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U.S.

Department of
Health and Human Services
2008 Physical Activity
Guidelines for Americans
BeActive,Healthy,andHappy!
www.health.gov/paguidelines

THE SECRETARY OF HEALTH AND HUMAN SERVI CES


WASHI NGTON, D. C. 20201
Iampleasedtopresentthe2008PhysicalActivityGuidelinesforAmericans,therstcomprehensive
guidelinesonphysicalactivityevertobeissuedbytheFederalgovernment.Thisdocumentis
intendedtobeaprimarysourceofinformationforpolicymakers,physicaleducators,health
providers,andthepublicontheamount,types,andintensityofphysicalactivityneededtoachieve
manyhealthbenetsforAmericansacrossthelifespan.Thegoodnewsisthattheseguidelinesare
achievableandcanbecustomizedaccordingtoapersonsinterests,lifestyle,andgoals.
ThisdocumentisbasedonthereportsubmittedbythePhysicalActivityGuidelinesAdvisory
Committee,agroupcomprising13leadingexpertsintheeldofexercisescienceandpublic
health.Thecommitteeconductedanextensivereviewofthescienticdatarelatingphysical
activitytohealthpublishedsincethereleaseofthe1996SurgeonGeneralsReportonPhysical
ActivityandHealth.IwanttothanktheCommitteeandotherpublicandprivateprofessionals
whoassistedincreatingthisdocumentfortheirhardworkanddedication.
AlongwithPresidentBush,Ibelievethatphysicalactivityshouldbeanessentialcomponentof
anycomprehensivediseasepreventionandhealthpromotionstrategyforAmericans.Weknow
thatsedentarybehaviorcontributestoahostofchronicdiseases,andregularphysicalactivityis
animportantcomponentofanoverallhealthylifestyle.Thereisstrongevidencethatphysically
activepeoplehavebetterhealth-relatedphysicaltnessandareatlowerriskofdevelopingmany
disablingmedicalconditionsthaninactivepeople.
Preventionisoneofmytoppriorities.Althoughphysicalactivityisclearlyvitaltoprevention,
itiseasyformanyofustooverlook.ThesePhysicalActivityGuidelinesforAmericansprovide
achievablestepsforyouth,adults,andseniors,aswellaspeoplewithspecialconditionstolive
healthierandlongerlives.
Sincerely,
MichaelO.Leavitt
2008PhysicalActivityGuidelinesforAmericans ii

Acknowledgments
TheU.S.DepartmentofHealthandHumanServices(HHS)wouldliketorecognizetheeffortsofthePhysicalActivity
GuidelinesSteeringCommitteethatoversawtheworkofthePhysicalActivityGuidelinesAdvisoryCommitteeand
thePhysicalActivityGuidelineswritinggroup:RearAdmiralPenelopeSladeRoyall,PT,MSW(OfceofDisease
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;andthescienticwriter/editor,
AnneBrownRodgers.
TheDepartmentalsogratefullyacknowledgestheworkconductedbythe2008PhysicalActivityGuidelines
AdvisoryCommittee.Theirextensivereviewofthescienticliteratureonphysicalactivityandhealthandtheir
committeedeliberationsaresummarizedinthePhysicalActivityGuidelinesAdvisoryCommitteeReport,2008.
TheCommitteesreportprovidedthebasisforthe2008PhysicalActivityGuidelinesforAmericans.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,policyofcials,andtheexternalpeerreviewerswhoreviewedthe2008Physical
ActivityGuidelinesforAmericansandprovidedhelpfulsuggestions.
Acknowledgments iii
Contents
2008PhysicalActivityGuidelinesforAmericansSummary...........................................................................vi
KeyGuidelinesforChildrenandAdolescents..................................................................................................vii
KeyGuidelinesforAdults..................................................................................................................................vii
KeyGuidelinesforOlderAdults.........................................................................................................................vii
KeyGuidelinesforSafePhysicalActivity.......................................................................................................viii
KeyGuidelinesforWomenDuringPregnancyandthePostpartumPeriod..............................................viii
KeyGuidelinesforAdultsWithDisabilities....................................................................................................viii
KeyMessagesforPeopleWithChronicMedicalConditions........................................................................viii
ARoadmaptothe2008PhysicalActivityGuidelinesforAmericans..........................................................ix
Chapter1:Introducingthe2008PhysicalActivityGuidelinesforAmericans.................................................1
WhyandHowtheGuidelinesWereDeveloped..................................................................................................1
TheFrameworkforthePhysicalActivityGuidelinesforAmericans..............................................................2
PuttingtheGuidelinesIntoPractice.....................................................................................................................5
Chapter2:PhysicalActivityHasManyHealthBenets.................................................................................. 7
ExaminingtheRelationshipBetweenPhysicalActivityandHealth...............................................................7
TheHealthBenetsofPhysicalActivity.............................................................................................................9
Chapter3:ActiveChildrenandAdolescents.................................................................................................... 15
ExplainingtheGuidelines................................................................................................................................... 16
MeetingtheGuidelines........................................................................................................................................ 18
GettingandStayingActive:Real-LifeExamples............................................................................................ 19
Chapter4:ActiveAdults........................................................................................................................................ 21
ExplainingtheGuidelines....................................................................................................................................21
MeetingtheGuidelines.......................................................................................................................................24
SpecialConsiderations.........................................................................................................................................25
GettingandStayingActive:Real-LifeExamples...........................................................................................26
Chapter5:ActiveOlderAdults............................................................................................................................. 29
ExplainingtheGuidelines................................................................................................................................... 29
MeetingtheGuidelines........................................................................................................................................ 32
SpecialConsiderations.........................................................................................................................................32
GettingandStayingActive:Real-LifeExamples............................................................................................ 34
2008PhysicalActivityGuidelinesforAmericans iv
Chapter6:SafeandActive.................................................................................................................................... 35
ExplainingtheGuidelines................................................................................................................................... 35
GraduallyIncreasingPhysicalActivityOverTime:Real-LifeExamples.....................................................40
Chapter7:AdditionalConsiderationsforSomeAdults................................................................................. 41
PhysicalActivityforWomenDuringPregnancyandthePostpartumPeriod.............................................41
PhysicalActivityforPeopleWithDisabilities.................................................................................................42
PhysicalActivityforPeopleWithChronicMedicalConditions...................................................................43
Chapter8:TakingAction:IncreasingPhysicalActivityLevelsofAmericans........................................... 45
WhatCanAdultsDoToGetEnoughPhysicalActivity?................................................................................46
HowCanWeHelpChildrenandAdolescentsGetEnoughPhysicalActivity?...........................................46
WhatCanCommunitiesDoToHelpPeopleBeActive?.................................................................................48
Glossary....................................................................................................................................................................... 51
Appendix1.TranslatingScienticEvidenceAboutTotalAmountandIntensityof
PhysicalActivityIntoGuidelines.......................................................................................................................... 54
Background............................................................................................................................................................54
TwoMethodsofAssessingAerobicIntensity.................................................................................................55
DevelopingGuidelinesBasedonMinutesofModerate-andVigorous-IntensityActivity...................... 55
UsingRelativeIntensityToMeetGuidelinesExpressedinTermsofAbsoluteIntensity..........................56
Appendix2.SelectedExamplesofInjuryPreventionStrategiesforCommon
PhysicalActivitiesandSports.............................................................................................................................. 58
Appendix3.FederalWebSitesThatPromotePhysicalActivity.................................................................. 60
IndividualsandFamilies.....................................................................................................................................60
Schools...................................................................................................................................................................60
Communities..........................................................................................................................................................60
HealthCare.............................................................................................................................................................61
Worksites.................................................................................................................................................................61
Contents v

2008PhysicalActivityGuidelinesfor
AmericansSummary
Beingphysicallyactiveisoneofthemostimportant
stepsthatAmericansofallagescantaketoimprove
theirhealth.The2008PhysicalActivityGuidelines
forAmericansprovidesscience-basedguidanceto
helpAmericansaged6andolderimprovetheirhealth
throughappropriatephysicalactivity.
TheU.S.DepartmentofHealthandHumanServices
(HHS)issuesthePhysicalActivityGuidelinesfor
Americans.ThecontentofthePhysicalActivity
GuidelinescomplementstheDietaryGuidelines
forAmericans,ajointeffortofHHSandthe
U.S.DepartmentofAgriculture(USDA).Together,
thetwodocumentsprovideguidanceonthe
importanceofbeingphysicallyactiveandeatinga
healthydiettopromotegoodhealthandreducethe
riskofchronicdiseases.
TheprimaryaudiencesforthePhysicalActivity
Guidelinesarepolicymakersandhealthprofessionals.
TheseGuidelinesaredesignedtoprovideinformation
andguidanceonthetypesandamountsofphysical
activitythatprovidesubstantialhealthbenets.This
informationmayalsobeusefultointerestedmembers
ofthepublic.ThemainideabehindtheGuidelinesis
thatregularphysicalactivityovermonthsandyears
canproducelong-termhealthbenets.Realizingthese
benetsrequiresphysicalactivityeachweek.
Regular
physicalactivitycanproducelong-
termhealthbenets.
ThestepsusedtodevelopthePhysicalActivity
GuidelinesforAmericansweresimilartothoseused
fortheDietaryGuidelinesforAmericans.In2007,
HHSSecretaryMikeLeavittappointedanexternal
scienticadvisorycommittee,calledthePhysical
ActivityGuidelinesAdvisoryCommittee.TheAdvisory
Committeeconductedanextensiveanalysisofthe
scienticinformationonphysicalactivityandhealth.
ThePhysicalActivityGuidelinesAdvisoryCommittee
Report,2008andmeetingsummariesareavailableat
http://www.health.gov/PAGuidelines/.
HHSprimarilyusedtheAdvisoryCommitteesreport
butalsoconsideredcommentsfromthepublicand
GovernmentagencieswhenwritingtheGuidelines.
TheGuidelineswillbewidelypromotedthrough
variouscommunicationsstrategies,suchasmaterials
forthepublic,Websites,andpartnershipswith
organizationsthatpromotephysicalactivity.
ThePhysicalActivityGuidelinesforAmericans
describesthemajorresearchndingsonthehealth
benetsofphysicalactivity:
Regularphysicalactivityreducestheriskofmany
adversehealthoutcomes.
Somephysicalactivityisbetterthannone.
Formosthealthoutcomes,additionalbenets
occurastheamountofphysicalactivityincreases
throughhigherintensity,greaterfrequency,and/or
longerduration.
Mosthealthbenetsoccurwithatleast150minutes
(2hoursand30minutes)aweekofmoderate-
intensityphysicalactivity,suchasbriskwalking.
Additionalbenetsoccurwithmorephysicalactivity.
Bothaerobic(endurance)andmuscle-strengthening
(resistance)physicalactivityarebenecial.
Healthbenetsoccurforchildrenandadolescents,
youngandmiddle-agedadults,olderadults,and
thoseineverystudiedracialandethnicgroup.
2008PhysicalActivityGuidelinesforAmericans vi




Thehealthbenetsofphysicalactivityoccurfor
peoplewithdisabilities.
Thebenetsofphysicalactivityfaroutweighthe
possibilityofadverseoutcomes.
ThefollowingarethekeyGuidelinesincludedinthe
PhysicalActivityGuidelinesforAmericans:
KeyGuidelinesforChildrenandAdolescents
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:Aspartoftheir60ormore
minutesofdailyphysicalactivity,childrenand
adolescentsshouldincludebone-strengthening
physicalactivityonatleast3daysoftheweek.
Itisimportanttoencourageyoungpeopleto
participateinphysicalactivitiesthatareappropriate
fortheirage,thatareenjoyable,andthatoffer
variety.
KeyGuidelinesforAdults
Alladultsshouldavoidinactivity.Somephysical
activityisbetterthannone,andadultswho
participateinanyamountofphysicalactivitygain
somehealthbenets.
Forsubstantialhealthbenets,adultsshoulddoat
least150minutes(2hoursand30minutes)aweek
ofmoderate-intensity,or75minutes(1hourand
15minutes)aweekofvigorous-intensityaerobic
physicalactivity,oran
equivalentcombinationof
moderate-andvigorous-
intensityaerobicactivity.
Aerobicactivityshould
beperformedinepisodes
ofatleast10minutes,
andpreferably,itshould
bespreadthroughout
theweek.
Foradditionalandmoreextensivehealthbenets,
adultsshouldincreasetheiraerobicphysicalactivity
to300minutes(5hours)aweekofmoderate-
intensity,or150minutesaweekofvigorous-
intensityaerobicphysicalactivity,oranequivalent
combinationofmoderate-andvigorous-intensity
activity.Additionalhealthbenetsaregainedby
engaginginphysicalactivitybeyondthisamount.
Adultsshouldalsodomuscle-strengthening
activitiesthataremoderateorhighintensityand
involveallmajormusclegroupson2ormore
daysaweek,astheseactivitiesprovideadditional
healthbenets.
KeyGuidelinesforOlderAdults
TheKeyGuidelinesforAdultsalsoapplytoolder
adults.Inaddition,thefollowingGuidelinesarejust
forolderadults:
Whenolderadults
cannotdo150minutes
ofmoderate-intensity
aerobicactivityaweek
becauseofchronic
conditions,theyshould
beasphysicallyactive
astheirabilitiesand
conditionsallow.
Olderadultsshoulddoexercisesthatmaintainor
improvebalanceiftheyareatriskoffalling.
Olderadultsshoulddeterminetheirlevelofeffortfor
physicalactivityrelativetotheirleveloftness.
Olderadultswithchronicconditionsshould
understandwhetherandhowtheirconditionsaffect
theirabilitytodoregularphysicalactivitysafely.
PhysicalActivityGuidelinesforAmericansSummary vii








KeyGuidelinesforSafePhysicalActivity
Todophysicalactivitysafelyandreducetheriskof
injuriesandotheradverseevents,peopleshould:
Understandtherisksandyetbecondentthat
physicalactivityissafeforalmosteveryone.
Choosetodotypesofphysicalactivitythatare
appropriatefortheircurrenttnessleveland
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.
KeyGuidelinesforWomenDuringPregnancy
andthePostpartumPeriod
Healthywomenwhoarenotalreadyhighly
activeordoingvigorous-intensityactivityshould
getatleast150minutesofmoderate-intensity
aerobicactivityaweekduringpregnancyandthe
postpartumperiod.Preferably,thisactivityshould
bespreadthroughouttheweek.
Pregnantwomenwhohabituallyengagein
vigorous-intensityaerobicactivityorwhoare
highlyactivecancontinuephysicalactivityduring
pregnancyandthepostpartumperiod,provided
thattheyremainhealthyanddiscusswiththeir
health-careproviderhowandwhenactivityshould
beadjustedovertime.
KeyGuidelinesforAdultsWithDisabilities
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
additionalhealthbenets.
Whenadultswithdisabilitiesarenotabletomeet
theGuidelines,theyshouldengageinregular
physicalactivityaccordingtotheirabilitiesand
shouldavoidinactivity.
Adultswithdisabilitiesshouldconsulttheirhealth-
careproviderabouttheamountsandtypesof
physicalactivitythatareappropriatefortheir
abilities.
KeyMessagesforPeopleWithChronicMedical
Conditions
Adultswithchronicconditionsobtainimportant
healthbenetsfromregularphysicalactivity.
Whenadultswithchronicconditionsdoactivity
accordingtotheirabilities,physicalactivityissafe.
Adultswithchronicconditionsshouldbeunderthe
careofahealth-careprovider.Peoplewithchronic
conditionsandsymptomsshouldconsulttheir
health-careprovideraboutthetypesandamounts
ofactivityappropriateforthem.
viii 2008PhysicalActivityGuidelinesforAmericans

ARoadmaptothe2008Physical
ActivityGuidelinesforAmericans
Foranoverviewofthedevelopmentofthe
PhysicalActivityGuidelinesforAmericans
andimportantbackgroundinformationabout
physicalactivity,read
Chapter1Introducing NOTE
The Guidelines assume
that many readers will
not read all the chapters,
but will read only what is
relevant to them. Important
information may therefore
be repeated in several
chapters.
the2008Physical
ActivityGuidelinesfor
Americans.
Tolearnaboutthe
healthbenetsof
physicalactivity,read
Chapter2Physical
ActivityHasMany
HealthBenets.Thisinformationmayhelpmotivate
peopletobecomeregularlyactive.
Tounderstandhowtodophysicalactivityina
mannerthatmeetstheGuidelines:
Foryouthaged6to17,includingyouthwith
disabilities,readChapter3ActiveChildren
andAdolescents.
Foradultsaged18to64,readChapter4
ActiveAdults.
Foradultsaged65andolder,readChapter5
ActiveOlderAdults.Thischapterisalso
appropriatereadingforadultsyounger
thanage65whohavechronicconditions.
TheGuidelinesforolderadultsaresimilarto
thoseforotheradultsbutaddsomespecic
considerations,suchasguidelinesforfall
prevention.
Forwomenwhoarepregnantorwhohave
recentlygivenbirth(postpartumperiod),readthe
age-appropriatechapterandalsothesectionon
physicalactivityandpregnancyinChapter6
SafeandActiveandChapter7Additional
ConsiderationsforSomeAdults.
Foradultswithdisabilities,readChapter4Active
AdultsandChapter7AdditionalConsiderations
forSomeAdults.
Tounderstandhowtoreducetherisksofactivity-
relatedinjury,readChapter6SafeandActive.
Thoseinterestedinanoverviewofwaystohelp
peopleparticipateregularlyinphysicalactivity
shouldreadChapter8TakingAction:Increasing
PhysicalActivityLevelsofAmericans.
TheGlossarycontainsdenitionsofkeytermsused
intheGuidelines.Termsthataredenedinthe
glossaryareunderlinedthersttimetheyareused.
Additionalinformationandresourcesrelevanttothe
GuidelinesareavailableintheAppendices.
ARoadmaptothePhysicalActivityGuidelinesforAmericans ix







Introducingthe2008
PhysicalActivity
GuidelinesforAmericans
B
eingphysicallyactiveisoneofthemost
importantstepsthatAmericansofallagescan
taketoimprovetheirhealth.Thisinaugural
PhysicalActivityGuidelinesforAmericansprovides
science-basedguidancetohelpAmericansaged6
andolderimprovetheirhealththroughappropriate
physicalactivity.
TheU.S.DepartmentofHealthandHumanServices
(HHS)issuesthePhysicalActivityGuidelinesfor
Americans.ThecontentofthePhysicalActivity
GuidelinescomplementstheDietaryGuidelines
forAmericans,ajointeffortofHHSandtheU.S.
DepartmentofAgriculture(USDA).Together,thetwo
documentsprovideguidanceontheimportanceofbeing
physicallyactiveandeatingahealthydiettopromote
goodhealthandreducetheriskofchronicdiseases.
Thischapterprovidesbackgroundinformation
abouttherationaleandprocessfordevelopingthe
Guidelines.Itthendiscussesseveralissuesthatprovide
theframeworkforunderstandingtheGuidelines.
ThechapteralsoexplainshowtheseGuidelinestin
withotherpublishedphysicalactivityrecommendations
andhowtheyshouldbeusedinpractice.
WhyandHowtheGuidelinesWere
Developed
The Rationale for Physical Activity Guidelines
Weclearlyknowenoughnowtorecommendthat
allAmericansshouldengageinregularphysical
activitytoimproveoverallhealthandtoreduce
riskofmanyhealthproblems.Physicalactivityis
aleadingexampleofhowlifestylechoiceshavea
profoundeffectonhealth.Thechoiceswemakeabout
otherlifestylefactors,suchasdiet,smoking,and
alcoholuse,alsohaveimportantandindependent
effectsonourhealth.
TheprimaryaudiencesforthePhysicalActivity
GuidelinesforAmericansarepolicymakersand
healthprofessionals.TheGuidelinesaredesignedto
provideinformationandguidanceonthetypesand
amountsofphysicalactivitythatprovidesubstantial
healthbenets.Thisinformationmayalsobeuseful
tointerestedmembersofthepublic.Themainidea
behindtheGuidelinesisthatregularphysicalactivity
overmonthsandyearscanproducelong-termhealth
benets.Realizingthesebenetsrequiresphysical
activityeachweek.
2008PhysicalActivityGuidelinesforAmericans 1





TheseGuidelinesarenecessarybecauseofthe
importanceofphysicalactivitytothehealthof
Americans,whosecurrentinactivityputsthemat
unnecessaryrisk.HealthyPeople2010setobjectives
forincreasingthelevelofphysicalactivityin
Americansoverthedecadefrom2000to2010.
Unfortunately,thelatestinformationshowsthat
inactivityamongAmericanadultsandyouthremains
relativelyhighandthatlittleprogresshasbeen
madeinmeetingtheseobjectives.
The Development of the Physical Activity Guidelines
for Americans
Since1995theDietaryGuidelinesforAmericans
hasincludedadviceonphysicalactivity.However,
withthedevelopmentofarmsciencebaseon
thehealthbenetsofphysicalactivity,HHSbegan
toconsiderwhetherseparatephysicalactivity
guidelineswereappropriate.Withthehelpofthe
InstituteofMedicine,HHSconvenedaworkshopin
October2006toaddressthisquestion.Theworkshops
report,AdequacyofEvidenceforPhysicalActivity
GuidelinesDevelopment(http://www.nap.edu/
catalog.php?record_id=11819),afrmedthat
advancesinthescienceofphysicalactivityand
healthjustiedthecreationofseparatephysical
activityguidelines.
ThestepsusedtodevelopthePhysicalActivity
GuidelinesforAmericansweresimilartothoseused
fortheDietaryGuidelinesforAmericans.In2007
HHSSecretaryMikeLeavittappointedanexternal
scienticadvisorycommitteecalledthePhysical
ActivityGuidelinesAdvisoryCommittee.TheAdvisory
Committeeconductedanextensiveanalysisofthe
scienticinformationonphysicalactivityandhealth.
ThePhysicalActivityGuidelinesAdvisoryCommittee
Report,2008andmeetingsummariesareavailable
athttp://www.health.gov/PAGuidelines/.
HHSprimarilyusedtheAdvisoryCommitteesreport
butalsoconsideredcommentsfromthepublicand
GovernmentagencieswhenwritingtheGuidelines.
TheGuidelineswillbewidelypromotedthrough
variouscommunicationsstrategies,suchasmaterials
forthepublic,Websites,andpartnershipswith
organizationsthatpromotephysicalactivity.
TheFrameworkforthePhysicalActivity
GuidelinesforAmericans
TheAdvisoryCommitteereportprovidedthecontent
andconceptualunderpinningfortheGuidelines.
Themainelementsofthisframeworkaredescribed
inthefollowingsections.
Baseline Activity Versus Health-Enhancing
Physical Activity
Physicalactivityhasbeendenedasanybodily
movementproducedbythecontractionofskeletal
musclethatincreasesenergyexpenditureabovea
basallevel.However,inthisdocument,theterm
physicalactivitywillgenerallyrefertobodily
movementthatenhanceshealth.Bodilymovement
canbedividedintotwocategories:
Baselineactivityreferstothelight-intensity
activitiesofdailylife,suchasstanding,walking
slowly,andliftinglightweightobjects.Peoplevary
inhowmuchbaselineactivitytheydo.People
whodoonlybaselineactivityareconsideredto
beinactive.Theymaydoveryshortepisodesof
moderate-orvigorous-intensityactivity,suchas
climbingafewightsofstairs,buttheseepisodes
arentlongenoughtocounttowardmeetingthe
Guidelines.TheGuidelinesdontcommenton
howvariationsintypesandamountsofbaseline
physicalactivitymightaffecthealth,asthiswas
notaddressedbytheAdvisoryCommitteereport.
Health-enhancingphysicalactivityisactivitythat,
whenaddedtobaselineactivity,produceshealth
benets.Inthisdocument,thetermphysical
activitygenerallyreferstohealth-enhancing
physicalactivity.Briskwalking,jumpingrope,
dancing,liftingweights,climbingonplayground
equipmentatrecess,anddoingyogaareall
examplesofphysicalactivity.Somepeople(suchas
postalcarriersorcarpentersonconstructionsites)
maygetenoughphysicalactivityonthejobto
meettheGuidelines.
Wedontunderstandenoughaboutwhetherdoing
morebaselineactivityresultsinhealthbenets.
Evenso,effortstopromotebaselineactivitiesare
justiable.Afterall,baselineactivitiesarenormal
Chapter1.Introducingthe2008PhysicalActivityGuidelinesforAmericans 2

