Physical Activity for Heart Health

American Heart Association Recommendations for Physical Activity in Adults and Kids

Physical Activity for Heart Health | Johns Hopkins Medicine

Are you fitting in at least 150 minutes (2.5 hours) of heart-pumping physical activity per week? If not, you’re not alone. Only about one in five adults and teens get enough exercise to maintain good health. Being more active can help all people think, feel and sleep better and perform daily tasks more easily. And if you’re sedentary, sitting less is a great place to start.

These recommendations are the Physical Activity Guidelines for Americans, 2nd edition, published by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.

They recommend how much physical activity we need to be healthy.

The guidelines are current scientific evidence supporting the connections between physical activity, overall health and well-being, disease prevention and quality of life.

Recommendations for Adults

  • Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.
  • Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week.
  • Spend less time sitting. Even light-intensity activity can offset some of the risks of being sedentary.
  • Gain even more benefits by being active at least 300 minutes (5 hours) per week.
  • Increase amount and intensity gradually over time.

Recommendations for Kids

  • Children 3-5 years old should be physically active and have plenty of opportunities to move throughout the day.
  • Kids 6-17 years old should get at least 60 minutes per day of moderate- to vigorous-intensity physical activity, mostly aerobic.
  • Include vigorous-intensity activity on at least 3 days per week.
  • Include muscle- and bone-strengthening (weight-bearing) activities on at least 3 days per week.
  • Increase amount and intensity gradually over time.

Physical activity is anything that moves your body and burns calories.

This includes things walking, climbing stairs and stretching.

Aerobic (or “cardio”) activity gets your heart rate up and benefits your heart by improving cardiorespiratory fitness. When done at moderate intensity, your heart will beat faster and you’ll breathe harder than normal, but you’ll still be able to talk. Think of it as a medium or moderate amount of effort.

Examples of moderate-intensity aerobic activities:

  • brisk walking (at least 2.5 miles per hour)
  • water aerobics
  • dancing (ballroom or social)
  • gardening
  • tennis (doubles)
  • biking slower than 10 miles per hour

Vigorous intensity activities will push your body a little further. They will require a higher amount of effort. You’ll probably get warm and begin to sweat. You won’t be able to talk much without getting breath.

Examples of vigorous-intensity aerobic activities:

  • hiking uphill or with a heavy backpack
  • running
  • swimming laps
  • aerobic dancing
  • heavy yardwork continuous digging or hoeing
  • tennis (singles)
  • cycling 10 miles per hour or faster
  • jumping rope

Knowing your target heart rate can also help you track the intensity of your activities.

For maximum benefits, include both moderate- and vigorous-intensity activity in your routine along with strengthening and stretching exercises.

What if I’m just starting to get active?

Don’t worry if you can’t reach 150 minutes per week just yet. Everyone has to start somewhere.

Even if you've been sedentary for years, today is the day you can begin to make healthy changes in your life. Set a reachable goal for today.

You can work up toward the recommended amount by increasing your time as you get stronger. Don't let all-or-nothing thinking keep you from doing what you can every day.

The simplest way to get moving and improve your health is to start walking. It's free, easy and can be done just about anywhere, even in place.

Any amount of movement is better than none. And you can break it up into short bouts of activity throughout the day. Taking a brisk walk for five or ten minutes a few times a day will add up.

If you have a chronic condition or disability, talk with your healthcare provider about what types and amounts of physical activity are right for you before making too many changes. But don’t wait! Get started today by simply sitting less and moving more, whatever that looks for you.

The takeaway:  Move more, with more intensity, and sit less

Science has linked being inactive and sitting too much with higher risk of heart disease, type 2 diabetes, colon and lung cancers, and early death.

It’s clear that being more active benefits everyone and helps us live longer, healthier lives.

Here are some of the big wins:

  • Lower risk of heart disease, stroke, type 2 diabetes, high blood pressure, dementia and Alzheimer’s, several types of cancer, and some complications of pregnancy
  • Better sleep, including improvements in insomnia and obstructive sleep apnea
  • Improved cognition, including memory, attention and processing speed
  • Less weight gain, obesity and related chronic health conditions
  • Better bone health and balance, with less risk of injury from falls
  • Fewer symptoms of depression and anxiety
  • Better quality of life and sense of overall well-being

So what are you waiting for? Let’s get moving!

