Module 2

Physical Activity and Sedentary Behaviour Guidelines

You may be unsure about what you should be recommending to your patients in terms of physical activity. How much is needed for health benefits? What kind of physical activity should patients do? You also may have wondered if you should be guiding patients about spending less time sitting in front of a TV or computer.

This module will provide you with knowledge of Canadian physical activity and sedentary guidelines for various age groups that you can use to inform your physical activity counselling practices with patients!

How much physical activity is required for health benefits?

Walking Dog

The Canadian Society for Exercise Physiology (CSEP) has developed Canadian Physical Activity Guidelines for realizing health benefits and improving function for children, younger/middle aged adults, and older adults. 1 These guidelines can help you provide guidance about physical activity for the patients you care for!

Physical Activity Guidelines for Children Aged 0-4 Years:

  • Infants (< 1 year of age): should be encouraged to be physically active several times per day through play.
  • Toddlers (1-2 years of age) and preschoolers (3-4 years of age): should accumulate 180 minutes of any intensity physical activity per day. Activities should include:
    • A variety of different activities that develop movement skills.
    • Progression towards at least 60 minutes of energetic play by age 5 years.
  • Greater benefits can be achieved with higher levels of physical activity.

Physical Activity Guidelines for Children Aged 5-11 Years and Youth Aged 12-17 Years:

  • 60 minutes of moderate-to-vigorous intensity physical activity per day, including vigorous intensity activity 3 or more times per week.
  • Muscle and bone strengthening activities (resistance exercises) that use major muscle groups should be included at least 3 days of the week.
  • Greater health benefits can be achieved with greater levels of physical activity.

Physical Activity Guidelines for Adults Aged 18 – 64 Years:

  • 150 minutes or more of moderate-to-vigorous physical activity per week. Bouts of physical activity should last 10 minutes or longer.
  • Muscle and bone strengthening activities (resistance exercise) that use major muscle groups should be included on at least 2 days of the week.
  • Greater health benefits can be achieved with greater levels of physical activity.

Physical Activity Guidelines for Adults Aged 65 years and Older:

  • 150 minutes or more of moderate-to-vigorous physical activity per week. Bouts of physical activity should last 10 minutes or longer.
  • Muscle and bone strengthening activities (resistance exercises) that use major muscle groups should be included at least 2 days of the week.
  • Physical activities to enhance balance and prevent falls should be incorporated for those with poor mobility.
  • Greater health benefits can be achieved with greater levels of physical activity.

What Kinds of Activities should Patients Do?

Moderate Intensity Activities (50-70% of maximum heart rate):

  • Activities that increase heart rate and involve some sweating yet still allow the exerciser to have a conversation.
  • Examples include: Brisk walking, moderate cycling, water aerobics, pushing a lawn mower, playing golf (without cart), playing doubles tennis, ballroom dancing, actively playing with children.

Vigorous Intensity Activities (70-85% of maximum heart rate)

  • Activities that involve an even faster heart rate and make the exerciser feel breathless and able to only say a few words at a time.
  • Examples include: Running, aerobics, cross country skiing, fast cycling, shoveling snow, carrying heavy loads, playing a basketball game, playing singles tennis.

Muscle and Bone Strengthening Activities:

  • Activities that increase skeletal muscle and bone, power, endurance, and mass.
  • Examples include: Lifting weights, doing exercises that involve body weight for resistance (e.g., sit ups, push ups), exercising with resistance bands, yoga, heavy yard work (e.g., digging).

How Are Canadians Doing?

  • Despite the many benefits of physical activity most Canadians do not meet physical activity guidelines for physical activity.
  • Tables 1. and 2. show accelerometer data of physical activity levels for Canadian children/youth and adults from the 2007 to 2009 Canadian Health Measures Survey2,3.

 

Table 1. Percentage of Canadian children and youth with at least 60 minutes of physical activity on at least 1, 3 or 6 days per week2.

