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Introduction

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Exercise in the prevention of coronary heart disease: today’s best buy in public health.

Jeremy Morris, 1994

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The three previous editions of Clinical Sports Medicine focused on how to practice sports and exercise medicine. This chapter takes us back one step to “why?” Why practice sports and exercise medicine?

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The burden of physical inactivity and sedentary behavior

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Where to start? Surf the web, read any magazine, look around you as you walk down the street. The problem of physical inactivity is not subtle, and this chapter aims to provide a launching pad for the sports clinician—a key agent in the war against physical inactivity.

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The one trillion dollar argument (US alone!)

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The year 2000 seems like antiquity, but even then physical inactivity cost the US $1 trillion annually.1 This information gained enormous exposure and the fundamental data and methods that underpin those calculations still apply. Methods to analyze economic burden of disease have been refined,2 updated, and expanded3 to include many additional costs. Thus, the costs of physical inactivity can only have increased in the past decade (Table 1.1). Note that a week of physical inactivity is estimated to incur the same health costs as a week of smoking.4

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Table 1.1

Conditions precipitated by physical inactivity and resulting health care costs in the US

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Physical fitness—more health benefits than smoking cessation or weight loss

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Having identified that physical inactivity is a problem, we can look for a solution. How can the problem of physical inactivity be addressed? Physical activity! It is known that physical fitness provides more health benefits than smoking cessation or losing weight.5 Numerous systematic reviews expound the many health benefits of physical activity, but systemic reviews are complex, predictable, and unemotional—a perfect combination for boring the general public and policy makers alike.

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However, brief slogan-like (“sticky”) messages (see also Chapter 16 for more on “sticky messages”) are useful in helping convince people that physical activity is a remarkable medical therapy. Some ...

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