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Am Fam Physician. 2001;64(6):1076

Exercise prescriptions of the 1970s and 1980s strove to improve physical fitness by encouraging participation in vigorous endurance exercise. This traditional plan has been supported by the belief that achievement of a given heart-rate range or exercise intensity is necessary to obtain benefit. This recommendation has discouraged many people from becoming more physically fit through exercising. Pescatello reviewed the health merits of lifestyle physical activity.

Lifestyle physical activity is the daily accumulation of at least 30 minutes of self-selected activities, which include all leisure, occupational or household activities that are at least moderate in intensity and could be planned or unplanned activities that are part of everyday life. This kind of activity differs from physical activity that is planned, structured, repetitive and purposive, in that improvement or maintenance of physical fitness is the intent.

CharacteristicsRecommended extent and type of exercise
Frequency5 to 7 days per week, preferably daily, to total 1,000 to 2,000 kcal per week
Intensity (low-to- moderate)<55 to 70 percent peak heart rate achieved on graded exercise stress test
<40 to 60 percent VO2 max
<4 to 6 metabolic energy equivalents (i.e., 1 MET = 3.5 mL per kg per minute)
Borg rating of perceived exertion of <11 to 12
Time10 to 60 minutes per session to total 150 to 500 kcal per day; consider two or more sessions per day for a total time of 20 to 60 minutes per day
TypeAccumulated endurance activities typical of everyday life (i.e., three 10-minute walks per day while using the stairs rather than the elevator at work, supplemented by resistive (strength) and flexibility (stretching) exercises)

Exercise is a subset of physical activity. The recent documentation of the merits of low-to-moderate physical activity has led to the concept of lifestyle physical activity. The amount of exercise, especially the intensity, that can produce health benefits is significantly less than the amount needed to improve physical fitness. Physical activity of low-to-moderate intensity that is typical of everyday life has favorable effects on cardiovascular health, including improved glucose control, blood lipoprotein levels, abdominal fat distribution and blood pressure, even in the absence of substantial weight loss or physical fitness gains.

Lifestyle physical activity may be more successful than structured and more vigorous exercise in motivating sedentary and overweight persons. Lifestyle physical activity programs actually increase physical activity levels and optimize the cardiometabolic health of older and overweight persons. A lifestyle physical activity program modified for the overweight and the obese can be recommended using the FITT format: Frequency (how often), Intensity (how hard), Time (duration) and Type (modality); see accompanying table.

The author concludes that the amount of exercise needed for health benefits is significantly less than the amount needed to become physically fit, and that lifestyle physical activity programs can be more motivating than vigorous structured exercise programs, especially in the sedentary, overweight older population.

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