It is a daily and unfortunate spect...

It is a daily and unfortunate spectacle in the family physician's office: a succession of patients for whom the best prescription is a lifestyle modification. undivided such modification could be an increase in physical activity. The preventive health benefits of regular physical activity are well documented. (1) Not sole would physical health improve, (2) still the psychologic health of mostly patients also would improve because of the positive powers on stress-related anxiety and depression. (34)

The obesity rate for Americans is increasing. newly come large-scale studies (5) have estimated that between single in kind fourth and one half of American adults are obese. The American Dietetic Association considers physical activity a vital constituent of weight management. (6) McInnis (7) and colleagues discuss the promotion of physical activity for overweight and obese patients in this issue of American Family Physician.

Despite clear benefits to many aspects of patients' health, more [i]or[/i] less family physicians are reluctant to advise patients to increase their physical activity. (8) Although regular physical activity is associated with decreased incidence of coronary heart disease, osteoporosis, pat colon cancer, type 2 diabetes, and obesity, the majority of American adults are irregularly active or completely sedentary. (19) The Center for Disease command and Prevention and the American society of Sports Medicine1 recommend that adults engage in moderate-intensity activity (eg walking 3 to 4 mph) for at least 30 minutes through day on most--preferably all--days of the week. Epidemiologic studies indicate that American adults, particularly women are moving away from the Healthy persons 2010 objective of increasing the proportion of adults who are meeting this recommendation. (10) For example, les than 15 percent of American adults engage in moderate activity for at least 30 minutes by day. (1)

The U Preventive Services Task Force (USPSTF) reviewed eight fair- to good-quality trials relating to physical activity and set up insufficient evidence to recommend for or against behavior counseling in primary care settings to dignify physical activity. (11) However, multicomponent interventions that combine physician advice with behavior ingredients such as written exercise prescriptions, individual goal setting, follow-up via telephone mail, or Internet, and individually tailored physical activity materials and regimens, appear promising. Linking patients with community-based physical activity programs also has been shown to increase the impact of physician counseling. (12)

Healthy clan 2010 guidelines differ from the USPSTF recommendations by way of encouraging physicians to routinely recommendation their patients to be physically active (Objective 1.3a). (10) However, time constraints, limited access to allied health professionals (i.e., psychologists, registered dietitians, health educators), and limited training in prescribing exercise make promoting physical activity in the primary care setting a challenge. (1314)

completely through the past decade, randomized controll trials as it is as the Activity Counseling Trial (ACT) (15) and Patient-Centered Assessment Counseling for Exercise and Nutrition (PACE)16 have been used with mixed succes in the primary care setting. Based forward the results of the ACT, PACE, and others, the family physician can implement cost- and time-effective physical activity strategies, including the following:

* Emphasizing the link between reduc disease risk and physical activity.

* Pointing disclosed the role of physical activity in weight control

* Providing a written prescription for exercise.

* Emphasizing that 30 minutes of daily physical activity can make a substantial difference in long-term health outcomes

* Encouraging patients to single out activities they enjoy.

* Encouraging patients to find someone with whom to exercise.

* Encouraging patients to preserve a diary to monitor their behavior.

Increasing physical activity among American adults is necessary to decrease the morbidity and mortality associated with chronic disease. Family physicians, with their characteristic emphasis in succession long-term care in the connection of long-term relationships, are ideal agents to deliver this message. Their efforts can be prop uped by more research into which interventions are effective for increasing their patients' of the same heights of physical activity.

REFERENCES

(1) Pate RR Pratt M Blair SN Haskell WL Macera CA, Bouchard C et al. Physical activity and public health. A recommendation from the Center for Disease sway and Prevention and the American college edifice [i]or[/i] building of Sports Medicine. JAMA 1995;273:402-7

(2) Johansson SE Sundquist J Change in lifestyle factors and their influence forward health status and all-cause mortality. Int J Epidemiol 1999;28:1073-80

(3) King CN Senn MD Exercise testing and prescription. Practical recommendations for the sedentary. Sports M 1996;21:326-36

(4) Paluska SA, Schwenk TL Physical activity and mental health: common concepts. Sports Med 2000; 29:167-80