WHO Guidelines on Physical Activity and Sedentary Behaviour 2020: The Essentials

The World Health Organization (WHO) has recently released new ‘Guidelines on Physical Activity and Sedentary Behaviour’. This article will present the essential details of the guidelines.

Background information:

Aerobic physical activity: Activity in which the body’s large muscles move in a rhythmic manner for a sustained period of time. Aerobic activity –also called endurance activity – improves cardiorespiratory fitness.
Examples include walking, running, swimming, and bicycling.

Balance training: Static and dynamic exercises that are designed to improve an individual’s ability to withstand challenges from postural sway or destabilizing stimuli caused by self-motion, the environment, or other objects.

Bone-strengthening activity: Physical activity primarily designed to increase the strength of specific sites in bones that make up the skeletal system.
Bone-strengthening activities produce an impact or tension force on the bones that promotes bone growth and strength.
Running, jumping rope, and lifting weights are examples of bone-strengthening activities.

Exercise: A subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective. “Exercise” and “exercise training” frequently are used interchangeably and generally refer to physical activity performed during leisure time with the primary purpose of improving or maintaining physical fitness, physical performance, or health.

Executive Function: Includes constructs such as: working memory, cognitive flexibility (also called flexible thinking) and inhibitory control (which includes self-control).

Functional exercises: Exercises that can be embedded into everyday tasks to improve lower-body strength, balance, and motor performance.
Examples include tandem and one-leg stands, squatting, chair stands, toe raises, and stepping over obstacles.

Light-intensity physical activity: Light-intensity physical activity is between 1.5 and 3 METs, i.e. activities with energy cost less than 3 times the energy expenditure at rest for that person.
This can include slow walking, bathing, or other incidental activities that do not result in a substantial increase in heart rate or breathing rate.

Metabolic equivalent of task: The metabolic equivalent of task, or simply metabolic equivalent, is a physiological measure expressing the intensity of physical activities. One MET is the energy equivalent expended by an individual while seated at rest.

Moderate-intensity physical activity: On an absolute scale, moderate-intensity refers to the physical activity that is performed between 3 and less than 6 times the intensity of rest. On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually a 5 or 6 on a scale of 0–10.

Muscle-strengthening activity: Physical activity and exercise that increase skeletal muscle strength, power, endurance, and mass (e.g. strength training, resistance training, or muscular strength and endurance exercises).

Multicomponent physical activity: For older adults, multicomponent physical activity is important to improve physical function and decrease the risk of falls or injury from a fall. These activities can be done at home or in a structured group setting. Many studied interventions combine all types of exercise (aerobic, muscle strengthening, and balance training) into a session, and this has been shown to be effective. An example of a multicomponent physical activity programme could include walking (aerobic
activity), lifting weights (muscle strengthening), and incorporates balance training.

Examples of balance training can include walking backwards or sideways or standing on one foot while doing an upper body muscle-strengthening activity, such as bicep curls. Dancing also combines aerobic and balance components.

Physical activity: Any bodily movement produced by skeletal muscles that requires energy expenditure.

Physical inactivity: An insufficient physical activity level to meet present physical activity recommendations.

Recreational screen time: Time spent watching screens (television (TV), computer, mobile devices) for purposes other than those related to education/study or work.

Sedentary screen time: Time spent watching screen-based entertainment (TV, computer, mobile devices). Does not include active screen-based games where physical activity or movement is required.

Sedentary behaviour: Any waking behaviour characterized by an energy expenditure of 1.5 METS or lower while sitting, reclining, or lying.
Most desk-based office work, driving a car, and watching television are examples of sedentary behaviours; these can also apply to those unable to stand, such as wheelchair users.
The guidelines operationalize the definition of sedentary behaviour to include self-reported low movement sitting (leisure time, occupational, and total), television (TV viewing or screen time, and low levels of movement measured by devices that assess movement or posture).

Vigorous-intensity physical activity: On an absolute scale, vigorous-intensity refers to physical activity that is performed at 6.0 or more METS. On a scale relative to an individual’s personal capacity, vigorous-intensity physical activity is usually a 7 or 8 on a scale of 0–10.

Key Messages:

Up to 5 million deaths a year could be averted if the global population was more active. The new guidelines emphasize that everyone, of all ages and abilities, can be physically active and that every type of movement counts.

The new guidelines recommend at least 150 to 300 minutes of moderate to vigorous aerobic activity per week for all adults, including people living with chronic conditions or disability, and an average of 60 minutes per day for children and adolescents.

WHO statistics show that one in four adults, and four out of five adolescents, do not get enough physical activity.  Globally this is estimated to cost US$54 billion in direct health care and another US$14 billion to lost productivity.

The guidelines encourage women to maintain regular physical activity throughout pregnancy and post-delivery. They also highlight the valuable health benefits of physical activity for people living with disabilities.

Older adults (aged 65 years or older) are advised to add activities which emphasize balance and coordination, as well as muscle strengthening, to help prevent falls and improve health.

Regular physical activity is key to preventing and helping to manage

  • heart disease,
  • type-2 diabetes, and
  • cancer

It also

  • reduces symptoms of depression and anxiety,
  • reduces cognitive decline,
  • improves memory and boosts brain health.

The new guidelines provide recommendations for some categories of individuals not explicitly covered in the previous guidelines:

  • Pregnant and postpartum women
  • Children with disability
  • Adults with disability

The new guidelines also cover sedentary behaviour (missing from the previous guideline) and mention how additional benefits may be accrued by adults.

Across all ages one must limit the amount of time spent being sedentary and replace it with more physical activity of any intensity (including low-intensity physical activity).


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