HHS Issues Physical Activity Guidelines

Posted Oct 13, 2008.By Mary Ellen Schneider

Adults who engage in at least 2.5 hours of moderate-intensity aerobic exercise each week and children who are physically active for 1 hour a day can realize "substantial" health benefits, according to new guidelines from the U.S. Department of Health and Human Services.

There is strong evidence that engaging in the recommended amount of physical activity can reduce the risk of heart disease, stroke, high blood pressure, type 2 diabetes, metabolic syndrome, and colon and breast cancers in adults. For children, regular exercise can improve cardiorespiratory endurance, muscular fitness, and bone health, according to HHS.

The "2008 Physical Activity Guidelines for Americans" is an evidence-based guide to appropriate physical activity for individuals aged 6 years and older. The guidelines, issued in October by HHS, are based primarily on recommendations from an external scientific advisory committee convened in 2007.

This is the first major review of the evidence surrounding the benefits of physical activity in more than a decade, according to HHS. Along with the "Physical Activity Guidelines for Americans," which is aimed primarily at health care professionals and policy makers, HHS has produced a guide for adults called "Be Active Your Way." The consumer guide is designed for men and women aged 18-64 years and suggests moderate-level activities that adults can fit into their lives, such as biking slowly and general gardening.

The recommendations add "validity" to advice from physicians to be active, said Dr. Michelle May, a family physician in Phoenix and chairperson of the American Academy of Family Physician's Americans in Motion Advisory Panel. However, it's critical that physicians don't just tell patients that the government is recommending more exercise. "That's really not what's helpful to patients," she said.

Patients already know that they need to be more active, and for those who have sedentary lifestyles, adding 2.5 hours of exercise a week can be daunting, she said. A more helpful approach is to sit down with patients and find out what they are already doing, what they enjoy doing, and what obstacles keep them from exercising on a regular basis.

For example, if a patient wants to exercise to be healthier but can't find the time because of family commitments, brainstorm with him or her about some family activities that could incorporate moderate physical activity, such as going to the park, Dr. May said.

The guidelines alone won't make much of a difference in behavior, agreed Miriam E. Nelson, Ph.D., vice chair of the scientific advisory committee that worked on the government's new guidelines. However, if the report begins to influence policy makers within schools, businesses, and communities, it could have an impact in the long term, she said. For example, new policies could lead to the construction of more sidewalks and crosswalks, making it possible for children to walk to school.

"We need a collective effort around this," said Dr. Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts University, Boston.

For children and adolescents aged 6-17 years, the guidelines call for engaging in 60 minutes or more of physical activity daily, with most of the time spent on moderate- or vigorous-intensity aerobic activity. Children should be participating in some type of vigorous physical activity at least 3 days a week. As part of their 60 minutes of physical activity, children should also spend at least 3 days a week on muscle- and bone-strengthening activities, according to the guidelines.

But this doesn't mean that children need to be hitting the gym, Dr. May said. Much of the natural play done by children - running, hopping, skipping, and jumping - is aerobic and bone strengthening. "Children naturally want to play and explore," she said.

Finding a safe place for children to play can also be a challenge. In cases where a child's neighborhood isn't safe for play, parents can consider activities at the local YMCA, for example, Dr. May said. Physicians can help by creating a list of local options for physical activity that includes locations and cost. This type of community-specific handout is more effective than a generic list of recommendations for physical activity, Dr. May said.

The HHS guidelines also recommend that adults aged 18-64 years engage in either 2.5 hours of moderate-intensity aerobic exercise or 1 hour and 15 minutes of vigorous-intensity aerobic exercise weekly. Moderate-intensity activities can include brisk walking, general gardening, and ballroom dancing. Vigorous activities include running, swimming laps, hiking uphill, or bicycling 10 miles per hour or faster.

Adults can gain additional health benefits by performing moderate-intensity aerobic activities for 5 hours a week or performing vigorous aerobic exercise for 2.5 hours a week. The guidelines also call for adults to do muscle-strengthening activities 2 or more days each week.

But engaging in any amount of physical activity is better than doing nothing, according to the guidelines. Even exercising in 10-minute increments can have health benefits, according to HHS.

For adults aged 65 and older and those with disabilities or chronic diseases, HHS recommends avoiding inactivity and being as active as a person's age or physical condition allows. Patients who are at risk for falls should focus on activities that maintain or improve balance.

Pregnant and postpartum women should try to meet the 2.5-hour requirement for moderate-intensity aerobic activity each week. Pregnant women who already engage in vigorous exercise don't need to significantly scale back their exercise regimens but should consult with their health care provider about their activity level throughout pregnancy, according to the guidelines. The guidelines are available online at www.health.gov/paguidelines.