US Physical Activity

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U.S. Department of

Health and Human Services

2008 Physical Activity

Guidelines for Americans

Be Active, Healthy, and Happy!

www.health.gov/paguidelines
http://www.health.gov/paguidelineshttp://www.health.gov/paguidelines


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THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

Iampleasedtopresentthe2008PhysicalActivityGuidelinesforAmericans,thefirstcomprehensive

guidelinesonphysicalactivityevertobeissuedbytheFederalgovernment.Thisdocumentis

intendedtobeaprimarysourceofinformationforpolicymakers,physicaleducators,health

providers,andthepublicontheamount,types,andintensityofphysicalactivityneededtoachieve

manyhealthbenefitsforAmericansacrossthelifespan.Thegoodnewsisthattheseguidelinesare

achievableandcanbecustomizedaccordingtoapersonsinterests,lifestyle,andgoals.

ThisdocumentisbasedonthereportsubmittedbythePhysicalActivityGuidelinesAdvisory

Committee,agroupcomprising13leadingexpertsinthefieldofexercisescienceandpublichealth.Thecommitteeconductedanextensivereviewofthescientificdatarelatingphysical

activitytohealthpublishedsincethereleaseofthe1996SurgeonGeneralsReportonPhysical

ActivityandHealth.IwanttothanktheCommitteeandotherpublicandprivateprofessionals

whoassistedincreatingthisdocumentfortheirhardworkanddedication.

AlongwithPresidentBush,Ibelievethatphysicalactivityshouldbeanessentialcomponentof

anycomprehensivediseasepreventionandhealthpromotionstrategyforAmericans.Weknow

thatsedentarybehaviorcontributestoahostofchronicdiseases,andregularphysicalactivityis

animportantcomponentofanoverallhealthylifestyle.Thereisstrongevidencethatphysically

activepeoplehavebetterhealth-relatedphysicalfitnessandareatlowerriskofdevelopingmany

disablingmedicalconditionsthaninactivepeople.

Preventionisoneofmytoppriorities.Althoughphysicalactivityisclearlyvitaltoprevention,

itiseasyformanyofustooverlook.ThesePhysicalActivityGuidelinesforAmericansprovide

achievablestepsforyouth,adults,andseniors,aswellaspeoplewithspecialconditionstolive

healthierandlongerlives.

Sincerely,

MichaelO.Leavitt


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2008 Physical Activity Guidelines for Americansii


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Acknowledgments

TheU.S.DepartmentofHealthandHumanServices(HHS)wouldliketorecognizetheeffortsofthePhysicalActivity

GuidelinesSteeringCommitteethatoversawtheworkofthePhysicalActivityGuidelinesAdvisoryCommitteeand

thePhysicalActivityGuidelineswritinggroup:RearAdmiralPenelopeSladeRoyall,PT,MSW(OfficeofDisease

PreventionandHealthPromotion;Director,SecretarysPreventionPriority);CaptainRichardP.Troiano,PhD

(NationalInstitutesofHealth;PhysicalActivityGuidelinesCoordinatorandAdvisoryCommitteeExecutiveSecretary);

MelissaA.Johnson,MS(PresidentsCouncilonPhysicalFitnessandSports;PhysicalActivityOutreachCoordinator);

HaroldW.(Bill)KohlIII,PhD(CentersforDiseaseControlandPrevention(CDC);PhysicalActivityScienceCoordinator

untilOctober2007);andJanetE.Fulton,PhD(CDC;PhysicalActivityScienceCoordinatorbeginningOctober2007).

TheDepartmentisgratefulforthecontributionsoftheHHSscientistsandstaffwhoparticipatedinthePhysical

ActivityGuidelineswritinggroupthatdevelopedandcreatedthisdocument:DavidM.Buchner,MD,MPH(chair);JenniferBishop,MPH;DavidR.Brown,PhD;JanetE.Fulton,PhD;DeborahA.Galuska,PhD,MPH;Commander

JulieGilchrist,MD;JackM.Guralnik,MD,PhD;JenniferM.Hootman,PhD,ATC;MelissaA.Johnson,MS;

HaroldW.(Bill)KohlIII,PhD;SarahM.Lee,PhD;KathleenA.(Kay)Loughrey,MPH,MSM;JudithA.McDivitt,

PhD;DeniseG.Simons-Morton,MD,PhD;AshleyWilderSmith,PhD,MPH;WilmaM.Tilson,MPH;

CaptainRichardP.Troiano,PhD;JaneD.Wargo,MA;GordonB.Willis,PhD;andthescientificwriter/editor,

AnneBrownRodgers.

TheDepartmentalsogratefullyacknowledgestheworkconductedbythe2008PhysicalActivityGuidelines

AdvisoryCommittee.Theirextensivereviewofthescientificliteratureonphysicalactivityandhealthandtheir

committeedeliberationsaresummarizedinthePhysical Activity Guidelines Advisory Committee Report, 2008.

TheCommitteesreportprovidedthebasisforthe2008 Physical Activity Guidelines for Americans.TheAdvisory

CommitteeconsistedofWilliamL.Haskell,PhD(chair);MiriamE.Nelson,PhD(vice-chair);RodK.Dishman,PhD;EdwardT.Howley,PhD;WendyM.Kohrt,PhD;WilliamE.Kraus,MD;I-MinLee,MBBS,ScD;AnneMcTiernan,

MD,PhD;RussellR.Pate,PhD;KennethE.Powell,MD,MPH;JudithG.Regensteiner,PhD;JamesH.Rimmer,PhD;

andAntronetteK.(Toni)Yancey,MD,MPH.

TheDepartmentalsoacknowledgestheimportantroleofthosewhoprovidedcommentsthroughoutthePhysical

ActivityGuidelinesdevelopmentprocess.Finally,theDepartmentappreciatesthecontributionsofnumerousother

departmentalscientists,staff,policyofficials,andtheexternalpeerreviewerswhoreviewedthe2008 Physical

Activity Guidelines for Americansandprovidedhelpfulsuggestions.

Acknowledgments


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Contents

2008 Physical Activity Guidelines for Americans Summary...........................................................................vi

KeyGuidelinesforChildrenandAdolescents..................................................................................................vii

KeyGuidelinesforAdults..................................................................................................................................vii

KeyGuidelinesforOlderAdults

.........................................................................................................................vii

KeyGuidelinesforSafePhysicalActivity

.......................................................................................................viii

KeyGuidelinesforWomenDuringPregnancyandthePostpartumPeriod..............................................viii

KeyGuidelinesforAdultsWithDisabilities

....................................................................................................viii

KeyMessagesforPeopleWithChronicMedicalConditions

........................................................................viii

A Roadmap to the 2008 Physical Activity Guidelines for Americans

..........................................................ix

Chapter 1: Introducing the 2008 Physical Activity Guidelines for Americans.................................................1

WhyandHowtheGuidelinesWereDeveloped..................................................................................................1

TheFrameworkforthePhysicalActivityGuidelinesforAmericans..............................................................2

PuttingtheGuidelinesIntoPractice.....................................................................................................................5

Chapter 2: Physical Activity Has Many Health Benefits.................................................................................. 7

ExaminingtheRelationshipBetweenPhysicalActivityandHealth...............................................................7

TheHealthBenefitsofPhysicalActivity.............................................................................................................9

Chapter 3: Active Children and Adolescents....................................................................................................15

ExplainingtheGuidelines

................................................................................................................................... 16

MeetingtheGuidelines

........................................................................................................................................ 18

GettingandStayingActive:Real-LifeExamples

............................................................................................ 19

Chapter 4: Active Adults........................................................................................................................................21

ExplainingtheGuidelines

....................................................................................................................................21

MeetingtheGuidelines.......................................................................................................................................24

SpecialConsiderations.........................................................................................................................................25


...........................................................................................26

Chapter 5: Active Older Adults.............................................................................................................................29

ExplainingtheGuidelines................................................................................................................................... 29

MeetingtheGuidelines........................................................................................................................................ 32

SpecialConsiderations.........................................................................................................................................32


............................................................................................ 34

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Chapter 6: Safe and Active....................................................................................................................................35

ExplainingtheGuidelines................................................................................................................................... 35

GraduallyIncreasingPhysicalActivityOverTime:Real-LifeExamples.....................................................40

Chapter 7: Additional Considerations for Some Adults

.................................................................................41

PhysicalActivityforWomenDuringPregnancyandthePostpartumPeriod.............................................41

PhysicalActivityforPeopleWithDisabilities.................................................................................................42

PhysicalActivityforPeopleWithChronicMedicalConditions...................................................................43

Chapter 8: Taking Action: Increasing Physical Activity Levels of Americans...........................................45

WhatCanAdultsDoToGetEnoughPhysicalActivity?................................................................................46

HowCanWeHelpChildrenandAdolescentsGetEnoughPhysicalActivity?

...........................................46

WhatCanCommunitiesDoToHelpPeopleBeActive?

.................................................................................48

Glossary

.......................................................................................................................................................................51

Appendix 1. Translating Scientific Evidence About Total Amount and Intensity of

Physical Activity Into Guidelines..........................................................................................................................54

Background............................................................................................................................................................54

TwoMethodsofAssessingAerobicIntensity

.................................................................................................55

DevelopingGuidelinesBasedonMinutesofModerate-andVigorous-IntensityActivity...................... 55

UsingRelativeIntensityToMeetGuidelinesExpressedinTermsofAbsoluteIntensity..........................56

Appendix 2. Selected Examples of Injury Prevention Strategies for Common

Physical Activities and Sports ..............................................................................................................................58

Appendix 3. Federal Web Sites That Promote Physical Activity..................................................................60

IndividualsandFamilies.....................................................................................................................................60

Schools...................................................................................................................................................................60

Communities..........................................................................................................................................................60

HealthCare.............................................................................................................................................................61

Worksites.................................................................................................................................................................61

Contents


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2008 Physical Activity Guidelines forAmericansSummary

Beingphysicallyactiveisoneofthemostimportant

stepsthatAmericansofallagescantaketoimprove

theirhealth.The2008 Physical Activity Guidelines

for Americans providesscience-basedguidanceto

helpAmericansaged6andolderimprovetheirhealth

throughappropriatephysicalactivity.

TheU.S.DepartmentofHealthandHumanServices(HHS)issuesthePhysical Activity Guidelines for

Americans.ThecontentofthePhysical Activity

GuidelinescomplementstheDietary Guidelines

for Americans, ajointeffortofHHSandthe

U.S.DepartmentofAgriculture(USDA).Together,

thetwodocumentsprovideguidanceonthe

importanceofbeingphysicallyactiveandeatinga

healthydiettopromotegoodhealthandreducethe

riskofchronicdiseases.

