New WHO Guidelines Emphasize Vital Role of Physical Activity

On November 26, 2020, the World Health Organization (WHO) launched a webinar to announce their much anticipated 2020 Guidelines on Physical Activity and Sedentary Behavior. These guidelines replace the 2010 Global Recommendations on Physical Activity for Health, confirming and building on the scientific evidence presented in the earlier guidelines.

Key Messages for the New Guidelines

1. Physical activity improves health, helping to prevent and manage cardiovascular disease, type 2 diabetes, and cancer, reducing depression and anxiety symptoms, and improving thinking, learning, and well-being. In children, physical activity improves physical fitness, cardiovascular health, bone health, cognitive health, mental health, and reduced adiposity.

2. Any amount of physical activity is better than none, and more is better. Physical activity no longer needs to occur in bouts of 10 minutes or more to count—any movement, anywhere is beneficial, even if it does not reach the recommended levels.

3. All types of physical activity count and are beneficial, including leisure-time exercise and sport as well as transportation (like walking, wheeling, or biking) and light household activities (like gardening).

4. Muscle-strengthening exercises—like bodyweight calisthenics or resistance training—are good for everyone and recommended for all groups, including those over 65.

5 . Sedentary time exerts negative effects on health, and people should strive to reduce sedentary time and replace sedentary time with physical activity.

6. Physical activity is for everyone and should be accessible for people of all ages and abilities. These guidelines specifically highlight the importance of including people with disabilities and chronic disease and pregnant and postpartum women.

Every Move Counts—For Everyone

Earlier iterations of physical activity guidelines focused on the health benefits of intentional physical activity or exercise for health and tended to focus on adults. The new guidelines were expanded to include specific guidelines for people living with chronic health conditions and disability, pregnant and postpartum women, and children and adolescents.

The 2020 guidelines also for the first time present evidence for the negative effects of sedentary time, and recommend exceeding the recommended levels of physical activity to compensate for long periods of time spent sitting. Children are advised to avoid long periods of sitting and looking at screens.

The 2020 guidelines also include evidence around the impact of physical activity on mental health.

The recommendation for children changed slightly, from one hour of moderate-vigorous activity every day to an average of one hour a day across the week. This recommendation provides for a little more flexibility in scheduling activities across the week.

The guidelines emphasize that any activity is better than none, even if guideline recommendations are not achieved. In the previous guidelines, exercise was counted in 10-minute bouts. In the 2020 guidelines, any amount of movement counts toward the total. The webinar launching the guidelines, titled “Every Move Counts,” focused on this theme.

For those new to physical activity or those struggling to attain recommended levels, 150 to 300 minutes may seem daunting. But fitness professionals can highlight the importance of any amount of physical activity—even if it is just twenty minutes a week starting out.

Finally, these new guidelines include specific recommendations for new groups—adults with chronic disease, adults and children with disabilities, and pregnant and postpartum women—that were not included in 2010. Not surprisingly, the recommendations for each of these groups are the same as their age-matched counterparts.

Guidelines for Each Group

The guidelines recommend an average of 60 minutes per day of physical activity across the week for children and adolescents both with and without disabilities and emphasize the importance of vigorous activities.

Adults, regardless of disability status, are recommended to get 150-300 minutes of moderate or 75-150 minutes of vigorous activity across the week, with two days of muscle strengthening exercises. The guidelines note that achieving higher levels of activity does confer added benefits. Adults are advised to limit sedentary time to the extent they can and replace it with physical activity, and those required to sit for long periods should do more than the recommended amount of physical activity.

For older adults and adults over 18 who have a chronic condition, the recommendations were the same, with the addition of three days per week of multicomponent exercises for functional balance and strength, which can help with fall prevention.

Pregnant women should get at least 150 minutes of moderate-intensity physical activity, incorporating muscle strengthening exercises. Women who regularly engaged in vigorous activities can continue doing those activities throughout their pregnancy and postpartum periods.

Implications

These guidelines further underline the importance of physical activity for all people and urge policymakers and stakeholders to act on and invest in physical activity promotion. Communities need to come together to make physical activity more accessible and attainable for more people.

Much of the research informing these guidelines was conducted and reviewed prior to the COVID-19 pandemic. However, the importance of increasing access to physical activity is even more apparent now.

• Physical inactivity-related health conditions such as diabetes and cardiovascular disease increase the risk of more severe COVID-19.
• Physical activity and higher fitness levels have been linked to lower odds of COVID-19 hospitalization and death.
• Physical activity is beneficial for promoting immune system health.
• Physical activity is linked to lower rates of depression and anxiety and better mood, especially significant given the pandemic’s negative impact on mental health.

Additionally, as the 2020s progress, we will continue to learn more about the long-term effects of COVID-19 on the cardiovascular and neurological systems. However, early evidence suggests physical activity may play a role in COVID-19 recovery.

Governments and communities should invest more in disability inclusion initiatives to create more opportunities for participating in exercise and sport, especially among groups who have been disproportionately affected by COVID-19 or COVID-19 related restrictions. A more collaborative relationship between the medical and allied health communities and physical activity and fitness providers would help make physical activity more accessible and achievable for more people with chronic disease and disabilities.

Health clubs play a key role in promoting physical activity, providing a safe space with knowledgeable staff, supportive programming, and built-in social support for members and visitors. For example, in the “Every Move Counts” webinar, one panelist discussed the issue around women feeling safe to exercise outdoors. In addition to social connection and support, indoor fitness centers also play a key role during extremely cold or hot months or inclement weather.

Fitness centers also provide all the tools and resources necessary to fulfill the muscle-strengthening recommendations, a component that can be harder to achieve than aerobic activities, which can usually be done equipment-free by walking, wheeling, or running.

IHRSA Supporting WHO

IHRSA has been supporting the WHO since 2018 when we provided input into the Global Action Plan on Physical Activity (GAPPA). That same year IHRSA, along with The World Federation of the Sporting Goods Industry (WFSGI), were invited to join the first WHO Sport Sector Dialogue in December 2018. The 5th Sport Sector Dialogue meeting was held in December.

In spring 2020, the WHO Health Emergencies Team and Physical Activity Unit facilitated IHRSA in leading the working group of global experts in establishing key considerations and risk assessment tools to enable sports, fitness, health clubs, and aquatics facilities around the globe to operate safety—and to show they are safe. This work informed the Active & Safe Commitment, launched in December 2020, to show governments, health authorities, and consumers that these clubs are operating according to recognized protocols.