Physical Activity Guidelines

Physical Activity Guidelines        
Prepared by  Prepared by: Dr Ralph Richards and Christine May, Senior Research Consultants, Clearinghouse for Sport, Sport Australia
Reviewed by  Reviewed by network: Australian Sport Information Network (AUSPIN)
Last updated  Last updated: 23 October 2018
Please refer to the Clearinghouse for Sport disclaimer page for
more information concerning this content.

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Introduction

Physical inactivity has been identified by the World Health Organisation (WHO) as the fourth leading risk factor globally for mortality. High levels of sedentary behaviour and physical inactivity can also have a significant negative impact on a nation’s health budget and wider economy. 

Governments play a central role in partnering and cooperating with many other stakeholders to promote and implement preventative health initiatives. This collective impact can create an environment that empowers and encourages physically active behaviour by individuals, families, and communities.

Being physically active can have many positive personal health benefits—for both mind and body—as well as social and community benefits. Sport and active recreation organisations and clubs play a key role in helping people and communities to be more physically active and meet established physical activity guidelines. 

Key Messages 

1

Governments play a central role in providing evidence-based guidelines for health and lifestyle enhancing physical activity across all age-groups.

2

The World Health Organization (WHO) has issued a global strategy on physical activity, advocating a mixture of 'top-down' and community-based actions.

3

The total economic cost of physical inactivity to the Australian economy is substantial, it consists of increased health care costs, lost productivity, and premature mortality.

4

Governments and stakeholders can use physical activity guidelines to shape policy and implement relevant strategies.


Australia's Physical Activity and Sedentary Behaviour Guidelines, Australian Government, Department of Health. This page contains links to the age-based physical activity guidelines recommended as one (of many) contributing factors to good health. The guidelines also incorporate recommendations about the amount of sedentary time (not including sleep) that persons should allow in their daily routine. These guidelines are supported by a rigorous evidence review process, based on the best available evidence relating to the relationship between physical activity (i.e. amount, frequency, intensity, and type of physical activity) and health outcome indicators (risk of chronic disease and obesity), and the relationship between sedentary behaviour (i.e. sitting or lying down for extended periods, except when sleeping) and health outcome indicators.

The Australian Government Department of Health is responsible for the promotion of health-enhancing physical activity. The Government has commissioned research, developed guidelines, and published consumer resources to inform the public about the well established link between regular physical activity and health; as well as the risks associated with excessive sedentary time.

The overall theme of the government guidelines is 'Make your move - Sit less - Be active for life!'

  • Australian 24-Hour Movement Guidelines for the Early Years (PDF  - 150 KB) ,National Physical Activity and Sedentary Behaviour, and Sleep Recommendations for Children (Birth to 5 years), Commonwealth of Australia (2017?). Being physically active every day is important for the healthy growth and development of infants, toddlers and pre-schoolers. These recommendations are for all children aged 0-5 years who have not yet started school, irrespective of cultural background, gender or ability.
  • Make your Move – Sit less – Be active for life! (PDF  - 330 KB), Australia’s Physical Activity & Sedentary Behaviour Guidelines for Children 5-12 years. Commonwealth of Australia (2014). Being physically active is good for kids’ health and creates opportunities for making new friends and developing physical and social skills. These guidelines are for all children aged 5-12 years who have started school, irrespective of cultural background, gender or ability.
  • Make your move – Sit less – Be active for life! (PDF  - 1.3 MB), Australia’s Physical Activity & Sedentary Behaviour Guidelines for Young People 13 -17 years old. Commonwealth of Australia (2014). As young people move through school, start work and become more independent, being physically active and limiting sedentary behaviour every day is not always easy, but it is possible and it is important. These guidelines are for all young people aged 13-17 years old, irrespective of cultural background, gender or ability.
  • Make your Move – Sit less – Be active for life! (PDF  - 324 KB), Australia’s Physical Activity & Sedentary Behaviour Guidelines for Adults 18-64 years. Being physically active and limiting your sedentary behaviour every day is essential for health and wellbeing. These guidelines are for all adults aged 18 – 64 years, irrespective of cultural background, gender or ability.
  • Choose Health: Be Active - A physical activity guide for older Australians (PDF  - 1.3 MB), Physical Activity Recommendations for Older Australians 65 years and older. Commonwealth of Australia, (2008) Being physically active and staying fit and healthy will help you to get the most out of life, whatever your age. These recommendations are designed to help older Australians achieve sufficient physical activity for good health as they age. They are mainly for people who are not currently building 30 minutes of physical activity into their daily lives, and are looking for ways they can do so.
  • Is your family missing out on the benefits of being active every day? Make your Move - Sit less - Be active for life! (PDF - 1.4 MB). Commonwealth of Australia (2014). This publication provides information about the benefits to families of being physically active, and offers steps that every family can take towards better health.

Background resources and information available from the Department of Health:

Information and guidelines for Active Women in Sport, including exercise during and after pregnancy have been published by Sports Medicine Australia (SMA).

The National Heart Foundation of Australia recognises that increased population levels of physical activity will result in community-wide benefits in health, the environment, social cohesion, and the economy. They have published an extensive report that serves as a blueprint for action.
 
Blueprint for an Active Australia (PDF  - 13.0 MB), Second Edition, National Heart Foundation of Australia (2014). Active living plays a key role in broader economic and social goals for our nation, as well as providing personal benefits. This report outlines the responsibility of governments (federal, state/territory, and local) in health promotion policies and programs, school physical education, sport and fitness, active transport (school or work), urban planning, and sport and recreation programs. It also makes recommendations on what must be done to make Australia a more active nation:

  1. Implement a national, integrated, and ongoing physical activity mass-media strategy.
  2. Regulate to provide a built environment that supports active living.
  3. Actively encourage, support, and facilitate more walking, cycling, and public transport use.
  4. Develop and implement a physical activity workforce training strategy.
  5. Provide financial incentives (tax and price) for individuals, families, and business to make active choices cheaper and easier.
  6. Activate healthcare funding systems that support general medical practitioners and other health professionals to prescribe and provide advice about physical activity.
  7. Provide programs and opportunities to increase physical activity levels among Aboriginal and Torres Strait Islander peoples.
  8. Implement a life-stage approach to physical activity programming, including:
    a) a comprehensive active children and youth program,
    b) an active families initiative,
    c) an active adults initiative,
    d) an active older adults campaign.
  9. Provide physical activity programs in key settings where people live, work, and are educated, including:
    a) workplaces,
    b) local government,
    c) schools and childcare facilities.
  10. Provide leadership, coordination, and infrastructure to support implementation of the above actions:
    a) establish a Prime Minister’s Advisory Council on Physical Activity to oversee development of an implementation strategy for Blueprint for an active Australia,
    b) identify fiscal measures to ensure dedicated financial resources to fund ongoing implementation,
    c) fund and support regular monitoring of the Australian population’s physical activity levels,
    d) prioritise funding for physical activity research and program evaluation,
    e) monitor the impact of a changing environment.

