Sedentary behavior is one of the five risk factors for cardiovascular disease. Physical activity is a boon for heart health as it reduces blood pressure and LDL cholesterol, increases HDL cholesterol, and promotes insulin selectivity. Also, it is a supportive aid to weight loss and an essential one for weight maintenance. Despite these benefits, less than 20% of adults meet national physical activity guidelines.
The Physical Activity Guidelines for Americans issued by the US Department of Health and Human Services recommend that for substantial health benefits, adults should do:
- At least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or
- 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or
- An equivalent combination of moderate- and vigorous-intensity aerobic activity.
Preferably, aerobic activity should be spread throughout the week. Adults are also recommended to do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on two or more days a week, as these activities provide additional health benefits.
So, what’s keeping people from achieving these targets? One of the most frequently patient-cited barriers to engaging in exercise or physical activity is lack of time. However, for the majority of middle class and affluent people, this shouldn’t be a barrier. The Bureau of Labor Statistics reports that Americans average 34 hours per week in employed working hours. Household responsibilities and child/elder care eat up an additional 49 or so hours per week. Add sleep to that, and we are left with around 29 hours available for other activities. People from lower socioeconomic strata often have legitimate time constraints due to holding two or three less-flexible jobs and requiring circuitous routes on public transportation, but even people in these circumstances should be encouraged to engage in physical activity when they can, as health and well-being benefits accrue from any amount of exercise.
Often people say they do not have the time to exercise, because it is an easy explanation. However, the reasons are likely more complicated. In fact, at Silver Fern, our Physical Activity assessment module explores fourteen barriers to physical activity, helping clinicians and their patients uncover what’s truly getting in the way. While time may be part of the picture, it could also be, “this activity is not important enough for me,” or “I haven’t found an exercise that I enjoy.”
Here are five ways you can help patients when they say time is a barrier:
- Show them why exercise is critical to their personal goals. For example, the older adult who wants to remain in her home needs to exercise if she wants to continue to be able to complete daily living activities by herself. The middle-aged man who wants to continue the family tradition of joining the community Turkey Trot on Thanksgiving needs to exercise to finish the race without getting winded before the first turn in the road. Framing the benefits of physical activity in a way that are specific to the patient’s personal goals will help them to prioritize it and stay motivated.
- Help them find time in their schedule. Once the benefits and importance of exercise are established with the individual patient, the focus shifts to prioritization and time management. Review the patient’s schedule with them to see where there is time to fit in physical activity and have them schedule the time as an appointment in their calendars so they treat it like other important events.
- Help them find an activity they enjoy. Remind patients that there is a broad definition of physical activity. Fun activities like dancing or playing outdoors with children are exercise. Gardening and yard work are also great forms of exercise. Help the patient explore what options are available to them and encourage them to try new types of physical activity that are accessible and safe based on their personal health situation.
- Help them plan physical activity in smaller bites if long stretches are too challenging. The duration and frequency of exercise is flexible and up to the patient. A ten-minute brisk walk with the dog before work, a 15-minute bike ride, or a walking meeting count toward the weekly total.
- Help patients modify their approach to daily activities to increase opportunities for physical too. Remind patients that we all have opportunities in our everyday life to add physical activity here and there. Recommend that they take the stairs instead of the elevator or that they park their car in the farthest spot from the store.
Regular physical activity is one of the most important actions people can take to feel better, stay healthier, and ward off or control chronic disease. Helping patients understand how physical activity fits into their own goals, and then helping them work through the “I don’t have enough time,” barrier, is essential for them to experience the benefits to their hearts and minds.
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Nora Saul is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Nora has more than 25 years of experience in the field of diabetes education, consulting for the Joslin Diabetes Center and other industry partners. Nora leads content development for Silver Fern’s diabetes products and training.