Share an infographic of the Physical Activity Recommendations for Adults and the Physical Activity Recommendations for Kids

Last Reviewed: Apr 18, 2018

Source: https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Physical Activity and Exercise

Physical Activity for Heart Health | Johns Hopkins Medicine

— The first section of this topic is shown below —

  • Physical activity: bodily movements produced by the contraction of skeletal muscle that requires energy expenditure beyond resting energy expenditure
  • Exercise: planned, structured physical activity performed to develop or improve one or more components of physical fitness.
  • Physical fitness: includes cardiorespiratory fitness, muscular fitness and flexibility (see below).
  • Intensity of exercise: refers to the level of effort or physiological demand required to perform the activity
  • Metabolic equivalent (MET): unit to estimate the level of effort (oxygen consumption) of the physical activity. It indexes the intensity of exercise. E.g. sleeping (0.9 MET), walking 2.5 mph (2.9 MET), bicycling < 10 mph (4.0 MET), jogging (7 MET), rope jumping (10 MET). Often expressed as MET per minute or MET per hour
  • Classification of physical intensity: light (35-54% maximum heart rate, or 1.1 to 2.9 METs); moderate (55-69% maximum heart rate or 3.0 to 5.9 METs); vigorous or high (70 – 89% maximum heart rate or ≥6 METs).
  • For most people with type 2 diabetes, brisk walking is a moderate-intensity exercise.
  • Aerobic exercise: Rhythmic, repeated, and continuous movements of the same large muscle groups for at least 10 min at a time (e.g.walking, bicycling, jogging, and swimming). Increases cardiorespiratory fitness and energy expenditure. Resistance exercise: Activities that use muscular strength to move a weight or work against a resistive load (e.g. weight lifting and exercise using weight machines). Increases muscular fitness and whole body glucose utilization.
  • Maximum heart rate = 220 – age, preferably determined by graded exercise testing (GXT).

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  • Physical activity: bodily movements produced by the contraction of skeletal muscle that requires energy expenditure beyond resting energy expenditure
  • Exercise: planned, structured physical activity performed to develop or improve one or more components of physical fitness.
  • Physical fitness: includes cardiorespiratory fitness, muscular fitness and flexibility (see below).
  • Intensity of exercise: refers to the level of effort or physiological demand required to perform the activity
  • Metabolic equivalent (MET): unit to estimate the level of effort (oxygen consumption) of the physical activity. It indexes the intensity of exercise. E.g. sleeping (0.9 MET), walking 2.5 mph (2.9 MET), bicycling < 10 mph (4.0 MET), jogging (7 MET), rope jumping (10 MET). Often expressed as MET per minute or MET per hour
  • Classification of physical intensity: light (35-54% maximum heart rate, or 1.1 to 2.9 METs); moderate (55-69% maximum heart rate or 3.0 to 5.9 METs); vigorous or high (70 – 89% maximum heart rate or ≥6 METs).
  • For most people with type 2 diabetes, brisk walking is a moderate-intensity exercise.
  • Aerobic exercise: Rhythmic, repeated, and continuous movements of the same large muscle groups for at least 10 min at a time (e.g.walking, bicycling, jogging, and swimming). Increases cardiorespiratory fitness and energy expenditure. Resistance exercise: Activities that use muscular strength to move a weight or work against a resistive load (e.g. weight lifting and exercise using weight machines). Increases muscular fitness and whole body glucose utilization.
  • Maximum heart rate = 220 – age, preferably determined by graded exercise testing (GXT).

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Lazo, Mariana, and Mimi Huizinga. “Physical Activity and Exercise.” Johns Hopkins Diabetes Guide, 2015. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_Exercise. Lazo M, Huizinga M. Physical Activity and Exercise. Johns Hopkins Diabetes Guide. 2015. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_Exercise. Accessed May 18, 2020.Lazo, M., & Huizinga, M. (2015). Physical Activity and Exercise. In Johns Hopkins Diabetes Guide Retrieved May 18, 2020, from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_ExerciseLazo M, Huizinga M. Physical Activity and Exercise [Internet]. In: Johns Hopkins Diabetes Guide. ; 2015. [cited 2020 May 18]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_Exercise.* Article titles in AMA citation format should be in sentence-caseMLAAMAAPAVANCOUVERTY – ELECT1 – Physical Activity and ExerciseID – 547121A1 – Lazo,Mariana,M.D.AU – Huizinga,Mimi,M.D.Y1 – 2015/10/04/BT – Johns Hopkins Diabetes GuideUR – https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_ExerciseDB – Johns Hopkins GuideDP – Unbound MedicineER –

Source: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547121/all/Physical_Activity_and_Exercise

Johns Hopkins Gazette | August 7, 2006

Physical Activity for Heart Health | Johns Hopkins Medicine
A Johns Hopkins study should ease the concerns held by many older adults with mild high blood pressure about the strain or harm exercise could cause their hearts.