In 2015, VicHealth commissioned research to identify key segments of Victorians based on their levels and type of physical activity. The research, published in June 2017, found that there are five distinct ‘life stages’ which have common themes as well as unique attributes that influence physical activity behaviour. These stages are Youth (PDF  - 89 KB) [ages 12-17]; Young adults (PDF  - 101 KB) [ages 18-24]; Parents (PDF  - 113 KB) [ages not specified]; Adults with no children (PDF  - 103 KB) [ages 25+ without children]; and Retirees (PDF  - 120 KB) [ages not specified]. 

  • Insights to engage Victorians in physical activity at different life stages (PDF  - 119 KB). VicHealth, (June 2017). This research involved online surveys of 3145 Victorians aged 12 and over across Victoria, as well as focus groups with Victorian adults aged 18 and over. It resulted in five distinct ‘life stages’ for which there are common themes and unique attributes that influence physical activity behaviour. Within each life stage, sub-groups were identified based on their physical activity levels and their likelihood to respond to programs and communications encouraging them to be more active. Some enablers and barriers to physical activity are common to all life stages. But to increase the success of strategies to increase activity, consider the sub-groups and what influences their attitudes and motivations, and the level of personal or external support available. Strategies must also consider the awareness and availability of physical activity options to the sub-group and what and how to communicate with them. 

Many countries and jurisdictions have developed guidelines for the amount and level of physical activity that individuals should aspire to for the maintenance of good health. As physical activity has moved into the mainstream of public health, the quantity and quality of global research has grown. In 2013, scientific papers on physical activity were published in 105 countries. However, about half of all scientific publications on physical activity came from only 6 countries (listed in descending order of the number of publications): United States, Australia, Canada, United Kingdom, Spain, and Germany. The leading 20 countries accounted for 82% of global physical activity research. Further, 103 countries have now initiated public health efforts that address physical inactivity as evidenced by inclusion of physical activity guidelines/policies/plans within their national public health sector.

  • 1st Physical Activity Almanac (PDF  - 285 MB), Varela A, Pratt M, Borges C and Hallal P, Global Observatory for Physical Activity, International Society for Physical Activity and Health (2016). The Global Observatory for Physical Activity (GoPA!) was formed in 2012 in response to the challenge of making governments aware of the importance of physical activity as a preventive health measure. This Almanac provides reliable, high quality, and timely global information on key physical activity measures and their health impact for 139 countries. Data-sets are collected and presented in a consistent manner to assess each country on: (1) general statistics – population size, life expectancy, literacy rate, and socioeconomic indicators; (2) physical activity prevalence – national physical activity guidelines and gender differences in physical activity among the adult population; (3) physical inactivity and health burden related mortality – estimated all-cause mortality associated with physical inactivity; (4) national physical activity plans – government policies that encourage and promote physical activity and regular monitoring protocols; (5) physical activity surveillance – regular collection, analysis, interpretation, and dissemination of information (i.e. sampling methodology must conform to World Health Organization, WHO, guidelines); and (6) research – number of scientific publications (i.e. obtained from PubMed) attributed to that country. These reporting metrics are translated into a standard reporting format – Country Card – that allows meaningful comparisons and may serve as a research and advocacy tool.
  • Country Cards. The aim is to update the GOPA Country Cards every two years, which will then be published on the main GOPA website. As of September 2017 there were 141 approved cards available on the website
  • 127 Steps toward a more active world (PDF  - 4.2 MB), Pratt M, Ramiriz A, Martins R, Bauman A, Heath G, Kohl H, Lee I, Powell K and Hallal P, Journal of Physical Activity and Health, Volume 12 (2015). The Global Observatory for Physical Activity (GoPA) released the first ever comprehensive country-by-country report on the status of physical activity in 2015. The report looked at physical activity surveillance, research, and policies among 127 countries. The countries surveyed account for 81% of the world’s population. It’s estimated that physical inactivity accounts for more than 5 million deaths each year globally and the economic burden of this mortality is spread across both developed and developing countries.
  • Global Observatory for Physical Activity. This project tracks physical activity surveillance, research, and policy worldwide.

World Health Organisation (WHO)