TheprimaryaudiencesforthePhysical Activity

Guidelines arepolicymakersandhealthprofessionals.TheseGuidelinesaredesignedtoprovideinformation

andguidanceonthetypesandamountsofphysical

activitythatprovidesubstantialhealthbenefits.This

informationmayalsobeusefultointerestedmembers

ofthepublic.ThemainideabehindtheGuidelinesis

thatregularphysicalactivityovermonthsandyears

canproducelong-termhealthbenefits.Realizingthese

benefitsrequiresphysicalactivityeachweek.

Regularphysicalactivitycanproducelong-

termhealthbenefits.

ThestepsusedtodevelopthePhysical Activity

Guidelines for Americansweresimilartothoseused

fortheDietary Guidelines for Americans. In2007,

HHSSecretaryMikeLeavittappointedanexternal

scientificadvisorycommittee,calledthePhysical

ActivityGuidelinesAdvisoryCommittee.TheAdvisory

Committeeconductedanextensiveanalysisofthe

scientificinformationonphysicalactivityandhealth.

ThePhysical Activity Guidelines Advisory Committee

Report, 2008andmeetingsummariesareavailableat

http://www.health.gov/PAGuidelines/.

HHSprimarilyusedtheAdvisoryCommitteesreport

butalsoconsideredcommentsfromthepublicand

GovernmentagencieswhenwritingtheGuidelines.

TheGuidelineswillbewidelypromotedthrough

variouscommunicationsstrategies,suchasmaterials

forthepublic,Websites,andpartnershipswith

organizationsthatpromotephysicalactivity.

ThePhysical Activity Guidelines for Americans

describesthemajorresearchfindingsonthehealth

benefitsofphysicalactivity:

Regularphysicalactivityreducestheriskofmany

adversehealthoutcomes.

Somephysicalactivityisbetterthannone.

Formosthealthoutcomes,additionalbenefits

occurastheamountofphysicalactivityincreases

throughhigherintensity,greaterfrequency,and/or

longerduration.

Mosthealthbenefitsoccurwithatleast150minutes

(2hoursand30minutes)aweekofmoderate-

intensityphysicalactivity,suchasbriskwalking.Additionalbenefitsoccurwithmorephysicalactivity.

Bothaerobic(endurance)andmuscle-strengthening

(resistance)physicalactivityarebeneficial.

Healthbenefitsoccurforchildrenandadolescents,

youngandmiddle-agedadults,olderadults,and

thoseineverystudiedracialandethnicgroup.

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Thehealthbenefitsofphysicalactivityoccurfor

peoplewithdisabilities.

Thebenefitsofphysicalactivityfaroutweighthe

possibilityofadverseoutcomes.

ThefollowingarethekeyGuidelinesincludedinthe

Physical Activity Guidelines for Americans:

Key Guidelines for Children and Adolescents

Childrenandadolescents

shoulddo60minutes

(1hour)ormoreof

physicalactivitydaily.

Aerobic: Mostofthe

60ormoreminutes adayshouldbe

eithermoderate- or

vigorous-intensity

aerobicphysicalactivity,

andshouldincludevigorous-intensityphysical

activityatleast3daysaweek.

Muscle-strengthening:Aspartoftheir60ormore

minutesofdailyphysicalactivity,childrenand

adolescentsshouldincludemuscle-strengthening

physicalactivityonatleast3daysoftheweek.

Bone-strengthening:Aspartoftheir60ormoreminutesofdailyphysicalactivity,childrenand

adolescentsshouldincludebone-strengthening

physicalactivityonatleast3daysoftheweek.

Itisimportanttoencourageyoungpeopleto

participateinphysicalactivitiesthatareappropriate

fortheirage,thatareenjoyable,andthatoffer

variety.

Key Guidelines for Adults

Alladultsshouldavoidinactivity.Somephysicalactivityisbetterthannone,andadultswho

participateinanyamountofphysicalactivitygain

somehealthbenefits.

Forsubstantialhealthbenefits,adultsshoulddoat

least150minutes(2hoursand30minutes)aweek

ofmoderate-intensity,or75minutes(1hourand

15minutes)aweekofvigorous-intensityaerobic

physicalactivity,oran

equivalentcombinationof

moderate-andvigorous-

intensityaerobicactivity.

Aerobicactivityshould

beperformedinepisodes

ofatleast10minutes,

andpreferably,itshould

bespreadthroughout

theweek.

Foradditionalandmoreextensivehealthbenefits,

adultsshouldincreasetheiraerobicphysicalactivity

to300minutes(5hours)aweekofmoderate-

intensity,or150minutesaweekofvigorous-

intensityaerobicphysicalactivity,oranequivalent

combinationofmoderate-andvigorous-intensity

activity.Additionalhealthbenefitsaregainedby

engaginginphysicalactivitybeyondthisamount.

Adultsshouldalsodomuscle-strengthening

activitiesthataremoderateorhighintensityand

involveallmajormusclegroupson2ormore

daysaweek,astheseactivitiesprovideadditional

healthbenefits.

Key Guidelines for Older Adults

The Key Guidelines for Adults also apply to older

adults. In addition, the following Guidelines are justfor older adults:

Whenolderadults

cannotdo150minutes

ofmoderate-intensity

aerobicactivityaweek

becauseofchronic

conditions,theyshould

beasphysicallyactive

astheirabilitiesand

conditionsallow.

Olderadultsshoulddoexercisesthatmaintainor

improvebalanceiftheyareatriskoffalling.

Olderadultsshoulddeterminetheirlevelofeffortfor

physicalactivityrelativetotheirleveloffitness.

Olderadultswithchronicconditionsshould

understandwhetherandhowtheirconditionsaffect

theirabilitytodoregularphysicalactivitysafely.

Physical Activity Guidelines for Americans Summary


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Key Guidelines for Safe Physical Activity

Todophysicalactivitysafelyandreducetheriskof

injuriesandotheradverseevents,peopleshould:

Understandtherisksandyetbeconfidentthatphysicalactivityissafeforalmosteveryone.

Choosetodotypesofphysicalactivitythatare

appropriatefortheircurrentfitnessleveland

healthgoals,becausesomeactivitiesaresafer

thanothers.

Increasephysicalactivitygraduallyovertime

whenevermoreactivityisnecessarytomeet

guidelinesorhealthgoals.Inactivepeopleshould

startlowandgoslowbygraduallyincreasing

howoftenandhowlongactivitiesaredone.

Protectthemselvesbyusingappropriategearand

sportsequipment,lookingforsafeenvironments,

followingrulesandpolicies,andmakingsensible

choicesaboutwhen,where,andhowtobeactive.

Beunderthecareofahealth-careproviderifthey

havechronicconditionsorsymptoms.Peoplewith

chronicconditionsandsymptomsshouldconsult

theirhealth-careprovideraboutthetypesand

amountsofactivityappropriateforthem.

Key Guidelines for Women During Pregnancyand the Postpartum Period

Healthywomenwhoarenotalreadyhighly

activeordoingvigorous-intensityactivityshould

getatleast150minutesofmoderate-intensity

aerobicactivityaweekduringpregnancyandthe

postpartumperiod.Preferably,thisactivityshould

bespreadthroughouttheweek.

Pregnantwomenwhohabituallyengagein

vigorous-intensityaerobicactivityorwhoare

highlyactivecancontinuephysicalactivityduring

pregnancyandthepostpartumperiod,provided

thattheyremainhealthyanddiscusswiththeir

health-careproviderhowandwhenactivityshould

beadjustedovertime.

Key Guidelines for Adults With Disabilities

Adultswithdisabilities,whoareableto,shouldget

atleast150minutesaweekofmoderate-intensity,

or75minutesaweekofvigorous-intensityaerobic

activity,oranequivalentcombinationofmoderate-

andvigorous-intensityaerobicactivity.Aerobic

activityshouldbeperformedinepisodesofatleast

10minutes,andpreferably,itshouldbespread

throughouttheweek.

Adultswithdisabilities,whoareableto,shouldalso

domuscle-strengtheningactivitiesofmoderateor

highintensitythatinvolveallmajormusclegroups

on2ormoredaysaweek,astheseactivitiesprovide

additionalhealthbenefits.

Whenadultswithdisabilitiesarenotabletomeet

theGuidelines,theyshouldengageinregular

physicalactivityaccordingtotheirabilitiesand

shouldavoidinactivity.

Adultswithdisabilitiesshouldconsulttheirhealth-

careproviderabouttheamountsandtypesof

physicalactivitythatareappropriatefortheir

abilities.

Key Messages for People With Chronic Medical

Conditions

Adultswithchronicconditionsobtainimportant

healthbenefitsfromregularphysicalactivity.

Whenadultswithchronicconditionsdoactivity

accordingtotheirabilities,physicalactivityissafe.

Adultswithchronicconditionsshouldbeunderthe

careofahealth-careprovider.Peoplewithchronic

conditionsandsymptomsshouldconsulttheir

health-careprovideraboutthetypesandamounts

ofactivityappropriateforthem.

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ARoadmaptothe2008 PhysicalActivity Guidelines for Americans

Foranoverviewofthedevelopmentofthe

Physical Activity Guidelines for Americans

andimportantbackgroundinformationabout

physicalactivity,read

Chapter 1Introducing NOTE

The Guidelines assumethat many readers will

not read all the chapters,but will read only what isrelevant to them. Importantinformation may thereforebe repeated in severalchapters.

the 2008 Physical

Activity Guidelines for

Americans. Tolearnaboutthe

healthbenefitsof

physicalactivity,read

Chapter 2Physical

Activity Has Many

Health Benefits. Thisinformationmayhelpmotivate

peopletobecomeregularlyactive.

Tounderstandhowtodophysicalactivityina

mannerthatmeetstheGuidelines:

Foryouthaged6to17,includingyouthwith

disabilities,readChapter 3Active Children

and Adolescents.

Foradultsaged18to64,readChapter 4

Active Adults.

Foradultsaged65andolder,readChapter 5

Active Older Adults. Thischapterisalso

appropriatereadingforadultsyounger

thanage65whohavechronicconditions.

TheGuidelinesforolderadultsaresimilarto

thoseforotheradultsbutaddsomespecific

considerations,suchasguidelinesforfallprevention.

Forwomenwhoarepregnantorwhohave

recentlygivenbirth(postpartumperiod),readthe

age-appropriatechapterandalsothesectionon

physicalactivityandpregnancyinChapter 6

Safe and ActiveandChapter 7Additional

Considerations for Some Adults.

Foradultswithdisabilities,readChapter 4Active

AdultsandChapter 7Additional Considerations

for Some Adults.

