A Prescription For What Costs $117 Billion A Year And 10 Percent Of Premature Deaths In America

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The U.S. Department of Health & Human Services (HHS) this month released the first-ever revision to the Physical Activity Guidelines for Americans since the document’s first publishing in 2008. In it, the HHS underscored not only the essential role the guidelines play in setting the bar for a more physically active nation, but also the recommendation that any amount of daily activity—no matter how big or small—maximizes good health and reduces the risk for many chronic diseases in everyone, no matter their age.

But likely the biggest news is that the guidelines reflect the latest research that exercise actually wards off disease. “The scientific evidence continues to build—physical activity is linked with even more positive health outcomes than we previously thought,” said HHS Secretary Alex M. Azar II. “And, even better, benefits can start accumulating with small amounts of, and immediately after doing, physical activity.”

Doctor with stethoscope on fitness room background.Getty

The American Council on Exercise (ACE) spoke out in support of the revisions. “The revised guidelines reflect the latest science from the past 10 years, which is that physical activity not only wards off disease but helps individuals to sleep better, feel better and more easily perform daily tasks,” the ACE shared in a statement. “With more and more individuals, families and communities struggling with chronic diseases like heart disease and diabetes, ACE affirms the Guidelines recommendation that a greater volume of moderate-to-vigorous physical activity can help prevent or minimize excessive weight gain and maintain a healthy weight. Additionally, healthy weight management through physical activity can reduce the risk of progression of a current condition or the risk of developing a new chronic condition.”

“This update takes a significant step forward in the application of the science of physical activity, making the guidelines more usable for more Americans in everyday life,” said Cedric X. Bryant, PhD, FACSM, President and Chief Science Officer at ACE.

A nonprofit global organization, ACE certifies exercise professionals and health coaches—some 80,000 to date—as well as publishes original research, convenes experts on physical activity and health and advocates for policies to get people from all walks of life moving.

The organization commended the HHS for recognizing that for individuals leading sedentary lifestyles, incorporating any amount of physical activity can reduce health risks and called for policy changes to reflect that. “Evidence suggests that more dedicated, accessible spaces in which to be physically active make it easier for individuals and communities to incorporate this into a daily routine. ACE supports the call to action in the Guidelines and advocates for environmental and policy changes that enable more people to get moving.”

Regular physical activity is one of the most important things people can do to improve their health, Azar said. “Moving more and sitting less have tremendous benefits for everyone, regardless of age, sex, race, ethnicity or current fitness level. Individuals with a chronic disease or a disability benefit from regular physical activity, as do women who are pregnant.”

Azar noted that about half of all American adults—117 million people—have one or more preventable chronic diseases, and seven of the ten most common chronic diseases are favorably influenced by regular physical activity. Exercising could net huge benefits in health care cost savings as well. “Yet nearly 80 percent of adults are not meeting the key guidelines for both aerobic and muscle-strengthening activity, while only about half meet the key guidelines for aerobic physical activity. This lack of physical activity is linked to approximately $117 billion in annual health care costs and about 10 percent of premature mortality.”

Azar said this new edition of the Physical Activity Guidelines for Americans has the potential to change everything. “It is grounded in the most current scientific evidence and informed by the recommendations of the 2018 Physical Activity Guidelines Advisory Committee. This Federal advisory committee, which was composed of prestigious researchers in the fields of physical activity, health and medicine, conducted a multifaceted, robust analysis of the available scientific literature. Their work culminated in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, which provided recommendations to the Federal Government on physical activity, sedentary behavior, and health.”

The new guidelines, Azar said, provide guidance on the amounts and types of physical activity necessary to maintain or improve overall health and reduce the risk of, or even prevent, chronic disease and are an “essential resource” for health professionals and policymakers as they design and implement physical activity programs, policies and promotion initiatives.

The guidelines also provide information that can help Americans make healthy choices and discusse evidence-based, community-level interventions that can help “reverse the high rates of inactivity-related chronic diseases,” he said.

Though older adults are a varied group, many have one or more chronic conditions, such as type 2 diabetes, cardiovascular disease, osteoarthritis or cancer, and these conditions vary in type and severity. Still, being physically active has significant benefits for all older adults and is key to preventing and managing chronic disease.

Some key benefits of exercise, according to the guidelines, include a lower risk of dementia, better perceived quality of life, and reduced symptoms of anxiety and depression. And doing physical activity with others can provide opportunities for social engagement and interaction.

The Physical Activity Guidelines for Americans lists the health benefits of physical activity according to major research findings. They include:

  • Regular moderate-to-vigorous 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.
  • Substantial health benefits for adults occur with 150 to 300 minutes a week of moderate-intensity physical activity, such as brisk walking. Additional benefits occur with more physical activity.
  • Both aerobic and muscle-strengthening 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 chronic conditions or disabilities.
  • The benefits of physical activity generally outweigh the risk of adverse outcomes or injury.

Surprisingly, the key physical activity guidelines for older Americans are the same for all adults:

  • Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
  • For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 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.
  • Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
  • Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on two or more days a week, as these activities provide additional health benefits.

The guidelines specifically set out for older adults include:

  • As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities.
  • Older adults should determine their level of effort for physical activity relative to their level of fitness.
  • Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.
  • When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.

Examples of physical activities for older adults include aerobic activities such as walking or hiking, dancing, swimming, water aerobics, jogging or running, aerobic exercise classes, some forms of yoga, bicycle riding (stationary or outdoors), some yard work like raking and pushing a lawn mower, sports like tennis or basketball and walking as part of golf.

Muscle-strengthening activities for older adults can include: strengthening exercises using exercise bands, weight machines, or hand-held weights; body-weight exercises such as push-ups, pull-ups, planks, squats and lunges; digging, lifting and carrying as part of gardening; carrying groceries; some yoga postures and some forms of tai chi.

The federal government supports several physical activity resources which can be found in the appendix to the guidelines.

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