10 months ago
Physical Activity for Health—Every Minute Counts
Peter T. Katzmarzyk, John M. Jakicic
Public health guidelines for physical activity provide evidence-based recommendations for the amount, intensity, and types of physical activity that should be undertaken to obtain and maintain health benefits. The Physical Activity Guidelines for Americans, 2nd Edition, recommend participation in moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities throughout the week.1 These recommendations are especially important for the estimated 76% of US residents who are not currently meeting the physical activity guidelines for aerobic and muscle-strengthening activity.2
One important component of the current guidelines for adults is that for substantial health benefits, engagement in 150 to 300 minutes a week of moderate-intensity aerobic physical activity, or 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity is recommended.1 However, these ranges are couched within other recommendations that indicate that additional health benefits can be gained by engaging in physical activity beyond the equivalent of 300 minutes of moderate-intensity physical activity a week. More importantly, the first bullet for adults in the Physical Activity Guidelines for Americans, 2nd Edition, indicates that adults should move more and sit less throughout the day, and that some activity is better than none because adults who sit less and do any amount of moderate to vigorous physical activity (MVPA) gain some health benefits.1 Thus, an important takeaway from the guidelines is that a range of health benefits can be obtained across the entire continuum of physical activity. And while attaining between 150 and 300 minutes per week (21 to 43 minutes per day) of moderate activity is the sweet spot that balances engagement with optimizing health benefits, health benefits can be obtained at lower levels of activity. This is especially important for older adults and adults with chronic conditions or disabilities. While the key guidelines apply across the spectrum of adulthood, older adults and those with chronic conditions or disabilities also realize numerous health benefits and should be as physically active as their abilities and conditions allow, and they should avoid inactivity.1
These concepts are derived from the 2018 Physical Activity Guidelines Advisory Committee Scientific Report,3 which is emphatic that the health benefits associated with physical activity begin to accrue at levels below the public health target range. For example, the report indicates that small increases in moderate-intensity physical activity provide health benefits among individuals whose activity levels are below the current public health target range. Further, there is no threshold that must be exceeded before benefits begin to occur, and for individuals below the target range, substantial reductions in risk can occur with small increases in physical activity.
Several studies have provided support that small increases in physical activity among physically inactive people are beneficial for health. For example, a meta-analysis of 6 studies (661 137 participants) observed that participants achieving less than 7.5 metabolic equivalent hours per week (approximate lower range of the guidelines) had a 20% lower mortality risk compared with those who did not undertake any physical activity.4 Another meta-analysis of 8 studies (36 383 participants) that used device-based measures of physical activity demonstrated an approximate 60% risk reduction for all-cause mortality among those achieving 20 to 30 minutes of daily moderate to vigorous activity.5 However, there was a steep dose-response association at lower levels of activity, with a risk reduction of 45% to 50% among participants achieving 10 to 15 minutes per day of moderate to vigorous activity.5 More recently, Garcia et al6 analyzed data from 94 cohorts with more than 30 million participants and reported that 75 minutes per week of moderate-intensity activity (about 11 minutes per day) was associated with a significantly lower risk of mortality, cardiovascular disease, and cancers. Further, based on wrist-worn accelerometer measurements from approximately 72 000 adults in the UK Biobank, just 15 to 20 minutes per week of vigorous-intensity physical activity was associated with a 16% to 40% lower risk of mortality.7 Step counters, accelerometry-based, and other wearable devices allow individuals to track their physical activity. A recent meta-analysis of 15 studies (47 471 participants) demonstrated significantly lower mortality across successively higher levels of daily step counts up to 8000 to 10 000 steps per day in younger adults (<60 years) and 6000 to 8000 steps per day in older a
-Abstract Truncated-
Publisher URL: https://jamanetwork.com/journals/jama/fullarticle/2807275
DOI: 10.1001/jama.2023.11014
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