Heart Foundation-funded study shows prescribing exercise works

The first NZ-specific study to show two-year sustainability into the benefits of “exercise on prescription” shows significant increases in physical activity and quality of life for its participants.

The NZ Women’s Lifestyle Study, the results of which were recently published in the British Medical Journal, recommends that such “prescriptive” programmes become part of wider population strategies to promote exercise and help reduce risk factors for heart disease and Type Two diabetes.

Led by Dr Beverly Lawton and a team from the University of Otago’s Wellington School of Medicine and Health Sciences, the study was a randomised controlled trial studying the health effects of ‘prescribing’ exercise on 1089 less active women, aged 40-74, over two years.

The trial used an augmented “Green Prescription” and involved an initial nurse consultation and telephone support over nine months to help women become more physically active as well as a follow-up check with the primary care nurse.

The study received substantial funding support from Heart Foundation of NZ in its 2004 research funding round.

Heart Foundation medical director Prof. Norman Sharpe says it is vitally important that NZ-specific research is funded, as the country has its own particular health issues and needs.

“In NZ, we cannot rely on overseas studies alone, we need to conduct research that is relevant to our particular population needs and the health inequalities that exist here,” he says.

“The significant funding the Heart Foundation gave to this NZ-specific study into lifestyle change, reflects the importance of this type of research. Such research activity has a direct effect on the quality of heart health care available across the spectrum of prevention and treatment, and can also assist good decision making to ensure that our health system works most effectively.”

Prof. Sharpe says on average, seven NZ women die from cardiovascular disease every day and a recent poll showed a clear majority of women (74 per cent) mistakenly believe breast cancer is their leading cause of death. In reality, women are much more likely to die of cardiovascular disease.

“We want to alert women to these statistics, encourage them to talk to their doctor about their heart health. Very often, simple practical steps can reduce their future heart disease risk,” he says.

“To do so, the Heart Foundation, has launched Go Red for Women – a campaign to boost awareness of heart disease among women and give them the motivation to take action to improve their future heart health prospects. The positive results of the Lifestyle Study, show how a prescribed exercise programme can have a positive effect on heart health.”

The NZ Women’s Lifestyle Study is the first to show a significant effect of an exercise on prescription programme on physical activity over two years.

However, there was a small increase in falls and injuries associated with the programme.

“The increases in physical activity were most marked at 12 months,” says Dr Lawton.

“Although we expected a decline after one year, the drop off was not as great as expected, with activity levels still higher than at the beginning of the study and significantly higher in the intervention than in the control group.”

Participants completed self-report questionnaires about physical activity and quality of life and had their weight, blood pressure and fasting bloods measured at regular intervals.

The results show that after 12 months the number of women engaged in moderate physical activity (30 minutes on five or more days of the week) increased from 10 per cent to 42 per cent of the intervention group, and after two years 39 per cent were still achieving this goal.

Physical functioning and mental health measures improved in the intervention compared to the control group, but one physical function measure was lower. There were no statistical differences in clinical outcomes (such as blood pressure or cholesterol levels) however.

“The overall results of the Women’s Lifestyle Study support the use of exercise on prescription programmes with women over 40 years of age,” says Dr Lawton.

“There is now widespread acceptance that regular exercise has considerable health benefits, including reducing the risk of heart and lung disease, type two diabetes, some cancers and death from all causes by an estimated 20-30 per cent.

“This means an exercise on prescription programme with less active adults could have considerable health impacts for individuals and cost savings for governments.”

This research was funded by grants from the Heart Foundation, the Maori Health Directorate (Ministry of Health), Sport and Recreation NZ (SPARC), the Hutt Valley District Health Board and the NZ Lottery Health Research Grants Board.