Inthisdocument,
thetermphysicalactivitywill
generallyrefertobodilymovement
thatenhanceshealth.
lifestyleactivities.EncouragingAmericanstoincrease
theirbaselineactivityissensibleforseveralreasons:
Increasingbaselineactivityburnscalories,which
canhelpinmaintainingahealthybodyweight.
Somebaselineactivitiesareweight-bearingand
mayimprovebonehealth.
Therearereasonsotherthanhealthtoencourage
morebaselineactivity.Forexample,walkingshort
distancesinsteadofdrivingcanhelpreducetrafc
congestionandtheresultingairpollution.
Encouragingbaselineactivitieshelpsbuildaculture
wherephysicalactivityingeneralisthesocialnorm.
Shortepisodesofactivityareappropriatefor
peoplewhowereinactiveandhavestartedto
graduallyincreasetheirlevelofactivity,andfor
olderadultswhoseactivitymaybelimitedby
chronicconditions.
Theavailabilityofinfrastructuretosupportshort
episodesofactivityisthereforeimportant.Forexample,
peopleshouldhavetheoptionofusingsidewalks
andpathstowalkbetweenbuildingsataworksite,
ratherthanhavingtodrive.Peopleshouldalsohave
theoptionoftakingthestairsinsteadofusingan
elevator.
Health Benets Versus Other Reasons To Be
Physically Active
AlthoughtheGuidelinesfocusonthehealthbenets
ofphysicalactivity,thesebenetsarenottheonly
reasonwhypeopleareactive.Physicalactivitygives
peopleachancetohavefun,bewithfriendsand
family,enjoytheoutdoors,improvetheirpersonal
appearance,andimprovetheirtnesssothatthey
canparticipateinmoreintensivephysicalactivity
orsportingevents.Somepeopleareactivebecause
theyfeelitgivesthemcertainhealthbenets(suchas
feelingmoreenergetic)thatarentyetconclusively
provenforthegeneralpopulation.
TheGuidelinesencouragepeopletobephysically
activeforanyandallreasonsthataremeaningful
forthem.NothingintheGuidelinesisintendedto
meanthathealthbenetsaretheonlyreasontodo
physicalactivity.
Focus on Disease Prevention
TheGuidelinesfocusonpreventiveeffectsof
physicalactivity,whichincludeloweringtheriskof
developingchronicdiseasessuchasheartdisease
andtype2diabetes.
Physicalactivityalsohasbenecialtherapeutic
effectsandiscommonlyrecommendedaspartof
thetreatmentformedicalconditions.TheAdvisory
Committeereportdidnotreviewthetherapeutic
effectsofactivity,andtheGuidelinesdonotdiscuss
theuseofphysicalactivityasmedicaltreatment.
Health-Related Versus Performance-Related Fitness
TheGuidelinesfocusonreducingtheriskofchronic
diseaseandpromotinghealth-relatedtness,
particularlycardiovascularandmusculartness.
Peoplecangainthiskindoftnessbydoingthe
amountandtypesofactivitiesrecommendedinthe
Guidelines.
2008PhysicalActivityGuidelinesforAmericans 3














TheGuidelinesdonotaddressthetypesandamounts
ofactivitynecessarytoimproveperformance-related
tness.Athletesneedthiskindoftnesswhenthey
compete.Medicalscreeningissuesforcompetitive
athletesalsoareoutsidethescopeoftheGuidelines.
Peoplewhoareinterestedintrainingprogramsto
increaseperformance-relatedtnessshouldseek
advicefromothersources.Generally,thesepeople
domuchmoreactivitythanrequiredtomeetthe
Guidelines.
Lifespan Approach
Thebestwaytobephysicallyactiveistobeactivefor
life.Therefore,theGuidelinestakealifespanapproach
andproviderecommendationsforthreeagegroups:
ChildrenandAdolescents,Adults,andOlderAdults.
ThePhysicalActivityGuidelinesareforAmericans
aged6andolder.TheAdvisoryCommitteereport
didnotreviewevidenceforchildrenyoungerthan
age6.Physicalactivityininfantsandyoungchildren
is,ofcourse,necessaryforhealthygrowthand
development.Childrenyoungerthan6shouldbe
physicallyactiveinwaysappropriatefortheirage
andstageofdevelopment.
Individualized Health Goals
TheGuidelinesgenerallyexplaintheamountsand
typesofphysicalactivityneededforhealthbenets.
Withintheseoverallparameters,individualshave
manychoicesaboutappropriatetypesandamounts
ofactivity.
Tomakethesechoices,Americanadultsneedtoset
personalgoalsforphysicalactivity.Settingthese
goalsinvolvesquestionslike,Howphysicallyt
doIwanttobe?Howimportantisittometo
reducemyriskofheartdiseaseanddiabetes?How
importantisittometoreducemyriskoffallsand
hipfracture?HowmuchweightdoIwanttolose
andkeepoff?
PeoplecanmeettheGuidelinesandtheirownpersonal
goalsthroughdifferentamountsandtypesofactivity.
Writtenmaterials,health-careproviders,andtness
professionalscanprovideusefulinformationandhelp
peoplesetandcarryoutspecicgoals.
Four Levels of Physical Activity
TheAdvisoryCommitteereportprovidesthebasis
fordividingtheamountofaerobicphysicalactivity
anadultgetseveryweekintofourcategories:
inactive,low,medium,andhigh(seetablebelow).
Thisclassicationisusefulbecausethesecategories
providearuleofthumbofhowtotalamountof
physicalactivityisrelatedtohealthbenets.Low
amountsofactivityprovidesomebenets;medium
amountsprovidesubstantialbenets;andhigh
amountsprovideevengreaterbenets.
ClassicationofTotalWeeklyAmountsofAerobicPhysicalActivityIntoFourCategories
LevelsofPhysical
Activity
RangeofModerate-Intensity
MinutesaWeek
SummaryofOverall
HealthBenets 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 minutes
a week
Substantial Activity at the high end of this range has additional
and more extensive health benets than activity at
the low end.
High More than 300 minutes a week Additional Current science does not allow researchers to identify
an upper limit of activity above which there are no
additional health benets.
Chapter1.Introducingthe2008PhysicalActivityGuidelinesforAmericans 4





Actionisneeded
attheindividual,community,and
societallevelstohelpAmericans
becomephysicallyactive.
Inactiveisnoactivitybeyondbaselineactivities
ofdailyliving.
Lowactivityisactivitybeyondbaselinebutfewer
than150minutes(2hoursand30minutes)of
moderate-intensityphysicalactivityaweekor
theequivalentamount(75minutes,or1hourand
15minutes)ofvigorous-intensityactivity.
Mediumactivityis150minutesto300(5hours)
minutesofmoderate-intensityactivityaweek
(or75to150minutes
ofvigorous-intensity
physicalactivityaweek).
Inscienticterms,this
rangeisapproximately
equivalentto500to1,000
metabolicequivalent
(MET)minutesaweek.
ForMoreInformation
Appendix 1 provides a
detailed explanation
of MET-minutes, a unit
useful for describing the
energy expenditure of a
specic physical activity.
Highactivityismorethantheequivalentof
300minutesofmoderate-intensityphysical
activityaweek.
Relationship to Previous Public Health
Recommendations
In1995theCentersforDiseaseControlandPrevention
(CDC)andtheAmericanCollegeofSportsMedicine
(ACSM)publishedphysicalactivityrecommendations
forpublichealth.Thereportstatedthatadultsshould
accumulateatleast30minutesadayofmoderate-
intensityphysicalactivityonmost,preferablyall,
daysperweek.In1996PhysicalActivityandHealth:
AReportoftheSurgeonGeneralsupportedthissame
recommendation.
Inordertotrackthepercentageofadultswhomeet
thisguideline,CDCspeciedthatmostdaysperweek
was5days.Since1995thecommonrecommendation
hasbeenthatadultsobtainatleast30minutesof
moderate-intensityphysicalactivityon5ormoredays
aweek,foratotalofatleast150minutesaweek.
ThePhysicalActivityGuidelinesforAmericans
afrmsthatitisacceptabletofollowtheCDC/ACSM
recommendationandsimilarrecommendations.
However,accordingtotheAdvisoryCommittee
report,theCDC/ACSMguidelinewastoospecic.
Inotherwords,existingscienticevidencedoesnot
allowresearcherstosay,forexample,whetherthe
healthbenetsof30minuteson5daysaweekare
anydifferentfromthehealthbenetsof50minutes
on3daysaweek.Asaresult,thenewGuidelines
allowapersontoaccumulate150minutesaweekin
variousways.
PuttingtheGuidelinesIntoPractice
AlthoughtheAdvisoryCommitteedidnotreview
strategiestopromotephysicalactivity,actionisneeded
attheindividual,community,andsocietallevelsto
helpAmericansbecomephysicallyactive.Publications
suchastheGuidetoCommunityPreventiveServices
(http://www.thecommunityguide.org/pa/)andthe
recommendationsoftheU.S.PreventiveServices
TaskForce(http://www.ahrq.gov/clinic/cps3dix.htm)
summarizeevidence-basedstrategiesforpromoting
physicalactivityonthecommunitylevelandthrough
primaryhealthcare.Accordingly,thenalchapter
ofthePhysicalActivityGuidelinesforAmericans
providesonlyabriefdiscussiononpromotingphysical
activity,andindicateshowtolinktheGuidelinesto
actionstrategies.
2008PhysicalActivityGuidelinesforAmericans 5



Assessing Whether Physical Activity Programs Are
Consistent With the Guidelines
Programsthatprovideopportunitiesforphysical
activity,suchasclassesorcommunityactivities,can
helppeoplemeettheGuidelines.Theseprogramsdonot
havetoprovideall,orevenmost,oftherecommended
weeklyactivity.Forexample,amallwalkingprogram
forolderadultsmaymeetonlyonceaweekyet
provideusefulamountsofactivity,aslongaspeople
gettherestoftheirweeklyrecommendedactivityon
otherdays.
ProgramsthatareconsistentwiththeGuidelines:
Provideadviceandeducationconsistentwiththe
Guidelines;
Addepisodesofactivitythatcounttowardmeeting
theGuidelines;and
Mayalsoincludeactivities,suchasstretching
orwarmingupandcoolingdown,whosehealth
benetsarenotyetprovenbutthatareoftenused
ineffectivephysicalactivityprograms.
The Importance of Understandable Guidelines
HHShastriedtokeepthePhysicalActivityGuidelines
straightforwardandclear,whileremainingconsistent
withcomplexscienticinformation.Ineachchapterthe
keyGuidelinesaresetapartfromthetext,inorderto
identifythemostimportantinformationtocommunicate
tothepublic.Themessagescontainedinthese
Guidelinesshouldbedisseminatedtothegeneralpublic
andtoanyoneinvolvedinpromotingphysicalactivity.
Chapter1.Introducingthe2008PhysicalActivityGuidelinesforAmericans 6



PhysicalActivityHas
ManyHealthBenets
A
llAmericansshouldberegularlyphysically
activetoimproveoverallhealthandtnessand
topreventmanyadversehealthoutcomes.The
benetsofphysicalactivityoccuringenerallyhealthy
people,inpeopleatriskofdevelopingchronicdiseases,
andinpeoplewithcurrentchronicconditionsor
disabilities.Thischaptergivesanoverviewofresearch
ndingsonphysicalactivityandhealth.Theboxon
page8providesasummaryofthesebenets.
Physicalactivityaffectsmanyhealthconditions,andthe
specicamountsandtypesofactivitythatbeneteach
conditionvary.Indevelopingpublichealthguidelines,
thechallengeistointegratescienticinformation
acrossallhealthbenetsandidentifyacriticalrangeof
physicalactivitythatappearstohaveaneffectacross
thehealthbenets.Oneconsistentndingfromresearch
studiesisthatoncethehealthbenetsfromphysical
activitybegintoaccrue,additionalamountsofactivity
provideadditionalbenets.
Althoughsomehealthbenetsseemtobeginwithas
littleas60minutes(1hour)aweek,researchshowsthat
atotalamountof150minutes(2hoursand30minutes)
aweekofmoderate-intensityaerobicactivity,suchas
briskwalking,consistentlyreducestheriskofmany
chronicdiseasesandotheradversehealthoutcomes.
ExaminingtheRelationshipBetweenPhysical
ActivityandHealth
Inmanystudiescoveringawiderangeofissues,
researchershavefocusedonexercise,aswellason
themorebroadlydenedconceptofphysicalactivity.
Exerciseisaformofphysicalactivitythatisplanned,
structured,repetitive,andperformedwiththegoalof
improvinghealthortness.So,althoughallexerciseis
physicalactivity,notallphysicalactivityisexercise.
Studieshaveexaminedtheroleofphysicalactivityin
manygroupsmenandwomen,children,teens,adults,
olderadults,peoplewithdisabilities,andwomen
duringpregnancyandthepostpartumperiod.These
studieshavefocusedontherolethatphysicalactivity
playsinmanyhealthoutcomes,including:
Premature(early)death;
Diseasessuchascoronaryheartdisease,stroke,some
cancers,type2diabetes,osteoporosis,anddepression;
2008PhysicalActivityGuidelinesforAmericans 7



TheHealthBenetsofPhysicalActivityMajorResearchFindings
Regularphysicalactivityreducestheriskofmanyadversehealthoutcomes.
Somephysicalactivityisbetterthannone.
Formosthealthoutcomes,additionalbenetsoccurastheamountofphysicalactivityincreasesthrough
higherintensity,greaterfrequency,and/orlongerduration.
Mosthealthbenetsoccurwithatleast150minutesaweekofmoderate-intensityphysicalactivity,suchas
briskwalking.Additionalbenetsoccurwithmorephysicalactivity.
Bothaerobic(endurance)andmuscle-strengthening(resistance)physicalactivityarebenecial.
Healthbenetsoccurforchildrenandadolescents,youngandmiddle-agedadults,olderadults,andthosein
everystudiedracialandethnicgroup.
Thehealthbenetsofphysicalactivityoccurforpeoplewithdisabilities.
Thebenetsofphysicalactivityfaroutweighthepossibilityofadverseoutcomes.
Riskfactorsfordisease,suchashighbloodpressure
andhighbloodcholesterol;
Aerobicactivitycausesapersonshearttobeatfaster
thanusual.
Physicaltness,suchasaerobiccapacity,and
musclestrengthandendurance;
Aerobicphysicalactivityhasthreecomponents:
Functionalcapacity(theabilitytoengagein
activitiesneededfordailyliving);
Intensity,orhowhardapersonworkstodothe
activity.Theintensitiesmostoftenexaminedare
moderateintensity(equivalentinefforttobrisk
walking)andvigorousintensity(equivalentin
efforttorunningorjogging);
Mentalhealth,suchasdepressionandcognitive
function;and
Injuriesorsuddenheartattacks.
Frequency,orhowoftenapersondoesaerobic
activity;and
Thesestudieshavealsopromptedquestionsasto
whattypeandhowmuchphysicalactivityisneeded
forvarioushealthbenets.Toanswerthisquestion,
investigatorshavestudiedthreemainkindsofphysical
activity:aerobic,muscle-strengthening,andbone-
strengthening.Investigatorshavealsostudiedbalance
andexibilityactivities.Theselattertwoactivitiesare
addressedinChapters4,5,and6.
Duration,orhowlongapersondoesanactivityin
anyonesession.
Althoughthesecomponentsmakeupaphysical
activityprole,researchhasshownthatthetotal
amountofphysicalactivity(minutesofmoderate-
intensityphysicalactivity,forexample)ismore
importantforachievinghealthbenetsthanisany
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
Chapter2.PhysicalActivityHasManyHealthBenets 8






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
forceiscommonlyproducedbyimpactwiththe
ground.Examplesofbone-strengtheningactivity
includejumpingjacks,running,briskwalking,and
weight-liftingexercises.Astheseexamplesillustrate,
bone-strengtheningactivitiescanalsobeaerobicand
musclestrengthening.
TheHealthBenetsofPhysicalActivity
Studiesclearlydemonstratethatparticipatinginregular
physicalactivityprovidesmanyhealthbenets.These
benetsaresummarizedintheaccompanyingtable.
Manyconditionsaffectedbyphysicalactivityoccur
withincreasingage,suchasheartdiseaseandcancer.
Reducingriskoftheseconditionsmayrequireyearsof
participationinregularphysicalactivity.However,other
benets,suchasincreasedcardiorespiratorytness,
increasedmuscularstrength,anddecreaseddepressive
symptomsandbloodpressure,requireonlyafewweeks
ormonthsofparticipationinphysicalactivity.
HealthBenetsAssociatedWithRegularPhysical
Activity
ChildrenandAdolescents
Strongevidence
Improved cardiorespiratory and muscular tness
Improved bone health
Improved cardiovascular and metabolic health biomarkers
Favorable body composition
Moderateevidence
Reduced symptoms of depression
AdultsandOlderAdults
Strongevidence
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 prole
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 reduced
calorie intake
Improved cardiorespiratory and muscular tness
Prevention of falls
Reduced depression
Better cognitive function (for older adults)
Moderatetostrongevidence
Better functional health (for older adults)
Reduced abdominal obesity
Moderateevidence
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 benets 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 ndings across studies that addressed each outcome.
The Committee also considered evidence for causality and dose response
in assigning the strength-of-evidence rating.
2008PhysicalActivityGuidelinesforAmericans 9








TheBenecialEffectsofIncreasingPhysicalActivity:ItsAboutOverload,Progression,
andSpecicity
Overloadisthephysicalstressplacedonthebodywhenphysicalactivityisgreaterinamountorintensitythan
usual.Thebodysstructuresandfunctionsrespondandadapttothesestresses.Forexample,aerobicphysical
activityplacesastressonthecardiorespiratorysystemandmuscles,requiringthelungstomovemoreairand
thehearttopumpmorebloodanddeliverittotheworkingmuscles.Thisincreaseindemandincreasesthe
efciencyandcapacityofthelungs,heart,circulatorysystem,andexercisingmuscles.Inthesameway,muscle-
strengtheningandbone-strengtheningactivitiesoverloadmusclesandbones,makingthemstronger.
Progressioniscloselytiedtooverload.Onceapersonreachesacertaintnesslevel,heorsheprogressesto
higherlevelsofphysicalactivitybycontinuedoverloadandadaptation.Small,progressivechangesinoverload
helpthebodyadapttotheadditionalstresseswhileminimizingtheriskofinjury.
Specicitymeansthatthebenetsofphysicalactivityarespecictothebodysystemsthataredoingthework.
Forexample,aerobicphysicalactivitylargelybenetsthebodyscardiovascularsystem.
Thehealthbenetsofphysicalactivityareseen
inchildrenandadolescents,youngandmiddle-
agedadults,olderadults,womenandmen,people
ofdifferentracesandethnicities,andpeoplewith
disabilitiesandchronicconditions.Thehealthbenets
ofphysicalactivityaregenerallyindependentofbody
weight.Adultsofallsizesandshapesgainhealthand
tnessbenetsbybeinghabituallyphysicallyactive.
Thebenetsofphysicalactivityalsooutweightherisk
ofinjuryandsuddenheartattacks,twoconcernsthat
preventmanypeoplefrombecomingphysicallyactive.
Thefollowingsectionsprovidemoredetailonwhatis
knownfromresearchstudiesaboutthespecichealth
benetsofphysicalactivityandhowmuchphysical
activityisneededtogetthehealthbenets.
approximately7hoursaweekhavea40percent
lowerriskofdyingearlythanthosewhoareactive
forlessthan30minutesaweek.
Second,itisnotnecessarytodohighamountsof
activityorvigorous-intensityactivitytoreducethe
riskofprematuredeath.Studiesshowsubstantially
lowerriskwhenpeopledo150minutesofatleast
moderate-intensityaerobicphysicalactivityaweek.
Researchclearlydemonstratestheimportanceof
avoidinginactivity.Evenlowamountsofphysical
activityreducetheriskofdyingprematurely.Asthe
gureonpage11shows,themostdramaticdifference
inriskisseenbetweenthosewhoareinactive
(30minutesaweek)andthosewithlowlevelsof
activity(90minutesor1hourand30minutesaweek).
Therelativeriskofdyingprematurelycontinuesto
belowerwithhigherlevelsofreportedmoderate-or
vigorous-intensityleisure-timephysicalactivity.
Alladultscangainthishealthbenetofphysical
activity.Age,race,andethnicitydonotmatter.Men
andwomenyoungerthan65yearsaswellasolder
adultshavelowerratesofearlydeathwhenthey
arephysicallyactivethanwhentheyareinactive.
Physicallyactivepeopleofallbodyweights(normal
weight,overweight,obese)alsohavelowerratesof
earlydeaththandoinactivepeople.
Premature Death
Strongscienticevidenceshowsthatphysicalactivity
reducestheriskofprematuredeath(dyingearlierthan
theaverageageofdeathforaspecicpopulation
group)fromtheleadingcausesofdeath,suchasheart
diseaseandsomecancers,aswellasfromothercauses
ofdeath.Thiseffectisremarkableintwoways:
First,onlyafewlifestylechoiceshaveaslargean
effectonmortalityasphysicalactivity.Ithasbeen
estimatedthatpeoplewhoarephysicallyactivefor
Chapter2.PhysicalActivityHasManyHealthBenets 10










R
e
l
a
t
i
v
e

R
i
s
k

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


TheRiskofDyingPrematurelyDeclinesasPeople
BecomePhysicallyActive
Cardiorespiratory Health
Thebenetsofphysicalactivityoncardiorespiratory
healtharesomeofthemostextensivelydocumentedof
allthehealthbenets.Cardiorespiratoryhealthinvolves
thehealthoftheheart,lungs,andbloodvessels.
Heartdiseasesandstrokearetwooftheleadingcauses
ofdeathintheUnitedStates.Riskfactorsthatincrease
thelikelihoodofcardiovasculardiseasesinclude
smoking,highbloodpressure(calledhypertension),
type2diabetes,andhighlevelsofcertainbloodlipids
(suchaslow-densitylipoprotein,orLDL,cholesterol).
Lowcardiorespiratorytnessalsoisariskfactorfor
heartdisease.
Peoplewhodomoderate- orvigorous-intensityaerobic
physicalactivityhaveasignicantlylowerriskof
cardiovasculardiseasethandoinactivepeople.Regularly
activeadultshavelowerratesofheartdiseaseand
stroke,andhavelowerbloodpressure,betterbloodlipid
proles,andtness.Signicantreductionsinriskof
cardiovasculardiseaseoccuratactivitylevelsequivalent
to150minutesaweekofmoderate-intensityphysical
activity.Evengreaterbenetsareseenwith200minutes
(3hoursand20minutes)aweek.Theevidenceisstrong
thatgreateramountsofphysicalactivityresultineven
furtherreductionsintheriskofcardiovasculardisease.
Everyonecangainthecardiovascularhealthbenets
ofphysicalactivity.Theamountofphysicalactivity
thatprovidesfavorablecardiorespiratoryhealthand
tnessoutcomesissimilarforadultsofvariousages,
includingolderpeople,aswellasforadultsofvarious
racesandethnicities.Aerobicexercisealsoimproves
cardiorespiratorytnessinindividualswithsome
disabilities,includingpeoplewhohavelosttheuse
ofoneorbothlegsandthosewithmultiplesclerosis,
stroke,spinalcordinjury,andcognitivedisabilities.
Moderate-intensityphysicalactivityissafefor
generallyhealthywomenduringpregnancy.Itincreases
cardiorespiratorytnesswithoutincreasingtherisk
ofearlypregnancyloss,pretermdelivery,orlowbirth
weight.Physicalactivityduringthepostpartumperiod
alsoimprovescardiorespiratorytness.
Metabolic Health
Regularphysicalactivitystronglyreducestheriskof
developingtype2diabetesaswellasthemetabolic
syndrome.Themetabolicsyndromeisdenedasa
conditioninwhichpeoplehavesomecombination
ofhighbloodpressure,alargewaistline(abdominal
obesity),anadversebloodlipidprole(lowlevels
ofhigh-densitylipoprotein[HDL]cholesterol,raised
triglycerides),andimpairedglucosetolerance.
Peoplewhoregularlyengageinatleastmoderate-
intensityaerobicactivityhaveasignicantlylower
riskofdevelopingtype2diabetesthandoinactive
people.Althoughsomeexpertsdebatetheusefulness
ofdeningthemetabolicsyndrome,goodevidence
existsthatphysicalactivityreducestheriskofhaving
thiscondition,asdenedinvariousways.Lowerrates
oftheseconditionsareseenwith120to150minutes
(2hoursto2hoursand30minutes)aweekofat
leastmoderate-intensityaerobicactivity.Aswith
cardiovascularhealth,additionallevelsofphysical
activityseemtolowerriskevenfurther.Inaddition,
physicalactivityhelpscontrolbloodglucoselevelsin
personswhoalreadyhavetype2diabetes.
Physicalactivityalsoimprovesmetabolichealthin
youth.Studiesndthiseffectwhenyoungpeople
participateinatleast3daysofvigorousaerobic
activityaweek.Morephysicalactivityisassociated
withimprovedmetabolichealth,butresearchhasyetto
determinetheexactamountofimprovement.
11 2008PhysicalActivityGuidelinesforAmericans






