Physical inactivity is now identified as the fourth leading risk factor for global mortality. The World Health Organization (WHO) has clear recommendations on how much exercise we need to reap the most health benefits.

The WHO guidelines

5–17 years old

For children and young people of this age group physical activity includes play, games, sports, transportation, recreation, physical education or planned exercise, in the context of family, school, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone health, cardiovascular and metabolic health biomarkers and reduced symptoms of anxiety and depression, the following are recommended:

1. Children and young people aged 5–17 years old should accumulate at least 60 minutes of moderate to vigorous-intensity physical activity daily.

2. Physical activity of amounts greater than 60 minutes daily will provide additional health benefits.

3. Most of daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least 3 times per week.

Yong girl swimming with yellow pool noodle

18–64 years old

For adults of this age group, physical activity includes recreational or leisure-time physical activity, transportation (e.g walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone health and reduce the risk of NCDs and depression the following are recommended:

1. Adults aged 18–64 years should do at least 150 minutes of moderate intensity aerobic physical activity throughout the week, or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.

2. Aerobic activity should be performed in bouts of at least 10 minutes duration.

3. For additional health benefits, adults should increase their moderate intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.

4. Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

Man hiking in hilly countryside in jeans carrying backpack

65 years old and above

For adults of this age group, physical activity includes recreational or leisure-time physical activity, transportation (e.g walking or cycling), occupational (if the person is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone and functional health, and reduce the risk of NCDs, depression and cognitive decline, the following are recommended:

1. Adults aged 65 years and above should do at least 150 minutes of moderate intensity aerobic physical activity throughout the week, or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.

2. Aerobic activity should be performed in bouts of at least 10 minutes duration.

3. For additional health benefits, adults aged 65 years and above should increase their moderate intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous intensity aerobic physical activity per week, or an equivalent combination of moderate and vigorous intensity activity.

4. Adults of this age group with poor mobility should perform physical activity to enhance balance and prevent falls on 3 or more days per week.

5. Muscle-strengthening activities should be done involving major muscle groups, on 2 or more days a week.

6. When adults of this age group cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

Overall, across all the age groups, the benefits of implementing the above recommendations, and of being physically active, outweigh the harms. At the recommended level of 150 minutes per week of moderate intensity activity, musculoskeletal injury rates appear to be uncommon. In a population-based approach, in order to decrease the risks of musculoskeletal injuries, it would be appropriate to encourage a moderate start with gradual progress to higher levels of physical activity.

For more information read the WHO’s complete document: Global recommendations on physical activity for health.

peaceful-442070

Measuring activity intensity: light, moderate, vigorous activity

The easiest measure informally measures respiration. If your breathing is unaffected, it’s light activity. If you can talk but can’t sing, it’s moderate activity. If you can get a few words out, but then have to pause to breathe, it’s vigorous activity.

Another good measure of activity levels is measuring heart rate. Many of us have wearables that calculate and record heart rate, which makes this a quick and convenient test. To start, calculate your maximum heart rate by subtracting your age from 220.
– Light activity: less than 50% of the maximum
– Moderate activity: 50-70% of the maximum
– Vigorous activity: 70 – 85% of the maximum
– Overdoing it, slow down: over 85% of the maximum.

Example:

For a 35-year old, maximum pulse is 220 – 35 = 185.
50% = 185 x 0.5 = 93, 70% = 185 x 0.70 = 130 and 85% is 157.
Light activity = pulse under 93, moderate activity =  pulse range 93 – 130, vigorous activity = 130 – 157.

Incremental health benefits

For those of us who live fairly sedentary lifestyles, the good news is that any increase in activity have health related benefits. For some of us, the message is aim higher and don’t be complacent about inactivity. For others, particularly those with serious health issues or impaired mobility, the message is aim lower, but be persistent. Work up slowly at a sustainable pace and don’t view set-backs in a bad light.

Even if you stop exercising completely, it is like riding a bike – each failed attempt takes you one step closer to success.

There are many ways to be moderately active and some are possible despite severe restrictions. Yoga, hydrotherapy, adapted cycling (there are charities who make this affordable with cycling days and some cycle hire venues also offer adapted cycles for hire, sometimes at a reduced cost for those with a disability), pilates, calisthenics can all be adapted to suit a variety of abilities and requirements.

Have fun

Activity should be fun. If you hate cycling, walking, running, swimming or gyms, don’t do it. There are many moderate – vigorous intensity activities apart from sports:

active gardening tasks like mowing the lawn, digging, sweeping up leaves, dancing, playing frisbee, actively playing with younger children, walk up a hill to fly a kite, rollerblading, ice-skating, wheeling in a manual wheelchair, walking, walking with crutches, stepping up the pace when dusting, mopping or vacuuming, paddle boating, swinging, climbing, walking whilst pushing a stroller or wheelchair, washing the car or den building.

Consider whether it is the activity that is disliked or the context. Walking up a countryside hill is a different experience than a brisk walk to the pharmacy or just going for a walk around the neighbourhood. Change the context if you can to make it more fun – listen to an audio book or music whilst going for a walk, walk with a friend, your teenager you never get to have a relaxed conversation with or encourage young children to bring along their scooter or balance bike.

I often see exercise as a punishment – something painful and exhausting that frequently exacerbate many symptoms in the short term. However, it isn’t exercise that’s the culprit, but my impatience, tendency to over reach and determination to spend as little time on it as possible because there are more important things to do. However, done gradually at the right time, becoming more active, particularly for someone with a mobility related disability, can be a liberating experience.

Exercise is a good thing. It can also be immensely enjoyable. Make it fun and chances are you will still be doing it this time next year and the year after that.

This article was first published on 30 January 2016.