Conference Coverage

New HHS physical activity guidelines break fresh ground



– The newly released comprehensive second edition of the federal physical activity guidelines have a lofty goal.

“Our overarching vision is to transform the current sick care system into a health promoting system,” Adm. Brett P. Giroir, MD, declared in introducing the recommendations at the American Heart Association scientific sessions.

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Admiral Brett P. Giroir

“Physical activity is one of the most effective preventive health interventions available, and we need more emphasis on prevention as we transition to a value-based reimbursement structure that rewards better health maintenance and avoids chronic conditions,” added Adm. Giroir, assistant secretary for health at the U.S. Department of Health & Human Services.

Although the agency opted to unveil the new guidelines before an audience of cardiologists at the AHA scientific sessions, the report includes sections relevant for a wide range of medical specialists, including primary care physicians, pediatricians, psychiatrists, neurologists, endocrinologists, and geriatricians.

Before launching into a description of what’s new in the second edition, Adm. Giroir set the stage with blunt talk about the nation’s poor state of physical fitness.

“Inactivity causes 10% of premature mortality in the United States. That means if we can just get 25% of inactive people to be active and meet the recommendations, almost 75,000 deaths per year would be prevented in the United States. And on an even larger scale worldwide, if 25% of those same people who are inactive started moving and met the guidelines, more than 1.3 million deaths would be prevented,” according to Adm. Giroir.

At present, only 26% of men, 19% of women, and 20% of teenagers meet the physical activity recommendations.

Failure to meet the federal aerobic physical activity recommendations accounts for an estimated nearly $117 billion in annual health care costs. And it poses a national security threat, too: Nearly one-third of all 17- to 24-year-olds are disqualified from military service because of obesity. Even more eye-opening, he continued, is that fully 71% of all 17- to 24-year-olds are ineligible for military service because of obesity, lack of physical fitness, lack of education, or substance use.

The actual recommendations contained in the second edition of the Physical Activity Guidelines for Americans remain unchanged from those in the first, issued a decade earlier. That is, in order to gain substantial health benefits, adults and adolescents should engage in at least 150-300 min/week of moderate intensity aerobic physical activity or 75-150 min/week of vigorous intensity aerobic activity. Plus they should do muscle-strengthening exercises such as weight lifting or push-ups at moderate or greater intensity at least 2 days/week.

Asked why the guidelines are sticking with time-based physical activity recommendations in an era when popular smartwatches and other mobile devices can readily spit out number of steps walked, calories burned, and heart-rate data, cardiologist William E. Kraus, MD, one of the 17 members of the scientific advisory committee who reviewed and graded the scientific evidence on physical activity, sedentary behavior, and health, answered. He said the group’s careful review concluded that “there’s just not enough evidence at this time to make a recommendation” with regard to mobile device–based measurements of physical activity and their relationship with health benefits.

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Dr. William E. Kraus

“We’re hoping to spur more research in this area, so that the next time we make recommendations, that can be incorporated,” added Dr. Kraus, a professor of medicine and cardiologist at Duke University, Durham, N.C., as well as president-elect of the American College of Sports Medicine.


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