Physical Activity Guidelines for Americans

Piercy KL, Troiano RP, Ballard RM, et al.
The Physical Activity Guidelines for Americans. JAMA 2018;Nov 12:[Epub ahead of print].

The following are key perspectives from this Special Report on the new Physical Activity Guidelines for Americans:

  1. In the United States, an estimated $117 billion in annual healthcare costs and about 10% of premature deaths are associated with inadequate physical activity. Although the latest federal monitoring data show some improvements in physical activity levels among US adults, as of 2016 (adults) and 2015 (adolescents), only 26% of men,19% of women, and 20% of adolescents report performing enough activity.
  2. The Department of Health and Human Services has published updated Physical Activity Guidelines for Americans based on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, which included a systematic review of the science supporting physical activity and health.
  3. A significant change since the 2008 Physical Activity Guidelines for Americans is that previously, aerobic physical activity for adults had to be accumulated in bouts, or sessions, that lasted at least 10 minutes to count toward meeting the key guidelines. Current evidence shows that the total volume of moderate-to-vigorous physical activity is related to many health benefits; bouts of a prescribed duration are not essential. Sufficient physical activity is defined as at least 150 minutes of moderate-intensity aerobic physical activity and 2 days per week of muscle-strengthening activity for adults and at least 60 minutes of moderate-intensity aerobic physical activity and 3 days per week of muscle-strengthening activity for youth.
  4. Preschool-aged children (ages 3-5 years) should be physically active throughout the day to enhance growth and development. Increased physical activity is associated with improvements in bone health and weight status. Children and adolescents ages 6-17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Increased physical activity is associated with improvements in bone health, weight status, cardiorespiratory fitness, and cardiometabolic health. Additional benefits include improved cognitive function and reduced risk of depression.
  5. Adults should do at least 150-300 minutes a week of moderate-intensity, or 75-150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Adults should perform muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Benefits of increased physical activity include lower risk of mortality including cardiovascular mortality, lower risk of cardiovascular events and associated risk factors (hypertension and diabetes), and lower risk of many cancers (including bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach). Additional improvments have been seen in cognition, risk of dementia, anxiety and depression, improved bone health, lower risk of falls, and associated injuries.
  6. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week.
  7. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity.
  8. Both aerobic and muscle-strengthening physical activity are beneficial. Some health benefits begin immediately after exercising, and even short episodes or small amounts of physical activity are beneficial.
  9. Technology, such as step counters or other wearable devices or fitness apps, can provide physical activity feedback directly to the user. Technology can be used alone or combined with other strategies, such as goal setting and coaching, to encourage and maintain increased physical activity.
  10. Health care professionals can also partner with other sectors to promote physical activity. The 2016 National Physical Activity Plan identified nine sectors of society that have a role to play in promoting physical activity. For example, health care professionals can link patients or clients to physical activity programs within the Community, Recreation, Fitness, and Parks sectors. Implementing population-level approaches to improve physical activity requires collaboration across these sectors at local, state, and national levels.

Clinical Topics: Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Exercise, Hypertension, Sleep Apnea, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology

Keywords: Accidental Falls, Adolescent, Anxiety, Child, Child, Preschool, Chronic Disease, Cognition, Dementia, Depression, Diabetes Mellitus, Exercise, Exercise Therapy, Health Care Costs, Hypertension, Neoplasms, Physical Fitness, Postpartum Period, Primary Prevention, Pregnancy, Risk Factors

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