Exercise is medicine, but which type should you prescribe?

After reading an article on the BBC News website this week about how a study has shown that exercise can be as effective a treatment for managing the risks of a stroke as medications, we got to thinking about why this idea is already more embedded into our society. If you read any of the government reports on exercise, you'll know that it has been well established for some time that picking your body up off the sofa and moving it around, however hard those first few steps might feel, is very good for you, and that whilst medications certainly have their part to play, activity comes without all of the unwanted side-effects.

This is why a few years ago, the American College of Sports Medicine started a campaign they called 'Exercise is Medicine', and what a wonderfully clever title that is! The notion that exercise could, and indeed should be prescribed by doctors is a brilliant one, and hopefully one that will seep through more and more in the coming months and years. Some exercise schemes run for those with medical conditions in the UK are known as 'exercise on prescription', with funding provided to make the exercise sessions cheap or even free for people to attend.

The problem is, doctors have specific medications for conditions, but there's a huge variety in the types of exercise available, it's like having a medicine cabinet full of pills and not knowing which one should be taken. And in the fitness industry you'll often hear debate about which type of exercise is 'the best' for people. The truth is, it depends who you are, what you want and on a whole host of other factors, but the one thing that is certain, is that regardless of what it is, it does you good.

One debate that has raged on in those of us who spend our days getting up at 6 to train someone, pop to the gym ourselves before the day begins, work in the gym all day, train a few more people and then go home and read a book about exercise, is that of cardio versus resistance. Or for those who aren't familiar with these terms, rhythmical exercise that makes you hot and sweaty (those with the filthy minds can stop right there, research shows that doing that probably doesn't count as you're probably lying down and not getting the heart rate up enough) versus lifting weights, or your own body weight for that matter.

So which is better? Let's have a look, but obviously we'll be giving you a balanced view, hence the name. It can be very uncomfortable sitting on this fence all the time, those splinters in your backside can really hurt! ;-)

Well, cardiovascular exercise has been shown time and again to benefit the body if done effectively. I can help to reduce blood pressure, manage stress, depression and anxiety, boost energy levels and of course burn a few calories along the way. Too much of it can be a bad thing as it is catabolic, this means that it can actually cause muscle wastage if people overtrain. It can also increase the risk of injuries if supporting exercises are not done to help the body cope with the stresses of regularly, repeatedly performing the same movements, often with impact in the case of running. But this doesn't make it bad, it just means people need to find a healthy balance.

Resistance training has been exalted in recent years as the answer. It is certainly true that resistance training, whilst not burning as many calories during an exercise session, can lead to a greater overall calorie burn through EPOC, or Excess Post-exercise Oxygen Consumption. This is the amount of energy expended after a workout in helping the body to recover and repair, and challenging resistance training sessions can increase this more than cardiovascular workouts.

Also, resistance training develops muscles and muscles consume energy, helping you to burn calories even when you are sat on your sofa. Lean people who have low body fat levels and decent muscle mass, the ones who people see on the front cover of magazines and think 'I want to look like that', not oversized bodybuilders, will be at a decreased risk of ill health over the years, and certainly at less risk of weight gain. Thin people who have a small frame but low muscle mass and high body fat percentage are at a surprisingly high risk of illness, it's about how much fat you have and not just how much space you take up.

Resistance training is anabolic, in that it builds lean muscle tissue. But there can be downsides, people can overtrain if they do too much just like with cardio, and the risk of injury is just as great if lifting too much or using bad technique. Some will fear entering the weights area of a gym, but you on't have to, there are many ways to add it in to your exercise schedule:

• Body weight exercises such as squats and press-ups can be done anywhere and are great because they use so many muscles.
• Classes such as Bodypump have become very popular these days and are a great introduction to resistance training for some, although be careful as the repetitions are fairly high and done at a reasonable speed with the music. Start with sensible weights and just do one to two classes per week to begin with, you can always mix in other exercise sessions to get a good balance.
• Pilates and Yoga all involve bodyweight-based exercises and count as resistance training.
• Swiss balls, dynabands, suspension training and a host of other tools mean that it's easier than ever to find something that you enjoy and that fits into your lifestyle.

But what about keeping your heart healthy. Well, if resistance training uses big muscle exercises and is suitably intense then it can do this too. Research shows that circuit-style training can keep the heart rate elevated above 140 beats per minute for an hour and that is the same as a reasonable cardiovascular workout. Obviously some may find these intensities too challenging to begin with and should build up gradually.

With all of this in mind, if you held us at gunpoint and made us choose, resistance training would probably have the edge. It's also vital for women especially as it's a great way of maintaining or even improving bone mass, decreasing the risk of osteoporosis in later life. But in the ideal world, you'll find a nice balance and a place for both of these wonderful types of exercise in your life. What many often forget is that ultimately, exercise must be enjoyable, and so finding the thing you love doing, or at least like doing is they key.

So get your notepad out and write yourself a prescription, take it at least five times a week for 30 minutes if its cardiovascular, and combine with 2-3 capsules of resistance training for maximum effect. Take with water and enjoy the benefits.

balance your life, balance your scales :-)