Healthy People 2010, Conference Edition, Chapter Physical Activity and Fitness Contents Goal Overview Issues and Trends Disparities Opportunities Interim Progress Toward Year 2000 Objectives Healthy People 2010—Summary of Objectives Healthy People 2010 Objectives Physical Activity in Adults Muscular Strength/Endurance and Flexibility Physical Activity in Children and Adolescents Access Related Objectives From Other Focus Areas Terminology References Goal: Improve health, fitness, and quality of life through daily physical activity. Overview: The 1990s brought a historic new perspective to exercise, fitness, and physical activity by shifting the focus from intensive vigorous exercise to a broader range of health-enhancing physical activities. Research has demonstrated that virtually all individuals will benefit from regular physical activity.1 The Surgeon General`s Report on Physical Activity and Health concluded that moderate physical activity can reduce substantially the risk of developing or dying from heart disease, diabetes, colon cancer, and high blood pressure.1 Physical activity also may protect against lower back pain and some forms of cancer (for example, breast cancer), but the evidence is not yet conclusive.2, 3 Issues and Trends: On average, physically active people outlive those who are inactive.4, 5, 6, 7, 8 Regular physical activity also helps to maintain the functional independence of older adults and enhances the quality of life for people of all ages.9, 10, 11 The role of physical activity in preventing coronary heart disease (CHD) is of particular importance, given that this disease is the leading cause of death and disability in the United States. Physically inactive people are almost twice as likely to develop CHD as persons who engage in regular physical activity. The risk posed by physical inactivity is almost as high as several well-known risk factors, such as cigarette smoking, high blood pressure, and high blood cholesterol. Physical inactivity, though, is more prevalent than any one of these other risk factors. People with other risk factors for CHD, such as obesity and high blood pressure, may particularly benefit from physical activity. Regular physical activity is especially important for people who have joint or bone problems and has been shown to improve muscle function, cardiovascular function, and physical performance.12 However, people with arthritis (20 percent of the adult population) are less active than those without arthritis.13 People with osteoporosis, a chronic condition affecting more than 25 million people in the United States, may respond positively to regular physical activity, particularly weight-bearing activities—such as walking14 and especially when combined with appropriate drug therapy and calcium intake. Increased bone mineral density has been positively associated with aerobic fitness, body composition, and muscular strength.15 Although vigorous physical activity is recommended for improved cardiorespiratory fitness, increasing evidence suggests that moderate physical activity also can have significant health benefits, including a decreased risk of CHD. For people who are inactive, even small increases in physical activity are associated with measurable health benefits. In addition, moderate physical activity is more readily adopted and maintained than vigorous physical activity.16 As research continues to illustrate the links between physical activity and selected health outcomes, people will be able to choose physical activity patterns optimally suited to individual preferences, health risks, and physiologic benefits. For individuals who do not engage in any physical activity during their leisure time, taking the first step toward developing a pattern of regular physical activity is important. Unfortunately, few individuals engage in regular physical activity despite its documented benefits. Only about 11 percent of adults in the United States report regular, vigorous physical activity that involves large muscle groups in dynamic movement for 20 minutes or longer 3 or more days per week. About 23 percent of adults report physical activity for 5 or more days per week for 30 minutes or longer, but another 23 percent do not participate in any regular physical activity. Public education efforts need to address the specific barriers that inhibit the adoption and maintenance of physical activity by different population groups. Older adults, for example, need information about safe walking routes. Persons with foot problems need to learn about proper foot care and footwear in order to reach appropriate activity levels. People with CHD and other chronic conditions must understand the importance of regular physical activity to maintain function. Each person should recognize that starting out slowly with an activity that is enjoyable and gradually increasing the frequency and duration of the activity is central to the adoption and maintenance of physical activity behavior. Along with the public education efforts, public programs in a variety of settings (recreation centers, worksites, health care settings, and schools) need to be developed, evaluated, and shared as potential models. The availability of group activities in the community is important for many.