Obesity and Energy Balance
Overweightandobesityoccurwhenfewercaloriesare
expended,includingcaloriesburnedthroughphysical
activity,thanaretakeninthroughfoodandbeverages.
Physicalactivityandcaloricintakebothmustbe
consideredwhentryingtocontrolbodyweight.
Becauseofthisroleinenergybalance,physicalactivity
isacriticalfactorindeterminingwhetheraperson
canmaintainahealthybodyweight,loseexcessbody
weight,ormaintainsuccessfulweightloss.People
varyagreatdealinhowmuchphysicalactivitythey
needtoachieveandmaintainahealthyweight.Some
needmorephysicalactivitythanotherstomaintaina
healthybodyweight,toloseweight,ortokeepweight
offonceithasbeenlost.
Strongscienticevidenceshowsthatphysicalactivity
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
peoplewhoaretryingtokeepasignicantamountof
weightoffonceithasbeenlostneedahighamountof
physicalactivityunlesstheyalsoreducetheircaloric
intake.Manypeopleneedtodomorethan300minutes
ofmoderate-intensityactivityaweektomeetweight-
controlgoals.
Regularphysicalactivityalsohelpscontrolthe
percentageofbodyfatinchildrenandadolescents.
Exercisetrainingstudieswithoverweightandobese
youthhaveshownthattheycanreducetheirbody
fatnessbyparticipatinginphysicalactivitythatisat
leastmoderateintensityon3to5daysaweek,for
30to60minuteseachtime.
Musculoskeletal Health
Bones,muscles,andjointssupportthebodyandhelp
itmove.Healthybones,joints,andmusclesarecritical
totheabilitytododailyactivitieswithoutphysical
limitations.
Preservingbone,joint,andmusclehealthisessential
withincreasingage.Studiesshowthatthefrequent
declineinbonedensitythathappensduringagingcan
beslowedwithregularphysicalactivity.Theseeffects
areseeninpeoplewhoparticipateinaerobic,muscle-
strengthening,andbone-strengtheningphysicalactivity
programsofmoderateorvigorousintensity.Therange
oftotalphysicalactivityforthesebenetsvaries
widely.Importantchangesseemtobeginat90minutes
aweekandcontinueupto300minutesaweek.
Hipfractureisaserioushealthconditionthatcan
havelife-changingnegativeeffectsformanyolder
people.Physicallyactivepeople,especiallywomen,
appeartohavealowerriskofhipfracturethando
inactivepeople.Researchstudiesonphysicalactivityto
preventhipfractureshowthatparticipatingin120to
300minutesaweekofphysicalactivitythatisofat
leastmoderateintensityisassociatedwithareduced
risk.Itisunclear,however,whetheractivityalsolowers
riskoffracturesofthespineorotherimportantareas
oftheskeleton.
Chapter2.PhysicalActivityHasManyHealthBenets 12

Thebottomline
isthatthehealthbenetsofphysicalactivityfaroutweightherisksof
adverseeventsforalmosteveryone.
Buildingstrong,healthybonesisalsoimportantfor
childrenandadolescents.Alongwithhavingahealthy
dietthatincludesadequatecalciumandvitaminD,
physicalactivityiscriticalforbonedevelopmentin
childrenandadolescents.Bone-strengtheningphysical
activitydone3ormoredaysaweekincreasesbone-
mineralcontentandbonedensityinyouth.
Regularphysicalactivityalsohelpspeoplewith
arthritisorotherrheumaticconditionsaffectingthe
joints.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,
mostlyduetotheriskofinjuryinvolvedincompeting
insomesports.
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
abilitytofulllbasicliferoles,suchaspersonalcare,
groceryshopping,orplayingwiththegrandchildren.
Lossoffunctionalabilityisreferredtoasfunctional
limitation.
Middle-agedandolderadultswhoarephysically
activehavelowerriskoffunctionallimitationsthando
inactiveadults.Itappearsthatgreaterphysicalactivity
levelscanfurtherreduceriskoffunctionallimitations.
Olderadultswhoalreadyhavefunctionallimitations
alsobenetfromregularphysicalactivity.Typically,
studiesofphysicalactivityinadultswithfunctional
limitationstestedacombinationofaerobicandmuscle-
strengtheningactivities,makingitdifculttoassessthe
relativeimportanceofeachtypeofactivity.However,
bothtypesofactivityappeartoprovidebenet.
Inolderadultsatriskoffalls,strongevidenceshows
thatregularphysicalactivityissafeandreducesthis
risk.Reductioninfallsisseenforparticipantsin
programsthatincludebalanceandmoderate-intensity
muscle-strengtheningactivitiesfor90minutesaweek
plusmoderate-intensitywalkingforaboutanhoura
week.Itsnotknownwhetherdifferentcombinations
oftype,amount,orfrequencyofactivitycanreduce
fallstoagreaterdegree.Taichiexercisesalsomay
helppreventfalls.
Cancer
Physicallyactivepeoplehaveasignicantlylower
riskofcoloncancerthandoinactivepeople,and
physicallyactivewomenhaveasignicantlylower
riskofbreastcancer.Researchshowsthatawide
rangeofmoderate-intensityphysicalactivitybetween
210and420minutesaweek(3hoursand30minutes
to7hours)isneededtosignicantlyreducetherisk
ofcolonandbreastcancer;currently,150minutesa
13 2008PhysicalActivityGuidelinesforAmericans






weekdoesnotappeartoprovideamajorbenet.Italso
appearsthatgreateramountsofphysicalactivitylower
risksofthesecancersevenfurther,althoughexactly
howmuchlowerisnotclear.
Althoughnotdenitive,someresearchsuggeststhat
theriskofendometrialcancerinwomenandlung
cancersinmenandwomenalsomaybeloweramong
thosewhoareregularlyactivecomparedtothosewho
areinactive.
Finally,cancersurvivorshaveabetterqualityoflife
andimprovedphysicaltnessiftheyarephysically
active,comparedtosurvivorswhoareinactive.
Mental Health
Physicallyactiveadultshavelowerriskofdepression
andcognitivedecline(declineswithaginginthinking,
learning,andjudgmentskills).Physicalactivityalso
mayimprovethequalityofsleep.Whetherphysical
activityreducesdistressoranxietyiscurrentlyunclear.
Mentalhealthbenetshavebeenfoundinpeoplewho
doaerobicoracombinationofaerobicandmuscle-
strengtheningactivities3to5daysaweekfor30to
60minutesatatime.Someresearchhasshownthat
evenlowerlevelsofphysicalactivityalsomayprovide
somebenets.
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,peoplewhoarelesstaremorelikely
tobeinjuredthanpeoplewhoaretter.
Cardiacevents,suchasaheartattackorsuddendeath
duringphysicalactivity,arerare.However,therisk
ofsuchcardiaceventsdoesincreasewhenaperson
suddenlybecomesmuchmoreactivethanusual.
Thegreatestriskoccurswhenanadultwhoisusually
inactiveengagesinvigorous-intensityactivity(suchas
shovelingsnow).Peoplewhoareregularlyphysically
activehavethelowestriskofcardiaceventsboth
whilebeingactiveandoverall.
Thebottomlineisthatthehealthbenetsofphysical
activityfaroutweightherisksofadverseeventsfor
almosteveryone.
Chapter2.PhysicalActivityHasManyHealthBenets 14


ActiveChildrenand
Adolescents
R
egularphysicalactivityinchildrenand
adolescentspromoteshealthandtness.
Comparedtothosewhoareinactive,physically
activeyouthhavehigherlevelsofcardiorespiratory
tnessandstrongermuscles.Theyalsotypicallyhave
lowerbodyfatness.Theirbonesarestronger,andthey
mayhavereducedsymptomsofanxietyanddepression.
Youthwhoareregularlyactivealsohaveabetter
chanceofahealthyadulthood.Childrenandadolescents
dontusuallydevelopchronicdiseases,suchasheart
disease,hypertension,type2diabetes,orosteoporosis.
However,riskfactorsforthesediseasescanbeginto
developearlyinlife.Regularphysicalactivitymakesit
lesslikelythattheseriskfactorswilldevelopandmore
likelythatchildrenwillremainhealthyasadults.
Youthcanachievesubstantialhealthbenetsbydoing
moderate-andvigorous-intensityphysicalactivityfor
periodsoftimethataddupto60minutes(1hour)or
moreeachday.Thisactivityshouldincludeaerobic
activityaswellasage-appropriatemuscle-andbone-
strengtheningactivities.Althoughcurrentscienceis
notcomplete,itappearsthat,aswithadults,thetotal
amountofphysicalactivityismoreimportantfor
achievinghealthbenetsthanisanyonecomponent
(frequency,intensity,orduration)orspecicmix
ofactivities(aerobic,muscle-strengthening,bone-
strengthening).Evenso,bone-strengtheningactivities
remainespeciallyimportantforchildrenandyoung
adolescentsbecausethegreatestgainsinbonemass
occurduringtheyearsjustbeforeandduringpuberty.
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.
15 2008PhysicalActivityGuidelinesforAmericans






KeyGuidelinesforChildrenandAdolescents
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.
ExplainingtheGuidelines
Types of Activity
TheGuidelinesforchildrenandadolescentsfocuson
threetypesofactivity:aerobic,muscle-strengthening,
andbone-strengthening.Eachtypehasimportant
healthbenets.
Aerobicactivitiesarethoseinwhichyoung
peoplerhythmicallymovetheirlargemuscles.
Running,hopping,skipping,jumpingrope,
swimming,dancing,andbicyclingareallexamples
ofaerobicactivities.Aerobicactivitiesincrease
cardiorespiratorytness.Childrenoftendo
activitiesinshortbursts,whichmaynottechnically
beaerobicactivities.However,thisdocument
willalsousethetermaerobictorefertothese
briefactivities.
Muscle-strengthening
activitiesmakemuscles
domoreworkthan
usualduringactivities
ofdailylife.Thisis
calledoverload,
anditstrengthensthe
ForMoreInformation
See Chapter 2Physical
Activity Has Many Health
Benets, for more on
overload and progression.
muscles.Muscle-strengtheningactivitiescanbe
unstructuredandpartofplay,suchasplaying
onplaygroundequipment,climbingtrees,and
playingtug-of-war.Ortheseactivitiescanbe
structured,suchasliftingweightsorworkingwith
resistancebands.
Bone-strengtheningactivitiesproduceaforceon
thebonesthatpromotesbonegrowthandstrength.
Thisforceiscommonlyproducedbyimpactwith
theground.Running,jumpingrope,basketball,
tennis,andhopscotchareallexamplesofbone-
strengtheningactivities.Astheseexamplesillustrate,
bone-strengtheningactivitiescanalsobeaerobic
andmuscle-strengthening.
How Age Inuences Physical Activity in Children
and Adolescents
ChildrenandadolescentsshouldmeettheGuidelines
bydoingactivitythatisappropriatefortheirage.
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,counts
towardtheGuidelines.
Childrenalsocommonlyincreasemusclestrength
throughunstructuredactivitiesthatinvolvelifting
ormovingtheirbodyweightorworkingagainst
resistance.Childrendontusuallydoorneedformal
muscle-strengtheningprograms,suchasliftingweights.
Chapter3.ActiveChildrenandAdolescents 16

Regularphysical
activityinchildrenandadolescents
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
cardiorespiratorytness.
Theintensityofaerobicphysicalactivitycanbe
denedoneitheranabsoluteorarelativescale.Either
scalecanbeusedtomonitortheintensityofaerobic
physicalactivity:
Absoluteintensityisbasedontherateofenergy
expenditureduringtheactivity,withouttaking
intoaccountapersons
cardiorespiratorytness. ForMoreInformation
See Appendix 1 for more
information on using
absolute or relative
intensity.
Relativeintensityuses
apersonslevelof
cardiorespiratorytness
toassesslevelofeffort.
Relativeintensitydescribesapersonslevelofeffort
relativetohisorhertness.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
includesexamplesofactivitiesclassiedbyabsolute
intensity.Itshowsthatthesameactivitycanbe
moderateorvigorousintensity,dependingonfactors
suchasspeed(forexamplebicyclingslowlyorfast).
Physical Activity and Healthy Weight
Regularphysicalactivityinchildrenandadolescents
promotesahealthybodyweightandbodycomposition.
17 2008PhysicalActivityGuidelinesforAmericans















ExamplesofModerate- andVigorous-IntensityAerobicPhysicalActivitiesandMuscle- andBone-Strengthening
ActivitiesforChildrenandAdolescents
AgeGroup
TypeofPhysicalActivity Children Adolescents
Moderateintensity
aerobic
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 or
pushing 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 eld hockey,
basketball, swimming, tennis
Cross-country skiing
such as ag football
Bicycle riding
Jumping rope
Martial arts, such as karate
Running
Sports such as soccer, ice or eld hockey,
basketball, swimming, tennis
Vigorous dancing
Cross-country skiing
Muscle-strengthening Games such as tug-of-war
Modied push-ups (with knees on the oor)
Resistance exercises using body weight or
resistance 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
Exercisetraininginoverweightorobeseyouthcan
improvebodycompositionbyreducingoveralllevelsof
fatnessaswellasabdominalfatness.Researchstudies
reportthatfatnesscanbereducedbyregularphysical
activityofmoderatetovigorousintensity3to5times
aweek,for30to60minutes.
MeetingtheGuidelines
Americanyouthvaryintheirphysicalactivity
participation.Somedontparticipateatall,others
participateinenoughactivitytomeettheGuidelines,
andsomeexceedtheGuidelines.
Chapter3.ActiveChildrenandAdolescents 18

Childrenandadolescents
canmeetthePhysicalActivityGuidelinesandbecomeregularly
physicallyactiveinmanyways.
Onepracticalstrategytopromoteactivityinyouthis
toreplaceinactivitywithactivitywheneverpossible.
Forexample,whereappropriateandsafe,youngpeople
shouldwalkorbicycletoschoolinsteadofridingin
acar.Ratherthanjustwatchingsportingeventson
television,youngpeopleshouldparticipateinage-
appropriatesportsorgames.
Childrenandadolescentswhodonotmeetthe
Guidelinesshouldslowlyincreasetheiractivityin
smallstepsandinwaysthattheyenjoy.Agradual
increaseinthenumberofdaysandthetimespent
beingactivewillhelpreducetheriskofinjury.
ChildrenandadolescentswhomeettheGuidelines
shouldcontinuebeingactiveonadailybasisand,
ifappropriate,becomeevenmoreactive.Evidence
suggeststhatevenmorethan60minutesofactivity
everydaymayprovideadditionalhealthbenets.
ChildrenandadolescentswhoexceedtheGuidelines
shouldmaintaintheiractivitylevelandvarythe
kindsofactivitiestheydotoreducetheriskof
overtrainingorinjury.
Childrenandadolescentswithdisabilitiesaremore
likelytobeinactivethanthosewithoutdisabilities.
Youthwithdisabilitiesshouldworkwiththeirhealth-
careprovidertounderstandthetypesandamountsof
physicalactivityappropriateforthem.Whenpossible,
childrenandadolescentswithdisabilitiesshouldmeet
theGuidelines.Whenyoungpeoplearenotableto
participateinappropriatephysicalactivitiestomeet
theGuidelines,theyshouldbeasactiveaspossible
andavoidbeinginactive.
GettingandStayingActive:Real-LifeExamples
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).
19 2008PhysicalActivityGuidelinesforAmericans





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-strengtheningactivities6timesduringthe
week:jumpingrope(MondayandWednesday),
running(Wednesday),soccer(Thursdayand
Sunday),playingtag(Sunday);and
Muscle-strengtheningactivities4timesduring
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).
MariameetstheGuidelinesbydoingvigorous-intensity
aerobicactivities,bone-strengtheningactivities,and
muscle-strengtheningactivitiesonatleast3daysof
theweek:
Vigorous-intensityaerobicactivities4timesduring
theweek:basketball(MondayandWednesday),
dancing(Saturday),hiking(Sunday);
Bone-strengtheningactivities4timesduringthe
week:basketball(MondayandWednesday),dancing
(Saturday),hiking(Sunday);and
Muscle-strengtheningactivities3timesduringthe
week:sit-upsandpush-ups(TuesdayandThursday),
yoga(Saturday).
Chapter3.ActiveChildrenandAdolescents 20

ActiveAdults
A
dultswhoarephysicallyactivearehealthier
andlesslikelytodevelopmanychronicdiseases
thanadultswhoareinactive.Theyalsohave
bettertness,includingahealthierbodysizeand
composition.Thesebenetsaregainedbymenand
womenandpeopleofallracesandethnicitieswho
havebeenstudied.
Adultsgainmostofthesehealthbenetswhenthey
dotheequivalentofatleast150minutesofmoderate-
intensityaerobicphysicalactivity(2hoursand
30minutes)eachweek.Adultsgainadditionaland
moreextensivehealthandtnessbenetswitheven
morephysicalactivity.Muscle-strengtheningactivities
alsoprovidehealthbenetsandareanimportantpart
ofanadultsoverallphysicalactivityplan.
Thischapterprovidesguidanceformostmenand
womenaged18to64years,andfocusesonphysical
activitybeyondbaselineactivity(theusuallightor
sedentaryactivitiesofdailyliving).Physicalactivity
guidelinesforwomenduringpregnancyandthe
postpartumperiodandforadultswithdisabilitiesand
selectchronicconditionsarediscussedinChapter
7AdditionalConsiderationsforSomeAdults.
ExplainingtheGuidelines
TheGuidelinesforadultsfocusontwotypesof
activity:aerobicandmuscle-strengthening.Eachtype
providesimportanthealthbenets,asexplainedin
Chapter2PhysicalActivityHasManyHealthBenets.
Aerobic Activity
Aerobicactivities,alsocalledenduranceactivities,
arephysicalactivitiesinwhichpeoplemovetheir
largemusclesinarhythmicmannerforasustained
period.Running,briskwalking,bicycling,playing
basketball,dancing,andswimmingareallexamples
ofaerobicactivities.Aerobicactivitymakesapersons
heartbeatmorerapidlytomeetthedemandsofthe
bodysmovement.Overtime,regularaerobicactivity
makestheheartandcardiovascularsystemstronger
andtter.
Thepurposeoftheaerobicactivitydoesnotaffect
whetheritcountstowardmeetingtheGuidelines.
Forexample,physicallyactiveoccupationscan
counttowardmeetingtheGuidelines,ascanactive
transportationchoices(walkingorbicycling).Alltypes
ofaerobicactivitiescancountaslongastheyareof
21 2008PhysicalActivityGuidelinesforAmericans










KeyGuidelinesforAdults
Alladultsshouldavoidinactivity.Somephysicalactivityisbetterthannone,andadultswhoparticipatein
anyamountofphysicalactivitygainsomehealthbenets.
Forsubstantialhealthbenets,adultsshoulddoatleast150minutes(2hoursand30minutes)aweekof
moderate-intensity,or75minutes(1hourand15minutes)aweekofvigorous-intensityaerobicphysical
activity,oranequivalentcombinationofmoderate-andvigorous-intensityaerobicactivity.Aerobicactivity
shouldbeperformedinepisodesofatleast10minutes,andpreferably,itshouldbespreadthroughouttheweek.
Foradditionalandmoreextensivehealthbenets,adultsshouldincreasetheiraerobicphysicalactivityto
300minutes(5hours)aweekofmoderate-intensity,or150minutesaweekofvigorous-intensityaerobic
physicalactivity,oranequivalentcombinationofmoderate- andvigorous-intensityactivity.Additional
healthbenetsaregainedbyengaginginphysicalactivitybeyondthisamount.
Adultsshouldalsodomuscle-strengtheningactivitiesthataremoderateorhighintensityandinvolveall
majormusclegroupson2ormoredaysaweek,astheseactivitiesprovideadditionalhealthbenets.
sufcientintensityandduration.Timespentinmuscle-
strengtheningactivitiesdoesnotcounttowardthe
aerobicactivityguidelines.
WhenputtingtheGuidelinesintoaction,itsimportant
toconsiderthetotalamountofactivity,aswellas
howoftentobeactive,forhowlong,andatwhat
intensity.
Thebenetscontinuetoincreasewhenapersondoes
morethantheequivalentof300minutesaweekof
moderate-intensityaerobicactivity.Forexample,
apersonwhodoes420minutes(7hours)aweekhasan
evenlowerriskofprematuredeaththanapersonwho
does150to300minutesaweek.Currentsciencedoes
notallowidentifyinganupperlimitoftotalactivity
abovewhichtherearenoadditionalhealthbenets.
HowMuchTotalActivityaWeek? HowManyDaysaWeekandforHowLong?
Whenadultsdotheequivalentof150minutesof
moderate-intensityaerobicactivityeachweek,the
benetsaresubstantial.Thesebenetsincludelower
riskofprematuredeath,coronaryheartdisease,stroke,
hypertension,type2diabetes,anddepression.
Notallhealthbenetsofphysicalactivityoccur
at150minutesaweek.Asapersonmovesfrom
150minutesaweektoward300minutes(5hours)
aweek,heorshegainsadditionalhealthbenets.
Additionalbenetsincludelowerriskofcolonand
breastcancerandpreventionofunhealthyweightgain.
Also,asapersonmovesfrom150minutesaweek
toward300minutesaweek,thebenetsthatoccur
at150minutesaweekbecomemoreextensive.
Forexample,apersonwhodoes300minutesaweek
hasanevenlowerriskofheartdiseaseordiabetes
thanapersonwhodoes150minutesaweek.
Aerobicphysicalactivityshouldpreferablybespread
throughouttheweek.Researchstudiesconsistently
showthatactivityperformedonatleast3daysaweek
produceshealthbenets.Spreadingphysicalactivity
acrossatleast3daysaweekmayhelptoreducethe
riskofinjuryandavoidexcessivefatigue.
Bothmoderate-andvigorous-intensityaerobicactivity
shouldbeperformedinepisodesofatleast10minutes.
Episodesofthisdurationareknowntoimprove
cardiovasculartnessandsomeriskfactorsforheart
diseaseandtype2diabetes.
HowIntense?
TheGuidelinesforadultsfocusontwolevelsof
intensity:moderate-intensityactivityandvigorous-
intensityactivity.TomeettheGuidelines,adultscando
eithermoderate-intensityorvigorous-intensityaerobic
activities,oracombinationofboth.Ittakeslesstimeto
Chapter4.ActiveAdults 22




