Tuesday, July 27, 2010

"Exercise is Medicine" (and a great smokescreen for Big Food)

Further to my post from yesterday regarding the innocence by association test for conflicts of interest comes "Exercise is Medicine".

Exercise is Medicine is a laudable organization whose aims are,

"To make physical activity and exercise a standard part of a disease prevention and treatment medical paradigm in the United States.


"For physical activity to be considered by all health care providers as a vital sign in every patient visit, and that patients are effectively counseled and referred as to their physical activity and health needs, thus leading to overall improvement in the public's health and long-term reduction in health care cost."
It has great buy-in too with a massive list of supporters that include the who's who in health promotion.

So why am I knocking it?

It's not so much that I'm knocking it, more I'm questioning its role, as Big Food conspiracist that I am, I see a dual role for Exercise is Medicine.

On the one hand its role is to encourage exercise for health - a true, valuable and important endeavour.

But on the other hand, its other role is to serve its founding sponsor Coca-Cola, in the promotion of the assertion that the best means to deal with our current obesity epidemic is to ensure that people exercise. Or to put it another way, that sugary soda's not a bad thing so long as you live an active lifestyle.

The "obesity can be treated effectively through exercise alone" message, crucial to the purveyors of high calorie foods everywhere, is indeed spread by Exercise is Medicine,
"This is just the beginning. Hopefully, the insurance and medical communities will soon realize that the most effective way to treat and prevent a wide variety of obesity-related conditions is through exercise."

- Press release from Exercise is Medicine founding partner Anytime Fitness, June 28th, 2010

"As a whole, people are significantly less active today, even compared to just 20 years ago. When we look at the data that shows how diseases like obesity and diabetes are rapidly increasing, there's an obvious correlation to the decline in physical activity.

Even though everyone has heard it before, something as simple as taking the steps instead of an elevator can make a big difference. It's too easy to consume a massive amount of calories and sit at a desk all day - both of which have negative consequences to our health. We need to remember to take breaks during the day to take a ten minute walk. Any bit of activity is better than being sedentary."

- Press release for Exercise is Medicine quoting Sandra Billinger, PT, PhD, FAHA, research assistant professor in the KU Physical Therapy and Rehabilitation Science department, June 9th, 2010

"Dr. Sallis poses this question to health-care providers: "What if there was one prescription that could prevent and treat dozens of diseases, such as diabetes, hypertension and obesity? Would you prescribe it to your patients? Certainly."

Well, there is one prescription available to you that will do just that. It's called exercise."

- Dr. Robert Sallis, past President of the American College of Sports Medicine (a founding partner of Exercise is Medicine) to Charleston's Sunday Gazette-Mail, March 7th, 2010

"The International Health, Racquet & Sportsclub Association (IHRSA) announced today their partnership with the Institute of Lifestyle Medicine (ILM); a division of Harvard Medical School's Department of Physical Medicine and Rehabilitation and of Spaulding Rehabilitation Hospital. IHRSA and ILM join together to fight the global obesity epidemic by working to improve physician knowledge of the science and benefits of physical activity, and to increase the practice of physician-prescribed exercise."

- Press release from Active Doctors, an organization whose President is part of Exercise is Medicine's Task Force, May 19th, 2009

"In an effort to decrease the prevalence of childhood obesity and promote physical activity to children, the American College of Sports Medicine (ACSM) has announced a partnership with the Youth Fitness Coalition (YFC). This partnership will feature ACSM's Exercise is Medicine(TM) initiative, designed to encourage America's patients to incorporate physical activity and exercise into their daily routine, and YFC's signature program, Project ACES (All Children Exercise Simultaneously)."

- Press release from the American College of Sports Medicine, March 10th, 2009
The message that obesity can be prevented or treated with exercise is an important one to the food industry as it shifts the blame for obesity from the consumption of their calorific products to a decline in fitness, a link which at best is described as debatable and at worst, inconsequential. It also fuels Big Food's ability to preach about what Coca-Cola refers to as, "an active, balanced lifestyle", McDonald's a, "balanced, active lifestyle" and "it's what i eat and what i do ... i'm lovin' it" campaign, Pepsi a, "balanced lifestyle", Unilever a, "balanced diet and lifestyle", Mars a "well-balanced lifestyle", and Nestlé' a, "balanced lifestyle".

That the message is being spread by Exercise is Medicine and sometimes directly and other times by extension by the exceedingly reputable organizations included in Exercise is Medicine 397 signatory partners helps embolden the purveyors of calorific foods to make statements like Pepsi CEO's Indra Nooyi's,
"If all consumers exercised, did what they had to do, the problem of obesity wouldn't exist."
And Coca-Cola's President Sandy Douglas',
"And we're for active lifestyles, with more than 6 billion Diet Coke packages helping the National Heart, Lung and Blood Institute remind women about the importance of staying active and maintaining a healthy weight, and our support of physical activity initiatives like Exercise Is Medicine."
Ultimately, while exercise is indeed medicine, Exercise is Medicine again illustrates the risks and inherent conflicts of interest consequent to Big Food partnerships, and I would argue these risks and conflicts shouldn't come as a big surprise.


Because Big Food doesn't care about your health; they don't care about your well-being; and they don't care if you exercise. All Big Food cares about is whether or not you'll buy their products, and certainly every single dollar they spend on programs such as Exercise is Medicine are earmarked to further that goal. A goal Coca-Cola's certainly meeting as last week they reported North American sales volume growth for the first time in two years which led Coca-Cola CEO Muhtar Kent to proclaim,
"We firmly believe that North America will be a growth market of great opportunity for the next 10 years and beyond"
So while the notion of Big Food capitalizing on their investments in programs such as Exercise is Medicine to fuel sales isn't in and of itself surprising, what is surprising to me is the fact that well intentioned individuals, along with top-notch medical and public health organizations, don't seem to realize it, or simply don't care.

[For some further reading on what I think about "balanced, active lifestyles", please have a read of the article I co-authored this year, Running Away with the Facts on Food and Fitness, published in the journal Public Health Nutrition]