical activity are irrefutable.  Studies are showing lower risk of cardiovascular disease (including heart disease and stroke), lower risk of hypertension, lower risk of type II diabetes, lower risk of adverse blood lipid profile, lower risk of cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach, and the list goes on…  We’ll circle back and discuss these general health-related benefits in future posts.  In this article, we highlight two important aspects of recovery, brain and physical health.

Brain Health

Brain benefits of exercise.

Moderate to vigorous physical activity has been shown to have both immediate (acute) and habitual (long-term) effects on brain health.  Some of the benefits of physical activity are reduced anxiety, improved sleep, improved cognitive function, improved executive function and other functions of the prefrontal cortex.  The cognitive benefits of physical activity, accounting for acute and habitual changes, are summarized in the following table.

Improvements in cognition are seen in people who perform moderate to vigorous physical activity compared to people who remain inactive.  Significant improvements are seen in academic achievement tests that involve mental processing speed, memory, and executive function.  Increased levels of physical activity have also been shown to reduce the risk of developing cognitive impairments.  Physically active healthy adults and those with schizophrenia related disorders also report having a better quality of life (QOL).  Longer duration participation in moderate to vigorous physical activity also reduces symptoms of anxiety.  It also reduces the risk of developing depression or decrease symptoms of depression in children and adults.  In order to achieve better sleep outcomes, higher volumes

Musculoskeletal Health

Regular moderate to vigorous levels of activity also have significant benefits for musculoskeletal health.  The musculoskeletal system is composed of bones, muscles, joints, and other passive structures that help to hold the body in a three-dimensional space.  Aerobic activity may slow the loss of muscle mass with aging.  Preserving musculoskeletal health is essential with increasing age.  A decline in bone density is known to be a normal part of aging, but may progress to diseases like osteoporosis.  Osteoporosis is a major cause of fractures among the elderly that suffer falls.  Strength training and aerobic activity may help decrease the rate of bone density decline and even maintain bone density in certain situations.  Studies have also shown that regular, weekly participation in 150 minutes of moderate-intensity aerobic activity plus muscle-strengthening improves pain management, function, and quality of life.

A healthy musculoskeletal system, free of pain, is critical for people to be able to participate in their daily activities.  If you’re feeling any sort of knee pain, how motivated would you be to get up and go to a 7am meeting?  Several psychosocial, environmental, and physiological factors play into the presentation of addiction in the brain.  As stated in Addiction is a Chronic Disease, the primary area in the brain affected by addiction.  Impaired executive function may make it even more difficult to make better choices on a day to day basis.  Dr. Dmitry Foox, a member of the PHYSrecovery team, takes heed in a saying that “smart feet” will take you where you need to go while you are in recovery.  Improving musculoskeletal health will help those in addiction recovery be where they need to be to allow for a more conducive transition into a recovered life.