SCIENCE FRIDAY: NO TIME MINIMUM, SAY NEW GOV’T GUIDELINES FOR AMERICANS’ PHYSICAL ACTIVITY; RESIST SEDENTARY CONVENIENCES

Mackinac Island MI. Taken by PKSenagore August 2018. All rights reserved.

There is such encouraging new evidence of the benefits of physical activity on health that the new Physical Activity Guidelines, issued by the Department of Health and Human Services*, have changed the emphasis on how to meet them.  Rather than recommending that persons perform minimum SESSIONS of exercise 10 minutes in duration, the updated 2018 PAG want all persons to exercise at least with moderate intensity, ANYTIME!
 
That’s right, any opportunity to significantly pick up the pace and boost heart rate will now officially contribute to the total tally of prescribed exercise minutes. A Special Communication published in the Journal of the American Medical Association (JAMA) this week indicates that “routine daily physical activity such as parking farther away from a destination and walking, or taking stairs rather than the elevator” should be encouraged by health care practitioners to “promote small increases in physical activity that do not take 10 minutes.”  Amazing!!!
 
Yes, the article clearly says that “these small changes can contribute to providing increases in health-enhancing physical activity.”
 
Areas that stand out as receiving heightened or NEW attention, include recommendations for:
1) Muscle strengthening for ALL age groups and situations from 2-3 days per week.
2) Bone strengthening for pre-schoolers, children, and adolescents
3) Balance work and multi-component activity for older persons
4) All types of activity for pre-schoolers for about 3 hours/day
5) Aerobic fitness work for women during pregnancy and the post-partum period
6) Aerobic fitness activity and muscle strengthening for adults with chronic health conditions or disabilities.
 
The JAMA Special Communication includes important details intended to help health care providers guide patients and care-givers of children, older persons, and those with chronic conditions. Best to read them for ourselves!

The article explains/defines:

• New evidence for health benefits at different ages and situations (like pregnancy)
• Total list of health benefits of regular exercise
• Types of activity: aerobic, muscle strengthening, bone strengthening, balance, and multi-component
• Intensity of activity
• Progression and overload
• Key guidelines

Earned Runs has summarized the guidelines (below) but it’s best to read the official publication to obtain the best understanding of why and how to accomplish the goal activities.

(NEW) Preschoolers, ages 3 to 5:

• Maintain physical activity, “to enhance growth and development”.
• A “reasonable target may be 3 hours a day of activities of all intensities: light, moderate, or vigorous”
• Adult caregivers should “encourage active play that includes a variety of activity types”.

Children and teens ages 6 to 17:

• Aerobic fitness: 60 minutes of vigorous activity/day,
• Muscle strengthening: specific activity, 3 days/week (as part of 60 minutes/day)
• Bone strengthening: specific activity 3 days/week (as part of 60 minutes/day)

Adults (roughly ages 18-64)

• Generally; should move more and sit less throughout the day
• Aerobic fitness: minimum 150 to 300 minutes (2.5-5hours)/week spread over most of the days; more as is possible at moderate intensity; vigorous intensity exercise can be lessened to 75-150 minutes (1.25 -2.5 hours)/week.  Or an “equivalent combination” of moderate and vigorous intensity activity somewhere in between.
• Muscle strengthening: work all major muscle groups 2+ times/week

Older adults (65+ years)

• Aerobic fitness: same as adult standards, as fitness level permits
• Balance training; important to lower risk of falls
• Muscle-strengthening workouts: important to lower risk of falls
• Multi-component exercise is most beneficial

(NEW) Pregnant and postpartum women

• Aerobic fitness: 150 minutes (2.5 hours)/over week
• Highly fit women (exercised vigorously prior to pregnancy) can continue same activity
• Exercise should be monitored by health care practitioners

(NEW) Adults with a chronic health condition or a disability

• Exercise should be monitored by health care practitioners
• Aerobic fitness: same as adult standards, as fitness level and condition permits
• Muscle-strengthening workouts

Earned Runs thinks an important message is MISSING in this Special Communication, that there SHOULD be a clearer message to us about avoiding sedentary time. We should be warned that any new lifestyle convenience might be a nudge toward increasing our sedentary time, which by definition will decrease time spent performing recommended healthy physical activities. 

Current trends are pushing us toward accomplishing most of what we do in our waking hours with the help of online services. For example, we are encouraged not to personally grocery shop in a brick-and-mortar establishment, but to order needed items and have them delivered. If this convenience is adopted there won’t be an opportunity to park "farther away from a destination and walking" because we won’t be driving to the store. There won’t be the chance to lug heavy groceries home either, a muscle strengthening activity.

The same goes for dropping-off/picking-up laundry and dry cleaning. For ordering food, rather than preparing meals. The hiring of pet walkers, home cleaning, and landscape maintenance services similarly make life easier but less active. It’s now possible to ask a smart device to turn on/off the TV and house lights, which decreases the steps taken while in our own homes! 

The gripe my family hears about, routinely, regards stairs.  If the need for muscle strengthening and balance work is increased for older folks, why would we strive to remove stairs from our homes? Where else will we encounter them?  If we don’t climb stairs regularly won’t we lose the muscular ability to do this eventually, and be unable to take the "stairs rather than the elevator"?

The JAMA Special Communication article should lead us to question how we wish to live our lives in this age of convenience. If even the smallest amounts of moderately vigorous activity in an entire day can have health benefits which accumulate over a lifetime, should we be accepting of convenience services that mostly eliminate it?

An opportunity to slow the push toward convenience is approaching. After Thanksgiving Day in the US, we will celebrate Black Friday, Small Business Saturday, and Cyber Monday. Perhaps we should use these days to show retailers that we continue to value the experience of shopping at physical stores in malls, and downtown and business districts by doing just that! This 2018 holiday season could be the first in which online purchasing, and thus ‘sedentary shopping’ is reduced in favor of active, in-store sales.

I’ve experienced societal pressures to globally “do less” as I’ve gotten older but, after reading this communication, am determined to continue resisting. To “do more”, throughout my days, when possible.  The 2018 PAG tells us that we must be moving most of each day to become and remain healthy, and that designated periods of formal exercise may not be necessary, or perhaps sufficient.

That’s welcome news, if we acknowledge the hidden dangers of convenience.

RUN AND MOVE HAPPY!

*NOTE: "The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report."

https://jamanetwork.com/journals/jama/fullarticle/2712935
The Physical Activity Guidelines for Americans
Katrina L. Piercy, PhD, RD1; Richard P. Troiano, PhD2; Rachel M. Ballard, MD, MPH3; et al

https://www.washingtonpost.com/national/health-science/new-government-guidelines-say-you-can-get-your-exercise-in-small-doses/2018/11/11/3201d4c0-e5f8-11e8-bbdb-72fdbf9d4fed_story.html