Exercise and Activity (cont.)

There is good news for all Americans. Scientific evidence shows that physical activity done at a moderate-intensity level can produce health benefits (USDHHS, 1996). If people have been sedentary, they can improve their health and well-being with regular, moderate levels of activity each day.

Those who participate in moderate- to vigorous-intensity activities regularly should be encouraged and supported in their efforts to continue. While activity at a higher intensity or performed longer offers more health benefits, this level of activity may not be a realistic goal for everyone, at least not to start with. Many Americans, for whom the term "exercise" brings up negative images and emotions, can celebrate the good news by setting a new personal goal-achieving and enjoying the benefits of a regularly active lifestyle that includes a variety of moderate- and/or vigorous-intensity activities.

Adults should strive to meet either of the following physical activity recommendations. See General Physical Activities Defined By Level of Intensity for a chart that lists the intensity levels of many types of activities.

• Adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days of the week.

- Centers for Disease Control and Prevention/American College of Sports Medicine

OR

• Adults should engage in vigorous-intensity physical activity 3 or more days per week for 20 or more minutes per occasion

- Healthy People 2010

More good news is that it's never too late to start an active lifestyle. No matter how old you are, how unfit you feel, or how long you've been inactive, research shows that starting a more active lifestyle now through regular, moderate-intensity activity can make you healthier and improve your quality of life.

This next section provides guidelines for how active you need to be to gain some benefit and general information on activity levels of Americans.

How active do adults need to be to gain some benefit?

Physical activity does not need to be hard to provide some benefit. Participating in moderate-intensity physical activity is a vital component of a healthy lifestyle for people of all ages and abilities. There is no demographic or social group in America that could not benefit from becoming more active.

The table* below provides recommendations on how to increase your physical activity based on your current activity level. Check it out to see where you are and how you can challenge yourself.

If....	Then...
You do not currently engage in regular physical activity,	you should begin by incorporating a few minutes of physical activity into each day, gradually building up to 30 minutes or more of moderate-intensity activities.
You are now active, but at less than the recommended levels,	you should strive to adopt more consistent activity: moderate-intensity physical activity for 30 minutes or more on 5 or more days of the week, or vigorous-intensity physical activity for 20 minutes or more on 3 or more days of the week.
You currently engage in moderate-intensity activities for at least 30 minutes on 5 or more days of the week,	you may achieve even greater health benefits by increasing the time spent or intensity of those activities.
You currently regularly engage in vigorous-intensity activities 20 minutes or more on 3 or more days of the week,	you should continue to do so

*Scientific evidence to date supports the statements above.

What is "moderate-intensity physical activity?"

Moderate-intensity physical activity refers to any activity that burns 3.5 to 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while walking briskly, mowing the lawn, dancing, swimming for recreation, or bicycling.

What is "vigorous-intensity physical activity?"

Vigorous-intensity physical activity refers to any activity that burns more than 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while jogging, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill.

• On average, regularly participating in one or more moderate-intensity or vigorous-intensity activities is required to burn a minimum of 150 Calories of energy per day, 7 days per week, or total of 1,000 Calories/week (Jones et al., 1998).
• The time needed to burn 150 Calories of energy in a day depends on the intensity of the activities chosen. For example, if someone selects moderate-intensity activities, the time required to meet the minimum recommendation would be generally 30 minutes per day. The more vigorous the activities chosen, the less time needed (22 minutes or less) to burn the minimum of 150 Calories during the day.

Number of Minutes of Activity Required to Burn 150 kcalories

Are there special recommendations for young people?

It is recommended that children and adolescents participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily.¹

Children and adolescents can choose any type of moderate or higher intensity physical activity, such as brisk walking, playing tag, jumping rope, or swimming, as long as it is adds up to at least one hour a day.

For children and adolescents, regular physical activity has beneficial effects on the following aspects of health:

• Weight
• Muscular strength
• Cardiorespiratory (aerobic) fitness
• Bone mass (through weight-bearing physical activities)
• Blood pressure (for hypertensive youth)
• Anxiety and stress
• Self-esteem

Children and adolescents who are just beginning to be physically active should start out slowly and gradually build to higher levels in order to prevent the risk of injury or feel defeated from unrealistic goals. It is important that children and adolescents are encouraged to be physically active by doing things that interest them. This will help them establish an active lifestyle early on.

¹This physical activity recommendation is from the Dietary Guidelines for Americans 2005.

Tips for Parents

As a parent, you have an important role in shaping your children's physical activity attitudes and behaviors. Here are some tips to encourage your children to be more physically active.

