Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure^[1]. Physical activity encompasses all activities, at any intensity, performed during any time of day or night^[2]. It includes exercise and incidental activity integrated into daily activity. This integrated activity may not be planned, structured, repetitive or purposeful for the improvement of fitness, and may include activities such as walking to the local shop, cleaning, working, active transport etc. Lack of physical activity is associated with a range of negative health outcomes whereas increased physical activity can improve physical as well as mental health.^[3]

Terminology misconception

"Exercise" and "physical activity" are frequently are used interchangeably and generally refer to physical activity performed during leisure time with the primary purpose of improving or maintaining physical fitness, physical performance, or health. Physical activity is not exactly the same concept as exercise. Exercise is defined as a subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective^[1]. Conversely, physical activity includes exercise but may also be unplanned, unstructured, random and non-purposeful carried out for a multitude of reasons.

Intensity

Physical activity can be at any intensity, from a simple twitch of a muscle, to an all out sprint. For practicality, physical activity can be viewed as a continuum from sedentary behavior to vigorous intensity activity. Intensities are broadly categorized according to energy expenditure using a standard measure of intensity, metabolic equivalents (METs). The broad categories are sedentary behavior, light activity, moderate activity and vigorous activity.

Example activities at each intensity

The example activities presented below are just that, examples. Depending on the individual and the activity involved, activities may overlap intensity categories or change categories completely.

Physical inactivity and sedentary behaviour

Physical inactivity is the absence of physical activity, which is conceptually different to sedentary behavior (not sedentary lifestyle). Sedentary behavior is defined as any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents (METs), while in a sitting, reclining or lying posture. In general this means that any time a person is passively sitting or lying down, they are engaging in sedentary behavior^[4].

Other types of physical activity

• Aerobic Physical Activity
• Anaerobic Physical Activity
• Muscle-strengthening Activity

Recommendations for physical activity (including sleep and sedentary behavior)

Global recommendations

The World Health Organization recommend the following:^[1]

Adults aged 18–64

1. Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.

2. Aerobic activity should be performed in bouts of at least 10 minutes duration.

3. For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.

4. Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

Adults aged 65+

1. Adults aged 65 years and above should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.

2. Aerobic activity should be performed in bouts of at least 10 minutes duration.

3. For additional health benefits, adults aged 65 years and above should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and vigorous-intensity activity.

4. Adults of this age group, with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week.

5. Muscle-strengthening activities should be done involving major muscle groups, on 2 or more days a week.

6. When adults of this age group cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

Children and Adolescents aged 5–17

1. Children and youth aged 5–17 should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.

2. Amounts of physical activity greater than 60 minutes provide additional health benefits.

3. Most of the daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least 3 times per week.

Country-level recommendations

Australia

Source: ^[5]

Early Years (Birth to 5 years)

Physical activity recommendations

For healthy growth and development in:

• Infants (Birth to one year) physical activity particularly through supervised interactive floor-based play in safe environments should be encouraged from birth. For those not yet mobile, 30 minutes of tummy time including reaching and grasping, pushing and pulling, and crawling spread throughout the day during awake periods is encouraged.
• Toddlers (1 to 2 years) should spend at least 180 minutes a day doing a variety of physical activities including energetic play such as running, jumping and twirling spread throughout the day- noting more is better.
• Pre-schoolers (3 to 5 years) should spend at least 180 minutes a day in a variety of physical activities, of which 60 minutes is energetic play such as running, jumping and kicking and throwing, spread throughout the day - noting more is better.