Tounderstandhowtoreducetherisksofactivity-

relatedinjury,readChapter 6Safe and Active.

Thoseinterestedinanoverviewofwaystohelp

peopleparticipateregularlyinphysicalactivityshouldreadChapter 8Taking Action: Increasing

Physical Activity Levels of Americans.

TheGlossary containsdefinitionsofkeytermsused

intheGuidelines.Termsthataredefinedinthe

glossaryareunderlinedthefirsttimetheyareused.

Additionalinformationandresourcesrelevanttothe

GuidelinesareavailableintheAppendices.

A Roadmap to the Physical Activity Guidelines for Americans


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Introducingthe2008Physical Activity


Beingphysicallyactiveisoneofthemost

importantstepsthatAmericansofallagescan

taketoimprovetheirhealth.Thisinaugural

Physical Activity Guidelines for Americansprovides

science-basedguidancetohelpAmericansaged6

andolderimprovetheirhealththroughappropriatephysicalactivity.

TheU.S.DepartmentofHealthandHumanServices

(HHS)issuesthePhysical Activity Guidelines for

Americans.ThecontentofthePhysical Activity

GuidelinescomplementstheDietary Guidelines

for Americans, ajointeffortofHHSandtheU.S.

DepartmentofAgriculture(USDA).Together,thetwo

documentsprovideguidanceontheimportanceofbeing

physicallyactiveandeatingahealthydiettopromote

goodhealthandreducetheriskofchronicdiseases.

Thischapterprovidesbackgroundinformation

abouttherationaleandprocessfordevelopingthe

Guidelines.Itthendiscussesseveralissuesthatprovide

theframeworkforunderstandingtheGuidelines.

ThechapteralsoexplainshowtheseGuidelinesfitin

withotherpublishedphysicalactivityrecommendations

andhowtheyshouldbeusedinpractice.

Why and How the Guidelines Were

Developed

The Rationale for Physical Activity Guidelines

Weclearlyknowenoughnowtorecommendthat

allAmericansshouldengageinregularphysicalactivitytoimproveoverallhealthandtoreduce

riskofmanyhealthproblems.Physicalactivityis

aleadingexampleofhowlifestylechoiceshavea

profoundeffectonhealth.Thechoiceswemakeabout

otherlifestylefactors,suchasdiet,smoking,and

alcoholuse,alsohaveimportantandindependent

effectsonourhealth.

TheprimaryaudiencesforthePhysical Activity

Guidelines for Americans arepolicymakersand

healthprofessionals.TheGuidelinesaredesignedto

provideinformationandguidanceonthetypesand

amountsofphysicalactivitythatprovidesubstantial

healthbenefits.Thisinformationmayalsobeuseful

tointerestedmembersofthepublic.Themainidea

behindtheGuidelinesisthatregularphysicalactivity

overmonthsandyearscanproducelong-termhealth

benefits.Realizingthesebenefitsrequiresphysical

activityeachweek.

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TheseGuidelinesarenecessarybecauseofthe

importanceofphysicalactivitytothehealthof

Americans,whosecurrentinactivityputsthemat

unnecessaryrisk.Healthy People 2010 setobjectives

forincreasingthelevelofphysicalactivityin

Americansoverthedecadefrom2000to2010.

Unfortunately,thelatestinformationshowsthat

inactivityamongAmericanadultsandyouthremains

relativelyhighandthatlittleprogresshasbeen

madeinmeetingtheseobjectives.

The Development of the Physical Activity Guidelines

for Americans

Since1995theDietary Guidelines for Americans

hasincludedadviceonphysicalactivity.However,

withthedevelopmentofafirmsciencebaseon

thehealthbenefitsofphysicalactivity,HHSbegan

toconsiderwhetherseparatephysicalactivity

guidelineswereappropriate.Withthehelpofthe

InstituteofMedicine,HHSconvenedaworkshopin

October2006toaddressthisquestion.Theworkshops

report,Adequacy of Evidence for Physical Activity

Guidelines Development(http://www.nap.edu/

catalog.php?record_id=11819),affirmedthat

advancesinthescienceofphysicalactivityand

healthjustifiedthecreationofseparatephysical

activityguidelines.

ThestepsusedtodevelopthePhysical Activity

Guidelines for Americansweresimilartothoseused

fortheDietary Guidelines for Americans. In2007

HHSSecretaryMikeLeavittappointedanexternal

scientificadvisorycommitteecalledthePhysical

ActivityGuidelinesAdvisoryCommittee.TheAdvisory

Committeeconductedanextensiveanalysisofthe

scientificinformationonphysicalactivityandhealth.

ThePhysical Activity Guidelines Advisory Committee

Report, 2008 andmeetingsummariesareavailable

athttp://www.health.gov/PAGuidelines/.

HHSprimarilyusedtheAdvisoryCommitteesreport

butalsoconsideredcommentsfromthepublicand

GovernmentagencieswhenwritingtheGuidelines.

TheGuidelineswillbewidelypromotedthrough

variouscommunicationsstrategies,suchasmaterials

forthepublic,Websites,andpartnershipswith

organizationsthatpromotephysicalactivity.

The Framework for the Physical Activity


TheAdvisoryCommitteereportprovidedthecontent

andconceptualunderpinningfortheGuidelines.

Themainelementsofthisframeworkaredescribed

inthefollowingsections.

Baseline Activity Versus Health-Enhancing

Physical Activity

Physicalactivityhasbeendefinedasanybodily

movementproducedbythecontractionofskeletal

musclethatincreasesenergyexpenditureabovea

basallevel.However,inthisdocument,theterm

physicalactivitywillgenerallyrefertobodily

movementthatenhanceshealth.Bodilymovement

canbedividedintotwocategories:

Baseline activity referstothelight-intensity

activitiesofdailylife,suchasstanding,walking

slowly,andliftinglightweightobjects.Peoplevary

inhowmuchbaselineactivitytheydo.People

whodoonlybaselineactivityareconsideredto

beinactive.Theymaydoveryshortepisodesof

moderate-orvigorous-intensityactivity,suchas

climbingafewflightsofstairs,buttheseepisodes

arentlongenoughtocounttowardmeetingthe

Guidelines.TheGuidelinesdontcommenton

howvariationsintypesandamountsofbaseline

physicalactivitymightaffecthealth,asthiswas

notaddressedbytheAdvisoryCommitteereport.

Health-enhancing physical activity isactivitythat,

whenaddedtobaselineactivity,produceshealth

benefits.Inthisdocument,thetermphysical

activitygenerallyreferstohealth-enhancing

physicalactivity.Briskwalking,jumpingrope,

dancing,liftingweights,climbingonplayground

equipmentatrecess,anddoingyogaareall

examplesofphysicalactivity.Somepeople(suchas

postalcarriersorcarpentersonconstructionsites)

maygetenoughphysicalactivityonthejobto

meettheGuidelines.

Wedontunderstandenoughaboutwhetherdoing

morebaselineactivityresultsinhealthbenefits.

Evenso,effortstopromotebaselineactivitiesare

justifiable.Afterall,baselineactivitiesarenormal

Chapter 1. Introducing the 2008 Physical Activity Guidelines for Americans
http://www.nap.edu/catalog.php?record_id=11819http://www.health.gov/PAGuidelines/http://www.health.gov/PAGuidelines/http://www.nap.edu/catalog.php?record_id=11819


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In this document,thetermphysicalactivitywill

generallyrefertobodilymovement

thatenhanceshealth.

lifestyleactivities.EncouragingAmericanstoincrease

theirbaselineactivityissensibleforseveralreasons:

Increasingbaselineactivityburnscalories,whichcanhelpinmaintainingahealthybodyweight.

Somebaselineactivitiesareweight-bearingand

mayimprovebonehealth.

Therearereasonsotherthanhealthtoencourage

morebaselineactivity.Forexample,walkingshort

distancesinsteadofdrivingcanhelpreducetraffic

congestionandtheresultingairpollution.

Encouragingbaselineactivitieshelpsbuildaculture

wherephysicalactivityingeneralisthesocialnorm.

Shortepisodesofactivityareappropriatefor

peoplewhowereinactiveandhavestartedto

graduallyincreasetheirlevelofactivity,andfor

olderadultswhoseactivitymaybelimitedby

chronicconditions.

Theavailabilityofinfrastructuretosupportshort

episodesofactivityisthereforeimportant.Forexample,

peopleshouldhavetheoptionofusingsidewalks

andpathstowalkbetweenbuildingsataworksite,

ratherthanhavingtodrive.Peopleshouldalsohave

theoptionoftakingthestairsinsteadofusingan

elevator.

Health Benefits Versus Other Reasons To Be

Physically Active

AlthoughtheGuidelinesfocusonthehealthbenefits

ofphysicalactivity,thesebenefitsarenottheonly

reasonwhypeopleareactive.Physicalactivitygives

peopleachancetohavefun,bewithfriendsand

family,enjoytheoutdoors,improvetheirpersonal

appearance,andimprovetheirfitnesssothatthey

canparticipateinmoreintensivephysicalactivity

orsportingevents.Somepeopleareactivebecause

theyfeelitgivesthemcertainhealthbenefits(suchas

feelingmoreenergetic)thatarentyetconclusively

provenforthegeneralpopulation.

TheGuidelinesencouragepeopletobephysically

activeforanyandallreasonsthataremeaningful

forthem.NothingintheGuidelinesisintendedto

meanthathealthbenefitsaretheonlyreasontodo

physicalactivity.

Focus on Disease Prevention

TheGuidelinesfocusonpreventiveeffectsof

physicalactivity,whichincludeloweringtheriskof

developingchronicdiseasessuchasheartdisease

andtype2diabetes.

Physicalactivityalsohasbeneficialtherapeutic

effectsandiscommonlyrecommendedaspartof

thetreatmentformedicalconditions.TheAdvisory

Committeereportdidnotreviewthetherapeutic

effectsofactivity,andtheGuidelinesdonotdiscuss

theuseofphysicalactivityasmedicaltreatment.

Health-Related Versus Performance-Related Fitness

TheGuidelinesfocusonreducingtheriskofchronic

diseaseandpromotinghealth-relatedfitness,

particularlycardiovascularandmuscularfitness.

Peoplecangainthiskindoffitnessbydoingthe

amountandtypesofactivitiesrecommendedinthe

Guidelines.



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TheGuidelinesdonotaddressthetypesandamounts

ofactivitynecessarytoimproveperformance-related

fitness.Athletesneedthiskindoffitnesswhenthey

compete.Medicalscreeningissuesforcompetitive

athletesalsoareoutsidethescopeoftheGuidelines.