  • Global Action Plan on Physical Activity 2018-2030: more active people for a healthier world (PDF  - 1.5 MB), World Health Organisation (2018). WHO has developed a new global action plan to help countries scale up policy actions to promote physical activity. It responds to the requests by countries for updated guidance, and a framework of effective and feasible policy actions to increase physical activity at all levels. The plan sets out four objectives (create active societies, active environments, active people and active systems) and recommends 20 evidence-based policy actions that are applicable to all countries and address the cultural, environmental and individual determinants of inactivity.
    • Let’s be active for health for all, World Health Organisation/YouTube, (3 June 2018). The Let’s be active campaign is promoting the advice of the WHO Global action plan on physical activity, which was endorsed at the World Health Assembly in 2018.
  • Global Recommendations on Physical Activity for Health (PDF  - 1.8 MB), World Health Organisation (2010). Physical inactivity is now identified as the fourth leading risk factor for global mortality. The recommendations set out in this document address three age groups: 5–17 years old; 18–64 years old; and 65 years old and above.
  • Physical activity promotion in socially disadvantaged groups: principles for action  (PDF  - 2.2 MB) World Health Organisation (2013). The promotion of physical activity has increasingly been recognised in Europe as a priority for public health action and many countries have responded by developing guidelines and policies. Current evidence indicates that low levels of physical activity are often found in socially disadvantaged groups. A total of 127 government policy documents on promoting physical activity were reviewed for their coverage of socially disadvantaged groups. Only 24% acknowledged the need to consider social disadvantage, indicating that both awareness of the issue and integration into mainstream policies are still to be developed. WHO has issued some best practice principles for the promotion of physical activity to disadvantaged groups, with a focus on the role of healthy environments. This report offers suggestions for national and local action on interventions and policy formulation and identifies gaps in evidence to be addressed by future research.
  • Population-based approaches to childhood obesity prevention (PDF  - 1.4 MB), World Health Organisation (2012). As part of its global commitment, the WHO has issued a ‘Global Strategy on Diet, Physical Activity and Health’. Population-based approaches should consist of a mixture of 'top-down' policy decisions and community-based actions.
  • WHO fact sheet – physical activity. World Health Organisation, (updated February 2017). The WHO says the term "physical activity" should not be confused with "exercise", which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Both, moderate and vigorous intensity physical activity brings health benefits. At all ages, the benefits of being physically active outweigh potential harm, and some physical activity is better than doing none.
  • WHO Global Strategy on Diet, Physical Activity and Health (PDF  - 1.7 MB), World Health Organisation (2004). Governments have a central role in creating an environment that empowers and encourages physical activity by individuals and communities. This strategy document was developed through a wide-ranging series of consultations with all concerned stakeholders in response to a request from Member States.

Canada FlagCanada

Physical activity guidelines have been developed by the Canadian Society for Exercise Physiology for specific age groups: Children in their early years (0-4 years of age); Children (5-17 years); Adults (18-64 years); and Older Adults (65+ years). In addition, guidelines have been established for special populations. The Society updated these guidelines in 2016 to integrate their recommendations on physical activity, sedentary behaviour and sleep to represent behaviour on a 24-hour cycle.

Active Canada 20/20: A physical activity plan for Canada, Spence J, Faulkner G, Bradstreet C, Duggan M and Tremblay M, Canadian Journal of Public Health, Volume 106, Number 8 (2015). Physical inactivity is a major public health concern in Canada. To date, Canada’s approach to increasing population physical activity has been fragmented and has lacked coordination, funding, and a strategic approach. Active Canada 20/20 provides both a national plan and a commitment to action from non-government as well as the public sector to engage the general public. It outlines a road map for initiating, coordinating, and implementing proactive initiatives to address the prominent health risk factor that inactivity presents.

The Brain + Body Equation: Canadian kids need active bodies to build their best brains: 2018 ParticipACTION Report Card on Physical Activity for Children and Youth, ParticpACTION, (2018). The Report Card synthesizes data from multiple sources, including the best available peer reviewed research, to assign evidence-informed grades across 14 indicators. While 62% of 3- to 4-year-olds are reaching their recommended physical activity levels as outlined in the Canadian 24-Hour Movement Guidelines for the Early Years, only 35% of 5- to 17-year-olds are achieving the recommended activity levels for their age group. We also know that 76% of 3- to 4-year-olds and 51% of 5- to 17-year-olds are engaging in more screen-time than is recommended by the Canadian Guidelines for screen-based sedentary behaviours.

Expert Statement on Physical  Activity and Brain Health in Children and Youth, ParticipACTION, (2018), (PDF  - 3.2 MB). The best available scientific evidence was used to inform the development of this report, and an expert advisory group provided feedback on its messaging. All members of the expert team approved this Expert Statement. For better brain health,all children and youthshould be physicallyactive on a regular basis.In addition to physicalhealth benefits, physicalactivity also improvescognition, brain functionand mental health.

Being active needs to be the Canadian norm, not the exception, ParticipAction (16 November 2016). Canada has above-average (internationally) physical activity infrastructure and programs, yet physical activity statistics show Canadian children and youth fall behind their age cohort in many other countries. The comparisons also reveal kids move the most in countries where being active is a priority or is an integral part of their everyday lifestyle. Experts suggest that Canada (as a society) must resist the decline in habitual movement offered by urbanization, mechanization, and the use of motorized transport for routine travel; and not just by creating policies, strategies, facilities, and bike lanes, but also by encouraging and re-establishing Canadian cultural norms where being physically active year roundthrough outdoor play, active transportation, recreation, and sportare the Canadian standard, not the exception. 

ParticipACTION Pulse Report, MEC/Participaction, (April 2018). The Pulse Report assesses the social climate of physical activity among Canadian adults. A first of its kind, this Report explores Canadians’ thoughts, feelings, and motivations as they relate to physical activity and informs what shifts are needed in order to make physical activity a vital part of everyday life in Canada. It highlights that despite Canadians apparently valuing and enjoying physical activity; knowing they’re not physically active enough; and thinking that this is something that they could change, they are not actually changing their behaviours. The report also suggests that although the majority of Canadians think that individuals have primary responsibility for being sufficiently active they also need help, and organisations and the government should be working towards this. 

