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Physical Activity and Public Health : Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association
 
 
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Circulation 2007
 
Summary-In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts.
 
Comments were integrated into the final recommendation.
 
Primary Recommendation-To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum by performing bouts each lasting 10 or more minutes. [I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition, every adult should perform activities that maintain or increase muscular strength and endurance a minimum of two days each week. [IIa (A)] Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of physical activity. [I (A)] (Circulation. 2007;116:1081-1093.)
 
UPDATED RECOMMENDATION STATEMENT
 
This recommendation applies to healthy adults between 18 and 65 yr of age, and to persons in this age range with chronic conditions not related to physical activity (e.g., hearing impairment). During pregnancy and the post- partum period additional precautions may be needed: these issues have been considered by other expert committees (3,7). The present preventive recommendation specifies how adults, by engaging in regular physical activity, can promote and maintain health, and reduce risk of chronic disease and premature mortality. A companion recommen- dation (47) builds on the information in this paper but specifically applies to adults aged 65 and over, and adults aged 50-64 with chronic conditions or physical functional limitations (e.g., arthritis), that affect movement ability or physical fitness. The following recommendation reflects a review of evidence published since the issuance of the CDC/ACSM recommendation in 1995 and considers key issues not fully clarified in the original recommendation. Classification of recommendations (COR) and level of evidence (LOE) are expressed in American College of Cardiology/American Heart Association (ACC/AHA) for- mat as defined in Table 1 and the Methodology Manual for ACC/AHA Guideline Writing Committees (2).
 
Aerobic Activity.
 
To promote and maintain health, all healthy adults aged 18-65 yr need moderate-intensity aerobic physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic activity for a minimum of 20 min on three days each week. [I (A)] Also, combinations of moderate- and vigorous- intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum from bouts lasting 10 or more minutes.
 
[I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. This recommended amount of aerobic activity is in addition to routine activities of daily living of light intensity (e.g., self care, cooking, casual walking or shopping) or lasting less than 10 min in duration (e.g., walking around home or office, walking from the parking lot).
 
Muscle-Strengthening Activity.
 
To promote and maintain good health and physical independence, adults will benefit from performing activities that maintain or increase muscular strength and endurance for a minimum of two days each week. [IIa (A)] It is recommended that 8-10 exercises be performed on two or more nonconsecutive days each week using the major muscle groups. To maximize strength development, a resistance (weight) should be used that allows 8-12 repetitions of each exercise resulting in volitional fatigue. Muscle-strengthening activities include a progressive weight-training program, weight bearing calisthenics, stair climbing, and similar resistance exercises that use the major muscle groups.
 
Benefits of Greater Amounts of Activity.
 
Participation in aerobic and muscle-strengthening physical activities above minimum recommended amounts provides additional health benefits and results in higher levels of physical fitness. [I (A)] Many adults, including those who wish to improve their personal fitness or further reduce their risk for premature chronic health conditions and mortality related to physical inactivity, should exceed the minimum recommended amounts of physical activity (33). In addition, to further promote and maintain skeletal health, adults will benefit by engaging in extra weight-bearing activity and higher-impact activity such as stair-climbing or jogging, as tolerated. [IIa (B)] To help prevent unhealthy weight gain, some adults will need to exceed minimum recommended amounts of physical activity to a point that is individually effective in achieving energy balance, while considering their food intake and other factors that affect body weight. [IIa (B)]
 
 
 
 
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