Exercise and Physical Activity

Authored by Dr Jacqueline Payne, Reviewed by Dr Helen Huins on | Certified by The Information Standard

Doing regular physical activity can make you feel good about yourself and it can have a number of benefits for your health. For example, it reduces the risk of developing heart disease, stroke, high blood pressure, many cancers, type 2 diabetes and 'thinning' of the bones (osteoporosis).

Regular physical activity also helps to control weight and ease stress. Ideally, you should aim for at least 30 minutes of moderate-intensity physical activity on at least five days of the week but even 10 minutes is better than nothing. You should aim to do at least a couple of sessions of muscle-strengthening activities per week as well.

Physical activity is any activity that you may do that helps to improve or maintain your physical fitness as well as your health in general.

It can include:

  • Everyday activities. For example, walking or cycling to work or school, doing housework, gardening, DIY around the house, or any active or manual work that you may do as part of your job.
  • Active recreational activities. This includes activities such as dancing, active play amongst children, or walking or cycling for recreation.
  • Sport. For example, exercise and fitness training at a gym or during an exercise class, swimming and competitive sports such as football, rugby and tennis, etc.

In the UK over 6.3 million adults (about 4 out of 10) aged 40 to 60 do not achieve 10 minutes of continuous brisk walking over the course of a month and are missing out on important health benefits. Lifestyles have changed over time, and people in the UK are 20% less active now than they were in the 1960s, walking on average 15 miles less a year than two decades ago. The sedentary nature of modern, busy lives makes it difficult for many to find the time for enough exercise to benefit their health but it is important to try to make physical activity part of everyday life.

Adults should aim to do a mixture of aerobic activities and muscle-strengthening activities.

Current recommendations

During the daytime, all age groups should minimise the amount of time spent sitting (being sedentary). There is good evidence that if you are currently not active at all, taking a brisk walk for 10 minutes a day brings health benefits. However the more you do, the greater the benefits.

In the following recommendations:

  • Moderate-intensity activity means an activity that makes you breathe a bit faster, feel a bit warmer and notice your heart beating faster - for example, walking briskly.
  • Vigorous-intensity activity will usually make you breathe very hard, so you feel short of breath, make your heart beat quickly and mean you will be unable to carry on a conversation - for example, running or cycling fast or uphill.

Under-5s

  • Physical activity in young children shouldn't need to be encouraged as it comes naturally! However, it is still important to allow young children play from birth, particularly through floor-based play and water-based activities in safe environments.
  • Children of preschool age who are capable of walking unaided should be physically active daily for at least 180 minutes (three hours), spread throughout the day.

Children and young people (aged 5-18 years)

  • Moderate- to vigorous-intensity physical activity for at least 60 minutes and up to several hours every day. This can be made up from various shorter sessions and a mixture of different activities. For example, a mixture of play, physical education (PE) at school, games, dance, cycling, a brisk walk to school, sports, various outdoor activities, etc.
  • Vigorous-intensity activities, including those that strengthen muscle and bone, should be incorporated at least three days a week.

Adults (aged 19-64 years)

  • Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate-intensity activity in bouts of 10 minutes or more. For example, 30 minutes on at least five days a week.
  • Comparable benefits can be achieved by 75 minutes of vigorous-intensity activity spread across the week or combinations of moderate-intensity and vigorous-intensity activity.

Older adults (aged 65 years and older)

  • Older adults who participate in any amount of physical activity gain some health benefits. Some physical activity is better than none and more physical activity provides greater health benefits.
  • Older adults should aim to be active daily and, if possible, aim for the same amount of physical activity as younger adults.

Aerobic activities

Aerobic activities are any activity that makes your heart and lungs work harder. To gain health benefits, government experts in the UK suggest that you should do at least 30 minutes of moderate-intensity physical activity on most days of the week.

  • 30 minutes at least is ideal but you do not have to do this all at once. For example, cycling to work and back for 15 minutes each way adds up to 30 minutes.
  • Moderate-intensity physical activity, as explained above, means that you get warm, mildly out of breath and mildly sweaty. For example, brisk walking, jogging, swimming, cycling, dancing, badminton, tennis, etc. However, as mentioned above, normal activities that are part of your daily routine (everyday activities) may make up some of the 30 minutes. For example, housework, DIY, climbing lots of stairs, and gardening can all make you mildly out of breath and mildly sweaty.
  • On most days means that you cannot store up the benefits of physical activity. You need to do it regularly. Being physically active on at least five days a week is recommended.