Europe FlagEuropean Union 

  • EU Physical Activity Guidelines: recommended policy actions in support of health-enhancing physical activity (PDF  - 213 KB), EU Working Group ‘Sport & Health’ (2008). School-aged youth should participate in 60 minutes or more of moderate to vigorous physical activity daily, in forms that are developmentally appropriate, enjoyable, and involve a variety of activities. The full dose can be accumulated in bouts of at least 10 minutes. Development of motor skills should be emphasised in early age groups. Specific types of activity according to the needs of the age group should be addressed: aerobic, strength, weight bearing, balance, flexibility, motor development. For healthy adults aged 18 to 65 years, the goal recommended by the WHO is to achieve a minimum of 30 minutes of moderate-intensity physical activity 5 days a week or at least 20 minutes of vigorous-intensity physical activity 3 days a week. For adults aged over 65, in principle the same goals as for healthy younger adults should be achieved. In addition, strength training and balance exercises to prevent falls are of particular importance in this age group.
  • National physical activity recommendations: systematic overview and analysis of the situation in European countries (PDF  - 427 KB), Kahlmeier S, Wijnhoven T, Alpiger P, Schweizer C, Breda J and Martin B, BMC Public Health, published online (12 February 2015). Developing national physical activity guidelines and recommendations provide a benchmark for the implementation and assessment of programs that promote physical activity (PA). A systematic review was conducted of the national PA recommendations across 37 of the 53 countries within the European Region. Only 40% of the countries have developed recommendations/guidelines for PA, a necessary first step towards comprehensive PA promotional strategies. In addition, only a few countries have addressed the influences of sedentary behaviours in their recommendations.
  • European normative values for physical fitness in children and adolescents aged 9–17 years: results from 2 779 165 Eurofit performances representing 30 countries, Tomkinson GR, Carver KD, Atkinson F, et al., British Journal of Sports Medicine, (published online 30 November 2017). Data from studies identified by a systematic review were included to generate results for the nine Eurofit tests (measuring balance, muscular strength, muscular endurance, muscular power, flexibility, speed, speed-agility, and cardiorespiratory fitness (CRF). Following harmonisation for methodological variation where appropriate, pseudodata were generated to provide population-weighted sex-specific and age-specific normative centiles. This study provides the largest and most geographically representative sex-specific and age-specific European normative values for children and adolescents, which have utility for health and fitness screening, profiling, monitoring and surveillance.

New Zealand FlagNew Zealand

Sport New Zealand, the Ministry of Education, and the Ministry of Health have released activity guidelines for a range of ages:

  • Physical activity for healthy, confident kids (PDF - 3.1 MB), Ministry of Education (2007). These guidelines, produced by the Ministry of Education and supported by Sport New Zealand, are part of a package of initiatives aimed at improving the lifestyles of young New Zealanders by targeting improved nutrition and increased physical activity.
  • Physical Activity, Ministry of Health. Physical activity can help people live longer and healthier lives. The New Zealand Physical Activity Guildlines outline minimum levels of physical activity required to gain health benefits. Guidelines are established for older adults (over the age of 65), adults (ages 18 to 65 years), children and young people (ages 5 to 18 years) and children under the age of 5 years.
  • Eating and Activity Guidelines for New Zealand Adults (PDF  - 4.4 MB), McIntyre L and Dutton M, New Zealand Ministry of Health (2015). This document provides evidence-based population health advice on healthy eating and being physically active. The document is written for health practitioners and others who provide advice on nutrition and physical activity for New Zealand adults. The new guidelines bring together the eating and physical activity guidelines, outlining each statement and why it is recommended. This document also identifies the international evidence that underpins the statements and provides some information for putting the statements into practice.
  • Guidelines on Physical Activity for Older People, aged 65 years and older, New Zealand Government, Ministry of Health (2013). These guidelines give five key recommendations to help older people live longer, healthier lives. These recommendations are: (1) be as physically active as possible and limit sedentary behaviour; (2) consult an appropriate health practitioner before starting or increasing physical activity; (3) start off slowly and build up to the recommended daily physical activity levels; (4) aim to participate in physical activity on five days per week for at least 30 minutes if the activity is of moderate-intensity, and 15 minutes if it is of vigorous-intensity, or a mixture of moderate and vigorous intensity aerobic activity; (5) aim to do three sessions of flexibility and balance activities, and two sessions of muscle-strengthening activities per week.

United Kingdom flagUnited Kingdom

  • Start Active, Stay Active (PDF  - 1.3 MB), (2011).  A report on physical activity from the four home countries' Chief Medical Officers (England, Northern Ireland, Scotland, Wales).  This is a UK-wide document that presents guidelines on the volume, duration, frequency, and type of physical activity required across the life-course to achieve general health benefits. The report is intended for professionals, practitioners, and policymakers concerned with formulating and implementing policies and programmes that utilise the promotion of physical activity, sport, exercise, and active travel to achieve health gains.
  • A more active Scotland: Scotland's Physical Activity Delivery Plan (PDF  - 1.1 MB), Scottish Government, (June 2018). The Active Scotland Outcomes Framework sets out the shared vision and goals which have shaped the approach the Scottish Government and a wide range of partner organisations have taken to supporting and enabling people in Scotland to be more physically active. The identified actions and outcomes align with the WHO Global Action Plan. 
  • Early years slides. British Heart Foundation National Centre for Physical Activity and Health, (2014). This comprehensive set of PowerPoint slides presents key data and information on physical activity in the early years. The slides are designed for use by early years professionals to help share information on physical activity in this age group with peers, parents/carers, commissioners, and other agencies. They can be tailored and used as the basis for a presentation or adapted to include local information. The slides can be mixed and matched to include just the information that you need. Information is included on: (1) the UK physical activity guidelines for the early years and the benefits of physical activity in this age group; (2) physical activity levels and factors influencing these in the early years; (3) recommendations for promoting physical activity and levers to influence policy in the early years; (4) resources to promote physical activity in the early years. These slides can be used freely with acknowledgement to the British Heart Foundation National Centre for Physical Activity and Health.
  • Everybody Active, Every Day: An evidence-based approach to physical activity (PDF  - 1.3 MB), Varney J, Brannan M and Aaltonen G, Public Health England (2014). This report from Public Health England, an autonomous executive agency of the Department of Health, provides evidence that physical activity reduces the risk of many preventable diseases. It also supports the role of physical activity in enhancing the life of everyone, from children to mature age.
  • Older adults slides - physical activity guidelines and benefits, National Centre for Physical Activity and Health and British Heart Foundation (September 2016). These PowerPoint slides provide an overview of the UK physical activity guidelines for older adults and the associated benefits for health and wellbeing. 
  • Motivate 2 Move, British Association of Sport & Exercise. The purpose of this website is to give all health professionals the tools and information they need to educate, motivate, and encourage patients to be physical activity.

