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Exercise promotion schemes a waste of effort

Promoting exercise intensively in primary care appears to be a waste of effort, with no evidence that it is any better than simply offering patients an information leaflet.

UK researchers warned GPs to be sceptical over commissioning exercise promotion services after finding no benefit for either telephone or face-to-face exercise advice.

In the Proactive study – of 365 sedentary adults with a family history of type 2 diabetes – all participants received advice leaflets but some were also offered telephone support or four hour-long home visits.

Over the year long study, published in the latest issue of The Lancet, neither intervention proved more effective than advice leaflets alone in terms of daily energy expenditure.

The participants all increased their physical activity by the equivalent of 20 minutes of brisk walking every day.

There was no difference between groups in weight loss, BMI, waist circumference, fat percentage, blood pressure, glycosylated haemoglobin or biochemistry.

But programme attendance and patient acceptability were high throughout the study and most participants said they had used the behaviour change strategies they had learnt.

The research team, from the department of primary care at the University of Cambridge, said the results suggested approaches based on personal education and individual behaviour change alone were unlikely to work when in a culture where there are plenty of incentives to ‘keep still'.

Future preventive strategies need to take into account the need for ‘wider public-health strategies and sociocultural change', they concluded.

Dr Ahzar Farooqi, a GP in Leicester and member of the Primary Care Diabetes Society, said the study showed how hard it was for GPs to improve patients' levels of physical activity.

"There is some evidence elsewhere that quite intensive intervention can make a difference but superficial intervention doesn't do much good.

‘The message for GPs is it's very difficult to get people to change with the amount of time we have. Future research needs to look at identifying people who are more willing to change.'

Woman on scales

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