“Exercise is Medicine” is a mantra that is widely and irrefutably accepted by the medical community as well as the general public. It is, although, largely perceived in a more figurative manner with the simple understanding that a lifestyle incorporating exercise is good for health and is thereby, “medicine”. However, with growing knowledge of the biological mechanisms underlying the health promoting benefits of exercise, the popularized saying has developed a more literal and technical meaning. There is no question that in the world of metabolic syndrome and related diseases drug prescriptions supersede exercise prescriptions. Medical students are often taught the intricate mechanisms and biological targets for a variety of pharmacological treatments for conditions related to metabolic syndrome, but what is less emphasized is that many of these drugs are in fact exercise mimetics. In other words, they mimic a particular biological effect of exercise. As exemplified by this infographic, common drugs for type II diabetes and dyslipidemia are PPAR (peroxisome proliferator-activated receptor) or AMPK (adenosine monophosphate kinase) agonist/activators. These molecules are the biological targets for these drugs because they regulate and stimulate processes like lipid breakdown, glucose uptake, and mitochondrial biogenesis all of which are conducive to improved metabolic health status. What may be less known and less communicated is that exercise is also an agonist for these very same molecular targets, targets that are implicated in many of the physiological mechanisms through which exercise improves metabolic health. So yes, even from a technical perspective, exercise is indeed medicine. Now only if exercise prescriptions were given more attention.
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