Peoplewhoareinterestedintrainingprogramsto

increaseperformance-relatedfitnessshouldseek

advicefromothersources.Generally,thesepeople

domuchmoreactivitythanrequiredtomeetthe

Guidelines.

Lifespan Approach

Thebestwaytobephysicallyactiveistobeactivefor

life.Therefore,theGuidelinestakealifespanapproach

andproviderecommendationsforthreeagegroups:

ChildrenandAdolescents,Adults,andOlderAdults.

ThePhysical Activity Guidelines areforAmericans

aged6andolder.TheAdvisoryCommitteereport

didnotreviewevidenceforchildrenyoungerthan

age6.Physicalactivityininfantsandyoungchildren

is,ofcourse,necessaryforhealthygrowthand

development.Childrenyoungerthan6shouldbe

physicallyactiveinwaysappropriatefortheirage

andstageofdevelopment.

Individualized Health Goals

TheGuidelinesgenerallyexplaintheamountsand

typesofphysicalactivityneededforhealthbenefits.

Withintheseoverallparameters,individualshave

manychoicesaboutappropriatetypesandamounts

ofactivity.

Tomakethesechoices,Americanadultsneedtosetpersonalgoalsforphysicalactivity.Settingthese

goalsinvolvesquestionslike,Howphysicallyfit

doIwanttobe?Howimportantisittometo

reducemyriskofheartdiseaseanddiabetes?How

importantisittometoreducemyriskoffallsand

hipfracture?HowmuchweightdoIwanttolose

andkeepoff?

PeoplecanmeettheGuidelinesandtheirownpersonal

goalsthroughdifferentamountsandtypesofactivity.

Writtenmaterials,health-careproviders,andfitness

professionalscanprovideusefulinformationandhelppeoplesetandcarryoutspecificgoals.

Four Levels of Physical Activity

TheAdvisoryCommitteereportprovidesthebasis

fordividingtheamountofaerobicphysicalactivity

anadultgetseveryweekintofourcategories:

inactive,low,medium,andhigh(seetablebelow).

Thisclassificationisusefulbecausethesecategories

providearuleofthumbofhowtotalamountof

physicalactivityisrelatedtohealthbenefits.Low

amountsofactivityprovidesomebenefits;mediumamountsprovidesubstantialbenefits;andhigh

amountsprovideevengreaterbenefits.

Classification of Total Weekly Amounts of Aerobic Physical Activity Into Four Categories

Levels of PhysicalActivity

Range of Moderate-IntensityMinutes a Week

Summary of OverallHealth Benefits Comment

Inactive No activity beyond baseline None Being inactive is unhealthy.

Low Activity beyond baseline but

fewer than 150 minutes a week

Some Low levels of activity are clearly preferable to an

inactive lifestyle.

Medium 150 minutes to 300 minutesa week

Substantial Activity at the high end of this range has additionaland more extensive health benefits than activity atthe low end.

High More than 300 minutes a week Additional Current science does not allow researchers to identifyan upper limit of activity above which there are noadditional health benefits.



16/76

Action is neededattheindividual,community,and

societallevelstohelpAmericans

becomephysicallyactive.

Inactiveisnoactivitybeyondbaselineactivities

ofdailyliving.

Low activity isactivitybeyondbaselinebutfewer

than150minutes(2hoursand30minutes)of

moderate-intensityphysicalactivityaweekor

theequivalentamount(75minutes,or1hourand

15minutes)ofvigorous-intensityactivity.

Medium activity is150minutesto300(5hours)

minutesofmoderate-intensityactivityaweek

(or75to150minutes

ofvigorous-intensity

physicalactivityaweek).

Inscientificterms,this

rangeisapproximately

equivalentto500to1,000

metabolicequivalent

(MET)minutesaweek.

For More Information

Appendix 1 provides adetailed explanationof MET-minutes, a unituseful for describing theenergy expenditure of aspecific physical activity.

High activity ismorethantheequivalentof

300minutesofmoderate-intensityphysicalactivityaweek.

Relationship to Previous Public Health

Recommendations

In1995theCentersforDiseaseControlandPrevention

(CDC)andtheAmericanCollegeofSportsMedicine

(ACSM)publishedphysicalactivityrecommendations

forpublichealth.Thereportstatedthatadultsshould

accumulateatleast30minutesadayofmoderate-

intensityphysicalactivityonmost,preferablyall,

daysperweek.In1996Physical Activity and Health:A Report of the Surgeon General supportedthissame

recommendation.

Inordertotrackthepercentageofadultswhomeet

thisguideline,CDCspecifiedthatmostdaysperweek

was5days.Since1995thecommonrecommendation

hasbeenthatadultsobtainatleast30minutesof

moderate-intensityphysicalactivityon5ormoredays

aweek,foratotalofatleast150minutesaweek.

ThePhysical Activity Guidelines for Americans

affirmsthatitisacceptabletofollowtheCDC/ACSM

recommendationandsimilarrecommendations.

However,accordingtotheAdvisoryCommittee

report,theCDC/ACSMguidelinewastoospecific.

Inotherwords,existingscientificevidencedoesnot

allowresearcherstosay,forexample,whetherthe

healthbenefitsof30minuteson5daysaweekare

anydifferentfromthehealthbenefitsof50minutes

on3daysaweek.Asaresult,thenewGuidelines

allowapersontoaccumulate150minutesaweekinvariousways.

Putting the Guidelines Into Practice

AlthoughtheAdvisoryCommitteedidnotreview

strategiestopromotephysicalactivity,actionisneeded

attheindividual,community,andsocietallevelsto

helpAmericansbecomephysicallyactive.Publications

suchastheGuide to Community Preventive Services

(http://www.thecommunityguide.org/pa/)andthe

recommendationsoftheU.S.PreventiveServices

TaskForce(http://www.ahrq.gov/clinic/cps3dix.htm)

summarizeevidence-basedstrategiesforpromoting

physicalactivityonthecommunitylevelandthrough

primaryhealthcare.Accordingly,thefinalchapter

ofthePhysical Activity Guidelines for Americans

providesonlyabriefdiscussiononpromotingphysical

activity,andindicateshowtolinktheGuidelinesto

actionstrategies.

http://www.thecommunityguide.org/pa/http://www.ahrq.gov/clinic/cps3dix.htmhttp://www.thecommunityguide.org/pa/http://www.ahrq.gov/clinic/cps3dix.htm


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Assessing Whether Physical Activity Programs Are

Consistent With the Guidelines

Programsthatprovideopportunitiesforphysical

activity,suchasclassesorcommunityactivities,can

helppeoplemeettheGuidelines.Theseprogramsdonothavetoprovideall,orevenmost,oftherecommended

weeklyactivity.Forexample,amallwalkingprogram

forolderadultsmaymeetonlyonceaweekyet

provideusefulamountsofactivity,aslongaspeople

gettherestoftheirweeklyrecommendedactivityon

otherdays.

ProgramsthatareconsistentwiththeGuidelines:

Provideadviceandeducationconsistentwiththe

Guidelines;

Addepisodesofactivitythatcounttowardmeeting

theGuidelines;and

Mayalsoincludeactivities,suchasstretching

orwarmingupandcoolingdown,whosehealth

benefitsarenotyetprovenbutthatareoftenusedineffectivephysicalactivityprograms.

The Importance of Understandable Guidelines

HHShastriedtokeepthePhysical Activity Guidelines

straightforwardandclear,whileremainingconsistent

withcomplexscientificinformation.Ineachchapterthe

keyGuidelinesaresetapartfromthetext,inorderto

identifythemostimportantinformationtocommunicate

tothepublic.Themessagescontainedinthese

Guidelinesshouldbedisseminatedtothegeneralpublic

andtoanyoneinvolvedinpromotingphysicalactivity.



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PhysicalActivityHas

ManyHealthBenefits

AllAmericansshouldberegularlyphysically

activetoimproveoverallhealthandfitnessand

topreventmanyadversehealthoutcomes.The

benefitsofphysicalactivityoccuringenerallyhealthy

people,inpeopleatriskofdevelopingchronicdiseases,

andinpeoplewithcurrentchronicconditionsordisabilities.Thischaptergivesanoverviewofresearch

findingsonphysicalactivityandhealth.Theboxon

page8providesasummaryofthesebenefits.

Physicalactivityaffectsmanyhealthconditions,andthe

specificamountsandtypesofactivitythatbenefiteach

conditionvary.Indevelopingpublichealthguidelines,

thechallengeistointegratescientificinformation

acrossallhealthbenefitsandidentifyacriticalrangeof

physicalactivitythatappearstohaveaneffectacross

thehealthbenefits.Oneconsistentfindingfromresearch

studiesisthatoncethehealthbenefitsfromphysical

activitybegintoaccrue,additionalamountsofactivity

provideadditionalbenefits.

Althoughsomehealthbenefitsseemtobeginwithas

littleas60minutes(1hour)aweek,researchshowsthat

atotalamountof150minutes(2hoursand30minutes)

aweekofmoderate-intensityaerobicactivity,suchas

briskwalking,consistentlyreducestheriskofmany

chronicdiseasesandotheradversehealthoutcomes.

Examining the Relationship Between Physical

Activity and HealthInmanystudiescoveringawiderangeofissues,

researchershavefocusedonexercise,aswellason

themorebroadlydefinedconceptofphysicalactivity.

Exerciseisaformofphysicalactivitythatisplanned,

structured,repetitive,andperformedwiththegoalof

improvinghealthorfitness.So,althoughallexerciseis

physicalactivity,notallphysicalactivityisexercise.

Studieshaveexaminedtheroleofphysicalactivityin

manygroupsmenandwomen,children,teens,adults,

olderadults,peoplewithdisabilities,andwomenduringpregnancyandthepostpartumperiod.These

studieshavefocusedontherolethatphysicalactivity

playsinmanyhealthoutcomes,including:

Premature(early)death;

Diseasessuchascoronaryheartdisease,stroke,some

cancers,type2diabetes,osteoporosis,anddepression;



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The Health Benefits of Physical ActivityMajor Research Findings

Regularphysicalactivityreducestheriskofmanyadversehealthoutcomes.

Somephysicalactivityisbetterthannone.

Formosthealthoutcomes,additionalbenefitsoccurastheamountofphysicalactivityincreasesthrough

higherintensity,greaterfrequency,and/orlongerduration.

Mosthealthbenefitsoccurwithatleast150minutesaweekofmoderate-intensityphysicalactivity,suchas

briskwalking.Additionalbenefitsoccurwithmorephysicalactivity.

Bothaerobic(endurance)andmuscle-strengthening(resistance)physicalactivityarebeneficial.