getthesamebenetfromvigorous-intensityactivities
asfrommoderate-intensityactivities.Ageneralruleof
thumbisthat2minutesofmoderate-intensityactivity
countsthesameas1minuteofvigorous-intensity
activity.Forexample,30minutesofmoderate-intensity
activityaweekisroughlythesameas15minutesof
vigorous-intensityactivity.
Therearetwowaystotracktheintensityofaerobic
activity:absoluteintensityandrelativeintensity.
Absoluteintensityistheamountofenergy
expendedperminuteofactivity.Theenergy
expenditureoflight-intensityactivity,forexample,
is1.1to2.9timestheamountofenergyexpended
whenapersonisatrest.Moderate-intensity
activitiesexpend3.0to5.9timestheamountof
energyexpendedatrest.Theenergyexpenditure
ofvigorous-intensityactivitiesis6.0ormoretimes
theenergyexpendedatrest.
Relativeintensityisthelevelofeffortrequiredto
doanactivity.Lesstpeoplegenerallyrequirea
higherlevelofeffortthantterpeopletodothe
sameactivity.Relativeintensitycanbeestimated
usingascaleof0to10,wheresittingis0andthe
highestlevelofeffortpossibleis10.Moderate-
intensityactivityisa5or6.Vigorous-intensity
activityisa7or8.
TheGuidelinesforadults
refertoabsoluteintensity
becausemoststudies
demonstratinglower
risksofclinicalevents
(forexample,premature
ForMoreInformation
See Appendix 1 for more
information on using
absolute or relative intensity.
death,cardiovasculardisease,type2diabetes,cancer)
havefocusedonmeasuringabsoluteintensity.Thatis,
theGuidelinesarebasedontheabsoluteamountof
energyexpendedinphysicalactivitythatisassociated
withhealthbenets.Thetablelistssomeexamplesof
activitiesclassiedasmoderate-intensityorvigorous-
intensitybasedonabsoluteintensity.Eitherabsolute
orrelativeintensitycanbeusedtomonitorprogressin
meetingtheGuidelines.
Whenusingrelativeintensity,peoplepayattention
tohowphysicalactivityaffectstheirheartrate
ExamplesofDifferentAerobicPhysicalActivities
andIntensities
ModerateIntensity
Walking briskly (3 miles per hour or faster, but not
race-walking)
Water aerobics
Bicycling slower than 10 miles per hour
Tennis (doubles)
Ballroom dancing
General gardening
VigorousIntensity
Racewalking, jogging, or running
Swimming laps
Tennis (singles)
Aerobic dancing
Bicycling 10 miles per hour or faster
Jumping rope
Heavy gardening (continuous digging or hoeing, with heart
rate increases)
Hiking uphill or with a heavy backpack
Note: This table provides several examples of activities classied as
moderate-intensity or vigorous-intensity, based on absolute intensity.
This list is not all-inclusive. Instead, the examples are meant to help
people make choices.
andbreathing.Asaruleofthumb,apersondoing
moderate-intensityaerobicactivitycantalk,butnot
sing,duringtheactivity.Apersondoingvigorous-
intensityactivitycannotsaymorethanafewwords
withoutpausingforabreath.
Muscle-Strengthening Activity
Muscle-strengtheningactivitiesprovideadditional
benetsnotfoundwithaerobicactivity.Thebenetsof
muscle-strengtheningactivityincludeincreasedbone
strengthandmusculartness.Muscle-strengthening
activitiescanalsohelpmaintainmusclemassduringa
programofweightloss.
Muscle-strengtheningactivitiesmakemusclesdo
moreworkthantheyareaccustomedtodoing.That
is,theyoverloadthemuscles.Resistancetraining,
includingweighttraining,isafamiliarexampleof
muscle-strengtheningactivity.Otherexamplesinclude
workingwithresistancebands,doingcalisthenics
23 2008PhysicalActivityGuidelinesforAmericans



thatusebodyweightforresistance(suchaspush-ups,
pull-ups,andsit-ups),carryingheavyloads,andheavy
gardening(suchasdiggingorhoeing).
Muscle-strengtheningactivitiescountiftheyinvolvea
moderatetohighlevelofintensityoreffortandwork
themajormusclegroupsofthebody:thelegs,hips,
back,chest,abdomen,shoulders,andarms.Muscle-
strengtheningactivitiesforallthemajormusclegroups
shouldbedoneatleast2daysaweek.
Nospecicamountoftimeisrecommendedfor
musclestrengthening,butmuscle-strengthening
exercisesshouldbeperformedtothepointatwhich
itwouldbedifculttodoanotherrepetitionwithout
help.Whenresistancetrainingisusedtoenhance
musclestrength,onesetof8to12repetitionsofeach
exerciseiseffective,althoughtwoorthreesetsmay
bemoreeffective.Developmentofmusclestrength
andenduranceisprogressiveovertime.Increasesin
theamountofweightorthedaysaweekofexercising
willresultinstrongermuscles.
MeetingtheGuidelines
Adultshavemanyoptionsforbecomingphysically
active,increasingtheirphysicalactivity,andstaying
activethroughouttheirlives.Indecidinghowto
meettheGuidelines,adultsshouldthinkabouthow
muchphysicalactivitytheyrealreadydoingandhow
physicallyttheyare.Personalhealthandtnessgoals
arealsoimportanttoconsider.Examplesprovidedlater
inthechapterillustratehowtoincludethesegoalsin
decisionstobeactive.
Ingeneral,healthymenandwomenwhoplanprudent
increasesintheirweeklyamountsofphysicalactivity
donotneedtoconsultahealth-careproviderbefore
becomingactive.
Inactive Adults
Inactiveadultsorthosewhodontyetdo150minutes
ofphysicalactivityaweekshouldworkgradually
towardthisgoal.Theinitialamountofactivityshould
beatalightormoderateintensity,forshortperiods
oftime,withthesessionsspreadthroughouttheweek.
Thegoodnewsisthatsomeisbetterthannone.
Peoplegainsomehealthbenetsevenwhentheydo
aslittleas60minutesaweekofmoderate-intensity
aerobicphysicalactivity.
ForMoreInformation
See Chapter 6Safe and
Active, for more information
on how to increase physical
activity gradually.
Toreduceriskofinjury,
itisimportanttoincrease
theamountofphysical
activitygraduallyovera
periodofweekstomonths.
Forexample,aninactivepersoncouldstartwitha
walkingprogramconsistingof5minutesofslow
walkingseveraltimeseachday,5to6daysaweek.
Thelengthoftimecouldthengraduallybeincreased
to10minutespersession,3timesaday,andthe
walkingspeedcouldbeincreasedslowly.
Muscle-strengtheningactivitiesshouldalsobe
graduallyincreasedovertime.Initially,theseactivities
canbedonejust1dayaweekstartingatalightor
moderatelevelofeffort.Overtime,thenumberofdays
aweekcanbeincreasedto2,andthenpossiblytomore
than2.Eachweek,thelevelofeffort(intensity)canbe
increasedslightlyuntilitbecomesmoderatetohigh.
Active Adults
Adultswhoarealreadyactiveandmeettheminimum
Guidelines(theequivalentof150minutesof
moderate-intensityaerobicactivityeveryweek)can
gainadditionalandmoreextensivehealthandtness
benetsbyincreasingphysicalactivityabovethis
amount.MostAmericanadultsshouldincreasetheir
Chapter4.ActiveAdults 24



aerobicactivitytoexceedtheminimumleveland
movetoward300minutesaweek.Adultsshouldalso
domuscle-strengtheningactivitiesonatleast2days
eachweek.
Onetime-efcientwaytoachievegreatertness
andhealthgoalsistosubstitutevigorous-intensity
aerobicactivityforsomemoderate-intensityactivity.
Usingthe2-to-1ruleofthumb,doing150minutesof
vigorous-intensityaerobicactivityaweekprovides
aboutthesamebenetsas300minutesofmoderate-
intensityactivity.
Adultsareencouragedtodoavarietyofactivities,
asvarietyprobablyreducesriskofinjurycausedby
doingtoomuchofonekindofactivity(thisiscalled
anoveruseinjury).
Highly Active Adults
Adultswhoarehighlyactiveshouldmaintaintheir
activitylevel.Theseadultsarealsoencouragedtodo
avarietyofactivities.
SpecialConsiderations
Flexibility Activities
Flexibilityisanimportantpartofphysicaltness.Some
typesofphysicalactivity,suchasdancing,requiremore
exibilitythanothers.Stretchingexercisesareeffective
inincreasingexibility,andtherebycanallowpeopleto
moreeasilydoactivitiesthatrequiregreaterexibility.
Forthisreason,exibilityactivitiesareanappropriate
partofaphysicalactivityprogram,eventhoughthey
havenoknownhealthbenetsanditisunclearwhether
theyreduceriskofinjury.Timespentdoingexibility
activitiesbythemselvesdoesnotcounttowardmeeting
theaerobicormuscle-strengtheningGuidelines.
Thehealthbenets
ofphysicalactivityaregenerallyindependentofbodyweight.Thegood
newsforpeopleneedingtoloseweightisthatregularphysicalactivity
providesmajorhealthbenets,nomatterhowtheirweightchanges
overtime.
Warm-up and Cool-down
Warm-upandcool-downactivitiesareanacceptable
partofapersonsphysicalactivityplan.Commonly,
thewarm-upandcool-downinvolvedoingan
activityataslowerspeedorlowerintensity.Awarm-
upbeforemoderate- orvigorous-intensityaerobic
activityallowsagradualincreaseinheartrateand
breathingatthestartoftheepisodeofactivity.Acool-
downafteractivityallowsagradualdecreaseatthe
endoftheepisode.Timespentdoingwarm-upand
cool-downmaycounttowardmeetingtheaerobic
activityGuidelinesiftheactivityisatleastmoderate
intensity(forexample,walkingbrisklyasawarm-up
beforejogging).Awarm-upformuscle-strengthening
activitycommonlyinvolvesdoingexerciseswith
lighterweight.
Physical Activity in a Weight-Control Plan
Alongwithappropriate
ForMoreInformation
See the Dietary Guidelines
for Americans for additional
information on weight
management and how
to determine a healthy
weight.
dietaryintake,physical
activityisanimportant
partofmaintaininghealthy
weight,losingweight,
andkeepingextraweight
offonceithasbeenlost.
Physicalactivityalsohelps
reduceabdominalfatand
preservemuscleduringweightloss.Adultsshould
aimforahealthy,stablebodyweight.Theamountof
physicalactivitynecessarytoachievethisweightvaries
greatlyfrompersontoperson.
Therststepinachievingormaintainingahealthy
weightistomeettheminimumlevelofphysical
activityintheGuidelines.Forsomepeoplethiswill
resultinastableandhealthybodyweight,butfor
manyitmaynot.
25 2008PhysicalActivityGuidelinesforAmericans

Adultsshould
stronglyconsiderwalkingasone
goodwaytogetaerobicphysical
activity.Manystudiesshowthat
walkinghashealthbenetsanda
lowriskofinjury.Itcanbedone
year-roundandinmanysettings.
Peoplewhoareatahealthybodyweightbutslowly
gainingweightcaneithergraduallyincreasethe
levelofphysicalactivity(towardtheequivalentof
300minutesaweekofmoderate-intensityaerobic
activity),orreducecaloricintake,orboth,untiltheir
weightisstable.Byregularlycheckingbodyweight,
peoplecanndtheamountofphysicalactivitythat
worksforthem.
Manyadultswillneedtodomorethanthe150minutes
aweekofmoderate-intensityaerobicphysicalactivity
aspartofaprogramtoloseweightorkeepitoff.
Theseadultsshoulddomorephysicalactivityand/or
furtherreducetheircaloricintake.Somepeoplewill
needtodotheequivalentof300ormoreminutesof
moderate-intensityphysicalactivityaweektomeet
theirweight-controlgoals.Combinedwithrestricting
caloricintake,theseadultsshouldgraduallyincrease
minutesortheintensityofaerobicphysicalactivity
perweek,tothepointatwhichthephysicalactivity
iseffectiveinachievingahealthyweight.
Itisimportanttorememberthatallactivitiesboth
baselineandphysicalactivitycountforenergy
balance.Activechoices,suchastakingthestairsrather
thantheelevatororaddingshortepisodesofwalking
totheday,areexamplesofactivitiesthatcanbe
helpfulinweightcontrol.
Forweightcontrol,vigorous-intensityactivityisfar
moretime-efcientthanmoderate-intensityactivity.
Forexample,anadultwhoweighs165pounds
(75kg)willburn560caloriesfrom150minutesof
briskwalkingat4milesanhour(thesecaloriesarein
additiontothecaloriesnormallyburnedbyabody
atrest).Thatpersoncanburnthesamenumberof
additionalcaloriesin50minutesbyrunning5miles
ata10minutes-per-milepace.
GettingandStayingActive:Real-LifeExamples
AdultscanmeetthePhysicalActivityGuidelinesinall
sortsofwaysandwithmanytypesofphysicalactivity.
Thechoicesoftypesandamountsofphysicalactivity
dependonpersonalhealthandtnessgoals.Hereare
threeexamples.
Jean: An Inactive Middle-Aged Woman
Hergoals:Jeansetsagoalofdoing1houradayof
moderate-intensityaerobicactivityon5daysaweek
(atotalof300minutesaweek).Weighing220pounds,
Jeanisobeseandwantstoloseabout1poundof
weighteachweek.
Startingout:Jeancutsbackonhercaloricintakeand
startswalking5minutesinthemorningand5minutes
intheeveningmostdaysoftheweek.Shewalksat
a2.5mile-an-hourpace.Althoughphysicalactivity
tablesshowthistobelight-intensityactivity,forher
leveloftnessandfatness,itisappropriatemoderate-
intensityactivity.
Makinggoodprogress:Twomonthslater,Jeanis
comfortablywalking30to40minutesatmoderate
intensitytoandfromherbusstopeveryday.She
thenaddsvarietytoheractivitybyalternatingamong
walking,ridingastationarycycle,andlow-impact
aerobics.Shealsobeginsmuscle-strengthening
activities,usingelasticbandstwiceeachweek.
Chapter4.ActiveAdults 26


Adultscanmeet
thePhysicalActivityGuidelines
inallsortsofwaysandwith
manytypesofphysicalactivity.
Reachinghergoal:Eventually,Jeanworksupto
300minutesaweekofmoderate-intensityaerobic
activity,includingherbriskwalkstoandfromthe
busstop.Shehaslost40poundsofweightin1year,
withmostoftheweightlossoccurringtheprevious
6monthswhenshemasteredherdietandwasable
todogreateramountsofphysicalactivity.
Douglas: An Active Middle-Aged Man
Hisgoalandcurrentactivitypattern:Douglaswas
asoccerplayerinhisyouth.Hisgoalistogetback
intoshapebybecomingaregularrecreationalrunner.
Inadditiontohisjoboperatingheavyequipment,
hewalks30to40minutesadayon5dayseachweek.
Healsoliftsweights2daysaweek.
Startingout:Douglasstartsawalk/jogprogramwith
aco-workerandplanstograduallyreplacewalking
withjoggingandthenrunning.Therstweekhegoes
outon5days,walkingfor25minutesandjogging
for5minutes.
Makinggoodprogress:Eachweek,Douglasgradually
increasesthetimespentjogging(vigorous-intensity
activity)andreducesthetimespentwalking(moderate-
intensityactivity).Healsocontinueshisweight-lifting
program.
Reachinghisgoal:Eventually,Douglasisrunning
30to45minutes4daysaweekandliftingweights
2daysaweek.Hegoesfora1-hourbicyclerideon
mostweekends.
Anita: A Very Active College-Aged Adult
Hergoalsandcurrentactivitypattern:Anitaplays
leaguebasketball(vigorous-intensityactivity)4days
eachweekfor90minuteseachday.Shewantsto
reduceherriskofinjuryfromdoingtoomuchofone
kindofactivity(thisiscalledanoveruseinjury).
Startingout:Anitastartsoutbycuttingbackher
basketballplayingto3dayseachweek.Shebegins
tobicycletoandfromcampus(30minuteseachway)
insteadofdrivinghercar.Shealsojoinsayogaclass
thatmeetstwiceeachweek.
Reachinghergoal:Eventually,Anitaisbicycling
3dayseachweektoandfromcampusinadditionto
playingbasketball.Heryogaclasshelpshertobuild
andmaintainstrengthandexibility.
27 2008PhysicalActivityGuidelinesforAmericans






AchievingTargetLevelsofPhysicalActivity:ThePossibilitiesAreEndless
TheseexamplesshowhowitspossibletomeettheGuidelinesbydoingmoderate-intensityorvigorous-intensity
activityoracombinationofboth.Physicalactivityatthislevelprovidessubstantialhealthbenets.
Waystogettheequivalentof150minutes(2hoursand30minutes)ofmoderate-intensityaerobicphysical
activityaweekplusmuscle-strengtheningactivities:
Thirtyminutesofbriskwalking(moderateintensity)on5days,exercisingwithresistancebands(muscle
strengthening)on2days;
Twenty-veminutesofrunning(vigorousintensity)on3days,liftingweightson2days(musclestrengthening);
Thirtyminutesofbriskwalkingon2days,60minutes(1hour)ofsocialdancing(moderateintensity)on
1evening,30minutesofmowingthelawn(moderateintensity)on1afternoon,heavygardening(muscle
strengthening)on2days;
Thirtyminutesofanaerobicdanceclasson1morning(vigorousintensity),30minutesofrunningon1day
(vigorousintensity),30minutesofbriskwalkingon1day(moderateintensity),calisthenics(suchassit-ups,
push-ups)on3days(musclestrengthening);
Thirtyminutesofbikingtoandfromworkon3days(moderateintensity),playingsoftballfor60minuteson
1day(moderateintensity),usingweightmachineson2days(muscle-strengtheningon2days);and
Forty-veminutesofdoublestennison2days(moderateintensity),liftingweightsafterworkon1day
(musclestrengthening),hikingvigorouslyfor30minutesandrockclimbing(musclestrengthening)on1day.
Ways to be even more active
Foradultswhoarealreadydoingatleast150minutesofmoderate-intensityphysicalactivity,hereareafew
waystodoevenmore.Physicalactivityatthislevelhasevengreaterhealthbenets.
Forty-veminutesofbriskwalkingeveryday,exercisingwithresistancebandson2or3days;
Forty-veminutesofrunningon3or4days,circuitweighttraininginagymon2or3days;
Thirtyminutesofrunningon2days,45minutesofbriskwalkingon1day,45minutesofanaerobicsand
weightsclasson1day,90minutes(1hourand30minutes)ofsocialdancingon1evening,30minutesof
mowingthelawn,plussomeheavygardenworkon1day;
Ninetyminutesofplayingsocceron1day,briskwalkingfor15minuteson3days,liftingweightson
2days;and
Forty-veminutesofstationarybicyclingon2days,60minutesofbasketballon2days,calisthenicson3days.
Chapter4.ActiveAdults 28


ActiveOlderAdults
R
egularphysicalactivityisessentialforhealthy
aging.Adultsaged65yearsandoldergain
substantialhealthbenetsfromregularphysical
activity,andthesebenetscontinuetooccurthroughout
theirlives.Promotingphysicalactivityforolderadults
isespeciallyimportantbecausethispopulationisthe
leastphysicallyactiveofanyagegroup.
Olderadultsareavariedgroup.Most,butnotall,
haveoneormorechronicconditions,andthese
conditionsvaryintypeandseverity.Allhave
experiencedalossofphysicaltnesswithage,some
morethanothers.Thisdiversitymeansthatsome
olderadultscanrunseveralmiles,whileothers
struggletowalkseveralblocks.
Thischapterprovidesguidanceaboutphysicalactivity
foradultsaged65yearsandolder.Thechapter
focusesonphysicalactivitybeyondbaselineactivity.
TheGuidelinesseektohelpolderadultsselecttypes
andamountsofphysicalactivityappropriatefor
theirabilities.TheGuidelinesforolderadultsare
alsoappropriateforadultsyoungerthanage65who
havechronicconditionsandthosewithalowlevel
oftness.
Foradultsaged65andolderwhoaretandhave
nolimitingchronicconditions,theguidanceinthis
chapterisessentiallythesameasthatprovidedin
Chapter4ActiveAdults.
ExplainingtheGuidelines
LiketheGuidelinesforotheradults,thoseforolder
adultsmainlyfocusontwotypesofactivity:aerobic
andmuscle-strengthening.Inaddition,theseGuidelines
discusstheadditionofbalancetrainingforolderadults
atriskoffalls.Eachtypeprovidesimportanthealth
benets,asexplainedinChapter2PhysicalActivity
HasManyHealthBenets.
Aerobic Activity
Peopledoingaerobicactivitiesmovelargemuscles
inarhythmicmannerforasustainedperiod.Brisk
walking,jogging,biking,dancing,andswimmingare
allexamplesofaerobicactivities.Thistypeofactivity
isalsocalledenduranceactivity.
Aerobicactivitymakesapersonsheartbeatmore
rapidlytomeetthedemandsofthebodysmovement.
29 2008PhysicalActivityGuidelinesforAmericans





KeyGuidelinesforOlderAdults
ThefollowingGuidelinesarethesameforadultsandolderadults:
Allolderadultsshouldavoidinactivity.Somephysicalactivityisbetterthannone,andolderadultswho
participateinanyamountofphysicalactivitygainsomehealthbenets.
Forsubstantialhealthbenets,olderadultsshoulddoatleast150minutes(2hoursand30minutes)aweek
ofmoderate-intensity,or75minutes(1hourand15minutes)aweekofvigorous-intensityaerobicphysical
activity,oranequivalentcombinationofmoderate-andvigorous-intensityaerobicactivity.Aerobicactivity
shouldbeperformedinepisodesofatleast10minutes,andpreferably,itshouldbespreadthroughouttheweek.
Foradditionalandmoreextensivehealthbenets,olderadultsshouldincreasetheiraerobicphysicalactivity
to300minutes(5hours)aweekofmoderate-intensity,or150minutesaweekofvigorous-intensityaerobic
physicalactivity,oranequivalentcombinationofmoderate- andvigorous-intensityactivity.Additional
healthbenetsaregainedbyengaginginphysicalactivitybeyondthisamount.
Olderadultsshouldalsodomuscle-strengtheningactivitiesthataremoderateorhighintensityandinvolve
allmajormusclegroupson2ormoredaysaweek,astheseactivitiesprovideadditionalhealthbenets.
ThefollowingGuidelinesarejustforolderadults:
Whenolderadultscannotdo150minutesofmoderate-intensityaerobicactivityaweekbecauseofchronic
conditions,theyshouldbeasphysicallyactiveastheirabilitiesandconditionsallow.
Olderadultsshoulddoexercisesthatmaintainorimprovebalanceiftheyareatriskoffalling.
Olderadultsshoulddeterminetheirlevelofeffortforphysicalactivityrelativetotheirleveloftness.
Olderadultswithchronicconditionsshouldunderstandwhetherandhowtheirconditionsaffecttheirability
todoregularphysicalactivitysafely.
Overtime,regularaerobicactivitymakestheheartand
cardiovascularsystemstrongerandtter.
WhenputtingtheGuidelinesintoaction,itsimportant
toconsiderthetotalamountofactivity,aswellashow
oftentobeactive,forhowlong,andatwhatintensity.
Howmuchtotalactivityaweek?
Olderadultsshouldaimtodoatleast150minutes
(2hoursand30minutes)ofmoderate-intensityphysical
activityaweek,oranequivalentamount(75minutes
or1hourand15minutes)ofvigorous-intensity
activity.Olderadultscanalsodoanequivalentamount
ofactivitybycombiningmoderate-andvigorous-
intensityactivity.Asistrueforyoungerpeople,greater
amountsofphysicalactivityprovideadditionaland
moreextensivehealthbenetstopeopleaged65years
andolder.
Nomatterwhatitspurposewalkingthedog,
takingadanceorexerciseclass,orbicyclingtothe
storeaerobicactivityofalltypescountstoward
theGuidelines.
Howmanydaysaweekandforhowlong?
Aerobicphysicalactivityshouldbespreadthroughout
theweek.Researchstudiesconsistentlyshowthat
activityperformedonatleast3daysaweekproduces
healthbenets.Spreadingphysicalactivityacrossat
least3daysaweekmayhelptoreducetheriskof
injuryandavoidexcessivefatigue.
Episodesofaerobicactivitycounttowardmeeting
theGuidelinesiftheylastatleast10minutesandare
performedatmoderateorvigorousintensity.These
episodescanbedividedthroughoutthedayorweek.
Forexample,apersonwhotakesabrisk15-minute
Chapter5.ActiveOlderAdults 30












