Do not underestimate the power of ‘move more and sit less’ guideline, speaker says

Key takeaways:

• When a patient goes from “doing nothing to something, that's a win,” an expert said.
• Ways to improve nonexercise activity can be simple, like walking upstairs more often.

DENVER —Exercise “pretty much improves everything” from metabolic health to musculoskeletal, cardiovascular, pulmonary, mental, sexual and cognitive health, an expert said.

The Physical Activity Guidelines for Americans outlines the amount of activity that patients need to achieve health benefits.

“This is the guideline that you're going to go back to over and over again in your clinical practice,” Carolynn Francavilla Brown, MD, FOMA, D-ABOM, owner and founder of Green Mountain Partners for Health in Lakewood, Colorado, said during her talk at Obesity Medicine 2024. “This is the most important piece of information that you're going to want to know.”

The first statement in the Physical Activity Guidelines for Americans “is simply that adults should move more and sit less,” Brown said.

“How easy is that recommendation, right guys?” Brown said. “If you have a patient who is currently doing nothing and you go from doing nothing to something, that’s a win. I think that’s important for us to recognize.”

For substantial health benefits, the guidelines recommend that adults partake in at least 150 to 300 minutes of moderate-intensity physical activity per week; 75 to 150 minutes of vigorous-intensity aerobic physical activity per week; or “an equivalent combination of moderate- and vigorous-intensity aerobic activity.”

“There are additional health benefits from doing more,” Brown said.

The guidelines also recommend muscle-strengthening activities at least 2 days per week.

Physical activity vs. physical exercise

Brown noted that physical activity and physical exercise are often used “interchangeably” despite being distinct.

“Physical activity is any movement,” she said. “Physical exercise is a planned activity, something you’re intentionally doing for movement. We know exercise improves health regardless of our weight ... and we all need to do it in order to live longer and live better.”

Although physical exercise alone does not result in significant weight reduction, “when it comes to maintaining weight, exercise may be a very powerful tool,” Brown said. “The National Weight Control Registry ... showed that [among people] who had lost 30 pounds or more and kept it off for more than a year in the study, 90% were exercising more and most of them were exercising for more than an hour a day.”

Nonexercise activities

Brown said that “simple movements,” or nonexercise activity thermogenesis (NEAT), can add to a patient’s fitness.

“That could be as simple as just typing [or] tapping your foot while you’re talking to someone. It might be walking to your car, walking up stairs at your house [or] office, singing, fidgeting ... all those little movements that we do throughout the day that we don’t really think of,” she said.

NEAT often represents the widest variance in energy expenditure among people, which can range between 150 to 500 calories a day and is often greater vs. physical activity bouts, Brown said.

She also said that NEAT can explain the perception that some people are naturally lean “and don’t have to maybe formally exercise as much, maybe don’t seem to be watching their diet as much.”

“Some of those people may be maintaining their weight better, [have a more natural BMI] because they have more NEAT,” she said. “Those people who are moving more, they’re just burning more calories throughout the day."

Clinicians can encourage patients who may not naturally do as much movement to increase their NEAT by tracking steps on their phone, watch or fitness tracker, Brown said.

“A lot of times we’ll start with this base of 5,000 steps per day, then we’ll try and push them to increase their steps by maybe 500 each week until they get closer to 10,000 steps a day,” Brown said.

Other ways to increase NEAT could include parking further away, taking stairs instead of the elevator and ultimately just moving more throughout the day.