USA FlagUnited States 

  • Physical Activity Guidelines for Americans, President’s Council on Fitness, Sports & Nutrition (2008). Physical activity is critical for overall health at every age, but today America’s youth are less active than ever before. Many settings provide opportunities to increase youth physical activity to the recommended 60 minutes or more a day, including the places kids live, learn and play.
  • Physical Activity Guidelines, Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, (2008). These guidelines are based on the latest science, they provide guidance on how children and adults can improve their health through physical activity.
  • At-A-Glance - A Fact Sheet for Professionals, Physical Activity Guidelines for Americans. The Office of Disease Prevention and Health Promotion, (2008). This fact sheet provides a quick reference guide for each population group; children and adolescents, age 6-17 years; adults, age 18-64 years; older adults, 65+ years of age, persons with a disability, and pregnant and postpartum women.
  • National Physical Activity Plan 2016 (PDF  - 9.6 MB). The 2016 Plan builds on the first U.S. National Physical Activity Plan, which was released in 2010. It is a collaboration of nine sectors: business and industry; community recreation; fitness and parks; education; faith-based settings; media; public health; sport; and transportation. The Plan is grounded in a socio-ecological model of health behaviour. This model holds that physical activity behaviour is influenced by a broad constellation of factors operating at the personal, family, institutional, community and policy levels. Sustainable behaviour change is most likely when influences at all the levels are aligned to support change. The Plan includes recommendations for actions at the national, state, local and institutional levels, but fundamentally it is a roadmap for change at the community level that facilitates personal behaviour change.
  • 2018 Physical Activity Guidelines Advisory Committee: Scientific Report, 2018 Physical Activity Guidelines Advisory Committee, U.S. Department of Health and Human Services, (February 2018). The 2018 Physical Activity Guidelines Advisory Committee submitted its Scientific Report to the Secretary of Health and Human Services in February 2018. The report summarizes the scientific evidence on physical activity and health, and will be used by the government to develop the second edition of the Physical Activity Guidelines for Americans.

Reference iconPosition Statements

  • COSA Position Statement on Exercise in Cancer Care (PDF  - 1.1 MB), Clinical Oncology Society of Australia (COSA), (April 2018). This document outlines the position of COSA with respect to exercise recommendations [28-33], taking into account the strengths and limitations of the epidemiological and clinical trials evidence base. COSA recommends that: 
    • All people with cancer should avoid inactivity and return to normal daily activities as soon as possible following diagnosis (i.e. be as physically active as current abilities and conditions allow) 
    • All people with cancer should progress towards and, once achieved, maintain participation in: at least 150 minutes of moderate intensity or 75 minutes of vigorous-intensity aerobic exercise (e.g. walking, jogging, cycling, swimming) each week; and two to three resistance exercise (i.e. lifting weights) sessions each week involving moderate to vigorous-intensity exercises targeting the major muscle groups.
    • Exercise recommendations should be tailored to the individual’s abilities noting that specific exercise programming adaptations may be required for people with cancer based on disease and treatment-related adverse effects, anticipated disease trajectory and their health status 
    • Accredited exercise physiologists and physiotherapists are the most appropriate health professionals to prescribe and deliver exercise programs to people with cancer.
    • All health professionals involved in the care of people with cancer have an important role in promoting these recommendations. 

Reading Reading

  • Children and physical activity, British Heart Foundation. The Foundation believes that the UK Government should be: (1) tackling inequalities and ensuring gender equity in access to enjoyable sports and physical activities, (2) prioritising physical activity in and around the school day, and (3) raising awareness of the 60 minutes a day physical activity guideline and promoting the health benefits of regular activity among children, young people, and adults.
  • CSEP Special Supplement – Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep, Canadian Society for Exercise Physiology – Special Supplement – Applied Physiology, Nutrition, and Metabolism, Volume 41, Issue 6. Supplement 3 (2016). There is growing interest and support for an integrated approach to understand and promote movement behaviours based upon a 24-hour activity cycle. This special supplement of the journal, Applied Physiology, Nutrition, and Metabolism, provides an evidence base for new ‘physical activity – sedentary behaviour – and sleep guidelines’ for Canadians.
  • Interventions on Diet and Physical Activity: What Works (PDF  - 1.7 MB), World Health Organisation (2009).  The WHO has published evidence on effective interventions under the eight categories: (1) policy and environment; (2) mass media; (3) school settings; (4) the workplace; (5) the community; (6) primary health care; (7) older adults; and (8) religious settings. Although there is no one-size-fits-all approach for selecting interventions, the results of this review provides a summary of tried and tested diet and physical activity interventions to support and enable individuals to make healthy choices. Interventions on Diet and Physical Activity: What Works, Evidence Tables (PDF  - 920 KB), World Health Organisation (2009).
  • Time to challenge public health guidelines on physical activity (PDF  - 352 KB), De Souto Barreto P, Sports Medicine, Volume 45, p769-773 (2015). Since the mid-1990s, public health guidelines on physical activity (PA) have been established in many countries. These PA recommendations are intended to promote health and reduce the risk of many non-communicable diseases. A growing body of evidence suggests that PA undertaken through leisure-time or occupational activity, active transport or housework can contribute to meeting daily PA requirements. This article discusses two major issues relating to public health PA guidelines for adults and older adults: (1) the minimum volumes of PA required, and; (2) the importance of PA domains.
  • Toronto Charter for Physical Activity (PDF  - 1.2 MB), International Society for Physical Activity and Health (2010). The Society has developed this Charter as a call for action and an advocacy document for greater political and social commitment to support health enhancing physical activity for everyone.

