Recently, the US federal government used tax dollars to structure a much publicized bail-out of the financial and banking industries worth approximately $700 billion, but did you realize that the federal government provided the fitness industry with a massive shot in the arm as well? It did. On October 7, 2008 the Department of Health and Human Services released the new 2008 Physical Activity Guidelines for Americans (available at www.fitness.gov) in order to establish recommendations on how much physical activity Americans should be doing in order to enhance their health and reduce the risk of a variety of diseases.
“It’s important for all Americans to be active, and the Guidelines are a roadmap to include physical activity (PA) in their daily routine. The evidence is clear—regular PA over months and years produces long term health benefits and reduces the risk of many diseases. The more physically active you are, the more health benefits you gain,” said the Secretary of the Department of Health and Human Services (HHS) Mike Leavitt. The new Guidelines are the most comprehensive of their kind and were developed by a 13 member advisory committee convened to analyze the current scientific literature regarding the health benefits of regular exercise. The Guidelines are the first thorough review of scientific research on PA and health in more than a decade and are meant as an update for the Surgeon General’s Report on Physical Activity and Health released during President Bill Clinton’s administration in 1996.
The primary purpose of the Guidelines is to provide a source of information for government officials responsible for developing health policy. The secondary purpose is to establish a framework for how physical educators and health providers can inform the public on the amount, types and intensity of PA to perform in order to achieve health benefits. The Guidelines provide an extensive review of the benefits of regular PA and make recommendations for achieving certain levels of PA but do little to explain exactly how a person can structure an exercise program to achieve those benefits. The Guidelines include a few case studies of how the average person can include daily activity into his lifestyle but fail to go into specific details of how to structure a progressive exercise program to provide results. This omission presents a major opportunity for fitness professionals to work with the public in order to develop structured exercise programs that can provide the health benefits identified by the Guidelines.
The Guidelines define exercise as “a planned form of physical activity that is structured and repetitive with the goal of improving health and fitness.” According to Secretary Leavitt, “Sedentary behavior contributes to a host of chronic diseases, and regular PA is a component of an overall healthy lifestyle. Physically active people are at lower risk of developing many disabling medical conditions than inactive people.” The Guidelines represent a major policy shift for the government because they recognize and promote regular exercise as a preventative measure for reducing the risk of early death from diseases such as coronary artery disease (CAD), stroke, high blood pressure, type 2 diabetes, some forms of cancer and depression.
The federal National Institutes of Health (NIH) and Center for Disease Control (CDC) have long recognized PA as a component of a healthy lifestyle, but federal health policy as reflected in programs such as Medicare and Medicaid has been focused on reactive health care through treatment of disease with medicine. The Guidelines confirm what many fitness professionals have known for years: regular PA over the long term produces numerous health benefits that can actually prevent many diseases. The Guidelines provide scientifically based guidance on requisite levels of PA for Americans to achieve the defined health benefits and emphasize the fact that realizing these benefits requires regularly scheduled PA almost every day. These new Guidelines are a huge benefit for the fitness industry in general and fitness professionals in particular because we have the skill sets to help Americans develop the healthy lifestyle habits to reap the rewards of improved health through regularly scheduled PA. The exciting part of the Guidelines is their attempt to encourage baseline activities to help build a culture where PA is the social norm and not just a hobby for a small percentage of the population.
Think of it this way: there are approximately 230 million Americans. Of this number, only about 15 percent of American adults belong to a health club, according to the International Health and Racquet Sportsclub Association (IHRSA). If the average health club has approximately five percent of members currently participating in personal training or other fee-based fitness programming, then think of the exponential growth of potential clients who will need the expertise of fitness professionals if PA becomes the rule instead of the exception. This is why the financial services industry is not the only sector of the American economy to recently get business financial support from the federal government. If public health officials begin using the Guidelines to aggressively promote PA, then fitness professionals benefit because Americans will look to you for advice on how to safely begin and follow an exercise program.
