Which is more effective: drugs or lifestyle change?

Suzanne B. Robotti
Suzanne B. Robotti Executive Director
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My brother-in-law was chagrined to be told by his doctor that he needed to take blood pressure medicine. “I’m one of the few people my age that I know that doesn’t need to take daily medicine. I really don’t like this, I’d like to get off it. I was wondering was is right: drugs or lifestyle change?paigerd

His experience is all too common. A number on a test slipped past the target rate and his doctor wrote a prescription. There was no discussion of exercise, which is often more effective than medicine. Perhaps because of the more than 4 billion prescriptions filled by Americans each year, there seems to be a perception that “most people” would rather pop a pill than go to the effort of taking a walk.

I suspect that “most people” believe erroneously that medicine is more effective than lifestyle changes. Given the benefits of exercise and lifestyle changes versus the risks and side effects of medicines, oftentimes the best choice is to call your doctor and discuss starting to exercise and avoiding the medicines.

Here are some common health issues that generally respond better to lifestyle changes (which cost you nothing!) than to medicines.

Blood Pressure “Research tells us exercise will reduce blood pressure even in patients with the toughest blood pressures to control—resistive hypertension,” says Amy Doneen, MSN, ARNP, co-author of Beat the Heart Attack Gene (Wiley, 2014) with Bradley Bale, MD. “One of the biggest causes of high blood pressure is pre-diabetes. Lots of pre-diabetic patients present with hypertension and are on several blood pressure medications. Once they start moving away from diabetes, their blood pressure will start to decrease and blood pressure medications can be reduced or stopped.

“Exercise is known to lower blood pressure and is considered a cornerstone of blood pressure management,” adds Doneen. “The average reduction is approximately 3 mmHg systolic (the top number) and 2.5 mmHg diastolic (lower number). This amount of reduction translates into a significant reduction in mortality risk from stroke and heart attack of around 9 percent and 6 percent respectively”…”The good news is that studies show that both aerobic and resistance training improve blood pressure.”

See the full article: Exercise As Medicine.

Heartburn & Gastroesophageal Reflux Disease (GERD)  Why take a drug when you can change your diet? In the case of GERD (gastroesophageal reflux disease), many sufferers choose to pop a pill and risk side effects, such as heart disease, vitamin deficiency and bone fractures. But medical experts have found that by eliminating certain foods from the diet, adding others and watching portion size, GERD can be prevented and treated almost entirely by these lifestyle  changes.

In short, more plants equal less heartburn, notes Joel Fuhrman, M.D., a board-certified family physician, author of The End of Dieting: How to Live for Life (HarperOne, 2014) and a nutritional researcher who specializes in preventing and reversing disease through nutritional and natural methods. “GERD goes away easily for a person eating a plant-based diet. Think ‘G-BOMBS’ -– greens, beans, onions, mushrooms, berries, and seeds. Add in things like winter squash, corn, beets, and grains, and eliminate processed foods, and you’re likely to see symptoms disappear,” he says. On top of that, try juices made at home in a blender with green cruciferous veggies like cabbage or kale. These nutrient-rich foods promote a healthy digestive tract lining and reduce acid in the stomach. Also, don’t forget whole, unprocessed carbs, such as whole grains and breads, whole wheat pasta, and brown rice. These complex carbs make it easier to absorb stomach acid. Lean proteins like chicken and fish are other good bets for GERD sufferers.

See the full article: Avoiding GERD Meds’ Side Effects.

Cholesterol By following a heart-healthy lifestyle many people will not need cholesterol drugs. Dr. David L. Katz, author of Disease-Proof, believes that “if lifestyle were used as medicine, 80 percent of all heart disease could be eliminated, no prescription required.” He adds, “Using medication is not nearly as good, and yet we tend to neglect the power of lifestyle as medicine and rely on meds.”

Dr. Katz recommends losing extra weight, getting more exercise and following a healthy, mostly plant-based diet. One good choice is the Mediterranean diet, which includes plenty of fruits and vegetables as well as good-for-you fats from nuts, seeds, olives, avocados and fish.

See the full article: Statins: How Safe Are These Life-Savers?

Pain In their policy statement (pdf), the American Academy of Neurology (AAN) finds that the effectiveness of opioids for chronic non-cancer pain is “modest” and the effect on function “small.” The Academy acknowledges that in some cases the need for immediate pain relief is clear. However, the few studies on long-term pain management that the Academy found conclude that alternatives to drug therapy such as cognitive behavioral therapy and activity coaching are as effective at managing pain as meds and probably better at improving functionality without the side effects and risks of medications.

See the full article: Pain Docs Warn Against Opioids.

Diabetes Even though it may seem easier to rely on prescription medicines, most doctors would urge their patients to use drugs as a last resort. That’s because there’s a clear-cut link between being overweight and having an increased risk of developing diabetes. “Obesity is a driving force behind type 2 diabetes. By losing excess weight, you automatically lower your risk for diabetes and its severe complications — loss of vision, foot amputations, kidney disease and, in some cases, an early death,” says Neal Barnard, MD, a diabetes researcher who is the founding president of the Physicians Committee for Responsible Medicine (PCRM) and the author of Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs.

See the full article: Diabetes: Finding the Right Drug/Diet Balance.

In my vision of a health check-up, my brother-in-law’s doctor might have said the following:

Your blood pressure is a little high and I think we need to get it down. If you exercise moderately for 40 minutes, 3 to 4 times a week, it could bring your blood pressure under control. Medicine is available, but it can have side effects like dizziness and fluid retention, and some meds increase the risk of diabetes. Which would you like to try, exercise 40 minutes 3x a week or the medicine?

Then my brother-in-law could have made an informed decision.

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