How effective are lifestyle activities for function and health?

In 1995 the CDC & ACSM expert panel proposed the now widely applied health-enhancing physical activity recommendation: “Every US adult should accumulate 30 minutes or more of moderate- intensity physical activity on most, preferably all, days of the week” (Pate et al. 1995). This recommendation introduced the health-enhancing physical activity concept, which posits that daily half-an-hour moderate-intensity physical activity such as brisk walking even in shorted bouts provides health benefits especially for previously inactive people. It opened the way for the understanding of the importance of lifestyle physical activity, which was subsequently defined as: “the daily accumulation of at least 30 minutes of self-selected activities, which includes all leisure, occupational or household activities that are at least moderate to vigorous in their intensity and could be planned or unplanned activities that are part of everyday life” (Dunn et al. 1998).

During the decade after the CDC & ACSM recommendation new evidence has been published in support of the health benefits of lifestyle physical activity. Murphy concluded her review in 2004 as follows: “There is growing body of evidence suggesting that for sedentary individuals, lifestyle physical activity can bring both fitness and health benefits. Moreover, there is encouraging, if not convincing evidence that, among the sedentary population, this approach to physical activity may result in superior levels of adherence than more traditional approaches”.

Typical lifestyle physical activities are walking and cycling in various settings, stair-climbing and some domestic activities. Walking and cycling have been shown in intervention studies to provide fitness and health benefits (e.g. Oja et al. 1991) and in large epidemiological studies to reduce all-cause and disease-specific mortality (e.g. Andersen et al. 2000, Manson et al. 2002, Hakim et al. 1998). Dog walking is another very common walking mode, but its health-enhancing effects have not been documented (Kohl et al. 2006). Stair-climbing is physiologically very effective and with sufficient daily and weekly frequency results in improved cardio-respiratory function. It has been estimated that the effective dose is a minimum of 125 floors per week for sedentary men and 85-100 floors per week for sedentary women done five days a week in at least 5 floor bouts for ten weeks (Ilmarinen et al.1978). Some domestic activities can meet the minimum criteria for effective dose, but the available evidence for long-term health benefits is at the moment inconclusive (Kohl et al. 2006).

The health-enhancing physical activity concept is inclusive for many lifestyle physical activities not only during leisure time but also in occupational and domestic work and in active transportation. This lowers the threshold for inactive people to become active and extends the potential for increased activity and the concomitant health benefits to wider population segments beyond those interested and capable of vigorous exercise and sports. Current evidence largely supports the notion of promoting lifestyle physical activities for health among inactive population groups.

References:

1. Andersen LB, Schnohr P, Schroll M, Ole Hein O (2000). All cause mortality associated with physical activity during leisure time, work, sports and cycling to work. Archieves of Internal Medicine, 160(11), 1621-1628.Dunn AL, Anderson RE, Jackicic JM (1998). Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations. American Journal of Preventive Medicine, 15(4), 394-412.

2. Hakim AA, Petrovitch H, Burchfiel CM et al. (1998). Effects of walking on mortality among non-smoking retired men. New England Journal of Medicine 338, 94-99.

3. Ilmarinen J. Rutenfranz J, Knauth P. et al. (1978). The effect of an on the job training program – staiclimbing – on the physical working capacity of employees. European Journal of Applied Physiology and Occupational Physiology, 38, 25-40.

4. Kohl III HV, Lee I-M, Vuori IM et al. (2006). Physical activity and public health: The emergence of a subdiscipline – Report from the International Congress on Physical Activity and Public Health April 17-21, 2006, Atlanta, Georgia, USA. Journal of Physical Activity and Health 3, 344-364.

5. Manson JA, Greenland P, LaCroix AZ et al. (2002). Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine 347, 716-725.

6. Murphy MH (2004). Lifestyle activity for health. In: Oja P, Borms J. (Eds.) (2004). Health Enhancing Physical Activity. Perspectives – The Multidisciplinary Series of Physical Education and Sport Science; Vol 6. Oxford: Meyer & Meyer Sport (UK) Ltd; 2004.Oja P, Mänttäri A, Heinonen A at al. (1991). Physiological effects of walking and cycling to work. Scandinavian Journal of Medicine and Science in Sports 1, 151-157.Pate, R. R., Pratt, M., Blair, S. N., et al. (1995). Physical Activity and Public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association, 273, 402-407.