ACSM: Behaviour change and advocacy

As you know, the American College of Sports Medicine is actively advocating clinicians take a more active role in exercise prescription. The organization also aims to be politically active – an essential for behaviour change. Here you see a letter that Robert Sallis shared with members; also new ACSM president James Pivarnik wrote to President Obama’s nominee for Surgeon-General. Interesting times with much more attention to behaviour change and advocacy than there was in the past.

– K. Khan

Prevention involves lifestyle changes, not just diagnostics

As health system reform takes center stage in the United States, prevention has become a hot topic among lawmakers, media and the public.

Some question the cost savings of preventive health care. Does it save money in the long run, or is it an expensive indulgence with too little benefit to justify the up-front cost?

Answer: It depends. While many diagnostics, such as colonoscopies and mammograms, save lives and head off expensive treatment regimens, some may be unneeded. Sound medical judgment and appropriate guidelines are required.

But, everyone can practice prevention in the form of healthy lifestyles, and it doesn’t cost a dime. Better nutrition and higher levels of physical activity don’t increase cost, and they bring a huge payoff in terms of lower health-care costs, increased productivity and greater quality of life. Getting more active, eating a bit healthier, incorporating some kind of movement into everyday life – those are the main keys to health, longevity and disease prevention. It was recently reported that treating obesity was responsible for the biggest jump in health care spending in recent years; obese populations accounted for $303.1 billion in health care costs in 2006, nearly doubling the $166.7 billion spent on these individuals in 2001.

In a very real sense, exercise is medicine. Studies repeatedly show that physical activity and exercise can help prevent obesity, cardiovascular disease, diabetes and other chronic conditions.

And leading a healthier lifestyle needn’t mean hitting the treadmill every night or becoming fanatical about exercise. Walking for 30 minutes each night after dinner or during a lunch hour has powerful preventive effects and requires just a pair of comfortable walking shoes.

Physicians and other health care providers should encourage patients to become physically active. A public survey conducted in 2007 by the American College of Sports Medicine found that nearly two-thirds of patients (65 percent) would be more interested in exercising to stay healthy if advised by their doctor and given additional resources.

Bottom line: While we trim unnecessary costs to better manage health-care resources, let’s keep in mind the powerful and necessary cost-effective potential of healthy lifestyles. Truly, exercise is medicine—a prescription for better health.


Robert Sallis, M.D., FACSM

Dear Dr. Benjamin,

Congratulations on your nomination as United States Surgeon General. Based on your extraordinary career and your commitment to addressing health disparities among underserved populations, no doubt your tenure will be marked by great progress toward the goal of improved health for all Americans.

Each United States Surgeon General has the unique opportunity to create his or her own lasting legacy. Dr. Koop focused on smoking prevention. Dr. Satcher, one of your own mentors, released the first comprehensive report on mental health. We encourage you to build your own legacy around the concept o prevention through healthy lifestyles – a legacy that is both sustainable and cost-effective.This also is an important issue for Members of Congress, many of whom believe that promoting prevention and wellness initiatives will bring down costs and help people lead healthier lives.  ACSM would be honored to partner with you on such an initiative.

The American College of Sports Medicine (ACSM), the largest sports medicine and exercise science organization in the world, stands ready to work with you to increase healthy behaviors – especially physical activity – throughout the life span.  During this crucial period of health system reform, we’ve been advocating for strategies that support preventive medicine not just through diagnostic testing, but by promoting healthy, active behaviors that all Americans can achieve at little or no cost.

In fact, ACSM already has a working agreement with the Surgeon General’s office, focused initially on a series of healthy-lifestyle public service announcements for our Exercise is Medicine™ program, a program that specifically calls on doctors to encourage their patients to incorporate physical activity and exercise into their daily routine. As you are well aware, physical activity can prevent and treat a host of chronic conditions – such as heart disease, type II diabetes, and obesity – that currently plague our country. Your example as one whose family has suffered from preventable disease and who demonstrates healthy lifestyles can be powerful indeed.

Anytime either before or after your appointment is confirmed, we would welcome the opportunity to meet with you and your staff to discuss how we, along with other leading health organizations, can enhance the prevention paradigm through physical activity.

Again, Dr. Benjamin, I extend our deepest congratulations and best wishes.


James Pivarnik, Ph.D., FACSM

President, American College of Sports Medicine

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