Physical activity and health: Interview with Dr Damien Ekoué-Kouvahey, Sports Doctor (Togo)

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Extract from the article: Prescribing sport on prescription is possible. Sports doctor Dr Damien Ekoué-Kouvahey explains why this system has its place in a society rife with chronic illnesses. He talks about all the benefits of physical activity for the body.

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‘Physical activity is a real medicine... moving around is now a validated treatment for virtually all chronic illnesses’.

Prescribing sport on prescription is possible. Sports doctor Dr Damien Ekoué-Kouvahey explains why this system has its place in a society rife with chronic illnesses. He talks about all the benefits of physical activity for the body.

Santé-Education: What is prescription sport for health?

Dr Damien Ekoué-Kouvahey: It's the prescription of physical activity for the prevention or treatment of chronic illnesses such as cardiovascular disease, hypertension or diabetes. Obviously, this does not involve intensive sport: it covers all light to moderate physical activities and sports, as well as active modes of transport, such as walking or cycling.

Practising these activities for around 30 minutes five times a week, as recommended by the WHO, keeps us active and healthy. It is therefore absolutely vital to reduce sedentary lifestyles and increase physical activity.

A sports prescription: how does it work in practice?

The system relies on a specialist (oncologist, cardiologist, diabetologist, neurologist, etc.), a general practitioner and a physiotherapist. It is the latter who prescribes and puts the patient in contact with one of the network's sport and health educators. Following a motivational interview, the educator then sets up an activity programme tailored to the patient's state of health and physical abilities. This interview is essential: it's when we explain to the patient that getting moving will lower blood sugar and blood pressure, and improve breath, strength and energy. So physical activity acts like a medicine.

What illnesses can physical activity be used to treat?

Physical activity is a real medicine, a therapy, a basic treatment, a cure for illness.  Sport reduces stress. It relieves tension, channels energy and puts you in a good mood. You secrete euphoric hormones, i.e. hormones that make you feel happy. You feel better, your anxiety level is reduced and you sleep more peacefully.

Physical activity is an effective treatment for type 2 diabetes. In diabetes, sugar and fat build up in the blood and muscles. This disturbs the pancreas, which does not secrete enough insulin. Sport will improve circulation and prevent complications. Physical activity allows glucose to be consumed by the muscles.

As a result, all the glucose that hurts the body is eliminated during physical activity. As a result, the blood will reduce the amount of glucose and fat in it. And what's most interesting is that the pancreas will be motivated by sport. And therefore an increase in insulin secretion.

Physical activity helps you to take less medication, control your blood sugar levels, correct sexual impotence, reduce the risk of amputation and improve your vision as a diabetic.  People with type 2 diabetes tend to live longer, healthier lives if they engage in regular physical activity.

Compared with high blood pressure, sport helps to tone blood vessels and significantly reduce complications such as stroke and infactus. Exercise is as effective as medication in reducing high blood pressure. Physical activity is always good for the heart. It prevents the onset of cardiovascular disease and, if properly adapted, is also part of its treatment, limiting its repercussions and complications.

Physical activity plays a decisive role in the management of overweight and obesity. In obese patients, it is vital to monitor changes in body composition in order to reduce the volume of fat and increase the volume of muscle. Why should this be done? Because fat secretes adipokines, some of which can promote the onset of chronic disease. Muscle, for its part, secretes substances that regulate adipokines. The challenge is therefore to harmonise the relationship between fat and muscle.

And the only medicine known to date for achieving this balance is physical activity. Physical exercise prevents and treats osteoporosis, a bone disease that combines a reduction in bone density with changes in its micro-architecture.

Generally speaking, exercise is now a valid treatment for virtually all chronic diseases.

Interview by Abel OZIH