Sports Medicine

, Volume 22, Issue 1, pp 1–7 | Cite as

Lifestyle Activity

Current Recommendations
  • Wayne T. Phillips
  • Leslie A. Pruitt
  • Abby C. King
Current Opinion


An accumulation of international scientific evidence indicates that physical inactivity is detrimental to health and that moderate levels of physical activity confer significant health benefits. Unfortunately, in countries where major surveys of physical activity have been conducted, the prevalence of sedentary behaviour has been found to be as high as 40%. In the US, where approximately 30% of adults report little or no physical activity, the Centers for Disease Control and the American College of Sports Medicine recently issued guidelines and recommendations on the amount and frequency of moderate levels of physical activity necessary to elicit health benefits in predominantly sedentary adults. These guidelines utilise a physical activity-health paradigm and, uniquely, recommend the potential effectiveness of activities of daily living or ‘lifestyle activity’ for achieving health benefits. This article briefly reviews the rationale behind these guidelines and, in view of the historical association of the exercise training-fitness model to health, highlights some challenges and potential problems in applying these new guidelines to the general population.


  1. 1.
    Morris JN, Heady JA, Raffle PAB, et al. Coronary heart disease and physical activity of work. Lancet 1953; II: 1053–7CrossRefGoogle Scholar
  2. 2.
    Morris JN, Kagan A, Pattison DC, et al. Incidence and prediction of ischaemic heart disease in London busmen. Lancet 1966; II: 552–9Google Scholar
  3. 3.
    Morris JN, Clayton DG, Everitt MG, et al. Exercise in leisure time: coronary heart attack and death rates. Br Heart J 1990; 63: 325–34PubMedCrossRefGoogle Scholar
  4. 4.
    Paffenbarger RS, Hyde RT, Wing AL, et al. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986; 314: 605–13PubMedCrossRefGoogle Scholar
  5. 5.
    Powell KE, Thompson PD, Caspersen CJ, et al. Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987; 8: 253–87PubMedCrossRefGoogle Scholar
  6. 6.
    King AC, Taylor CB, Haskell WL, et al. Influence of regular exercise on psychological health. Health Psychol 1989; 8: 305–24PubMedCrossRefGoogle Scholar
  7. 7.
    Dishman RK. Psychological effects of exercise for disease resistance and health promotion. In: Watson RR, Eisinher M, editors. Exercise and disease. Boca Raton (FL): CRC Press, 1992: 179–207Google Scholar
  8. 8.
    Drinkwater BL. Physical activity, fitness and osteoporosis. In: Bouchard C, Shephard RJ, Stephens T, editors. Physical activity, fitness, and health. International Proceedings and Consensus Statement. Champaign (IL): Human Kinetics Publishers, 1994: 724–36Google Scholar
  9. 9.
    Hagberg JM. Exercise, fitness, and hypertension. In: Bouchard C, Shephard RJ, Stevens T, et al., editors. Exercise, fitness and health. Champaign (IL): Human Kinetics Publishers, 1990: 455–566Google Scholar
  10. 10.
    Lie H, Mundal R, Eriksson J. Coronary risk factors and incidence of coronary health in relation to physical fitness: seven-year follow-up of middle-aged and elderly men. Eur Heart J 1985; 6: 147–57PubMedGoogle Scholar
  11. 11.
    Scragg R, Stewart A, Jackson R, et al. Alcohol and exercise in myocardial infarction and sudden coronary death in men and women. Am J Epidemiol 1987; 126: 77–85PubMedGoogle Scholar
  12. 12.
    McGinnis JM, Foege WH. Actual cause of death in the United States. JAMA 1993; 270: 2207–12PubMedCrossRefGoogle Scholar
  13. 13.
    Hahn RA, Teutsch SM, Rothenberg RB, et al. Excess deaths from nine chronic diseases in the United States. JAMA 1986; 264: 2654–9CrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control and Prevention. Prevalence of sedentary lifestyle — behavioral risk factor surveillance system, United States, 1991. MMWR Morb Mortal Wkly Rep 1991; 42: 576–9Google Scholar
  15. 15.
    Stephens T, Thomas CJ. The demography of physical activity. In: Bouchard C, Shephard RJ, Stephens T, editors. Physical activity, fitness and health. International Proceedings and Consensus Statement. Champaign (IL): Human Kinetics Publishers, 1994: 204–13Google Scholar
  16. 16.
    Risk Factor Prevalence Study Management Committee. Risk Factor Prevalence Study. Canberra: National Heart Foundation of Australia and Australian Institute of Health, 1990Google Scholar
  17. 17.
    Stephens T, Craig CL. The well-being of Canadians: highlights of the 1988 Cambells Survey. Ottawa: Canadian Fitness and Lifestyle Research Institute, 1990Google Scholar
  18. 18.
    Allied Dunbar National Fitness Survey. Main findings. Activity and health research. London: The Sports Council and the Health Education Authority, 1992Google Scholar
  19. 19.
    American College of Sports Medicine. The recommended quality and quantity of exercise for developing and maintaining fitness in healthy adults. Med Sci Sports Exerc 1990; 22: 265–74Google Scholar
