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The elements of the National Physical Activity Guidelines. History.
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History • Prior to 1990, the focus of activity promotion was to improve the cardio-vascular functions of the body. The recommended levels of activity were for people to engage in vigorous activity (heart rate levels of between 60 – 90% or O2 uptake of between 50 – 85%) three to five days a week for a duration of 15 – 60 minutes per session. • Australia revised these guidelines and recommended vigorous or aerobic exercise for a minimum duration of 20 minutes at least 3 time a week.
History • By 1996, research studies showed a very small proportion of people were meeting the fitness based guidelines, and the focus switched to potential health gains through participation in regular physical activities of a less intense nature. These studies recommended that significant health gains could be obtained through engaging in moderate-intensity physical activity on most days of the week. • Following these recommendations, the Guidelines were revised once again to include lifestyle physical activities within all domains of physical activity.
Definitions for the Guidelines • Physical activity refers to any activity that involves significant movement of the body or limbs. • Health, in this instance, refers to metabolic well-being as reflected in low risk levels of blood fats, blood pressure and body weight as well as general physical and mental well-being. • Exercise is a type of physical activity defined as a planned, structured and repetitive body movement done to improve or maintain physical fitness.
Definitions for the Guidelines • Fitness relates to the capacity of the heart and lungs to supply oxygen-rich blood to the working muscles and the capacity of the muscles to use oxygen to produce the energy for movement. • Movement is defined here as any motion of the body and limbs. • Moderate-intensity physical activity will cause a slight, but noticeable, increase in breathing and heart rate and may cause light sweating in some people.
The Guidelines • The guidelines are an indication of what is recommended minimum amount of exercise each person does to enhance their health. These guidelines are based on what is recommended for adults • Guidelines 1 – 3 are not intended for high levels of fitness, sports training or weight loss. The best results are achieved by carrying out all 3 guidelines and by combining an active lifestyle with healthy eating. • Guideline 4 is for those who are able, and wish, to achieve greater health and fitness benefits.
Guideline 1 • Think of movement as an opportunity, not an inconvenience. • Where any form of movement of the body is seen as an opportunity for improving health, not as a time-wasting inconvenience. • Due to the improvements in our technology, people are becoming more inactive as machines do more of the physical work for us. As a result obesity and other health problems are increasing. • To combat this, we need to view all movement as an opportunity, rather than an inconvenience, and in doing so taking the first steps towards improved health.
Guideline 2 • Be active every day in as many ways as you can. • Make a habit of walking or cycling instead of using the car, or do things yourself instead of using labour-saving machines. • Small increases in daily activity can be achieved through small changes to your activities throughout the day. • Examples: riding your bike or walking instead of driving or catching a lift, taking the stairs instead of the lift, doing some gardening, walk and/or play with your pets.
Guideline 3 • Put together at least 30 minutes of moderate intensity physical activity on most, preferably all, days. • You can accumulate your 30 minutes (or more) throughout the day by combining a few shorter sessions of activity of around 10 to 15 minutes each. • Moderate-intensity activity will cause a slight, but noticeable, increase in your breathing and heart rate. A good example of moderate-intensity activity is brisk walking, that is at a pace where you are able to comfortably talk but not sing.
Guideline 3 • Research has shown that accumulated short bouts of moderate intensity activity are just as effective as continuous activity at improving indicators of health such as blood pressure and blood cholesterol. • So you can: * accumulate your 30 minutes or more throughout the day by combining a few shorter sessions of activity of around 10 to 15 minutes each; or * do 30 minutes or more continuously. • Moderate-intensity activity should, however, be carried out for at least 10 minutes at a time without stopping.
Guideline 4 • If you can, also enjoy some regular, vigorous activity for extra health and fitness. • This guideline does not replace Guidelines 1-3. Rather, it adds an extra level for those who are able, and wish, to achieve greater health and fitness benefits. • Research has shown that people who participate in regular vigorous activity can get health and fitness benefits over and above the benefits they get from increasing daily movement or regular moderate-intensity activity. This includes extra protection against heart disease.
Guideline 4 • ‘Vigorous’ implies activity, which makes you ‘huff and puff’, and where talking in full sentences between breaths is difficult. In technical terms this is exercise at a heart rate of 70-85% of maximum heart rate (MHR), where MHR is calculated as 220 minus your age. Vigorous exercise can come from active sports such as football, squash, netball and basketball, and activities such as aerobics, circuit training, speed walking, jogging, fast cycling or brisk rowing. For best results, this type of activity should be carried out for a minimum of around 30 minutes on 3 to 4 days a week.
What the Guidelines do not include • In each of the 4 Guidelines, the time and activities that are suggested do not include the warm up and cool down phases for the activities. These will still need to be added on, especially a stretching routine. • These guidelines are to be followed in conjunction with a balanced, healthy diet.
