Unlocking Wellness: How an Active Lifestyle Reduces the Risk of 19 Chronic Illnesses

Researchers from the University of Iowa are advocating for all patients to be questioned regarding their levels of physical activity, following a recent study that highlights the connection between physical activity and chronic illness.

The research, spearheaded by Lucas Carr, an associate professor in the Department of Health and Human Physiology, scrutinized responses from over 7,000 patients at the University of Iowa Health Care Medical Center who indicated their physical activity levels in a survey.

The study, titled “Screening Patients for Physical Inactivity Helps Identify Patients at Risk for Cardiometabolic and Chronic Diseases,” was published online in Preventing Chronic Disease.

From the patients’ responses to the questionnaire, the investigators discovered that those who stated they engaged in the highest levels of physical activity—defined as exercising moderately to vigorously for at least 150 minutes each week— were at a statistically significant lower risk of experiencing 19 chronic diseases, such as cardiovascular illness, cancer, respiratory issues, and diabetes.

The results further imply that patients who are the least active—indicating they reported minimal to no exercise in a week—are at heightened risk of developing a chronic condition.

In light of these findings, the researchers at Iowa also suggest that healthcare systems should offer information regarding health and wellness services to physically inactive patients who are at the greatest risk.

“Within our healthcare setting, there is no straightforward way for doctors to be compensated for assisting patients in increasing their physical activity,” Carr, the study’s principal author, states. “Thus, for these patients, many of whom admit to insufficient activity, we require options to easily connect them with supportive services like exercise prescriptions and/or community health professionals.”

According to the researchers, most hospitals in the United States do not inquire about patients’ physical activity, and no hospital system in the Midwest has implemented such inquiries.

During this investigation, Carr collaborated with Britt Marcussen, a family medicine physician at UI Health Care, to present the questionnaire to patients who attended annual wellness exams. The study was conducted from November 2017 to December 2022.

The Exercise Vital Sign survey, as this questionnaire is titled, posed two questions to patients that they answered on a tablet:

• “On average, how many days per week do you partake in moderate to vigorous exercise (such as brisk walking)?” (0-7 days)
• “On average, how many minutes do you engage in exercise at this intensity?”

Carr and his colleagues advocate for making the survey accessible to all patients.

“This two-question survey typically requires fewer than 30 seconds for a patient to finish, ensuring it does not disrupt their appointment. However, it can reveal much about that patient’s overall health,” Carr explains.

The researchers also compared the outcomes from patients who completed the surveys with over 33,000 patients who were not offered the survey in other parts of the hospital. The analysis indicated that those who participated in the survey were younger and healthier than the patient group who did not receive the questionnaire, based on a review of all patients’ electronic medical records.

Although the relationship between physical activity and decreased risk of chronic disease is well-established, the researchers indicate that the study emphasizes the importance of querying patients about their physical activity levels.

“We believe this finding results from those patients who invest the time to attend annual wellness exams are also dedicating more time to engaging in healthy habits, such as maintaining physical activity,” Carr states.

In a related research, published in the Journal of Physical Activity and Health, Carr’s team discovered that when healthcare providers billed for offering exercise counseling to patients, those claims were reimbursed by insurance companies nearly 95% of the time.

“Our discoveries indicate that the recommended billing codes for physical activity receive a high reimbursement rate when providers submit them for payment, which supports the need to offer physical activity surveys and counseling services,” Carr notes.

Cole Chapman, an assistant professor in the College of Pharmacy, is the lead author of the study. Chapman, who joined the Pharmacy faculty in 2019 after obtaining his bachelor’s and doctoral degrees from Iowa, collected and analyzed the data derived from the patients’ electronic medical records.

Marcussen and Mary Schroeder, an associate professor in the Department of Pharmacy Practice and Science within the College of Pharmacy, are co-authors of the study.