What if I told you there was something you could do, every day, that would reduce your risk of dying prematurely by 19%? It isn’t a pill or a potion, it is something you can do with friends, or alone, it is something you are more likely to do if you own a dog – it is engaging in physical activity! The 2008 guidelines for physical activity recommend that adults get 30 minutes of physical activity a day or a total of 150 minutes a week. Being active reduces the likelihood of getting a heart attack or stroke, and it is a powerful mechanism to prevent disease as well as loss of mobility and function as we age.
How Active are Americans?
The gold standard for measuring physical activity is using accelerometers to track movement. A 2008 study by Troiano and colleagues from the National Cancer Institute published in Medicine and Science in Sports Exercise, using data from 2003-2004 National Health and Nutritional Examination Survey (NHANES), found that only 5% of adults met the recommended 30 mins/day; 42% of 6-11 year old reached the 60 mins/day, but only 8% of adolescents did. Significant declines are seen in rates of physical activity as we age, which doesn’t bode well for overall health and wellness given we also lose muscle mass in our later decades.
Is Your Doctor Asking About Physical Activity?
Health Systems like Kaiser Permanente and Intermountain Healthcare have added “Exercise as a Vital Sign” to their routine screenings. When you visit your doctor, you are asked how active you are and how many minutes you are active. Sharing your activity levels provides additional data to your care team about your day-to-day life that can give a broader context for your overall health. Self-reported data has often been criticized for lack of accuracy, but one paper by Kaiser Permanente’s Deborah Rohm-Young and colleagues published 2014 in Preventing Chronic Disease looked at the self-reported physical activity and cardiometabolic risk factors, including fasting glucose, random glucose, glycosylated hemoglobin, and blood pressure. Data from 622,897 participants were divided into consistently inactive (0 mins activity a week), consistently active (>150 mins activity a week), and irregularly active (0-149 mins activity a week). Across all measures, participants who were consistently active had the most favorable cardiometabolic risk profiles, followed by those who were irregularly active. Those who were inactive had poorer outcomes on all the risk factors, pointing not only to the importance of activity levels in general but also to the added context this data provides healthcare teams with as they support people’s health.
Active Minutes vs. Steps
With the increase of wearables in our day-to-day lives, to be able to track how active we are has become more accessible and more manageable. In recent years, the American Heart Association (AHA) has moved toward counting active minutes instead of just counting steps. Achieving 10,000 steps a day is still a goal for many people, but if you are finding that goal hard to meet, try looking at your “active minutes,” as you may be able to reach your goal counting those. AHA advises getting these minutes (30 in total) in a minimum of ten-minute increments, as less than that doesn’t seem to have the same risk reduction impact. Think of ten minutes as the “dose” you need to improve health. Many apps and wearables count both, so you have a choice in what you may find more motivating to you.
Pokémon GO – and gone?
I confess I play Pokémon GO, a location-based augmented reality game. I started in July 2016 and have been grinding out the levels since then. Yesterday, I walked for three hours for the monthly Community Day, and I reached level 39 (there are 40), so I am almost there… Well, 5,000,000 experience points away (or XP, as we call it).
When the game first came out, it was a global sensation: people were out walking all over the world, it was fun and social and got people to explore their neighborhood. Ben Ma and colleagues from the Chinese University of Hong Kong have just published a study in the Journal of Medical Internet Research on how Pokémon GO related to changes in physical activity. Ma collected data from 210 residents in Hong Kong, aged 13-65, and looked at data for walking and running over a 35-day period in the time right after the game’s release. In the first weeks, the release activity levels rose 18% compared to pre-game release activity levels. Findings showed the most significant gains in physical activity in the group that was more sedentary before the game’s release; considering the game experienced 650 million downloads in its first six months, it speaks to the potential power of augmented reality games as a global tool for health promotion.
Lastly, Dr. Mike Evans who leads health Innovation at Apple and a former Associate Professor of Family Medicine at the University of Toronto makes a compelling case for the importance of physical activity in his YouTube lecture. If catching Pikachu isn’t your thing, it is worth the nine-minute investment of time to watch it: https://www.youtube.com/watch?v=aUaInS6HIGo.
One thing is clear: if you don’t move it, you lose it.
Thanks for reading – Trina
(My opinions are my own)
2008 Guidelines for Physical Activity
Physical Activity Rates in the USA measured by Accelerometer
Physical Activity and Cardiometabolic Risk
Pokémon GO and Physical Activity in Asia
Dr. Mike Evans 23.5 hours