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• Focus on prevention •
BY SHERI PORTER
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It's no secret that a fit body is much better equipped to ward off disease.
According to the American Heart Association, cardiovascular disease is the leading cause of death in the United States. Tell your couch potato patients that their lack of physical activity could set them up for heart disease and other health problems including obesity, diabetes and high blood pressure.
While you're at it, give them these AHA stats to chew on:
How many of your patients insist they would exercise if only they had time?
The "time crunch" is always an issue, says FP Derek Clevidence, M.D., of Cottage Grove, Wis. He asks patients to reserve 30 minutes a day, four days a week for exercise.
"That's just 1.2 percent of their entire week -- I tell them they owe it to themselves," Clevidence says. He encourages the use of a pedometer, a heart rate monitor or some other "feedback device." Sometimes he schedules patients for a treadmill test. "It's just to let them know how much work they need to do to achieve an adequate heart rate -- it gives them a frame of reference," he says.
The "I'm too busy" excuse never flies with Maj. Leslie Knight, M.D., of Lakenheath, England. She counters by pointing out her own hectic schedule. "I work 12 hours a day and manage to fit exercise in -- make it a priority and you'll have time," she tells patients.
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Knight encourages people to pick activities they like -- try cycling, walking, running, rowing, rollerblading or swimming -- and then vary the routine to fend off boredom. "The key to success is variety and persistence," she says.
But what about motivation? "My experience is that even though patients say it is a problem with time, it's really about willpower," says John Chomer, M.D., of Noblesville, Ind. "I tell patients to motivate themselves by wha tever mind games are necessary: Do five push-ups and sit-ups before their shower; take the stairs; fit in a quick walk while the dishes soak." Chomer says the hardest part is getting started and developing a lifestyle change.
Eugene Guazzo, M.D., tells his patients to run. The 74-year-old FP from Chaptico, Md., has been running since his teens and considers it the best overall exercise. "It's the most efficient use of time and money -- it's cheap, and you can do it anywhere," says Guazzo. He doesn't let his "frequent flyer" patients off the hook, either: "I tell them to pack their running shoes."
If a patient can't run, Guazzo suggests walking briskly -- aim for a 15-minute mile. "Get a little perspiration going and you'll know you've stressed your body enough," he says.
Here's the bottom line: Set a good example for your patients. Tell them exercise will help them feel and look better, increase their stamina, improve their circulation, tone their muscles and strengthen their bones. If they still resist, tell them this, says Guazzo: "It improves your sex life. It's true ... it's that cardiovascular business again."
To reach writer Sheri Porter, e-mail sporter@aafp.org.
FP Report is published by the
AAFP News Department.
Copyright © 2003 by
American Academy of Family Physicians.