The amount of physical activity that you do may need to be a little more in some situations:

  • If you are at risk of putting on weight, you should ideally build up to 45-60 minutes of moderate-intensity physical activity on most days to help to manage your weight.
  • If your body mass index (BMI) was in the obese category and you have lost a lot of weight, or if you are in this situation and you are trying to lose weight, you should ideally build up to 60-90 minutes of moderate-intensity physical activity on most days to help manage your weight.

Muscle-strengthening activities

In addition to the above aerobic activities, adults should also aim to do a minimum of two sessions of muscle-strengthening activities per week.

Muscle-strengthening activities can include climbing stairs, walking uphill, lifting or carrying shopping, digging the garden, weight training, Pilates, yoga or similar resistance exercises that use the major muscle groups. Ideally, the activities and exercises should not only aim to improve or maintain your muscle strength but also aim to maintain or improve your flexibility and balance. A session at a gym might suit you but activities at home can be equally as good. For example, stair climbing, stretching and resistance exercises can be done at home without any special clothing or equipment.

A session should be a minimum of 8-10 exercises using the major muscle groups. Ideally, to help build up your muscle strength, use some sort of resistance (such as a weight for arm exercises) and do 8-12 repetitions of each exercise. The level (weight) of each exercise should be so that you can do 8-12 repetitions before the muscle group gets tired and you have to stop. So, for example, for the upper arm muscles, hold a weight in your hand and bend (flex) your arm up and down 8-12 times. This should make your arm muscles tire. You can use heavier weights and do fewer repetitions if you prefer.

You can do the exercises one after another to complete a session. Or, you can split a session up over a day in, say, bouts of 10 minutes.

If you are doing intense muscle-strengthening exercises for a particular sport, your muscle-strengthening sessions should not be on consecutive days.

Older people

If you are over the age of 65 you should still aim to do the same amount of aerobic activity and muscle-strengthening activity as younger adults, depending on your ability. As well as this, a particular goal for older people should be, where possible, to do activities to help with flexibility and balance.This is to help reduce the risk of falls and injury from falls. Examples of activities to help flexibility include yoga, housework such as vacuuming, and DIY. Examples of activities to help balance include dancing, t'ai chi or keep fit classes. Special keep fit classes for older people are available in many areas and will usually include activities for flexibility and balance. 

Pregnant women

If you are already active it is perfectly safe to keep going with your activities when you are pregnant but listen to your body and adjust what you do as you need to. If you aren't already active, there are lots of benefits from being physically active in pregnancy but start gradually. The separate leaflet called Pregnancy and Physical Activity has more information about this.

The health benefits of doing regular physical activity have been shown in many studies. You are likely to obtain the most benefits to your health if you are someone who is not very active at all and you become more active. However, there are still benefits to be gained for anyone who increases their physical activity levels, even if they are already doing 30 minutes of moderate-intensity activity on most days.

Overall, people who do the recommended levels of physical activity can reduce their risk of premature death by 20-30%. Other health benefits include the following:

High blood pressure

Regular physical activity can help to lower your blood pressure levels if you have high blood pressure. It can also help to prevent high blood pressure from developing. High blood pressure is one of the risk factors for heart disease and stroke.

Coronary heart disease

Your risk of developing coronary heart disease, such as angina or a heart attack, is much reduced if you are regularly physically active. Inactive people have almost double the risk of having a heart attack compared with those who are regularly physically active.

If you already have heart disease, regular physical activity is usually advised as an important way to help prevent your heart disease from getting worse. Special rehabilitation physical activity programmes exist if you have had a heart attack or have another heart problem. These are supervised by physical activity specialists who can show you how to do physical activity safely.

Stroke

Physically active people are less likely to have a stroke. One study found that women aged 45 and older who walk briskly (at least three miles per hour), or who walk for more than two hours a week, reduce their risk of stroke by a third compared with less active women.

Cholesterol

Regular physical activity has been shown to raise levels of high-density lipoprotein (HDL) cholesterol. This is good cholesterol because it may actually help to protect against cardiovascular disease (coronary heart disease, stroke and peripheral arterial disease). HDL cholesterol seems to help prevent patches of atheroma forming. These are like small fatty lumps that develop within the inside lining of blood vessels (arteries) and are involved in the development of cardiovascular disease.

