• Physical Activity
• Education
• Prevention
• Medicine

I have read with interest articles published by British Journal of Sports Medicine in recent years highlighting the need for greater emphasis on physical activity (PA) in medical student curricula.1 2 Physical inactivity debilitates the nation and puts pressure on the UK National Health Service (NHS).3 PA reduces type 2 diabetes risk, cardiovascular disease and obesity, as well as improves mental well-being.4 5 Despite the importance of regular PA, it is not routinely included in health conversations with patients. I agree with Osborne et al 1 that medical school should provide students with the skills to discuss and advise patients on PA, but this should extend to students asking each patient about their PA level. Students are taught to take a comprehensive history from patients. This includes presenting complaint, history of presenting complaint, medical history, drug history, family history and social history. The social history almost always includes alcohol consumption and smoking status, as these behaviours have harmful effects on health. In a UK consensus statement on the content of medical education curricula,6 it explicitly states that the curriculum should include skills ‘pertaining to… health promotion and behaviour change’. Surprisingly, medical students are not taught to include PA level as part of history taking. Patients are often advised to cut down on the units of alcohol they drink and to quit smoking. By discussing a patient’s level of PA, a doctor can promote the positive effects such activity has on health. The public understand that PA is good for the body, but formally reinforcing this idea during a consultation will have an impact on future behaviour. Inclusion of PA in history taking as part of the curriculum will highlight its importance to both students and patients. This small addition has the potential to make a difference and lessen the burden on the NHS. In addition, enquiring about PA may make it easier for clinicians and students to explore the sensitive subject of weight with patients. If all patients were asked about their PA level in a standardised way, this would not be seen as targeting overweight/obese individuals. Medical students introduced to this approach at university would hopefully gain confidence in asking these questions and continue to use them in practice. Measuring the specific quantity of PA, for example, by using self-report questionnaires, would be time consuming and unhelpful in the clinical setting. However, having an overall idea of the patient’s activity level is useful. The question ‘how physically active are you?’ engages the patient in the topic of PA. They may have never related their activity level to their medical problem and may not understand the health benefits they could gain. There will be times when this question is inappropriate/unnecessary, but there is often opportunity to include it when talking with a patient. The promotion of healthy behaviours such as PA is particularly relevant to medical students. They are the doctors who will be treating physical inactivity-related illnesses in the future. The endorsement of PA by health professionals and students would have positive effect on patient behaviour and help combat the burden of preventable disease. ‘How physically active are you?’: it is a simple question that could have a significant impact.