There is incontrovertible evidence linking poor air quality to adverse health outcomes. This is especially true for people with pre-existing conditions such as heart disease, stroke, asthma and chronic obstructive pulmonary disease. However, healthy people are at risk too. Exposure to air pollution has been linked to a higher risk of developing asthma, and recent studies have identified links between air pollution and adverse pregnancy outcomes.

The American Fitness Index added air quality as an indicator of a healthy and fit city for the first time with the 2019 rankings release. The Fitness Index used the Air Quality Index (AQI) from the Environmental Protection Agency which measures major air pollutants, including particle pollution, ground level ozone, sulfur dioxide and nitrogen dioxide, and carbon monoxide. The Fitness Index’s 2019 Summary Report notes that the 100 largest cities in the U.S. average only 62 percent of the year with good air quality. That means for over a third of the year residents in these cities are breathing polluted air that is harmful to their health.

The AQI provides guidance as to the safety of the air quality. You can download the airnow.gov app for your smart phone or visit www.airnow.gov, and review the AQI for an entered zip code.

Of course, we want people to be physically active, and better yet, to be active outdoors. While air pollution can affect your health, the health benefits of being physically active outweigh the risks of air pollution for most healthy individuals. However, it is important to keep in mind that an adult exercising at a moderate level of exertion exchanges about six liters of air per minute! An athlete running at 70 percent of their maximal oxygen uptake for the length of a marathon inhales the same volume of air as a sedentary person does in two days!

Tips to maintain an active lifestyle when air quality is poor:

• Exercise earlier in the day. Both particulate pollution and ground level ozone tend to accumulate throughout the day.
• The vast majority of air pollution comes from tailpipes – cars and trucks on the road – so avoid outdoor activity during commuting time (7:30 a.m. – 9:00 a.m., and 4:00 p.m. – 7:00 p.m.), and when possible avoid exercise next to heavily trafficked roadways.
• Consider indoor activity opportunities like going to the gym, walking laps at the mall or working out along with an exercise video (local libraries often lend these for free).
• It is important to note that a scarf or paper mask does not protect you from the poor air quality.

Finally, think about what you can do as an individual to reduce your contribution to poor air quality by using public transportation when possible, walking or biking to work or school, combining driving trips, eliminate idling, avoiding wood-burning and replacing or installing ultra-low nitrogen oxide water heaters. If we all do our part to clean the air, it will make the environment safer for the outdoor activities we love.

Author: Liz Joy, M.D., MPH, FACSM, Intermountain Healthcare

Originally published on July 16, 2019

In 2008, the US Department of Health and Human Services (DHHS) issued the federal government’s first-ever Physical Activity Guidelines for Americans (Guidelines) to help Americans understand the types and amounts of physical activity that offer important health benefits. Given the extensive amount of new information available over the past decade, DHHS released the second edition of the Physical Activity Guidelines for Americans on November 12, 2018.

#1 How many Americans meet the Physical Activity Guidelines?

In 2017, only about 20% of high school students and 25% of adults reported getting enough physical activity to meet the aerobic and muscle-strengthening guidelines.

#2 How much physical activity do school-aged youth and adults need?

The guidelines for children and adolescents are as follows:

• It is important to provide young people opportunities and encouragement to participate in physical activities that are appropriate for their age, that are enjoyable and that offer variety.
• Children and adolescents aged six through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily:
  • Aerobic: Most of the 60 minutes or more per day should be either moderate- or vigorous-intensity aerobic physical activity and should include vigorous-intensity physical activity on at least three days a week.
  • Muscle-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least three days a week.
  • Bone-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least three days a week.

The guidelines for adults are as follows:

• Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
• For substantial health benefits, adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week.
• Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes of moderate-intensity physical activity a week.
• Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on two or more days a week, as these activities provide additional health benefits.

See  Physical Activity Guidelines for Americans, 2nd Edition for additional key guidelines for the following populations:

• Preschool-aged children.
• Older adults.
• Women during pregnancy and the postpartum period.
• Adults with chronic health conditions and adults with disabilities.
• Safe physical activity.

#3 To meet the current Physical Activity Guidelines, do Americans need to be more or less active compared to what was first recommended in 2008?

The new evidence reinforces the amounts and types of physical activity recommended for youth and adults in the 2008 Guidelines. The total amount of physical activity didn’t change in the second edition of the Guidelines. However, unlike the 2008 Guidelines, with the current Guidelines, moderate- and vigorous-intensity physical activity no longer needs to occur in bouts of at least 10 minutes to count towards meeting the adult aerobic activity guideline.

#4 What has changed in this second edition of the Guidelines?

This second edition of the Guidelines reflects the extensive amount of new knowledge gained since the 2008 release of the first edition of the Guidelines. This second edition of the Guidelines discusses the proven benefits of physical activity and outlines the amounts and types of physical activity recommended for different ages and populations. For example, new aspects include discussions of:

• Immediate and longer-term benefits for how people feel, function and sleep after being physically active.
• Additional health benefits of physical activity related to brain health, additional cancer sites and fall-related injuries.
• Further benefits of being active among older adults and people with additional chronic conditions.
• Risks of sedentary behavior and their relationship with physical activity.
• Guidance on activity levels for preschool children aged three through five years.
• Elimination of the requirement for physical activity of adults to occur in bouts of at least 10 minutes.
• Tested strategies that can be used to get the population more active.

#5 Where can I find more information?

