Doctors should consider exercise a fifth 'vital sign'

In a new Lancet paper, an international team of researchers set out to examine whether sport and exercise contribute to the health of nations. They argue that although country-wide data on participation in sports are too scarce to draw any firm conclusions in this respect, the existing evidence suggests that regular participation in sports and / or exercise has clear benefits for physical and mental health, and that health professionals need to pay more attention to their patients' fitness.

"Low fitness is a better predictor of mortality than obesity or hypertension, which are health risk factors afforded far greater emphasis than fitness by the media and most health professionals," according to Professor Karim Khan of the University of British Columbia, Canada, one of the paper's authors.

The researchers suggest that if health professionals were to consider exercise levels as a "vital sign", they could provide more help for patients to adopt exercise regimes. This could result in dramatic improvements in the number of people who regularly exercise, in the same way that smoking cessation advice has resulted in reductions in the number of people who smoke in many countries.

Despite the lack of high-quality data on nationwide sport participation levels, existing studies appear to show clear health benefits associated with regular participation in sport and / or exercise. For instance, a series of small randomised clinical trials published in 2010 showed that people who started playing football two or three times a week, having formerly never played the game, experienced reduced risk factors for cardiovascular disease, diabetes and osteoporosis.

Sport can also have a positive effect on health awareness, with the authors mentioning FIFA's 11 for Health education programme in which football superstars such as Cameroon's Samuel Eto'o provide educational messages about health issues for young people. This programme resulted in an 18% improvement in health knowledge in schools in Zimbabwe and Mauritius.

According to the authors, "The evidence for physical activity as a major public health preventative approach and a potent medical therapy has increased exponentially in the 64 years since London, UK, last hosted the Olympic Games…We believe that small changes at the community level and large, nationwide policies and initiatives are needed to improve health at a country level."