ACSM Issues New Guidelines on Exercise Quality, Quantity

The American College of Sports Medicine released new recommendations Tuesday regarding the quantity and quality of exercise for adults. So now when health club and fitness center staff members are asked by patrons, "How much exercise do I need?" they can respond definitively, the organization says.

In a position statement titled "Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise," the ACSM provides current scientific evidence on physical activity and includes recommendations on aerobic exercise, strength training and flexibility. Consistent with the 2008 Physical Activity Guidelines for Americans, ACSM's overall recommendation is for most adults to engage in at least 150 minutes of moderate-intensity exercise each week.

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"The scientific evidence we reviewed is indisputable," says Carol Ewing Garber, chair of the writing committee and an associate professor of movement sciences at the Teachers College of Columbia University. "When it comes to exercise, the benefits far outweigh the risks. A program of regular exercise - beyond activities of daily living - is essential for most adults."

The position statement's purpose is to offer health and fitness professionals scientific, evidence-based recommendations that help them customize exercise prescriptions for healthy adults, and it is published in the July 2011 issue of Medicine & Science in Sports & Exercise®, the official journal of ACSM.

Here are the basic recommendations, by exercise category:

Cardiorespiratory Exercise: Adults should get at least 150 minutes of moderate-intensity exercise per week. Exercise recommendations can be met through 30 to 60 minutes of moderate-intensity exercise five days per week or 20 to 60 minutes of vigorous-intensity exercise three days per week. One continuous session and multiple shorter sessions of at least 10 minutes are both acceptable to accumulate the desired amount of daily exercise.

Resistance Exercise: Adults should train each major muscle group two or three days each week using a variety of exercises and equipment. Very light or light intensity is best for older individuals or previously sedentary adults just starting to exercise. Two to four sets of each exercise, with anywhere between eight and 20 repetitions, will help adults improve strength and power.

Flexibility Exercise: Adults should do flexibility exercises at least two or three days each week to improve range of motion. Each stretch should be held for 10 to 30 seconds, to the point of tightness or slight discomfort. Repeat each stretch two to four times, accumulating 60 seconds per stretch.

Neurometer Exercise: Neuromotor exercise, also referred to as "functional fitness training," is recommended two or three days per week. Exercises should involve motor skills (balance, agility, coordination and gait), proprioceptive exercise training, and multifaceted activities (yoga) to improve physical function and prevent falls in older adults. Between 20 and 30 minutes per day is appropriate for neuromotor exercise.

In addition to outlining basic recommendations and their scientific reasoning, the position statement also clarifies three new points:

1. Pedometers are not an accurate measure of exercise quality and should not be used as the sole measure of physical activity.

2. Though exercise protects against heart disease, it is still possible for active adults to develop heart problems. All adults must be able to recognize the warning signs of heart disease, and all health care providers should ask patients about these symptoms.

3. Sedentary behavior is distinct from physical activity and has been shown to be a health risk in itself. Meeting the guidelines for physical activity does not make up for a sedentary lifestyle.

"It is no longer enough to consider whether an individual engages in adequate amounts of weekly exercise," Garber says. "We also need to determine how much time a person spends in sedentary pursuits, like watching television or working on a computer. Health and fitness professionals must be concerned with these activities, as well."

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