Updated Exercise Guidelines

By now, almost everyone is aware that regular physical activity offers a number of health benefits including:

• Delaying death from all causes
  
  
• Decreasing the risk of developing coronary heart disease, heart attack, and stroke
  
  
• Lessening the likelihood of developing type 2 diabetes
  
  
• Reducing the risk of certain cancers including breast and colon cancer
  
  
• Improving blood pressure control in hypertensive individuals
  
  
• Preserving bone mass and reducing the risk of developing osteoporosis
  
  
• Improving mood in mild-to-moderate depression
  
  
• Lowering the risk of cognitive decline and dementia

What is not clear to many people is the amount and type of exercise necessary to achieve these benefits. Since 1998, the American College of Sports Medicine (ACSM) has periodically issued exercise guidelines geared toward the average individual who is interested in improving their physical fitness and health. Their latest position statement, issued in 2012, provides evidence-based guidance to health and fitness professionals to help with the development of individualized exercise prescriptions for healthy adults of all ages. Let's look at those recommendations and see if you are getting the appropriate types and amount of exercise as defined by the ACSM. The ACSM recommendations, categorized to the major types of fitness---cardiorespiratory, strength training, flexibility, and neuromotor exercise training, are as follows:

1. Cardiorespiratory Exercise, also known as "aerobic" or "cardio" exercise, utilizes major muscles such as those in the arms and legs walking while increasing heart and respiratory rate. Examples of this type of exercise include jogging, aerobic dancing, rowing and bicycling. The ACSM advises that adults should get at least 150 minutes of moderate-intensity cardiorespiratory exercise each week. One way of reaching this goal would be to perform 30 minutes (or more) of moderate-intensity exercise on 5 days during the week. Alternatively, the goal could be reached with multiple shorter sessions of at least 10 minutes during the week.
   
   
2. Resistance Exercise or "weight training" is defined as exercise that causes the muscles to contract against an external resistance with the expectation of increasing strength, tone, mass, and/or endurance. Many people see this as "pumping iron", with heavy weights, but actually lifting, pushing, or pulling against resistance at higher repetitions (10-20) with lower weights is best for most people. The ACSM recommends that adults train each major muscle group two or three days each week. The use of free weights, dumbbells, weight machines, and resistance bands are all appropriate ways of reaching this goal. It is advised that adults wait at least 48 hours between resistance training sessions.
   
   
3. Flexibility Exercises or "stretching exercises" are designed to improve range of motion in the back and joints. The ACSM advises performing flexibility exercises at least two or three days each week. A description of some of the most important stretching exercises can be found here. It is advised that each stretch should be held for 10-30 seconds to the point of tightness and repeated four times. Flexibility exercises should be done at least two or three days each week. In general, flexibility exercises are most effective when the muscle is warmed up following a hot bath or light aerobic activity.
   
   
4. Neuromotor Exercise is a new addition to the regular ACSM exercise guidelines. Neuromotor exercise is sometimes called "functional fitness training" and incorporates motor skills such as balance, coordination, gait, and agility, and proprioceptive training. Examples of this type of exercise include yoga and tai chi, the ancient Chinese exercise that involves a series of movements performed in a slow, focused manner. Neuromotor exercise is particularly beneficial for older individuals to help prevent falls. The ACSM recommends that this type of exercise be performed for 20-30 minutes, two or three days per week.

It is important that any new exercise program, particularly in those over the age of 50 or with chronic medical problems, be initiated after receiving clearance from your doctor. In some cases, as with resistance training and neuromotor exercise, it may be best to consult a qualified trainer or physical therapist to assure that the exercises are being performed safely and effectively. The ACSM stresses that if these levels of activity cannot be reached there are still health benefits that can be gained from lower amounts of exercise. Go here to read the full report from the ACSM.