Physical activity is one of the most important components of successful health promotion and disease prevention for individuals and communities. While physical activity has long been a priority for public health, it rose to a new level of prominence in October of 2008, when the U.S. Department of Health and Human Services (HHS) launched the Physical Activity Guidelines for Americans.1 These guidelines, which are the first set of comprehensive, evidence-based national recommendations for physical activity across the lifespan, are designed to serve as the basis for programs and policies nationwide.
Physical activity is an integral component in the body's energy balance. The benefits of physical activity extend well beyond achievement and/or maintenance of a healthy weight. In fact, a thorough review of the scientific literature by the Physical Activity Guidelines Advisory Committee has shown that regular physical activity is associated with a reduced risk of many conditions that impact physical and mental well-being, including coronary heart disease, stroke, hypertension, type 2 diabetes, metabolic syndrome, colon cancer, breast cancer, and depression. Physical activity also helps to build muscular and cardiovascular fitness, and has a positive effect on sleep patterns and bone density. Given all of this information, it should come as no surprise that physical activity is also associated with a reduced risk of premature death.2
Many Americans still undervalue the benefits of physical activity and underestimate their personal ability to incorporate physical activity into their daily lives. Exercise is a word laden with negative connotations, often viewed as a chore. Thus, one of the primary messages conveyed in the Physical Activity Guidelines communication tools is the idea of personalizing physical activity to meet an individual's interests, abilities, and lifestyle patterns. The guidelines' companion piece, Be Active Your Way, a guidebook for adults, is centered on this theme of tailoring physical activity to become an enjoyable and beneficial component of life.3
Some physical activity is better than none, and more is even better. Physical activity should not be viewed as an all-or-nothing venture; this mindset welcomes barriers and, ultimately, inactivity. Research shows that at least 150 minutes of moderate-intensity activity, or 75 minutes of vigorous activity (or an equivalent combination of the two) each week consistently reduces the risk of many chronic diseases and adverse health events among adults. Doubling those numbers to 300 and 150 minutes per week, respectively (or an equivalent combination), is associated with additional and more extensive health benefits.2 However, some health benefits seem to begin with as little as 60 minutes per week of moderate-intensity activity. Ideally, aerobic activity is completed in at least 10-minute intervals, and muscle-strengthening activities (involving all major muscle groups) are included two or more days per week. While the previous mantra of 30 minutes, five days per week is one way to achieve the physical activity recommendations, it is not the only way.1
Everyone has a need for and can enjoy physical activity. The Physical Activity Guidelines are all-inclusive, providing general recommendations for multiple age groups (beginning with those aged 6 years), as well as tailored recommendations for special subgroups, such as women during pregnancy and postpartum, and adults with disabilities or chronic medical conditions.
The Physical Activity Guidelines send an undeniably encouraging message to the American public. Everyone has the flexibility to select various activities that he or she truly enjoys (e.g., dancing, martial arts, tennis, canoeing, swimming, lifting weights, and walking), the freedom to select the time for these activities that fits best into individual lifestyle patterns (e.g., 10-minute intervals throughout the day or one-hour blocks scattered throughout the week), and the option of adapting these activities to align with physical abilities. Ultimately, these choices create countless paths to healthier lives and a healthier nation.
Public health leaders can also focus on environmental and policy changes to encourage physical activity. Construction of bike and walking paths; better gyms, parks, and playgrounds; an improved focus on physical activity in schools; safe walking routes for children; and support of sports and other organized programs can also help facilitate adherence to these Physical Activity Guidelines.
I encourage you to visit www.health.gov/paguidelines and www.health.gov/getactive and use the resources available to help yourself, your loved ones, your program partners, your patients, your constituents, and/or your community to be more physically active.
RADM Steven K. Galson, Acting Surgeon General
FAREWELL MESSAGE FROM RADM STEVEN K. GALSON
As our nation prepares to welcome a new Surgeon General, and I move forward in my professional journey, I would like to share my sense of honor and privilege to have served in this position for the past two years. I reflect on my service with a sense of accomplishment but certainty that there is still much work to do.