ExamplesofAerobicandMuscle-
StrengtheningPhysicalActivitiesfor
OlderAdults
Theintensityoftheseactivitiescanbeeither
relativelymoderateorrelativelyvigorous,
dependingonanolderadultsleveloftness.
Aerobic Muscle-Strengthening
Walking
Dancing
Swimming
Water aerobics
Jogging
Aerobic exercise classes
Bicycle riding (stationary
or on a path)
Some activities of
gardening, such as
raking and pushing a
lawn mower
Tennis
Golf (without a cart)
Exercises using exercise
bands, weight machines,
hand-held weights
Calisthenic exercises
(body weight provides
resistance to movement)
Digging, lifting, and
carrying as part of
gardening
Carrying groceries
Some yoga exercises
Some tai chi exercises
walktwiceadayoneverydayoftheweekwould
easilymeettheminimumGuidelineforaerobicactivity.
Howintense?
OlderadultscanmeettheGuidelinesbydoingrelatively
moderate-intensityactivity,relativelyvigorous-
intensityactivity,oracombinationofboth.Timespent
inlightactivity(suchaslighthousework)andsedentary
activities(suchaswatchingTV)donotcount.
Therelativeintensityofaerobicactivityisrelatedtoa
personslevelofcardiorespiratorytness.
Moderate-intensityactivityrequiresamediumlevel
ofeffort.Onascaleof0to10,wheresittingis0and
thegreatesteffortpossibleis10,moderate-intensity
activityisa5or6andproducesnoticeableincreases
inbreathingrateandheartrate.
Vigorous-intensityactivityisa7or8onthisscale
andproduceslargeincreasesinapersonsbreathing
andheartrate.
Ageneralruleofthumbisthat2minutesofmoderate-
intensityactivitycountthesameas1minuteof
vigorous-intensityactivity.Forexample,30minutesof
moderate-intensityactivityaweekisroughlysameas
15minutesofvigorous-intensityactivity.
Muscle-Strengthening Activities
Atleast2daysaweek,olderadultsshoulddomuscle-
strengtheningactivitiesthatinvolveallthemajor
musclegroups.Thesearethemusclesofthelegs,hips,
chest,back,abdomen,shoulders,andarms.
Muscle-strengtheningactivitiesmakemusclesdomore
workthantheyareaccustomedtoduringactivitiesof
dailylife.Examplesofmuscle-strengtheningactivities
includeliftingweights,workingwithresistancebands,
doingcalisthenicsusingbodyweightforresistance
(suchaspush-ups,pull-ups,andsit-ups),climbing
stairs,carryingheavyloads,andheavygardening.
Muscle-strengtheningactivitiescountiftheyinvolvea
moderatetohighlevelofintensity,oreffort,andwork
themajormusclegroupsofthebody.Whateverthe
reasonfordoingit,anymuscle-strengtheningactivity
countstowardmeetingtheGuidelines.Forexample,
muscle-strengtheningactivitydoneaspartofatherapy
orrehabilitationprogramcancount.
Nospecicamountoftimeisrecommendedfor
musclestrengthening,butmuscle-strengthening
exercisesshouldbeperformedtothepointatwhich
itwouldbedifculttodoanotherrepetitionwithout
help.Whenresistancetrainingisusedtoenhance
musclestrength,onesetof8to12repetitionsofeach
exerciseiseffective,althoughtwoorthreesetsmaybe
moreeffective.Developmentofmusclestrengthand
enduranceisprogressiveovertime.Thismeansthat
gradualincreasesintheamountofweightorthedays
perweekofexercisewillresultinstrongermuscles.
Balance Activities for Older Adults at Risk of Falls
Olderadultsareatincreasedriskoffallsiftheyhave
hadfallsintherecentpastorhavetroublewalking.
Inolderadultsatincreasedriskoffalls,strong
evidenceshowsthatregularphysicalactivityissafe
andreducestheriskoffalls.Reductioninfallsisseen
forparticipantsinprogramsthatincludebalanceand
31 2008PhysicalActivityGuidelinesforAmericans










moderate-intensitymuscle-strengtheningactivities
for90minutes(1hourand30minutes)aweekplus
moderate-intensitywalkingforabout1houraweek.
Preferably,olderadultsatriskoffallsshoulddobalance
training3ormoredaysaweekanddostandardized
exercisesfromaprogramdemonstratedtoreduce
falls.Examplesoftheseexercisesincludebackward
walking,sidewayswalking,heelwalking,toewalking,
andstandingfromasittingposition.Theexercises
canincreaseindifcultybyprogressingfromholding
ontoastablesupport(likefurniture)whiledoingthe
exercisestodoingthemwithoutsupport.Itsnotknown
whetherdifferentcombinationsoftype,amount,or
frequencyofactivitycanreducefallstoagreater
degree.Taichiexercisesalsomayhelppreventfalls.
MeetingtheGuidelines
Olderadultshavemanywaystoliveanactivelifestyle
thatmeetstheGuidelines.Manyfactorsinuence
decisionstobeactive,suchaspersonalgoals,current
physicalactivityhabits,andhealthandsafety
considerations.
Healthyolderadultsgenerallydonotneedtoconsult
ahealth-careproviderbeforebecomingphysically
active.However,health-careproviderscanhelppeople
attainandmaintain
regularphysicalactivity
ForMoreInformation
See Chapter 6Safe and
Active, for details on
consulting a health-care
provider.
byprovidingadviceon
appropriatetypesof
activitiesandwaysto
progressatasafeand
steadypace.
Adultswithchronicconditionsshouldtalkwith
theirhealth-careprovidertodeterminewhethertheir
conditionslimittheirabilitytodoregularphysical
activityinanyway.Suchaconversationshouldalso
helppeoplelearnaboutappropriatetypesandamounts
ofphysicalactivity.
Inactive Older Adults
Olderadultsshouldincreasetheiramountofphysical
activitygradually.Itcantakemonthsforthosewitha
lowleveloftnesstograduallymeettheiractivitygoals.
Toreduceinjuryrisk,inactiveorinsufcientlyactive
adultsshouldavoidvigorousaerobicactivityatrst.
Rather,theyshouldgraduallyincreasethenumberof
daysaweekanddurationofmoderate-intensityaerobic
activity.Adultswithaverylowleveloftnesscanstart
outwithepisodesofactivitylessthan10minutesand
slowlyincreasetheminutesoflight-intensityaerobic
activity,suchaslight-intensitywalking.
Olderadultswhoareinactiveorwhodontyetmeet
theGuidelinesshouldaimforatleast150minutesa
weekofrelativelymoderate-intensityphysicalactivity.
Gettingatleast30minutesofrelativelymoderate-
intensityphysicalactivityon5ormoredayseach
weekisareasonablewaytomeettheseGuidelines.
Doingmuscle-strengtheningactivityon2or3non-
consecutivedayseachweekisalsoanacceptableand
appropriategoalformanyolderadults.
Active Older Adults
Olderadultswhoarealreadyactiveandmeetthe
Guidelinescangainadditionalandmoreextensive
healthbenetsbymovingbeyondthe150-minute-
a-weekminimumto300ormoreminutesaweekof
relativelymoderate-intensityaerobicactivity.Muscle-
strengtheningactivitiesshouldalsobedoneatleast
2daysaweek.
Older Adults With Chronic Conditions
Olderadultswhohavechronicconditionsthatprevent
themfromdoingtheequivalentof150minutesof
moderate-intensityaerobicactivityaweekshouldset
physicalactivitygoalsthatmeettheirabilities.They
shouldtalkwiththeirhealth-careproviderabout
settingphysicalactivity
goals.Theyshouldavoid
ForMoreInformation
See Chapter 7Additional
Considerations for Some
Adults, for more information
on chronic conditions.
aninactivelifestyle.Even
60minutes(1hour)aweek
ofmoderate-intensity
aerobicactivityprovides
somehealthbenets.
SpecialConsiderations
Doing a Variety of Activities, Including Walking
InworkingtowardmeetingtheGuidelines,older
adultsareencouragedtodoavarietyofactivities.This
Chapter5.ActiveOlderAdults 32

Olderadults
havemanywaystoliveanactive
lifestylethatmeetstheGuidelines.
approachcanmakeactivitymoreenjoyableandmay
reducetheriskofoveruseinjury.
Olderadultsalsoshouldstronglyconsiderwalkingas
onegoodwaytogetaerobicactivity.Manystudiesshow
thatwalkinghashealthbenets,andithasalowriskof
injury.Itcanbedoneyear-roundandinmanysettings.
Physical Activity for Older Adults Who Have
Functional Limitations
Whenapersonhaslostsomeabilitytodoataskof
everydaylife,suchasclimbingstairs,thepersonhas
afunctionallimitation.Inolderadultswithexisting
functionallimitations,scienticevidenceindicates
thatregularphysicalactivityissafeandhelpsimprove
functionalability.
Resuming Activity After an Illness or Injury
Olderadultsmayhavetotakeabreakfromregular
physicalactivitybecauseofillnessorinjury,suchas
theuoramusclestrain.Iftheseinterruptionsoccur,
olderadultsshouldresumeactivityatalowerleveland
graduallyworkbackuptotheirformerlevelofactivity.
Flexibility, Warm-up, and Cool-down
Olderadultsshouldmaintaintheexibilitynecessary
forregularphysicalactivityandactivitiesofdaily
life.Whendoneproperly,stretchingactivitiesincrease
exibility.Althoughtheseactivitiesalonehaveno
knownhealthbenetsandhavenotbeendemonstrated
toreduceriskofactivity-relatedinjuries,theyarean
appropriatecomponentofaphysicalactivityprogram.
However,timespentdoingexibilityactivitiesby
themselvesdoesnotcounttowardmeetingaerobicor
muscle-strengtheningGuidelines.
Researchstudiesofeffectiveexerciseprograms
typicallyincludewarm-upandcool-downactivities.
Warm-upandcool-downactivitiesbeforeandafter
physicalactivitycanalsobeincludedaspartofa
personalprogram.Awarm-upbeforemoderate-or
vigorous-intensityaerobicactivityallowsagradual
increaseinheartrateandbreathingatthestartof
theepisodeofactivity.Acool-downafteractivity
allowsagradualdecreaseattheendoftheepisode.
Timespentdoingwarm-upandcool-downmaycount
towardmeetingtheaerobicactivityGuidelinesifthe
activityisatleastmoderateintensity(forexample,
walkingbrisklytowarm-upforajog).Awarm-up
formuscle-strengtheningactivitycommonlyinvolves
doingexerciseswithlessweightthanduringthe
strengtheningactivity.
Physical Activity in a Weight-Control Plan
Theamountofphysicalactivitynecessaryto
successfullymaintainahealthybodyweightdepends
oncaloricintakeandvariesconsiderablyamong
olderadults.Toachieveandmaintainahealthybody
weight,olderadultsshouldrstdotheequivalentof
150minutesofmoderate-intensityaerobicactivityeach
week.Ifnecessary,olderadultsshouldincreasetheir
weeklyminutesofaerobicphysicalactivitygradually
overtimeanddecreasecaloricintaketoapointwhere
theycanachieveenergybalanceandahealthyweight.
Someolderadultswillneedahigherlevelofphysical
activitythanotherstomaintainahealthybody
weight.Somemayneedmorethantheequivalentof
300minutes(5hours)aweekofmoderate-intensity
activity.Itispossibletoachievethislevelofactivityby
graduallyincreasingactivityovertime.
33 2008PhysicalActivityGuidelinesforAmericans

Olderadultswhoarecapableofrelativelyvigorous-
intensityactivityandneedahighlevelofphysical
activitytomaintainahealthyweightshouldconsider
somerelativelyvigorous-intensityactivityasameans
ofweightcontrol.Thisapproachismoretime-efcient
thandoingonlymoderate-intensityactivity.However,
highlevelsofactivityarenotfeasibleformanyolder
adults.Theseadultsshouldachievealevelofphysical
activitythatissustainableandsafe.Iffurtherweight
lossisneeded,theseolderadultsshouldachieveenergy
balancebyregulatingcaloricintake.
Itisimportanttorememberthatallactivitiescount
forenergybalance.Activechoices,suchastakingthe
stairsratherthantheelevatororaddingshortepisodes
ofwalkingtotheday,areexamplesofactivitiesthat
canbehelpfulinweightcontrol.
GettingandStayingActive:Real-LifeExamples
Thefollowingexamplesshowhowdifferentpeople
withdifferentlivingcircumstancesandlevelsoftness
canmeettheGuidelinesforolderadults.
Mary: A 75-Year-Old Woman Living Independently
in Her Own Home
Marygetstheequivalentof180minutes(3hours)of
moderate-intensityaerobicactivityeachweek,plus
muscle-strengtheningactivity3daysaweek.
Sheparticipatesregularlyinanexerciseclassat
herlocalseniorcenter.TheclassmeetsMondays,
Wednesdays,andFridays.Itincludes30minutes
ofaerobicdance,whichshecandoatmoderate
intensity,aswellas20minutesofstrengthtraining,
a5-minutewarm-up,a5-minutecool-down,and
somestretchingexercises.
OnmostSundays,shevisitsherfavoriteparkand
walksalooptrailwithseveralfriends,whichtakes
themabout45minutes.Thetrailishilly,soabout
30minutesofthewalkismoderate-intensity
walkingforher,andabout15minutesisvigorous-
intensity(the15minutesofvigorousintensity
countsas30minutesofmoderate-intensitywalking).
Sheaddsatleastanadditional30minutesofwalking
eachweekindifferentways.Forexample,shewalks
hergrandsontoschool,shewalkstoherfriends
homes,orshewalksatthemallduringshoppingtrips.
Manuel: An 85-Year-Old Man Living in an
Assisted-Living Facility
Manuel,whohasproblemswithfalls,getsabout
70minutes(1hourand10minutes)ofaerobicactivity
eachweekandhasanindividualizedstrength-training
program.Hecannotdo150minutesofmoderate-
intensityphysicalactivitybecauseofhischronic
conditions,butheisbeingasphysicallyactiveashis
conditionallows.
Toreducetheriskoffalls,aphysicaltherapisthas
prescribedanindividualizedexerciseprogram.This
programincludes3daysaweek(30minuteseach
session)ofstrength- andbalance-trainingexercises.
Manuelusesankleweightsforlowerbodymuscle-
strengtheningexercisesanddoesaseriesofbalance
exercises.Hedoesthisprogramwiththeassistance
ofaresidentialaide.
Manuelsresidenceincludesagardenwithwalking
pathsandbenches.Hehasgraduallyincreasedhis
physicalactivitytowalkingabout10minuteseach
day.Onsomedayshecanwalkmorethanonothers,
buthetriestowalkalittleeveryday.Theplanisfor
himtosustainthislevelofactivityforseveralweeks.
Afterhebuildsstrengthandhisbalanceimproves,
Manuelwillconsiderincreasinghislevelofactivity
andjoininganexerciseclassspeciallydesignedto
reducetheriskoffallsinolderpeople.
Anthony: A 65-Year-Old Man Living in a Retirement
Community
Anthonyhasbeenactiveandtallhislife.Hedoes
180minutesofrelativelyvigorous-intensityactivity
eachweek,plusmuscle-strengtheningactivitieson
3days.
Sixdaysaweek,Anthonygetsupearlyandruns
3miles,whichtakesabout30minutes.
Withhelpfromstaffathiscommunitystness
facility,Anthonydesignedaweight-liftingprogram
usingweightmachines.Hedoesthisprogramon
3days.
Chapter5.ActiveOlderAdults 34






SafeandActive
A
lthoughphysicalactivityhasmanyhealth
benets,injuriesandotheradverseeventsdo
sometimeshappen.Themostcommoninjuries
affectthemusculoskeletalsystem(thebones,joints,
muscles,ligaments,andtendons).Otheradverseevents
canalsooccurduringactivity,suchasoverheating
anddehydration.Onrareoccasions,peoplehave
heartattacksduringactivity.
Thegoodnewsisthatscienticevidencestrongly
showsthatphysicalactivityissafeforalmosteveryone.
Moreover,thehealthbenetsofphysicalactivityfar
outweightherisks.
Still,peoplemayhesitatetobecomephysicallyactive
becauseofconcerntheyllgethurt.Forthesepeople,
thereisevenmoregoodnews:Theycantakesteps
thatareproventoreducetheirriskofinjuryand
adverseevents.
TheGuidelinesinthischapterprovideadviceto
helppeopledophysicalactivitysafely.Mostadvice
appliestopeopleofallages.Specicguidance
forparticularagegroupsandpeoplewithcertain
conditionsisalsoprovided.
ExplainingtheGuidelines
Physical Activity Is Safe for Almost Everyone
Mostpeoplearenotlikelytobeinjuredwhendoing
moderate-intensityactivitiesinamountsthatmeetthe
PhysicalActivityGuidelines.However,injuriesand
otheradverseeventsdosometimeshappen.Themost
commonproblemsaremusculoskeletalinjuries.Evenso,
studiesshowthatonlyonesuchinjuryoccursforevery
1,000hoursofwalkingforexercise,andfewerthan
fourinjuriesoccurforevery1,000hoursofrunning.
Bothphysicaltnessandtotalamountofphysical
activityaffectriskofmusculoskeletalinjuries.People
whoarephysicallythavealowerriskofinjurythan
peoplewhoarenot.Peoplewhodomoreactivity
generallyhaveahigherriskofinjurythanpeoplewho
dolessactivity.Sowhatshouldpeopledoiftheywant
tobeactiveandsafe?Thebeststrategiesareto:
Beregularlyphysicallyactivetoincreasephysical
tness;and
Followtheotherguidanceinthischapter(especially
increasingphysicalactivitygraduallyovertime)
35 2008PhysicalActivityGuidelinesforAmericans


InjuryRisk
Level ActivityType Examples
LowerRisk Commuting Walking, bicycling
Lifestyle Home repair, gardening/
yard work
Recreation/sports Walking for exercise,
No contact golf, dancing, swimming,
running, tennis
Recreation/sports Bicycling, aerobics,
Limited contact skiing, volleyball,
baseball, softball
Recreation/sports Football, hockey, soccer,
HigherRisk Collision/contact basketball
KeyGuidelinesforSafePhysicalActivity
Todophysicalactivitysafelyandreduceriskofinjuriesandotheradverseevents,peopleshould:
Understandtherisksandyetbecondentthatphysicalactivityissafeforalmosteveryone.
Choosetodotypesofphysicalactivitythatareappropriatefortheircurrenttnesslevelandhealthgoals,
becausesomeactivitiesaresaferthanothers.
Increasephysicalactivitygraduallyovertimewhenevermoreactivityisnecessarytomeetguidelinesor
healthgoals.Inactivepeopleshouldstartlowandgoslowbygraduallyincreasinghowoftenandhow
longactivitiesaredone.
Protectthemselvesbyusingappropriategearandsportsequipment,lookingforsafeenvironments,following
rulesandpolicies,andmakingsensiblechoicesaboutwhen,where,andhowtobeactive.
Beunderthecareofahealth-careprovideriftheyhavechronicconditionsorsymptoms.Peoplewithchronic
conditionsandsymptomsshouldconsulttheirhealth-careprovideraboutthetypesandamountsofactivity
appropriateforthem.
TheContinuumofInjuryRiskAssociatedWith
DifferentTypesofActivity
tominimizetheinjuryriskfromdoingmediumto
highamountsofactivity.
Followingthesestrategiesmayreduceoverallinjury
risk.Activepeoplearemorelikelytohaveanactivity-
relatedinjurythaninactivepeople.Buttheyappear
lesslikelytohavenon-activity-relatedinjuries,suchas
work-relatedinjuriesorinjuriesthatoccuraroundthe
homeorfrommotorvehiclecrashes.
Choose Appropriate Types and Amounts of Activity
Peoplecanreducetheirriskofinjurybychoosing
appropriatetypesofactivity.Asthetableshows,the
safestactivitiesaremoderateintensityandlowimpact,
anddontinvolvepurposefulcollisionorcontact.
Walkingforexercise,gardeningoryardwork,bicycling
orexercisecycling,dancing,swimming,andgolfare
activitieswiththelowestinjuryrates.Intheamounts
commonlydonebyadults,walking(amoderate-
intensityandlow-impactactivity)hasathirdorless
oftheinjuryriskofrunning(avigorous-intensityand
higherimpactactivity).
Theriskofinjuryforatypeofphysicalactivitycan
alsodifferaccordingtothepurposeoftheactivity.
Forexample,recreationalbicyclingorbicyclingfor
Note: The same activity done for different purposes and with different
frequency, intensity, and duration leads to different injury rates. Competitive
activities tend to have higher injury rates than non-competitive activities,
likely due to different degrees of intensity of participation.
transportationleadstofewerinjuriesthantrainingfor
andcompetinginbicycleraces.
Peoplewhohavehadapastinjuryareatriskof
injuringthatbodypartagain.Theriskofinjurycanbe
reducedbyperformingappropriateamountsofactivity
andsettingappropriatepersonalgoals.Performinga
Chapter6.SafeandActive 36




