Physical activity

5 October 2022

Key facts
 Physical activity has significant health benefits for hearts, bodies and minds
 Physical activity contributes to preventing and managing non communicable
diseases such as cardiovascular diseases, cancer and diabetes
 Physical activity reduces symptoms of depression and anxiety
 Physical activity enhances thinking, learning, and judgment skills
 Physical activity ensures healthy growth and development in young people
 Physical activity improves overall well-being
 Globally, 1 in 4 adults do not meet the global recommended levels of physical
activity
 People who are insufficiently active have a 20% to 30% increased risk of
death compared to people who are sufficiently active
 More than 80% of the world's adolescent population is insufficiently
physically active

What is physical activity?

WHO defines physical activity as any bodily movement produced by skeletal muscles
that requires energy expenditure. Physical activity refers to all movement including
during leisure time, for transport to get to and from places, or as part of a person’s work.
Both moderate- and vigorous-intensity physical activity improve health.

Popular ways to be active include walking, cycling, wheeling, sports, active recreation
and play, and can be done at any level of skill and for enjoyment by everybody.

Regular physical activity is proven to help prevent and manage non communicable
diseases such as heart disease, stroke, diabetes and several cancers. It also helps
prevent hypertension, maintain healthy body weight and can improve mental health,
quality of life and well-being.
How much of physical activity is recommended?
WHO guidelines and recommendations provide details for different age groups and
specific population groups on how much physical activity is needed for good health.

WHO recommends:
For children under 5 years of age

In a 24-hour day, infants (less than 1 year) should:

 be physically active several times a day in a variety of ways, particularly through

interactive floor-based play; more is better. For those not yet mobile, this includes
at least 30 minutes in prone position (tummy time) spread throughout the day while
awake;
 not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs,
or strapped on a caregiver’s back);
o Screen time is not recommended.
 When sedentary, engaging in reading and storytelling with a caregiver is
encouraged; and
 have 14-17h (0-3 months of age) or 12-16h (4-11 months of age) of good quality
sleep, including naps.

In a 24-hour day, children 1-2 years of age should:

 spend at least 180 minutes in a variety of types of physical activities at any

intensity, including moderate- to vigorous-intensity physical activity, spread
throughout the day; more is better;
 not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs,
or strapped on a caregiver’s back) or sit for extended periods of time.
o For 1 year olds, sedentary screen time (such as watching TV or videos,
playing computer games) is not recommended.
o For those aged 2 years, sedentary screen time should be no more than 1
hour; less is better.
 When sedentary, engaging in reading and storytelling with a caregiver is
encouraged; and
 have 11-14h of good quality sleep, including naps, with regular sleep and wake-up
times.

In a 24-hour day, children 3-4 years of age should:

 spend at least 180 minutes in a variety of types of physical activities at any

intensity, of which at least 60 minutes is moderate- to vigorous-intensity physical
activity, spread throughout the day; more is better;
  not be restrained for more than 1 hour at a time (e.g., prams/strollers) or sit for
extended periods of time.
o Sedentary screen time should be no more than 1 hour; less is better.

 When sedentary, engaging in reading and storytelling with a caregiver is);

encourage; and
 have 10-13h of good quality sleep, which may include a nap, with regular sleep and
wake-up times.

For more information World Health Organization. Guidelines on physical activity,

sedentary behaviour and sleep for children under 5 years of age.

Children and adolescents aged 5-17 years

 should do at least an average of 60 minutes per day of moderate-to-vigorous

intensity, mostly aerobic, physical activity, across the week.
 should incorporate vigorous-intensity aerobic activities, as well as those that
strengthen muscle and bone, at least 3 days a week.
 should limit the amount of time spent being sedentary, particularly the amount of
recreational screen time.