Report iconReports

  • 2018 Physical Activity Guidelines Advisory Committee: Scientific Report, 2018 Physical Activity Guidelines Advisory Committee, U.S. Department of Health and Human Services, (February 2018). The 2018 Physical Activity Guidelines Advisory Committee submitted its Scientific Report to the Secretary of Health and Human Services in February 2018. The report summarizes the scientific evidence on physical activity and health, and will be used by the government to develop the second edition of the Physical Activity Guidelines for Americans. This report provides a comprehensive review of the various benefits that can be attributed to physical activity including physical and mental benefits for all ages. 
  • AusPlay Focus: Children's participation in organised physical activity outside of school hours (PDF  - 1.3 MB), Australian Sports Commission, (April 2018). Provides an analysis of the 2016/2017 AusPlay data as it relates to children's participation outside of school hours in organised physical activity (i.e. not free play or school sport). Information includes top sports/activities, demographics, barriers, and time spent. The overall participation rate rose in 2017 compared to 2016 but significant differences still exist between different population groups and ages, and many children are still not meeting the recommended PA guidelines. Age is a key determinant of child participation in organised physical activity, with participation peaking in the 9 to 11 age group before declining in the 12 to 14 age group. Analysis of the reasons for non-participation found that a dislike of physical activity was cited for almost one half of girls (compared to less than one quarter of boys) aged 12 to 14. The 2017 AusPlay results confirm a high correlation between the engagement of parents in physical activity and that of their child. Having at least one active parent is likely to lead children to be more active. Additionally, living in a regional or remote area; having 3 or more siblings; having a LOTE parent; or being from a low income family also significantly decrease the likelihood that a child will participate in organised, out-of-school hours physical activities. 
  • Australian Aboriginal and Torres Strait Islander Health Survey: Physical activity 2012-13, Australian Bureau of Statistics, Catalogue Number 4727.0.55.004 (2014). This ABS survey looked at the level of physical activity and sedentary activity among Indigenous children, adolescents and adults living in remote and non-remote areas. The survey data were compared to the recommended physical activity guidelines for the maintenance of health.
  • The cost of physical inactivity, Medibank Private (2008). This is the second report by Medibank Private and KPMG-Econtech investigating the economic costs of physical inactivity. This report considers the costs to employers, individuals and the economy more broadly from reduced productivity, chronic illness and premature mortality. The total economic cost of physical inactivity to the Australian economy is estimated to be $13.8 billion. This takes into account direct healthcare costs for non-communicable diseases associated with a sedentary lifestyle; offset by expenses associated with participation in physical activity including sports injuries and fitness-related expenses. It is estimated that in 2007/08, physical inactivity caused GDP to be around $9.3 billion lower than would otherwise be the case.
  • Discussion paper for the development of recommendations for children’s and youths’ participation in health promoting physical activity (PDF  - 388 KB), Trost S, Australian Government, Department of Health and Aging (2005).  The Australian Government commissioned researchers by the University of Queensland’s School of Human Movement Studies to facilitate the development of Australian recommendations for both children’s and youths’ participation in health-promoting physical activity.
  • Increasing participation in physical activity and reducing sedentary behaviour: Local Government action guide (PDF  - 1.0 MB), VicHealth (2016). Local Governments can influence the quality and distribution of conditions needed for participation in various physical activities. The natural and built environments in which we live, learn, work and play have a major effect on promoting, improving and achieving physical activity guidelines. Councils can make it easier for all residents to be physically active by: (1) adopting policy and planning approaches that can equitably enable all of the community to engage in active recreation and active travel through transport plans, parks, street amenities, paths, trails and open spaces; (2) supporting increased participation in sport and leisure activities for all residents through promotions, programs and the provision of safe, affordable, clean and accessible sport and recreation facilities, and; (3) encouraging less sitting and more movement every day within workplaces.
  • Insights to engage Victorians in physical activity at different life stages (PDF  - 119 KB). VicHealth, (June 2017). This research involved online surveys of 3145 Victorians aged 12 and over across Victoria, as well as focus groups with Victorian adults aged 18 and over. It resulted in five distinct ‘life stages’ for which there are common themes and unique attributes that influence physical activity behaviour. Within each life stage, sub-groups were identified based on their physical activity levels and their likelihood to respond to programs and communications encouraging them to be more active. Some enablers and barriers to physical activity are common to all life stages. But to increase the success of strategies to increase activity, consider the sub-groups and what influences their attitudes and motivations, and the level of personal or external support available. Strategies must also consider the awareness and availability of physical activity options to the sub-group and what and how to communicate with them. 
  • Physical Activity, 2014, Australian Medical Association, Position Statement. While physical activity forms part of the body’s energy balance equation, all too often the benefits of physical activity are only considered in relation to obesity and weight loss. The benefits of physical activity extend much further. Regular participation in physical activity is known to reduce the risk of physical health problems such as cardiovascular disease and stroke, type 2 diabetes, hypertension, some cancers and osteoporosis. There is also evidence that regular participation in physical activity improves both short- and long-term psychosocial wellbeing by reducing feelings of stress, anxiety and depression. A lack of physical activity, or physical inactivity, has been identified as the fourth leading risk factor for global mortality. Estimates suggest that physical inactivity is the principal cause for approximately 21-25 per cent of breast and colon cancer disease burden, 27 per cent of diabetes, and 30 per cent of ischemic heart disease burden worldwide.
  • Physical activity across the life stages. Cat. no. PHE 225, Australian Institute of Health and Welfare, (2018). This report presents information on the physical activity and sedentary participation rate of Australians across the life stages, reported against Australia’s Physical Activity and Sedentary Behaviour Guidelines. According to the most recent available data, 30% of children aged 2–17 and 44% of adults aged 18 and over met the physical activity guidelines. Most children exceeded the recommended amount of sedentary screen-based activity time, while the amount of time spent sitting at leisure increased in adults as aged increased.
  • Physical activity and sedentary behaviour: Evidence summary (PDF  - 869 KB), VicHealth (2016). Regular physical activity contributes to good health across all life stages, whereas inactivity is one of the most significant risk factors contributing to the global burden of disease. This evidence summary builds upon previous work and includes publications between 2009 and 2014. This report also includes physical activity statistics and trends for Victoria and Australia.
  • Physical Activity Guidelines Advisory Committee Report, 2008 (PDF  - 4.6 MB), U.S. Department of Health and Human Services (2008). This report provides the underpinning rationale and evidence for the ‘Physical Activity Guidelines for Americans’.
  • Review of physical activity among Indigenous people (PDF  - 1.0 MB), Gray C, Macniven R, and Thomson N, Australian Indigenous Health Reviews, Australian Indigenous HealthInfoNet  (August 2013). This report is part of ‘closing the gap’ research and summarises information from a range of sources, specifically comparing information on Indigenous and non-Indigenous populations.  Recommended physical activity guidelines and activities may not be seen by many Indigenous people as a separate, measurable concept in the same way as it is by non-Indigenous people. The National Physical Activity Guidelines for Australians do not yet incorporate guidelines for Indigenous people; however, the overall recommendations should stay the same for Indigenous people, but the type of physical activity, communication and dissemination of the recommendations may differ.
  • Sedentary Behaviour and Obesity: Review of the Current Scientific Evidence (PDF  - 964 KB), Department of Health and Department of Children, Schools and Families, United Kingdom (2010). – This document outlines the current evidence linking sedentary behaviour to obesity and strengthens the underpinning rationale for physical activity.
  • A systematic review to inform the Australian sedentary behaviour guidelines for children and young people (PDF  - 1.2 MB), Okely T, et. al. Commonwealth of Australian, Department of Health (2013). This review is to inform Australian Government policy in regards to the relationship between sedentary behaviour/sitting time and health outcome indicators, including the risk and prevention of chronic disease and obesity; and to provide information to guide evidence-based recommendations that can be used to encourage healthy living in children and adolescents aged 5-17 years, and as a basis for monitoring sedentary behaviour on a population level.