Theriskofinjury
tobones,muscles,andjointsisdirectlyrelatedtothegapbetweena
personsusuallevelofactivityandanewlevelofactivity.
varietyofdifferentphysicalactivitiesmayalsoreduce
theriskofoveruseinjury.
Increase Physical Activity Gradually Over Time
Scienticstudiesindicatethattheriskofinjuryto
bones,muscles,andjointsisdirectlyrelatedtothe
gapbetweenapersonsusuallevelofactivityanda
newlevelofactivity.Thesizeofthisgapiscalledthe
amountofoverload.Creatingasmalloverloadand
waitingforthebodytoadaptandrecoverreducesthe
riskofinjury.Whenamountsofphysicalactivityneed
tobeincreasedtomeettheGuidelinesorpersonal
goals,physicalactivityshouldbeincreasedgradually
overtime,nomatterwhatthepersonscurrentlevelof
physicalactivity.
Scientistshavenotestablishedastandardforhowto
graduallyincreasephysicalactivityovertime.The
followingrecommendationsgivegeneralguidancefor
inactivepeopleandthosewithlowlevelsofphysical
activityonhowtoincreasephysicalactivity:
Userelativeintensity(intensityoftheactivity
relativetoapersonstness)toguidethelevelof
effortforaerobicactivity.
Generallystartwithrelativelymoderate-intensity
aerobicactivity.Avoidrelativelyvigorous-intensity
activity,suchasshovelingsnoworrunning.Adults
withalowleveloftnessmayneedtostartwith
lightactivity,oramixoflight-tomoderate-
intensityactivity.
First,increasethenumberofminutespersession
(duration),andthenumberofdaysperweek
(frequency)ofmoderate-intensityactivity.Later,
ifdesired,increasetheintensity.
Payattentiontotherelativesizeoftheincreasein
physicalactivityeachweek,asthisisrelatedtoinjury
risk.Forexample,a20-minuteincreaseeachweek
issaferforapersonwhodoes200minutesaweek
ofwalking(a10percentincrease),thanforaperson
whodoes40minutesaweek(a50percentincrease).
Theavailablescienticevidencesuggeststhatadding
asmallandcomfortableamountoflight-tomoderate-
intensityactivity,suchas5to15minutesofwalking
persession,2to3timesaweek,toonesusual
activitieshasalowriskofmusculoskeletalinjuryand
noknownriskofseverecardiacevents.Becausethis
rangeisratherwide,peopleshouldconsiderthree
factorsinindividualizingtheirrateofincrease:age,
leveloftness,andpriorexperience.
Age
Theamountoftimerequiredtoadapttoanewlevel
ofactivityprobablydependsonage.Youthandyoung
adultsprobablycansafelyincreaseactivitybysmall
amountseveryweekor2.Olderadultsappearto
requiremoretimetoadapttoanewlevelofactivity,
intherangeof2to4weeks.
LevelofFitness
Lesstadultsareathigherriskofinjurywhendoing
agivenamountofactivity,comparedtotteradults.
Slowerratesofincreaseovertimemayreduceinjury
risk.Thisguidanceappliestooverweightandobese
adults,astheyarecommonlylessphysicallyt.
PriorExperience
Peoplecanusetheirexperiencetolearntoincrease
physicalactivityovertimeinwaysthatminimize
theriskofoveruseinjury.Generally,ifanoveruse
injuryoccurredinthepastwithacertainrateof
progression,apersonshouldincreaseactivitymore
slowlythenexttime.
Take Appropriate Precautions
Takingappropriateprecautionsmeansusingtheright
gearandequipment,choosingsafeenvironmentsin
whichtobeactive,followingrulesandpolicies,and
37 2008PhysicalActivityGuidelinesforAmericans


makingsensiblechoicesabouthow,when,andwhere
tobeactive.
UseProtectiveGearandAppropriateEquipment
Usingpersonalprotectivegearcanreducethe
frequencyofinjury.Personalprotectivegearis
somethingwornbyapersontoprotectaspecic
bodypart.Examplesincludehelmets,eyewearand
goggles,shinguards,elbowandkneepads,and
mouthguards.
Usingappropriatesportsequipmentcanalsoreduce
riskofinjury.Sportsequipmentreferstosportor
activity-specictools,suchasballs,bats,sticks,
andshoes.
Forthemostbenet,protectiveequipmentandgear
shouldbe:
Therightequipmentfortheactivity;
Appropriatelytted;
ForMoreInformation
See Appendix 2 for a
resource chart that provides
selected examples of injury
prevention strategies for
common physical activities.
Appropriately
maintained;and
Usedconsistentlyand
correctly.
BeActiveinSafeEnvironments
Peoplecanreducetheirinjuryrisksbypayingattention
totheplacestheychoosetobeactive.Tohelp
themselvesstaysafe,peoplecanlookfor:
Physicalseparationfrommotorvehicles,suchas
sidewalks,walkingpaths,orbikelanes;
Neighborhoodswithtrafc-calmingmeasuresthat
slowdowntrafc;
Placestobeactivethatarewell-lighted,whereother
peoplearepresent,andthatarewell-maintained
(nolitter,brokenwindows);
Shock-absorbingsurfacesonplaygrounds;
Well-maintainedplayingeldsandcourtswithout
holesorobstacles;
Breakawaybasesatbaseballandsoftballelds;and
Paddedandanchoredgoalsandgoalpostsatsoccer
andfootballelds.
FollowRulesandPoliciesThatPromoteSafety
Rules,policies,legislation,andlawsarepotentially
themosteffectiveandwide-reachingwayto
reduceactivity-relatedinjuries.Togetthebenet,
individualsshouldlookforandfollowtheserules,
policies,andlaws.Forexample,policiesthatpromote
theuseofbicyclehelmetsreducetheriskofhead
injuryamongcyclists.Rulesagainstdivinginto
shallowwateratswimmingpoolspreventheadand
neckinjuries.
MakeSensibleChoicesAboutHow,When,andWhere
ToBeActive
Apersonschoicescanobviouslyinuencethe
riskofadverseevents.Bymakingsensiblechoices,
injuriesandadverseeventscanbeprevented.Consider
weatherconditions,suchasextremesofheatandcold.
Forexample,duringveryhotandhumidweather,
peoplelessenthechancesofdehydrationandheat
stressby:
Exercisinginthecoolofearlymorningasopposed
tomid-dayheat;
Switchingtoindooractivities(playingbasketballin
thegymratherthanontheplayground);
Changingthetypeofactivity(swimmingratherthan
playingsoccer);
Chapter6.SafeandActive 38


developnewsymptomswhenincreasingtheirlevelsof
activityshouldconsultahealth-careprovider.
Inactivepeople
whograduallyprogressovertime
torelativelymoderate-intensity
activityhavenoknownriskof
suddencardiacevents,andvery
lowriskofbone,muscle,orjoint
injuries.
Loweringtheintensityofactivity(walkingrather
thanrunning);and
Payingcloseattentiontorest,shade,drinkingenough
uids,andotherwaystominimizeeffectsofheat.
Exposuretoairpollutionisassociatedwithseveral
adversehealthoutcomes,includingasthmaattacks
andabnormalheartrhythms.Peoplewhocanmodify
thelocationortimeofexercisemaywishtoreduce
theserisksbyexercisingawayfromheavytrafc
andindustrialsites,especiallyduringrushhouror
timeswhenpollutionisknowntobehigh.However,
currentevidenceindicatesthatthebenetsofbeing
active,eveninpollutedair,outweightheriskof
beinginactive.
Advice From Health-Care Providers
Theprotectivevalueofamedicalconsultation
forpersonswithorwithoutchronicdiseaseswho
areinterestedinincreasingtheirphysicalactivity
levelisnotestablished.Peoplewithoutdiagnosed
chronicconditions(suchasdiabetes,heartdisease,
orosteoarthritis)andwhodonothavesymptoms
(suchaschestpainorpressure,dizziness,orjointpain)
donotneedtoconsultahealth-careproviderabout
physicalactivity.
Inactivepeoplewhograduallyprogressovertime
torelativelymoderate-intensityactivityhaveno
knownriskofsuddencardiacevents,andverylow
riskofbone,muscle,orjointinjuries.Apersonwho
ishabituallyactivewithmoderate-intensityactivity
cangraduallyincreasetovigorousintensitywithout
needingtoconsultahealth-careprovider.Peoplewho
Health-careproviderscan
provideusefulpersonalized
adviceonhowtoreduce
riskofinjuries.Forpeople
whowishtoseekthe
adviceofahealth-care
provider,itisparticularly
appropriatetodosowhen
ForMoreInformation
See Chapter 4Active
Adults, for guidance
and examples of how
to gradually increase
activity levels.
contemplatingvigorous-intensityactivity,because
therisksofthisactivityarehigherthantherisksof
moderate-intensityactivity.
Thechoiceofappropriatetypesandamountsof
physicalactivitycanbeaffectedbychronicconditions.
Peoplewithsymptomsorknownchronicconditions
shouldbeundertheregularcareofahealth-care
provider.Inconsultationwiththeirprovider,theycan
developaphysicalactivityplanthatisappropriatefor
them.Peoplewithchronicconditionstypicallynd
thatmoderate-intensityactivityissafeandbenecial.
However,theymayneedtotakespecialprecautions.
Forexample,peoplewithdiabetesneedtopayspecial
attentiontobloodsugarcontrolandproperfootwear
duringactivity.
Womenwhoarepregnantandthosewhove
recentlyhadababyshouldbeundertheregular
careofahealth-careprovider.Moderate-intensity
physicalactivityisgenerallysafeforwomenwith
uncomplicatedpregnancies,butwomenshouldtalk
withtheirproviderabouthowtoadjusttheamounts
39 2008PhysicalActivityGuidelinesforAmericans

andtypesofactivitywhiletheyarepregnantandright
afterthebabysbirth.
Duringpregnancy,women
shouldavoid:
ForMoreInformation
See Chapter 7Additional
Considerations for Some
Adults, for more details
about physical activity
during pregnancy and the
postpartum period.
Doingactivitiesthat
involvelyingontheir
backaftertherst
trimesterofpregnancy;
and
Doingactivitieswithhighriskoffallingor
abdominaltrauma,includingcontactorcollision
sports,suchashorsebackriding,soccer,basketball,
anddownhillskiing.
GraduallyIncreasingPhysicalActivityOver
Time:Real-LifeExamples
Herearetwoexamplesthatshowhowpeopleat
differentages,levelsoftness,andlevelsofexperience
cansafelybecomemoreactiveovertime.
Bill: A Man Who Has Been Inactive for Many Years
Billwantstoworkhiswayuptotheequivalentof
180to210minutes(3hoursto3hoursand30minutes)
ofwalkingaweek.Onweekdayshehastimeforupto
45minutesofwalking,andheplanstodosomething
physicallyactiveeachweekend.Hedecidestostart
withwalkingbecauseitismoderateintensityandhas
alowriskofinjury.
Therstweek,Billstartsatalowlevel.Hewalks
10minutesaday3daysaweek.Sometimeshe
dividesthe10minutesadayintotwosessions.
Hepreferstoalternaterestdaysandactivedays.
(Total=30minutesaweek.)
Betweenweeks3and8,Billincreasesdurationby
adding5minutesadayandcontinueswalkingon
3non-consecutivedayseachweek.Theweekly
increaseis15minutes.(Week3total=45minutes.
Week8total=120minutesor2hours.)
Inweek9,Billaddsanotherdayofmoderate-
intensityactivityontheweekend,andstartsdoinga
varietyofactivities,includingbiking,hiking,andan
aerobicsclass.Graduallyincreasingtheminutesof
activity,byweek12heisdoing60minutesormore
ofmoderate-intensityactivityontheweekend.
Reachinghisgoal:Over3months,Billhasincreased
toatotalof180moderate-intensityminutesaweek.
Kim: An Active Woman
Kimcurrentlydoes150minutes(2hoursand
30minutes)aweekofmoderate-intensityactivity.
Shewantstoworkuptoatleasttheequivalentof
300minutes(5hours)ofmoderate-intensityactivity
aweek.Shealsowantstoshiftsomeofthatmoderate-
intensityactivitytovigorous-intensityactivity.Her
current150minutesaweekincludes:
Thirtyminutesofmowingthegrass1dayaweek;
Thirtyminutesofbriskwalking4daysaweek;and
Fifteenminutesofmuscle-strengtheningexercises
2daysaweek.
Increasingfrequencyandduration:
Overamonth,Kimaddswalkingonanother
weekday,andshegraduallyadds15minutesof
moderate-intensityactivityoneachofthe5walking
dayseachweek.Thisprovidesanadditional
105minutes(1hourand45minutes)ofmoderate-
intensityactivity.
Increasingintensity:
Overthenextmonth,Kimdecidestoreplacesome
walkingwithjogging.Insteadofwalking45minutes,
shewalksfor30minutesandjogsfor15minutes
oneachweekday,providingtheequivalentof
300minutesaweekofmoderate-intensityphysical
activityfromherwalkingandjogging.
Reachinghergoal:Aftertheseincreases,Kimisdoing
atotalof180minutesofmoderate-intensityactivity
eachweek(walkingandmowing)andalsodoing
75minutes(1hourand15minutes)ofvigorous-
intensityjogging.Oneminuteofvigorous-intensity
activityisaboutthesameas2minutesofmoderate-
intensityactivity,sosheisnowdoingtheequivalent
of330moderate-intensityminutes(5hoursand
30minutes)aweek.Shehasmorethanmethergoal.
Chapter6.SafeandActive 40


AdditionalConsiderations
forSomeAdults

A
llAmericansshouldbephysicallyactive
toimproveoverallhealthandtnessand
topreventmanyadversehealthoutcomes.
MostAmericansshouldfollowtheGuidelinesofthe
childandadolescent,adult,orolderadultchapters,
dependingupontheirage.However,somepeoplehave
conditionsthatraisespecialissuesaboutrecommended
typesandamountsofphysicalactivity.Thischapter
providesguidanceonphysicalactivityforhealthy
womenwhoarepregnantandforpeoplewith
disabilities.Thischapteralsoafrmsandillustrates
howphysicalactivityisgenerallyappropriatefor
adultswithchronicconditionsbyconsideringthree
groupsofadults:
Adultswithosteoarthritis;
Adultswithtype2diabetes;and
Adultswhoarecancersurvivors.
PhysicalActivityforWomenDuringPregnancy
andthePostpartumPeriod
Physicalactivityduringpregnancybenetsawomans
overallhealth.Forexample,moderate-intensity
physicalactivitybyhealthywomenduringpregnancy
maintainsorincreasescardiorespiratorytness.
Strongscienticevidenceshowsthattherisksof
moderate-intensityactivitydonebyhealthywomen
duringpregnancyareverylow,anddonotincreaserisk
oflowbirthweight,pretermdelivery,orearlypregnancy
loss.Someevidencesuggeststhatphysicalactivity
reducestheriskofpregnancycomplications,suchas
preeclampsiaandgestationaldiabetes,andreducesthe
lengthoflabor,butthisevidenceisnotconclusive.
Duringanormalpostpartumperiod,regularphysical
activitycontinuestobenetawomansoverall
health.Studiesshowthatmoderate-intensityphysical
activityduringtheperiodfollowingthebirthofa
childincreasesawomanscardiorespiratorytness
andimproveshermood.Suchactivitydoesnotappear
tohaveadverseeffectsonbreastmilkvolume,breast
milkcomposition,orinfantgrowth.
Physicalactivityalsohelpswomenachieveand
maintainahealthyweightduringthepostpartum
period,andwhencombinedwithcaloricrestriction,
helpspromoteweightloss.
41 2008PhysicalActivityGuidelinesforAmericans





KeyGuidelinesforWomenDuringPregnancyandthePostpartumPeriod
Healthywomenwhoarenotalreadyhighlyactiveordoingvigorous-intensityactivityshouldgetatleast
150minutes(2hoursand30minutes)ofmoderate-intensityaerobicactivityperweekduringpregnancyand
thepostpartumperiod.Preferably,thisactivityshouldbespreadthroughouttheweek.
Pregnantwomenwhohabituallyengageinvigorous-intensityaerobicactivityorarehighlyactivecan
continuephysicalactivityduringpregnancyandthepostpartumperiod,providedthattheyremainhealthy
anddiscusswiththeirhealth-careproviderhowandwhenactivityshouldbeadjustedovertime.
Explaining the Guidelines
Womenwhoarepregnantshouldbeunderthe
careofahealth-careproviderwithwhomtheycan
discusshowtoadjustamountsofphysicalactivity
duringpregnancyandthepostpartumperiod.Unless
awomanhasmedicalreasonstoavoidphysical
activityduringpregnancy,shecanbeginorcontinue
moderate-intensityaerobicphysicalactivityduringher
pregnancyandafterthebabyisborn.
Whenbeginningphysicalactivityduringpregnancy,
womenshouldincreasetheamountgraduallyover
time.Theeffectsofvigorous-intensityaerobicactivity
duringpregnancyhavenotbeenstudiedcarefully,so
thereisnobasisforrecommendingthatwomenshould
beginvigorous-intensityactivityduringpregnancy.
Womenwhohabituallydovigorous-intensityactivity
orhighamountsofactivityorstrengthtrainingshould
continuetobephysicallyactiveduringpregnancy
andaftergivingbirth.Theygenerallydonotneedto
drasticallyreducetheiractivitylevels,providedthat
theyremainhealthyanddiscusswiththeirhealth-care
providerhowtoadjustactivitylevelsduringthistime.
Duringpregnancy,womenshouldavoiddoingexercises
involvinglyingontheirbackafterthersttrimester
ofpregnancy.Theyshouldalsoavoiddoingactivities
thatincreasetheriskoffallingorabdominaltrauma,
includingcontactorcollisionsports,suchashorseback
riding,downhillskiing,soccer,andbasketball.
PhysicalActivityforPeopleWithDisabilities
Thebenetsofphysicalactivityforpeoplewith
disabilitieshavebeenstudiedindiversegroups.These
groupsincludestrokevictims,peoplewithspinal
cordinjury,multiplesclerosis,Parkinsonsdisease,
musculardystrophy,cerebralpalsy,traumaticbrain
injury,limbamputations,mentalillness,intellectual
disability,anddementia.
Overall,theevidence
showsthatregularphysical
activityprovidesimportant
healthbenetsforpeople
withdisabilities.The
benetsincludeimproved
ForMoreInformation
See Chapter 2Physical
Activity Has Many Health
Benets, for details.
cardiovascularandmuscletness,improvedmental
health,andbetterabilitytodotasksofdailylife.
Sufcientevidencenowexiststorecommendthat
adultswithdisabilitiesshouldgetregularphysical
activity.Physicalactivityinchildrenandadolescents
withdisabilitiesisconsideredinChapter3Active
ChildrenandAdolescents.
Explaining the Guidelines
Inconsultationwiththeir
health-careproviders,
peoplewithdisabilities
shouldunderstandhow
theirdisabilitiesaffect
theirabilitytodophysical
activity.Somemaybe
ForMoreInformation
See Chapter 4Active
Adults, for details on these
Guidelines and how to
meet them.
capableofdoingmediumtohighamountsofphysical
activity,andtheyshouldessentiallyfollowthe
Guidelinesforadults.
Somepeoplewithdisabilitiesarenotabletofollowthe
Guidelinesforadults.Thesepeopleshouldadapttheir
physicalactivityprogramtomatchtheirabilities,in
consultationwiththeirhealth-careproviders.Studies
Chapter7.AdditionalConsiderationsforSomeAdults 42









KeyGuidelinesforAdultsWithDisabilities
Adultswithdisabilities,whoareableto,shouldgetatleast150minutesperweek(2hoursand30minutes)
ofmoderate-intensity,or75minutes(1hourand15minutes)perweekofvigorous-intensityaerobicactivity,
oranequivalentcombinationofmoderate- andvigorous-intensityaerobicactivity.Aerobicactivityshould
beperformedinepisodesofatleast10minutes,andpreferably,itshouldbespreadthroughouttheweek.
Adultswithdisabilities,whoareableto,shouldalsodomuscle-strengtheningactivitiesofmoderateor
highintensitythatinvolveallmajormusclegroupson2ormoredaysperweek,astheseactivitiesprovide
additionalhealthbenets.
WhenadultswithdisabilitiesarenotabletomeettheaboveGuidelines,theyshouldengageinregular
physicalactivityaccordingtotheirabilitiesandshouldavoidinactivity.
Adultswithdisabilitiesshouldconsulttheirhealth-careprovidersabouttheamountsandtypesofphysical
activitythatareappropriatefortheirabilities.
showthatphysicalactivitycanbedonesafelywhen
theprogramismatchedtoanindividualsabilities.
Meeting the Guidelines
Peoplewithdisabilitiesareencouragedtogetadvice
fromprofessionalswithexperienceinphysicalactivity
anddisabilitybecausematchingactivitytoabilities
canrequiremodifyingphysicalactivityinmany
differentways.Somepeoplewithdisabilitiesalsoneed
helpwiththeirexerciseprogram.Forexample,some
peoplemayneedsupervisionwhenperformingmuscle-
strengtheningactivities,suchasliftingweights.
PhysicalActivityforPeopleWithChronic
MedicalConditions
Adultswithchronicconditionsshouldengageinregular
physicalactivitybecauseitcanhelppromotetheir
qualityoflifeandreducetheriskofdevelopingnew
conditions.Thetypeandamountofphysicalactivity
shouldbedeterminedbyapersonsabilitiesandthe
severityofthechroniccondition.Threeexamplesare
providedbelowtoillustratethebenetsofphysical
activityforpersonswithchronicconditions.
Formanychronicconditions,physicalactivityprovides
therapeuticbenetsandispartofrecommended
treatmentforthecondition.However,thischapterdoes
notdiscusstherapeuticexerciseorrehabilitation.
Example 1. Physical Activity for Adults With
Osteoarthritis
Osteoarthritisisacommonconditioninolderadults,
andpeoplecanlivemanyyearswithosteoarthritis.
Peoplewithosteoarthritisarecommonlyconcerned
thatphysicalactivitycanmaketheirconditionworse.
Osteoarthritiscanbe
painfulandcausefatigue,
makingithardtobeginor
maintainregularphysical
activity.Yetpeoplewith
thisconditionshouldget
regularphysicalactivity
ForMoreInformation
See Chapter 2Physical
Activity Has Many Health
Benets, for details on
these benets.
tolowertheirriskofgettingotherchronicdiseases,
suchasheartdiseaseortype2diabetes,andtohelp
maintainahealthybodyweight.
Strongscienticevidenceindicatesthatbothaerobic
activityandmuscle-strengtheningactivityprovide
therapeuticbenetsforpersonswithosteoarthritis.
Whendonesafely,physicalactivitydoesnotmakethe
diseaseorthepainworse.Studiesshowthatadults
withosteoarthritiscanexpectimprovementsinpain,
physicalfunction,qualityoflife,andmentalhealth
withregularphysicalactivity.
Peoplewithosteoarthritisshouldmatchthetypeand
amountofphysicalactivitytotheirabilitiesandthe
severityoftheircondition.Mostpeoplecanusuallydo
43 2008PhysicalActivityGuidelinesforAmericans




moderate-intensityactivityfor150minutes(2hours
and30minutes)aweekormore,andmaychooseto
beactive3to5daysaweekfor30to60minutesper
episode.Somepeoplewitharthritiscansafelydomore
than150minutesofmoderate-intensityactivityeach
weekandmaybeabletotolerateequivalentamounts
ofvigorous-intensityactivity.Health-careproviders
typicallycounselpeoplewithosteoarthritistodo
activitiesthatarelowimpact,notpainful,andhavelow
riskofjointinjury.Swimming,walking,andstrength-
trainingaregoodexamplesofthistypeofactivity.
Example 2. Physical Activity for Adults With
Type 2 Diabetes
Physicalactivityinadultswithtype2diabetesshows
howimportantitcanbeforpeoplewithachronic
diseasetobeactive.Physicalactivityhasimportant
therapeuticeffectsinpeoplewithdiabetes,butitisalso
routinelyrecommendedtoreduceriskofotherdiseases
andhelppromoteahealthybodyweight.
Forexample,strongscienticevidenceshowsthat
physicalactivityprotectsagainstheartdiseasein
peoplewithdiabetes.Moderate-intensityactivityfor
about150minutesaweekhelpstosubstantiallylower
theriskofheartdisease.Apersonwhomovestoward
300minutes(5hours)ormoreofmoderate-intensity
activityaweekgetsevengreaterbenet.
Adultswithchronicconditionsshouldworkwiththeir
health-careproviderstoadaptphysicalactivityso
thatitisappropriatefortheircondition.Forexample,
peoplewithdiabetesmustbecarefultomonitortheir
bloodglucoseandavoidinjurytotheirfeet.
Example 3. Physical Activity for Cancer Survivors
Withmoderntreatments,manypeoplewithcancer
caneitherbecuredorsurviveformanyyears,living
longenoughtobeatriskofotherchronicconditions,
suchashighbloodpressureortype2diabetes.Some
cancersurvivorsareatriskofrecurrenceoftheoriginal
cancer.Somehaveexperiencedsideeffectsofthe
cancertreatment.
Likeotheradults,cancersurvivorsshouldengagein
regularphysicalactivityforitspreventivebenets.
Physicalactivityincancersurvivorscanreducerisk
ofnewchronicdiseases.Further,studiessuggest
physicallyactiveadultswithbreastorcoloncancer
arelessliketodieprematurelyorhavearecurrence
ofthecancer.Physicalactivitymayalsoplayarolein
reducingadverseeffectsofcancertreatment.
Cancersurvivors,likeotheradultswithchronic
conditions,shouldconsulttheirhealth-careproviders
tomatchtheirphysicalactivityplantotheirabilities
andhealthstatus.
KeyMessagesforPeopleWithChronicMedicalConditions
Adultswithchronicconditionsobtainimportanthealthbenetsfromregularphysicalactivity.
Whenadultswithchronicconditionsdoactivityaccordingtotheirabilities,physicalactivityissafe.
Adultswithchronicconditionsshouldbeunderthecareofhealth-careproviders.Peoplewithchronic
conditionsandsymptomsshouldconsulttheirhealth-careprovidersaboutthetypesandamountsof
activityappropriateforthem.
Chapter7.AdditionalConsiderationsforSomeAdults 44




TakingAction:Increasing
PhysicalActivityLevels
ofAmericans
T
helowlevelofphysicalactivityamong
Americansisamajorcontributortotheburden
ofchronicdisease.Thisburdeniscostlyinterms
ofqualityoflifeandeconomicresourcesneededto
providemedicalcare.Likelifeinothermodernsocieties
aroundtheworld,lifeintheUnitedStatesrequiresvery
littledailyphysicalactivity.Theamountofphysical
activitywedoislargelyamatterofpersonalchoice
andtheenvironmentalconditionsunderwhichwelive.
Sofar,littleprogresshasbeenmadeinmeetingour
nationalhealthobjectivesforphysicalactivity.
Basedonacarefulreviewofthescience,thePhysical
ActivityGuidelinesprovidesessentialguidanceto
helpAmericansachievethehealthbenetsofregular
physicalactivity.However,providingguidancebyitself
isnotenoughtoproducechange.Actionisnecessary.
Regularphysicalactivityneedstobemadetheeasy
choiceforAmericans.
Toaccomplishthisgoal,publichealthresearch
suggeststheuseofasocio-ecologicapproach.This
comprehensiveapproachinvolvesactionatalllevels
ofsociety:individual,interpersonal,organizational,
community,andpublicpolicy.Exampleactionsinclude:
Personalgoalsetting(individuallevel);
Socialsupportandencouragementtobeactive
(interpersonallevel);
Promotionofphysical
activityaspartof
worksitehealth
promotionprograms
(organizational);
ForMoreInformation
See Appendix 3Federal
Web Sites That Promote
Physical Activity, for useful
resources at all these
levels.
Goodaccesstoparksand
recreationalfacilitiesin
neighborhoods(community);and
Promotionofpoliciesthatsupportfamilieswho
wanttheirchildrentowalkorbiketoschool
(publicpolicy).
Togiveasenseofhowtomakeregularphysical
activitytheeasychoice,theremainderofthischapter
rstconsidersstepsindividualscantaketoadopt
anactivelifestyle.Thenitconsidersstepssocietycan
taketosupportandfacilitateactivelifestyles.The
purposeistoillustrateachievablestepsthatwillmake
adifference,nottoaddresseverythingthatneedsto
bedone.
45 2008PhysicalActivityGuidelinesforAmericans


