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If exercise is so important for good health, why don't doctors actually prescribe it?

Actually, some do, according to a recent report in the Journal of Clinical Outcomes Management, which concludes that while there is little hard data, exercise prescriptions seem to help get patients moving.

Numerous studies have shown that increases in physical activity can reduce the risk for cardiovascular disease, type 2 diabetes, depression, certain cancers and other conditions. The problem has been getting people to exercise -- even to just take a walk.

One solution, Drs. Caroline R. Richardson and Thomas L. Schwenk of the department of family medicine at the University of Michigan Medical School wrote in their paper, is to literally write down exactly how much a patient should walk day by day. For instance, said Richardson, the doctor might write a prescription telling the patient to start with 3,500 steps -- as counted by a pedometer -- on Monday, Wednesday and Friday, then gradually increase to 5,000 steps five days a week and report back a couple of months later.

"If you write down on a prescription pad very specific exercise goals, if you make it very concrete and sign your name, that helps people get started. It's much better than just verbal recommendations," Richardson said.

Wendy Landman , executive director of WalkBoston, a nonprofit advocacy group working to encourage walking and make communities more walkable, said her group is developing a program to promote walking prescriptions, as well as other strategies to get people walking. WalkBoston is also trying to remove impediments to walking -- such as trash on the streets, and ice and snow in the winter.

Public health campaigns, such as one launched by the city of Somerville and Tufts University researchers to get first-, second-, and third-graders in Somerville to eat better and exercise more, are also a step in the right direction, Landman said.