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Encouraging Patients To Become More Physically Active: The Physician's Role

Ross E. Andersen, PhD; Steven N. Blair, PED; Lawrence J. Cheskin, MD; and Susan J. Bartlett, PhD
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From Johns Hopkins University School of Medicine, Baltimore, Maryland; and Cooper Institute for Aerobics Research, Dallas, Texas. Grant Support: In part by NIH grant 1 F32 DK 09241-01 ZRG1 03; American Heart Association Investigatorship (Maryland Affiliate) grant MDBG7096 (Dr. Andersen); an American College of Sports Medicine Visiting Scholarship (Dr. Andersen); NIH grant AGO6945 from the National Institute on Aging (Dr. Blair); and grant HL48597 from the National Heart, Lung, and Blood Institute (Dr. Blair). Requests for Reprints: Ross E. Andersen, PhD: Johns Hopkins University School of Medicine, 333 Cassell Drive, Suite 1640, Baltimore, MD 21224. Current Author Addresses: Drs. Andersen, Cheskin, and Bartlett: Johns Hopkins University School of Medicine, Department of Medicine, Division of Gastroenterology, 333 Cassell Drive, Suite 1640, Baltimore, MD 21224.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(5):395-400. doi:10.7326/0003-4819-127-5-199709010-00010
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A sedentary lifestyle is recognized as a risk factor for poor health.Only 22% of adults in the United States are currently active enough to derive health benefits from their activity. Inactive persons who improve their physical fitness are less likely to die of all causes and of cardiovascular disease than are those who remain sedentary. Many physicians do not feel adequately prepared to prescribe exercise to their patients. An active lifestyle does not require patients to follow a formal, uninterrupted, vigorous exercise program. Recent recommendations about physical activity have been simplified to encourage activity for the promotion of health and the prevention of disease. Physicians are advised to routinely counsel sedentary patients to accumulate 30 minutes of moderate-intensity activity-equivalent to walking at 3 to 4 mph for most healthy adults-on most, preferably all, days of the week. The most sedentary patients should be encouraged to simply begin doing something and to make gradual changes over time. With continued support and encouragement from their physicians and families, these persons may progress to higher levels of activity that will further reduce their risk for disease.


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Figure 1.
Energy expenditure.[26]

The solid line indicates the energy expenditure over the course of a day for a sedentary person; the dashed line represents the energy expenditure of a person who engages in planned, vigorous exercise during leisure time but is otherwise sedentary; and the dotted line illustrates the energy expenditure of a person with a sedentary job who seeks opportunities to accumulate short bouts of physical activity throughout the day. Reproduced from Blair and associates with permission of Blackwell Scientific.

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