Physical Activity Guidelines for Adults Dehong Xu The

Physical Activity Guidelines for Adults Dehong Xu The Hospital of Fudan University

Introducing the 2008 Physical Activity Guidelines for Americans • • • These guidelines are for Americans aged 6 and older. Issued by the U. S. Department of Health and Human Services (HHS) It’s content complements the Dietary Guidelines for Americans [Issued by the U. S. Department of Agriculture (USDA)] The primary audiences are policymakers and health professionals. This information may also be useful to interested members of the public.

The Development of the Physical Activity Guidelines for Americans • • • the 1995 Dietary Guidelines for Americans has included advice on physical activity. In October 2006, the workshop’s report, Adequacy of Evidence for Physical Activity Guidelines Development In 2007, the Physical Activity Guidelines Advisory Committee was composed of 13 leading experts in the field of exercise science and public health. The Physical Activity Guidelines Advisory Committee Report, formed in 2008. HHS issued the 2008 Physical Activity Guidelines for Americans.

What Is Physical Activity? • Physical activity has been defined as any bodily movement produced by the contraction of skeletal muscle(骨 骼肌收缩) that increases energy expenditure above a basal level. • In this guidelines, physical activity generally refers to the subset of physical activity that enhances health.

Two Categories of Bodily Movement • Baseline activity • Health-enhancing physical activity

Baseline activity • Baseline activity refers to the lightintensity activities of daily life, such as, ■ standing, ■ walking slowly, and ■ lifting lightweight objects. • People who do only baseline activity are considered to be inactive.

Health-enhancing physical activity • • Health-enhancing physical activity is activity that, when added to baseline activity, produces health benefits. Examples ■ Brisk walking, ■ Jumping rope, ■ Dancing, ■ Lifting weights, and ■ Doing yoga(瑜伽).

Classification of Total Weekly Amounts of Aerobic Physical Activity Levels of Physical Activity Range of Moderate Intensity Minutes a Week Inactive No activity beyond baseline Low Activity beyond baseline but fewer than 150 minutes a week. Medium High 150 minutes to 300 minutes a week More than 300 minutes a week Summary of Overall Health Benefits Comment None Being inactive is unhealthy. Some Low levels of activity are clearly preferable to an inactive lifestyle. Substantial Activity at the high end of this range has additional and more extensive health benefits than activity at the low end. Additional Current science does not allow researchers to identify an upper limit of activity above which there are no additional health benefits.

Four Categories of Total Weekly Amounts of Aerobic Physical Activity § Inactive is no activity beyond baseline activities of daily § § § living. Low activity is activity beyond baseline but fewer than 150 minutes of moderate-intensity physical activity a week or the equivalent amount (75 minutes) of vigorousintensity activity. Medium activity is 150 minutes to 300 minutes of moderate-intensity activity a week (or 75 to 150 minutes of vigorous-intensity physical activity a week). In scientific terms, this range is approximately equivalent to 500 to 1, 000 metabolic equivalent (MET代谢当量) minutes a week. High activity is more than the equivalent of 300 minutes of moderate-intensity physical activity a week.

The Health Benefits of Physical Activity—Major Research Findings § Regular physical activity reduces the risk of many adverse health outcomes. § Some physical activity is better than none. § For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration. § Most health benefits occur with at least 150 minutes a week of moderate-intensity physical activity. § Additional benefits occur with more physical activity.

The Health Benefits of Physical Activity—Major Research Findings § Both aerobic (endurance) and muscle- strengthening (resistance) physical activity are beneficial. § Health benefits occur for children and adolescents, young and middle-aged adults, older adults, and those in every studied racial and ethnic group. § The health benefits of physical activity occur for people with disabilities. § The benefits of physical activity far outweigh the possibility of adverse outcomes.

Health Benefits Associated With Regular Physical Activity Strong Evidence Lower risk of n early death n coronary heart disease (冠心病) n stroke （中风） n high blood pressure n adverse blood lipid(血脂) profile n type 2 diabetes(2型糖尿病) n metabolic syndrome (代谢综合征) n colon cancer （大肠癌） n breast cancer （乳腺癌）

Health Benefits Associated With Regular Physical Activity Strong Evidence § Prevention of weight gain § Weight loss, particularly when combined § with reduced calorie intake Improved cardiorespiratory (心肺的)and muscular fitness Prevention of falls § § Reduced depression § Better cognitive function (for older adults)

Health Benefits Associated With Regular Physical Activity Moderate to Strong Evidence § Better functional health (for older adults) § Reduced abdominal obesity（腹型肥胖） Moderate Evidence § Lower risk of hip fracture (髋部骨折) § Lower risk of lung cancer § Lower risk of endometrial cancer （子宫内膜癌） § Weight maintenance after weight loss § Increased bone density（骨密度） § Improved sleep quality