Adults aged 18–64 years

 should do at least 150–300 minutes of moderate-intensity aerobic physical activity;

 or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an
equivalent combination of moderate- and vigorous-intensity activity throughout the
week
 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.
 may increase moderate-intensity aerobic physical activity to more than 300
minutes; or do more than 150 minutes of vigorous-intensity aerobic physical
activity; or an equivalent combination of moderate- and vigorous-intensity activity
throughout the week for additional health benefits.
 should limit the amount of time spent being sedentary. Replacing sedentary time
with physical activity of any intensity (including light intensity) provides health
benefits, and
 to help reduce the detrimental effects of high levels of sedentary behaviour on
health, all adults and older adults should aim to do more than the recommended
levels of moderate- to vigorous-intensity physical activity

Adults aged 65 years and above

 Same as for adults; and

  as part of their weekly physical activity, older adults should do varied
multicomponent physical activity that emphasizes 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.

Pregnant and postpartum women

All pregnant and postpartum women without contraindication should:

 do at least 150 minutes of moderate-intensity aerobic physical activity throughout

the week
 incorporate a variety of aerobic and muscle-strengthening activities
 should limit the amount of time spent being sedentary. Replacing sedentary time
with physical activity of any intensity (including light intensity) provides health
benefits.

People living with chronic conditions (hypertension, type 2 diabetes, HIV and cancer
survivors)

 should do at least 150–300 minutes of moderate-intensity aerobic physical activity;

 or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an
equivalent combination of moderate- and vigorous-intensity activity throughout the
week
 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.
 as part of their weekly physical activity, older adults should do varied
multicomponent physical activity that emphasizes 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.
 may increase moderate-intensity aerobic physical activity to more than 300
minutes; or do more than 150 minutes of vigorous-intensity aerobic physical
activity; or an equivalent combination of moderate- and vigorous-intensity activity
throughout the week for additional health benefits.
 should limit the amount of time spent being sedentary. Replacing sedentary time
with physical activity of any intensity (including light intensity) provides health
benefits, and
 to help reduce the detrimental effects of high levels of sedentary behaviour on
health, all adults and older adults should aim to do more than the recommended
levels of moderate- to vigorous-intensity physical activity.

Children and adolescents living with disability:

 should do at least an average of 60 minutes per day of moderate-to-vigorous

intensity, mostly aerobic, physical activity, across the week.
  should incorporate vigorous-intensity aerobic activities, as well as those that
strengthen muscle and bone, at least 3 days a week.
 should limit the amount of time spent being sedentary, particularly the amount of
recreational screen time.

Adults living with disability:

 should do at least 150–300 minutes of moderate-intensity aerobic physical activity;

 or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an
equivalent combination of moderate- and vigorous-intensity activity throughout the
week
 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.
 As part of their weekly physical activity, older adults should do varied
multicomponent physical activity that emphasizes 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.
 may increase moderate-intensity aerobic physical activity to more than 300
minutes; or do more than 150 minutes of vigorous-intensity aerobic physical
activity; or an equivalent combination of moderate- and vigorous-intensity activity
throughout the week for additional health benefits.
 should limit the amount of time spent being sedentary. Replacing sedentary time
with physical activity of any intensity (including light intensity) provides health
benefits, and
 to help reduce the detrimental effects of high levels of sedentary behaviour on
health, all adults and older adults should aim to do more than the recommended
levels of moderate- to vigorous-intensity physical activity.
 It is possible to avoid sedentary behaviour and be physically active while sitting or
lying. E.g. Upper body led activities, inclusive and/or wheelchair-specific sport and
activities.

For more information World Health Organization. Guidelines on physical activity and
sedentary behaviour. Geneva: World Health Organization; 2020.

Benefits and risks of physical activity and

sedentary behavior
Regular physical activity, such as walking, cycling, wheeling, doing sports or active
recreation, provides significant benefits for health. Some physical activity is better than
doing none. By becoming more active throughout the day in relatively simple ways,
people can easily achieve the recommended activity levels.
Physical inactivity is one of the leading risk factors for noncommunicable diseases
mortality. People who are insufficiently active have a 20% to 30% increased risk of
death compared to people who are sufficiently active.

