Magazine article Clinical Psychiatry News

Exercise Guidelines Emphasize Health Maintenance

Magazine article Clinical Psychiatry News

Exercise Guidelines Emphasize Health Maintenance

Article excerpt

Exercise experts have clarified what qualifies as the minimum level of physical activity for maintaining health and lowering the risk of disease in older and younger adults as well as in middle-aged adults with chronic conditions, according to updated recommendations issued by the American College of Sports Medicine and the American Heart Association.

The update to 1995 guidelines from the ACSM and the Centers for Disease Control and Prevention now specify a frequency of at least 30 minutes of moderate-intensity aerobic physical activity 5 days per week, at least 20 minutes of vigorous-intensity activity 3 days per week, or a combination of the two to reach the minimum recommendation for adults aged 18-65 years (Circulation 2007 [Epub doi:10.1161/circulationaha.107.185649]; Med. Sci. Sports Exerc. 2007;39:1423-34).

Similar guidelines with allowances for individualized physical activity levels were issued for adults 65 years of age and older and those aged 50-64 years with functional limitations or chronic conditions, such as arthritis (Circulation 2007 [Epub doi:10.1161/circulationaha.107.185650]; Med. Sci. Sports Exerc. 2007;39:1435-45).

The guidelines describe moderate-intensity physical activities as those that noticeably accelerate heart rate and cause a person to "break a sweat" while remaining capable of carrying on a conversation, such as fast walking, cycling at moderate speeds, and mopping.

Older adults and those with chronic conditions may have a higher degree of variation in fitness levels, meaning that for one person a moderate-intensity walk is a slow walk, whereas for another it is a brisk walk. For this reason, the panel members chose to define aerobic intensity for older adults and those with chronic conditions as relative to their fitness level, such that the perceived exertion is rated on a scale of 1 (resting) to 10 (all-out effort), rather than based on the metabolic equivalents for particular activities. On the 1-10 scale, a level of 5 or 6 would be moderate intensity, W. Jack Rejeski, Ph.D., cochair of the guidelines for older adults, said in an interview.

"Many months of activity at less than recommended levels is appropriate for some older adults (for example, those with low fitness) as they increase activity in a stepwise manner," the guidelines state.

Both guidelines make it a point to note that the daily time allotments for moderate-intensity physical activity can be broken up into shorter bouts of at least 10 minutes rather than completed all at once.

"For a lot of people that we work with who have arthritis pain or other chronic conditions, knowing that they can go out and do some things for 10 minutes, and then sit for a while, and then go back to it again is really a relief to them," said Dr. …

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