LIFESTYLE MEDICINE: FITNESS

Move More. Live Longer.

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THE SIGNIFICANCE

There is an overwhelming amount of evidence that recognizes physical activity as a key component of a healthy lifestyle. Being physically active can improve health outcomes in all individuals – regardless of age, gender, ethnicity, or disability. For this reason, consistent physical activity is an effective lifestyle intervention for optimizing overall health and well-being.

THE EVIDENCE

The 2018 Physical Activity Guidelines Advisory Committee scientific report summarizes current evidence on physical activity and health, highlighting specific physical activity-related health benefits. These include a decreased risk of chronic conditions such as heart disease, stroke, hypertension, and type 2 diabetes as well as eight different types of cancer. Physical activity has also been shown to affect brain function by reducing the risk of Alzheimer’s disease as well as improving anxiety, depression, sleep, cognitive function, and overall quality of life.

Despite widely-established benefits across the lifespan, the proportion of individuals engaging in sufficient levels of physical activity is alarmingly low. The Centers for Disease Control and Prevention reports only 50% of adults are achieving the necessary physical activity levels to reduce and prevent chronic diseases. To make matters worse, this lack of physical activity has been linked to 10% of premature deaths. Current research also suggests that there has been no significant increase in aerobic activity over the past decade, while sedentary behaviors have significantly increased. Sedentary behavior is an independent risk factor for adverse health outcomes such as cardiovascular disease, type 2 diabetes, cancer, and all-cause mortality.

THE RECOMMENDATIONS

The 2018 Physical Activity Guidelines strives to combat this negative health behavior by encouraging optimal physical activity levels and minimizing the detrimental impact of a predominantly-sedentary lifestyle.

Adults are encouraged to meet the following guidelines:

  • Move more and sit less throughout the day. Any physical activity is better than none. Adults who sit less and engage in any amount of moderate-to-vigorous physical activity experience health benefits.
  • For substantial health benefits
    • At least 150 minutes to 300 minutes a week of moderate-intensity; OR
    • 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity; OR
    • An equivalent combination of moderate- and vigorous-intensity aerobic activity.
  • Muscle-strengthening activities of moderate or greater intensity. These should involve all major muscle groups 2 or more days per week, as this provides additional health benefits.
  • More than 300 minutes of moderate-intensity aerobic physical activity a week (or the equivalent) results in additional health benefits.
  • Aerobic activity should be spread throughout the week.

The following definitions can be used to guide types of exercise and corresponding intensity levels:


  • Aerobic: physical activity in which the body’s large muscles move in a rhythmic manner for a sustained period of time
    • Examples: brisk walking, running/jogging, swimming, bicycling
  • Muscle-Strengthening: physical activity that increases skeletal muscle strength, power, endurance, and mass
    • Examples: lifting weights, using resistance bands, bodyweight exercises, carrying heavy loads, heavy gardening
  • Bone-Strengthening (also called “weight-bearing”): physical activity that produces an impact or tension force on the bones that promotes bone growth and strength
    • Examples: running, jumping rope, lifting weights
    • *note: bone strengthening activities can also be aerobic and muscle-strengthening
  • Moderate-Intensity: 5 or 6 (on a scale of 0 to 10); a person can talk, but not sing, during the activity
  • Vigorous- Intensity: begins at a 7 or 8 (on a scale of 0-10); a person cannot say more than a few words without pausing for a breath

THE TAKEAWAY

Finding enjoyable ways to incorporate exercise into daily activities can be helpful in meeting the national guidelines. However, even individuals who fail to meet the specified levels of physical activity experience health benefits simply by replacing sedentary behaviors with light-intensity physical activity. The main takeaway is that the body and brain crave movement, but no single exercise prescription is essential.

Lifestyle medicine practitioners can integrate information about a patient’s health history to determine a fitness plan that is best-suited for each person. By making simple and realistic recommendations, practitioners can support individuals in maintaining sustainable exercise habits and optimize health for people of all backgrounds and ability levels.

SELECTED SUPPORTING RESEARCH

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