Regular physical activity can:

 improve muscular and cardiorespiratory fitness;

 improve bone and functional health;
 reduce the risk of hypertension, coronary heart disease, stroke, diabetes, various
types of cancer (including breast cancer and colon cancer), and depression;
 reduce the risk of falls as well as hip or vertebral fractures; and
 help maintain a healthy body weight.

In children and adolescents, physical activity improves:

 physical fitness (cardiorespiratory and muscular fitness)

 cardiometabolic health (blood pressure, dyslipidaemia, glucose, and insulin
resistance)
 bone health
 cognitive outcomes (academic performance, executive function)
 mental health (reduced symptoms of depression)
 reduced adiposity

In adults and older adults, higher levels of physical activity improves:

 risk of all-cause mortality

 risk of cardiovascular disease mortality
 incident hypertension
 incident site-specific cancers (bladder, breast, colon, endometrial, oesophageal
adenocarcinoma, gastric and renal cancers)
 incident type-2 diabetes
 prevents of falls
 mental health (reduced symptoms of anxiety and depression)
 cognitive health
 sleep
 measures of adiposity may also improve

For pregnant and post-partum women

Physical activity confers the following maternal and fetal health benefits: a decreased
risk of:

 pre-eclampsia,
 gestational hypertension,
 gestational diabetes (for example 30% reduction in risk)
  excessive gestational weight gain,
 delivery complications
 postpartum depression
 newborn complications,
 and physical activity has no adverse effects on birthweight or increased risk of
stillbirth.

Health risks of sedentary behaviour

Lives are becoming increasingly sedentary, through the use of motorized transport and
the increased use of screens for work, education and recreation. Evidence shows
higher amounts of sedentary behaviour are associated with the following poor health
outcomes:

In children and adolescents:

 increased adiposity (weight gain)

 poorer cardiometabolic health, fitness, behavioural conduct/pro-social behaviour
 reduced sleep duration

In adults:

 all-cause mortality, cardiovascular disease mortality and cancer mortality

 incidence of cardiovascular disease, cancer and type-2 diabetes.

Levels of physical activity globally

 More than a quarter of the world’s adult population (1.4 billion adults) are
insufficiently active
 Worldwide, around 1 in 3 women and 1 in 4 men do not do enough physical activity
to stay healthy.
 Levels of inactivity are twice as high in high-income countries compared to low-
income countries,
 There has been no improvement in global levels of physical activity since 2001
 Insufficient activity increased by 5% (from 31.6% to 36.8%) in high-income
countries between 2001 and 2016.

Increased levels of physical inactivity have negative impacts on health systems, the
environment, economic development, community well-being and quality of life.

Globally, 28% of adults aged 18 and over were not active enough in 2016 (men 23%
and women 32%). This means they do not meet the global recommendations of at least
150 minutes of moderate-intensity, or 75 minutes vigorous-intensity physical activity per
week.

In high-income countries, 26% of men and 35% of women were insufficiently physically
active, as compared to 12% of men and 24% of women in low-income countries. Low or
decreasing physical activity levels often correspond with a high or rising gross national
product.

The drop in physical activity is partly due to inaction during leisure time and sedentary
behaviour on the job and at home. Likewise, an increase in the use of "passive" modes
of transportation also contributes to insufficient physical activity.

Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in
2016. Adolescent girls were less active than adolescent boys, with 85% vs. 78% not
meeting WHO recommendations of at least 60 minutes of moderate to vigorous
intensity physical activity per day.

How to increase physical activity?

Countries and communities must take action to provide everyone with more
opportunities to be active, in order to increase physical activity. This requires a
collective effort, both national and local, across different sectors and disciplines to
implement policy and solutions appropriate to a country’s cultural and social
environment to promote, enable and encourage physical activity.