Healthbenefitsoccurforchildrenandadolescents,youngandmiddle-agedadults,olderadults,andthosein

everystudiedracialandethnicgroup.

Thehealthbenefitsofphysicalactivityoccurforpeoplewithdisabilities.

Thebenefitsofphysicalactivityfaroutweighthepossibilityofadverseoutcomes.

Riskfactorsfordisease,suchashighbloodpressure

andhighbloodcholesterol;

Aerobicactivitycausesapersonshearttobeatfaster

thanusual.

Physicalfitness,suchasaerobiccapacity,and

musclestrengthandendurance;Aerobicphysicalactivityhasthreecomponents:

Functionalcapacity(theabilitytoengagein

activitiesneededfordailyliving);

Intensity,orhowhardapersonworkstodothe

activity.Theintensitiesmostoftenexaminedare

moderateintensity(equivalentinefforttobrisk

walking)andvigorousintensity(equivalentinefforttorunningorjogging);

Mentalhealth,suchasdepressionandcognitivefunction;and

Injuriesorsuddenheartattacks. Frequency, orhowoftenapersondoesaerobic

activity;andThesestudieshavealsopromptedquestionsasto

whattypeandhowmuchphysicalactivityisneeded

forvarioushealthbenefits.Toanswerthisquestion,

investigatorshavestudiedthreemainkindsofphysical

activity:aerobic,muscle-strengthening,andbone-

strengthening.Investigatorshavealsostudiedbalance

andflexibilityactivities.Theselattertwoactivitiesare

addressedinChapters4,5,and6.

Duration, orhowlongapersondoesanactivityin

anyonesession.

Althoughthesecomponentsmakeupaphysical

activityprofile,researchhasshownthatthetotal

amountofphysicalactivity(minutesofmoderate-

intensityphysicalactivity,forexample)ismore

importantforachievinghealthbenefitsthanisany

onecomponent(frequency,intensity,orduration).Aerobic Activity

Inthiskindofphysicalactivity(alsocalledan

enduranceactivityorcardioactivity),thebodyslarge

musclesmoveinarhythmicmannerforasustained

periodoftime.Briskwalking,running,bicycling,

jumpingrope,andswimmingareallexamples.

Muscle-Strengthening Activity

Thiskindofactivity,whichincludesresistancetraining

andliftingweights,causesthebodysmusclestowork

orholdagainstanappliedforceorweight.These

Chapter 2. Physical Activity Has Many Health Benefits


20/76

activitiesofteninvolverelativelyheavyobjects,such

asweights,whichareliftedmultipletimestotrain

variousmusclegroups.Muscle-strengtheningactivity

canalsobedonebyusingelasticbandsorbodyweight

forresistance(climbingatreeordoingpush-ups,

forexample).

Muscle-strengtheningactivityalsohasthree

components:

Intensity, orhowmuchweightorforceisused

relativetohowmuchapersonisabletolift;

Frequency,orhowoftenapersondoesmuscle-

strengtheningactivity;and

Repetitions, orhowmanytimesapersonliftsa

weight(analogoustodurationforaerobicactivity).

Theeffectsofmuscle-strengtheningactivityarelimited

tothemusclesdoingthework.Itsimportanttowork

allthemajormusclegroupsofthebody:thelegs,hips,

back,abdomen,chest,shoulders,andarms.

Bone-Strengthening Activity

Thiskindofactivity(sometimescalledweight-bearing

orweight-loadingactivity)producesaforceonthe

bonesthatpromotesbonegrowthandstrength.This

forceiscommonlyproducedbyimpactwiththeground.Examplesofbone-strengtheningactivity

includejumpingjacks,running,briskwalking,and

weight-liftingexercises.Astheseexamplesillustrate,

bone-strengtheningactivitiescanalsobeaerobicand

musclestrengthening.

The Health Benefits of Physical Activity

Studiesclearlydemonstratethatparticipatinginregular

physicalactivityprovidesmanyhealthbenefits.These

benefitsaresummarizedintheaccompanyingtable.

Manyconditionsaffectedbyphysicalactivityoccur

withincreasingage,suchasheartdiseaseandcancer.

Reducingriskoftheseconditionsmayrequireyearsof

participationinregularphysicalactivity.However,other

benefits,suchasincreasedcardiorespiratoryfitness,

increasedmuscularstrength,anddecreaseddepressive

symptomsandbloodpressure,requireonlyafewweeks

ormonthsofparticipationinphysicalactivity.

Health Benefits Associated With Regular Physical

Activity

Children and Adolescents

Strong evidence

Improved cardiorespiratory and muscular fitness

Improved bone health

Improved cardiovascular and metabolic health biomarkers

Favorable body composition

Moderate evidence

Reduced symptoms of depression

Adults and Older Adults

Strong evidence

Lower risk of early death

Lower risk of coronary heart disease

Lower risk of stroke

Lower risk of high blood pressure

Lower risk of adverse blood lipid profile

Lower risk of type 2 diabetes

Lower risk of metabolic syndrome

Lower risk of colon cancer

Lower risk of breast cancer

Prevention of weight gain

Weight loss, particularly when combined with reducedcalorie intake

Improved cardiorespiratory and muscular fitness

Prevention of falls

Reduced depression

Better cognitive function (for older adults)

Moderate to strong evidence

Better functional health (for older adults)

Reduced abdominal obesity

Moderate evidence

Lower risk of hip fracture

Lower risk of lung cancer

Lower risk of endometrial cancer

Weight maintenance after weight loss

Increased bone density

Improved sleep quality

Note:The Advisory Committee rated the evidence of health benefits of

physical activity as strong, moderate, or weak. To do so, the Committee

considered the type, number, and quality of studies available, as well

as consistency of findings across studies that addressed each outcome.

The Committee also considered evidence for causality and dose response

in assigning the strength-of-evidence rating.



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The Beneficial Effects of Increasing Physical Activity: Its About Overload, Progression,

and Specificity

Overload isthephysicalstressplacedonthebodywhenphysicalactivityisgreaterinamountorintensitythan

usual.Thebodysstructuresandfunctionsrespondandadapttothesestresses.Forexample,aerobicphysicalactivityplacesastressonthecardiorespiratorysystemandmuscles,requiringthelungstomovemoreairand

thehearttopumpmorebloodanddeliverittotheworkingmuscles.Thisincreaseindemandincreasesthe

efficiencyandcapacityofthelungs,heart,circulatorysystem,andexercisingmuscles.Inthesameway,muscle-

strengtheningandbone-strengtheningactivitiesoverloadmusclesandbones,makingthemstronger.

Progression iscloselytiedtooverload.Onceapersonreachesacertainfitnesslevel,heorsheprogressesto

higherlevelsofphysicalactivitybycontinuedoverloadandadaptation.Small,progressivechangesinoverload

helpthebodyadapttotheadditionalstresseswhileminimizingtheriskofinjury.

Specificity meansthatthebenefitsofphysicalactivityarespecifictothebodysystemsthataredoingthework.

Forexample,aerobicphysicalactivitylargelybenefitsthebodyscardiovascularsystem.

Thehealthbenefitsofphysicalactivityareseen

inchildrenandadolescents,youngandmiddle-

agedadults,olderadults,womenandmen,people

ofdifferentracesandethnicities,andpeoplewith

disabilitiesandchronicconditions.Thehealthbenefits

ofphysicalactivityaregenerallyindependentofbody

weight.Adultsofallsizesandshapesgainhealthand

fitnessbenefitsbybeinghabituallyphysicallyactive.

Thebenefitsofphysicalactivityalsooutweightherisk

ofinjuryandsuddenheartattacks,twoconcernsthat

preventmanypeoplefrombecomingphysicallyactive.

Thefollowingsectionsprovidemoredetailonwhatis

knownfromresearchstudiesaboutthespecifichealth

benefitsofphysicalactivityandhowmuchphysical

activityisneededtogetthehealthbenefits.

approximately7hoursaweekhavea40percent

lowerriskofdyingearlythanthosewhoareactive

forlessthan30minutesaweek.

Second,itisnotnecessarytodohighamountsof

activityorvigorous-intensityactivitytoreducethe

riskofprematuredeath.Studiesshowsubstantially

lowerriskwhenpeopledo150minutesofatleast

moderate-intensityaerobicphysicalactivityaweek.

Researchclearlydemonstratestheimportanceof

avoidinginactivity.Evenlowamountsofphysical

activityreducetheriskofdyingprematurely.Asthe

figureonpage11shows,themostdramaticdifference

inriskisseenbetweenthosewhoareinactive

(30minutesaweek)andthosewithlowlevelsof

activity(90minutesor1hourand30minutesaweek).

Therelativeriskofdyingprematurelycontinuesto

belowerwithhigherlevelsofreportedmoderate-or

vigorous-intensityleisure-timephysicalactivity.

Alladultscangainthishealthbenefitofphysical

activity.Age,race,andethnicitydonotmatter.Men

andwomenyoungerthan65yearsaswellasolder

adultshavelowerratesofearlydeathwhenthey

arephysicallyactivethanwhentheyareinactive.

Physicallyactivepeopleofallbodyweights(normal

weight,overweight,obese)alsohavelowerratesof

earlydeaththandoinactivepeople.

Premature Death

Strongscientificevidenceshowsthatphysicalactivity

reducestheriskofprematuredeath(dyingearlierthan

theaverageageofdeathforaspecificpopulation

group)fromtheleadingcausesofdeath,suchasheart

diseaseandsomecancers,aswellasfromothercauses

ofdeath.Thiseffectisremarkableintwoways:

First,onlyafewlifestylechoiceshaveaslargean

effectonmortalityasphysicalactivity.Ithasbeen

estimatedthatpeoplewhoarephysicallyactivefor



22/76

Relative

Risk

1.2

1.0

0.8

0.6

0.4

0.2

0.0

0 60 120 180 240 300 360 420

Minutes per Week of Moderate- or Vigorous-Intensity

Physical Activity

The Risk of Dying Prematurely Declines as People

Become Physically Active

Cardiorespiratory Health

Thebenefitsofphysicalactivityoncardiorespiratory

healtharesomeofthemostextensivelydocumentedof

allthehealthbenefits.Cardiorespiratoryhealthinvolves

thehealthoftheheart,lungs,andbloodvessels.

Heartdiseasesandstrokearetwooftheleadingcauses

ofdeathintheUnitedStates.Riskfactorsthatincrease

thelikelihoodofcardiovasculardiseasesinclude

smoking,highbloodpressure(calledhypertension),

type2diabetes,andhighlevelsofcertainbloodlipids(suchaslow-densitylipoprotein,orLDL,cholesterol).

