Man sitting watch TV being sedentary
Exercise,  Fitness tips

One thing great doctors doThis article is a 5 min read

My Mom has a great doctor. As an elderly adult, Mom has many health concerns that range from joint and skeletal muscle dysfunction to vascular problems. The first time she met her new doctor about half-way through the session her doctor stopped and sat in front of my Mom and said: “I think getting more physically active would help you.”

As an exercise physiologist, when I heard this I got out my mental pom poms and started my cheer! I’ve been to doctors with my wife and kids and have rarely heard this outside of physical therapy after an injury although it would have been a discussion that I would have had (and have had) with almost anyone who needed it.

However, what made my Moms’ doc great was not the recommendation, but the recommendation AND the next thing that was provided. Advice.

Too many times I’ve talked to people that have told me that their doctor told them to “get more exercise” and do not provide any guidance. That’s too bad because doctors can play a pivotal role in you becoming more active (Lamming et al., 2017). But are we asking too much of doctors? I think if you talked to any doctor they would agree that being physically active is important for good health. Having said that, things like knowledge, visit time, procedures and exams, scheduling, and follow-up all make it hard.

But increasing physical activity cannot be “an extra” thing during an appointment. It should be a health metric like blood pressure – a vital sign. It is associated with lower risk of heart disease, various cancers, reduced disability and improved independence in late life, lower blood pressure, better cholesterol profiles, reduction of diabetes and overweight, protection against heart damage associated with heart attack and ischemia, reduce risk of dementia, good bone health, better sleep, reduce depression and anxiety, improved physical function for people with lung disorders, and much more.

In fact, if physical activity were a pill, we would not need many others.

So what advice should doctors give you?

If you are relatively healthy (not having symptoms of any disease) you’ll probably be able to start with moderate exercise. However, let’s take a step back before we get into exercise. You can do something much easier than exercise to get started. Just move. Really, just move. The 2018 Physical Activity Guidelines for Americans stresses the importance of less sedentary time, especially sitting!

Non-exercise physical activity

Late researcher Ralph Paffenbarger and many others show lifetime increase with just 60 minutes of physical activity a day, total. Even low-level activity can help. In fact, some research shows that simply increasing your physical activity (getting off the couch) by 30-minutes a day can reduce your risk of premature death by 14 percent.

So here’s my RX for being less sedentary: for every hour of job/home wake sedentary time, you walk around for 5-minutes – Ta-da!

For example, if you wake up at 6:00 – 7:00 am and go to sleep at 11:00 pm this 16 to 17 hours of total “wake-time”. But for some of that time, you’re up and doing stuff like taking a shower (I hope), doing laundry, or making meals. Let’s say you have a job where you sit for 7-8 hours and then you go home and watch TV or sit in front of the computer for 4-5 hours – use this as your targeted time for moving. If for every 60 minutes of sedentary time (11 – 13 hours) you move around for 5-minutes that would give you 55 – 65 minutes of “non-exercise physical activity”. If you exercise for 1-hour 3-5 days a week you would subtract that sedentary time. With this plan each week you would have added about 275 – 325 minutes of non-exercise physical activity which does not include weekends! Of course, this would be low-level activity but added activity anyway. There are plenty of other ways to do this and they can be found here on the American College of Sports Medicine “Sit Less. Move More.” publication.

Exercise

From the perspective of “exercise”, which is planned physical activity, walking may be one of the best activities for many. Sometimes I think we make things too complicated and that turns people off.

I can tell you the following:

“Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both preferably spread throughout the week.”

AND

“Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week.”

But then you’ll think what’s moderate or high intensity? I can give you the details on the percent of VO2 max and target heart rates but without that personalized information what good does it do? Maybe you can use the BORG scale and rate your intensity based on how hard you feel your working (good option for many). You could try tracking your daily steps and look to work your way up to the magic number of between 7,000 – 10,000.

OR

You can simply start moving to today and increase it a bit every day after. When your feeling okay increase your walking time, then eventually your pace. Keep a notebook or mark your exercise sessions on a calendar to track your progress. Get to that 150 minutes of exercise you’ll live and feel better (actually you’ll feel better way before that). If you’re looking for specific guidance get to a local gym and talk to a qualified exercise professional or you can always bug your doctor.

More reading and references

Lamming, L., Pears, S., Mason, D., Morton, K., Bijker, M., Sutton, S., & Hardeman, W. (2017). What do we know about brief interventions for physical activity that could be delivered in primary care consultations? A systematic review of reviews. Preventive Medicine, 99, 152-163. doi:10.1016/j.ypmed.2017.02.017

U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans (2nd ed.). Washington, DC: U.S. Department of Health and Human Services.