Almost any doctor will agree that exercise is a great preventive and helps keep people well. Most will even acknowledge that regular exercise helps manage many chronic diseases, from diabetes to asthma.
But how often do doctors come right out and prescribe exercise -- or even ask how much physical activity you get on a routine basis?
Not nearly as often as warranted, especially given the scores of studies on the physical, mental and emotional benefits that regular exercise brings.
Maybe part of the reason is that the majority of U.S. medical schools don't offer any courses on physical activity. And when the courses are offered, they're rarely required, according to a recent study out of Oregon State University. In fact, fewer than half of physicians trained in the United States in 2013 received formal education or training on physical activity, the study found.
That's too bad, because research shows that a low level of physical activity exposes a patient to a greater risk of dying than does smoking, obesity, hypertension, or high cholesterol, according to Exercise is Medicine. What's more, physical inactivity costs the U.S. Health Care System $330 per person each year -- or more than $102 billion annually.
Just recently, in fact, a new study came out that found that exercise goes further than diet in weight management for aging adults. These findings are significant when you consider that roughly two out of three U.S. adults are overweight or obese. And as far back as 2008, the medical care costs of obesity in the United States totaled about $147 billion, according to the Centers for Disease Control and Prevention.
Unquestionably, exercise is both a health and money saver. Yet, as many as 36 percent of U.S. adults don't engage in any leisure-time physical activity at all -- not to mention the 56 percent who don't meet the recommendations for sufficient physical activity set forth by the 2008 Physical Activity Guidelines for Americans.
Compounding the problem is the fact that doctors are not far behind the general public in their rates of inactivity. All told, 40 percent of U.S. primary care doctors and 36 percent of U.S. medical students do not meet the Physical Activity Guidelines. And we know that doctors who are not physically active are less likely to provide exercise counseling to patients. They're also less credible role models for promoting healthy behaviors. So it should come as no surprise that barely a third -- only 34 percent -- of U.S. adults say they received exercise counseling at their last medical visit.
So what can be done?
A lot -- according to the National Physical Activity Plan Congress, which met in Washington, D.C., in February to discuss the future of physical activity in America.
The National Physical Activity Plan -- first launched in May 2010 -- is a comprehensive set of policies, programs, and initiatives aimed at increasing physical activity in all sectors of American society. Its ultimate goal is a society where: "One day, all Americans will be physically active and will live, work, and play in environments that facilitate regular physical activity."
The Plan addresses eight distinct sectors of society -- business and industry; education; health care; mass media; parks, recreation, fitness and sports; public health; transportation, land use, and community design; and volunteer and non-profit. But it explicitly calls on health care providers to encourage adults, children and families to increase their daily physical activity.
Specifically, the Plan urges health care providers to make physical activity a patient "vital sign" that they assess and discuss with their patients regularly. It also calls on providers to establish physical inactivity as a treatable and preventable condition with profound health implications.
Importantly, the National Physical Activity Plan proposes steps for including physical activity education in the training of all health care providers and lays out concepts like adding physical activity education to accreditation criteria and licensing exams, and including physical activity in continuing education professional development programs.
The beauty of the National Physical Activity Plan is that it sets forth a roadmap with specific solutions to how we, as a society, can overcome barriers to physical activity and create an American culture that both supports and enables daily exercise. An important outcome of February's Congress will be the release of an updated Plan, which is anticipated in late 2015.
One strategy emphasized in the Plan is to advocate for policies that promote physical activity. And the Expanding Nutrition's Role in Curricula and Healthcare (ENRICH) Act (H.R. 1411) does just that. This bipartisan bill, sponsored by Rep. Tim Ryan (D-Ohio) and Rep. Pat Tiberi (R-Ohio), calls for offering nutrition and physical activity education throughout medical school, residency programs, and in conjunction with other health education programs -- which can also mean offering additional opportunities, like Continuing Medical Education (CME) and seminars.
From reducing back pain to protecting against depression, heart disease, Type 2 diabetes, several cancers and more, regular exercise is a critical component of healthy living. It's time we found ways to bring exercise into doctors' exam rooms and medical schools across the country. The ideas set forth in the National Physical Activity Plan and the ENRICH Act are critically important steps. But for physical activity to really become an integral part of health care in America, we need our doctors -- and all health care providers -- to get moving.
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