Lowcardiorespiratoryfitnessalsoisariskfactorfor

heartdisease.

Peoplewhodomoderate- orvigorous-intensityaerobic

physicalactivityhaveasignificantlylowerriskof

cardiovasculardiseasethandoinactivepeople.Regularly

activeadultshavelowerratesofheartdiseaseand

stroke,andhavelowerbloodpressure,betterbloodlipid

profiles,andfitness.Significantreductionsinriskof

cardiovasculardiseaseoccuratactivitylevelsequivalent

to150minutesaweekofmoderate-intensityphysicalactivity.Evengreaterbenefitsareseenwith200minutes

(3hoursand20minutes)aweek.Theevidenceisstrong

thatgreateramountsofphysicalactivityresultineven

furtherreductionsintheriskofcardiovasculardisease.

Everyonecangainthecardiovascularhealthbenefits

ofphysicalactivity.Theamountofphysicalactivity

thatprovidesfavorablecardiorespiratoryhealthand

fitnessoutcomesissimilarforadultsofvariousages,

includingolderpeople,aswellasforadultsofvarious

racesandethnicities.Aerobicexercisealsoimproves

cardiorespiratoryfitnessinindividualswithsome

disabilities,includingpeoplewhohavelosttheuse

ofoneorbothlegsandthosewithmultiplesclerosis,

stroke,spinalcordinjury,andcognitivedisabilities.

Moderate-intensityphysicalactivityissafefor

generallyhealthywomenduringpregnancy.Itincreases

cardiorespiratoryfitnesswithoutincreasingtherisk

ofearlypregnancyloss,pretermdelivery,orlowbirth

weight.Physicalactivityduringthepostpartumperiod

alsoimprovescardiorespiratoryfitness.

Metabolic Health

Regularphysicalactivitystronglyreducestheriskof

developingtype2diabetesaswellasthemetabolic

syndrome.Themetabolicsyndromeisdefinedasa

conditioninwhichpeoplehavesomecombination

ofhighbloodpressure,alargewaistline(abdominal

obesity),anadversebloodlipidprofile(lowlevels

ofhigh-densitylipoprotein[HDL]cholesterol,raised

triglycerides),andimpairedglucosetolerance.

Peoplewhoregularlyengageinatleastmoderate-

intensityaerobicactivityhaveasignificantlylowerriskofdevelopingtype2diabetesthandoinactive

people.Althoughsomeexpertsdebatetheusefulness

ofdefiningthemetabolicsyndrome,goodevidence

existsthatphysicalactivityreducestheriskofhaving

thiscondition,asdefinedinvariousways.Lowerrates

oftheseconditionsareseenwith120to150minutes

(2hoursto2hoursand30minutes)aweekofat

leastmoderate-intensityaerobicactivity.Aswith

cardiovascularhealth,additionallevelsofphysical

activityseemtolowerriskevenfurther.Inaddition,

physicalactivityhelpscontrolbloodglucoselevelsin

personswhoalreadyhavetype2diabetes.

Physicalactivityalsoimprovesmetabolichealthin

youth.Studiesfindthiseffectwhenyoungpeople

participateinatleast3daysofvigorousaerobic

activityaweek.Morephysicalactivityisassociated

withimprovedmetabolichealth,butresearchhasyetto

determinetheexactamountofimprovement.

11 2008 Physical Activity Guidelines for Americans


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Obesity and Energy Balance

Overweightandobesityoccurwhenfewercaloriesare

expended,includingcaloriesburnedthroughphysical

activity,thanaretakeninthroughfoodandbeverages.

Physicalactivityandcaloricintakebothmustbeconsideredwhentryingtocontrolbodyweight.

Becauseofthisroleinenergybalance,physicalactivity

isacriticalfactorindeterminingwhetheraperson

canmaintainahealthybodyweight,loseexcessbody

weight,ormaintainsuccessfulweightloss.People

varyagreatdealinhowmuchphysicalactivitythey

needtoachieveandmaintainahealthyweight.Some

needmorephysicalactivitythanotherstomaintaina

healthybodyweight,toloseweight,ortokeepweight

offonceithasbeenlost.

Strongscientificevidenceshowsthatphysicalactivity

helpspeoplemaintainastableweightovertime.

However,theoptimalamountofphysicalactivity

neededtomaintainweightisunclear.Peoplevary

greatlyinhowmuchphysicalactivityresultsinweight

stability.Manypeopleneedmorethantheequivalent

of150minutesofmoderate-intensityactivityaweek

tomaintaintheirweight.

Overshortperiodsoftime,suchasayear,research

showsthatitispossibletoachieveweightstabilityby

doingtheequivalentof150to300minutes(5hours)aweekofmoderate-intensitywalkingatabouta

4mile-an-hourpace.Muscle-strengtheningactivities

mayhelppromoteweightmaintenance,althoughnot

tothesamedegreeasaerobicactivity.

Peoplewhowanttoloseasubstantial(morethan

5percentofbodyweight)amountofweightand

peoplewhoaretryingtokeepasignificantamountof

weightoffonceithasbeenlostneedahighamountof

physicalactivityunlesstheyalsoreducetheircaloric

intake.Manypeopleneedtodomorethan300minutes

ofmoderate-intensityactivityaweektomeetweight-controlgoals.

Regularphysicalactivityalsohelpscontrolthe

percentageofbodyfatinchildrenandadolescents.

Exercisetrainingstudieswithoverweightandobese

youthhaveshownthattheycanreducetheirbody

fatnessbyparticipatinginphysicalactivitythatisat

leastmoderateintensityon3to5daysaweek,for30to60minuteseachtime.

Musculoskeletal Health

Bones,muscles,andjointssupportthebodyandhelp

itmove.Healthybones,joints,andmusclesarecritical

totheabilitytododailyactivitieswithoutphysical

limitations.

Preservingbone,joint,andmusclehealthisessential

withincreasingage.Studiesshowthatthefrequent

declineinbonedensitythathappensduringagingcanbeslowedwithregularphysicalactivity.Theseeffects

areseeninpeoplewhoparticipateinaerobic,muscle-

strengthening,andbone-strengtheningphysicalactivity

programsofmoderateorvigorousintensity.Therange

oftotalphysicalactivityforthesebenefitsvaries

widely.Importantchangesseemtobeginat90minutes

aweekandcontinueupto300minutesaweek.

Hipfractureisaserioushealthconditionthatcan

havelife-changingnegativeeffectsformanyolder

people.Physicallyactivepeople,especiallywomen,

appeartohavealowerriskofhipfracturethando

inactivepeople.Researchstudiesonphysicalactivityto

preventhipfractureshowthatparticipatingin120to

300minutesaweekofphysicalactivitythatisofat

leastmoderateintensityisassociatedwithareduced

risk.Itisunclear,however,whetheractivityalsolowers

riskoffracturesofthespineorotherimportantareas

oftheskeleton.



24/76

The bottom lineisthatthehealthbenefitsofphysicalactivityfaroutweightherisksof

adverseeventsforalmosteveryone.

Buildingstrong,healthybonesisalsoimportantfor

childrenandadolescents.Alongwithhavingahealthy

dietthatincludesadequatecalciumandvitaminD,

physicalactivityiscriticalforbonedevelopmentin

childrenandadolescents.Bone-strengtheningphysical

activitydone3ormoredaysaweekincreasesbone-

mineralcontentandbonedensityinyouth.

Regularphysicalactivityalsohelpspeoplewith

arthritisorotherrheumaticconditionsaffectingthejoints.Participationin130to150minutes(2hours

and10minutesto2hoursand30minutes)aweek

ofmoderate-intensity,low-impactphysicalactivity

improvespainmanagement,function,andqualityof

life.Researchersdontyetknowwhetherparticipation

inphysicalactivity,particularlyatlowtomoderate

intensity,reducestheriskofosteoarthritis.Veryhigh

levelsofphysicalactivity,however,mayhaveextra

risks.Peoplewhoparticipateinveryhighlevelsof

physicalactivity,suchaseliteorprofessionalathletes,

haveahigherriskofhipandkneeosteoarthritis,

mostlyduetotheriskofinjuryinvolvedincompetinginsomesports.

Progressivemuscle-strengtheningactivitiesincrease

orpreservemusclemass,strength,andpower.

Higheramounts(throughgreaterfrequencyorhigher

weights)improvemusclefunctiontoagreaterdegree.

Improvementsoccurinyoungerandolderadults.

Resistanceexercisesalsoimprovemuscularstrength

inpersonswithsuchconditionsasstroke,multiple

sclerosis,cerebralpalsy,spinalcordinjury,and

cognitivedisability.Thoughitdoesntincreasemuscle

massinthesamewaythatmuscle-strengthening

activitiesdo,aerobicactivitymayalsohelpslowthe

lossofmusclewithaging.

Functional Ability and Fall Prevention

Functionalabilityisthecapacityofapersontoperform

tasksorbehaviorsthatenablehimorhertocarryout

everydayactivities,suchasclimbingstairsorwalking

onasidewalk.Functionalabilityiskeytoapersons

abilitytofulfillbasicliferoles,suchaspersonalcare,

groceryshopping,orplayingwiththegrandchildren.

Lossoffunctionalabilityisreferredtoasfunctional

limitation.

Middle-agedandolderadultswhoarephysically

activehavelowerriskoffunctionallimitationsthando

inactiveadults.Itappearsthatgreaterphysicalactivitylevelscanfurtherreduceriskoffunctionallimitations.

Olderadultswhoalreadyhavefunctionallimitations

alsobenefitfromregularphysicalactivity.Typically,

studiesofphysicalactivityinadultswithfunctional

limitationstestedacombinationofaerobicandmuscle-

strengtheningactivities,makingitdifficulttoassessthe

relativeimportanceofeachtypeofactivity.However,

bothtypesofactivityappeartoprovidebenefit.

Inolderadultsatriskoffalls,strongevidenceshows

thatregularphysicalactivityissafeandreducesthis

risk.Reductioninfallsisseenforparticipantsin

programsthatincludebalanceandmoderate-intensity

muscle-strengtheningactivitiesfor90minutesaweek

plusmoderate-intensitywalkingforaboutanhoura

week.Itsnotknownwhetherdifferentcombinations

oftype,amount,orfrequencyofactivitycanreduce

fallstoagreaterdegree.Taichiexercisesalsomay

helppreventfalls.