Policies to increase physical activity aim to ensure that:

 walking, cycling and other forms of active non-motorized forms of transport are
accessible and safe for all;
 labour and workplace policies encourage active commuting and opportunities for
being physically active during the work day;
 childcare, schools and higher education institutions provide supportive and safe
spaces and facilities for all students to spend their free time actively;
 primary and secondary schools provide quality physical education that supports
children to develop behaviour patterns that will keep them physically active
throughout their lives;
 community-based and school-sport programmes provide appropriate opportunities
for all ages and abilities;
  sports and recreation facilities provide opportunities for everyone to access and
participate in a variety of different sports, dance, exercise and active recreation;
and
 health care providers advise and support patients to be regularly active.

WHO response
In 2018 WHO launched a new Global Action Plan on Physical Activity 2018-2030 which
outlines four policy actions areas and 20 specific policy recommendations and actions
for Member States, international partners and WHO, to increase physical activity
worldwide. The global action plan calls for countries, cities and communities to adopt a
‘whole-of-system’ response involving all sectors and stakeholders taking action at
global, regional and local levels to provide the safe and supportive environments and
more opportunities to help people increase their levels of physical activity.

In 2018, the World Health Assembly agreed on a global target to reduce physical
inactivity by 15% by 2030 and align with the Sustainable Development Goals. The
commitments made by world leaders to develop ambitious national SDG responses
provides an opportunity to refocus and renew efforts at promoting physical activity.

The WHO toolkit ACTIVE launched in 2019 provides more specific technical guidance
on how to start and implement the 20 policy recommendations outlined in the global
action plan.

The global action plan and ACTIVE propose policy options that can be adapted and
tailored to local culture and contexts to help increase levels of physical activity globally,
these include:

 the development and implementation of national guidelines for physical activity for
all age groups;
 establishing national coordinating mechanisms involving all relevant government
departments and key non-government stakeholders to develop and implement
coherent and sustainable policy and actions plans;
 implementing community wide communication campaigns to raise awareness and
knowledge of the multiple health, economic and social benefits of being physically
active;
 invest in new technologies, innovation and research to develop cost effective
approaches to increasing physical activity, particularly in low resource contexts;
 ensure regular surveillance and monitoring of physical activity and policy
implementation.
For more information - Global action plan on physical activity 2018–2030: more active
people for a healthier world

To help countries and communities measure physical activity in adults, WHO has
developed the Global Physical Activity Questionnaire (GPAQ). This questionnaire helps
countries monitor insufficient physical activity as one of the main NCD risk factors. The
GPAQ has been integrated into the WHO STEPwise approach, which is a surveillance
system for the main NCD risk factors.

To assess physical activity among schoolchildren WHO has collaborated on a

questionnaire module which has been integrated into the Global school-based student
health survey (GSHS). The GSHS is a WHO/US CDC surveillance project designed to
help countries measure and assess the behavioural risk factors and protective factors in
10 key areas among young people aged 13 to 17 years.

WHO is also working with international experts on the development of methods and
instruments to assess physical activity in children under the age of five years of age and
under 10 years of age. In addition, WHO is testing the use of digital and wearable
technologies, such as pedometers and accelerometers, in national population
surveillance of physical activity in adults. This work will be extended to include children
and will inform the development of updated global guidance on the monitoring of
physical activity and sedentary behaviours.

To support a ‘whole of system’ response, WHO is collaborating across multiple sectors

to strengthen coordination, advocacy and alignment of policy and actions. WHO has
established partnerships to help support Member States in their efforts to promote
physical activity – these include working with the United Nations Educational, Scientific
and Cultural Organization (UNESCO) to advance and align the implementation of
GAPPA and the Kazan Action Plan on physical education, sports and physical activity.
WHO is also working with many other UN agencies in the shared agenda to
promote Sport for Development and Peace. Within the sports system WHO is
collaborating with the International Olympic Committee and International Sports
Federations, The International Federation of Football Associations, FIFA, and others to
support and strengthen the promotion of health through sports and the sports for all
agenda.