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Boost strength and balance, says new exercise guidance

UK chief medical officers issue new physical activity guidelines across the life course

Caroline White

Monday, 09 September 2019

Adults should undertake strength-based exercise at least two days of the week, to build their strength and balance, recommends new physical activity guidance across the life course from the UK’s chief medical officers.

This can help delay the natural decline in muscle mass and bone density that starts from around the age of 50 ─ thought to be a major reason why older people lose their ability to carry out daily tasks.


And falls, the main reason older people are taken to A&E, could be avoided through daily activities such as brisk walking, carrying heavy shopping, climbing stairs, swimming and gardening, says the guidance.  

There is strong evidence that physical activity can stave off a range of chronic conditions. Meeting the guideline recommendations could cut the risk of type 2 diabetes by 40%, coronary heart disease by 35%, and depression by 30%.


The new guidelines update those released in 2011, but the overall message remains the same: any activity is better than none, and more is better still.

Each week, adults should accumulate at least 150 minutes (two 1/2 hours) of moderate intensity activity, such as brisk walking or cycling; or 75 minutes of vigorous intensity activity, such as running; or even shorter durations of very vigorous intensity activity, such as sprinting or stair climbing; or a combination of moderate, vigorous and very vigorous intensity activity, says the guidance.

Adults should aim to minimise the amount of time spent being sedentary, and when physically possible should break up long periods of inactivity with at least light physical activity.

Older adults should maintain or improve their physical function by undertaking activities aimed at improving or maintaining muscle strength, balance and flexibility on at least two days a week, says the guidance.

These could be combined with sessions involving moderate aerobic activity or could be additional sessions aimed specifically at these components of fitness. And they should break up periods of inactivity where possible by standing.

The guidance advises for the first time on safe levels of activity for pregnant women and new mothers. A moderate amount of exercise for new mothers can help them regain strength; ease back pain; reduce the risk of gestational diabetes.

And it recognises an emerging evidence base for the health benefits of very vigorous intensity activity performed in short bouts interspersed with periods of rest or recovery (high intensity interval exercise, or HIIT).

In children and young people, regular physical activity is associated with improved learning and attainment, better mental health and cardiovascular fitness, and helping to maintain a healthy weight.

The guidance recommends as much active play as possible in the under 5s, and older children are recommended to be active for an average of 60 minutes a day across the week.


Chief medical officer for England, Professor Dame Sally Davies, said: “Physical activity is an under-appreciated asset in our clinical arsenal. It is cheap and brings a long list of health benefits.

“As we age, our muscles weaken and we can become stiff, leading to falls and difficulty performing everyday activities. Physical activity can prevent fragility and support mobility in old age. By keeping active, both throughout the day and also through hobbies, we can slow muscle and bone decline, ultimately keeping us independent for longer.”

Scotland’s chief medical officer Dr Catherine Calderwood said: “Since 2011, the evidence on the benefits of physical activity for our health has become even more compelling. Much of the guidance has been retained, but there is now greater flexibility in how these goals can be achieved.”

She added: “Our environment can make it difficult to be healthy, and our health is being damaged by inactivity. But the good news is that even small changes can make a big difference over time. Any amount of physical activity is beneficial.”

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