Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association.

Physical inactivity is one of the most prevalent major health risk factors, with 8 in 10 US adults not meeting aerobic and muscle-strengthening guidelines, and is associated with a high burden of cardiovascular disease. Improving and maintaining recommended levels of physical activity leads to reductions in metabolic, hemodynamic, functional, body composition, and epigenetic risk factors for noncommunicable chronic diseases. Physical activity also has a significant role, in many cases comparable or superior to drug interventions, in the prevention and management of >40 conditions such as diabetes mellitus, cancer, cardiovascular disease, obesity, depression, Alzheimer disease, and arthritis. Whereas most of the modifiable cardiovascular disease risk factors included in the American Heart Association's My Life Check - Life's Simple 7 are evaluated routinely in clinical practice (glucose and lipid profiles, blood pressure, obesity, and smoking), physical activity is typically not assessed. The purpose of this statement is to provide a comprehensive review of the evidence on the feasibility, validity, and effectiveness of assessing and promoting physical activity in healthcare settings for adult patients. It also adds concrete recommendations for healthcare systems, clinical and community care providers, fitness professionals, the technology industry, and other stakeholders in order to catalyze increased adoption of physical activity assessment and promotion in healthcare settings and to contribute to meeting the American Heart Association's 2020 Impact Goals.

Physical activity levels and counseling practices of U.S. medical students.

INTRODUCTION: Some literature shows a positive relationship between physicians' personal physical activity (PA) levels and physicians' encouraging patients' PA, though it remains unclear how this evolves during medical training. In this paper, we describe U.S. medical students' PA levels and factors predicting relevance and frequency of their PA counseling of patients. METHODS: This is a prospective survey of a representative sample of U.S. medical students from 16 schools (N = 2316) designed to determine health-related attitudes and practices. Student's PA levels were assessed using a Godin exercise questionnaire. An 80.3% (N = 1658) response rate was achieved during 4 yr. RESULTS: More than half (61%) of U.S. medical students adhered to CDC PA recommendations. This rate was relatively stable during the 4 yr of medical training. Of those who reported a lot of stress in the last 12 months or 2 wk, fewer than 60% complied with the CDC exercise recommendations, compared with at least 80% who reported almost no stress. Frequency of PA counseling of patients was consistently related to personal PA practices. The percent of students perceiving that PA counseling would be highly relevant to their practices decreased during the 4 yr of medical school, from 69 to 53% (P < 0.01). DISCUSSION: Among U.S. medical students, personal PA levels are higher than those of age-matched peers in the general population, are maintained throughout medical school, and are correlated with frequency of PA counseling of their patients. Promotion of adequate PA habits during medical education may be an important step to improve the PA preventive counseling that future clinicians provide.

[Physical activity levels in adults living in Bogotá (Colombia): prevalence and associated factors]. / Nivel de actividad física global en la población adulta de Bogotá (Colombia). Prevalencia y factores asociados.

OBJECTIVE: To determine the prevalence of physical activity levels in adults aged 18 to 65 years in Bogotá city and identify the factors associated with regular physical activity. METHODS: We conducted a population-based, cross-sectional survey in 3,000 adult residents of Bogotá in 2003 who were selected through a multistage probabilistic sample. Physical activity levels were determined using the short version of the International Physical Activity Questionnaire. Factors associated with regular physical activity were identified by logistic regression models. RESULTS: The adjusted prevalence of persons undertaking regular physical activity was 36.8%. After adjustment for potential confounders, regular physical activity was more likely in men (odds ratio [OR] = 1.62; 95% CI, 1.31-2.01) and in those whose self-perceived health status was good or very good (OR = 1.87; 95% CI, 1.41-2.49) and was less likely in those aged 30-49 years or 50-65 years (OR = 0.78; 95% CI, 0.63-0.96, and OR = 0.60; 95% CI, 0.43-0.82, respectively) and in those whose main activity in the previous 30 days was searching for a job (OR = 0.71; 95% CI, 0.51-0.97) or carrying out household tasks (OR = 0.72; 95% CI, 0.54-0.96). In women, unlike men, age groups showed no association with regular physical activity. CONCLUSION: This study shows gender differences in the prevalence of physical activity levels and associated factors. Future studies should establish, in the context of Latin American cities, whether it is appropriate to determine specific measures in each domain, in addition to overall physical activity levels.