What ‘intervention’ reduces risk for all-cause and cardiovascular mortality, cardiac and cerebrovascular events, hypertension, type 2 diabetes, lipid disorders, and cancer of the bladder, breast, colon, endometrium, esophagus, kidney, stomach, and lung? As an interventional cardiologist and outcomes researcher, I would have been happy to attribute this to the latest device/procedure or a cure-all pill. But the answer is ‘none of the above’. The the answer is probably one of the biggest take aways from AHA Scientific Sessions 2018 for me.
As the AHA18 meeting drew to a close, amidst all the ‘buzz’ of the late-breaking clinical trials and other remarkable research, a largely less publicized session celebrated physical activity and their favorable impact on health outcomes.The ‘Physical Activity Guidelines Advisory Committee’ under the auspices of the Department of Health and Human Services (HHS) came out with a systematic review and proposed recommendations for physical activity for the American public:
- A significant change since the 2008 Physical Activity Guidelines for Americans is that previously, aerobic physical activity for adults had to be accumulated in bouts, or sessions, that lasted at least 10 minutes to count toward meeting the key guidelines. Current evidence shows that the total volume of moderate-to-vigorous physical activity is related to many health benefits; bouts of a prescribed duration are not essential. Sufficient physical activity is defined as at least 150 minutes of moderate-intensity aerobic physical activity and 2 days per week of muscle-strengthening activity for adults and at least 60 minutes of moderate-intensity aerobic physical activity and 3 days per week of muscle-strengthening activity for youth.
- Preschool-aged children (ages 3-5 years) should be physically active throughout the day to enhance growth and development. Increased physical activity is associated with improvements in bone health and weight status. Children and adolescents ages 6-17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Increased physical activity is associated with improvements in bone health, weight status, cardiorespiratory fitness, and cardiometabolic health. Additional benefits include improved cognitive function and reduced risk of depression.
- Adults should do at least 150-300 minutes a week of moderate-intensity, or 75-150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Adults should perform muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Benefits of increased physical activity include lower risk of mortality including cardiovascular mortality, lower risk of cardiovascular events and associated risk factors (hypertension and diabetes), and lower risk of many cancers (including bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach). Additional improvements have been seen in cognition, risk of dementia, anxiety and depression, improved bone health, lower risk of falls, and associated injuries.
- Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week.
- Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Both aerobic and muscle-strengthening physical activity are beneficial. Some health benefits begin immediately after exercising, and even short episodes or small amounts of physical activity are beneficial.
- Technology, such as step counters or other wearable devices or fitness apps, can provide physical activity feedback directly to the user. Technology can be used alone or combined with other strategies, such as goal setting and coaching, to encourage and maintain increased physical activity. (Adapted from https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2018/11/14/14/37/the-physical-activity-guidelines-for-americans)
As an interventional cardiologist, I feel that these interventions or recommendations, if observed, could have significant positive impact on the health and well-being of the US population, and I will try my best to incorporate these in my practice and encourage peers to do the same.
Saurav Chatterjee is a Staff Interventionist at Saint Francis Hospital of the University of Connecticut, and an Assistant Professor of Medicine and Research at the Frank H Netter School of Medicine, Quinnipiac University- living in Hartford, Connecticut. He volunteers for the PAD council and the Council on Clinical Cardiology. @SauravChMD