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A study (October 3) collating several clinical trials and demonstrating that exercise can be as effective a ‘medicine’ as pharmaceutical drugs in treating heart disease and stroke, and also in preventing diabetes, only confirms what some doctors have been advocating for some time.

Dean Ornish, a San Francisco University cardiologist, claims that coronary artery narrowings causing heart disease can be reversed by modifications in diet and lifestyle without pharmaceutical drugs.

Ornish has also reported on patients who had been on waiting lists for heart transplant and whom he returned to a normal life within a year, without surgical intervention or drugs. He has claimed that as many as 90 per cent of cardiac interventions are potentially unnecessary.

His three-pronged programme essentially consists of eating more vegetables and fruit, less sugar, less starchy meals and less animal-derived foods, exercise (safest is walking) and stress management.

Another feature (October 5) on walking and breast cancer risk reduction confirms earlier claims that regular exercise diminishes risk of some cancers. However, diet is probably more important than exercise in breast cancer, which is mainly promoted by two hormones: oestrogen and insulin.

Breast cancer is far less common in Asian countries, like Korea and Japan, where the traditional diet has been mainly vegetarian, consisting of beans and other vegetables containing substances which dampen the effect of oestrogen and lower cancer risk. Western diets tend to be rich in starches and animal-derived foods. They promote earlier commencement of menstrual cycles and, therefore, more breast exposure to oestrogen. A long-term increase in blood insulin promotes cancers. Individuals with metabolic syndrome (abdominal obesity, high blood pressure and abnormal blood cholesterol pattern) and type 2 diabetics have high blood insulin levels and increased cancer risk – a diet rich in sugars and starches, promoting high insulin levels, makes things worse. Having emphasised diet, exercise definitely remains good medicine and should be encouraged.