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- Introduction
- Physical Activity and
Health: A Report of the Surgeon General
This is the first Surgeon General's report
to address physical activity and health. The main message of this report is that
Americans can substantially improve their health and quality of life by
including moderate amounts of physical activity in their daily lives. Health
benefits from physical activity are thus achievable for most Americans,
including those who may dislike vigorous exercise and those who may have been
previously discouraged by the difficulty of adhering to a program of vigorous
exercise. For those who are already achieving regular moderate amounts of
activity, additional benefits can be gained by further increases in activity
level.
This report grew out of an emerging
consensus among epidemiologists, experts in exercise science, and health
professionals that physical activity need not be of vigorous intensity for it to
improve health. Moreover, health benefits appear to be proportional to amount of
activity; thus, every increase in activity adds some benefit. Emphasizing the
amount rather than the intensity of physical activity offers more options for
people to select from in incorporating physical activity into their daily lives.
Thus, a moderate amount of activity can be obtained in a 30- minute brisk walk,
30 minutes of lawn mowing or raking leaves, a 15-minute run, or 45 minutes of
playing volleyball, and these activities can be varied from day to day. It is
hoped that this different emphasis on moderate amounts of activity, and the
flexibility to vary activities according to personal preference and life
circumstances, will encourage more people to make physical activity a regular
and sustainable part of their lives.
The information in this report summarizes
a diverse literature from the fields of epidemiology, exercise physiology,
medicine, and the behavioral sciences. The report highlights what is known about
physical activity and health, as well as what is being learned about promoting
physical activity among adults and young people.
Development of the Report
In July 1994, the Office of the Surgeon
General authorized the Centers for Disease Control and Prevention (CDC) to
serve as lead agency for preparing the first Surgeon General's report on
physical activity and health. The CDC was joined in this effort by the
President's Council on Physical Fitness and Sports (PCPFS) as a collaborative
partner representing the Office of the Surgeon General. Because of the wide
interest in the health effects of physical activity, the report was planned
collaboratively with representatives from the Office of the Surgeon General,
the Office of Public Health and Science (Office of the Secretary), the Office
of Disease Prevention (National Institutes of Health [NIH]), and the following
institutes from the NIH: the National Heart, Lung, and Blood Institute; the
National Institute of Child Health and Human Development; the National
Institute of Diabetes and Digestive and Kidney Diseases; and the National
Institute of Arthritis and Musculoskeletal and Skin Diseases. CDC's nonfederal
partners - including the American Alliance for Health, Physical Education,
Recreation, and Dance; the American College of Sports Medicine; and the
American Heart Association - provided consultation throughout the development
process.
The major purpose of this report is to
summarize the existing literature on the role of physical activity in
preventing disease and on the status of interventions to increase physical
activity. Any report on a topic this broad must restrict its scope to keep its
message clear. This report focuses on disease prevention and therefore does
not include the considerable body of evidence on the benefits of physical
activity for treatment or rehabilitation after disease has developed. This
report concentrates on endurance-type physical activity (activity involving
repeated use of large muscles, such as in walking or bicycling) because the
health benefits of this type of activity have been extensively studied. The
importance of resistance exercise (to increase muscle strength, such as by
lifting weights) is increasingly being recognized as a means to preserve and
enhance muscular strength and endurance and to prevent falls and improve
mobility in the elderly. Some promising findings on resistance exercise are
presented here, but a comprehensive review of resistance training is beyond
the scope of this report. In addition, a review of the special concerns
regarding physical activity for pregnant women and for people with
disabilities is not undertaken here, although these important topics deserve
more research and attention.
Finally, physical activity is only one
of many everyday behaviors that affect health. In particular, nutritional
habits are linked to some of the same aspects of health as physical activity,
and the two may be related lifestyle characteristics. This report deals solely
with physical activity; a Surgeon General's Report on Nutrition and Health was
published in 1988.
Chapters 2 through 6 of this report
address distinct areas of the current understanding of physical activity and
health. Chapter 2 offers a historical perspective: after outlining the history
of belief and knowledge about physical activity and health, the chapter
reviews the evolution and content of physical activity recommendations.
Chapter 3 describes the physiologic responses to physical activity - both the
immediate effects of a single episode of activity and the long-term
adaptations to a regular pattern of activity. The evidence that physical
activity reduces the risk of cardiovascular and other diseases is presented in
Chapter 4. Data on patterns and trends of physical activity in the U.S.
population are the focus of Chapter 5. Lastly, Chapter 6 examines efforts to
increase physical activity and reviews ideas currently being proposed for
policy and environmental initiatives.
Major Conclusions
- People of all ages, both male and
female, benefit from regular physical activity.
- Significant health benefits can be
obtained by including a moderate amount of physical activity (e.g., 30
minutes of brisk walking or raking leaves, 15 minutes of running, or 45
minutes of playing volleyball) on most, if not all, days of the week.
Through a modest increase in daily activity, most Americans can improve
their health and quality of life.
- Additional health benefits can be
gained through greater amounts of physical activity. People who can
maintain a regular regimen of activity that is of longer duration or of
more vigorous intensity are likely to derive greater benefit.
- Physical activity reduces the risk of
premature mortality in general, and of coronary heart disease,
hypertension, colon cancer, and diabetes mellitus in particular. Physical
activity also improves mental health and is important for the health of
muscles, bones, and joints.
- More than 60 percent of American
adults are not regularly physically active. In fact, 25 percent of all
adults are not active at all.
- Nearly half of American youths 12-21
years of age are not vigorously active on a regular basis. Moreover,
physical activity declines dramatically during adolescence.
- Daily enrollment in physical
education classes has declined among high school students from 42 percent
in 1991 to 25 percent in 1995.
- Research on understanding and
promoting physical activity is at an early stage, but some interventions
to promote physical activity through schools, worksites, and health care
settings have been evaluated and found to be successful.
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Cancer Prevention and Control
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Activity and Your Health: Introduction
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