CHAPTeR 6. REGULAR EXERCISE 149 recent controlled studies suggested that counseling for regular exercise in clinical practice may be effective in helping patients to become regular exercisers(5-7). Whether there is high-quality evidence to support exercise counseling in the primary care setting, patients may request advice on how to become more physically active. The goal of this chapter is to guide clinicians on how to provide exercise counseling to their otherwise healthy patients: the sedentary person who wants to exercise; the sedentary person who needs to exercise for risk factor modification and the exerciser who is looking for advice because of injury, burnout or a need for consultation and reinforcement. This chapter presents a practical guide, based on 20 years of experience in the field and an extensive lay literature, on how to effectively offer physical activity counseling. The approach presented in subsequent text therefore reflects an experience-based consensus on fostering leisure-time, health-promoting, regular exercise, for its own sake This chapter does not specifically address the role of regular exercise in either the treatment or management of diseases or pathologic conditions(such as hypertension), or rehabilitation, although many of the basic principles for helping any patient to become a regular exerciser would hold true BASIC CONCEPTS IN EXERCISE Epidemiology of Exercise Epidemiologic data show that regular exercise promotes general health while its lack, known variously as physical inactivity or sedentary lifestyle, increases the risk of a variety of diseases and negative health conditions. At the beginning of the chapter on Physical Activity and Fitness in Healthy People 2010(2)it is stated that Research has demonstrated that virtually all individuals will benefit from regular physical activity... Moderate physical activity can reduce substantially the risk of developing or dying from heart disease, diabetes, colon cancer, and high blood pressure. Physical activity may also protect against lower back pain and some other] forms of cancer(for example breast cancer). On average, physically active people outlive those who are inactive. Regular physical activity also helps to maintain the functional independence of older adults and enhances the quality of life for people of all ages. The 2004"Best Practices Statement"of the American College of S Medicine(ACSM)(8)states Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations a substantial body of scientific evidence indicates that regular