Evidence-Based Medicine: Acknowledging the Role for Physical Activity

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Brendan M Levac
Ellen LR Cusano
Ryan McGinn


Modern technology and lifestyles have created an environment that predisposes our population to inactivity, resulting in fewer people meeting the Canadian Physical Activity Guidelines. There is a clear link between inactivity and the risk of developing chronic health conditions including hypertension, type 2 diabetes, and cancer; however, exercise prescription and counselling by physicians is lacking. This may in part be attributed to inadequate training of physicians during medical school. In this commentary, we outline the demand for awareness and training of physicians to prepare them to prescribe physical activity, and propose steps to increase exercise prescrip­tion for improved population health.


La technologie moderne ainsi que nos habitudes de vie actuelles nous prédisposent à l’inactivité ce qui mène moins de personnes à respecter les directives canadiennes en matière d’activité physique. Un lien direct existe entre l’inactivité et le risque de développer des problèmes de santé chroniques incluant l’hypertension, le diabète de type 2, et le cancer. Toutefois, l’exercice et le counseling pre­scrits par les médecins sont peu pratiqués par les patients qui pourraient en bénéficier. Dans cet article, nous soulignerons le besoin de formation des médecins afin de mieux les préparer à prescrire de l’activité physique à leur patients et leur proposer des étapes pour améliorer la santé physique de la population.

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1. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2(2):1143–1211.

2. Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024–2035.

3. Fiuza-Luces C, Garatachea N, Berger NA, Lucia A. Exercise is the real polypill. Physiology (Bethesda). 2013;28(5):330–358.

4. Tremblay MS, Warburton DE, Janssen I, et al. New Canadian physical activity guidelines. Appl Physiol Nutr Metab. 2011;36(1):36–46; 47–58.

5. Warburton DER, Charlesworth S, Ivey A, Nettlefold L, Bredin SSD. A sys¬tematic review of the evidence for Canada’s Physical Activity Guidelines for Adults. Int J Behav Nutr Phys Act. 2010;7:39.

6. Statistics Canada. “Directly measured physical activity of Canadian adults, 2012 to 2013.” Health Fact Sheet. Statistics Canada Catalogue no. 82-625-X.

7. Krueger H, Turner D, Krueger J, Ready AE. The economic benefits of risk factor reduction in Canada: Tobacco smoking, excess weight and physical inactivity. Can J Public Health. 2014;105(1):69–78.

8. Tremblay MS, Esliger DW, Copeland JL, Barnes JD, Bassett DR. Moving for¬ward by looking back: lessons learned from long-lost lifestyles. Appl Physiol Nutr Metab. 2008;33(4):836–842.

9. Carroll JK, Antognoli E, Flocke SA. Evaluation of physical activity counsel¬ing in primary care using direct observation of the 5As. Ann Fam Med. 2011;9(5):416–422.

10. Petrella RJ, Lattanzio CN, Overend TJ. Physical activity counseling and prescription among canadian primary care physicians. Arch Intern Med. 2007;167(16):1774–1781.

11. Kennedy MF, Meeuwisse WH. Exercise counselling by family physicians in Canada. Prev Med. 2003;37(3):226–232.

12. Hébert ET, Caughy MO, Shuval K. Primary care providers’ perceptions of physical activity counselling in a clinical setting: a systematic review. Br J Sports Med. 2012;46(9):625–631.

13. Stoutenberg M, Stasi S, Stamatakis E, et al. Physical activity training in US medical schools: preparing future physicians to engage in primary preven¬tion. Phys Sportsmed. 2015;43(4):388–394.

14. Holtz KA, Kokotilo KJ, Fitzgerald BE, Frank E. Exercise behaviour and atti¬tudes among fourth-year medical students at the University of British Co¬lumbia. Can Fam Physician. 2013;59(1):26–32.

15. Frank E, Segura C, Shen H, Oberg E. Predictors of Canadian physicians’ pre¬vention counseling practices. Can J Public Health. 2010;101(5):390–395.

16. Sequeira S, Cruz C, Pinto D, Santos L, Marques A. Prevalence of barriers for physical activity in adults according to gender and socioeconomic status. Br J Sports Med. 2011;45(15):A18–A19.