Children (5 – 12 years) guidelines • Children need at least 60 minutes (and up to several hours) of moderate to vigorous physical activity every day. • Children should not spend more than two hours a day using electronic media for entertainment (e.g. computer games,TV, Internet), particularly during daylight hours. • A range of activities that suit skills, interest and abilities should be undertaken.
Youth (12 – 18 years) Guidelines • At least 60 minutes of moderate to vigorous activity every day to keep healthy. • There should be a range of different activities. • No more than 2 hours in total using all electronic forms of media (eg. Internet, DVDs, computer games, email, etc.)
Guidelines for Older People • Older people still follow the National PA guidelines for adults. • Strength and balance training are recommended to reduce the risk of falls and to increase mobility. • Activities will tend to be of a more gentle nature (eg gardening, tai chi) but still lead to health benefits.
Recommendations for Overweight and Obese People • 55 - 60% of the population are overweight. • For those who are just restarting physical activity it is recommended that moderate intensity activity is accumulated over 30 minutes on most days of the week for achieving long-term behaviour change. • To achieve weight loss (beyond the health benefit mentioned above), it appears that the necessary amount of physical activity is 60 minutes of light-moderate intensity activity accumulated over the course of the day, on most days of the week. • Evidence shows that about 60 to 90 minutes of activity accumulated over the course of the day on most days of the week is probably best for effective weight maintenance once weight has been lost. • In general, those activities where the body weight is not supported (e.g. walking) are more effective for weight loss than weight-supported activities (e.g. swimming). However, weight supported activities are a useful means of helping patients with locomotor difficulties to become active.
Recommendations for Overweight and Obese Children • More physical activity than the levels currently being engaged in should be prescribed to help manage obesity in children and adolescents. The more physical activity undertaken, the less stringent the dietary restriction needs to be to achieve an energy deficit. • Activities should be prescribed in accordance with the child’s age. • There are at least four types of activity to explore: • structured organised activities such as swimming lessons, sporting clubs, dance, scouts, youth clubs • less structured activities such as family walks, long bike rides • lifestyle activities such as walking part or all of the way to school, using stairs, doing chores around the house • spontaneous activities such as inviting friends over to play, going to the pool for fun.
Recommendations for Overweight and Obese Children • A few hours of organised sport a week will not counteract hours of daily inactivity. The following need to be considered: • the activity level of the family unit • types of activities in which the child/adolescent feels comfortable • when and where the child/adolescent is most active • choices of activity/inactivity in free time • what normally occurs after school • how much time is spent outside • barriers to being physically inactive (safety, transport, costs, time issues) • knowledge and perception of neighbourhood facilities for physical activities.
Occupational Activity • These are physical activities that are undertaken each day as part of a person’s employment. • Eg, builder (lifting frames), courier (delivering parcels), clerk (typing and delivery messages.).
Household/gardening activity • These are physical activities that a person does at home outside of their work hours. • Activities include gardening, cleaning, painting, mowing the lawns.
Leisure – time activity • These are physical activities in which a person chooses to participate in. The can be either individual, social or competitive, or a combination. • Eg. golf, tennis, basketball, lawn bowls.
Active transportation activity • These physical activities are based on allowing a person to get from one place to another. They often are replacing modern means of transportation. • Eg., running, bike-riding, walking.
Physical Activity Pyramid • The Physical Activity Pyramid provides a framework for educating people about the types of physical activities to enhance fitness, health and well-being. • For optimal health benefits, participation in all levels of the pyramid is required each week.
Dimensions of Physical Activity • Type/behaviours of activity F.I.T. • F = Frequency (how often per week) • I = Intensity (how vigorous the activity) • T = Time/repetition (activity time length/ no. of repeated actions)
Level 1 – Lifetime physical activity • These are activities that can be performed at anytime, anywhere with minimal equipment and can be done either alone or with others. • F = All or most days of the week • I = Moderate • T = 30+ minutes
Level 2 – Active Aerobic Activity and Active Spots and Recreation • These activities consist of aerobic activities (eg bike riding, running, swimming) and active sport and recreational activities(eg dancing, tennis, basketball). • F = 3 – 6 days per week • I = Moderate to Vigorous • T = 20+ minutes
Level 3 – Exercise for Flexibility, Strength and Muscular Endurance • These activities are specifically focussed upon improving muscular strength, endurance and flexibility. • Flexibility F = 3 – 7 days per week I = stretching T = 15 – 60 seconds, 1 – 3 sets • Muscular strength/endurance F = 2 – 3 days per week I = Muscle overload (fatigue) T = 8 – 12 reps, 1 – 3 sets
Level 4 – Inactivity or Rest • These are sedentary activities where movement is minimal. These activities need to be kept to a minimum. • F= Infrequent • I = Low • T = Short