Updated Physical Activity Guidelines: A Call to Action to Doctors

For the first time in a decade, physical activity guidelines have been updated, featuring new information and guidance on the types and amounts of physical activity that yield substantial health benefits.

In 2008, the Department of Health and Human Services (HHS) released the first-ever Physical Activity Guidelines for Americans (PAG). In November 2018, HHS released an update to these guidelines and expanded the medical conditions for which physical activity is likely beneficial. The recommendations, available at https://health.gov/PAGuidelines and also published in JAMA, are based on a systematic literature review by a committee of exercise and health experts.

“Since the PAG was first released, we’ve learned much more about the benefits of physical activity in people of different ages and with a variety of health conditions,” explains Katrina L. Piercy, PhD, RD, an author of the new PAG (Table). “Physical activity reduces risk for and improves many chronic conditions like obesity, type 2 diabetes, heart disease, dementia, and several forms of cancer, and it also improves sleep and physical function, prevents fall injuries, and is beneficial as an adjunct to pain management.” Although the guidelines are available to all people, the primary audience for the PAG is healthcare providers (HCPs) and policymakers. The PAG features a myriad of tools to educate HCPs on how they can help patients increase physical activity and improve health.

Highlighting Key Recommendations

According to the PAG, for substantial health benefits, adults should perform 150-300 minutes per week of moderate intensity activity or 75-150 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups 2 or more days per week. “Older patients should follow the adult activity recommendations but also include exercises that enhance balance to decrease fall risks,” says Dr. Piercy. “It’s never too late to use physical activity to ensure that older adults do not outlive their muscles.”

The PAG notes it is important to provide young people opportunities and encouragement to participate in physical activities that are appropriate for their age, enjoyable, and offer variety. For patients aged 6-17 years, at least 60 minutes of moderate-intensity aerobic physical activity is recommended per day and muscle-strengthening activity is recommended 3 days per week. Preschool children aged 3-5 years are encouraged to be physically active throughout the day.

A critical message in the 2018 PAG is that even small amounts of physical activity can yield substantial benefits. “HCPs must inform their patients that every little effort to increase physical activity helps,” Dr. Piercy says. “Simply getting people to move can reduce risks of many diseases. Any activity is better than none. The previous PAG noted that activity bouts of at least 10 minutes’ duration were required, but the 2018 update indicates there is no such threshold of benefit. Any amount of activity can count toward the recommended 150 minutes per week, and going beyond that amount has even more benefits.”

A Call to Action to Engage Patients

People with chronic health conditions and disabilities are recommended to try achieving the levels of physical activity recommended for adults. “To help HCPs, the HHS has developed online toolkits for planning for physical activity and having conversations about it with patients,” says Dr. Piercy. “Many factors can influence physical activity behavior, meaning it’s critical to engage patients to determine how to increase their physical activity levels.”

Efforts to increase physical activity will require cooperation from many healthcare sectors, but achieving these recommendations will substantially improve individual and population health. “HCPs must play a major role in the call to action to increase physical activity,” Dr. Piercy says. “Clinical examinations should routinely include physical activity. The tools developed by HHS are especially important considering that physical activity is widely considered a fifth vital sign during patient exams. HCPs can’t afford to allow patients to miss out on this inexpensive path to healthier lives.”