• Set a positive example by leading an active lifestyle yourself, and make physical activity part of your family's daily routine such as designating time for family walks or playing active games together.
• Provide opportunities for children to be active by playing with them. Give them active toys and equipment, and take them to places where they can be active.
• Offer positive reinforcement for the physical activities in which your child participates and encourage them as they express interest in new activities.
• Make physical activity fun. Fun activities can be anything the child enjoys, either structured or non-structured. They may range from team sports, individual sports, and/or recreational activities such as walking, running, skating, bicycling, swimming, playground activities, and free-time play.
• Ensure that the activity is age appropriate and, to ensure safety, provide protective equipment such as helmets, wrist pads, and knee pads.
• Find a convenient place to be active regularly.
• Limit the time your children watch television or play video games to no more than two hours per day. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity (walking, playing chase, dancing).

Are there special recommendations for seniors?

Being physically active can prevent and help treat many of the most common chronic medical conditions associated with old age. Physical activity is one of the most important steps older adults can take to maintain physical and mental health and quality of life. Scientists have proven that being active can help reduce the risk of obesity, high blood pressure, diabetes, osteoporosis, stroke, depression, colon cancer, and premature death. Yet today, more than 60% of older adults are inactive. Older adults face the same obstacles to being more physically active as younger adults but also have special concerns.

The Challenge to Get Moving

Getting older adults to be active is a challenge. The average American lives a long time, but many are sedentary, physically unfit, and experience disability from chronic medical conditions as they age. Physicians and exercise experts hear many reasons from older adults as to why they are not active: It doesn't feel good. It makes my arthritic joints hurt. It takes too much time. It's boring. However, older adults need physical activity like everyone else, at least as much as younger adults. In fact, the loss of strength and stamina often attributed to aging is in part caused by reduced physical activity.

Walking groups and physical activity programs especially designed for older adults can help seniors become-and remain active. For example, senior swim clubs and water aerobic classes are excellent activities for people with arthritis.

The Need for Strength

Strength training is recommended for all adults, but it is a vital link to health for older adults. The reason is that strength training prevents sarcopenia, the muscle deterioration that comes with aging, and also helps maintain bone mass. "Stronger people have better health outcomes," noted Dr. David Buchner, Chief of CDC's Physical Activity and Health Branch and renowned Gerontologist. However, some elderly people avoid physical activity and become sedentary out of fear of falling and fracturing a bone. Dr. Buchner added that emerging data indicate that physical activity can prevent falls by improving strength, balance, and endurance.

Keeping Young at Heart Aerobic activity (also known as cardiorespiratory or cardiovascular endurance activity) is also important. It keeps the heart strong, lowers blood pressure, and relieves anxiety and depression. Older adults can obtain significant health benefits with moderate physical activity, such as walking or gardening.

"We need to make physical activity part of the daily routine for older adults," said Dr. Buchner. Health clubs also provide older adults with a variety of opportunities to improve their aerobic fitness, muscular strength, and flexibility. Dr. Buchner adds, "Traditionally health and fitness facilities have marketed mainly to body-conscious younger adults, who focus on the cosmetic effects. It's great to see that health clubs have developed more programs for older adults, and we hope this trend continues."

*The above information was adapted from: CDC, NCCDPHP. Special focus: healthy aging. Chronic Disease Notes and Reports 1999;12(3):10-11.

Recommendations

The CDC/ACSM recommends that all adults should accumulate at least 30 minutes of moderate-intensity physical activity on five or more days of the week. Cardiorespiratory (aerobic) endurance, strength, balance, and flexibility exercises should all be part of a physical activity program for older adults. No one type of activity will bring about all the benefits of physical activity. It is important to include all of them. Older adults can meet the physical activity recommendation with a combination of these activities using the following sample schedule:

• Cardiorespiratory: Participate in moderate-intensity aerobic activities 3-5 days a week for at least 30 minutes each session.
• Flexibility*: Stretch every day.
• Strength training: Do strength-building activities 2-3 days per week.

*Flexibility refers to how fully one's joints or limbs are able to move. Being flexible allows for easier movements and reduced pain in joints so that it is also easier to perform daily activities of independent living. By adding stretching to your daily physical activity plan, you can help keep your joints flexible which will help you move with more freedom and comfort.

Participating in these types of activities can help you more easily perform many of your day-to-day tasks. For example, being more flexible will help you more easily do things like reaching in your cupboard and tying your shoes. Being stronger and having more balance will help you lift and carry items like sacks of groceries and will make it easier to get in and out of chairs and the bathtub. Improving your cardiorespiratory endurance will allow you to do things like climbing stairs, dancing, or playing with grandchildren without getting out of breath.

The chart below provides ideas of activities in the areas of cardiorespiratory endurance, strength, and flexibility. Many of these activities will also help improve your balance. Most importantly, choose activities that you enjoy. This will make it more likely that you'll keep doing them!

Cardiorespiratory	Strength	Flexibility
Walking	Chair exercises	Stretching
Swimming	Lifting weights or cans	Yoga
Dancing	Carrying laundry or groceries	Tai chi
Skating	Working in the yard
Hiking	Washing the car
Rolling your wheelchair	Scrubbing the floor