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by our Editor
Nelly Morrison

The biggest killers in Britain today are cancer and heart disease. And do you know who's responsible? Yes, that's right. It's us!

We don't eat any more than we did 20 years ago. The big difference is that we simply don't exercise any more.

What children walk to school any more? How many of us ride a bike rather than go by car or bus? And how many hours do we spend watching television and playing computer games instead of walking round galleries and playing tennis?

Research shows that 25% of the population are now overweight and the link between cancer and obesity has been proven. (It's the second biggest cause after smoking). The NHS is also under enormous strain coping, not just with accidents, emergencies, naturally occurring and inherited diseases, but also with a huge proportion of patients who could avoid being ill if only they took more responsibility for themselves. The National Audit Office recently presented disturbing evidence that a culture of inactivity is now a serious national Health threat.

Three sessions of thirty minutes exercise per week are recommended but figures show that 30% of the population do no exercise at all.

Health secretary, Alan Milburn acknowledges how terrifying these figures are.

"GPs are under enormous pressure and seeing huge numbers of patients," he said. "By referring people for exercise, they may improve the health of the population they serve and ease the burden on their busy surgeries. The fitness industry has a key part to play."

That's why, rather than prescribe slimming pills and diuretics, GPs are now prescribing exercise.

The Government is experimenting with an NHS exercise scheme and ten-week courses of regular workouts are now accepted as an opportunity for many people to improve their health rather than simply be treated once they become ill.

"The NHS is there for people when they fall ill, but it can do more to help people get well and stay well," said Mr Milburn. "In the end, prevention is better than cure."

There are already over three hundred such schemes up and running in the UK and the new DoH framework is expected to encourage many more to develop.

It's well known that physical activity can greatly improve a number of health conditions and obviously it is more economical - and ethical - to prevent or reduce illness through exercise than through medical intervention.

The four main patient groups that will benefit from this initiative are those affected by chronic heart disease and strokes, cancer, diabetes and mental health problems (chronic loneliness, depression, anxiety). Regular workouts lower pulse rate and blood pressure taking strain off the heart and relieving hypertension.

There is also a strong case for the elderly to take up exercise. Many are surprised by the positive effects of regular sessions in the gym and amazed at what their bodies can do. The benefits are enormous as falls and physical disability - particularly osteoporosis - are much reduced by increasing flexibility and mobility. Exercise massively improves bone density.

Mental health problems are frighteningly common in today's society with one in six people suffering at any one time. Exercise causes the release of serotonin, the naturally occurring feel-good drug and the psychological benefits are huge.

Not everyone is sold on the idea of exercise. "But," says Alan Milburn, " the schemes are developing rapidly and with a solid framework now in place, schemes that previously only operated on an ad hoc basis now have a stability to develop much more freely."

It is also important that exercise referrals are legally safe. GPs have expressed reluctance to refer, because of liability and lack of control during exercise sessions. They are under no obligation to make a referral nor will they be assuming responsibility for the administration or delivery of the exercise programme.

It's up to the exercise professional to make an assessment and devise a suitable programme for the doctor or practice nurse to sanction. The patient is not obliged to take part, much as he is not obliged to take any drugs prescribed, but in this case, the exercise regime might be cheaper as it is wholly or partly funded by the Health Authorities.

The schemes accomplish many of their aims through successful partnership working between the patient and the fitness professional.

The training might involve weight training, swimming, walking, exercise bikes, treadmills and resistance machines or any other cardio-vascular or muscle strengthening exercise.

And for your peace of mind, exercise professionals are currently required to be members of the Professional Register for Exercise and Fitness, (England) and hold a Level 3 coaching certificate.

Finally, if exercise keeps people well, this scheme is ultimately preserving NHS funds so that they can be used on people who really need them. Keeping fit is about looking good, feeling better and saving us ALL money!

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