Chapter 18 Physical Activity Recommendations and Exercise Guidelines Established by Leading Health Organizations Jacalyn J. Robert-McComb, PhD, FACSM

Learning Objectives Define the difference between moderate physical activity, vigorous physical activity, exercise, health-related physical fitness, and sports related fitness.Define the difference between moderate physical activity, vigorous physical activity, exercise, health-related physical fitness, and sports related fitness. Discuss physical activity recommendations for health- related fitness from leading health organizations.Discuss physical activity recommendations for health- related fitness from leading health organizations. Explain the American College and Sports Medicine’s exercise recommendations for cardiorespiratory fitness,Explain the American College and Sports Medicine’s exercise recommendations for cardiorespiratory fitness, muscular fitness, healthy body composition, and flexibility.

Introduction Women are generally less active than men at all ages and by age seventy-five, one in three men and one in two women engage in no regular physical activity (United States Department of Health and Human Services, 2000 ).This has important public health implications.Women are generally less active than men at all ages and by age seventy-five, one in three men and one in two women engage in no regular physical activity (United States Department of Health and Human Services, 2000 ).This has important public health implications.

What is the difference between physical activity and exercise? The United States Department of Health and Human Services refers to physical activity as, bodily movement that is produced by the contraction of skeletal muscle that substantially increases energy expenditure (1996).The United States Department of Health and Human Services refers to physical activity as, bodily movement that is produced by the contraction of skeletal muscle that substantially increases energy expenditure (1996). Whereas, exercise, is a type of physical activity that represents structured, planned activities, and repetitive bodily movement, designed to promote or enhance over-all physical fitness (Dwyer & Davis, 2004).Whereas, exercise, is a type of physical activity that represents structured, planned activities, and repetitive bodily movement, designed to promote or enhance over-all physical fitness (Dwyer & Davis, 2004).

Both physical activity and exercise contribute to increases in physical fitness.

Health-Related Components of Physical Fitness Cardiovascular EnduranceCardiovascular Endurance Muscular strength and Endurance Muscular strength and Endurance FlexibilityFlexibility and Body Composition.and Body Composition.

Skill-Related Components of Physical Fitness These components are associated mostly with sport performance. BalanceBalance AgilityAgility CoordinationCoordination Speed Power Reaction Time

How do we define moderate physical activity or exercise and vigorous physical activity or exercise? There are varying definitions, perhaps the easiest to understand involves the use of the Borg Scale or the Rate of Perceived Exertions Scale.There are varying definitions, perhaps the easiest to understand involves the use of the Borg Scale or the Rate of Perceived Exertions Scale.

Moderate Exercise In the 1996 Surgeon General’s Report (1996), moderate exercise was defined as some increase in breathing or heart rate or a "perceived exertion" of 11 to 14 on the Borg Rate of Perceived Exertion (RPE) scale. These levels are equal to the effort a healthy individual might burn while walking at a mph pace on a level surface, playing golf, gardening and yard work, swimming for recreation, or bicycling.In the 1996 Surgeon General’s Report (1996), moderate exercise was defined as some increase in breathing or heart rate or a "perceived exertion" of 11 to 14 on the Borg Rate of Perceived Exertion (RPE) scale. These levels are equal to the effort a healthy individual might burn while walking at a mph pace on a level surface, playing golf, gardening and yard work, swimming for recreation, or bicycling.

Vigorous Exercise In the 1996 Surgeon General’s Report (1996), vigorous exercise was defined as a large increase in breathing or heart rate (conversation is difficult or “broken”) or a "perceived exertion" of 15 or greater on the Borg RPE scale. These levels are equal to the effort a healthy individual might burn race walking or walking at a 5 mph pace, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, scuba diving, or bicycling uphill.In the 1996 Surgeon General’s Report (1996), vigorous exercise was defined as a large increase in breathing or heart rate (conversation is difficult or “broken”) or a "perceived exertion" of 15 or greater on the Borg RPE scale. These levels are equal to the effort a healthy individual might burn race walking or walking at a 5 mph pace, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, scuba diving, or bicycling uphill.

Borg Scale 6 No exertion at all6 No exertion at all 7 Extremely light (7.5) 8 9 Very light9 Very light Light11 Light Somewhat hard Hard (heavy) Very hard Extremely hard 20 Maximal exertion

Physical Activity Recommendations for Health- Related Fitness from Leading Health Organizations

Centers for Disease Control (CDC) and the American College of Sports Medicine All adults in the United States should accumulate 30 minutes or more of moderate physical activity on most, and preferably all, days of the week.

