Friday, 14 Dec 2018

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Physical Activity Guidelines for Americans

The data are clear and disappointing: despite the well-known health benefits, four out of five US adults are not active physically.  JAMA has published the new US Physical Activity Guidelines for Americans, so that health professionals and policy makers can promote lifestyle changes and awareness of the the health benefits of physical activity.

The report stems from the 2018 Physical Activity Guidelines (PAG) Advisory Committee's systematic review of the literature supporting physical activity and health. The evidence was graded as strong or moderate. 

Some of the benefits of physical activity include: 

  • Improved bone health and weight status for children aged 3 through 5 years
  • Improved cognitive function for youth aged 6 to 13 years
  • Reduced risk of cancer at additional sites
  • Brain health benefits, including improved cognitive function, reduced anxiety and depression risk, and improved sleep and quality of life
  • Reduced risk of fall-related injuries for older adults
  • For pregnant women, reduced risk of excessive weight gain, gestational diabetes, and postpartum depression
  • For people with various chronic medical conditions, reduced risk of all-cause and disease-specific mortality, improved function, and improved quality of life

The PAG guidelines provide information and guidance on the types and amounts of physical activity to improve health outcomes.

Guidelines for Children and Adolescents include:

Preschool-aged Children

  • Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development.
  • Adult caregivers of preschool-aged children should encourage active play that includes a variety of activity types.

School-aged Children and Adolescents

  • It is important to provide young people opportunities and encouragement to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety.
  • Children and adolescents aged 6 through 17 years should do 60 minutes (1 hour) or more of moderate-to-vigorous physical activity daily
  • Aerobic: Most of the 60 minutes or more per day should be either moderate- or vigorous-intensity aerobic physical activity and should include vigorous-intensity physical activity on at least 3 days a week.
  • Muscle-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days a week.
  • Bone-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days a week.

Guidelines for Adults include:

  • Adults should move more and sit less throughout the day. Some physical activity is better than none. 
  • For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week.
  • Additional health benefits are gained by doing physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
  • Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.
  • Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities

Older Adults:

  • As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities.
  • Older adults should determine their level of effort for physical activity relative to their level of fitness.
  • Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.
  • When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.

Guidelines during Pregnancy include:

  • Women should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity a week during pregnancy and the postpartum period. Preferably, aerobic activity throughout the week.
  • Women who habitually engaged in vigorous-intensity aerobic activity or who were physically active before pregnancy can continue these activities during pregnancy and the postpartum period.
  • Women who are pregnant should be under the care of a health care practitioner who can monitor the progress of the pregnancy. Women who are pregnant can consult their health care practitioner about whether or how to adjust their physical activity during pregnancy and after the child is born.

The authors point out that "being physically active is one of the best investments individuals and communities can make in their health and welfare. Now is the time to take action and help more individuals in the United States attain the numerous benefits of physical activity."

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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