Screening for physical inactivity can cut risk of chronic illness, study suggests

NEW YORK, Jan. 2 (UPI) -- Encouraging primary care physicians to screen patients for physical inactivity with a simple questionnaire can help identify people at risk for many chronic diseases, a new study suggests.

The study was published online Thursday in Preventing Chronic Disease, a journal established by the National Center for Chronic Disease Prevention and Health Promotion.

The research underscores the importance of having clinicians inquire about patients' exercise levels to help them become healthier, the researchers said.

"The major reason physical inactivity is not measured or managed in primary care in the U.S. is there simply isn't a lot of money in prevention," senior author Lucas Carr, an associate professor in the Department of Health and Human Physiology at the University of Iowa in Iowa City, told UPI.

"There are very few billing codes available for prescribing exercise to patients who need it," Carr said in advocating for healthcare reforms that would allow providers to prioritize "prevention efforts that could keep patients healthy and out of hospitals."

Based on patients' responses to a questionnaire, the researchers determined that those reporting the most physical activity -- moderate to vigorous exercise of at least 150 minutes weekly -- were at a significantly lower risk of 19 chronic conditions, including cardiovascular disease, cancer, respiratory disease and diabetes.

The findings also indicate that patients who are least active -- engaging in little to no exercise in a given week -- are at heightened risk of developing a chronic illness.

Physical activity is not commonly assessed in healthcare settings, even though strong evidence proves that remaining inactive is one of the most common causes of death, while being active provides wide-ranging health benefits, said Carr, who has a doctoral degree in physiology.

Most U.S. hospitals don't ask patients about their physical activity, and the researchers noted no hospital system in the Midwest has done so.

For this study, they reviewed responses from more than 7,000 patients at University of Iowa Health Care Medical Center.

Carr partnered with Dr. Britt Marcussen, an associate professor of family medicine, to offer the questionnaire to patients at annual wellness exam visits. The study period spanned from November 2017 to December 2022.

Known as the Exercise Vital Sign survey, the questionnaire posed two questions for patients to answer on a tablet. They were:

"On average, how many days per week do you engage in moderate to vigorous exercise (like a brisk walk)?" (0-7 days)

"On average, how many minutes do you engage in exercise at this level?"

Carr said he and his colleagues would like to make the survey accessible to all patients, adding that It takes less than 30 seconds to complete and can tell the clinician a lot about a patient's overall health.

"The take-home message here is that physical activity is one of the most important preventive actions an individual can take to protect themselves against a multitude of diseases," Carr said. "It's free, it works and it can be fun."

He added that "healthcare organizations should treat physical activity like a vital sign -- similar to blood pressure -- by asking all patients about their physical activity during all visits."

Patients who are inactive should be connected to supportive resources that could help them develop an active lifestyle that works for them, Carr said.

Other experts agreed with the study's positive assessment of exercise's benefits in helping ward off chronic diseases.

"This fits with the overall body of evidence that has been established across many different patient populations over many different health outcomes," said Dr. Gregory Katz, a cardiologist and an assistant professor of medicine at NYU Grossman School of Medicine in New York City.

"People who are more active are healthier -- they are less likely to have heart attacks and strokes, less likely to develop chronic disease and less likely to die," Katz said.

"But the study doesn't prove that physical activity is what causes these better health outcomes," he added. "For all we know, this is just telling us that people who are healthier feel better, so they can move more, and it's the better health that causes more physical activity rather than the other way around."

Measuring exercise as a critical "vital sign" doesn't occur routinely in most healthcare systems, said Dr. Michael McConnell, a clinical professor of cardiovascular medicine at Stanford Medicine in Palo Alto, Calif.

"This study reinforces that it's easy to implement this measurement and, as expected, it correlates with better health across many diseases," said McConnell, author of Fight Heart Disease Like Cancer.

While aiming for a 150-minute weekly goal would be ideal, "every step or minute counts," he said in recommending that people add walking to their work or home routines or in spending time with friends and family.

Dr. Steven Rothschild, chair of the Department of Family and Preventive Medicine at Rush University System for Health in Chicago, said he regularly screens patients for their physical activity.

He said he often tells them, "Exercise isn't the fountain of youth, but it's the closest thing we have to one."