How good are official exercise recommendations?

Last week I gave you the Department of Health’s recommendations for exercise – This week I am looking at just how good they are.

How good are they?

Any exercise is good and even just a bit is much better than none at all. This week’s picture emphasises that the greatest relative increase in benefit comes from doing nothing to doing something. However the more the better.

The DoH guidelines are both realistic and highly beneficial but by no means the end of the story. Although the recommended level of aerobic exercise is considerably less than the optimal dose which I have described previously, it is still enough to bring appreciable increase in physical fitness together with health and longevity benefits.  Note, however, that the Guidelines do point out that there is substantial evidence that more vigorous-intensity activity can bring health benefits over and above those of moderate intensity activity.

The World View
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Almost identical recommended exercise guidelines have been produced by a number of countries and continental groups. There is no science to these recommendations which are a compromise between what is ideal and what is achievable. The recommended level has been plucked from the sky and has no real evidence to support it. The benefits of exercise increase with increasing exercise level but the more exercise that is recommended the smaller the chance of it being taken up. No one has yet demonstrated the cross-over point beyond which the benefit of exercise at a population level is cancelled out by the reduction in uptake! That would really help to decide the best level to recommend.

In 2018 the “Physical activity guidelines for health and prosperity in the United States” were published. The overall levels of recommended activity were not changed from previous guidelines but the way in which the exercise is broken up was changed. “Even short-duration activity lasting less than 10 minutes is beneficial.”

What about age?

The Guidelines for adults of different ages do not change:

Adults (19-64 years old) and older people (65+): 150 mins – two and half hours – each week of moderate to vigorous intensity physical activity (and adults should aim to do some physical activity every day). Include muscle strengthening activity twice a week.

As we get older the benefits of exercise get greater and greater but unfortunately we take less and less of it. For instance in the US average walking time for 20-29 year olds is about 30 minutes per day which has fallen to about nine minutes per day by the age of 70-79. After that the drop is even steeper. Some of this is driven by disabilities of one sort or another but there is also a disinclination for physical activity which is probably driven by the fact that as we get older and stiffer it just becomes harder to struggle out of a comfortable arm chair and get active.

But I do believe that a big factor in the inactivity of the elderly is because of a lack of realisation of the huge benefits that keeping active brings.

For older people what I said above is particularly relevant – if they are asked to do too much they just won’t do it. For example it is futile to advise the elderly to triple their exercise. The target for everyone should not be a fixed amount of exercise but an increase which is within the bounds of possible attainment.  The UK Chief Medical Officer has stated “… the majority of UK older adults have low levels of activity so it is important to emphasise that they can achieve some benefits from increasing their activity even it is below the recommendation”.

Golf

I said last week that I would enlarge on this subject, but I just don’t have room! I have a lot to say about golf so I will devote a whole blog to it next week instead.

PS

Open studios – it is not too late to visit Toni Goffe’s (the illustrator of this blog) studio and see all the marvellous work on show, most of it on sale for bargain prices. So hurry on down today, tomorrow or Monday between 10am and 4pm to The Manse, 56 Ackender Road, Alton GU34 1JS.