American Heart Association Older adults and people with disabilities can gain significant health benefits with a moderate amount of physical activity, preferably daily. Physical activity doesn't need to be strenuous to bring health benefits. What's important is to include activity as part of a regular routine.Older adults and people with disabilities can gain significant health benefits with a moderate amount of physical activity, preferably daily. Physical activity doesn't need to be strenuous to bring health benefits. What's important is to include activity as part of a regular routine.

American Heart Association Children and adolescents should participate in at least 60 minutes of moderate to vigorous physical activity every day.Children and adolescents should participate in at least 60 minutes of moderate to vigorous physical activity every day. All children age 2 and older should participate in at least 30 minutes of enjoyable, moderate- intensity activities every day. They should also perform at least 30 minutes of vigorous physical activities at least 3–4 days each week to achieve and maintain a good level of cardiorespiratory (heart and lung) fitness.All children age 2 and older should participate in at least 30 minutes of enjoyable, moderate- intensity activities every day. They should also perform at least 30 minutes of vigorous physical activities at least 3–4 days each week to achieve and maintain a good level of cardiorespiratory (heart and lung) fitness.

A Report of the Surgeon General People of all ages should include a minimum of 30 minutes of physical activity of moderate intensity (such as brisk walking) on most, if not all, days of the week. Experts advise previously sedentary people embarking on a physical activity program to start with short durations of moderate-intensity activity and gradually increase the duration or intensity until the goal is reached.People of all ages should include a minimum of 30 minutes of physical activity of moderate intensity (such as brisk walking) on most, if not all, days of the week. Experts advise previously sedentary people embarking on a physical activity program to start with short durations of moderate-intensity activity and gradually increase the duration or intensity until the goal is reached.

American College of Sports Medicine’s Resistance Training Guidelines for Healthy Adults Perform a minimum of 8 to 10 separate exercises that train the major muscles of the hips, thigh, legs, back, chest, shoulders, arms, and abdomen. A primary goal of the program should be to develop total body strength and endurance in a relatively time-efficient manner. Total exercise training programs lasting longer than 1 hour per session to the point of volitional fatigue for healthy individuals, while maintaining good form.Perform a minimum of 8 to 10 separate exercises that train the major muscles of the hips, thigh, legs, back, chest, shoulders, arms, and abdomen. A primary goal of the program should be to develop total body strength and endurance in a relatively time-efficient manner. Total exercise training programs lasting longer than 1 hour per session to the point of volitional fatigue for healthy individuals, while maintaining good form.

Continued….. Exercise each muscle group 2 to 3 nonconsecutive days per week and if possible, perform a different exercise for the muscle group every two to three sessions.Exercise each muscle group 2 to 3 nonconsecutive days per week and if possible, perform a different exercise for the muscle group every two to three sessions. Maintain a normal breathing pattern; breath- holding can induce excessive increases in blood pressure.Maintain a normal breathing pattern; breath- holding can induce excessive increases in blood pressure. For people with high cardiovascular risk or those with chronic disease (hypertension, diabetes), terminate each exercise as the concentric portion of the exercise becomes difficult (RPE 15 to 16) while maintaining good form.For people with high cardiovascular risk or those with chronic disease (hypertension, diabetes), terminate each exercise as the concentric portion of the exercise becomes difficult (RPE 15 to 16) while maintaining good form.

General Exercise Prescription for Achieving and Maintaining Flexibility (ACSM, 2006) Precede stretching with a warm-up to elevate muscle temperaturePrecede stretching with a warm-up to elevate muscle temperature Stretch major muscle groups: neck, shoulders and upper arms, chest and upper arms, back and posterior thighs, thighs and hips, legs and anklesStretch major muscle groups: neck, shoulders and upper arms, chest and upper arms, back and posterior thighs, thighs and hips, legs and ankles

Continued…….. Perform a minimum of 2 to 3 dwk -1, ideally 5 to 7 dwk -1Perform a minimum of 2 to 3 dwk -1, ideally 5 to 7 dwk -1 Stretch to the end of the range of motion to a point of tightness, without inducing discomfortStretch to the end of the range of motion to a point of tightness, without inducing discomfort Hold each stretch for 15 to 30 secondsHold each stretch for 15 to 30 seconds Repeat two to four repetitions for each stretchRepeat two to four repetitions for each stretch

Recommendations for Body Fat Percentages for Women (Lohman TG, Houtkooper LB, Going SB. 1997) CategoryCategory EssentialEssential MinimalMinimal AthleticAthletic Recommended % 8-12% 10-12% 12-22%

Continued…. Recommendations for 34 years or less 20-35% 20-35% Recommendations for years 23-38% 23-38% Recommendations for over 56 years 25-38% 25-38%

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Continued…. Recommendations for 34 years or less 20-35% 20-35% Recommendations for years 23-38% 23-38% Recommendations for over 56 years 25-38% 25-38%