Each day, too many Americans suffer and die prematurely from preventable chronic diseases. Obesity costs our nation $147 billion annually. One in every three adults and nearly one in every five young people is obese. Healthy behaviors such as eating right, being physically active, getting appropriate health screenings, and not smoking are steps every American can take to prevent or delay disease. That's why prevention has been my top priority as Acting Surgeon General.
During the past two years, I have traveled the nation, spoken and listened to hundreds of audiences, and been truly inspired by community efforts toward prevention. Through my Healthy Youth for a Healthy Future initiative, I brought national attention to the complex issue of childhood obesity prevention, highlighted innovative community actions, and forged lasting partnerships to win the battle. I biked, gardened, danced, and enjoyed playground time alongside children of all ages. If children see adults adopting healthy behaviors, they are more likely to do the same. As compassionate leaders, we must continue to empower children to be a part of the solution.
As America's chief health educator, I have published Surgeon General's Calls to Action on Deep Vein Thrombosis and Pulmonary Embolism and the Promotion of Healthy Homes, promoted statewide policies to prevent underage drinking, helped rejuvenate the national dialogue on preventing preterm births, and focused on public health preparedness and response. Today, the U.S. Public Health Service Commissioned Corps is the nation's best asset in fighting public health crises. Our force now includes 6,500 officers and its readiness level is 93%, the highest level of readiness of all the uniformed service branches. More Americans are also sharing their time and talents through the Surgeon General's Medical Reserve Corps, which has grown to more than 845 units comprising more than 180,000 volunteers nationwide.
These are also historic and defining times in Washington, D.C., for advancing prevention. Within weeks of his swearing-in ceremony, President Obama signed the Children's Health Insurance Program Reauthorization (CHIPRA) legislation, which provides primary and preventive health services to more than 11 million children and authorizes childhood obesity demonstration programs across the nation. Additionally, Congress passed the American Reinvestment and Recovery Act, which included a $1 billion Prevention and Wellness Fund. This landmark opportunity will help communities develop and expand proven strategies that prevent disease and its risk factors, promote wellness, and better manage chronic conditions among its residents. I am proud to have played a role in the design of the Prevention and Wellness Fund and I look forward to communities' powerful results in the coming years. And, finally, health-care reform provides an unparalleled opportunity to move prevention into the mainstream of our medical system.
As public health professionals, I encourage you to draw upon the optimism and promise of the actions occurring in communities and in Washington. As I close my term as your Acting Surgeon General, I have the strong conviction that reversing the epidemic of chronic disease through prevention is within our grasp. Success will require commitments from professionals like you who dedicate their lives to advancing health and wellness and inspire others to do the same. My 23 years in public health have taught me that partnerships across government, communities, the business community, and individuals yield real and lasting progress in overcoming our greatest national challenges. I thank you for your support and ask for your continued perseverance in protecting and promoting the health of all Americans.
Steven K. Galson, MD, MPH, RADM, USPHS, Acting Surgeon General
The author thanks Rachel Hayes, MPH, RD, Public Health Advisor, Office of Disease Prevention and Health Promotion, for her contributions to this article.
Please note that this Surgeon General's Perspectives column was printed prior to Senate confirmation of the Surgeon General nominee.
1. Department of Health and Human Services (US) 2008 physical activity guidelines for Americans. Rockville (MD) HHS Office of Disease Prevention and Health Promotion (US) 2008. ODPHP Publication No. U0036.
2. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee report 2008. Department of Health and Human Services (US); 2008; Washington. [Google Scholar]
3. Department of Health and Human Services (US) Be active your way: a guide for adults. Rockville (MD) HHS Office of Disease Prevention and Health Promotion (US) 2008. ODPHP Publication No. U0037.