The Risk of Dying Prematurely Declines as People Become Physically Active Minutes per Week of Moderate- or Vigorous. Intensity Physical Activity Relative Risk 30 1 90 0. 8 180 0. 73 330 0. 64 420 0. 615

Physical Activity Lower Risk of Early Death The Risk of Dying Prematurely Declines as People Become Physically Active Minutes per Week of Moderate- or Vigorous. Intensity Physical Activity

How Much Physical Activity Do Adults Need? (Aerobic Activities) For substantial health benefits, adults need to do at least § 2 hours and 30 minutes (150 minutes) each week of moderate-intensity* aerobic activity, OR § 1 hour and 15 minutes (75 minutes) each week of vigorousintensity* aerobic activity, OR § An equivalent mix of moderate- and vigorous-intensity aerobic activity. • Aerobic activity should be performed for at least 10 minutes at a time, preferably, spread throughout the week. *Intensity is the level of effort required to do an activity.

How Much Physical Activity Do Adults Need? (Muscle-strengthening Activities) Muscle strengthening should be done 2 or more days a week. § All major muscle groups should be worked. These are the legs, hips, back, abdomen, chest, shoulders, and arms. § Exercises for each muscle group should be repeated 8 to 12 times per set. As exercises become easier, increase the weight or do another set.

How can adults get additional health benefits? (Aerobic Activities) For greater health benefits, adults should do • 5 hours (300 minutes) each week of moderate-intensity aerobic activity, OR • 2 hours and 30 minutes (150 minutes) a week of vigorous-intensity aerobic activity, OR • An equivalent mix of moderate- and vigorousintensity aerobic activity.

What are Aerobic Activities? • Activities that keep your body moving enough to increase your heart rate and make you breathe harder. • There are two intensities of aerobic activity: § Moderate-intensity § Vigorous-intensity

Three Components of Aerobic Physical Activity（有氧运动） § Intensity, or how hard a person works to do the activity. The intensities most often examined are moderate intensity (equivalent in effort to brisk walking) and vigorous intensity (equivalent in effort to running or jogging); § Frequency, or how often a person does aerobic activity; and § Duration, or how long a person does an activity in any one session.

Judging the Intensity of Aerobic Activities (Moderate-intensity Activity) • Moderate-intensity Activity § Heart will beat faster than normal and breathing will be harder than normal § On a scale of 0 to 10, moderate-intensity activity is a 5 or 6 § A person doing moderateintensity aerobic activity can talk, but not sing, during the activity.

Judging the Intensity of Aerobic Activities (Vigorous-intensity Activity) • Vigorous-intensity Activity § Heart will beat much faster than normal and breathing will be much harder than normal § On a scale of 0 to 10, a vigorous-intensity activity is 7 or 8 § A person doing vigorousintensity activity cannot say more than a few words without pausing for a breath.

Relative Intensity Estimate Maximum Heart rate &Target Heart Rate • Estimate maximum heart rate = 220 – Ages • Moderate-intensity Activity Target heart rate 50 to 70% of maximum heart rate • Vigorous-intensity Activity Target heart rate 70 to 85% of maximum heart rate

Types of Moderate- and Vigorous. Intensity Aerobic Activities Type of Physical activity Examples Moderateintensity aerobic • 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 (交际舞) • General gardening Vigorousintensity aerobic • 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(锄草), with heart rate increases) • Hiking uphill or with a heavy backpack(背包)

Moderate- intensity Aerobic Activities

Moderate- intensity Aerobic Activities

Vigorous-intensity Aerobic Activities

Vigorous-intensity Aerobic Activities

What are Muscle-Strengthening Activities? • • • Alternative names: strength training, resistance training, or muscular strength and endurance exercises. Make muscles do more work than they are accustomed to doing. Including exercise, that increases skeletal muscle strength, power, endurance, and mass.

Types of Muscle-Strengthening Activities Type of Physical Activity Musclestrengthening Adults • • Weight training, Push-ups(俯卧撑), Pull-ups(引体向上)， Sit-ups(仰卧起坐) Working with resistance bands Carrying heavy loads Heavy gardening (such as digging or hoeing).

Three Components of Musclestrengthening Activity § Intensity, or how much weight or force is used relative to how much a person is able to lift; § Frequency, or how often a person does muscle -strengthening activity; and § Repetitions, or how many times a person lifts a weight (analogous to(类似于) duration for aerobic activity).

