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Practitioner. 2012 Sep;256(1754):25-8, 3.

Time to encourage patients to take more exercise.

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  • 1University of Glasgow, Glasgow, UK.


Regular physical activity of moderate intensity can bring about major health benefits as well as significant cost savings for the NHS. Evidence suggests that regular exercise can produce up to a 30% reduction in all cause mortality with a 35% lower risk of cardiovascular disease, coronary heart disease and stroke. There is evidence to show that 37% of CHD deaths can be attributed to physical inactivity compared with 19% and 13% for smoking and hypertension respectively. In addition, a 40% reduction in the risk of metabolic syndrome and type 2 diabetes mellitus has been reported with moderate physical activity. Current guidelines from the CMO, for adults aged 19-64 years, recommend: 150 minutes of moderate intensity aerobic exercise per week such as fast walking or cycling plus muscle strengthening activities on two or more days a week, or 75 minutes of vigorous intensity aerobic activity such as running or singles tennis plus the same muscle strengthening regimen, or an equivalent mix of the two. Only 40% of men and 28% of women in England are achieving the recommended levels of exercise/physical activity. One way GPs can increase their patients' physical activity levels could be via an individualised tailored care pathway aiming to motivate individuals to make long-term health changes. Evidence suggests that the risks associated with physical activity at a level to promote health are low and that health benefits outweigh the risks. The 5 As system (Ask, Assess, Advise, Assist and Arrange) which is sometimes used in smoking cessation can be adapted for physical activity. Ask about the patient's current levels of physical activity using the General Practice Physical Activity Questionnaire; Assess their fitness and capabilities; Advise about appropriate exercise and the risks involved; Assist in locating places to get involved, use 'Let's Get Moving' and exercise referral schemes available; Arrange any necessary referrals.

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