The World Health Organisation (WHO) has been under criticised in the media for their 150 minutes plus per week of moderate intensity exercise recommendation. As this has come up with numerous clients within our practice I thought this to be a perfect time to discuss what we need to know and what we should be doing.
What are the WHO guidelines:
1. Adults aged 18–64 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.
What is the debate?
A Queensland study has reported to have found that these WHO guidelines are 5 times less than what they are required to be to provide resistance against health conditions such as heart disease, stroke, diabetes and cancer. This study (that I have been unable to locate – possibly not having been published) has announced examples of volumes of exercise, they are as follows through an ABC report;
1. Walk briskly for 15-20 hours per week
2. Run between six and eight hours per week
3. Ride for seven hours per week
4. Swim for eight hours per week
However, another article in Science Daily magazine has quoted Darren E.R. Warburton, PhD, and Shannon S. Bredin, PhD. as saying “There is compelling evidence that health benefits can be accrued at a lower volume and/or intensity of physical activity”, in regards to both clinical and healthy populations. In January 2015 the UK’s Telegraph newspaper printed a story with the headline, “Don't worry - 20 minutes exercise a week is enough, say experts”.
What is the truth? All of it comes from legitimate research but we need to contextualise it. The 150 minutes of exercise per week has been used as an intervention for countless studies and health reviews. The 150 minutes compared to a lesser volume of exercise and inactivity have been shown to have benefits in type 2 diabetes management, metabolic syndrome[6, 7], weight maintenance and so much more. Why are we arguing with that then? Ask yourself – can I achieve these revised guidelines? A study published in 2011 suggested less than 10% of the US population actually achieves the physical activity guideline recommendations as they are currently. Maybe we should be promoting the benefits of exercise and movement and then work on framework to increase adherence and volume/intensity of exercise. Don’t get me wrong, I’m all for the realisation we need to exercise more, and more effectively but let’s be realistic – the creation of more barriers to exercise is not helping anyone.
The debate continues... What should we be doing? Am I wasting my time by only exercising 150 minutes a week? No, you’re not. You are going to reap the health benefits. There is plenty of research to suggest you will gain significant health benefits even if you only achieve the guidelines. In fact, if you are currently not exercising or only to a small degree there is a high chance if you start doing even 150 min per week, you won’t sustain it. Behaviour change and creating healthy sustainable exercise habits is the key.
So what do I do? Start with small, achievable goals. Perhaps it’s making 30 minutes of time every second day for structured exercise. Structured being, its time for you to commit to something that isn’t just walking to the train station (albeit a great addition). Walk to the park and do some stretches, checkout a YouTube workout video (there are plenty) and do it in your living room – whatever it is, just make the time. From whatever you start with, add small weekly goals building upon that. You will get benefits from less than 150 minutes but you can build up to higher volumes and intensities with time, hey, it may even lead to you enjoying it more. For weight loss, 300 minutes per week has been shown to be more effective but once again long term effectiveness is low if it isn’t habitual.
The take home message is to move. Enjoy it, do it, make time for it and understand it isn’t an optional extra in life – more of it is better! If you need more information call one of our Exercise Physiologists at The Biomechanics in Melbourne - they will tailor what you need to know for your specific goals and or health concerns.
1. Global Strategy on Diet, Physical Activity and Health. 201614/8/2016]; Available from: http://www.who.int/dietphysicalactivity/factsheet_adults/en/.
2. Horn, A. WHO guidelines on hours of exercise needed to stay healthy are way off, Queensland study finds. 201614/8/2016]; Available from: http://www.abc.net.au/news/2016-08-10/australians-need-to-do-five-times-the-exercise-who-recommend/7711562.
3. Knapton, S. Don't worry - 20 minutes exercise a week is enough, say experts. 201514/8/2016]; Available from: http://www.telegraph.co.uk/news/science/science-news/11360617/NHS-weekly-exercise-guidelines-are-too-demanding-say-health-experts.html.
4. Warburton, D.E., C.W. Nicol, and S.S. Bredin, Health benefits of physical activity: the evidence. CMAJ, 2006. 174(6): p. 801-9.
5. Umpierre, D., et al., Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA, 2011. 305(17): p. 1790-9.
6. Ilanne-Parikka, P., et al., Leisure-time physical activity and the metabolic syndrome in the Finnish diabetes prevention study. Diabetes Care, 2010. 33(7): p. 1610-7.
7. Yamaoka, K. and T. Tango, Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis. BMC Med, 2012. 10: p. 138.
8. Donnelly, J.E., et al., The role of exercise for weight loss and maintenance. Best Pract Res Clin Gastroenterol, 2004. 18(6): p. 1009-29.
9. Tucker, J.M., G.J. Welk, and N.K. Beyler, Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. Am J Prev Med, 2011. 40(4): p. 454-61.