Overview
This ACSM position stand presents evidence-based guidelines on the optimal quantity and quality of exercise for developing and maintaining fitness in healthy adults. It summarizes recommendations for cardiorespiratory, resistance, flexibility, and neuromotor exercise, noting health benefits, dosing principles, individual variability, and risk management.
Health Benefits of Physical Activity and Fitness
- Regular physical activity reduces all-cause mortality, CVD, stroke, type 2 diabetes, and certain cancers.
- Exercise lowers blood pressure, improves lipid profiles, enhances insulin sensitivity, and aids weight management.
- Physical activity preserves bone mass, reduces fall risk, and supports mental health, energy, cognitive function, and quality of life.
- Higher cardiorespiratory and muscular fitness are linked with lower health risks and improved mortality rates.
Quantity and Quality of Exercise for Health
- Health benefits are seen with at least 150 min/week moderate or 75 min/week vigorous-intensity activity, or a combination.
- Dose-response exists: higher activity volumes yield greater health returns, but benefits begin even at half the recommended dose.
- Cardiorespiratory fitness improvements correlate with achieving activity levels near these guidelines.
Role of Exercise Intensity and Patterns
- Both moderate- and vigorous-intensity exercise confer health benefits; vigorous activity may provide additional reductions in some risks.
- A minimum intensity threshold is needed for fitness gains, varying with baseline fitness level.
- Activity can be accumulated in bouts of ≥10 minutes; "weekend warrior" and interval training can also be effective, but evidence on risks and long-term outcomes is limited.
- High sedentary time increases health risks, even for active individuals; breaking up sitting time is beneficial.
Muscular Fitness and Resistance Training
- Resistance training improves muscular strength, body composition, insulin sensitivity, bone density, and reduces chronic disease risks.
- Two to four sets per muscle group, 8-12 reps at 60-80% 1RM, 2-3 sessions/week are effective for general fitness.
- Older/deconditioned adults should start with lighter loads and progress as tolerated.
Flexibility and Neuromotor Exercise
- Flexibility exercises 2-3 times/week improve or maintain joint range of motion; effects are greater with daily stretching.
- Major muscle groups should be targeted, with each stretch held for 10-30 seconds, repeated to total 60 seconds/stretch.
- Neuromotor exercises (e.g., balance, agility, tai chi) are particularly important for older adults to improve function and reduce fall risk; optimal dosage is not firmly established.
Individual Variation and Maintenance
- Training responses vary by genetics, training regimen, baseline fitness, and other factors; prescriptions must be individualized.
- Lower exercise volumes are needed to maintain versus improve fitness.
- Gains in muscular strength and flexibility reverse quickly after stopping, but can be maintained with reduced frequency or volume.
Promoting Exercise Adoption and Adherence
- Enjoyment, individual choice, and behavioral strategies enhance exercise adoption and maintenance.
- Moderate-intensity activity may favor adherence, especially in novices.
- Supervision by fitness professionals and tailored behavioral interventions support adherence.
- Long-term adherence remains challenging, with continued contact and social support aiding maintenance.
Risks and Safety Considerations
- Physical activity is associated with transient increases in risk for musculoskeletal injury and CHD events, especially during unaccustomed strenuous activity.
- Proper screening, attention to warning signs, gradual progression, warm-up/cool-down, and professional supervision can reduce risks.
Recommendations / Advice
- Adults should engage in cardiorespiratory, resistance, flexibility, and neuromotor exercises in recommended volumes.
- Reduce sedentary time and interrupt sitting with short activity bouts.
- Exercise programs should be tailored to individual health status, fitness, and preferences to enhance safety and adherence.
- Consultation with health and fitness professionals is advised, especially for novices or those with health conditions.