Cancer

Physicallyactivepeoplehaveasignificantlylower

riskofcoloncancerthandoinactivepeople,and

physicallyactivewomenhaveasignificantlylower

riskofbreastcancer.Researchshowsthatawide

rangeofmoderate-intensityphysicalactivitybetween

210and420minutesaweek(3hoursand30minutes

to7hours)isneededtosignificantlyreducetherisk

ofcolonandbreastcancer;currently,150minutesa



25/76

weekdoesnotappeartoprovideamajorbenefit.Italso

appearsthatgreateramountsofphysicalactivitylower

risksofthesecancersevenfurther,althoughexactly

howmuchlowerisnotclear.

Althoughnotdefinitive,someresearchsuggeststhat

theriskofendometrialcancerinwomenandlung

cancersinmenandwomenalsomaybeloweramong

thosewhoareregularlyactivecomparedtothosewho

areinactive.

Finally,cancersurvivorshaveabetterqualityoflife

andimprovedphysicalfitnessiftheyarephysically

active,comparedtosurvivorswhoareinactive.

Mental Health

Physicallyactiveadultshavelowerriskofdepression

andcognitivedecline(declineswithaginginthinking,

learning,andjudgmentskills).Physicalactivityalso

mayimprovethequalityofsleep.Whetherphysical

activityreducesdistressoranxietyiscurrentlyunclear.

Mentalhealthbenefitshavebeenfoundinpeoplewho

doaerobicoracombinationofaerobicandmuscle-

strengtheningactivities3to5daysaweekfor30to

60minutesatatime.Someresearchhasshownthat

evenlowerlevelsofphysicalactivityalsomayprovide

somebenefits.

Regularphysicalactivityappearstoreducesymptoms

ofanxietyanddepressionforchildrenandadolescents.

Whetherphysicalactivityimprovesself-esteemis

notclear.

Adverse Events

Somepeoplehesitatetobecomeactiveorincreasetheir

levelofphysicalactivitybecausetheyfeargetting

injuredorhavingaheartattack.Studiesofgenerally

healthypeopleclearlyshowthatmoderate-intensity

physicalactivity,suchasbriskwalking,hasalowrisk

ofsuchadverseevents.

Theriskofmusculoskeletalinjuryincreaseswiththe

totalamountofphysicalactivity.Forexample,a

personwhoregularlyruns40milesaweekhasahigher

riskofinjurythanapersonwhoruns10mileseach

week.However,peoplewhoarephysicallyactivemay

havefewerinjuriesfromothercauses,suchasmotor

vehiclecollisionsorwork-relatedinjuries.Depending

onthetypeandamountofactivitythatphysically

activepeopledo,theiroverallinjuryratemaybelower

thantheoverallinjuryrateforinactivepeople.

Participationincontactorcollisionsports,suchas

soccerorfootball,hasahigherriskofinjurythan

participationinnon-contactphysicalactivity,suchas

swimmingorwalking.However,whenperformingthe

sameactivity,peoplewhoarelessfitaremorelikely

tobeinjuredthanpeoplewhoarefitter.

Cardiacevents,suchasaheartattackorsuddendeath

duringphysicalactivity,arerare.However,therisk

ofsuchcardiaceventsdoesincreasewhenaperson

suddenlybecomesmuchmoreactivethanusual.Thegreatestriskoccurswhenanadultwhoisusually

inactiveengagesinvigorous-intensityactivity(suchas

shovelingsnow).Peoplewhoareregularlyphysically

activehavethelowestriskofcardiaceventsboth

whilebeingactiveandoverall.

Thebottomlineisthatthehealthbenefitsofphysical

activityfaroutweightherisksofadverseeventsfor

almosteveryone.



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ActiveChildrenand

Adolescents

Regularphysicalactivityinchildrenand

adolescentspromoteshealthandfitness.

Comparedtothosewhoareinactive,physically

activeyouthhavehigherlevelsofcardiorespiratory

fitnessandstrongermuscles.Theyalsotypicallyhave

lowerbodyfatness.Theirbonesarestronger,andtheymayhavereducedsymptomsofanxietyanddepression.

Youthwhoareregularlyactivealsohaveabetter

chanceofahealthyadulthood.Childrenandadolescents

dontusuallydevelopchronicdiseases,suchasheart

disease,hypertension,type2diabetes,orosteoporosis.

However,riskfactorsforthesediseasescanbeginto

developearlyinlife.Regularphysicalactivitymakesit

lesslikelythattheseriskfactorswilldevelopandmore

likelythatchildrenwillremainhealthyasadults.

Youthcanachievesubstantialhealthbenefitsbydoing

moderate-andvigorous-intensityphysicalactivityfor

periodsoftimethataddupto60minutes(1hour)or

moreeachday.Thisactivityshouldincludeaerobic

activityaswellasage-appropriatemuscle-andbone-

strengtheningactivities.Althoughcurrentscienceis

notcomplete,itappearsthat,aswithadults,thetotal

amountofphysicalactivityismoreimportantfor

achievinghealthbenefitsthanisanyonecomponent

(frequency,intensity,orduration)orspecificmix

ofactivities(aerobic,muscle-strengthening,bone-

strengthening).Evenso,bone-strengtheningactivities

remainespeciallyimportantforchildrenandyoung

adolescentsbecausethegreatestgainsinbonemassoccurduringtheyearsjustbeforeandduringpuberty.

Inaddition,themajorityofpeakbonemassisobtained

bytheendofadolescence.

Thischapterprovidesphysicalactivityguidancefor

childrenandadolescentsaged6to17,andfocuseson

physicalactivitybeyondbaselineactivity.

Parentsandotheradultswhoworkwithorcarefor

youthshouldbefamiliarwiththeGuidelinesinthis

chapter.Theseadultsshouldbeawarethat,aschildren

becomeadolescents,theytypicallyreducetheirphysical

activity.Adultsplayanimportantroleinproviding

age-appropriateopportunitiesforphysicalactivity.

Indoingso,theyhelplayanimportantfoundation

forlife-long,health-promotingphysicalactivity.

Adultsneedtoencourageactiveplayinchildrenand

encouragesustainedandstructuredactivityaschildren

growolder.



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Key Guidelines for Children and Adolescents

Childrenandadolescentsshoulddo60minutes(1hour)ormoreofphysicalactivitydaily.

Aerobic: Mostofthe60ormoreminutesadayshouldbeeithermoderate- orvigorous-intensityaerobic

physicalactivity,andshouldincludevigorous-intensityphysicalactivityatleast3daysaweek.

Muscle-strengthening:Aspartoftheir60ormoreminutesofdailyphysicalactivity,childrenand

adolescentsshouldincludemuscle-strengtheningphysicalactivityonatleast3daysoftheweek.

Bone-strengthening:Aspartoftheir60ormoreminutesofdailyphysicalactivity,childrenand

adolescentsshouldincludebone-strengtheningphysicalactivityonatleast3daysoftheweek.

Itisimportanttoencourageyoungpeopletoparticipateinphysicalactivitiesthatareappropriatefortheir

age,thatareenjoyable,andthatoffervariety.

Explaining the Guidelines

Types of Activity

TheGuidelinesforchildrenandadolescentsfocuson

threetypesofactivity:aerobic,muscle-strengthening,

andbone-strengthening.Eachtypehasimportant

healthbenefits.

Aerobic activities arethoseinwhichyoung

peoplerhythmicallymovetheirlargemuscles.

Running,hopping,skipping,jumpingrope,

swimming,dancing,andbicyclingareallexamples

ofaerobicactivities.Aerobicactivitiesincrease

cardiorespiratoryfitness.Childrenoftendo

activitiesinshortbursts,whichmaynottechnically

beaerobicactivities.However,thisdocument

willalsousethetermaerobictorefertothese

briefactivities.

Muscle-strengthening

activitiesmakemuscles

domoreworkthan

usualduringactivities

ofdailylife.Thisis

calledoverload,

anditstrengthensthe

For More Information

See Chapter 2PhysicalActivity Has Many HealthBenefits, for more on

overload and progression.

muscles.Muscle-strengtheningactivitiescanbe

unstructuredandpartofplay,suchasplaying

onplaygroundequipment,climbingtrees,and

playingtug-of-war.Ortheseactivitiescanbe

structured,suchasliftingweightsorworkingwith

resistancebands.

Bone-strengthening activitiesproduceaforceonthebonesthatpromotesbonegrowthandstrength.

Thisforceiscommonlyproducedbyimpactwith

theground.Running,jumpingrope,basketball,

tennis,andhopscotchareallexamplesofbone-

strengtheningactivities.Astheseexamplesillustrate,

bone-strengtheningactivitiescanalsobeaerobic

andmuscle-strengthening.

How Age Influences Physical Activity in Children

and Adolescents

ChildrenandadolescentsshouldmeettheGuidelinesbydoingactivitythatisappropriatefortheirage.

Theirnaturalpatternsofmovementdifferfromthose

ofadults.Forexample,childrenarenaturallyactive

inanintermittentway,particularlywhentheydo

unstructuredactiveplay.Duringrecessandintheir

freeplayandgames,childrenusebasicaerobic

andbone-strengtheningactivities,suchasrunning,

hopping,skipping,andjumping,todevelopmovement

patternsandskills.Theyalternatebriefperiodsof

moderate-andvigorous-intensityactivitywithbrief

periodsofrest.Anyepisodeofmoderate-orvigorous-

intensityphysicalactivity,howeverbrief,countstowardtheGuidelines.

Childrenalsocommonlyincreasemusclestrength

throughunstructuredactivitiesthatinvolvelifting

ormovingtheirbodyweightorworkingagainst

resistance.Childrendontusuallydoorneedformal

muscle-strengtheningprograms,suchasliftingweights.

Chapter 3. Active Children and Adolescents


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Regular physicalactivityinchildrenandadolescents

promotesahealthybodyweightand

bodycomposition.

Aschildrengrowintoadolescents,theirpatterns

ofphysicalactivitychange.Theyareabletoplay

organizedgamesandsportsandareabletosustain

longerperiodsofactivity.Buttheystillcommonlydo

intermittentactivity,andnoperiodofmoderate-or

vigorous-intensityactivityistooshorttocounttoward

theGuidelines.

AdolescentsmaymeettheGuidelinesbydoingfree

play,structuredprograms,orboth.Structuredexercise

programscanincludeaerobicactivities,suchasplaying

asport,andmuscle-strengtheningactivities,suchas

liftingweights,workingwithresistancebands,orusing

bodyweightforresistance(suchaspush-ups,pull-ups,

andsit-ups).Muscle-strengtheningactivitiescountif

theyinvolveamoderatetohighlevelofeffortand

workthemajormusclegroupsofthebody:legs,hips,back,abdomen,chest,shoulders,andarms.

Levels of Intensity for Aerobic Activity

ChildrenandadolescentscanmeettheGuidelines

bydoingacombinationofmoderate-andvigorous-

intensityaerobicphysicalactivitiesorbydoing

onlyvigorous-intensityaerobicphysicalactivities.

