Physical Activity and Fitness in the Prevention of Coronary Heart Disease and Associated Risk Factors

Less than half of the adult population in the United States meet the minimum physical activity recommendations of the 1996 surgeon general's report: 30 minutes of moderate-intensity physical activity on most if not all days of the week. There is strong evidence that following these recommendations could potentially reduce the incidence of coronary heart disease and mortality. The benefits of more vigorous exercise are less clear, especially for women. Physical fitness demonstrates an even stronger negative association with coronary heart disease and mortality with a 17% to 20% reduction in mortality for every 1 metabolic equivalent (3.5 mL/kg/min) increase in aerobic power (VO _2max). For prevention or management of diabetes, the American Diabetes Association recommends 150 minutes per week or more of moderate-intensity aerobic exercise and/or 90 minutes per week or more of vigorous aerobic exercise. Weight loss may require 60 to 90 minutes of moderate exercise per day. Regular moderate, but not vigorous, exercise is recommended for the prevention/management of hypertension. Many studies support moderate to high-intensity exercise 3 to 5 times per week for at least 30 minutes per session to manage or improve cholesterol profiles, although changes reported vary and are modest in most cases.