Public Health

Only 1 in 3 patients is active enough. Here’s how to help.

Sara Berg, MS , News Editor

Regular physical activity can help prevent a variety of health conditions, including obesity, heart disease, stroke, high blood pressure and type 2 diabetes. Yet a large portion of the U.S. adult population fails to meet the recommended levels of daily physical activity, according to a report from the Centers for Disease Control and Prevention (CDC).

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For the report, published in the Morbidity and Mortality Weekly Report, researchers looked at the percentage of adults who get 150 minutes of moderate-intensity aerobic exercise—about 20 minutes a day—and two days of muscle-strengthening per week. Analysis of 2020 National Health Interview Survey data uncovered that 46.9% of U.S. adults are meeting one of those guidelines.

For adults living in the West, 28.5% performed the weekly recommended physical activity. Meanwhile, in the South, only 22% of adults performed the recommended amount of exercise each week. The same held true when breaking up the physical activity guidelines into aerobic exercise and muscle strengthening—meeting requirements was lower in the South than the West.

Additionally, 27.8% of adults in large central metropolitan areas—such as New York City, Chicago and Miami—met both guidelines compared to other geographies. Half of adults in large central metropolitan areas met individual guidelines for aerobic activity while 35.2% met recommendations for muscle-training. Meanwhile, only 16.2% of adults in rural areas met both physical activity guidelines. Individually, 38.2% met aerobic and 21.1% met muscle-strengthening recommendations.

These findings are concerning because inadequate physical activity can lead to obesity, heart disease, type 2 diabetes and cancer, which increase a person’s risk of death. Here is how physicians can help.

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It is important for physicians to “have an open nonjudgmental conversation with your patient about any barriers that keep them from getting more physical activity—such as time limitations and safety concerns,” said Kate Kirley, MD, a family physician and director of chronic disease prevention at the AMA. Also, “help them problem solve without ignoring or minimizing their concerns.”

National efforts such as the CDC’s “Active People, Healthy Nation” and “Healthy People 2030” require ongoing and detailed surveillance to understand inequities in meeting physical activity guidelines. Data for narrower geographic areas may also provide evidence needed to guide local efforts to promote physical activity and eliminate disparities, the report notes. 

“Physical activity counseling should always be tailored to each of our patients,” said Dr. Kirley. “It’s important to consider both what an individual enjoys doing for physical activity as well as what they can practically do.”

It’s important for patients to find their “soulmate exercise,” otherwise they will not incorporate that activity into their life.

“The American College of Sports Medicine encourages physicians to treat physical activity like a vital sign,” said Dr. Kirley. That “means we should ask about it pretty much every time we see our patients. 

“There is some evidence to suggest that more frequent physical activity counseling by physicians is associated with better physical activity habits in patients,” she added. But try to avoid using terms like “exercise” because people picture that they need to get a gym membership. Instead, reference physical activity or being less sedentary.

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“While there are many things that individuals can do to change their physical activity habits, the most impact is going to come from system and policy changes,” Dr. Kirley said, noting that chapter eight of the “Physical Activity Guidelines for Americans” offers recommendations about system changes and what communities can do to improve physical activity.

“Most of our lives and living environments are set up in ways that promote sedentary behavior and make it a challenge to be physically active,” Dr. Kirley said. That is why “we need changes to our environments that will support people in being more physically active and stop getting in the way.”

The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National Diabetes Prevention Program lifestyle-change program based on their individual needs.