Results of the research on 104 men and women ages 55 to 75 showed that a moderate program of physical exertion has no ill effects on the heart's ability to pump blood, nor does it produce a harmful increase in heart size.

In this study, “moderate” translated to sustained exercise for about an hour three times a week. Researchers say that people's concerns stem from the fact that during each workout blood pressure can rise on average from 40 millimeters to 60 millimeters of mercury.

The Johns Hopkins study is believed to be the first to evaluate the effects of exercise on the heart's ability to function, to pump and to fill up with blood.

“While having high blood pressure at rest is a well-established risk factor for heart problems, older people should not fear the effects of moderate exercise on the heart, despite short-term bump-ups in blood pressure during their workout,” said lead study investigator Kerry Stewart, a professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins School of Medicine and its Heart Institute. “Exercise is a highly effective means of increasing the heart's efficiency and reducing body fat, factors that may ward off future health problems, such as heart disease and diabetes.”

A report on the Johns Hopkins study, published in the July issue of the journal Heart, showed that after six months of aerobic exercise on a treadmill, bicycle or stepper, plus weightlifting, participants showed no overall ill effects in 11 measures of diastolic heart function, when the organ's main chamber fills with blood between beats. The researchers also found that exercise produced no increase in eight measures of heart size, including left ventricular mass and wall thickness. In contrast, a long-term effect of hypertension, even when the body is relaxed, is hypertrophy, an enlargement of the heart that eventually stiffens and weakens the muscle.

Not only were there no ill effects sustained despite periodic increases in blood pressure during the workout, Stewart and his team reported, but results also suggest that the exercise producing these effects benefited the hearts of those who made the most gains in physical fitness and for those who lost the most abdominal fat.

And, researchers say, un the increased heart size that results from high blood pressure, any increase in heart size observed in the active group was similar to what athletes experience when their hearts get bigger and stronger not stiff.

For a six-month period, the Johns Hopkins team assessed the benefits of a supervised program of exercise training in a group of 104 older men and women, measuring heart function, body fitness and fat levels at the start and end of the study. All the participants were in general good health except for untreated mild hypertension. Half were randomly placed in a widely recommended moderate exercise program, while the rest maintained their usual physical routine and diet.

The active group participated in a supervised series of exercises for 60 minutes three times per week. The combination of exercises was designed to work all major muscle groups, including the heart, with substantial improvements observed in active participants' body fat, and muscle and fitness levels.

Aerobic fitness, as measured by peak oxygen uptake on a treadmill, increased by 17 percent, as did average strength. The average weight loss in this group was only four pounds because much of the loss of fat was offset by increased muscle mass.

The fat in the abdominal region, measured by magnetic resonance imaging, was reduced by 20 percent among exercisers. The group that was not exercising had either no or significantly less improvement than the exercising group.

Special scans using an X-ray machine were used to assess total body fat.

“Making gains in body fitness and losing abdominal fat are truly important to the long-term health of the heart,” said study co-author Edward Shapiro, a professor of cardiology. “Our results confirm that moderate-intensity exercise can have many health benefits, including gains in heart function that are linked to increased fitness and reduced fatness.

“Our study also shows that the vast majority of older people with mildly elevated blood pressure can benefit from moderate exercise, and they should talk about it with their physician to determine an appropriate exercise and any other options for treatment,” he said.

The Johns Hopkins study's exercise program followed current guidelines from the American College of Sports Medicine. The study was part of a larger ongoing trial called the Senior Hypertension and Physical Exercise study, or SHAPE.

It is believed to be the first detailed examination of the guidelines' effectiveness and the separate effects of exercise on blood pressure, heart structure and cardiovascular function, with nearly an equal number of men and women enrolled.

A study published last year by the Johns Hopkins scientists showed that exercise reduced by more than 20 percent the number of people who develop metabolic syndrome, a clustering of three or more risk factors for developing heart disease, diabetes and stroke. Risk factors include high blood pressure, elevated blood glucose levels, excess abdominal fat and abnormal cholesterol.

Funding for the study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health, with additional assistance from the Johns Hopkins Bayview General Clinical Research Center, also funded by the NIH. In addition to Stewart and Shapiro, researchers who took part in this study were Pamela Ouyang, Anita Bacher and Sandra Lima, all of Johns Hopkins.

Source: https://pages.jh.edu/gazette/2006/07aug06/07older.html

Keep heart healthy to prevent cardiovascular disease

Physical Activity for Heart Health | Johns Hopkins Medicine

A “roadmap of strategies” for heart health have been outlined in recent guidance from the American College of Cardiology (ACC) and the American Heart Association (AHA).

