2018 Physical Activity Guidelines
Preventive cardiovascular nurses facilitate physical activity (PA) and educate about its benefits, with the goals of reducing cardiovascular risk and improving quality of life. Overall, the public health benefit from PA versus being sedentary is very large in terms of reduced medical costs. Additionally, individual benefits for health and well-being are well documented and include positive health effects accompanied by increased feelings of energy and vitality with heightened aerobic capacity and strength.
The new 2018 Physical Activity Guidelines have five major messages:
Can physical activity help individuals feel better?
In addition to a strong research base on the beneficial effect of PA on prevention, the guidelines state that PA can help people better perform daily tasks better like carrying groceries, sleep better including falling asleep, and feel better with less anxiety.
Do physical activity benefits happen immediately?
According to the guidelines, benefits to health begin after one session. For example, reduced blood pressure is seen the day PA is performed. Days and weeks of PA have additive benefits, so adopting a PA routine is best.
Does the latest research show continued evidence for reduced risk of many diseases and conditions?
Physical activity has been shown to provide health benefits from age 3. Anytime PA is successful in helping prevent weight gain and reduce weight, a whole cascade of related cardiometabolic disorders can be prevented. Also, PA benefits like reducing the risk of dementia or falls were noted.
How can the benefits of physical activity be achieved?
The guideline supports the performance of any PA and states that the evidence to have a minimum of 10 minutes is not strong, so it is no longer supported. Accumulating as much PA time per day is what is important.
What interventions were found to be effective?
For the greatest effect, physical activities at many levels are suggested. There is strong evidence for the continuation of individual-level programs that increase the amount of PA in youth and adults. Also, larger programs such as those that are community or school-based can improve PA volume.
At the PCNA Annual Symposium in April 2019, a keynote presentation shared by incoming PCNA President, Kim Newlin, MSN, ANP and Geoffrey Moore, MD emphasized the well-known cardiovascular benefits of PA within overall lifestyle interventions and pointed specifically to its role in improving glucose metabolism, and in some cases, remission of Type 2 diabetes mellitus. They reinforced that the 2018 Physical Activity Guidelines recommend 150-300 minutes/week (500 to 1,000 MET-minutes) of moderate-to-vigorous PA. Muscle strength training was recommended at least 2-3 days a week with a day of rest between each strength training day. The speakers gave excellent points of how nurses could effectively promote the Physical Activity Guidelines using an Exercise is Medicine™/ Screening, Brief Intervention & Referral to Treatment (SBIRT) model.
Screening, Brief Intervention & Referral to Treatment (SBIRT) includes:
- PA Assessment & American College of Sports Medicine Screening Algorithm
- Brief advice/counseling
- Prescription for PA (depending on health, fitness, patient & provider preferences)
- Refer patient to PA resources: programs, facilities, certified exercise professionals, self-directed
More detail and resources including the algorithm, a patient-friendly exercise prescription, patient handouts, and provider coding and billing tips are available on the Exercise is Medicine™ website. PCNA’s Heart Healthy Toolbox includes a wealth of patient-friendly resources on exercise and physical activity.
While evidence continues to grow related to specific mechanisms of action for PA, the guidelines are clear and provide strong support for action from preventive cardiac nurses to enact physical activity assessments, counseling, and follow-up at each patient encounter.
References
- 2018 Physical Activity Guidelines Advisory Committee Scientific Report. US Department of Health and Human Services. Health.gov/paguidelines/second-edition/report/pdf/PAG_Advisory_Committee_ Report.pdf