Surgeon General's Perspectives

THE IMPORTANCE OF 60 MINUTES OR MORE OF DAILY PHYSICAL ACTIVITY

Physical activity is fundamental for achieving optimal health at each stage in life and central to prevention programs and policies at every level. While many of us recognize that active living is key to reaching and maintaining a healthy weight, the long-term health benefits of regular physical activity extend far beyond a number on a scale. Being physically active can reduce the risk of dangerous chronic conditions such as heart disease, certain cancers, high blood pressure, and type 2 diabetes regardless of age, race/ethnicity, weight, or physical ability.¹ Still, many of us do not get the physical activity we need to enjoy a healthy, long life. In the United States, an estimated one out of every 10 premature deaths is associated with physical inactivity.²

In 2008, the U.S. Department of Health and Human Services (HHS) released the landmark “Physical Activity Guidelines for Americans” (hereafter, PAG) to help Americans improve their health and fitness through an active lifestyle. The PAG presents the first-ever set of comprehensive, evidence-based national recommendations for the types and amounts of physical activity Americans need for health, and serves as the basis for programs and policies nationwide. According to the PAG, young people aged 6–17 years need at least one hour of daily physical activity, while adults need 2.5 hours of physical activity each week, or about 30 minutes per day for five or more days each week.¹ Regular physical activity should include a variety of moderate and vigorous activities, as well as muscle-strengthening activities.

During our earliest years, regular physical activity is important for growth and development, and those who are regularly active during childhood and adolescence have a better chance of remaining healthy throughout adulthood.¹ Yet, many of America's young people simply aren't moving enough. Levels of physical activity for young people fall short of recommendations, while opportunities to be active are limited in many schools and communities across the nation. Today, fewer than 20% of adolescents engage in the recommended levels of physical activity,³ and daily physical education exists in a mere 4% of elementary schools, 8% of middle schools, and 2% of high schools.⁴

In March 2013, HHS released the “Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity in Youth” (hereafter, PAG Midcourse Report), which dives even deeper into the scientific literature to identify evidence-based strategies for increasing physical activity levels in Americans aged 3–17 years. With a focus on the places young people live, learn, and play, the PAG Midcourse Report describes key opportunities and approaches for getting America's young people moving more in five important settings: schools, preschools and childcare centers, communities, family and home, and primary health-care settings.⁵

All of us play an important role in providing opportunities for young people to be active. Like the National Prevention Strategy, our nation's first-ever comprehensive prevention plan,⁶ the PAG Midcourse Report underscores the importance of collaborative efforts to enhance physical activity programs and opportunities in schools and early learning centers, and encourages changes to the built environment that facilitate physical activity.

It is essential to have ongoing efforts that improve the quality and availability of well-designed PE programs in our nation's schools, and help shift the perception that physical activity is a competing rather than a complimentary priority. Physical activity can help improve grades, standardized test scores, and classroom behavior, as well as enhance concentration and attention.⁷ In addition to physical education -programs, bouts of physical activity can fit into the school day as classroom activity breaks, before- and after-school activities, and active transportation to and from school.

We should also help children develop active lifestyles even earlier by increasing physical activity in preschool and early care and education centers. Small steps can make a big difference. For example, increasing the time children spend outside, providing portable play equipment (e.g., balls, jump ropes, and tricycles) on playgrounds, and ensuring staff are properly trained to deliver physical activity instruction are ways to get kids moving more in these important settings.

Finally, supporting changes to our communities allows Americans of all ages to live, work, and play in environments that facilitate healthy, active lifestyles. Collaboration and coordination across many fields is particularly important for comprehensive community interventions aiming to improve the built environment. Ensuring that stakeholders from transportation, urban planning, and public safety are at the table is a critical first step for creating healthier physical environments.

During my time as America's Doctor, I have strived to provide Americans with the best scientific information available on how to live healthier lives. The PAG Midcourse Report deepens our understanding of how we can empower America's young people to develop physical activity habits that will help them enjoy longer, healthier lives. Together, we can make strides toward becoming a healthy and fit nation by ensuring that America's young people have opportunities for enjoyable, age-appropriate physical activity in the places they live, learn, and play.

It has been an honor to serve as your Surgeon General. I thank President Obama for the honor he bestowed on me. When I was appointed the 18th Surgeon General on July 13, 2009, in the Rose Garden, I spoke of wanting to prevent other Americans from suffering the loss of loved ones, as I had, due to preventable illnesses, such as smoking-related lung cancer, stroke, and human immunodeficiency virus. My goal was to create a grassroots movement, to change our health-care system from one focused on sickness and disease to a system focused on wellness and prevention. With your help, that movement has begun.

Public Health Reports will continue to be a vehicle for disseminating public health research and practice under the tutelage of the Acting Surgeon General, Rear Admiral Boris D. Lushniak, MD, MPH. Thank you for your support of my vision to improve the health of our nation by focusing on prevention.

VADM Regina M. Benjamin, 18th U.S. Surgeon General