WhatCanAdultsDoToGetEnoughPhysical
Activity?
Adultscanndadviceonhowtobeactivefrom
manysources,includingtnessprofessionals,health-
careproviders,books,andWebsites.Herearethree
commonlycitedstepsadultscantaketohelpmeet
theGuidelines.
Personalize the Benets of Regular Physical
Activity
Adultsneedtoidentifybenetsofpersonalvalueto
them.Formanypeople,thehealthbenets,which
arethefocusofthePhysicalActivityGuidelines
forAmericans,arecompellingenough.Forothers,
differentreasonsarekeymotivatorstobeactive.
Forexample,physicalactivity:
Providesopportunitiestoenjoyrecreational
activities,ofteninasocialsetting;
Improvespersonalappearance;
Providesachancetohelpaspouseloseweight;
Improvesthequalityofsleep;
Reducesfeelingsoflowenergy;and
Givesolderadultsagreateropportunitytolive
independentlyinthecommunity.
Set Personal Goals for Physical Activity
TheGuidelinesalonedontprovideenoughinformation
forindividualstodecidethetypesandamountsof
activitythatareappropriateforthem.Individuals
shouldsetgoalsforactivitythatallowthemtoachieve
benetstheyvalue.Simplegoalsarene.Forexample,
abriskwalkintheneighborhoodwithfriendsfor
45minutes3daysaweekandwalkingtolunchtwice
aweekmaybejusttherightapproachforsomeone
whowantstoincreasebothphysicalactivityand
socialopportunities.
Insettinggoals,peoplecanconsiderdoingavarietyof
activitiesandtrybothindoorandoutdooractivities.
Inparticular,publicparksandrecreationareasinthe
UnitedStatesofferopportunitiestoexperiencenature
andbephysicallyactiveatthesametime.
Thebest
physicalactivityistheonethatis
enjoyableenoughtodoregularly.
Develop Knowledge To Attain Goals
Itisimportanttolearnaboutthetypesandamount
ofactivityneededtoattainpersonalgoals.For
example,ifweightlossisagoal,itsusefultoknow
thatvigorous-intensityactivitycanbemuchmore
time-efcientinburningcaloriesthanmoderate-
intensityactivity.Ifrunningisagoal,itsimportant
tolearnhowtoreduceriskofrunninginjuriesby
selectinganappropriatetrainingprogramandproper
shoes.Ifregularwalkingisagoal,learningabout
neighborhoodwalkingtrailscanhelpapersonattain
thegoal.
HowCanWeHelpChildrenandAdolescents
GetEnoughPhysicalActivity?
Manychildrenandadolescentsarenaturallyphysically
active,andtheyneedopportunitiestobeactiveand
tolearnskills.Theybenetfromencouragementfrom
parentsandotheradults.Adultscanpromoteage-
appropriateactivityinyouththroughthesesteps:
Providetimeforbothstructuredandunstructured
physicalactivityduringschoolandoutsideofschool.
Childrenneedtimeforactiveplay.Throughrecess,
Chapter8.TakingAction:IncreasingPhysicalActivityLevelsofAmericans 46




UsingaPedometerToTrackWalking
Foradultswhopreferwalkingasaformofaerobicactivity,pedometersorstepcountersareusefulintracking
progresstowardpersonalgoals.Popularadvice,suchaswalking10,000stepsaday,isnotaGuidelineperse,
butawaypeoplemaychoosetomeettheGuidelines.ThekeytousingapedometertomeettheGuidelinesis
torstsetatimegoal(minutesofwalkingaday)andthencalculatehowmanystepsareneededeachdayto
reachthatgoal.
Episodesofbriskwalkingthatlastatleast10minutescounttowardmeetingtheGuidelines.However,just
countingstepsusingapedometerdoesntensurethatapersonwillachievethose10-minuteepisodes.People
generallyneedtoplanepisodesofwalkingiftheyaretouseapedometerandstepgoalsappropriately.
Asabasisforsettingstepgoals,itspreferablethatpeopleknowhowmanystepstheytakeperminuteofa
briskwalk.Apersonwithalowtnesslevel,whotakesfewerstepsperminutethanatadult,willneedfewer
stepstoachievethesameamountofwalkingtime.
Onewaytosetastepgoalisthefollowing:
1. Todetermineusualdailystepsfrombaselineactivity,apersonwearsapedometertoobservethenumberof
stepstakenonseveralordinarydayswithnoepisodesofwalkingforexercise.Supposetheaverageisabout
5,000stepsaday.
2. Whilewearingthepedometer,thepersonmeasuresthenumberofstepstakenduring10minutesofan
exercisewalk.Supposethisis1,000steps.Then,foragoalof40minutesofwalkingforexercise,thetotal
numberofstepswouldbe4,000(1,0004).
3. Tocalculateadailystepgoal,addtheusualdailysteps(5,000)tothestepsrequiredfora40-minutewalk
(4,000),togetthetotalstepsperday(5,000+4,000=9,000).
Eachweekthepersongraduallyincreasesthetimewalkingforexerciseuntilthestepgoalisreached.Rateof
progressionshouldbeindividualized.Somepeoplewhostartoutat5,000stepsadaycanadd500stepsperday
eachweek.Others,whoarelesstandstartingoutatalowernumberofsteps,shouldaddasmallernumberof
stepseachweek.
physicalactivitybreaks,physicaleducationclasses,
after-schoolprograms,andactivetimewithfamily
andfriends,youthcanlearnaboutphysicalactivity
andspendtimedoingit.
Providechildrenandadolescentswithpositive
feedbackandgoodrolemodels.Ithasbeensaid
thatifyoudonotpracticewhatyouteach,you
areteachingsomethingelse.Parentsandteachers
shouldmodelandencourageanactivelifestylefor
children.Praise,rewards,andencouragementhelp
childrentobeactive.Usingphysicalactivityas
punishmentdoesnothelpchildrentobeactive.
Helpyoungpeoplelearnskillsrequiredtodo
physicalactivitysafely.Asappropriatefortheir
age,youthneedtounderstandhowtoregulate
theintensityofactivity,increasephysicalactivity
graduallyovertime,setgoals,useprotective
gearandproperequipment,followrules,and
avoidinjuries.
Promoteactivitiesthatsetthebasisforalifetime
ofactivity.Childrenandadolescentsshouldbe
exposedtoavarietyofactivities,includingactive
recreation,teamsports,andindividualsports.Inthis
way,theycanndactivitiestheycandowelland
47 2008PhysicalActivityGuidelinesforAmericans

Communities
canprovidemanyopportunities
forphysicalactivity,suchas
walkingtrails,bicyclelaneson
roads,sidewalks,andsportselds.
enjoy.Includeexposuretoactivitiesthatadults
commonlydo,suchasjogging,bicycling,hiking,
andswimming.Youngpeopleshouldexperience
non-competitiveactivitiesandactivitiesthatdo
notrequireabove-averageathleticskills.
WhatCanCommunitiesDoToHelpPeople
BeActive?
Actionsbycommunitiescaninuencewhether
regularphysicalactivityisaneasychoice.
Communitiescanprovidemanyopportunitiesfor
physicalactivity,suchaswalkingtrails,bicyclelanes
onroads,sidewalks,andsportselds.Organizations
inthecommunityhavearoletoplayaswell.Schools,
placesofworship,worksites,andcommunitycenters
canprovideopportunitiesandencouragementfor
physicalactivity.
Use Evidence-Based Approaches and Tailor Them
to the Needs of Individual Communities
Tobeeffective,physicalactivitypromotionefforts
shoulduseanevidence-basedapproach.TheCDCs
GuidetoCommunityPreventiveServices
1
hasreviewed
manycommunity-levelapproachestopromotephysical
activity,includingthesevestronglyrecommended
strategies:
Community-widecampaignsthatcombinephysical
activitymessaging(distributedthroughtelevision,
newspapers,radio,andothermedia)withactivities
suchasphysicalactivitycounseling,community
healthfairs,andthedevelopmentofwalkingtrails.
Physicaleducationclassestoincreaseactivity.
Physicaleducationclassesshoulduseacurriculum
thatincreasestheamountoftimestudentsare
activeduringclass.
Approachesthatincreasethereachofindividual-
levelinterventions.Forexample,evidence-based,
individual-levelinterventionscanreachmorepeople
whentheyaredeliveredingroupsettings.
Interventionsthatincreasesocialsupportfor
physicalactivity.Theseinterventionsstartor
enhancesocial-supportnetworks,andincludeefforts
suchasorganizingabuddysystem(twoormore
peoplewhosetregulartimestodophysicalactivity
together),walkinggroups,andcommunitydances.
Programstocreateorenhanceaccesstoplaces
tobephysicallyactive.Thiscanincludebuilding
walkingtrailsandprovidingpublicaccesstoschool
gymnasiums,playgrounds,orcommunitycenters.
Thisalsoincludesworksiteactivityprogramsthat
provideaccesstoonsiteoroffsitetnessrooms,
walkingbreaks,orotheropportunitiestoengage
inphysicalactivity.Interventionstoimprove
accessshouldalsoincludeoutreachthatincreases
awarenessoftheopportunitytobeactive.
Involve Many Sectors in Promoting Physical Activity
Implementingcommunity-levelapproachesto
physicalactivityrequirescollaborationacrosssectors.
1
CentersforDiseaseControlandPrevention.(LastupdatedFebruary21,2008).PhysicalActivity.InGuidetoCommunityPreventive
ServicesWebsite.RetrievedApril17,2008,fromwww.thecommunityguide.org/pa.
Chapter8.TakingAction:IncreasingPhysicalActivityLevelsofAmericans 48

Implementing
community-levelapproaches
tophysicalactivityrequires
collaborationacrosssectors.
Thefollowinglistidentiesrelevantsectorsand
illustratesrolestheyplayinpromotingphysical
activity.Thedivisionoffunctionsinthecommunity
intothefollowingsectorsdoesnotusemutually
exclusivecategories.Thesesectorswerechosensimply
toillustratehowpartsofthecommunityhavearoleto
playinpromotingphysicalactivity.Somecommunities
mayusedifferentnamesanddivisionsoffunctions.
Parksandrecreation.Thissectorplaysaleadrolein
providingaccesstoplacesforactiverecreation,such
asplaygrounds,hikingandbikingtrails,basketball
courts,sportselds,andswimmingpools.
Lawenforcement.Concernaboutcrimecandeter
peoplefromoutdoorsrecreation.Lawenforcement
canpromoteasafeenvironmentthatfacilitates
outdooractivity.
Urbanplanning.Urbanplannershavealeadrole
inimplementingdesignprinciplestopromote
physicalactivity.
Transportation.Thetransportationsectorhasalead
roleindesigningandimplementingoptionsthat
provideareasforsafewalkingandbicycling.Mass
transitsystemsalsopromotewalking,aspeople
typicallywalktoandfromtransitstops.Programs
thatsupportsafewalkingandbicyclingtoschool
helpchildrenbephysicallyactive.
Education.Theeducationsectortakesaleadrolein
providingphysicaleducation,after-schoolsports,
andpublicaccesstoschoolfacilitiesduringafter-
schoolhours.
Architecture.Architectsandbuilderscandesign
andconstructbuildingswithactiveoptions,suchas
accesstostairs.Campusesshouldallowpedestrians
pleasantandefcientmethodsofwalkingwithin
andbetweenbuildings.
Employersandprivateorganizations.Employerscan
encourageworkerstobephysicallyactive,facilitate
activetransportationbysupplyingshowersand
49 2008PhysicalActivityGuidelinesforAmericans


securebicyclestorage,andprovideotherincentives
tobeactive.Privateandfaith-basedorganizations
cansupportcommunityphysicalactivityinitiatives
nanciallyorbyprovidingspaceforprograms.
Healthandtnessfacilitiesandcommunity
programscanprovideaccesstoexerciseprograms
andequipmentforabroadrangeofpeople,
includingolderadultsandpeoplewithdisabilities.
Localsportsorganizationscanorganizeroadraces
andeventsforthepublic.Seniorcenterscanprovide
exerciseprogramsforolderadults.
Healthcare.Health-careproviderscanassess,
counsel,andadvisepatientsonphysicalactivity
andhowtodoitsafely.Health-careproviders
canmodelhealthybehaviorsbybeingphysically
activethemselves.
Publichealth.Publichealthdepartmentscan
monitorcommunityprogressinprovidingplaces
andopportunitiestobephysicallyactiveandcan
trackchangesintheproportionofthepopulation
meetingthePhysicalActivityGuidelinesfor
Americans.Theycanalsotaketheleadinsetting
objectivesandcoordinatingactivitiesamongsectors.
Publichealthdepartmentsandorganizationscan
disseminateappropriatemessagesandinformation
tothepublicaboutphysicalactivity.
Chapter8.TakingAction:IncreasingPhysicalActivityLevelsofAmericans 50








Glossary
Thissectionprovidesdenitionsformanyterms
importanttophysicalactivityandhealth.Ithasbeen
adaptedfromtheglossaryprovidedinthePhysical
ActivityGuidelinesAdvisoryCommitteeReport
(http://www.health.gov/PAGuidelines/Report/Default.
aspx).Itisnotmeanttobeanexhaustivelist,and
denitionsofadditionaltermscanbefoundinthe
Committeesreport.
Absoluteintensity.SeeIntensity.
Accumulate.Theconceptofmeetingaspecic
physicalactivitydoseorgoalbyperformingactivity
inshortbouts,thenaddingtogetherthetimespent
duringeachofthesebouts.Forexample,agoalof
30minutesadaycouldbemetbyperforming3bouts
of10minuteseachthroughouttheday.
Adaptation.Thebodysresponsetoexerciseor
activity.Someofthebodysstructuresandfunctions
favorablyadjusttotheincreaseindemandsplaced
onthemwheneverphysicalactivityofagreater
amountorhigherintensityisperformedthanwhat
isusualfortheindividual.Theseadaptationsarethe
basisformuchoftheimprovedhealthandtness
associatedwithincreasesinphysicalactivity.
Adverseevent.Inthecontextofphysicalactivity,
anegativehealthevent.Examplesofadverseevents
asaresultofphysicalactivityincludemusculoskeletal
injuries(injurytobone,muscles,orjoints),heat-related
conditions(heatexhaustion),andcardiovascular
(heartattackorstroke)events.
Aerobiccapacity.SeeMaximaloxygenuptake.
Aerobicphysicalactivity.Activityinwhichthebodys
largemusclesmoveinarhythmicmannerfora
sustainedperiodoftime.Aerobicactivity,alsocalled
enduranceactivity,improvescardiorespiratorytness.
Examplesincludewalking,running,andswimming,
andbicycling.
Balance.Aperformance-relatedcomponentof
physicaltnessthatinvolvesthemaintenanceofthe
bodysequilibriumwhilestationaryormoving.
Balancetraining.Staticanddynamicexercises
thataredesignedtoimproveindividualsability
towithstandchallengesfromposturalswayor
destabilizingstimulicausedbyself-motion,the
environment,orotherobjects.
Baselineactivity.Thelight-intensityactivitiesof
dailylife,suchasstanding,walkingslowly,andlifting
lightweightobjects.Peoplewhodoonlybaseline
activityareconsideredtobeinactive.
Bodycomposition.Ahealth-relatedcomponentof
physicaltnessthatappliestobodyweightandthe
relativeamountsofmuscle,fat,bone,andothervital
tissuesofthebody.Mostoften,thecomponentsare
limitedtofatandleanbodymass(orfat-freemass).
Bone-strengtheningactivity.Physicalactivityprimarily
designedtoincreasethestrengthofspecicsites
inbonesthatmakeuptheskeletalsystem.Bone-
strengtheningactivitiesproduceanimpactortension
forceonthebonesthatpromotesbonegrowthand
strength.Running,jumpingrope,andliftingweights
areexamplesofbone-strengtheningactivities.
Cardiorespiratorytness(endurance).Ahealth-related
componentofphysicaltnessthatistheabilityofthe
circulatoryandrespiratorysystemstosupplyoxygen
duringsustainedphysicalactivity.Cardiorespiratory
tnessisusuallyexpressedasmeasuredorestimated
maximaloxygenuptake(VO
2
max).SeeMaximal
oxygenuptake.
Doseresponse.Therelationbetweenthedoseof
physicalactivityandthehealthortnessoutcomeof
interest.Intheeldofphysicalactivity,doserefers
totheamountofphysicalactivityperformedbythe
subjectorparticipants.Thetotaldose,oramount,
51 2008PhysicalActivityGuidelinesforAmericans






isdeterminedbythethreecomponentsofactivity:
frequency,duration,andintensity.
Duration.Thelengthoftimeinwhichanactivityor
exerciseisperformed.Durationisgenerallyexpressed
inminutes.
Enduranceactivity.SeeAerobicphysicalactivity.
Exercise.Asubcategoryofphysicalactivitythatis
planned,structured,repetitive,andpurposiveinthe
sensethattheimprovementormaintenanceofoneor
morecomponentsofphysicaltnessistheobjective.
Exerciseandexercisetrainingfrequentlyare
usedinterchangeablyandgenerallyrefertophysical
activityperformedduringleisuretimewiththeprimary
purposeofimprovingormaintainingphysicaltness,
physicalperformance,orhealth.
Fitness.SeePhysicaltness.
Flexibility.Ahealth-andperformance-related
componentofphysicaltnessthatistherangeof
motionpossibleatajoint.Flexibilityisspecicto
eachjointanddependsonanumberofspecic
variables,includingbutnotlimitedtothetightnessof
specicligamentsandtendons.Flexibilityexercises
enhancetheabilityofajointtomovethroughits
fullrangeofmotion.
Frequency.Thenumberoftimesanexerciseoractivity
isperformed.Frequencyisgenerallyexpressedin
sessions,episodes,orboutsperweek.
Health.Ahumanconditionwithphysical,socialand
psychologicaldimensions,eachcharacterizedona
continuumwithpositiveandnegativepoles.Positive
healthisassociatedwithacapacitytoenjoylifeand
towithstandchallenges;itisnotmerelytheabsence
ofdisease.Negativehealthisassociatedwithillness,
andintheextreme,withprematuredeath.
Health-enhancingphysicalactivity.Activitythat,when
addedtobaselineactivity,produceshealthbenets.
Briskwalking,jumpingrope,dancing,playingtennis
orsoccer,liftingweights,climbingonplayground
equipmentatrecess,anddoingyogaareallexamples
ofhealth-enhancingphysicalactivity.
Health-relatedtness.Atypeofphysicaltnessthat
includescardiorespiratorytness,muscularstrengthand
endurance,bodycomposition,exibility,andbalance.
Intensity.Intensityreferstohowmuchworkisbeing
performedorthemagnitudeoftheeffortrequired
toperformanactivityorexercise.Intensitycanbe
expressedeitherinabsoluteorrelativeterms.
Absolute.Theabsoluteintensityofanactivityis
determinedbytherateofworkbeingperformedand
doesnottakeintoaccountthephysiologiccapacity
oftheindividual.Foraerobicactivity,absolute
intensitytypicallyisexpressedastherateofenergy
expenditure(forexample,millilitersperkilogramper
minuteofoxygenbeingconsumed,kilocaloriesper
minute,orMETs)or,forsomeactivities,simplyasthe
speedoftheactivity(forexample,walkingat3miles
anhour,joggingat6milesanhour),orphysiologic
responsetotheintensity(forexample,heartrate).For
resistanceactivityorexercise,intensityfrequentlyis
expressedastheamountofweightliftedormoved.
Relative.Relativeintensitytakesintoaccountor
adjustsforapersonsexercisecapacity.Foraerobic
exercise,relativeintensityisexpressedasapercent
ofapersonsaerobiccapacity(VO
2
max)orVO
2

reserve,orasapercentofapersonsmeasuredor
estimatedmaximumheartrate(heartratereserve).
Italsocanbeexpressedasanindexofhowhard
thepersonfeelsheorsheisexercising(forexample,
a0to10scale).
Lifestyleactivities.Thistermisfrequentlyusedto
encompassactivitiesthatapersoncarriesoutinthe
courseofdailylifeandthatcancontributetosizeable
energyexpenditure.Examplesincludetakingthe
stairsinsteadofusingtheelevator,walkingtodo
errandsinsteadofdriving,gettingoffabusonestop
early,orparkingfartherawaythanusualtowalkto
adestination.
Maximaloxygenuptake(VO
2
max).Thebodyscapacity
totransportanduseoxygenduringamaximalexertion
involvingdynamiccontractionoflargemusclegroups,
suchasduringrunningorcycling.Alsoknown
asmaximalaerobicpowerandcardiorespiratory
endurancecapacity.
Glossary 52





MET.METreferstometabolicequivalent,and1MET
istherateofenergyexpenditurewhilesittingatrest.
Itistakenbyconventiontobeanoxygenuptakeof
3.5millilitersperkilogramofbodyweightperminute.
Physicalactivitiesfrequentlyareclassiedbytheir
intensityusingtheMETasareference.
Moderate-intensityphysicalactivity.Onanabsolute
scale,physicalactivitythatisdoneat3.0to5.9times
theintensityofrest.Onascalerelativetoanindividuals
personalcapacity,moderate-intensityphysicalactivityis
usuallya5or6onascaleof0to10.
Muscle-strengtheningactivity(strengthtraining,
resistancetraining,ormuscularstrengthand
enduranceexercises).Physicalactivity,including
exercise,thatincreasesskeletalmusclestrength,
power,endurance,andmass.
Overload.Theamountofnewactivityaddedtoa
personsusuallevelofactivity.Theriskofinjuryto
bones,muscles,andjointsisdirectlyrelatedtothe
sizeofthegapbetweenthesetwolevels.Thisgapis
calledtheamountofoverload.
Performance-relatedtness.Thoseattributesthat
signicantlycontributetoathleticperformance,
includingaerobicenduranceorpower,musclestrength
andpower,speedofmovement,andreactiontime.
Physicalactivity.Anybodilymovementproducedby
thecontractionofskeletalmusclethatincreasesenergy
expenditureaboveabasallevel.IntheseGuidelines,
physicalactivitygenerallyreferstothesubsetof
physicalactivitythatenhanceshealth.
Physicaltness.Theabilitytocarryoutdailytasks
withvigorandalertness,withoutunduefatigue,and
withampleenergytoenjoyleisure-timepursuitsand
respondtoemergencies.Physicaltnessincludesa
numberofcomponentsconsistingofcardiorespiratory
endurance(aerobicpower),skeletalmuscleendurance,
skeletalmusclestrength,skeletalmusclepower,
exibility,balance,speedofmovement,reactiontime,
andbodycomposition.
Progression.Theprocessofincreasingtheintensity,
duration,frequency,oramountofactivityorexercise
asthebodyadaptstoagivenactivitypattern.
Relativeintensity.SeeIntensity.
Relativerisk.Theriskofa(typically)adversehealth
outcomeamongagroupofpeoplewithacertain
conditioncomparedtoagroupofpeoplewithoutthe
condition.Inphysicalactivity,relativeriskistypically
theratiooftheriskofadiseaseordisorderwhen
comparinggroupsofpeoplewhovaryintheiramount
ofphysicalactivity.
Repetitions.Thenumberoftimesapersonliftsa
weightinmuscle-strengtheningactivities.Repetitions
areanalogoustodurationinaerobicactivity.
Resistancetraining.SeeMuscle-strengtheningactivity.
Specicity.Aprincipleofexercisephysiologythat
indicatesthatphysiologicchangesinthehumanbody
inresponsetophysicalactivityarehighlydependent
onthetypeofphysicalactivity.Forexample,the
physiologiceffectsofwalkingarelargelyspecicto
thelowerbodyandthecardiovascularsystem.
Strength.Ahealthandperformancecomponentof
physicaltnessthatistheabilityofamuscleormuscle
grouptoexertforce.
Strengthtraining.SeeMuscle-strengtheningactivity.
Vigorous-intensityphysicalactivity.Onanabsolute
scale,physicalactivitythatisdoneat6.0ormoretimes
theintensityofrest.Onascalerelativetoanindividuals
personalcapacity,vigorous-intensityphysicalactivityis
usuallya7or8onascaleof0to10.
53 2008PhysicalActivityGuidelinesforAmericans







