Physical Activity Guidelines for All Ages

Recommendations by Age Group

Children and Adolescents (6-17 years)

Recommendation	Detail
Daily aerobic	≥ 60 minutes of moderate-to-vigorous physical activity
Vigorous intensity	At least 3 days per week (bone and muscle strengthening)
Muscle/bone strengthening	At least 3 days per week
Types	Play, sports, active transportation, PE

Adults (18-64 years)

Recommendation	Minimum	Optimal
Moderate-intensity aerobic	150 min/week (30 min × 5 days)	300 min/week
OR Vigorous-intensity aerobic	75 min/week	150 min/week
OR Combination	Equivalent	Double minimum
Muscle strengthening	≥ 2 days/week (all major groups)	≥ 2 days/week
Duration per session	≥ 10 minutes (bouts)	Any duration counts

Older Adults (≥ 65 years)

Recommendation	Detail
Same as adults	As able, with modifications if needed
Balance training	≥ 3 days/week (fall prevention)
Multicomponent	Aerobic + strengthening + balance + flexibility
Relative intensity	Judged by effort level, not absolute speed

Intensity Classification

Intensity	Heart Rate (% max)	RPE (Borg 6-20)	Talk Test	Examples
Sedentary	—	—	—	Sitting, lying down
Light	30-39%	9-11	Can sing	Leisurely walking (2 mph)
Moderate	40-59%	12-13	Can talk, cannot sing	Brisk walking (3-4 mph), gentle cycling
Vigorous	60-84%	14-16	Can only say few words	Running, swimming laps, cycling ≥ 10 mph
Very vigorous	≥ 85%	17-19	Cannot talk	Sprinting, HIIT

Max HR estimation: 220 - age (or 207 - 0.7 × age)

Sedentary Behavior

Risk	Evidence
All-cause mortality	↑ 20-30% with prolonged sitting
Cardiovascular disease	↑ 15-20%
Type 2 diabetes	↑ 20-30%
Cancer	↑ 10-20% (colon, endometrial, lung)
Mental health	↑ depression, anxiety

Recommendation: Break prolonged sitting every 30 minutes (stand/walk 1-3 minutes).

Measuring Physical Activity

Objective Measures

Method	Accuracy	Cost	Best For
Accelerometer (wrist, hip)	High	$$	Research, tracking
Pedometer (step count)	Moderate	$	General tracking
Heart rate monitor	High (cardio)	$$	Intensity tracking
GPS watch	High (distance)	$$$	Running, cycling

Subjective Measures

Tool	Description	Uses
International Physical Activity Questionnaire (IPAQ)	7-question recall	Research, surveillance
Godin Leisure-Time Exercise Questionnaire	3-item simple recall	Clinical screening
Physical Activity Vital Sign	2-question screener	Clinical setting

Activity Equivalents

Activity	MET Value	Intensity	150 min/week =
Sitting quietly	1.0	Sedentary	—
Slow walking (2 mph)	2.0	Light	—
Brisk walking (3.5 mph)	3.8	Moderate	30 min × 5 days
Jogging (5 mph)	8.0	Vigorous	25 min × 3 days
Running (6 mph)	10.0	Vigorous	22 min × 3 days
Cycling (10-12 mph)	6.0	Moderate-vigorous	30 min × 5 days
Swimming (moderate)	6.0	Moderate-vigorous	30 min × 5 days
Resistance training	3.0-6.0	Light-moderate	—

1 MET (resting metabolic rate): 3.5 mL O₂/kg/min = ~1 kcal/kg/hour

Exercise Prescription (FITT-VP Principle)

Component	Description
Frequency	How often (days/week)
Intensity	How hard (% HRmax, RPE, METs)
Time	Duration per session
Type	Aerobic, strength, flexibility, balance
Volume	Total amount (MET-min/week)
Progression	Gradual increase over time

Sample Weekly Plan

Day	Activity	Duration	Intensity
Monday	Brisk walking	30 min	Moderate (RPE 12-13)
Tuesday	Resistance training	30-45 min	Moderate to vigorous
Wednesday	Brisk walking + stretching	30 min	Moderate
Thursday	Resistance training	30-45 min	Moderate to vigorous
Friday	Brisk walking	30 min	Moderate
Saturday	Recreation (hiking, swimming, sports)	30-60 min	Moderate to vigorous
Sunday	Rest or gentle stretching	15-30 min	Light

Special Populations

Population	Modification
Pregnancy (uncomplicated)	≥ 150 min/week moderate, avoid supine after 1st trimester, avoid contact sports
Postpartum	Gradual return, pelvic floor focus, ≥ 150 min/week
Type 2 diabetes	Pre/post-exercise glucose monitoring, insulin adjustment, foot care
Hypertension	Avoid Valsalva maneuver during strength training, monitor BP response
Osteoarthritis	Low-impact (swimming, cycling, walking), ↑ range of motion, joint protection
Osteoporosis	Weight-bearing (walking, climbing), avoid spinal flexion, ↑ balance training
Cancer (during/after treatment)	Individualized, fatigue management, ↑ flexibility, ↑ immune function
Cognitive impairment	Structured routine, caregiver involvement, simple instructions
Disability	Adapted activities, inclusion in community programs, modified equipment