Youthshouldnotdoonlymoderate-intensity

activity.Itsimportanttoincludevigorous-intensity

activitiesbecausetheycausemoreimprovementin

cardiorespiratoryfitness.

Theintensityofaerobicphysicalactivitycanbe

definedoneitheranabsoluteorarelativescale.Either

scalecanbeusedtomonitortheintensityofaerobic

physicalactivity:

Absolute intensity isbasedontherateofenergy

expenditureduringtheactivity,withouttaking

intoaccountapersons

cardiorespiratoryfitness. For More Information

See Appendix 1 for moreinformation on using

absolute or relativeintensity.

Relative intensity uses

apersonslevelof

cardiorespiratoryfitness

toassesslevelofeffort.

Relativeintensitydescribesapersonslevelofeffort

relativetohisorherfitness.Asaruleofthumb,ona

scaleof0to10,wheresittingis0andthehighestlevel

ofeffortpossibleis10,moderate-intensityactivityisa

5or6.Youngpeopledoingmoderate-intensityactivity

willnoticethattheirheartsarebeatingfasterthan

normalandtheyarebreathingharderthannormal.

Vigorous-intensityactivityisatalevelof7or8.Youth

doingvigorous-intensityactivitywillfeeltheirheart

beatingmuchfasterthannormalandtheywillbreathe

muchharderthannormal.

Whenadultssupervisechildren,theygenerallycant

ascertainachildsheartorbreathingrate.Buttheycan

observewhetherachildisdoinganactivitywhich,

basedonabsoluteenergyexpenditure,isconsideredto

beeithermoderateorvigorous.Forexample,achild

walkingbrisklytoschoolisdoingmoderate-intensity

activity.Achildrunningontheplaygroundisdoing

vigorous-intensityactivity.Thetableonpage18

includesexamplesofactivitiesclassifiedbyabsoluteintensity.Itshowsthatthesameactivitycanbe

moderateorvigorousintensity,dependingonfactors

suchasspeed(forexamplebicyclingslowlyorfast).

Physical Activity and Healthy Weight

Regularphysicalactivityinchildrenandadolescents

promotesahealthybodyweightandbodycomposition.



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Examples of Moderate- and Vigorous-Intensity Aerobic Physical Activities and Muscle- and Bone-Strengthening

Activities for Children and Adolescents

Age Group

Type of Physical Activity Children Adolescents

Moderateintensityaerobic

Active recreation, such as hiking, skateboarding,rollerblading

Bicycle riding

Brisk walking

Active recreation, such as canoeing, hiking,skateboarding, rollerblading

Brisk walking

Bicycle riding (stationary or road bike)

Housework and yard work, such as sweeping orpushing a lawn mower

Games that require catching and throwing,such as baseball and softball

Vigorousintensity Active games involving running and chasing, Active games involving running and chasing,aerobic such as tag

Bicycle riding

Jumping rope

Martial arts, such as karate

Running

Sports such as soccer, ice or field hockey,basketball, swimming, tennis

Cross-country skiing

such as flag football

Bicycle riding

Jumping rope

Martial arts, such as karate

Running

Sports such as soccer, ice or field hockey,basketball, swimming, tennis

Vigorous dancing

Cross-country skiing

Muscle-strengthening Games such as tug-of-war

Modified push-ups (with knees on the floor)

Resistance exercises using body weight orresistance bands

Rope or tree climbing

Sit-ups (curl-ups or crunches)

Swinging on playground equipment/bars

Games such as tug-of-war

Push-ups and pull-ups

Resistance exercises with exercise bands,weight machines, hand-held weights

Climbing wall

Sit-ups (curl-ups or crunches)

Bone-strengthening Games such as hopscotch

Hopping, skipping, jumping

Jumping rope

Running

Sports such as gymnastics, basketball,volleyball, tennis

Hopping, skipping, jumping

Jumping rope

Running

Sports such as gymnastics, basketball,volleyball, tennis

Note:Some activities, such as bicycling, can be moderate or vigorous intensity, depending upon level of effort

Exercisetraininginoverweightorobeseyouthcanimprovebodycompositionbyreducingoveralllevelsof

fatnessaswellasabdominalfatness.Researchstudies

reportthatfatnesscanbereducedbyregularphysical

activityofmoderatetovigorousintensity3to5times

aweek,for30to60minutes.

Meeting the Guidelines

Americanyouthvaryintheirphysicalactivity

participation.Somedontparticipateatall,others

participateinenoughactivitytomeettheGuidelines,

andsomeexceedtheGuidelines.

Chapter 3. Active Children and Adolescents


30/76

Children and adolescentscanmeetthePhysicalActivityGuidelinesandbecomeregularly

physicallyactiveinmanyways.

Onepracticalstrategytopromoteactivityinyouthis

toreplaceinactivitywithactivitywheneverpossible.

Forexample,whereappropriateandsafe,youngpeople

shouldwalkorbicycletoschoolinsteadofridingin

acar.Ratherthanjustwatchingsportingeventson

television,youngpeopleshouldparticipateinage-

appropriatesportsorgames.

Children and adolescents who do not meet the

Guidelines shouldslowlyincreasetheiractivityinsmallstepsandinwaysthattheyenjoy.Agradual

increaseinthenumberofdaysandthetimespent

beingactivewillhelpreducetheriskofinjury.

Children and adolescents who meet the Guidelines

shouldcontinuebeingactiveonadailybasisand,

ifappropriate,becomeevenmoreactive.Evidence

suggeststhatevenmorethan60minutesofactivity

everydaymayprovideadditionalhealthbenefits.

Children and adolescents who exceed the Guidelines

shouldmaintaintheiractivitylevelandvarythe

kindsofactivitiestheydotoreducetheriskofovertrainingorinjury.

Childrenandadolescentswithdisabilitiesaremore

likelytobeinactivethanthosewithoutdisabilities.

Youthwithdisabilitiesshouldworkwiththeirhealth-

careprovidertounderstandthetypesandamountsof

physicalactivityappropriateforthem.Whenpossible,

childrenandadolescentswithdisabilitiesshouldmeet

theGuidelines.Whenyoungpeoplearenotableto

participateinappropriatephysicalactivitiestomeet

theGuidelines,theyshouldbeasactiveaspossible

andavoidbeinginactive.

Getting and Staying Active: Real-Life Examples

ChildrenandadolescentscanmeetthePhysical

ActivityGuidelinesandbecomeregularlyphysically

activeinmanyways.Herearejusttwoexamples

showinghowachildandanadolescentcanbe

physicallyactiveforatleast60minuteseachdayover

thecourseofaweek.

Theseexamplesillustratethateventhoughtheactivity

patternsaredifferent,eachyoungpersonismeeting

theGuidelinesbygettingtheequivalentofatleast

60minutesormoreofaerobicactivityeachdaythat

isatleastmoderateintensity.Botharealsodoing

vigorous-intensity,muscle-strengthening,andbone-

strengtheningactivitiesonatleast3daysaweek.

Harold: A 7-Year-Old Child

Haroldparticipatesinmanytypesofphysicalactivities

inmanyplaces.Forexample,duringphysicaleducation

class,hejumpsropeanddoesgymnasticsandsit-ups.

Duringrecess,heplaysontheplaygroundoftenby

doingactivitiesthatrequirerunningandclimbing.

Healsolikestoplaysoccerwithhisfriendsandfamily.

WhenHaroldgetshomefromschool,helikestoengage

inactiveplay(playingtag)andridehisbicyclewith

hisfriendsandfamily.

Haroldgets60minutesofphysicalactivityeachday

thatisatleastmoderateintensity.Heparticipatesin

thefollowingactivitieseachday:

Monday:Walkstoandfromschool(20minutes),

playsactivelywithfamily(20minutes),jumpsrope

(10minutes),doesgymnastics(10minutes).

Tuesday:Walkstoandfromschool(20minutes),

playsonplayground(25minutes),climbson

playgroundequipment(15minutes).

Wednesday:Walkstoandfromschool(20minutes),

playsactivelywithfriends(25minutes),jumpsrope

(10minutes),runs(5minutes),doessit-ups(2minutes).

Thursday:Playsactivelywithfamily(30minutes),

playssoccer(30minutes).



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Friday:Walkstoandfromschool(20minutes),

playsactivelywithfriends(25minutes),bicycles

(15minutes).

Saturday:Playsonplayground(30minutes),climbs

onplaygroundequipment(15minutes),bicycles

(15minutes).

Sunday:Playsonplayground(10minutes),playssoccer

(40minutes),playstagwithfamily(10minutes).

HaroldmeetstheGuidelinesbydoingvigorous-

intensityaerobicactivities,bone-strengthening

activities,andmuscle-strengtheningactivitiesonat

least3daysoftheweek:

Vigorous-intensityaerobicactivities6timesduring

theweek:jumpingrope(MondayandWednesday),

running(Wednesday),soccer(Thursdayand

Sunday),playingtag(Sunday);

Bone-strengthening activities6timesduringthe

week:jumpingrope(MondayandWednesday),

running(Wednesday),soccer(Thursdayand

Sunday),playingtag(Sunday);and

Muscle-strengthening activities4timesduring

theweek:gymnastics(Monday),climbingon

playgroundequipment(TuesdayandSaturday),

sit-ups(Wednesday).

Maria: A 16-Year-Old Adolescent

Mariaparticipatesinmanytypesofphysicalactivities

inmanyplaces.Forexample,duringphysicaleducation

class,sheplaystennisanddoessit-upsandpush-ups.

ShealsolikestoplaybasketballattheYMCA,doyoga,

andgodancingwithfriends.Marialikestotakeher

dogonwalksandhikes.

Mariagets60ormoreminutesofdailyphysical

activitythatisatleastmoderateintensity.She

participatesinthefollowingactivitieseachday:

Monday:Walksdog(10minutes),playsbasketballat

YMCA(50minutes).

Tuesday:Walksdog(10minutes),playstennis

(30minutes),doessit-upsandpush-ups(5minutes),

walksbrisklywithfriends(15minutes).

Wednesday:Walksdog(10minutes),playsbasketball

atYMCA(50minutes).

Thursday:Walksdog(10minutes),playstennis

(30minutes),doessit-upsandpush-ups(5minutes),

playswithchildrenattheparkwhilebabysitting

(15minutes).

Friday:PlaysFrisbeeinpark(45minutes),mowslawn

(30minutes).

Saturday:Goesdancingwithfriends(60minutes),

doesyoga(30minutes).

Sunday:Hikes(60minutes).

MariameetstheGuidelinesbydoingvig

Documents

US Physical Activity