Eating healthy foods and exercising can reduce patients' risk of developing some of the country's leading causes of death, as well as improve their overall mental and physical well-being.
A healthy diet and frequent exercise can be powerful tools in combating serious chronic illness, which is why Health is Primary,(www.healthisprimary.org) a communications campaign launched by Family Medicine for America's Health, chose to focus its June outreach efforts on fitness and nutrition and the role family physicians can play in helping patients achieve their health goals in those areas.
As part of its "mini campaign," Health is Primary released tear sheets on exercise(healthisprimary.org) and nutrition(healthisprimary.org) that answer common questions about the recommended frequency and intensity of exercise, as well as strategies for adopting a healthier menu each week. The tear sheets, which are also available in Spanish, highlight ways family physicians can serve as an integral resource for patients as they try to embrace healthier habits.
- A healthy diet and frequent exercise can be powerful tools in combating serious chronic illness and improving patients' overall mental and physical well-being.
- Health is Primary, a communications campaign launched by Family Medicine for America's Health, focused its June outreach efforts on fitness and nutrition and the role family physicians can play in helping patients achieve their health goals in those areas.
- Two family physician experts offer hands-on tips to help educate and encourage patients to meet diet and exercise goals.
The Role of the Family Physician
Jason Matuszak, M.D., chief of sports medicine for Excelsior Orthopaedics in Buffalo, N.Y., says he thinks physical activity is the single most powerful medication family physicians have at their disposal.
"It reduces risk of cancer, it reduces risk of heart disease, it reduces pulmonary complications," he says. "Even for people who are sick or for people who have multiple medical conditions, being more physically active only improves their health outcomes across the board."
Rebecca Jaffe, M.D., M.P.H., who has a private practice in Wilmington, Del., says the unique relationships family physicians have with their patients make them ideal health educators for patients.
"As family physicians, we get to know our patients, and with just a few questions one can assess what they may be doing suboptimally in both the diet arena and the exercise arena," she says.
For example, family physicians can ask their patients questions as simple as, "What do you eat for breakfast?" or "What kind of activities do you enjoy doing, and how often are you able to do them?" to learn more about their habits.
Start with Small Achievable Change
The American College of Sports Medicine and the U.S. surgeon general recommend that adults get at least 150 minutes of moderate level activity each week.
Matuszak says that although that is the recommended amount of physical activity, he thinks it's important for family physicians to encourage patients to adopt small goals initially that are attainable.
"For people who are starting out with nothing, even going walking for 10 minutes a day, three times a week is still something and it's still a place to start," he says.
Jaffe says the same philosophy applies with diet. She'd rather her patients make two small changes that they can maintain rather than five major changes that aren't sustainable in the long term.
For instance, she says a common practice in the United States is to eat a carbohydrate-dense breakfast. Carbohydrates get broken down into sugar very quickly, however, and the patient is hungry again less than two hours later. A better alternative, and a small change, would be eating protein and healthy fat at each meal.
"If we could convince ourselves and our patients to better balance what they eat from all three of the major food groups -- protein, carbs and fats -- we've made a small step forward," says Jaffe, "because if they eat protein and fat with those carbs, they are not going to be, literally, ravenous two hours later because of the insulin surge that tells their body that they are hungry."
Matuszak says people can also focus on other small changes, such as cutting down their portion sizes or eating more meals that are smaller in size each day.
He also tries to help his patients set realistic expectations about what's to come in the months ahead. It's important for patients to know that weight loss isn't always consistent and that short-term weight spikes will happen and are a normal part of the process.
"Almost across the board, weight loss is a little bit of a roller coaster ride that you have to be prepared to weather through the periods of plateau or the periods where you might go up a little bit, before your body can adjust and hit another portion of the curve where it can start to come down," says Matuszak.
Model Healthy Habits
Both Jaffe and Matuszak contend that physicians and office staff members who model good health and fitness habits and discuss those habits with patients can help them achieve success by providing real-world examples of what is working for others.
For instance, Jaffe regularly shares the way she finds ways to exercise during a busy day -- by going up and down stairs in her office, home or other buildings -- with her patients, so they see that exercise can be possible even with a hectic schedule.
She also cites data from the National Weight Control Registry,(www.nwcr.ws) a large, prospective investigation that is studying factors that lead to sustained weight loss. According to findings from the registry, people who have been most successful in maintaining weight loss eat breakfast, weigh themselves only once a week, watch fewer than 10 hours of television a week and exercise an average of one hour a day.
Obstacles in the Field
Although proper diet and exercise have been found to reduce the risk of heart disease, high blood pressure, diabetes, obesity and osteoporosis, Matuszak says he thinks one of the challenges that remains in the field is that family physicians may not give diet and exercise modifications an adequate opportunity to work before prescribing medication.
Jaffe adds that she thinks nutrition and fitness wasn't something that was always stressed in medical schools, resulting in a lack of knowledge among the medical community. She says there is a still a need for more evidence-based information that can help guide family physicians and ensure patients are receiving a consistent message.
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