ACTIVE INTERVENTION: Doctors promote exercise and get results

Focuses on studies which discussed the role of exercise in preventing heart diseases. Details on the activity counseling trial for women; Information on the patient-centered assessment and counseling for exercise plus nutrition program for adolescents.

By J.F. Sallis, published on January 01, 2002

HEART DISEASE

ACTIVE INTERVENTION: DOCTORS PROMOTE EXERCISE AND GET RESULTS

Doctors know better than most the degree to which a sedentary lifestyle contributes to heart disease. Indeed, the American Heart Association has long considered physical inactivity as risky as smoking, high blood pressure and high cholesterol. J.F. Sallis, Ph.D., examines two recent studies that claim minimal encouragement from an M.D. motivates patients--especially women and teens--to make heart-healthy changes.

In the Activity Counseling Trial (ACT) researchers in California, Texas and Tennessee promoted exercise regimens for 874 sedentary adults between the ages of 35 and 75. Physicians advised a control group to perform at least 30 minutes of physical activity daily. Members of two experimental groups received one 10- to 20-minute phone counseling session, a device to measure physical activity and a health newsletter. One of these groups received additional telephone sessions and weekly classes about exercise.

After two years, women in both experimental groups improved their cardio-respiratory fitness by 5 percent more than women in the control group, who were only advised to increase their physical activity. This translates into an estimated 9 percent decrease in risk of death from heart disease. Twenty percent of women met the recommended goal of 30 minutes of moderate to intense exercise five days a week. Researchers did not speculate as to why men showed no improvement. The results were published in the Journal of the American Medical Association.

The PACE+ program (Patient-centered Assessment and Counseling for Exercise plus Nutrition) was the first to evaluate similar services for adolescents. Researchers at San Diego State University, including this author, administered a computer program about physical activity and nutrition to 117 teenagers. The program encouraged them to walk or engage in vigorous physical activity such as basketball or aerobic dance and to chose a dietary target such as eating more fruits and vegetables or less fat. A clinician reviewed the plan with the teenagers and most also received guidance through telephone counseling and mailed materials. The adolescents' targeted physical activity and diet improved in four months. The study was published in Archives of Pediatrics and Adolescent Medicine.

Studies like ACT and PACE+ demonstrate the influence physicians wield when it comes to adults and adolescents making behavioral changes. Researchers hope these findings will encourage primary-care doctors to routinely counsel patients about physical activity and nutrition as a means of preventing heart disease and other illnesses.

WOMEN WHO PARTICIPATED IN COUNSELING AND CLASSES IMPROVED THEIR CARDIORESPIRATORY FITNESS BY 5 PERCENT

J.F. Sallis Ph.D., is a professor of psychology at San Diego State University.