Adopting a heart-healthy eating plan, getting more exercise, avoiding tobacco and managing known risk factors are among the key recommendations made in 2019 Primary Prevention of Cardiovascular Disease.

“The most important way to prevent cardiovascular disease, whether it’s a build-up of plaque in the arteries, heart attack, stroke, heart failure or issues with how the heart contracts and pumps blood to the rest of the body, is by adopting heart healthy habits and to do so over one’s lifetime,” observes Roger Blumenthal, MD, co-chair of the guideline committee, and the Kenneth Jay Pollin Professor of Cardiology at Johns Hopkins Medicine.

“More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors.”

The guideline describes healthy lifestyle changes as the “cornerstone of preventing heart disease” and offers practical advice the latest research.

“We can all do better with our dietary and exercise habits,” notes Blumenthal, “and that’s so important when we think about wanting to live longer and healthier lives, whether it’s to see our grandchildren grow up or to stay as active as possible in older age.”

Top tips and advice

Eating more vegetables, fruits, legumes, nuts, wholegrains, and fish, are at the top of the list of recommendations, as is limiting salt, saturated fats, fried foods, processed meats and sweetened drinks.

It also advises at least 150 minutes of moderate-intensity exercise, such as brisk walking, swimming, dancing or cycling, each week.

“For people who are inactive, some activity is better than none and small 10-minute bursts of activity throughout the day can add up for those with hectic schedules.

“Currently, only half of American adults are getting enough exercise and prolonged periods of sitting can counteract the benefits of exercise,” say the authors.

Offer tailored support

One in three heart disease deaths are caused by smoking or exposure to second-hand smoke, so the guideline also advocates mitigating this risk.

“Every effort to try to quit through counseling and/or approved cessation medications should be supported and tailored to each individual,” adds the document.

The guideline also warns against the routine use of aspirin to prevent heart attacks and stroke in healthy people.

“Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease,” Blumenthal adds.

“It’s much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin. Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding.”

Source: https://www.changetogether.com/cardiology/keep-heart-healthy

3 Kinds of Exercise That Boost Heart Health

Physical Activity for Heart Health | Johns Hopkins Medicine

Linkedin Pinterest Heart Health Fitness and Performance Physical Activity for Heart Health Maintaining Heart Health

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Being physically active is a major step toward good heart health. It’s oneof your most effective tools for strengthening the heart muscle, keepingyour weight under control and warding off the artery damage from highcholesterol, high blood sugar and high blood pressure that can lead toheart attack or stroke. 

It’s also true that different types of exercise are needed to provide complete fitness.

“Aerobic exercise and resistance training are the most important for heart health,” says Johns Hopkins exercise physiologist Kerry J. Stewart, Ed.D.

 “Although flexibility doesn’t contribute directly to heart health, it’s nevertheless important because it provides a good foundation for performing aerobic and strength exercises more effectively.”

Here’s how different types of exercise benefit you.

Aerobic Exercise

What it does: Aerobic exercise improves circulation, which results in lowered blood pressure and heart rate, Stewart says.

In addition, it increases your overall aerobic fitness, as measured by a treadmill test, for example, and it helps your cardiac output (how well your heart pumps).

Aerobic exercise also reduces the risk of type 2 diabetes and, if you already live with diabetes, helps you control your blood glucose.

How much: Ideally, at least 30 minutes a day, at least five days a week.

Examples: Brisk walking, running, swimming, cycling, playing tennis and jumping rope. Heart-pumping aerobic exercise is the kind that doctors have in mind when they recommend at least 150 minutes per week of moderate activity.

Resistance Training (Strength Work)

What it does: Resistance training has a more specific effect on body composition, Stewart says.

For people who are carrying a lot of body fat (including a big belly, which is a risk factor for heart disease), it can help reduce fat and create leaner muscle mass.

Research shows that a combination of aerobic exercise and resistance work may help raise HDL (good) cholesterol and lower LDL (bad) cholesterol.

How much: At least two nonconsecutive days per week of resistance training is a good rule of thumb, according to the American College of Sports Medicine.

Examples: Working out with free weights (such as hand weights, dumbbells or barbells), on weight machines, with resistance bands or through body-resistance exercises, such as push-ups, squats and chin-ups.

Stretching, Flexibility and Balance

What they do: Flexibility workouts, such as stretching, don’t directly contribute to heart health. What they do is benefit musculoskeletal health, which enables you to stay flexible and free from joint pain, cramping and other muscular issues. That flexibility is a critical part of being able to maintain aerobic exercise and resistance training, says Stewart.

