Mid-Pandemic, WHO Urges More Physical Activity in New Guidelines - Medscape

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New World Health Organization (WHO) guidelines say more moderate to vigorous physical activity is needed to offset the harms of sedentary behavior, exceeding targets set in previous recommendations.

The 2020 WHO guidelines now specify that adults aim for 2.5 to 5 hours of moderate intensity and 1 hour 15 minutes to 2.5 hours of vigorous intensity physical activity a week. For children and adolescents, at least 1 hour/day of moderate to vigorous physical activity is now advised.

These recommendations exceed those made in 2010 for adults to achieve at least 2.5 hours of moderate intensity or at least 1 hour 15 minutes of vigorous intensity activity per week.

"These guidelines are very timely, given that we are in the middle of a global pandemic which has confined people indoors for long periods and encouraged an increase in sedentary behavior," one of the guideline authors, Emmanuel Stamatakis, PhD, associate professor of exercise, health, and physical activity, University of Sydney in Australia, said in a statement.

Nevertheless, "people can still protect their health and offset the harmful effects of physical inactivity," he added.

"As these guidelines emphasize, all physical activity counts and any amount of it is better than none," he stressed.

The guidelines are part of a dedicated issue of the British Journal of Sports Medicine.

Key Changes

Among the key changes for adults in the new 2020 guidelines is the removal of a previous stipulation that physical activity be accumulated in at least 10 minute bouts.

"This change reflects the accumulated evidence...which shows physical activity of any...duration is associated with improved health outcomes, including all-cause mortality," the authors emphasize.

The new recommendations also stress the need for adults to engage in muscle-strengthening activities such as weights on 2 or more days of the week. And older adults need to undertake activities that improve balance and strength, to enhance functional capacity and prevent falls.

And for the first time, WHO recommends pregnant women engage in regular physical activity throughout pregnancy and following birth and that even gentle stretching may be beneficial.

Another key change is for children and adolescents to get at least 60 minutes/day of moderate to vigorous physical activity rather than to simply "accumulate" 60 minutes of physical activity daily, as was previously recommended.

In addition, the guidelines now recommend people of all ages and abilities reduce time spent in sedentary behaviors and use that time for any physical activity of any intensity.

Increase Physical Activity to Offset Long Sedentary Periods

As such, one study included in the dedicated journal issue, by Ulf Ekelund, PhD, Norwegian School of Sport Sciences, Oslo, and colleagues, shows that those who clock up long hours sitting every day can in fact counter the risks by increasing physical activity.

Their meta-analysis included 44,370 men and women (mean age, 65.8 years) who were followed for 4 to 14.5 years, during which 7.8% of the cohort died. Associations between different combinations of moderate to vigorous intensity physical activity and sedentary time were analyzed, with average sedentary time ranging from 8.5 to 10.5 hours/day, and moderate to vigorous intensity physical activity varying between 8 to 35 minutes/day.

While a high daily tally of sedentary time (10 hours/day or more) was linked to a significantly increased risk of death — particularly among people who were physically inactive — just 30 to 40 minutes/day of moderate to vigorous intensity physical activity substantially lowered this risk, bringing it down to levels associated with very low amounts of sedentary time, the researchers emphasize.

"It is more difficult to be physically active during a lockdown or partial lockdown," Ekelund told Medscape Medical News, "and higher amounts of sedentary time is also likely an effect of the pandemic in those working from home."

So it's imperative to take every opportunity to be physically active by doing home exercises and safe outdoor activities.

"People need to schedule regular activity breaks every hour if they have a sedentary occupation — do some short workouts — and take every opportunity to be active, like using the stairs rather than the lift, going out for a walk, and any other activity they might like," he said.

The authors have reported no relevant financial relationships.

Br J Sports Med. 2020;54:1451-1462. Full text

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