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Start Active, Stay Active: A report on physical activity for health from the four home countries’ Chief Medical Officers

On 11 July 2011, the Department of Health published the first UK-wide physical activity guidelines, issued by the four Chief Medical Officers (of England, Scotland, Wales and Northern Ireland). The report contains new advice as to how people of all ages can maintain fitness levels and stay or get healthy, drawing on global evidence for the health benefits that can be achieved through regular physical activity throughout the lifespan.

Regular physical activity can reduce the risk of many chronic diseases including stroke and coronary heart disease, type 2 diabetes, cancer, obesity and musculoskeletal conditions. According to the report, even relatively small increases in physical activity are associated with some protection against chronic diseases and an improved quality of life.

The new report emphasizes the importance of physical activity for people of all ages and includes new guidelines for early years (under 5s) and older adults. It also highlights the risks of sedentary behaviour in all age groups. Emerging evidence shows that sedentary behavior is associated with overweight and obesity and may be independently linked to the risk of a number of diseases including type 2 diabetes and some types of cancer.   

The guidelines build on previous advice but a key element to the new guidelines is a more flexible approach for adults to get their 150 minutes of activity a week. Other key features include a lifecourse approach, more emphasis on vigorous activity and muscle strengthening, more flexible recommendations for busy lives, an emphasis on daily activity and new guidelines on reducing sedentary behaviour.

The guidelines can be summarised as follows:

Early years (under 5s)

  1. Physical activity should be encouraged from birth, particularly through floor-based play and water-based activities in safe environments.
  2. Children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.
  3. All under 5s should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping).

Children and young people (5-18 years)


  1. All children and young people should engage in moderate to vigorous intensity physical activity for at least 60 minutes and up to several hours every day.
  2. Vigorous intensity activities, including those that strengthen muscle and bone, should be incorporated at least three days a week.
  3. All children and young people should minimise the amount of time spent being sedentary (sitting) for extended periods.

Adults (19-64 years)

  1. Adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes on at least 5 days a week.
  2. Alternatively, comparable benefits can be achieved through 75 minutes of vigorous intensity activity spread across the week or a combination of moderate and vigorous intensity activity.
  3. Adults should also undertake physical activity to improve muscle strength on at least two days a week.
  4. All adults should minimise the amount of time spent being sedentary (sitting) for extended periods.

Older adults (65+ years)


  1. Older adults who participate in any amount of physical activity gain some health benefits, including maintenance of good physical and cognitive function. Some physical activity is better than none, and more physical activity provides greater health benefits.
  2. Older adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes on at least 5 days a week.
  3. For those who are already regularly active at moderate intensity, comparable benefits can be achieved through 75 minutes of vigorous intensity activity spread across the week or a combination of moderate and vigorous activity.
  4. Older adults should also undertake physical activity to improve muscle strength on at least two days a week.
  5. Older adults at risk of falls should incorporate physical activity to improve balance and co-ordination on at least two days a week.
  6. All older adults should minimise the amount of time spent being sedentary (sitting) for extended periods.

The report is available here

 Last reviewed October 2011. Next review due December 2014.

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