How much activity is recommended

How do national activity guidelines compare?

They largely agree. Most national guidelines match the WHO weekly target, and the differences are mainly in detail.

Australia (2017) recommends 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous activity each week, or an equivalent combination. The US (2018) gives the same ranges and adds muscle-strengthening on 2 or more days a week³. The European Society of Cardiology (2016) recommends at least 150 minutes of moderate or 75 minutes of vigorous activity for healthy adults, and the American College of Sports Medicine (2015) gives similar figures with resistance training 2 to 3 days a week³. The Health Council of the Netherlands states a minimum of at least 150 minutes of moderate activity a week, spread over several days³. Its committee chose that figure partly for continuity with existing guidelines⁵. NHS guidance for older adults also advises at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity if you are already active, or a combination⁶.

Some differences remain. A review of the WHO European Region found most countries still followed the older advice of at least 30 minutes on 5 days a week, and only four countries had adult advice matching the WHO target⁷. A later comparison of EU countries found 14 followed the WHO⁸. Most European countries also still allow shorter bouts, most often at least 10 minutes, whereas the WHO 2020 guidelines removed that requirement^7,1.

If you see different numbers, use the WHO range as your reference point. Treat 150 minutes as a goal to build towards, not a pass mark. Smaller amounts still count.

What does the WHO recommend for adults?

The WHO 2020 guidelines recommend that all adults do 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic activity a week, or an equivalent mix¹.

They add three other points:

• Strength: muscle-strengthening activity at moderate or greater intensity on 2 or more days a week gives additional health benefits¹.
• Adults aged 65 and over: varied activity that combines balance, strength and endurance, at moderate or greater intensity on 3 or more days a week, to improve function and prevent falls¹.
• Sitting: all adults should limit the time they spend sitting, and replacing sitting with activity of any intensity, including light activity, has health benefits¹. The WHO sets no specific limit, because the expert group judged the research was not strong enough to say how much sitting is too much⁹.

The guidelines also say that some activity is better than none. If you are not yet meeting the targets, doing some activity still brings health benefits, and you should start with small amounts and gradually increase how often, how hard and how long you are active¹. Activity in bouts of any length now counts; the old rule of at least 10 minutes at a time has been removed¹.

What are practical ways to meet the weekly guidelines?

Start small and build up. Look for easy ways to fit more movement into daily life, such as taking the stairs instead of the lift, and build from there⁴.

• Aim towards 150 minutes a week. That is around 20 minutes or so a day, but every minute counts⁴.
• Count everyday activity. Activity at work, at home, in leisure time or while travelling all counts¹. Examples of moderate activity include walking for health, water aerobics, riding a bike, dance for fitness, pushing a lawn mower and hiking⁶.
• Use any chunk size. Short bouts add up, so spread your activity through the week in whatever pieces suit you¹.
• Check your effort. Moderate activity raises your heart rate and makes you breathe faster and feel warmer⁴. If you can talk but not sing, you are at a moderate level.
• Add strength work. Plan some muscle-strengthening on 2 or more days a week as you build up¹.

What evidence are the activity guidelines based on?

The guidelines rest mainly on large observational studies, and on reviews that pool them. These link more activity with lower risk of early death, heart disease and type 2 diabetes. They show an association, not proof of cause.

A meta-analysis of studies that measured activity with wearable devices found that higher total activity at any intensity, and less time sitting, were associated with substantially lower risk of early death in middle-aged and older adults¹⁰. Light activity was also linked with lower risk (hazard ratio 0.48, 95% CI 0.38 to 0.63)¹⁰. The lowest risk was seen at about 24 minutes a day of moderate-to-vigorous activity, in line with the 150 minutes a week guideline, though the authors caution that estimates at high activity levels are imprecise¹⁰.

Another meta-analysis found that moving from inactive to 150 minutes of moderate activity a week was associated with 23% lower risk of death from cardiovascular disease, 17% lower cardiovascular disease incidence and 26% lower type 2 diabetes incidence². Its authors concluded that the greatest gain came from moving from inactivity to small amounts of activity².

The WHO says benefits occur below the recommended levels, and that more activity is better, though the relative benefits tend to diminish at higher levels¹. An expert working paper reached a similar view about lower amounts, lighter intensity and one to two sessions a week¹². Canadian guidelines drew on new systematic reviews and overviews of reviews¹¹.

On sitting, risk of death was higher at sitting times above about 9.5 hours a day¹⁰. The WHO still sets no limit⁹.

How do you know if you're meeting the guidelines?

The simplest check has two parts: judge how hard you are working, then add up your weekly minutes.

For effort, use the talk test. If you can still talk but not sing, you are at a moderate level. Moderate activity also raises your heart rate and makes you breathe faster and feel warmer, as in brisk walking, dancing, riding a bike or pushing a lawnmower⁴.

For the weekly total, jot down roughly how many minutes you were active each day and add them up at the end of the week. Compare the total with 150–300 minutes of moderate, or 75–150 minutes of vigorous, aerobic activity, or an equivalent mix¹. You can also check whether you did muscle-strengthening on 2 or more days¹.

If you are below the target, that is fine. Doing some activity still brings health benefits, and you can add a little each week¹. A step count that matches the 150-minute guideline isn't clear yet, so treat any tracking as a rough guide.

When to check with a health professional

Most people can start light-to-moderate activity without a medical check, as long as they build up gradually. The WHO says medical clearance is generally unnecessary for people without contraindications before activity no more intense than a brisk walk^13,9,1.

• Long-term conditions: the WHO recommends the same activity levels as for healthy adults, with some precautions, and advises talking to a healthcare professional about suitable types and amounts⁹.
• Older adults: NHS guidance advises speaking to a GP first if you have not exercised for some time, or have medical conditions or concerns. This is one national source's advice; the WHO does not require it for light or moderate activity^6,13.
• Heart disease: if you have known cardiovascular disease, it is essential to increase activity gradually¹³.
• Diabetes: do not start physical activity if you feel unwell or have had a low blood sugar (hypoglycaemia) episode in the previous 24 hours¹³.
• Feeling more tired than usual for a while after starting is common until your body adapts. Build up gradually¹³.

Don't push through chest pain, severe breathlessness, dizziness or fainting. Stop and seek medical help, and call your local emergency number if symptoms are severe^13,14.