Physical Activity: Updated Recommendations from HHS
Am Fam Physician. 2019 Jul 1;100(1):58-59.
Author disclosure: No relevant financial affiliations.
Key Points for Practice
• Adults should perform 150 to 300 minutes of moderate physical activity each week.
• Any increase in activity is beneficial for health, especially for those under the target range.
• Evidence for the benefits of physical activity for weight gain, adiposity, and bone health exists for children as young as three years.
• Increasing physical activity in older adults can help them maintain independence by reducing cognitive decline and falls.
• Physical activity reduces symptoms of depression and anxiety and improves sleep quality.
From the AFP Editors
In 2008, the U.S. Department of Health and Human Services (HHS) published the first Physical Activity Guidelines for Americans, which recommended that adults perform 150 to 300 minutes of moderate physical activity each week. More than 10 years later, only 50% of U.S. adults attain this level, and 30% report less than 10 minutes per week. This is improved from 2008, when nearly 40% of adults reported minimal physical activity. HHS recently published updated recommendations on physical activity based on a systematic review of the effect of physical activity on health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research.
Inactive people can achieve substantial health benefits by increasing their activity level, even if they do not reach the target range. For those who perform little to no moderate to vigorous physical activity, substituting light-intensity physical activity for sedentary behaviors reduces the risk of all-cause mortality, cardiovascular disease and mortality, and type 2 diabetes mellitus. In people whose amount of moderate to vigorous physical activity is below the target range of 150 to 300 minutes per week, even small increases in moderate-intensity physical activity provide health benefits, and there is no threshold that must be exceeded to achieve these benefits.
For any given increase in moderate to vigorous physical activity, the relative gain in benefits is greater for people who currently get less than the target range than for those who are already within the target range. However, people already within the target range can still benefit by doing more moderate to vigorous physical activity. The 2018 guidelines recognize any increase in activity as beneficial instead of the 10-minute increments suggested in 2008.
Over the past 10 years, the list of diseases and conditions for which greater amounts of physical activity reduce risk has expanded significantly.
There is strong evidence that greater volumes of moderate to vigorous physical activity are associated with preventing or minimizing excessive weight gain in adults, maintaining a healthy weight, and preventing obesity. Higher amounts of physical activity are also associated with a reduced risk of excessive body weight and adiposity in children three to 17 years of age.
Regular physical activity has been shown to provide health benefits, including improved bone health, in children as young as three years. Three hours of daily physical activity are recommended for all children, with at least 60 minutes of moderate-intensity activity every day for school-aged children.
Physically active women are less likely to gain excessive weight during pregnancy or to develop gestational diabetes or postpartum depression.
Strong evidence shows that greater volumes of physical activity reduce the risk of dementia and improve other aspects of cognitive function while reducing falls and fall-related injuries in older adults. These benefits can enable older adults to maintain their independence longer. Osteoarthritis pain is reduced with consistent physical activity. Physical activity improves function in patients with Parkinson disease, multiple sclerosis, stroke, and other types of frailty.
In addition to reductions in the risk of breast and colon cancers reported in 2008, studies have shown reduced risk of cancers of the bladder, endometrium, esophagus, kidney, lung, and stomach.
A large portion of the general population already has a chronic disease or condition. For these individuals, regular physical activity can reduce the risk of developing a new chronic condition, reduce the risk of progression of the condition they already have, and improve their quality of life and physical function.
Quality of Life
In addition to disease prevention benefits, regular physical activity provides a variety of benefits that help people sleep, function, and feel better.
Strong evidence shows that moderate to vigorous physical activity improves sleep quality by reducing sleep latency and interruptions. It also can increase the time in deep sleep and reduce daytime sleepiness.
Single episodes of physical activity also have a variety of benefits. Moderate-intensity physical activity sessions lead to improvements in blood pressure, insulin sensitivity, anxiety symptoms, and sleep. There are also cognitive benefits of exercise, including short-term improvements in executive function, memory, processing speed, attention, and academic performance.
Regular physical activity not only reduces the risk of clinical depression, but reduces depressive symptoms among people with and without clinical depression. It also reduces symptoms of chronic and acute anxiety.
Guideline source: U.S. Department of Health and Human Services
Evidence rating system used? Yes
Systematic literature search described? Yes
Guideline developed by participants without relevant financial ties to industry? Yes
Recommendations based on patient-oriented outcomes? Yes
Published source: 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, D.C.: U.S. Department of Health and Human Services; 2018
Available at: https://health.gov/paguidelines/second-edition/report/
Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.
This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.
A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.
Copyright © 2019 by the American Academy of Family Physicians.
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