March 12, 2018

The Activity Pill

In Vancouver, we put in bike lanes and encourage an active lifestyle in part because of health benefits (see below). But what if there was another way to get these benefits?
Exercise.PillRecent huge, major medical studies (discussed HERE in Price Tags) confirm the long-held belief that incorporating activity into the regular, routine parts of one’s life is strongly associated with enormous health benefits.  And people often posit, somewhat wryly, that a pill with similar benefits would be regarded as a miracle — to population health, to reduced medical costs and to the coffers of the developer, patent holder, supplier and the whole medical profit chain.  Talk about incentives. Wow.
It remains to be seen if the magic pill will be successful at producing the benefits of an active lifestyle (see below). Sceptics abound — but that won’t stop the hypemeisters and the greedy. Even if the pill is successful in limited circumstances.
If the pill is effective, it would be such a miracle, in fact, that people would be immediately suspicious. “Too good to be true”. “Crazy talk”.  And probably crazy prices too.  If even the hype is effective, it will attract many dollars to the owners.
So guess what.  The pill boffins in the labs are busy.  And so are those wrestling with law-bending bureaucratic machinations.
This article in the Washington Post describes both the pill research and the machinations.

But what if a drug could stimulate the body into producing some of the same effects of exercise — more endurance and weight control, for example — without the need to run a single step? Such a pill may be on the way. Several scientists are testing compounds that apparently can do this — and people wouldn’t even have to move at all to benefit.
. . .  Any such drug would require licensing by the Food and Drug Administration, yet the FDA doesn’t recognize “the inability to exercise” as an illness in need of a drug. So Evans has targeted 516 for young people with Duchenne muscular dystrophy, an approach that he believes offers the best chance for FDA approval.

Of course, until the pill’s on the market here in Vancouver, we’ll have to make do with changing our city so as to encourage and enable an active lifestyle.
Interested in those health benefits?  Are they big?  How big?  How does anyone know?  Check out these sources.  Caution, both are detailed, and may contain substantiated opinion that differs from your comfortable ideology.
The British Medical Journal (the real source, the real detail)
A solid summary is shown below, from the US National Library of Health

What were the basic results?

A total of 263,540 adults (52.4% of the total recruited to the Biobank), with an average age of 52.6 years, joined this sub-study. Only those in paid employment were included.
During the follow-up period of around five years 2,430 people died, 496 of which were due to cardiovascular disease. There were an additional 3,748 cancer events and 1,110 cardiovascular events.
Cycling was the mode of commuting most strongly linked to reduced risk of death, cardiovascular disease and cancer. When compared to the non-active group the following was seen:

41% lower risk of death from any cause
52% lower risk of death from cardiovascular disease (HR: 0.48, 95% CI: 0.25 to 0.92)
46% lower risk of cardiovascular events (HR: 0.54, 95% CI: 0.33 to 0.88)
40% lower risk of dying from cancer (HR: 0.60, 95% CI: 0.40 to 0.90)
45% lower risk of a cancer event (HR: 0.55, 95% CI: 0.44 to 0.69)

Thanks to Kay Teschke for the links to this material.

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