Research iconResearch

  • 2014 Global Summit on the Physical Activity of Children, Tremblay M, Journal of Physical Activity & Health, Volume 11, Supplement (2014). This supplement contains 21 articles that are open access, freely available to read and download. Acknowledging the global concern for physical inactivity and the need for preventive action, especially among children and youth, a Global Summit on Physical Activity of Children took place in Toronto, Canada, from 19-22 May 2014. Unique to the Global Summit was the cooperation among 15 countries (Australia, Canada, Columbia, England, Finland, Ghana, Ireland, Kenya, Mexico, Mozambique, New Zealand, Nigeria, Scotland, South Africa, United States) that prepared and released ‘report cards’ on physical activity among children and youth in their respective countries, using the best available evidence and following harmonized procedures. 
  • A 5-year longitudinal analysis of modifiable predictors for outdoor play and screen-time of 2- to 5-year-olds, Xu H, Wen L, Hardy L and Rissel C, International Journal of Behavioral Nutrition and Physical Activity, Volume 13 (2016). Early childhood (ages 0 to 5 years) is a critical time for establishing physical activity (PA) and sedentary behaviours (SB). This study aimed to identify modifiable predictors of outdoor play (as an expression of PA) and screen-time (as an expression of SB) in 2 to 5 year-old children. Data was collected from the Healthy Beginnings Trial conducted in Sydney (Australia) from 2007 to 2013. A total of 667 pregnant women were recruited for the study. Information on mothers’ demographics, physical activity, screen-time, knowledge of child development, and awareness of factors contributing to childhood obesity were collected during pregnancy as baseline measures. The amount of mother-infant ‘play-time’ (e.g. also called ‘tummy time’ of supervised play) and infant’s screen-time was recorded when the infant was 6 months and one-year old as modifiable predictors of behaviour at age 2, 3.5 and 5 years. The results indicate that mother’s screen-time during pregnancy and children’s daily screen-time at age 1 year significantly predicted children’s screen-time at age 2 and 5 years. Also, mother’s daily ‘tummy-time’ with their infant predicted children’s outdoor playtime at ages 2 and 5 years. This study concluded that mothers played an important role in their children’s PA and SB across ages 2 to 5 years. Early interventions should focus on improving pregnant women’s physical activity and awareness of the benefit of playing with their infant child, while reducing their own and the infant’s screen-time.
  • A review of global surveillance on the muscle strengthening and balance elements of physical activity recommendations, Karen Milton, Andrea Ramirez Varela, Tessa Strain, Nick Cavill, Charlie Foster, Nanette Mutrie, Journal of Frailty, Sarcopenia and Falls, Volume 3(2), pp.114-124, (June 2018). Despite the importance of muscle strengthening and balance activities for health, these elements of the physical activity recommendations are often omitted from communication campaigns and national surveillance systems. This paper reviews national physical activity surveillance systems as described in the Global Observatory for Physical Activity (GoPA) country cards to determine which tools assess muscle strengthening and balance activities. Of the 139 countries with GoPA country cards, 21 countries reported having no physical activity prevalence data. The prevalence estimates for 74 countries came from the World Health Organization 2014 Global Status Report on Non-Communicable Diseases. For the remaining 44 countries, a range of national and international surveys were used. A limited number of tools sought to assess muscle strengthening activities, and even fewer assessed balance and coordination activities. The authors suggest there is a need to verify the strength of the evidence to inform whether muscle strength and balance should be given equal prominence to the aerobic recommendation; establish which activities count towards different aspects of the guidelines; and confirm whether the muscle strengthening and balance components of the guidelines are ‘in addition’ to the aerobic component.
  • The descriptive epidemiology of total physical activity, muscle-strengthening exercises and sedentary behaviour among Australian adults – results from the National Nutrition and Physical Activity Survey, Bennie J, Pedisic Z, van Uffelen J, Gale J, Banting L, Vergeer I, Stamatakis E, Bauman A and Biddle S, BMC Public Health, Volume 16 (2016). This study determined the prevalence and sociodemographic correlates of moderate-to-vigorous physical activity (MVPA), strength training (ST) and sedentary behaviour (SB) in a nationally-representative sample (N=9345) of Australian adults. About 53% of the sample (age 18 to 85 years) met the MVPA guidelines; 19% the ST guidelines; and 15% the SB guidelines which set a limit on the amount of daily sedentary time. The results indicate a need for public health interventions to reduce physical inactivity and sedentary time among Australian adults, particularly among the subgroups at highest risk because of these unhealthy behaviours. At risk groups included females, older adults, and those with lower education attainment.
  • The Economic Burden Of Physical Inactivity: A Global Analysis Of Major Non-Communicable Diseases, Ding Ding, Kenny Lawson, Tracy Kolbe-Alexander, et.al., The Lancet, Volume 388(10051), pp.1311-1324, (September 2016). Conservatively estimated, physical inactivity cost health-care systems international $ (INT$) 53·8 billion worldwide in 2013, of which $31·2 billion was paid by the public sector, $12·9 billion by the private sector, and $9·7 billion by households. In addition, physical inactivity related deaths contribute to $13·7 billion in productivity losses, and physical inactivity was responsible for 13·4 million DALYs worldwide. High-income countries bear a larger proportion of economic burden (80·8% of health-care costs and 60·4% of indirect costs), whereas low-income and middle-income countries have a larger proportion of the disease burden (75·0% of DALYs). Sensitivity analyses based on less conservative assumptions led to much higher estimates.
  • Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant, Bo K, Aertal R, Barakat R, et.al., British Journal of Sports Medicine, Volume 50, Issue 10 (2016). Guidelines on physical activity or exercise and pregnancy encourage pregnant women to continue or adopt an active lifestyle during and following pregnancy. Two systematic reviews of pregnancy-related guidelines on physical activity found similarities between recommendations from different countries, but noted that the guidelines differed in focus. The IOC promotes high-level performance, and is also committed to promoting lifelong health among athletes, not just during their competitive sporting careers. With this background, the IOC assembled an international expert committee to review the literature on physical activity and exercise during pregnancy and after childbirth, using rigorous systematic review and search criteria; this consensus statement is the result of the Committee’s work. 