  20. 20.
    Puska P, Berg M-A, Peltoniemi J. Health behaviour among Finnish adult population. Helsinki: National Public Health Institute, Department of Epidemiology and Health Promotion, 1993Google Scholar
  21. 21.
    Casperson CJ, Merritt RK. Trends in physical activity patterns among older adults: the behavioural risk factor surveillance system, 1986–1992; 24: S26Google Scholar
  22. 22.
    Merritt RK, Casperson CJ. Trends in physical activity patterns among young adults: the behavioural risk factor surveillance system [abstract]. Med Sci Sports Exerc 1992; 24: S26Google Scholar
  23. 23.
    United States Department of Health and Human Services. Healthy People 2000: National health promotion and disease prevention objectives. Washington, DC: Public Health Service, 1991Google Scholar
  24. 24.
    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and the American College of Sports Medicine. JAMA 1995; 273: 402–7PubMedCrossRefGoogle Scholar
  25. 25.
    American College of Sports Medicine. The recommended quantity and quality of exercise for developing and maintaining fitness in healthy adults. Med Sci Sports Exerc 1978; 10: vii–xGoogle Scholar
  26. 26.
    Haskell WL. Health consequences of physical activity: understanding and challenges regarding dose-response. Med Sci Sports Exer 1994; 26: 649–60CrossRefGoogle Scholar
  27. 27.
    Blair SN, Kohl HW, Paffenbarger RS, et al. Physical fitness and all-cause mortality. JAMA 1989; 262: 2395–401PubMedCrossRefGoogle Scholar
  28. 28.
    Leon AS, Cornett J, Jacobs DR, et al. Leisure-time physical activity levels and risk of coronary heart disease and death: the Multiple Risk Factor Intervention Trial. JAMA 1987; 258: 2388–95PubMedCrossRefGoogle Scholar
  29. 29.
    Shapiro S, Weinblatt E, Frank CW, et al. Incidence of coronary heart disease in a population insured for medical care (hip). Am J Public Health 1969; 59 Suppl.: 1Google Scholar
  30. 30.
    Nelson L, Jennings GL, Elser MD, et al. Effects of changing levels of physical activity on blood pressure and hemodynamics in essential hypertension. Lancet 1986; 8505: 473–6CrossRefGoogle Scholar
  31. 31.
    Jennings G, Nelson L, Nestel P, et al. The effect of changes in physical activity on major cardiovascular risk factors, hemodynamics, sympathetic function, and glucose utilization in man: a controlled study of four levels of activity. Circulation 1986; 73: 30–40PubMedCrossRefGoogle Scholar
  32. 32.
    Duncan JJ, Gordon NF, Scott CB. Women walking for health and fitness. How much is enough? JAMA 1991; 266: 3295–9PubMedCrossRefGoogle Scholar
  33. 33.
    DeBusk RF, Stenestrand U, Sheehan M, et al. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol 1990; 65: 1010–3PubMedCrossRefGoogle Scholar
  34. 34.
    Paffenbarger RS, Hyde RT, Wing AL, et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328: 538–45PubMedCrossRefGoogle Scholar
  35. 35.
    Ebisu T. Splitting the distance of endurance running: on cardiovascular endurance and blood lipids. Jpn J Phys Educ 1985; 30: 37–43Google Scholar
  36. 36.
    National Institute of Health. Physical activity and cardiovascular health. Consensus Development Conference; 1995 Dec 18–20; BethesdaGoogle Scholar
  37. 37.
    Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1992; 25: 71–80Google Scholar
  38. 38.
    Dishman RK. Determinants of participation in activity. In: Bouchard C, Shephard RJ, Stephens T, et al., editors. Exercise, fitness, and health: a consensus of current knowledge. Champaign (IL): Human Kinetics Publishers, 1990; 93: 75–101Google Scholar
  39. 39.
    Haskell WL, Phillips WT. Exercise training fitness health and longevity. In: Gisolfi C, Lamb D, Nadel E, editors. Exercise in older adults. Perspectives in exercise science and sports medicine. Vol. 8. Carmel (IN): Cooper Publishing Group, 1995: 11–47Google Scholar
  40. 40.
    Phillips WT, Haskell WL. ‘Muscular fitness’ — easing the burden of disability in elderly adults. J Aging Phys Activ 1995; 3: 261–89Google Scholar
  41. 41.
    Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. JAMA 1995; 273: 1341–7PubMedCrossRefGoogle Scholar
  42. 42.
    King AC. Community intervention for promotion of physical activity and fitness. In: Holloszy JO, editor. Exercise and sports science reviews. Vol. 19. Baltimore (MD): Williams and Wilkins, 1991: 211–59Google Scholar
  43. 43.
    McGinnis MJ, Lee PR. Healthy People 2000 at mid decade. JAMA 1995; 273: 1123–9PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1996

Authors and Affiliations

  • Wayne T. Phillips
    • 1
  • Leslie A. Pruitt
    • 1
  • Abby C. King
    • 1
    • 2
  1. 1.Stanford Center for Research in Disease Prevention, School of MedicineStanford UniversityStanfordUSA
  2. 2.Division of Epidemiology, Department of Health Research and PolicyStanford UniversityStanfordUSA

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