The 2018 Physical Activity Guidelines for Americans
Marc Hochberg, MD, MPH, MACP, President, USBJI
As we approach the end of 2018 and look forward to beginning the New Year of 2019, we need to be reminded of and reaffirm our commitment to maintaining an adequate amount of physical activity. I had the opportunity to review the “2018 Physical Activity Guidelines Advisory Committee Scientific Report” for a presentation as part of a symposium entitled “Osteoarthritis as an Inflammatory Disease and its Modification by Physical Activity” at the 2018 annual meeting of the American College of Sports Medicine in May 2018. More recently, Drs. Piercy and colleagues published a “Special Communication” in the Journal of the American Medical Association entitled “The Physical Activity Guidelines for Americans” that informed the topic for this message.
Abundant scientific evidence supports the role of physical activity as a highly cost-effective method for both disease prevention and health promotion as well as treatment of selected chronic musculoskeletal conditions. As noted in the report, physical activity improves physical function among individuals of all ages, particularly middle-aged and older adults who suffer from musculoskeletal conditions. Physical activity reduces the severity of pain and improves physical performance and self-reported physical function in adults with lower limb osteoarthritis and is strongly recommended by all professional societies as part of the nonsurgical management of hip and knee osteoarthritis. Physical activity reduces the risk of falls and fall-related injuries which is important for older adults with low bone mineral density and osteoporosis as most fractures occur as the result of a fall.
How much physical activity is needed to achieve these benefits? The Guidelines Advisory Committee recommends 150 to 300 minutes per week of moderate intensity activity. The majority of the American population, however, either is sedentary (reports no moderate-to-vigorous physical activity) or reports only a light intensity level of activity. The Committee recommended that the sedentary individuals should take up light intensity physical activity while those who currently perform only light intensity activities should gradually add moderate intensity activities to their regimens.
What types of activities should be considered? Examples of light-intensity and moderate-intensity activities include walking at a slow or leisurely pace (2 miles per hour or less) and walking briskly or at a fast pace (more than 2 miles per hour), respectively. Walking very fast (more than 4 miles per hour), running, participating in an aerobics class and shoveling snow or mowing grass by hand are considered vigorous activities. Obviously, before sedentary older adults begin a supervised exercise program, they should be evaluated by a health care professional to determine their safety for exercise.
The USBJI recommends that our Member societies encourage their members to educate the public on this topic and that you personally incorporate physical activity into your daily routine in 2019 not only for maintaining your musculoskeletal health but also for the benefits in reducing the risk of cardiovascular disease and type 2 diabetes mellitus and improving brain health. This is one of the more important resolutions you can make for the New Year.