Appendix1.TranslatingScientic
EvidenceAboutTotalAmountand
IntensityofPhysicalActivityInto
Guidelines
Thisappendixdiscussestwoissuesthatarisewhen
translatingscienticevidenceintophysicalactivity
guidanceforthepublic:
Inscienticterms,totalweeklyphysicalactivityin
therangeof500to1,000MET-minutesproduces
substantialhealthbenetsforadults.Howshould
thisndingbesimpliedandtranslatedinto
Guidelinesthatareunderstandablebythepublic?
Twomethodsareusedtoassesstheintensityof
aerobicphysicalactivity,termedabsoluteintensity
andrelativeintensity.ShouldtheGuidelines
specifyonemethodorallowboth?
Afterdiscussingbackgroundinformationrelatedto
thesequestions,thisappendixexplainstheapproach
takenonthesetwoissuesinthePhysicalActivity
GuidelinesforAmericans.
Background
TheGuidelinesarederived
fromanevidence-based
reportonthehealth
benetsofphysical
activity,writtenbythe
PhysicalActivityGuidelines
AdvisoryCommittee.As
background,thisappendix
ForMoreInformation
See Chapter 1Introducing
the 2008 Physical Activity
Guidelines for Americans,
for details on the Advisory
Committee and its report.
rstbrieyexplainstheconceptofMETsandMET-
minutes.Itthendiscussesthreekeyndingsofthe
AdvisoryCommitteereport,andnallydiscussesthe
differencebetweenabsoluteandrelativeintensity.
METs and MET-minutes
Awell-knownphysiologiceffectofphysicalactivityis
thatitexpendsenergy.Ametabolicequivalent,orMET,
isaunitusefulfordescribingtheenergyexpenditure
ofaspecicactivity.AMETistheratiooftherateof
energyexpendedduringanactivitytotherateofenergy
expendedatrest.Forexample,1METistherateof
energyexpenditurewhileatrest.A4METactivity
expends4timestheenergyusedbythebodyatrest.Ifa
persondoesa4METactivityfor30minutes,heorshe
hasdone430=120MET-minutes(or2.0MET-hours)
ofphysicalactivity.Apersoncouldalsoachieve120
MET-minutesbydoingan8METactivityfor15minutes.
MET-Minutes and Health Benets
AkeyndingoftheAdvisoryCommitteeReportis
thatthehealthbenetsofphysicalactivitydepend
mainlyontotalweeklyenergyexpendituredueto
physicalactivity.Inscienticterms,thisrangeis500to
1,000MET-minutesperweek.Arangeisnecessary
becausetheamountofphysicalactivitynecessaryto
producehealthbenetscannotyetbeidentiedwitha
highdegreeofprecision;thisamountvariessomewhat
bythehealthbenet.Forexample,activityof500MET-
minutesaweekresultsinasubstantialreductionin
theriskofprematuredeath,butactivityofmorethan
500MET-minutesaweekisnecessarytoachievea
substantialreductionintheriskofbreastcancer.
Dose Response
TheAdvisoryCommitteeconcludedthatadose-
responserelationshipexistsbetweenphysicalactivity
Appendix1.TranslatingScienticEvidenceAboutTotalAmountandIntensityofPhysicalActivityIntoGuidelines 54


andhealthbenets.Arangeof500to1,000MET-
minutesofactivityperweekprovidessubstantial
benet,andamountsofactivityabovethisrange
haveevenmorebenet.Amountsofactivitybelow
thisrangealsohavesomebenet.Thedose-response
relationshipcontinuesevenwithintherangeof500to
1,000MET-minutes,inthatthehealthbenetsof
1,000MET-minutesperweekaregreaterthanthose
of500MET-minutesperweek.
TwoMethodsofAssessingAerobicIntensity
Theintensityofaerobicphysicalactivitycanbe
denedinabsoluteorrelativeterms.
Absolute Intensity
TheAdvisoryCommitteeconcludedthatabsolute
moderate-intensityorvigorous-intensityphysical
activityisnecessaryforsubstantialhealthbenets,
anditdenedabsoluteaerobicintensityinterms
ofMETs:
Light-intensityactivitiesaredenedas1.1METto
2.9METs.
Moderate-intensityactivitiesaredenedas3.0to
5.9METs.Walkingat3.0milesperhourrequires
3.3METsofenergyexpenditureandistherefore
consideredamoderate-intensityactivity.
Vigorous-intensityactivitiesaredenedas6.0METs
ormore.Runningat10minutespermile(6.0mph)
isa10METactivityandisthereforeclassiedas
vigorousintensity.
Relative Intensity
Intensitycanalsobedenedrelativetotness,with
theintensityexpressedintermsofapercentofa
persons(1)maximalheartrate,(2)heartratereserve,
or(3)aerobiccapacityreserve.TheAdvisoryCommittee
regardedrelativemoderateintensityas40to59percent
ofaerobiccapacityreserve(where0percentofreserve
isrestingand100percentofreserveismaximal
effort).Relativelyvigorous-intensityactivityis60to
84percentofreserve.
Tobettercommunicatetheconceptofrelativeintensity
(orrelativelevelofeffort),theGuidelinesadopteda
simplerdenition:
Relativelymoderate-intensityactivityisalevelof
effortof5or6onascaleof0to10,where0isthe
levelofeffortofsitting,and10ismaximaleffort.
Relativelyvigorous-intensityactivityisa7or8on
thisscale.
ThissimplicationwasendorsedbytheAmerican
CollegeofSportsMedicineandtheAmericanHeart
Associationintheirrecentguidelinesforolderadults.
1
Thisapproachdoescreateaminordifferencefrom
theAdvisoryCommitteeReportdenitions,however.
A5or6ona0to10scaleisessentially45percentto
64percentofaerobiccapacityreserveformoderate
intensity.Similarly,a7or8ona0to10scalemeans
65percentto84percentofreserveistherangefor
relativelyvigorous-intensityactivity.
DevelopingGuidelinesBasedonMinutesof
Moderate-andVigorous-IntensityActivity
PhysicalactivityguidelinesexpressedusingMET-
minutesarenotusefulforthegeneralpublic.The
conceptofMETsisdifculttounderstandandfew
peoplearefamiliarwithit.Itischallengingforthe
publictoknowtheMETvaluesforalltheactivities
theydo.
AslongaspeoplewhofollowtheGuidelinesgenerally
achieve500to1,000MET-minutesperweek(ormore),
itisappropriatetoexpresstheGuidelinesinsimpler
termsofminutesofmoderate-intensityactivity,and
minutesofvigorous-intensityactivity.Becausenotall
thebenetsofphysicalactivityoccurat500MET-
minutesperweek,Guidelinesthathelppeopleexceed
thisminimumaredesirable.
1
Nelson,M.E.,Rejeski,W.J.,Blair,S.N.,Duncan,P.W.,Judge,J.O.,King,A.C.,etal.(2007,August).Physicalactivityandpublic
healthinolderadults:RecommendationfromtheAmericanCollegeofSportsMedicineandtheAmericanHeartAssociation.
Medicine&ScienceinSports&Exercise8,14351445.
55 2008PhysicalActivityGuidelinesforAmericans





InformationintheAdvisoryCommitteeReportlays
thebasisforexpressingphysicalactivityguidelines
inminutes.TheAdvisoryCommitteeindicatedthat
150minutes(2hoursand30minutes)ofmoderate-
intensityactivityperweekcouldberegardedas
(roughly)equivalentto500MET-minutesperweek.
Infact,3.3METsfor150minutesperweekisequal
to500MET-minutesperweek.Byrecommending
thatadultsdoatleast150minutesofmoderate-
intensityactivityperweek,adultswillachieve
500to1,000MET-minutesperweekiftheintensity
is3.3METsorgreater.AsindicatedbytheAdvisory
CommitteeReport,peoplewhodo150minutesof
a3.0to3.2METactivityareacceptablycloseto
achieving500METminutes.Asnotedearlier,walking
at3.0milesperhourisa3.3METactivity.Hence,itis
appropriatetocommunicatetothepublicthatabrisk
walkiswalkingat3.0milesperhourorfaster.
Byrecommendingatleast75minutes(1hourand
15minutes)perweekofvigorous-intensityactivity,
adultswhochoosetodovigorous-intensityactivity
willalsogenerallyachieve500to1,000MET-minutes
perweek.Thelowerlimitofvigorousintensity
activity(6.0METs)istwicethelowerlimitof
moderate-intensityactivity(3.0METs).So,75minutes
ofvigorous-intensityactivityperweekisroughly
equivalentto150minutesofmoderate-intensity
activityperweek.AstheMETrangeforvigorous-
intensityactivityhasnoupperlimit,highlytpeople
canevenexceed1,000MET-minutesin75 minutes
bydoingactivitiesrequiring13.4METormore.Itis
notofconcernthatthevigorous-intensityGuideline
misleadspeoplewithahighdegreeoftnessinto
doingmoreactivitythanisreallyrequiredtomeetthe
Guidelines.Highlytpeoplehavealreadydecidedto
dolargeamountsofphysicalactivity,asthisisthe
onlywaytoachievethisdegreeoftness.
Finally,theGuidelinesneededtoaddresstheissue
thatsomepeopledobothmoderate-intensityand
vigorous-intensityactivityinaweek.Todetermine
whethertheyaredoingenoughactivitytomeet
theGuidelines,thesepeopleneedaruleofthumb
astohowvigorous-intensityminutessubstitute
formoderate-intensityones.Because150minutes
ofmoderate-intensityactivityand75minutesof
vigorous-intensityactivityaretheminimumamounts,
theruleofthumbbecomesthat1minuteofvigorous-
intensityactivitycountsthesameas2minutesof
moderate-intensityactivity.
UsingRelativeIntensityToMeetGuidelines
ExpressedinTermsofAbsoluteIntensity
TheintentoftheaerobicGuidelinesforadultsisto
ensurethatpeoplewhofollowthemgenerallyachieve
500to1,000MET-minutesormore.Forthistooccur,
thedenitionofintensityintheGuidelinesneedsto
beintermsofMETs(i.e.,absoluteintensity).However,
theGuidelinesforAdultsindicatethatrelativeintensity
canalsobeusedasameansofassessingtheintensity
ofaerobicactivities.AndtheGuidelinesforOlder
Adultsrequiretheuseofrelativeintensity.Howcan
thisbeappropriate?
Formanyadultsitdoesnotmatteragreatdeal
whethertheyuserelativeorabsoluteintensity.That
is,followingtheGuidelinesmeanstheyattain500to
1,000MET-minutesperweekusingeitherabsolute
orrelativeintensitytoguidelevelofeffort.Their
leveloftnessissuchthat,whentheydoabsolute
moderate-intensityactivitiesintherangeof3.0to
5.9METs,theygenerallyarealsodoingrelatively
moderate-intensityactivity.Similarly,absolutely
vigorousandrelativelyvigorousactivitiesoverlapa
greatdeal.
Foradultswithhigherlevelsoftness,usingrelative
intensitymeanstheywilldohigheramountsof
activitythanintendedbytheGuidelines.Forexample,
a3.5METactivitycanberelativelylightforthese
adults,andperhaps6.0METactivitiesarerelatively
moderate.Bydoing150minutesofa6.0METactivity,
theyexceedtheamountofactivityintendedinthe
Guideline.Butthisisacceptablefortworeasons:
First,theGuidelinesencouragepeopletodohigher
amountsofactivity,ashigheramountshavegreater
healthbenets.Second,peoplewithhigherlevelsof
tnessgenerallycanonlyachievethisleveloftness
bydoinghigheramountsofactivity,andthushave
alreadychosentodomoreactivity.
Someadultshavelowlevelsoftness,particularly
olderadults.Fortheseadults,activitiesintherange
of3.0to5.9METsareeitherrelativelyvigorous,or
Appendix1.TranslatingScienticEvidenceAboutTotalAmountandIntensityofPhysicalActivityIntoGuidelines 56



physiologicallyimpossible.TheAdvisoryCommittee
Reportstatedthatforolderadults,whocommonly
havelowlevelsoftness,thelevelofeffortshouldbe
guidedbyrelativeintensity(asopposedtoabsolute).
Thereportalsostatedthatinactiveadultsshouldnot
dorelativelyvigorous-intensityactivitywhenthey
starttoincreasetheiractivitylevel.Inotherwords,itis
notintendedorappropriateforpeoplewithlowlevels
oftnesstomeetamoderate-intensityguidelineby
routinelydoingrelativelyvigorous-intensityactivity.
Allowing the Use of Either Relative Intensity or
Absolute Intensity in Children
TheGuidelinesforChildrenandAdolescentsdonot
requirecarefullytrackingoftheintensityofthe
activity.Themixofmoderate- andvigorous-intensity
activityisexible,aslongassomevigorous-intensity
activityisdoneatleast3daysperweek.Thisexibility
meansthatrelativeandabsoluteintensityareboth
appropriatewaystotrackintensity.
Relativeintensityisappropriateforseveralreasons.
TheexercisestudiesonwhichtheGuidelinesare
basedcommonlyprescribedaerobicactivityusing
relativeintensity.Childrenandadolescentswho
followtheGuidelinesshouldhaveimprovementin
cardiorespiratorytness,andtherelativeintensity
oftheactivityisamajordeterminantofitstness
effects.TheintentoftheAdvisoryCommitteeReport
isthat,whenachildbreathesrapidlyduringphysical
activity(anindicatorofrelativelyvigorous-intensity
activityforthatchild),thisactivityshouldcountas
vigorousintensity.
However,itisnotalwaysfeasibletoobservechildren
closelyenoughtodeterminetheirlevelofeffort.Inthis
case,absoluteintensitycanbeusedtojudgewhether
thechildisdoingactivitythatcountstowardthe
Guidelines.Briskwalking(asopposedtoslowwalking)
countsasmoderate-intensityactivity,andrunning
countsasvigorous-intensityactivity,basedonthe
typicallevelofeffortrequiredfortheseactivities.
57 2008PhysicalActivityGuidelinesforAmericans

Appendix2.SelectedExamplesofInjury
PreventionStrategiesforCommon
PhysicalActivitiesandSports
Thischartprovidesexamplesofvariousevidence-basedinjurypreventionstrategiescompiledbyonegroupofsafety
andinjurypreventionexperts(Gilchristetal.,2007).Itisprovidedasaresourceforreadersandisnotaproductof
thePhysicalActivityGuidelinesAdvisoryCommittee.
Activity/Sport Proven* Promising/Potential*
Baseball/softball Breakaway bases
Reduced impact balls
Faceguards/protective eyewear
Batting helmets
Pitch count
Basketball Mouth guards Ankle disc (balance) training
Semi-rigid ankle stabilizers/braces**
Protective eyewear
Bicycling Helmet use

Bike paths/lanes
Retractable handle bars
Football Helmets and other personal protective
equipment
Ankle stabilizers/braces**
Minimizing cleat length
Rule changes (no spearing, clipping, etc.)
Playing eld maintenance
Preseason conditioning
Cross-training (reduce overuse injuries)
Coach training and experience
Limiting contact during practice
Icehockey Helmets with full face shield
Rule changes (fair play, no checking from
behind, no high sticking, etc.)
Increased rink size
Enforcement of rules
Discouraging ghting
In-lineskating/
skateboarding
Wrist guards
Knee/elbow pads
Helmets
Playgrounds Shock-absorbing surfacing
Height standards
Maintenance standards
Appendix2.SelectedExamplesofInjuryPreventionStrategiesforCommonPhysicalActivitiesandSports 58
Activity/Sport Proven* Promising/Potential*
Running/jogging Altered training regimen Shock-absorbing insoles
Skiing/snowboarding Training to avoid risk situations
Adjustable bindings
Wrist guards in snowboarding
Helmets
Soccer Anchored, padded goal posts
Shin guards
Neuromuscular training programs

Strength training
*Proven interventions have strong evidence of effectiveness in preventing injuries. Promising/potential interventions have moderately strong evidence of
effectiveness from small studies or have been tested only under laboratory conditions.
**Semi-rigid ankle stabilizers and braces have been shown to be most effective for persons with a previous history of ankle sprain. Stabilizers and braces are
recommended for persons who have a previous ankle injury and are participating in all activities with a risk of ankle injury (jumping, running, twisting, etc.).

Helmets worn while bicycling reduce the risk of death and injury. Educational campaigns, laws/legislation, and nancial subsidy programs all increase use
of helmets.

Neuromuscular training programs consist of 4 elements: (1) muscle strengthening, (2) balance training, (3) jump training, and (4) learning proper mechanics
(pivoting, landing, etc.).
Source: Adapted from Gilchrist, J., Saluja, G., & Marshall, S. W. (2007). Interventions to prevent sports and recreation-related injuries. In L. S. Doll, S. E. Bonzo,
J. Mercy, & D. A. Sleet (Eds), Handbook of injury and violence prevention (pp. 117136). New York: Springer.
59 2008PhysicalActivityGuidelinesforAmericans







Appendix3.FederalWebSitesThat
PromotePhysicalActivity
IndividualsandFamilies
CentersforDiseaseControlandPrevention(CDC)
http://www.cdc.gov/ncipc/duip/preventadultfalls.htm
PreventingFallsinOlderAdultspromotesphysical
activityaspartoftheapproachtoreducingfallsand
fall-relatedinjuriesamongolderadults.
NationalInstitutesofHealth
http://nihseniorhealth.gov/exercise/toc.html
NIHSeniorHealthprovidesaging-relatedhealth
informationforseniorsonavarietyoftopics,including
exerciseandthecausesandpreventionofbalance
problemsandfalls.ExerciseandPhysicalActivity:Your
EverydayGuidefromtheNationalInstituteonAging,
anevidence-basedguidethatprovidesinformation
abouthowolderadultscanmeetthePhysicalActivity
Guidelinescanbefoundathttp://www.nia.nih.gov/
HealthInformation/Publications/ExerciseGuide/.
OfceoftheSurgeonGeneral
http://www.surgeongeneral.gov/obesityprevention/
index.html
TheOfceoftheSurgeonGeneralpromotesHealthy
YouthforaHealthyFuture,anHHSchildhood
overweightandobesitypreventioninitiative.TheWeb
siteprovidesresourcestohelpyouthstayactiveand
makehealthychoices.
PresidentsCouncilonPhysicalFitnessandSports
http://www.presidentschallenge.org
ThePresidentsChallengeprogramrecognizesadults
andchildrenformeetingphysicalactivitygoals
throughitsPresidentialActiveLifestyleAwardand
PresidentialChampionsprogram.Inaddition,the
programcontinuesitslongstandingphysicaltness
testingprogramforchildrenandadolescents.Anadult
tnesstest,foundathttp://www.adulttnesstest.org,
allowsadultsaged18andoldertotracktheircurrent
leveloftness.Additionalinformationcanbefoundat
thePresidentsCouncilonPhysicalFitnessandSports
http://www.tness.gov.
Schools
DivisionofAdolescentandSchoolHealth,CDC
http://www.cdc.gov/HealthyYouth/physicalactivity
ThephysicalactivitysectionoftheHealthyYouth!
Websiteprovidesresourcesthatcanincreasethe
capacityofthenationsschoolstopromotelifelong
physicalactivity.
Communities
AdministrationonAging(AoA)
http://www.aoa.gov/
Search:physicalactivity
TheAoAEvidence-BasedDiseasePreventionProgram
providesexamplesofhowcommunity-based
organizationsdeliverlow-costevidence-basedphysical
activityprogramsthatbenetolderadultsandhelp
themtothriveintheircommunities.
DivisionofNutrition,PhysicalActivity,andObesity
(DNPAO),CDC
http://www.cdc.gov/nccdphp/dnpa/physical/index.htm
TheDNPAOphysicalactivityWebsiteprovides
resourcesforprogramplanners,healthprofessionals,
andothercommunitymembers.
FederalHighwayAdministration
http://www.fhwa.dot.gov/environment/bikeped/index.htm
TheBicycleandPedestrianprogramprovides
resourcestohelppromotebicycleandpedestrian
Appendix3.FederalWebSitesThatPromotePhysicalActivity 60


transportationuse,safety,andaccessibility.Resources
includealistingofStatePedestrianandBicycle
Coordinatorsandinformationonfundingsourcesand
legislation.ThisWebsitealsolinkstothePedestrian
andBicycleInformationCenter,whichprovides
informationonengineering,advocacy,education,
andenforcementtopics.
EnvironmentalProtectionAgency
http://www.epa.gov/aging/bhc/index.htm
TheBuildingHealthyCommunitiesforActiveAging
programprovidestoolstosupportcommunityefforts
toemploysmartgrowthandactiveagingpoliciesand
programs.OnefocusoftheprogramistheBuilding
HealthyCommunitiesforActiveAgingawards
program,whichrecognizescommunitiesforadvancing
smartgrowthandactiveagingmeasures.
NationalInstitutesofHealth
http://www.nhlbi.nih.gov/health/public/heart/obesity/
wecan/
WeCan!(WaystoEnhanceChildrensActivityand
Nutrition)isaneducationalprogramforfamiliesand
communitiesfocusedonhelpingyouthsimprovefood
choices,increasephysicalactivity,andreducescreen
time.WeCan!isjointlysponsoredbytheNational
Heart,Lung,andBloodInstitute;theNationalInstitute
ofDiabetesandDigestiveandKidneyDiseases;the
EuniceKennedyShriverNationalInstituteforChild
HealthandHumanDevelopment;andtheNational
CancerInstitute.
NationalParkService
http://www.nps.gov/ncrc/programs/rtca/helpfultools/
ht_publications.html
TheRivers,Trails,andConservationAssistance
Programhashelpfultoolsthatprovideresourcesand
informationontrailandgreenwaysprogramsand
traildevelopment.Forexample,thesitehasatoolbox
ofmaterialsonhowtoturnacommunitydreamof
buildingatrailorrevitalizingaparkoropenspace
intoreality.
HealthCare
U.S.PreventiveServicesTaskForce(USPSTF)
http://www.ahrq.gov/clinic/uspstf/uspsphys.htm
TheAgencyforHealthcareResearch&Qualitysupports
thisindependentpanelofexpertsinprimarycareand
preventionthatsystematicallyreviewstheevidence
ofeffectivenessanddevelopsrecommendationsfor
clinicalpreventiveservices.TheUSPSTFrecognizes
thatregularphysicalactivityhelpspreventchronic
diseaseanddecreasemorbidity.TheUSPSTFcounseling
recommendationaboutpromotingphysicalactivityis
focusedonbehavioralcounselingservicesdeliveredin
primarycarepractices.
Worksites
HealthierWorksiteInitiative,CDC
http://www.cdc.gov/nccdphp/dnpa/hwi/index.htm
ThisCDCinitiativeprovideshealthpromotionprogram
plannersworkinginStateandFederalGovernment
ofceswithinformationonavarietyofhealth
promotionprograms,includingphysicalactivity
promotionandtnesscenterdesignandmanagement.
TheWebsitealsolinkstoresourcesfromother
nonprotandeducationalorganizationsthroughthe
QuickResourcessection.
61 2008PhysicalActivityGuidelinesforAmericans
BeActive,Healthy,andHappy!
www.health.gov/paguidelines
You can nd more information about the new advice on physical activity at:
www.health.gov/paguidelines.
ODPHP Publication No. U0036
October 2008

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