Intended for healthcare professionals

Practice Practice Pointer

Promoting physical activity to patients

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5230 (Published 17 September 2019) Cite this as: BMJ 2019;366:l5230
  1. Christine Haseler, general practitioner1,
  2. Ranulf Crooke, general practitioner2,
  3. Tobias Haseler, general practitioner specialty trainee3
  1. 1Hucclecote Surgery, Gloucester, UK
  2. 2Hilary Cottage Surgery, Fairford, UK
  3. 3The Bloomsbury Surgery, London, UK
  1. Correspondence to C Haseler christine.haseler{at}nhs.net

What you need to know

  • Benefits to health start at just 30 minutes of physical activity a week, but more than a quarter of UK adults fail to achieve this

  • Physical activity can reduce all cause mortality more effectively than medication

  • Risk of harm from moderate physical activity is small, while the adverse effects of inactivity and sedentary time are clear

The health benefits of physical activity are proved and wide ranging, exceeding that of any drug. The Academy of Medical Royal Colleges has described physical activity as a “miracle cure.”1 Meanwhile, inactivity contributes to as many deaths in the UK as smoking2 and is the fourth leading risk factor for mortality worldwide.3 More than 25% of adults in the UK are inactive, doing less than 30 minutes of physical activity a week.2 Clinicians are uniquely placed to help their patients to become more physically active, and even a brief discussion within a consultation can lead to change.

This article offers a practical guide to help clinicians discuss physical activity within a consultation, including how to address concerns patients may have about becoming more active and how to help them overcome barriers to change.6

What do we mean by “physical activity”?

Although exercise and physical activity are sometimes used interchangeably, they have distinct meanings. In practice, although exercise may be a more familiar term to people, it can also be off putting to some: you don’t need to be doing exercise to be active.

Physical activity, defined by the World Health Organization, is “any body movement performed by skeletal muscles that expends energy,” whereas exercise is “physical activity with the primary purpose of improving or maintaining physical fitness or performance.7” Moderate intensity physical activity “requires a moderate amount of effort and noticeably accelerates the heart rate,5” leads to faster breathing and feeling warmer, …

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