Diabetes

If you are regularly physically active then you have a lower risk of developing type 2 diabetes than inactive people have. The greater the amount of physical activity that you do, the lower your risk of developing type 2 diabetes. If you have been diagnosed with impaired glucose tolerance (pre-diabetes), regular physical activity can help to prevent this from developing into diabetes. Also, if you already have type 2 diabetes, regular physical activity can help improve the control of your diabetes.

Weight control

Physical activity may help you to get rid of excess fat. Regular physical activity combined with a healthy diet is usually the best way of losing weight, and keeping that weight off. Regular physical activity may also offset the harmful effects of being obese or overweight. See the separate leaflet called Weight Loss (Weight Reduction) for more advice on this.

Bone and joint problems

Regular weight-bearing physical activity can also help to prevent 'thinning' of the bones (osteoporosis). The pulling and tugging on your bones by your muscles during exercise stimulates bone-making cells, which strengthens your bones. If your bones are stronger, you have a reduced risk of breaking your bones when you are older. (Weight-bearing physical activity means physical activity where your feet and legs bear your body's weight, such as brisk walking, aerobics, dancing, running, etc.)

Physical activity has also been shown to treat lower back pain and help the symptoms of osteoarthritis in some people.

Cancer

Regular physical activity can help to reduce your chance of developing cancer. It roughly halves your chance of developing oesophageal or bowel (colorectal) cancer. Breast cancer and cancer of the uterus (endometrial cancer) are also both less common in women who are regularly physically active. It used to be thought that the lower risk of cancer in people who are physically active is because they are also more likely not to be overweight or obese. However, it is now clear that regular physical activity reduces your risk of many cancers even if you are overweight or obese. 

Mental health

Physical activity is thought to help ease stress, boost your energy levels and improve your general well-being and self-esteem. It can also help to reduce anger. There is good evidence that regular physical activity reduces the chance that you will develop depression. As well as this, physical activity can make you sleep better. (However do the activity during the daytime or early evening, not near to bedtime.)

Keeping you mobile and more able to live by yourself

Regular physical activity throughout life can help to keep you more mobile as you get older. Still being mobile is one of the things that helps older people remain independent and able to live by themselves at home. As mentioned above, as you get older, flexibility and balance exercises are important to help reduce your risk of falling and becoming injured. If you are aged over 70, you are less likely to fall and be injured if you are regularly physically active.

Memory loss and dementia

Regular physical activity may help to prevent some types of dementia. If you do have dementia, regular physical activity may also help to keep you mobile for longer.

Smoking cessation

Increasing physical activity levels has been shown to help people trying to quit smoking. It can help to reduce your desire to smoke and can also help with withdrawal symptoms. See our sderies of leaflets about smoking and how to stop, particularly the one called How to Quit Smoking.

For children

There are many benefits to regular physical activity for children. It helps with healthy growth and development and, if children are physically active, they are less likely to become overweight or obese adults. A recent study found that teenagers who carry a gene for obesity are less likely to become overweight or obese if they are physically active for an hour a day. If an overweight child becomes an overweight or obese adult, they are more likely to develop health problems. Such problems include diabetes, stroke, heart disease and cancer.

Regular physical activity also helps children to socialise and mix with others and helps with their psychological well-being. A study that took place in Southern California also found that children with average or above-average fitness levels did better in terms of their academic performance than children with below-average fitness levels. However, more studies are needed to confirm this potential benefit.

There are very few reasons why physical activity may be harmful. A common false belief is that physical activity may be bad for the heart. On the contrary, physical activity is important for most people with heart disease provided they follow guidance given by their health professional or an exercise specialist. In general, the potential benefits to your health will greatly outweigh any small risks involved, as long as you build up your activity gradually.

However, sometimes problems can occur with physical activity:

  • Injury is possible. Sprains, and sometimes more serious injuries, are a risk with some types of physical activity. You can cut down your risk of injury by warming up before any activity and by using suitable equipment. You can find out more in the separate leaflet called Sports Injuries.
  • In extremely rare cases, sudden death can occur in people who are doing some physical activity. However, most of the time, there is an underlying heart problem (which may not have been previously diagnosed). It is the excess stress that is placed on the person's body during exercise that causes the sudden death. It should be stressed that, in general, regular exercise protects the heart.

