Don’t bother getting a doctor’s OK to exercise, research suggests

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Practically every article about exercise contains some version of this caveat: Talk to your doctor before embarking on any fitness regimen.

While it’s not bad advice, let’s face it -- most people don’t bother, bypassing the doc and going straight to the treadmill. By doing that, are they putting themselves at risk for serious cardiac problems, and even death?

Maybe not, according to a new study in the August issue of the Journal of General Internal Medicine. The study employed a Monte Carlo simulation -- an algorithm that uses repeated random samplings -- to determine the possible outcomes of having an exercise-tolerance test or not before beginning exercise among adults at low to high risk for coronary disease.

Researchers from Israel and the United States determined that although screenings could prevent deaths in people who fall into the intermediate to high-risk groups, the same wasn’t true for those at low risk. They argue that while exercise-induced death is rare, more common is death caused by a sedentary lifestyle. Also, coronary disease screenings could produce false negative or false positive results, possibly preventing people from exercising.

However, this doesn’t give sedentary people license to hop on a bicycle and pedal at top speed. Dr. Mayer Brezis, professor of medicine at the Hadassah-Hebrew University Medical Center in Jerusalem and one of the study’s authors, said in an interview with Reuters UK that exercise should start slowly and increase gradually and that people should seek medical help if they experience chest pain or dizziness while exercising. Also, those who know they have heart disease should be referred to a cardiac rehabilitation center.

In the study, the authors wrote, ‘If screening (an exercise tolerance test) is unsatisfactory for preventing exercise-induced cardiac events, other modalities should be explored, such as promoting public education about the need for gradual initiation of physical activity and about alarming symptoms (including through signs at gyms), while improving the availability of semi-automatic defibrillators and personnel trained in life support at sports facilities.’

-- Jeannine Stein