Go outside and play!

In this issue, Beaulac and colleagues (page 399) tell us that physical activity is beneficial not only for physical conditioning but also for morale.1 They base this affirmation on the results of a Cochrane systematic review of the literature2 published in 2009 and of a controlled clinical study3 comparing the effects of physical activity with the effects of antidepressants. Even if the conclusions of the meta-analysis should be regarded with caution because the benefits were less obvious when only rigorous studies were considered, the authors concluded nevertheless that exercise seemed to ameliorate depressive symptoms in those suffering from depression. The clinical comparative study cited by the authors, which was conducted on 202 adults, demonstrated that taking part in physical activity was at least as efficacious as taking antidepressants. This is very interesting when we consider the number of people who currently take such medications. These observations in themselves are not, however, surprising. If physical activity did not make people feel good, how would we explain the behaviour of those who go regularly to train in the gym during their lunch hours or go running after work, or simply go riding around on their bicycles? Some of them do it no doubt to stay in shape, which is always important. It only takes trying out a new activity to discover that we have muscles we knew nothing about until then and ultimately to realize that staying in shape can mean different things in different circumstances. Some people take part in physical activity in the hope of staying healthy and avoiding illness, and for the most part, such illness remains a dim and distant eventuality until it occurs. As no one is immune to catastrophe or the inevitable, we can all agree that taking part in physical activity, while surely beneficial, does not in any way guarantee eternal life. So probably, most of those who participate regularly in physical activity do so fundamentally because of the feeling of well-being they get, thanks to the endorphins. As for me, I openly admit, I exercise because it’s good for my morale. Even if I have not the least idea of what my cholesterol levels are (simply because I have not been able to find myself a family doctor—but that’s another story!); and even if my knowledge of my glycemic levels is based solely on the fact that the blood glucose monitor we use at the Family Medicine Unit is so complicated that I have to practise on myself when I want to use it; and even if I watch my weight only because people are keeping an eye on me at home; and finally, even if I have no idea of my maximal oxygen uptake, I am nevertheless convinced, like all the other “addicts,” that physical activity is good for me. When things are going badly, when I am tired, I get out my bicycle or I go to the pool. Nothing indicates that this will help, that I will not die of a heart attack or suffer a cerebrovascular accident or be carried off by a terrible cancer. But for the moment, I savour the delight and satisfying fatigue that physical activity brings to me. Whether I win or lose my tennis matches doesn’t matter a bit (or only a little!). Discovering and playing a new sport confers moments of pleasure and delight. I have recently been initiated into snow kiting—madness and pure pleasure. “Crazy old man,” my friends say to me. In truth, I am very happy to be just that! When you read these lines, spring will have already arrived. “Heureux d’un printemps qui me chauffe la couenne.”4 Unchain your bikes; go walking down the lane. Can’t you feel the sun that warms your skin? The wind that caresses your cheeks? The rain that makes you shiver and appreciate being indoors? I haven’t the least idea whether being an example for our patients has any influence at all on their participation in physical activity, but let’s just do it for ourselves. As the saying goes, even if physical activity doesn’t add years to your life, it adds life to your years. Hop to it!