There is nothing miraculous about exercise. What is extraordinary is how long it is taking mainstream medicine to accept the importance of physical activity. A recent report from the Academy of Medical Royal Colleges, Exercise: the Miracle Cure and the Role of the Doctor in Promoting It, reminds us of the benefits of physical activity,1 but we already know that it is effective in primary prevention, secondary prevention, and in the treatment of many common diseases. The report builds on decades of epidemiological evidence, years of identifying the “potential” health gain if physicians successfully prescribed physical activity, and even support efforts to medicalise inactivity by labelling it “sedentary death syndrome.”2

The role of doctors in promoting exercise has slowly developed through recent global dissemination of concepts such as “Exercise is Medicine,” started by the American College of Sports Medicine and adopted particularly in Canada, Australia, and South America,3 and “Health Enhancing Physical Activity,” initiated by WHO Europe.4 Promoting physical activity is, however, a major challenge in the modern environment with our lifestyle designed to reduce or eliminate physical activity at every opportunity.

Exercise is one of …