Sedentary behaviour recommendations

• Infants (Birth to one year) should not be restrained for more than 1 hour at a time (e.g. in a stroller, car seat or high chair). Infants should also not spend any time watching television or using other electronic media (DVDs, computer and other electronic games) and instead, when sedentary, the caregiver is encouraged to engage with them through activities such as reading, singing, puzzles and storytelling.
• Toddlers (aged 1–2 years) should not be restrained for more than 1 hour at a time (e.g. in a stroller, car seat or high chair) or sit for extended periods. For those toddlers younger than 2 years, screen time is not recommended during sedentary periods. For those aged 2 years, screen time should be no more than 1 hour in total throughout the 24-hour period- less is better. When toddlers are sedentary, the caregiver is encouraged to engage with them through activities such as reading, singing, puzzles and storytelling.
• Pre-schoolers (aged 3–5 years) should not be restrained, for more than 1 hour at a time e.g. in a stroller or car seat) or sitting for extended periods. Sedentary screen time should be no more than 1 hour in total throughout the 24-hour period -less is better. When pre-schoolers are sedentary, caregivers are encouraged to engage with them through activities such as reading, singing, puzzles and storytelling.

Sleep

• Infants (Birth to one year) are recommended to have 14 to 17 hours (for those aged 0-3 months) and 12 to 16 hours (for those aged 4-11 months) of good quality sleep, including naps during the 24 hour period.
• Toddlers (aged 1–2 years) are recommended to have from 11 to 14 hours of good quality sleep, including naps during the 24-hour period with consistent sleep and wake-up times.
• Pre-schoolers (aged 3–5 years) are recommended to have 10 to 13 hours of good quality sleep, which may include a nap, with consistent sleep and wake-up times.

Children (5–12 years)

Physical activity

• For health benefits, children aged 5–12 years should accumulate at least 60 minutes of moderate to vigorous intensity physical activity every day.
• Children’s physical activity should include a variety of aerobic activities, including some vigorous intensity activity.
• On at least three days per week, children should engage in activities that strengthen muscle and bone.
• To achieve additional health benefits, children should engage in more activity – up to several hours per day.

Sedentary behaviour

• To reduce health risks, children aged 5-12 years should minimise the time they spend being sedentary every day. To achieve this:
  • Limit use of electronic media for entertainment (e.g. television, seated electronic games and computer use) to no more than two hours a day – lower levels are associated with reduced health risks.
  • Break up long periods of sitting as often as possible.

Young people (13–17 years)

Physical activity guidelines

• For health benefits, young people aged 13–17 years should accumulate at least 60 minutes of moderate to vigorous intensity physical activity every day.
• Young peoples’ physical activity should include a variety of aerobic activities, including some vigorous intensity activity.
• On at least three days per week, young people should engage in activities that strengthen muscle and bone.
• To achieve additional health benefits, young people should engage in more activity – up to several hours per day.

Sedentary behaviour guidelines

• To reduce health risks, young people aged 13–17 years should minimise the time they spend being sedentary every day. To achieve this:
  • Limit use of electronic media for entertainment (e.g. television, seated electronic games and computer use) to no more than two hours a day – lower levels are associated with reduced health risks.
  • Break up long periods of sitting as often as possible.

Adults (18–64 years)

Physical activity guidelines

• Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
• Be active on most, preferably all, days every week.
• Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
• Do muscle strengthening activities on at least 2 days each week.

Sedentary behaviour guidelines

• Minimise the amount of time spent in prolonged sitting.
• Break up long periods of sitting as often as possible.

Older adults (65+ years)

Physical activity recommendations

1. Older people should do some form of physical activity, no matter what their age, weight, health problems or abilities.

2. Older people should be active every day in as many ways as possible, doing a range of physical activities that incorporate fitness, strength, balance and flexibility.

3. Older people should accumulate at least 30 minutes of moderate intensity physical activity on most, preferably all, days.

4. Older people who have stopped physical activity, or who are starting a new physical activity, should start at a level that is easily manageable and gradually build up the recommended amount, type and frequency of activity.

5. Older people who continue to enjoy a lifetime of vigorous physical activity should carry on doing so in a manner suited to their capability into later life, provided recommended safety procedures and guidelines are adhered to.

Other countries

• New Zealand^[6]
• United Kingdom (UK)^[7]
• United States of America (USA)^[8] =