Learn more about the latest Physical Activity Guidelines for Americans. You can also explore the Move Your Way for interactive tools (like the one below), motivational videos, and helpful tips to make it easier to move more and sit less. Remember, physical activity can make you feel better right away including:

• Boosting your mood,
• Sharpening your focus,
• Reducing your stress, and
• Improving your sleep.

Author: Kathleen B. Watson, Ph.D. 

Originally published February 27, 2019

The other day I heard a story about a woman who hated to exercise. She wanted nothing of it: going to the gym, sweating, walking on the treadmill. Boring. No way! She’d heard about the latest 2018 U.S. Physical Activity Guidelines, but had dismissed them as irrelevant to her life.

Recently, she stumbled onto an article that said the activities she was doing in everyday life counted as exercise and that moving more could actually make her feel better. “Cleaning the house, sweeping the porch, mowing the lawn, and walking my child to school are exercise? Really? I need to learn more!”

Off she went to search the internet. She discovered the  Compendium of Physical Activities that listed MET values for hundreds of activities. METs? What are those? After learning that METs are a multiple of energy expended at rest (1 MET), the woman got a paper and pen and went to work. She listed all of her daily activities and how much time she did them each week. Then she separated the activities into light-, moderate-, and vigorous-intensity categories based on the MET values. Low and behold, she spent a lot of time in moderate activities and even some in vigorous activities. Amazing!

She wondered, how many minutes are ‘enough’? She remembered the 2018 U.S. Physical Activity Guidelines and went back to the internet. The guidelines recommended that she should “move more and sit less throughout the day.” Check! She did that.

The guidelines also recommended that she also “do at least 150 – 300 minutes of moderate-intensity activities (3.0-5.9 METs) or 75 minutes of vigorous-intensity activities (6.0 and higher METs), or a combination of the two intensities each week. Preferably the activities should be aerobic. And every minute counted.” Based on her list of activities and METs, she was close to meeting that goal too. She was on a roll!

The third guideline stopped her in her tracks. They recommended she “do at least two days of muscle-strengthening activities of moderate or greater intensity that involve all her major muscle groups.” Whoa. She didn’t do any muscle strengthening activities. She had no idea what were her major muscle groups.

Back to the internet for more information.

The woman learned that it’s important to work the major muscle groups: the chest, shoulders, back, biceps and triceps, legs and calves, and stomach. Oh. No way she worked these muscle groups at least two days a week, let alone one day a week.

To get help with where to start, the woman went to a nearby gym and worked with a trainer who showed her exercises to strengthen her muscles. She added these exercises to her schedule twice a week and, she liked it! She was getting stronger, her body was firming up and she liked how she felt during and after her workouts. She was sweating and loving it!

Before she knew it, the woman was looking for ways to get moving intentionally. She dusted off that old bicycle in the garage and took it for a spin. She bought a fitness tracker and took the long way to pick up her child at school. She even signed up for an exercise class to get more minutes of vigorous-intensity activities. Moving more had become a part of her life. Everything she was doing, even the bite-sized amounts of activity, counted toward her activity goals. She felt great, slept better, and had more energy.

The moral to this story is that if we move every day, we are doing positive things for our mental and physical health. The new 2018 U.S. Physical Activity Guidelines tell us how much activity we need on a regular basis to improve our health and reduce our risk of chronic diseases. So here’s to an active and healthy 2019 as we aim for every child, adult and senior to reach the goals set in the 2018 U.S. Physical Activity Guidelines.

Author: Barbara E. Ainsworth

Originally published February 5, 2019

Summertime is in full swing, and, for many of us, it’s the time of year we consider engaging with the great outdoors. However, as much as we might like, we can’t make every day a journey into nature … or can we? Local parks are a significant way to bring a piece of nature into our neighborhoods. And perhaps surprisingly, they may be doing a lot more good than just being a place to take the kids for a push on the swing.

It’s not a stretch of the imagination that parks help communities be more physically active. The relationship between parks and activity levels is so strong that the American Fitness Index – a ranking that evaluates the health and fitness of cities – includes several measures of parks in a community. For example, the rankings look at the total number of parks, the percent of residents living within a ten-minute walk to a park, and even local government spending on parks, a policy-level consideration. These are just a few featured indicators that are used to evaluate the cities that are ranked yearly.

Science shows that in addition to getting people to move more, parks also improve mental well-being and are essential for community connectedness—a critical aspect of social health.

One might wonder how a simple park can achieve so much! The open space or grassy areas in parks are great places to play catch with a friend or do exercises on your own. In addition, parks provide beautiful tree canopies for walking and moments of tranquility. And of course, many parks have sports fields or courts for team activities, outdoor gyms, and playground equipment for kids that can easily be repurposed for working out.

And what about mental health? The mental health community knows that “greenspace” positively impacts psychological well-being. Greenspace is an umbrella term that includes both open wilderness and urban parks and has been linked to greater mental health and well-being. Not only do parks and greenspace support physical activity, which is well known to improve mental health, but they also benefit psychological health through peaceful and relaxing sounds as well as feelings of closeness to nature. Related to this are the benefits parks and greenspace may have to social health, one driver of which is community connectedness. The physical parkland area may attract family, friends, and the larger community to come together for various social reasons.

And finally, parks may actually be saving money in health care costs. A  recent UK report found that park users are healthier – saving an astonishing £111 million (US$146 million) in medical expenses for that country.

The parks in our neighborhoods are spaces that can contribute significantly to our health and well-being. While seasonal activities are a great way to get outdoors, for many, local parks are accessible nearly every day of the year. See how your city ranks on parks plus many other health and fitness indicators in the 2018 American Fitness Index.

Author: Jane C. Hurley 

Originally published August 8, 2018