  • Happier people live more active lives: Using smartphones to link happiness and physical activity, Lathia N, Sandstrom G, Mascolo C and Rentfrow P, Plos One, published online (4 January 2017). Both planned physical activity (e.g. exercise, physical recreation and sport) and informal physical activity (e.g. daily movement) may contribute to physical and psychological health. This study examined physical activity (in the broadest sense) and reported feelings of happiness, using a smartphone application in a sample of over 10,000 participants. The app collected self-reports of happiness while simultaneously gathering information about physical activity from the accelerometers on users' phones. The findings indicate that individuals who are more physically active are happier.  
  • Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship, Arem H, et.al., JAMA Internal Medicine, Volume 175, Number 6, p959-967 (2015). The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 minutes of vigorous-intensity, or 150 moderate-intensity minutes, per week (7.5 metabolic-equivalent hours per week) of aerobic activity for substantial health benefit and suggested that additional benefits could result from doing more than double this amount. This study looked at the upper limit of longevity benefit or possible harm with more physical activity. The results indicated a 31% lower risk of mortality at 1 to 2 times the recommended minimum, and a 37% lower risk at 2 to 3 times the minimum. An upper threshold for mortality benefit occurred at 3 to 5 times the physical activity recommendation. However, compared with the recommended minimum, the additional benefit was modest. There was no evidence that harm resulted from exercise at 10 or more times the recommended minimum.
  • Series on Physical ActivityThe Lancet. This series includes new analysis that quantifies the global impact of physical inactivity on the world's major non-communicable diseases. The Series also reviews current levels of physical activity and trends worldwide, why some people are active and why some are not, evidence-based strategies for effective physical activity promotion, and how a multi-sector and systems-wide approach that goes beyond health will be critical to increase population-levels of activity worldwide.
  • Socioeconomic position during childhood and physical activity during adulthood: a systematic review, Juneau C, Benmarhnia T, Poulin A, Cote S and Potvin L, International Journal of Public Health, published online (23 August 2015). A growing body of evidence links socioeconomic position early in life and physical activity during adulthood. This systematic review of literature provides a summary of the evidence. This reviews found the bulk of evidence supports this association.
  • Traditional and emerging lifestyle risk behaviors and all-cause mortality in middle-aged and older adults: Evidence from a large population-based Australian cohort (PDF  - 353 KB), Ding D, Rogers K, van der Ploeg H, Stamatakis E and Bauman A, Plos Medicine, published online( 8 December 2015). Behavioural risk factors, such as smoking, alcohol consumption, poor diet, and physical inactivity, tend to cluster within populations and may have synergistic effects on health. This study looks at the interaction of risk factors and also examines emerging lifestyle risk factors, such as prolonged sitting and unhealthy sleep patterns. Data was taken from a large (N=231,048) cohort of Australian adults, over a six year period. This study found that specific combinations of lifestyle risk behaviours may be more harmful than others. Australia’s physical activity guidelines were revised in 2012 to include recommendations regarding both physical activity and sedentary behaviour. A better understanding of how risk factors interact to affect health may shape future revisions in Australia’s Physical Activity and Sedentary Behaviour Guidelines.
  • Trends in prevalence of leisure time physical activity and inactivity: results from Australian National Health Surveys 1989 to 2011. Chau, J., Chey, T., Burks-Young, S., Engelen, L. and Bauman, A., Australian and New Zealand Journal of Public Health, (2017). Using data from six Australian National Health Surveys from 1989 to 2011 this research assessed the proportion of Australian physical activity. Overall the prevalence of sufficient physical activity remains low and inactivity high. Women appear to be a key target group for intervention. Public health efforts have been ineffective over two decades for improving physical activity among Australian adults. This research supports calls for a national physical activity action plan given the multitude of benefits from sufficient physical activity. Maintenance of consistent physical activity questions in future National Health Surveys will facilitate long term tracking of physical activity levels in the Australian population.
  • Twenty year fitness trends in young adults and incidence of prediabetes and diabetes: the CARDIA study , Chow L, Odegaard A, Bosch T, et.al., Diabetologia, (published online 16 May 2016). Data from 4300 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study in the United States was used to quantify cardio-respiratory fitness from young adulthood to middle age. Higher fitness was associated with lower risk for developing incident prediabetes or type 2 diabetes, after adjusting for covariates. The findings emphasise that the recommended level of physical activity – vigorous exercise or moderate exercise, 30 minutes/day and 40 minutes/day respectively, may reduce the risk of acquiring type 2 diabetes.
  • Worldwide Surveillance, Policy, and Research on Physical Activity and Health: The Global Observatory for Physical Activity.  Andrea Ramirez Varela, Michael Pratt, Kenneth Powell, et.al., Journal of Physical Activity and Health, Volume 14(9), (2017), pp.701-709. The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide. Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information’s accuracy and completeness. Associations were calculated among surveillance, policy and research categories. Surveillance, policy, and research indicators were positively correlated, suggesting that action at multiple levels tends to stimulate progress in other areas. Efforts to expand PA-related surveillance, policy, and research in lower income countries are needed.

resources iconResources

  • Physical Activity Strategy 2018-2023, VicHealth, (2018). Aims to increase the number of Victorians who are physically active – making being active part of everyday life. Key focus of the strategy is children aged 5-12 years; young people aged 12-17 years; and women and girls. 

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