By: Romina Tollerutti MD

THE LATEST RECOMMENDATIONS ABOUT PHYSICAL ACTIVITY From the Physical Activity Guidelines for Americans, 2nd edition. U.S. Department of Health and Human Services.

Regular Physical Activity is one of the pillars of a healthy life. Everyone benefits from keeping themselves active during the day and sitting less. Scientific evidence about the benefits of physical activity is substantial. This article will review the key recommendations and the benefits of physical activity for adults and children.

According to the Secretary of Health and Human Services: “… about half of all American adults – 117 million people – have one or more preventable diseases. Seven of the ten most common chronic diseases are favorably influenced by regular physical activity. Yet nearly 80% of adults are not meeting the key guidelines for aerobic physical activity.”

What about children? Only 24% of children 6 to 17 years of age participate in the recommended 60 minutes of physical activity every day. According to numbers from 2017:

Only 26.1% of High School students participated in at least 60 minutes per day of physical activity on all 7 days of the previous week.
51.1% of High School students participated in muscle strengthening exercises (like push-ups, weight lifting) on 3 or more days during the previous week.
51.7% of High School students attended physical education classes in an average week, and only 29.9% attended physical education classes daily.

What is a Sedentary Behaviour?

Sedentary behavior is any waking behavior characterized by an energy expenditure ≤ 1.5 metabolic equivalents (METs) while sitting, reclining, or lying.

Examples of Sedentary Behaviour are:

Toddlers and preschoolers (1–4 years): Use of electronic devices (e.g., television, computer, tablet, phone) while sitting, reclining, or lying; reading/drawing/painting while sitting; sitting in a stroller; sitting in baby chair or couch while eating a meal; sitting in a bus, car or train.
Children and youth (5–17 years): Use of electronic devices (e.g., television, computer, tablet, phone) while sitting, reclining or lying; reading/writing/drawing/painting while sitting; homework while sitting; sitting at school; sitting in a bus, car or train.
Adults (≥ 18 years): Use electronic devices (e.g., television, computer, tablet, phone) while sitting, reclining, or lying; reading/writing/talking while sitting; sitting in a bus, car, or train.

Examples of sedentary behavior: (A) Playing video games. (B) Watching TV. © Using a computer. (D) Reading a book.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700832/

You may be thinking: OK, but some of these activities are considered good ones (like reading, drawing, painting) or necessary (like commuting to work or sit on your desk)!. The problem is the amount of time during the day that we spend on these activities.

The U.S. National Health and Nutrition Examination Survey (NHANES) showed that children and adults spend approximately 7.7 hours per day (55% of their monitored waking time) being sedentary in their data collected by devices.

A sedentary lifestyle is strongly associated with:

Increased risk factors for cardiovascular disease: hyperlipidemia (high LDL and triglyceride levels), high blood pressure, obesity, and insulin resistance.
Increase risk for developing Type 2 Diabetes.
Expending less energy than consumed through diet can increase the risk of becoming overweight or obese.
Increase risk for developing breast, colon, endometrial, and lung cancer.
Results in low bone density, which leads to osteoporosis.

What are the Benefits of Physical Activity?

In Adults:

Decreased incidence of cardiovascular disease, including stroke and heart failure.
Reduced cardiovascular disease mortality.
Reduced Blood Pressure in people with normal blood pressure, prehypertension, and hypertension.
Reduced incidence of hypertension.
Weight loss when combined with dietary changes.
Prevention of weight regains after weight loss.
Reduced or slowed weight gain over time.
Reduced incidence of Type 2 Diabetes (any bodyweight).
Reduced risk of adverse lipid profile by increasing HDL and decreasing triglyceride.
Improved Brain Health: with reduction of anxiety and improvement of cognition. Long-term physical activity is linked with reducing the risk of dementia, risk of depression, and improving sleep and quality of life.
Improves physical function and reduces the risk of falling and an injury if a fall occurs (especially important for the elderly).
Improves bone strength reducing the risk for osteoporosis.
For pregnant women reduces the risk of excessive weight gain, gestational diabetes, and postpartum depression.
People with various chronic medical conditions reduce the risk of all-cause and disease-specific mortality, improve physical function, and improve quality of life.

In Children:

Improves cardiovascular fitness.
Builds strong bones and muscles.
Weight control.
Reduce symptoms of depression and anxiety.
Reduces the risk of developing (prevents): Heart disease, cancer, Type 2 Diabetes, high blood pressure, obesity, and Osteoporosis.
Better grades, school attendance, cognitive performance (concentration, memory), and classroom behaviors (like on-task behavior) are linked to physically active students.
Higher physical activity and physical fitness are associated with improved cognitive performance among students.

As you can see, Physical activity benefits your quality of life on many levels. To have an idea of what are the current recommendations, let’s review the following:

What are the Key Guidelines included in the new Physical Activity Guidelines for Americans?:

For Preschool-Aged Children (3-5 years old):

Should be physically active throughout the day to enhance growth and development.
Adult caregivers should encourage active play that includes a variety of activity types.

Personal note: kids at this age tend to be pretty active when allowed. Remember to limit screen time (T.V., tablets, phones) to 2 hours or less per day.

For Children and Adolescents:

Provide the opportunity and encouragement to participate in physical activities appropriate for their age, be enjoyable, and offer variety.
Kids ages 6 – 17 years old 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 a moderate or vigorous aerobic activity, including vigorous physical activity at least 3 days a week.
Muscle-strengthening: As part of their 60 minutes or more of daily physical activity or at least 3 days per week.
Bone-strengthening: As part of the 60 minutes or more of daily physical activity or at least 3 days a week.