The Guidelines define three categories of PA: aerobic, muscle strengthening and bone strengthening. The Guidelines strongly urge Americans to avoid inactive and sedentary lifestyles and set a minimum baseline of 150 minutes per week of moderate intensity aerobic activity OR 75 minutes per week of vigorous intensity aerobic activity, performed in episodes of at least 10 minutes in length. For more extensive benefits, the Guidelines recommend increasing aerobic activity to 300 minutes per week of moderate intensity OR 150 minutes per week of vigorous intensity or a combination of the two levels. The Guidelines identify six separate groups of Americans who can benefit from regular PA and make specific recommendations for optimal levels for each category: Children and Adolescents, Adults, Older Adults, Women during Pregnancy, Adults with Disabilities and People with Chronic Medical Conditions. The key Guidelines by group are:
Children and Adolescents – One hour or more of moderate or vigorous intensity aerobic PA a day, including vigorous intensity activity at least three days a week. These include hiking, team sports like soccer or basketball, bike riding or walking. The Guidelines suggest that Children and Adolescents should incorporate muscle strengthening activities three days a week and identify appropriate activities such as rope climbing, sit ups or tug-of-war. In order to receive specific benefits related to bone strengthening Children and Adolescents should participate in activities such as jumping rope, running and skipping.
Adults — Aerobic Exercise: Adults gain substantial health benefits from two and a half hours a week of moderate intensity aerobic PA or one hour and 15 minutes of vigorous PA every week. Recommended modes for moderate activities include walking, water aerobics and general gardening, while recommended activities for vigorous activity are jogging/running, swimming laps or hiking uphill. The Guidelines make the recommendation that for more extensive health benefits, adults should increase their activity to five hours a week of moderate intensity or two and a half hours a week of vigorous intensity. Muscle Strengthening: To improve muscular strength, adults should participate in activities such as weight training, push ups, sit ups or heavy gardening at least two days a week.
Older Adults – This category of Americans should follow the guidelines for other adults when it is within their physical capacity. If a chronic condition prohibits their ability to follow those guidelines, they should be as physically active as their abilities allow. If they are at risk of falling, they should also do exercises that maintain or improve balance.
Pregnant Women – Healthy women should get at least two and a half hours of moderate intensity aerobic activity a week during pregnancy and the time after delivery, preferably spread out over the course of the week. Pregnant women who habitually engage in vigorous aerobic activity or who are highly active can continue during pregnancy and the time after delivery, provided they remain healthy and discuss with their health care provider how and when activity should be adjusted over time.
Adults with Disabilities – Those who are able should get at least two and a half hours of moderate aerobic activity a week or one hour and 15 minutes of vigorous aerobic activity a week. They should incorporate muscle strengthening activities involving all major muscle groups two or more days a week. When they are not able to meet the Guidelines, they should engage in regular PA according to their abilities and should avoid inactivity.
People with Chronic Medical Conditions – Adults with chronic conditions get important health benefits from regular PA. They should do so with the guidance of their health care provider.
For all Americans, the Guidelines classify the recommended amounts of weekly activity into four categories.
*Be aware of and pay attention to the overtraining effect for clients who exercise at this level.
|Levels of Physical Activity
||Range of Moderate-Intensity Minutes per Week
||Summary of Overall Health Benefits
||No activity beyond baseline
||Being inactive is unhealthy.
||Activity beyond baseline but fewer than 150 minutes/week
||Low levels of activity are clearly preferable to an inactive lifestyle.
||150-300 minutes a week
||Activity at the high end of this range has additional and more extensive health benefits than activity at the low end.
||Current science does not allow researchers to identify an upper limit of activity, above which there are no additional health benefits.
In order to achieve the defined health benefits, the Guidelines recognize the need for the proper overload, progression and specificity of the activities chosen for exercise. This becomes the real opportunity for fitness professionals because we have the education and training regarding how to safely and successfully apply these principles of exercise program design. The Guidelines discuss general ideas for promoting the recommended levels of PA to Americans but stop short of proving specific strategies. This is where we need to rise to the occasion and become partners with the federal government in promoting regular exercise to meet the recommended baselines.
Soon we will have the New Year’s Resolution crowd entering our facilities. This will be our chance to establish ourselves as professionals with the ability to help address public health through exercise. In the October 15 debate against Senator Obama, who sets an example himself by taking the time during his campaign to exercise every day, Senator John McCain made a specific reference to health clubs as part of his preventative health care policy. This has huge implications for our industry. Over the past two years, I have attended the IHRSA Legislative Conference in Washington, DC and can tell you that the time is coming when our national health policy will recognize our industry as a key component of health care. The Guidelines are the first step in this direction.
EDITOR'S NOTE: From 2005-2006, the author was the NSCA State Director for Washington, DC and prior to becoming a certified fitness professional, he worked for a US Senator and in non-governmental organizations on issues such as transportation and public health policy.