Meeting the Guidelines Getting and Staying Active

Meeting the Guidelines • Adults Who Don’t Meet the Guidelines § Slowly increase activity in small steps § Participate in enjoyable activities • Adults Who Meet the Guidelines § Continue being active on a daily basis § Work toward becoming more active • Adults Who Exceed the Guidelines § Maintain activity level § Vary the kinds of activities to reduce the risk of injury

Special Considerations Flexibility Activities • • • Flexibility is an important part of physical fitness. Stretching exercises are effective in increasing flexibility, and thereby can allow people to more easily do activities that require greater flexibility Time spent doing flexibility activities by themselves does not count toward meeting the aerobic or musclestrengthening Guidelines.

Special Considerations Warm-up and Cool-down • • • They are an acceptable part of a person’s physical activity plan. Commonly, they involve doing an activity at a slower speed or lower intensity. A warm-up before moderate-or vigorous-intensity aerobic activity allows a gradual increase in heart rate and breathing at the start of the episode of activity. A cool-down after activity allows a gradual decrease at the end of the episode. Time spent doing them may count toward meeting the aerobic activity Guidelines. A warm-up for muscle-strengthening activity commonly involves doing exercises with lighter weight.

Moderate Aerobic Activity Routines Sample 1 Monday brisk walking 30 minutes Tuesday brisk walking 30 minutes Wednesday resistance band exercises Thursday brisk walking 30 minutes Friday brisk walking 30 minutes Saturday resistance band exercises Sunday brisk walking 30 minutes Physical Activity Total 150 minutes moderate-intensity aerobic activity AND 2 days muscle strengthening

Moderate Aerobic Activity Routines Sample 2 Monday brisk walking 30 minutes Tuesday playing softball (垒球) Wednesday brisk walking 60 minutes 30 minutes Thursday mowing the lawn 30 minutes Saturday Heavy gardening Sunday Heavy gardening Physical Activity Total 150 minutes moderate-intensity aerobic activity AND 2 days muscle strengthening Friday

Vigorous Aerobic Activity Routines Sample 3 Monday jogging Tuesday weight lifting Wednesday jogging Thursday weight lifting Friday jogging 25 minutes Saturday Sunday Physical Activity Total 75 minutes vigorous-intensity aerobic activity AND 2 days muscle strengthening

Mix of Moderate and Vigorous Aerobic Activity Routines Sample 4 Monday Water aerobic 30 minutes Tuesday jogging 30 minute Wednesday Brisk walking Thursday Yoga（瑜伽） Friday Brisk walking Saturday yoga 30 minutes 30 minutes Sunday Physical Activity Total 90 minutes moderate-intensity aerobic activity AND 30 minutes vigorous-intensity aerobic activity

Key Guidelines for Safe Physical Activity • • • Understand the risks and yet be confident that physical activity is safe for almost everyone. Choose to do types of physical activity that are appropriate for their current fitness level and health goals. Increase physical activity gradually over time. Protect themselves by using appropriate gear and sports equipment, looking for safe environments, following rules and policies, and making sensible choices about when, where, and how to be active. Be under the care of a health-care provider if they have chronic conditions or symptoms.

Activity Is Safe for Almost Everyone • • • The most common injuries affect the musculoskeletal(肌肉骨骼) system [the bones, joints, muscles, ligaments(韧带), and tendons(肌腱 )]. Other adverse events, such as overheating and dehydration. On rare occasions, people have heart attacks. Only one such injury occurs for every 1, 000 hours of walking for exercise, Fewer than four injuries occur for every 1, 000 hours of running.

Choose Appropriate Types and Amounts of Activity • The safest activities are moderate intensity and low impact, and don’t involve purposeful collision or contact. • In the amounts commonly done by adults, walking has a third or less of the injury risk of running. The risk of injury for a type of physical activity can also differ according to the purpose of the activity. People who have had a past injury are at risk of injuring that body part again. • •

Increase physical activity gradually over time • The risk of injury to bones, muscles, and joints is directly related to the gap between a person’s usual level of activity and a new level of activity. • Inactive people should “start low and go slow” by gradually increasing how often and how long activities are done.

Use Protective Gear and Appropriate Equipment • Personal protective gear ■ helmets（头盔）, ■ eyewear and goggles（护目镜）, ■ shin（胫） guards, ■ elbow（肘） and knee pads, ■ mouth guards. • Sports equipment ■ balls, ■ bats(球棒、球拍), ■ sticks, and ■ shoes.

Thank you! Questions? Be Active, Healthy, and Happy! Information in this presentation is provided by U. S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Adolescent and School Health www. cdc. gov/Healthy. Youth