1. Chapter 1: The Health Benefits of Physical Activity

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Introduction
It is recommended that everyone engage in regular physical activity throughout their lifespans.
Physical activity
Bodily movements that result in energy expenditure
Exercise
Subset of physical activity
Physical fitness
Set of attributes relating to physical activity performance
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Introduction—(cont.)
Physical activity and exercise are behaviors, whereas physical fitness is an outcome of behaviors.
Components of physical fitness can be measured with exercise testing protocols.
Time-consuming but reliable and valid
Physical activity can be measured with large-scale surveys or objective monitoring devices.
More feasible and cost-effective but less accurate
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Introduction—(cont.)
Sedentary behavior
Sitting or reclined while engaging in ≤1.5 METs
Physical inactivity
Not meeting the following activity recommendations
30 minutes of moderate-intensity activity on at least 5 days per week
20 minutes of vigorous-intensity activity on at least 3 days per week
Equivalent combination achieving 600 MET-minutes per week
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Introduction—(cont.)
Intensity of physical activity defined:
Light-intensity physical activity is <3.0 METs.
Example: walking
Moderate-intensity physical activity is 3.0–5.9 METs.
Example: jogging
Vigorous-intensity physical activity is ≥6.0 METs
Example: running
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6. Domains of Physical Activity
Four physical activity domains
Recreation
Exercise and recreation activities
Transport
Occupation
Household
Physical activity interventions and policies are most effective when they operate on multiple levels.
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7. Physical Activity Recommendations
2008 Physical Activity Guidelines for Americans
Adults should avoid inactivity.
Adults should engage in at least 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity activity.
For more extensive benefits, this recommendation should be extended to 300 minutes per week of moderate-intensity or 150 minutes per week of vigorous-intensity
Adults should engage in muscle-strengthening activities on at least 2 or more days per week.
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8. Physical Activity Recommendations—(cont.)
Healthy People 2020 (Box 1.1)
The nation’s health agenda sets a goal to improve health, fitness, and quality of life.
Includes 36 delineated objectives related to the promotion of physical activity across the lifespan
Objectives are categorized based upon the target population.
Adults and/or children
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9. Physical Activity Recommendations—(cont.)
American Heart Association (AHA) and ACSM’s Recommendations
All adults (18–65 yr) need moderate-intensity aerobic activity for 30 minutes on at least 5 days per week or 20 minutes of vigorous activity on at least 3 days per week
Combinations of moderate and vigorous activity can be used to meet this goal.
Exceeding the minimum recommendation may help to:
Further improve fitness
Reduce risk of chronic disease
Prevent unhealthy weight gain
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10. Prevalence of Physical Activity
Physical inactivity is considered a global pandemic.
One in 4 adults are insufficiently physically active.
Health equity
Every individual has the opportunity to “attain his or her full health potential.”
Health disparities
National physical activity data reveals health disparities exist due to all of the following:
Sex, race/ethnicity, age, educational attainment, family income, family type, country of birth, disability status, geographic location, health insurance status, sexual orientation, and marital status
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Prevalence of Physical Activity—(cont.)
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12. Benefits of Physical Activity and Chronic Disease
Regular physical activity can attenuate the prevalence, mortality, or morbidity of many leading causes of death.
Physical activity and all-cause mortality
Numerous studies underscore the relationship between physical activity and reduced all-cause mortality.
Example: Harvard Alumni Health Study
Physical activity and chronic diseases
Chronic diseases
Diseases that develop overtime and are not infectious
The World Health Organization (WHO) promotes physical activity for the improvement or maintenance of chronic diseases.
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13. Benefits of Physical Activity and Chronic Disease—(cont.)
Physical activity and cardiovascular disease (CVD)
The positive relationship between physical activity and cardiovascular health has been well established.
Physical activity and stroke
Meta-analysis data displays an 11% reduction in the risk of stroke with moderate-intensity exercise and a 19% reduction with vigorous-intensity exercise.
Physical activity and cancer
Exercise has been shown to benefit individuals with several types of cancer, including lung, breast, colon, and pancreatic.
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14. Benefits of Physical Activity and Chronic Disease—(cont.)
Physical activity and diabetes
Regular physical activity promotes glycemic control and insulin action.
This improves blood glucose, lipids, blood pressure control abnormalities, and weight loss/maintenance.
Physical activity and obesity
Physical activity is associated with weight loss and/or the prevention of weight gain.
Physical activity and disabilities/aging
Physical activity is recommended to all persons, including the aging population and to those with disabilities.
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Summary
Physical activity is a behavior associated with many benefits.
There are many federal initiatives to promote physical activity and it’s associated benefits, including:
Exercise is MedicineTM
“Step it Up!” initiative
“Let’s Move!” campaign
It is important to address health disparities and focus on delivering a variety of interventions.
Consider social determinants that may have a positive or negative impact on a patient’s ability to engage in activity.
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