When I was a nutrition intern in 2014, I would excitedly tell patients that walking 30 minutes a day, 5 days a week doesn’t have to be a daunting goal. In fact, research showed that accumulating bouts of 10 minutes conferred cardiac benefits.
Under the often cited “150 minutes/week moderate activity or 75 minutes/week vigorous activity” was the implication that if you couldn’t meet that goal, then why bother?
Did the research specifically say that? Nope. And over the years research on the so-called “Weekend Warriors” has flourished. Is it regular physical activity, or the cumulative amount, that reduces risk?
And then in 2016, the catchy phrase “Sitting is the new smoking” highlighted the birth of a newly emphasized term – physical inactivity – and the distinction between physical activity and exercise.
Earlier this month in Chicago, navigating the bustling 2018 AHA Scientific Sessions, the new Physical Activity Guidelines were revealed. Lo and behold, the news is even better – even a little bit of physical activity is worth it.
It’s not all about aerobic activity, either. We know that resistance training improves insulin sensitivity and helps maintain muscle mass as the human body ages. The result? Less frailty. “Healthy aging”. Fewer injuries from falls, and fewer falls overall.
The new Physical Activity Guidelines didn’t leave that goody out. Upper body weight training even once a week is beneficial – for your heart! Just when you thought you had to huff and puff to beef up your heart health.
With the new Hypertension Guidelines released at Scientific Sessions last year in Anaheim, a renewed effort surfaced for clinicians to encourage lifestyle behavior changes. Not enough time with the patient isn’t an excuse. Research showing that physicians who exercise are more likely to prescribe exercise hit headlines, and the simple fact that clinicians can utilize their position of authority to impart importance upon a topic.
“As a health care provider, you know it’s important to help your patients get more physical activity. But it can be challenging to motivate patients in the short time you spend together.” – Move Your Way, Physical Activity Guidelines 2nd Ed., Health Care Provider Fact Sheet
While not everyone feels comfortable taking on a counseling role with patients, there are key phrases and questions you can use to start the conversation. Check out this short Motivational Interviewing primer, which includes example wording to build rapport with your patient, empower them to make change, and establish a collaborative relationship.
- Help them set goals. “Are there activities you’d like to be able to do?” We’ve all heard “I want to be able to pick up my grandkids”. Knowing your patients’ motivations means you can work together to set goals that are important to them.
- Meet your patient where they are. Find out what they know, what they perceive as important and as barriers, and suggest small changes. Being able to walk a long driveway to get the mail is a better place to start than jumping from the couch to a 5K.
- Let them know what to look for. Instead of “aim for moderate intensity activity”, translate it to perceived exertion. A lazy walk is “I’m comfortable and could maintain this pace all day.” Encourage them to reach a Level 3 to 5 – “Comfortable but breathing harder – sweating a little but feel good and can carry on a conversation – just above comfortable, sweating more, and can still talk easily”. Everyone should start slow and build up to longer durations and higher intensities – take a look at the exertion table below to see what exertion level your patient should start in.
The new guidelines come with Move Your Way tools and resources to get the message out to your friends and family, your patients, and your community. Interactive tools and widgets, fact sheets and poster, and even videos, can help teach all Americans how they can move their way to move more.
Forming new habits is hard, and lifestyle change is no exception. We know the research, and we have the responsibility to translate that data into actionable information for our patients.
I had the opportunity to recap Scientific Sessions over dinner with my parents. What did I share? Just because you can’t run a marathon doesn’t mean you can’t reap the benefits of physical activity. A little bit goes a long way.
Bailey DeBarmore is an epidemiology doctoral student at UNC Chapel Hill, studying the intersection of epidemiology methods and clinical point of care. She is interested in chronic disease surveillance and use of electronic health records in research. She tweets @BaileyDeBarmore and blogs at baileydebarmore.com. Find her on LinkedIn and Facebook.