How much more evidence do we need, that exercise is good and any amount is better than none?
I was about to be put in blood pressure medication. Then I started a gym, with a trainer. I noticed that, after the exercise, blood pressure would immediately drop and stay low for a few hours.
Over time, the amount of time it spent lower than average increased, and it got lower and lower. It crossed 24h.
Now? I can go to the gym Mon/Wed/Fri and it will remain low at all times. I did stop for a couple of weeks and it started creeping back up so it's not a 'cure', but functionally, as long as I keep it up, I have normal BP.
I still have some weight to lose, that can further help things, most likely. And removing sugars also did help since I dropped a lot of liquid I was retaining.
Anybody can spike to 180 in a sufficiently stressful situation. (And, personally, I would very much notice 180. Otherwise calm, I'll probably notice 140.)
We don't need "more" evidence exactly, but rather a better model of how the effects of exercise map to a given individual's physiology. Exercise is good overall, but it's also considerably overhyped due to a procession of weak and narrowly-applicable results being misconstrued as adding up to a massive pile of benefits that applies to the average person. In reality, the average person does not get anywhere close to the sum of all the touted benefits; they get some constellation of some of the benefits, while other outcomes are flat or even regress [1].
So yes, "exercise is good" at a sufficient level of abstraction, but it's much harder to make the case that it's "good for [specific outcome] for [specific person]". Which is one reason that it's such an obnoxious trend for specific health complaints to be met with generic recommendations to exercise (or exercise more, or exercise differently).
It's not as true in some places in some circles, but it's hard not to notice a difference when you temporarily visit the others.
The NHS doesn't seem (as an outsider looking in) to do well with preventative care. I firmly believe (without necessarily a lot of evidence) that if we focused more on healthy lifestyles and made them more cost effective for people the amount of money we plough into the NHS every year could be reduced drastically.
The UK now has a sugar tax on soft drinks that seems to be having a measurable positive effect. Whether it is a meaningful effect remains to be seen though:
"The findings suggest that a year after the sugar tax was introduced, adults reduced their daily free sugar intake by about 10.9g, and a reduction in soft drinks accounted for over half of this reduction. This translates to a reduction of around 40 calories daily, which if maintained, and assuming no other changes, could lead to 1.5kg weight loss over a year."
https://theconversation.com/how-do-we-know-the-uks-sugar-tax...
So perhaps instead of exhorting people to do better the state should continue to try to make bad habits more expensive and good habits cheaper.
Ultimately it's down to the patient to put in the work but if the NHS focused more on creating community practices where these things could be more widely available then maybe we should see more meaningful change.
Of course doing 1 hour a day is better than nothing but it may not be effective