“If you have a good musculoskeletal foundation, that enables you to do the exercises that help your heart,” he says. As a bonus, flexibility and balance exercises help maintain stability and prevent falls, which can cause injuries that limit other kinds of exercise.

How much: Every day and before and after other exercise.

Examples: Your doctor can recommend basic stretches you can do at home, or you can find DVDs or videos to follow (though check with your doctor if you’re concerned about the intensity of the exercise). Tai chi and yoga also improve these skills, and classes are available in many communities.

Both aerobic exercise and resistance training burn calories, as well ashelp improve your baseline metabolic rate. The more muscle mass youdevelop, the more calories you burn, says Johns Hopkins exercisephysiologist Kerry J. Stewart, Ed.D. “Together with diet, that’s what leadsto weight loss,” he says.

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/3-kinds-of-exercise-that-boost-heart-health

Exercise levels predict lifespan better than smoking, medical history

Physical Activity for Heart Health | Johns Hopkins Medicine

Wearable activity trackers may pave the way for a better method to predict short term death risk, suggests a new study, which found that exercise data was more accurate than other risk factors, such as smoking and medical history.

Share on PinterestNew research suggests that physical activity levels might be a better predictor of lifespan than medical history or other lifestyle choices among older adults.

Being able to make an accurate prediction about a person’s risk of death can help them prolong their lives. Usually, doctors base these estimates on lifestyle choices, such as smoking and alcohol consumption, and health factors, such as cancer or heart disease history.

But new findings published in The Journal of Gerontology: Medical Sciences suggest that wearable activity trackers may provide more reliable predictions.

Researchers at John Hopkins Medicine in Baltimore, MD, studied the association between physical activity and risk of death.

“We’ve been interested in studying physical activity and how accumulating it in spurts throughout the day could predict mortality because activity is a factor that can be changed, un age or genetics,” says professor Ciprian Crainiceanu, Ph.D., from the Johns Hopkins Bloomberg School of Public Health.

Their work is not the first to find such a link, but, according to the team, the results might be some of the first to offer concrete proof that wearable technology works better for predicting a person’s risk of mortality than other means.

The study’s data set came from the National Health and Nutrition Examination Survey (NHANES) carried out in 2003–2004 and 2005–2006.

Involving almost 3,000 U.S. adults between the ages of 50 and 84, it examined more than 30 predictors of 5-year all-cause mortality, using survey responses, medical records, and laboratory test results.

Physical activity made up 20 of these predictors, including total activity, time spent doing moderate to vigorous activity, and time spent not moving at all.

To measure such activity, participants — 51% of whom were men — were asked to wear a wearable activity tracker on their hip for 7 days in a row. They were told only to remove the device when showering, swimming, or sleeping.

The research team was able to use the data to categorize which factors best predicted death risk within the next 5 years. However, they were unable to tell when people were sleeping or whether they had removed the tracker for other reasons.

Wearable trackers predicted the risk of death more accurately than surveys and other methods that doctors commonly use.

“The most surprising finding,” says lead author Ekaterina Smirnova, M.S., Ph.D., “was that a simple summary of measures of activity derived from a hip-worn accelerometer over a week outperformed well-established mortality risk factors, such as age, cancer, diabetes, and smoking.”

Smirnova is an assistant professor of biostatistics at Virginia Commonwealth University, VA.

The wearable trackers designated death risk 30% better than smoking-related information did, and was 40% more accurate than using data involving stroke or cancer history.

The researchers found that total daily physical activity was the strongest mortality predictor. Age came second, followed by time spent performing moderate to vigorous physical exercise.

Specifically, examining the amount of physical activity that a person performed between noon and 2 p.m. proved to be a better indicator of death risk than more established risk factors, such as alcohol consumption and diabetes.

Andrew Leroux, co-author and Ph.D. candidate at John Hopkins, says the study confirms “a link between physical activity and short term mortality risk in an older population.”

But, he adds, “the data [do not] guarantee that one’s risk of mortality is going to be lower with more physical activity.”

This does not take away from the fact that wearable tracker measurements, rather than self-reported data, may help doctors “intervene” more appropriately and therefore improve patient health.

Assistant professor of medicine at the John Hopkins University School of Medicine, Jacek Urbanek, Ph.D., notes that “the technology is readily available and relatively inexpensive, so it seems feasible to be able to incorporate recommendations for its use into a physician’s practice.”

But it does mean that further study is necessary. Researchers are hoping to use their findings in clinical trials designed to strengthen the link between physical activity and lifespan.

Source: https://www.medicalnewstoday.com/articles/326958