Physical activity and cardiovascular health. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health

OBJECTIVE--To provide physicians and the general public with a responsible assessment of the relationship between physical activity and cardiovascular health. PARTICIPANTS--A nonfederal, nonadvocate, 13-member panel representing the fields of cardiology, psychology, exercise physiology, nutrition, pediatrics, public health, and epidemiology. In addition, 27 experts in cardiology, psychology, epidemiology, exercise physiology, geriatrics, nutrition, pediatrics, public health, and sports medicine presented data to the panel and a conference audience of 600 during a 2-day public session. Questions and statements from conference attendees were considered during the open session. Closed deliberations by the panel occurred during the remainder of the second day and the morning of the third day. EVIDENCE--The literature was searched through MEDLINE and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS--The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. CONSENSUS STATEMENT--The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. There-after, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. CONCLUSIONS--All Americans should engage in regular physical activity at a level appropriate to their capacity, needs, and interest. Children and adults alike should set a goal of accumulating at least 30 minutes of moderate-intensity physical activity on most, and preferably all, days of the week. Most Americans have little or no physical activity in their daily lives, and accumulating evidence indicates that physical inactivity is a major risk factor for cardiovascular disease. However, moderate levels of physical activity confer significant health benefits. Even those who currently meet these daily standards may derive additional health and fitness benefits by becoming more physically active or including more vigorous activity. For those with known cardiovascular disease, cardiac rehabilitation programs that combine physical activity with reduction in other risk factors should be more widely used.

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Friedenberg
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Koffman et al.
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Fletcher et al.
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Hu et al.
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Stewart et al.
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Hussey et al.
Br. J. Sports. Med. 2001;35:268-272.
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Sacco et al.
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Hu et al.
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SEGAL et al.
Gut 2001;48:730-732.
FULL TEXT  

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Laukkanen et al.
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Hu et al.
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Maron et al.
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Goldstein et al.
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Goldstein et al.
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Felson et al.
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ABSTRACT | FULL TEXT  

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Wu and Porell
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ABSTRACT  

Exercise Intensity and Risk of Chronic Disease
Winett et al.
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FULL TEXT  

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Sesso et al.
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ABSTRACT | FULL TEXT  

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Miilunpalo et al.
Health Educ Res 2000;15:435-448.
ABSTRACT | FULL TEXT  

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Ross et al.
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Hu et al.
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Sparling et al.
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ABSTRACT | FULL TEXT  

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Campos and Siles
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