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Diet and exercise: the importance of getting the big picture

Diet and exercise: the importance of getting the big picture

Public Health Association media release, 8 September 2015

Government, policy makers, town planners and individuals need to be careful to keep the broader perspective in mind when thinking about integrating physical activity into the places we work, live, learn, travel and play, the Public Health Association conference was told today in Dunedin.

The more we look at these things the more complex they become said keynote speaker Associate Professor Jim Cotter of the University of Otago.

“For example, lack of exercise and sedentary behaviour appear to be two different things; and, while both exercise and good nutrition are beneficial, what you eat has much more to do with your weight than exercise does.

“On the other hand, regular exercise and, more importantly, improved levels of fitness are just as effective as medicines in helping with nearly all the non-communicable diseases we treat today. These include cardiovascular disease, diabetes and even dementia. In fact fitness seems to be a stronger predictor of how long you will live than your weight.”

The pair said there is still a lot to learn about exactly why and how health, susceptibility to disease, and early mortality are affected by sedentariness, physical activity, and substantial exercise.

“We are really only scratching the surface in our understanding of how exercise works. Its effects are extremely complex, acting beneficially on just about all bodily systems and structures and we know exercise is most potent when it is relatively strenuous.

“The notion of exercise being an effective therapy in the prevention and treatment of several diseases is not new, but the evidence has mounted rapidly across the last half century, culminating in the explicit term ‘Exercise is medicine’ – as trademarked by the American College of Sports Medicine.

The pair said it need not have costs or significant barriers, like medicines often do, and suggested the Government consider whether exercise should in fact be formalised into Pharmac’s purview.

“As our knowledge grows we should be able to prescribe suitable exercise as an alternative or adjunct approach for people who can’t or don’t gain these beneficial aspects by doing strenuous activity or regular manual work,” Assoc Prof Cotter said.

“It may even be possible to introduce stress in other ways – such as saunas - to provoke the same sort of physical reactions involved with exercise for people who are unable to be active.

“Strategies for incorporating these principles into people’s lives need to be considered by governments and town planners in conjunction with community groups and social and biological science researchers, because regulating the food environment and changing the way people eat is only part of the picture towards long-term health and wellbeing.”

He said Dunedin was a perfect example where much could be done with its active transport, hills, small geography, wonderful green space and proactive council.


Assoc Prof Jim Cotter is an Associate Professor at the School of Physical Education, Sport and Exercise Sciences, University of Otago, and an Accredited Exercise Physiologist with New Zealand’s national professional body – Sport & Exercise Science New Zealand.

Dr Chris Baldi is a Senior Research Fellow at the University of Otago specialising in diabetes and cardiovascular dysfunction.

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