Intended for healthcare professionals


“Some exercise is good, more is better,” say medical chiefs in new guidance

BMJ 2019; 366 doi: (Published 07 September 2019) Cite this as: BMJ 2019;366:l5470

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When it comes to physical activity some is good, but more is better

  1. Gareth Iacobucci
  1. The BMJ

New mothers should undertake a moderate amount of exercise to help them regain strength, ease back pain, and reduce the risk of gestational diabetes, the UK’s four chief medical officers have advised.

The recommendation is included in updated physical activity guidelines, which include advice on safe levels of activity for pregnant and postpartum women. The guidelines update the existing 2011 physical activity guidance for all age groups, drawing on the latest evidence available.

The updated guidelines emphasise the importance of building strength and balance, as well as cardiovascular exercise for adults. Adults aged 19-64 are advised to undertake strength based activities—such as heavy gardening, carrying heavy shopping, or resistance exercise—at least two days a week to help delay the natural decline in muscle mass and bone density that starts at around age 50.

Each week adults should undertake at least 150 minutes of moderate intensity activity such as brisk walking or cycling, or 75 minutes of vigorous intensity activity such as running, or even shorter durations of very vigorous intensity activity such as sprinting or stair climbing—or a combination of moderate, vigorous, and very vigorous intensity activity.

Over 65s should undertake activities such as dancing, bowls, swimming, and gardening to help prevent illness and falls—the latter being identified as the number one reason older people are taken to emergency departments.

“Any activity is better than none, and more is better still,” the guidelines conclude.

Healthy habits

Sally Davies, England’s chief medical officer, said, “Physical activity is an under-appreciated asset in our clinical arsenal. It is cheap and brings a long list of health benefits.

“As we age, our muscles weaken and we can become stiff, leading to falls and difficulty performing everyday activities. Physical activity can prevent fragility and support mobility in old age. By keeping active, both throughout the day and also through hobbies, we can slow muscle and bone decline, ultimately keeping us independent for longer.”

The guidelines also include new advice to encourage development in babies and children, based on global guidelines issued by the World Health Organization earlier this year.1 They recommend as much active play as possible for children under 5 and an average of 60 minutes a day for older children, throughout the week.

Max Davie, officer for health improvement at the Royal College of Paediatrics and Child Health, said that the advice was “extremely welcome.”

He added, “We know that healthy children are much more likely to grow into healthy adults. But key to longevity and success is embedding healthy habits into life early and making them part of a routine.”

For pregnant women and new mothers the guidance advises that:

  • Physical activity can be safely recommended to women during and after pregnancy, with no negative impact on breastfeeding postpartum

  • Physical activity choices should reflect pre-pregnancy activity levels and should include strength training. Vigorous activity is not recommended for previously inactive women; and

  • After the six to eight week postnatal check and depending on how the woman feels, more intense activities can gradually resume, building up intensity from moderate to vigorous over at least three months.


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