Prescribing a more active life

Don't be surprised if crowds suddenly descend on your health club or if the local mall experiences a dramatic uptick in sales of exercise gear.

Pledging to be more active and physically fit is, for many people, an annual rite of passage into the new year. And, of course, there is nothing wrong with making the decision to get off the couch. After all, physical inactivity and obesity are serious health issues, implicated in a range of chronic conditions. But resolving to become more active is only the beginning. It is what happens after the first few weeks of January are over that can transform the resolve into a healthier lifestyle.

A report published last month in the Morbidity and Mortality Weekly Report offered some positive signs that such sustained efforts are happening more often. Specifically, researchers from the Centers for Disease Control and Prevention analyzed Behavioral Risk Factor Surveillance System data from 2001 to 2005 to examine the prevalence of regular, leisure-time physical activity among U.S. adults. Respondents were considered physically active if they did moderate-intensity exercise 30 minutes a day, five days a week; vigorous-intensity activity for 20 minutes, three days a week; or both.

The researchers found that such rates of exercise increased 8.6% among women and 3.5% among men, to reach overall totals of 46.7% and 49.7% respectively. Racial and ethnic minorities also showed gains in levels of activity, although disparities still exist, and some pockets of the population are exercising much less frequently. Nevertheless, the bottom line is stark: In 2005, fewer than half the adult population engaged in recommended levels of physical activity. The nation's exercise levels are still falling short of the Healthy People 2010 exercise objective.

Doctors can play a pivotal role in helping patients -- one by one -- change this proportion and improve their health. Sometimes it comes down to a simple conversation.

Many studies have shown that patients listen when doctors discuss healthy lifestyle issues. A recent survey by the American College of Sports Medicine, for instance, found that 65% of patients responding said they would be more interested in exercising to stay healthy if advised by their doctor to do so and given additional resources. Meanwhile, 41% of the physicians surveyed said they talk to patients about the importance of exercise but don't always offer suggestions on the best ways to be active.

That's why the American College of Sports Medicine and the American Medical Association have teamed up to launch the Exercise is Medicine program. It offers help to physicians and patients to take everyday steps to improve the nation's problem with sedentary lifestyles and obesity.

The ACSM/AMA initiative is designed to encourage patients to incorporate physical activity and exercise into their daily routines. To this end, it urges doctors to prescribe exercise to their patients and to record physical activity as a vital sign during office visits.

More information is available online (link). A central message is the following scrip for physicians: Advise able patients to do 30 minutes of physical activity and 10 minutes of stretching and light muscle training five days a week.

These two organizations, along with the more than 25 other health and wellness groups signing on to the initiative, also have issued an action plan to advance its implementation. This plan includes reaching out to state and federal leaders and working to expand medical education about the health benefits of exercise. It seeks to build the science and evidence base connecting physical activity and health as well as the relationship between physical inactivity and chronic disease. It also urges increased collaboration between physicians and exercise professionals to help patients for whom increased physical activity will help prevent, treat or manage chronic disease.

Finally, one theme will be to educate the public on health benefits of exercise and physical activity and encourage patients to talk about these things with their doctors.

It is a new year and another chance for patients to make good on their resolutions to become more active. Physicians can help by supporting the Exercise is Medicine efforts and advising their patients to get moving.