Age group (years) At least 1 day (%) At least 3 days (%) At least 6 days (%)
Boys Girls Boys Girls Boys Girls
6-10 90 85 63 51 14 7
11-14 86 72 51 33 7 5
15-19 80 67 45 25 6 2

 

Table 2. Percentage of Canadian adults accumulating at least 150 minutes of moderate-to-vigorous physical activity per week in bouts of at least 10 minutes3.

Age group (years) Total (%) Men (%) Women (%)
20-39 17.4 21.1 13.8
40-59 14.6 15.1 14.1
60-79 13.1 13.7 12.6

 

Sedentary Behaviour

What is “sedentary behaviour”?

  • Any waking activity in a sitting or reclining posture (e.g., computer use, TV watching, reading, driving a car).
  • < 1.5 metabolic equivalents

A growing number of research studies indicate that excessive sedentary behaviour is harmful to health even in people who get the recommended amount of weekly physical activity!

 

Did you know?

A recent meta-analysis4 found that high levels of sedentary behaviour was associated with increased risk of:

  • Cardiovascular disease
  • Cancer
  • Type 2 diabetes
  • All-cause mortality
  • Cardiovascular disease mortality

These results held true even after controlling (accounting) for physical activity level, smoking, and age!

 

Recently, CSEP has developed sedentary behaviour guidelines for children and youth1. These guidelines can be used in addition to the physical activity guidelines to maximize health outcomes.

 

Sedentary Behaviour Guidelines for Children Aged 0-4 Years:

  • Infants, toddlers, and preschooler should minimize the amount of time spent being sedentary (during waking hours). Sedentary time (e.g., sitting, restrained in a high chair or stroller) should be limited to no more than one hour at a time.
  • Screen time (e.g., TV, computer, electronic games):
    • Under 2 years: not recommended.
    • 2-4 years of age: should be limited to less than one hour per day.

Sedentary Behaviour Guidelines for Children Aged 5-11 and Youth Aged 12-17 Years:

  • Minimize the amount of time spent being sedentary by:
    • Limiting screen time to less than 2 hours per day.
    • Reducing extended sitting time.
    • Limiting time spent indoors and in motorized transport.

 

What about physical activity for patients with a chronic disease?

Most patients with chronic disease can benefit from regular physical activity. Guidelines have been developed by expert panels and organizations that outline the benefits, risks, and recommendations for physical activity for various chronic disease populations. Patients should generally consult with a physician before starting an exercise program.

Links for guidelines for physical activity for common chronic disease populations:

Key Points:

  • The Canadian Society for Exercise Physiology has developed guidelines for physical activity and sedentary behaviour for children, youth, and adults that can be used to guide physical activity recommendations.
  • Most Canadians do not meet Canadian Society for Exercise Physiology physical activity recommendations.
  • Excessive and prolonged sedentary behaviour can be harmful to health.
  • Even most people with chronic disease can safely engage in physical activity and enjoy health benefits. Many expert organizations have developed physical activity guidelines for people with chronic diseases.

After reviewing this module you will have a better understanding about the amount and type of physical activity that is recommended for people of different age groups. Moreover, you will also be familiar with the potential risks of high levels of sedentary behaviour as well as the Canadian recommendations for limiting sedentary behaviour. You can use this information to help guide patients with their physical activity pursuits as well as make recommendations to limit continuous and excessive sedentary behaviour. In the next module you will learn more about an effective behaviour change counselling technique.

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References:

  1. Canadian Society for Exercise Physiology. Canadian Physical Activity Guidelines and Canadian Sedentary Behaviour Guidelines http://www.csep.ca/english/view.asp?x=949. Accessed August 28, 2015.
  2. Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay M. Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. http://www.statcan.gc.ca/pub/82-003-x/2011001/article/11397-eng.htm. Accessed September 1, 2015.
  3. Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay M. Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. http://www.statcan.gc.ca/pub/82-003-x/2011001/article/11396-eng.htm. Accessed September 1, 2015.
  4. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162, 123-132.