Start active, stay active: a report on physical activity from the four home countries' Chief Medical Officers
01 Jan 2013-
TL;DR: This document is intended for professionals, practitioners and policymakers concerned with formulating and implementing policies and programmes that utilise the promotion of physical activity, sport, exercise and active travel to achieve health gains.
Abstract: A UK-wide document that presents guidelines on the volume, duration, frequency and type of physical activity required across the lifecourse to achieve general health benefits. It is aimed at the NHS, local authorities and a range of other organisations designing services to promote physical activity. The document is intended for professionals, practitioners and policymakers concerned with formulating and implementing policies and programmes that utilise the promotion of physical activity, sport, exercise and active travel to achieve health gains
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TL;DR: Key guidelines in the Physical Activity Guidelines for Americans, 2nd edition, provide information and guidance on the types and amounts of physical activity that provide substantial health benefits and emphasize that moving more and sitting less will benefit nearly everyone.
Abstract: Importance Approximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases. Objective To summarize key guidelines in thePhysical Activity Guidelines for Americans, 2nd edition (PAG). Process and Evidence Synthesis 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 the2018 Physical Activity Guidelines Advisory Committee Scientific Report. Recommendations The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial. Conclusions and Relevance ThePhysical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.
4,280 citations
01 Jan 2012
TL;DR: A review of physical activity interventions, published between 2000 and 2011, and identifi ed eff ective, promising, or emerging interventions from around the world are recommended in this paper, where the informational approaches of community-wide and mass media campaigns, and short physical activity messages targeting key community sites are recommended.
Abstract: Promotion of physical activity is a priority for health agencies. We searched for reviews of physical activity interventions, published between 2000 and 2011, and identifi ed eff ective, promising, or emerging interventions from around the world. The informational approaches of community-wide and mass media campaigns, and short physical activity messages targeting key community sites are recommended. Behavioural and social approaches are eff ective, introducing social support for physical activity within communities and worksites, and school-based strategies that encompass physical education, classroom activities, after-school sports, and active transport. Recommended environmental and policy approaches include creation and improvement of access to places for physical activity with informational outreach activities, community-scale and street-scale urban design and land use, active transport policy and practices, and community-wide policies and planning. Thus, many approaches lead to acceptable increases in physical activity among people of various ages, and from diff erent social groups, countries, and communities.
834 citations
TL;DR: Recommendations include creation and improvement of access to places for physical activity with informational outreach activities, community-scale and street-scale urban design and land use, active transport policy and practices, and community-wide policies and planning.
833 citations
TL;DR: Promotion of physical activity to sedentary adults recruited in primary care significantly increases physical activity levels at 12 months, as measured by self report, and there is insufficient evidence to recommend exercise referral schemes over advice or counselling interventions.
Abstract: Objectives To determine whether trials of physical activity promotion based in primary care show sustained effects on physical activity or fitness in sedentary adults, and whether exercise referral interventions are more effective than other interventions. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, CINAHL, PsycINFO, EMBASE, SPORTDiscus, Centre for Reviews and Dissemination, the Cochrane Library, and article reference lists. Review methods Review of randomised controlled trials of physical activity promotion in sedentary adults recruited in primary care, with minimum follow-up of 12 months, reporting physical activity or fitness (or both) as outcomes, and using intention to treat analyses. Two reviewers independently assessed studies for inclusion, appraised risk of bias, and extracted data. Pooled effect sizes were calculated using a random effects model. Results We included 15 trials (n=8745). Most interventions took place in primary care, included health professionals in delivery, and involved advice or counselling given face to face or by phone (or both) on multiple occasions. Only three trials investigated exercise referral. In 13 trials presenting self reported physical activity, we saw small to medium positive intervention effects at 12 months (odds ratio 1.42, 95% confidence interval 1.17 to 1.73; standardised mean difference 0.25, 0.11 to 0.38). The number needed to treat with an intervention for one additional sedentary adult to meet internationally recommended levels of activity at 12 months was 12 (7 to 33). In four trials reporting cardiorespiratory fitness, a medium positive effect at 12 months was non-significant (standardised mean difference 0.51, −0.18 to 1.20). Three trials of exercise referral found small non-significant effects on self reported physical activity at 12 months (odds ratio 1.38; 0.98 to 1.95; standardised mean difference 0.20, −0.21 to 0.61). Conclusions Promotion of physical activity to sedentary adults recruited in primary care significantly increases physical activity levels at 12 months, as measured by self report. We found insufficient evidence to recommend exercise referral schemes over advice or counselling interventions. Primary care commissioners should consider these findings while awaiting further trial evaluation of exercise referral schemes and other primary care interventions, with longer follow-up and use of objective measures of outcome.
583 citations
TL;DR: A unique aspect of JBS3 is the emphasis upon the lifetime risk of CVD events, so as to encompass a large pool of people in the population who have a lower 10-year risk of a CVD event but who nevertheless have a high lifetime event risk.
Abstract: In 1961, the publication of the findings of the Framingham study provided the National Institutes of Health (NIH), the USA, and the world at large with a huge return on the initial investment. Identification of the common risk factors fuelling the epidemic of cardiovascular disease (CVD) stimulated a ‘call to arms’ and the initiation of programmes to attack these targets on a national scale. This has led to stunning declines in CVD mortality over the last 40–50 years in North America, Western Europe and other high income countries. Nonetheless, this is not the time for complacency. CVD is by far and away the leading cause of deaths worldwide; the epidemic of CVD in the low and middle income countries is rampant and the alarming increases in obesity and diabetes threaten to reverse or blunt the steady decline in CVD mortality, particularly in younger people. The focus on prevention is as imperative now as it ever has been.
This is the 3rd iteration of the Joint British Societies ( JBS) recommendations for the prevention of cardiovascular disease. Current prevention strategies tend to focus upon patients at relatively short term (10-year) risks and upon specific thresholds for pharmacologic therapies, although there is considerable variability among the different guidelines. This approach is logical and has been successful in directing therapy to those at highest risk who stand to gain the greatest benefit.
A unique aspect of JBS3 is the emphasis upon the lifetime risk of CVD events, so as to encompass a large pool of people in the population who have a lower 10-year risk of a CVD event but who nevertheless have a high lifetime event risk. Such predominantly younger patients and women might be excluded from therapy based upon the ‘high risk strategy’, even though they have a high rate of …
527 citations