For Adults:

Move more and seat less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
For substantial health benefits, should do:

150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity physical activity, 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. Preferable spread throughout the week.

Adults will gain additional health benefits of engaging in physical activity beyond 300 minutes (5 hours) of moderate-intensity a week.
Muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups should be performed 2 or more days a week. (I will explore this topic further in another post)

For Older Adults:

The key guidelines for adults also apply to older adults, with the following additions:

As part of their weekly physical activity, multicomponent physical activity that includes balance training and aerobic and muscle-strengthening exercises should be included.
Older adults should determine their level of effort 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.
Older adults cannot do 150 minutes of moderate-intensity aerobic activity a week due to chronic conditions, and they should be as physically active as their abilities and conditions allow.

For women during pregnancy and the Postpartum Period:

At least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity a week during pregnancy and postpartum. Better if spread during the week.
Women who were physically active before pregnancy can continue these activities during pregnancy and the postpartum period. (unless advised otherwise by their health care provider).
Pregnant women should be under the care of a health care provider who can monitor the pregnancy’s progress and advise them about whether or how to adjust their physical activity during pregnancy and after the baby is born.

The following definitions are important to better understand the recommendations:

What is Intensity?

It is the amount of work performed or the magnitude of the effort required to perform an activity or exercise. When exercising about heart rate goes up, and with regular exercising, your cardiovascular fitness will improve.

Use the following as a guide:

Light-intensity activity: your heart rate will increase, but not too much, and you will be able to have a conversation.

Examples:

walking at a slow o leisurely pace,
fishing
light household chores like cooking, dusting, ironing, folding laundry, washing dishes, and putting away groceries.

Moderate-intensity activities: your heart will beat faster, you will breathe harder than usual, but you’ll still be able to talk.

Examples:

Walking briskly (or with purpose)
racking the yard or gardening
pushing a lawnmower
mopping
vacuuming
Water aerobics
Riding a bike slower than 10 miles per hour
tennis (doubles)
Dancing

Vigorous-intensity activity: you will get warm and sweaty, and out of breath if you try to talk.

Examples:

Shoveling snow
heavy yardwork like continuous digging or hoeing
Carrying a heavy object (groceries) or not that heavy but upstairs
A strenuous fitness class
hiking uphill or with a heavy backpack
running
swimming laps
tennis (singles)
baking 10 miles per hour or faster
jumping rope

What are the levels of physical activity?

This is a concept to describe how much regular aerobic physical activity a person gets. These are related to the level of health benefits a person obtains.

Inactive: a person who is not active beyond basic movement from daily life activities.

Insufficiently active: a person doing some moderate or vigorous-intensity physical activity but less than 150 minutes per week of moderate-intensity or less than 75 minutes per week of vigorous-intensity physical activity (or a combination). This level does not meet the guidelines.

Active: a person who is meeting the guidelines. For an adult: the equivalent of 150 to 300 minutes of moderate-intensity physical activity a week.

Highly Active: a person doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week.

“A single session of moderate-to-vigorous physical activity can reduce blood pressure, improve insulin sensitivity, improve sleep, reduce anxiety symptoms, and improve some aspects of cognition on the day that it is performed. Most of these improvements become even larger with regular performance of moderate-to-vigorous physical activity.”

Let’s get moving!

What if you are starting from zero?

The most important point here: START NOW! But keep in mind the following essential points:

People who are Inactive or Sedentary should start with lower intensity activities and gradually increase the frequency and duration of the exercise.
Exercising is safe for most people. Understand the risks of certain activities, but don’t be afraid of starting.
Choose activities that are right for your fitness level and health goals.
Protect yourself: use appropriate gear and equipment for the activity, choose a safe environment, and when/where/how to be active.
If you have a chronic medical condition, let your health care provider know you want to start exercising. He/she can advise you about the type and amount of activity appropriate for you.
Set a reasonable starting goal (for example, start walking 10-20 minutes per day) and gradually work on going up to reach the recommended amount of physical activity.
Walking is a great exercise to start. You don’t need any gear or equipment (no money investment), and you can split how much you walk during the day (brisk walk of 5-10 minutes a couple of times a day to start).
Listen to your body and increase the amount and intensity as you get stronger.
Move more and sit less every day—any amount of exercise is better than none. Some ideas:

Park your car far from the place you are going,
Use the stairs instead of the elevator (start slowly),
Use your breaks for a brisk walk around or in place (choose the safest option),
Take breaks from sitting if you work on a desk every 20 minutes or so,
If you have to make a phone call, use your headphones or AirPods, walk around while you talk
Spend less time sitting in front of the TV or any other screen at home. Stand up and walk around. Do not spend hours in a row on your couch. Break out of the “couch potato syndrome.” If you need to binge on Netflix for your mental health, investing in a treadmill/elliptical machine/stationary bike to exercise while watching your favorite show may be a good option.

Final thoughts:

Parenting is incredible and exhausting. I am one of you!. Apart from being more fit, I have realized that exercising helps me be in a better mood and have more patience with my kids. It makes me feel good! Focusing on the benefits of exercising and having a goal in mind helps get the energy to do it. Do what you can every day, and do not get stuck on the all-of-nothing thinking. Try to schedule times during the week for physical activity, have some flexibility, so you don’t stress out about it (we don’t need extra pressure, right?), but make it happen. Planing fun physical activities with your family is a great way to enjoy time together and be more active. And don’t forget about being a role model. If your kids see you exercising regularly, they will say yes to do it themselves. Do not delay it, do it! It is an excellent investment in your health.

A positive and funny quote to end: