Table 4.

Summary of the WHO Guidelines on physcial activity and sedentary behaviour.

These public health guidelines are for all populations across the age groups from 5 years of age and above, irrespective of gender, cultural background or socioeconomic status and are relevant for people of all abilities. Those with chronic medical conditions and/or disability and pregnant and postpartum women should try to meet these recommendations where possible and as able.
	Physical activity	Sedentary behaviour
Children and adolescents (aged 5–17 years), including those living with disability	In children and adolescents, physical activity confers benefits for the following health outcomes: physical fitness (cardiorespiratory and muscular fitness), cardiometabolic health (blood pressure, dyslipidaemia, glucose and insulin resistance), bone health, cognitive outcomes (academic performance, executive function) and mental health (reduced symptoms of depression) and reduced adiposity. It is recommended that: Children and adolescents should do at least an average of 60 min/day of moderate-to-vigorous intensity, mostly aerobic, physical activity, across the week; Vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone should be incorporated at least 3 days a week. Strong recommendation	In children and adolescents, higher amounts of sedentary behaviour are associated with detrimental effects on the following health outcomes: fitness and cardiometabolic health, adiposity, behavioural conduct/pro-social behaviour and sleep duration. It is recommended that: Children and adolescents should limit the amount of time spent being sedentary, particularly the amount of recreational screen time. Strong recommendation
Adults (aged 18–64 years) including those with chronic conditions and those living with disability	In adults, physical activity confers benefits for the following health outcomes: all-cause mortality, cardiovascular disease mortality, incident hypertension, incident type 2 diabetes, incident site-specific cancers, mental health (reduced symptoms of anxiety and depression), cognitive health and sleep; measures of adiposity may also improve. It is recommended that: All adults should undertake regular physical activity; Adults should do at least 150–300 min of moderate-intensity aerobic physical activity, or at least 75–150 min of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate-intensity and vigorous-intensity activity throughout the week for substantial health benefits; Adults should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits. Strong recommendation Adults may increase moderate-intensity aerobic physical activity to >300 min, or do >150 min of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate-intensity and vigorous-intensity activity throughout the week for additional health benefits (when not contraindicated for those with chronic conditions). Conditional recommendation	In adults, higher amounts of sedentary behaviour are associated with detrimental effects on the following health outcomes: all-cause mortality, cardiovascular disease mortality and cancer mortality and incidence of cardiovascular disease, type 2 diabetes and cancer. It is recommended that: Adults should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits; To help reduce the detrimental effects of high levels of sedentary behaviour on health, adults should aim to do more than the recommended levels of moderate-to-vigorous physical activity. Strong recommendation
Older adults (aged 65 years and older) including those with chronic conditions and those living with disability	In older adults, physical activity also helps prevent falls and falls-related injuries and declines in bone health and functional ability. It is recommended that: As for adults, plus As part of their weekly physical activity, older adults should do varied multicomponent physical activity that emphasises functional balance and strength training at moderate or greater intensity on 3 or more days a week, to enhance functional capacity and to prevent falls. Strong recommendation	As for adults Strong recommendation
Pregnant and postpartum women	In women, physical activity during pregnancy and the postpartum period confers benefits for the following maternal and fetal health outcomes: reduced risk of pre-eclampsia, gestational hypertension, gestational diabetes, excessive gestational weight gain, delivery complications and postpartum depression and no increase in risk of stillbirth, newborn complications or adverse effects on birth weight. It is recommended that all pregnant and postpartum women without contraindication should: undertake regular physical activity throughout pregnancy and post partum; do at least 150 min of moderate-intensity aerobic physical activity throughout the week for substantial health benefits; incorporate a variety of aerobic and muscle-strengthening activities. Adding gentle stretching may also be beneficial. In addition: Women who, before pregnancy, habitually engaged in vigorous-intensity aerobic activity or who were physically active can continue these activities during pregnancy and the postpartum period. Strong recommendation	Pregnant and postpartum women should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits. Strong recommendation
Additional explanatory and practical notes: Some physical activity is better than none. If not currently meeting these recommendations, doing some physical activity will bring benefits to health. Start with small amounts of physical activity and gradually increase frequency, intensity and duration over time. Pre-exercise medical clearance is generally unnecessary for individuals without contraindications prior to beginning light-intensity or moderate-intensity physical activity not exceeding the demands of brisk walking or everyday living. It is important to provide all children and adolescents with safe and equitable opportunities and encouragement to participate in physical activities that are appropriate for their age and ability, that are enjoyable, and that offer variety. Older adults should be as physically active as their functional ability allows and adjust their level of effort for physical activity relative to their level of fitness. When not able to meet the recommendations, adults with chronic conditions should aim to engage in physical activity according to their abilities. Adults with chronic conditions may wish to consult with a physical activity specialist or healthcare professional for advice on the types and amounts of activity appropriate for their individual needs, abilities, functional limitations/complications, medications and overall treatment plan. If pregnant and postpartum women are not currently meeting these recommendations, doing some physical activity will bring benefits to health. They should start with small amounts of physical activity and gradually increase frequency, intensity and duration over time. Pelvic floor muscle training may be performed on a daily basis to reduce the risk of urinary incontinence. Additional on safety considerations when undertaking physical activity for pregnant women are: Avoid physical activity during excessive heat, especially with high humidity; Stay hydrated by drinking water before, during and after physical activity; Avoid participating in activities which involve physical contact, pose a high risk of falling or might limit oxygenation (such as activities at high altitude, when not normally living at altitude); Avoid activities in supine position after the first trimester of pregnancy; Pregnant women considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from a specialist healthcare provider; Pregnant women should be informed by their healthcare provider of the danger signs for when to stop, or limit physical activity and to consult a qualified healthcare provider immediately if they occur. Return to physical activity gradually after delivery and in consultation with a healthcare provider in the case of delivery by caesarean section. There are no major risks to people living with disability engaging in physical activity when it is appropriate to an individual’s current activity level, health status and physical function and the health benefits accrued outweigh the risks. People living with disability may need to consult a healthcare professional or other physical activity and disability specialist to help determine the type and amount of activity appropriate for them.