The update of the exercise guidelines gets generally positive reviews



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The revised recommendations of the US Department of Health and Human Services (HHS) on physical activity have generated largely positive feedback from cardiologists and other specialists in preventive medicine.

Major changes from the first edition published in 2008 – announced Monday at the American Heart Association meeting in Chicago and published online in JAMA — included:

  • Elimination of the threshold of 10 minutes of physical activity to count in the respect of the recommendations
  • Adding a goal of 3 hours of physical activity a day for children 3 to 5 years old
  • A longer list of health benefits related to physical activity, now including a reduced risk of excessive weight gain, improved cognition in young people, and reduced risk of dementia later in life. life, as well as a lower risk of litany of cancer types

Adults are advised to do 150 to 300 minutes of moderate exercise or 75 to 150 minutes of vigorous exercise each week, as well as to do weight training and weight training twice a week, in order to obtain more benefits, as in the first recommendation published in 2008.

Short Tips

But the time allowed for short periods to be taken into account makes "in fact easier the implementation of the recommendations contained in the physical activity guidelines," said Admiral Brett Giroir, MD , Assistant Secretary for Health at HHS, who presented the new recommendations to the AHA. meeting.

"It 's not just a change to have more people meeting it artificially, I think it will allow people to say: all I have to do, that' s it. is to climb the stairs instead of not doing it, "he said. MedPage today.

Sports cardiologist John Higgins, MD, MBA, of the Health Sciences Center at the University of Texas at Houston, agreed that the new council can succeed in encouraging sedentary people to make minor changes.

"I think it could help people maintain weight and, in some cases, change diets, lose weight," he said. "The more people know about the benefits, the more they are inclined to exercise."

While these small changes can not reverse the obesity epidemic on their own, it's a strong incentive for everyone to move more, no matter when or when, Connie Diekman, MEd, RD, from Washington University in St. Louis: "The process of making sure that Americans move more is a process. Therefore, any movement is a step in the right direction. "

The HHS guidelines, which the AHA has announced adopt to its official recommendations, specified that the many benefits of physical activity for health showed the greatest gains at the lowest levels. Although benefits are not maximized at all levels, those who move from sedentary to poorly active gain considerable gains in life expectancy and health.

"If we can get people to start, hopefully they will continue, if we ask them to change certain behaviors, climb stairs, park a little further, start doing some of these things, then They … And then, hopefully, we'll get them to 150 [minutes per week], "Katrina Piercy, PhD, Dt.P., from HHS in Rockville, Maryland, and first author of the guidelines, has MedPage today.

If only a quarter of sedentary Americans reached the recommended level of activity, 75,000 early deaths would be avoided, Giroir noted. "We know that physical inactivity is responsible for 10% of premature mortality."

"There was no evidence that only the 10-minute fights counted, but there is no evidence that this requirement has caught the attention," acknowledged William Kraus, MD, of the Faculty of Medicine's Duke University, author of the scientific report that informed the guidelines.

Challenges ahead

In fact, only about 1% of adults can correctly identify the volume of physical activity recommended in the guidelines, said Don Wright, MD, MPH, Assistant Under Secretary of Health at HHS.

And there is a risk of unintended consequences to make people feel better in the exercise by doing the same things that they do. This was illustrated by a large-scale trial of portable fitness trackers, noted Keith Fox, MD, of the University of Edinburgh, in an interview with MedPage today. "You know what he's done?" Increased weight. "Oh, I did well, I'd better go and eat something more."

Carl "Chip" Lavie, MD, Director of Exercise Labs at the Ochsner Heart and Vascular Institute in New Orleans, will be the key to implementing this directive at all levels.

In the audience studies and user tests conducted by HHS, the most frequently reported barrier among people not following the guidelines was to be too tired. Other barriers were time, pain, chronic illness and disability.

"As a physician, it's interesting to me that some of these barriers, such as pain, may be rooted in medical causes," said Wright at the AHA session.

"We are uniquely positioned to help patients resolve the underlying medical issues and understand that while it may seem counterintuitive to patients who are not feeling well enough to engage in physical activity, it can actually stimulate energy, manage pain and help them manage their chronic disease. "

Kraus urged health professionals to interview and counsel patients about their physical activity. "We spend a lot more time writing prescriptions for drugs that do not offer 10% of the benefits of physical activity."

HHS also has a campaign (called "Move Your Way", similar to the "My Plate" campaign for dietary recommendations), aimed at targeting people likely to consider a change.

But it would be naïve to think that health professionals can do anything, said Russell Pate, PhD of Duke University in Durham, North Carolina, and president of the National Plan's alliance. 39, physical activity. "Basically, we have to make profound changes on the ground, where the population is located all over the country."

Changes will be needed especially at the local level, such as mixed use zoning, rehabilitation and upgrading of park facilities, encouragement of local sports leagues and support for comprehensive physical activity programs. in schools.

Kyle Mandsager, MD, an electrophysiologist at the Cleveland Clinic, who participated in the research on physical activity, thinks that the update addresses physical activity at a younger age than before.

"Encouraging physical activity and developing healthy lifestyle habits from an early age will likely have a greater impact in the long term on the prevention of obesity," he said. MedPage today.

But the activity is only one element of the fight against the obesity epidemic, said Diekman, former president of the Academy of Nutrition and Dietetics.

The diet is perhaps even more important as a contributor to obesity, said Kim Williams Sr., MD, of the Rush University Medical Center in Chicago and former president of the American College of Cardiology.

"About a fifth of the weight loss felt by patients is due to the improvement of their exercise program.The changes in the quality of the calories and the contents of the diet are about four times more powerful, "he said. MedPage today. "The few people who do more exercise than diet do extreme endurance training, which of course is also aided by better nutrition."

The real test of endurance is waiting for us, suggested Pate. "We need perseverance because these things [population-level changes in health behaviors] are not going to happen quickly in many cases. "

1969-12-31T19: 00: 00-0500

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