A pill to replace exercise? It's in the works, but how close to 'perfect' can science get it?
Key Takeaways
New research around the LaKe molecule has shown it can mimic the effects of exercise and fasting without engaging in physical activity.
Increased levels of lactate and ketones could bring cardiovascular and cognitive benefits.
Research emerging from Aarhus University, Denmark, published in the Journal of Agricultural and Food Chemistry,[] suggests that a molecule called LaKe could replicate the benefits of exercise and fasting without the need for a specific diet or exercise regimen.[][] But how realistic is this claim, and what other factors should we take into consideration for our patients?
The Aarhus researchers observed the same metabolic effects of exercise—specifically, increased levels of lactate and ketones—from rats’ oral ingestion of the LaKe molecule. The authors said their results “suggest that LaKe is an excellent candidate molecule for achieving controlled, systematic elevation of plasma levels of lactate and ketone bodies and may trigger the biological responses associated with these metabolites.”[]
MDLinx spoke with Srividya Kidambi, MD, a board-certified endocrinologist with Froedtert Health & the Medical College of Wisconsin network, for insights on setting realistic expectations between providers and patients.
So, what can we expect such an “exercise pill” to achieve?
Breaking down the benefits
Dr. Kidambi says the new drug holds potential for dementia and Parkinson’s treatment, especially because “any exercise improves brain health.” However, she notes that it is too early to fully understand the LaKe molecule’s potential neurological benefits, particularly before human trials are completed.
In regards to physical activity, Dr. Kidambi also notes the drug could bring promising benefits to a subset of patients who live more sedentary lifestyles, due to health conditions or any other reason: “I see that if someone is unable to be active, something like this could benefit them,” she says.
However, specifically restricting its use to certain patient profiles could be tricky in terms of insurance coverage, cost for the patient, and, as a result, overall drug accessibility. Dr. Kidambi compares this to the current accessibility challenges seen among drugs used for weight loss, such as Ozempic. “As we now are seeing with GLP-1 agonists, it goes to people who can afford it—it’s not really just the people who need it. So you can almost never restrict it to [certain patients].”
She also notes that, in general, one could expect better heart health through the drug's metabolic effects: “It might benefit [any condition] that improves body weight, along with circulation and cardiovascular benefits.”
What remains to be addressed
The research is still “really preliminary,” Dr. Kidambi notes. While certain metabolic effects could be promising, we know there are other benefits of exercise that aren’t easily replicated by an exercise pill. “These types of drugs just mimic one aspect of exercise—the metabolic,” she explains. Two other aspects—mental health and social benefits—are also important payoffs of engaging in physical activity.
And yet, if a patient replaces exercise with a pill, it would be right to wonder if their mental health and social relationships would suffer. Would we really want to encourage patients to not engage in physical activity with its myriad benefits for both body and mind?[]
Dr. Kidambi also notes a number of factors that would need further investigation in the long-term use of an exercise pill. Specifically, it would be important to know more about dependency and tolerance. She notes, “If lactate and ketone levels are elevated all the time, does it cause more harm? What are the consequences in the long term?”
As providers, it's important to have answers to these questions to understand the actual effects and long-term impacts for our patients.
Knowing the limitations
The bottom line? Dr. Kidambi maintains a healthy dose of skepticism, particularly in the scope of such a drug. “These types of drugs are just looking at one pathway,” she says. “I don’t think it can mimic everything that exercise does.” For this reason, she would also hesitate to call a LaKe compound an “exercise pill,” rather than focusing on the drug’s particular targeted pathway. She believes advertising for such a drug should focus on the specific targeted aspects of exercise.
As with other newly emerging weight loss solutions, Dr. Kidambi advises patients and providers alike to “have that same skepticism you would have in the health food store, where you see lots of different compounds that have purported benefits.”
The weight-loss industry is valued in the billions, she observes, and if such a drug as the LaKe exercise mimic is indeed a breakthrough, “a pharmaceutical company will pick it up and do the trials.”
What this means for you
Until human studies are complete, details remain to be seen for the application of an “exercise pill.” In particular, we should pay attention to the specific pathways such a drug targets, while taking note of factors in long-term use, including dependency and tolerance. We also must consider other benefits of exercise not replicated by a LaKe compound, notably in mental and behavioral health.