If you are worried that a problem or medical condition may be made worse by physical activity, see a doctor before starting a programme to increase your physical activity levels. In particular, you should see your doctor before you start if you:

  • Have a known heart condition or have had a stroke.
  • Have any chest pains, particularly if chest pain is brought on by exercise.
  • Have had falls due to becoming dizzy or blacking out.
  • Become very breathless on mild exertion.
  • Are intending to start a vigorous physical activity programme.
  • Are worried that a joint or back problem may be made worse by increasing your physical activity levels.

Physical activity is not just for young sporty types. It is never too late to start to gain the benefits, no matter how old or unfit you are.

  • If you are not used to physical activity, it is best gradually to build up the level of activity. Start with 10 minutes and over time build this up to 30 minutes. Brisk walking is a great activity to start with.
  • One big obstacle is the uphill battle to become fit. Many people feel that the first few attempts at physical activity are quite a struggle. Do not become disheartened. You are likely to find that each time it becomes easier and more enjoyable.
  • Try to keep physical activity high on your list of priorities. If one kind of activity becomes boring, try switching to another type. A variety of different activities may be better. Physical activity needs to be something that you enjoy or it will not be something that you will keep up.
  • Set yourself an achievable goal, like walking briskly for 10 minutes a day every day for two weeks, then treating yourself when you achieve it. The next goal could be to do the same but for 20 minutes. Some people set their goals too high. Be aware of this pitfall. The marathon can come later.
  • Use everyday activities as part of your physical activity programme. Consider a brisk walk to work or to the shops instead of using a car or bus; take the stairs in the office or shopping centre and not the lift, etc. Reduce the amount of time that you spend being inactive (watching TV, sitting in front of a computer screen, etc). You may find the 'Couch to 5k' advice helpful - see Further reading below.
  • Remember to include some muscle-strengthening exercises.
  • Talk to your doctor or practice nurse about any groups or initiatives in your local area. For example, Exercise Referral Schemes run in some areas. They are programmes designed especially for people with various medical conditions (such as asthma, high blood pressure, type 2 diabetes, chronic obstructive pulmonary disease, anxiety, depression or obesity) who may benefit from increasing their physical activity levels. There are also a number of government campaigns and initiatives aimed at increasing physical activity levels in everyone.

Most importantly, do something! Ideally do something you enjoy or which has purpose, like cycling to work to save on travel costs.

A pedometer is a small step-counting device, usually worn on a belt, that counts the number of steps you have taken, by sensing the motion of your body. There are also activity trackers that are worn like a watch and many apps are available for smartphones that use the phone's accelerometer to measure steps. Many people find these devices to be useful tools to help motivate them when they are trying to increase their physical activity levels.

Measuring the number of steps you take on an average day can give you your baseline step count. A very sedentary person will take between 1,000-3,000 steps per day. However, most people are in the range of 4,000-6,000 steps per day.

About 30 minutes of brisk walking should be around 3,000 steps. So, a good target could be to add 3,000 steps to your baseline number and aim for this. You may want gradually to build up by increments of 500-1,000 steps. The magic number to aim for in the end is at least 10,000 steps per day. It is thought that if you can manage this, it will help to keep you fit and healthy. 

Recent research has suggested that a sedentary lifestyle in general may have adverse health effects even if you do the recommended amounts of moderate exercise. A sedentary lifestyle may still increase your risk of obesity, diabetes, heart disease and cancer.

It is not certain why this is and further research is needed. However, it is thought perhaps to be related to the effect that sitting down too much has on certain enzymes in the body which help to process fat and sugar.

So to combat this:

  • Take regular breaks from your desk while you are at work (a short break of a few minutes every hour).
  • Take the stairs and not the lift.
  • Walk to the shops instead of taking the car.
  • Stand up while you are talking on the phone.
  • Don't spend hours sitting in front of the television, etc.

Further reading and references

  • ; Dept of Health

  • ; Dept of Health

  • ; Dept of Health, 2017

  • ; Public Health England, August 2017

  • ; Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21380(9838):219-29. doi: 10.1016/S0140-6736(12)61031-9.

  • ; World Health Organization

  • ; Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016 Jun 1176(6):816-25. doi: 10.1001/jamainternmed.2016.1548.

  • ; Sedentary behavior and health outcomes: an overview of systematic reviews. PLoS One. 2014 Aug 219(8):e105620. doi: 10.1371/journal.pone.0105620. eCollection 2014.

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