Research article
Trend and Prevalence Estimates Based on the 2008 Physical Activity Guidelines for Americans

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Background

According to the 2008 Physical Activity Guidelines for Americans, adults need to engage in at least 150 minutes/week of moderate-intensity activity or its equivalent (defined as aerobically active) to obtain substantial health benefits and more than 300 minutes/week (defined as highly active) to obtain more extensive health benefits. In addition to aerobic activity, the 2008 Guidelines recommend that adults participate in muscle-strengthening activities on 2 or more days/week.

Purpose

This study examined the prevalence and trends of meeting the activity criteria defined by the 2008 Guidelines among U.S. adults.

Methods

Prevalence and trends of participation in leisure-time physical activity were estimated from the 1998–2008 National Health Interview Survey (analyzed in 2010).

Results

In 2008, 43.5% of U.S. adults were aerobically active, 28.4% were highly active, 21.9% met the muscle-strengthening guideline, and 18.2% both met the muscle-strengthening guideline and were aerobically active. The likelihood of meeting each of these four activity criteria was similar and were associated with being male, being younger, being non-Hispanic white, having higher levels of education, and having a lower BMI. Trends over time were also similar for each part of the 2008 Guidelines, with the prevalence of participation exhibiting a small but significant increase when comparing 1998 to 2008 (difference ranging from 2.4 to 4.2 percentage points).

Conclusions

Little progress has been made during the past 10 years in increasing physical activity levels in the U.S. There is much room for improvement in achieving recommended levels of physical activity among Americans, particularly among relatively inactive subgroups.

Introduction

The USDHHS recently released the 2008 Physical Activity Guidelines for Americans (2008 Guidelines),1 an evidence-based update on the benefits of physical activity.2 The 2008 Guidelines recommend that for substantial health benefits, including lower risk for premature death, coronary heart disease, stroke, hypertension, type 2 diabetes, and depression, adults should participate weekly in at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination, and that for increased and additional health benefits, including lower risk for colon and breast cancer and prevention of unhealthy weight gain, they should participate weekly in more than 300 minutes of moderate-intensity activity, 150 minutes of vigorous-intensity activity, or an equivalent combination. The 2008 Guidelines also recommend that adults participate in muscle-strengthening activities involving all seven major muscle groups on 2 or more days/week to increase bone strength and muscular fitness. To fully meet the 2008 Guidelines, adults must engage in at least the equivalent of 150 minutes/week of moderate-intensity aerobic activity and in muscle-strengthening activities on 2 or more days/week.

Currently, physical activity levels in the U.S. are monitored for the assessment of progress toward meeting national health objectives in Healthy People 2010.3 Criteria used to define levels of aerobic activity in Healthy People 2010 are based on the 1995 CDC/ACSM recommendations and the 1996 Surgeon General's Report on Physical Activity and Health that followed4, 5 and are different from 2008 Guidelines criteria. In Healthy People 2010 (objective 22-2), being active is defined as participating in at least 30 minutes/day of moderate-intensity aerobic activity 5 or more days/week or in at least 20 minutes of vigorous aerobic activity 3 or more days/week, whereas in the 2008 Guidelines, being active is defined on the basis of the total amount of activity in 1 week (at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination per week). The 2008 Guidelines criteria do not include a minimum frequency requirement or a duration requirement other than that physical activity must be for at least 10 minutes at a time, and they allow moderate- and vigorous-intensity activity to be combined. It is important to examine the effects that use of different criteria may have on national prevalence estimates of aerobic activity and trends in these estimates.

The National Health Interview Survey (NHIS) is the data source used to monitor national progress toward meeting Healthy People 2010 physical activity objectives. In the present study, NHIS data were used to estimate the prevalence of U.S. adults (overall and by selected demographic characteristics) who, in 2008, (1) were aerobically active according to Healthy People 2010 criteria and according to 2008 Guidelines criteria; (2) were highly aerobically active according to 2008 Guidelines criteria; (3) engaged in adequate muscle-strengthening activity as defined by Healthy People 2010 and 2008 Guidelines; and (4) both engaged in adequate muscle-strengthening activity and were aerobically active as defined by the 2008 Guidelines. Trends in prevalence estimates from 1998 through 2008 were also assessed.

Section snippets

Survey Description

The NHIS is a multistage probability sample survey of U.S. households that is conducted annually and designed to be representative of the civilian, non-institutionalized U.S. population. The NHIS collects basic health and demographic information from all family members and additional information, such as information about leisure-time physical activity, from one randomly selected adult (aged ≥18 years). During 1998–2008, annual NHIS sample sizes for completed interviews of sampled adults ranged

Results

In 2008, using Healthy People 2010 criteria 32.6% of U.S. adults were aerobically active during their leisure time compared with 43.5% using 2008 Guidelines criteria (Table 1). Reasons for the 10.9 percentage point shift are (1) upwards shift of 4.2 percentage points due to removal of the Healthy People 2010 frequency and duration requirements only; (2) upwards shift of 2.7 percentage points due to the combination of moderate- and vigorous-intensity activity only; (3) upwards shift of 4.2

Discussion

In 2008, an estimated 43.5% of U.S. adults were aerobically active during their leisure time according to 2008 Guidelines criteria, and 32.6% were according to Healthy People 2010 criteria. With both sets of criteria, being male, being of younger age, being non-Hispanic white, having higher levels of education, and having a lower BMI were associated with being aerobically active. And with both sets of criteria, a small but significant positive difference between 1998 and 2008 in the percentage

Conclusion

The 2008 Guidelines provide evidence-based recommendations for the amount of physical activity needed to provide various health benefits.1 On the basis of activity criteria in the 2008 Guidelines, in 2008, 56.5% of U.S. adults were not aerobically active during their leisure time, 71.6% were not highly aerobically active, and 81.8% did not participate in minimum recommended levels of both aerobic and muscle-strengthening activities. There is much room for improvement of the level of physical

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