Exercise Prescriptions for Cardiometabolic Health

Now more than ever, both children and adults are spending copious amounts of time in sedentary behavior—defined as any waking behavior characterized by a low energy expenditure while in a sitting or reclining posture.¹ Sedentary behavior, in and of itself, has emerged as a potential risk factor for cardiometabolic health, chronic disease, and mortality.^1,2

And yet, for many, a sedentary lifestyle has become the norm. Throw in a 30-minute workout a few times a week, and the average individual may even consider themselves to be physically active. The medical community says this is not enough. Current health policy guidelines recommend at least 150 minutes of physical activity per week coupled with reduced daily sedentary behavior by interrupting prolonged sitting with bouts of light activity every 30 minutes to promote health and quality of life.³ Anything less is considered physical inactivity, which is one of the most prevalent major health risk factors, with 8 in 10 US adults not meeting aerobic and muscle-strengthening guidelines.⁴ Over 80% of adolescents do not do enough aerobic physical activity to meet the guidelines for youth; many children spend more than seven and a half hours a day in front of a screen.⁵

Physical inactivity accounts for more cardiovascular disease (CVD)–related deaths (37%) than smoking (19%) and hypertension (13%) combined, and 15-17% of all premature deaths are attributable to low fitness according to data from a 2018 study.³ The American Heart Association (AHA) promotes physical activity as part of its 2020 Impact Goals to improve cardiovascular health and reduce deaths caused by stroke and cardiovascular disease.⁴ In April 2018, the AHA issued a scientific statement recommending a “systems change” approach for ameliorating sedentary behavior by imploring healthcare providers to call on others in the community, like clinical and community care providers, fitness experts, health coaches, and other stakeholders, to help get people moving.⁴

How can clinicians help patients modify sedentary behaviors—many of which are involuntary—and incorporate physical activity into their daily lives? Functional Medicine educators teach clinicians how to craft sustainable, personalized exercise prescriptions to reduce cardiometabolic risk for patients who are struggling with sedentary behavior and physical inactivity. “IFM has a wonderful tool in the toolkit that helps [clinicians] walk patients through the process of writing an exercise prescription,” says IFM educator Cheryl Montgomery, who offers Functional Medicine health coaching at the office of Shilpa Saxena, MD. “I think this is fantastic because when you tell your patient to go exercise, they are much more likely to do it if you hand them a piece of paper—just like if you write them a prescription for medication or a nutraceutical—they are more likely to do it if they have something in their hand.”

In the following video, IFM educator Elizabeth Boham, MD, MS, RD, talks about ways to improve a
patient’s health through exercise.