The recognition that adverse health outcomes are related to a sedentary lifestyle has created an opportunity for physicians to promote regular exercise in the office setting. The role of pediatricians in exercise guidance is indicated by the long-term salutary effects of exercise that begins in childhood and adolescence. However, a number of obstacles have prevented pediatricians from playing a role in delivering physical activity guidance for their young patients. These include the lack of an evidence-based means of creating an activity prescription, lack of expertise and time, and questions of reimbursement. This review addresses this issue, suggesting a number of alternative approaches for pediatricians in activity counseling. Whether these can be effectively delivered in the office setting, however, remains to be determined.
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