Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Commentary
DOI: 10.36502/2024/hcr.6232
J Health Care and Research 2024 May 06;5(1):22-25
Latest Standard Guideline of Physical Activity and Exercise Guide for Health Promotion
Hiroshi Bando1,2iD*
1Medical Research/Tokushima University, Tokushima, Japan
2Integrative Medicine Japan (IMJ), Shikoku Division, Tokushima, Japan
Corresponding Author: Hiroshi Bando ORCID iD
Address: Tokushima University /Medical Research, Nakashowa 1-61, Tokushima 770-0943, Japan.
Received date: 23 March 2024; Accepted date: 29 April 2024; Published date: 06 May 2024
Citation: Bando H. Latest Standard Guideline of Physical Activity and Exercise Guide for Health Promotion. J Health Care and Research 2024 May 06;5(1):22-25.
Copyright © 2024 Bando H. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Physical Activity and Exercise Guide for Health Promotion 2023, Ministry of Health, Labor and Welfare (MHLW) Japan, Multi-Element Exercise, Strength Training (ST), Sedentary Behavior
Abbreviations: MHLW: Ministry of Health, Labor and Welfare – Japan; ST: Strength Training
Abstract
The latest “Physical Activity and Exercise Guide for Health Promotion 2023” was published in January 2024 by the Ministry of Health, Labor, and Welfare (MHLW) in Japan. Adequate comments were found for some groups, which include age-related differences, various diseases, and working people. The elderly are recommended to have 15 METs of exercise per week, 6,000 walking steps a day, and multi-element exercise >3 days/week such as strength training (ST), balance, and flexibility. Furthermore, this guideline presented key points for safety in three steps: precautions before exercise, understanding symptoms and risk classification, and evaluation of physical activity status.
Commentary
The Ministry of Health, Labor, and Welfare (MHLW) in Japan has been announcing national policy in the health, medical, and nursing care fields for many years. In January 2024, the “Physical Activity and Exercise Guide for Health Promotion 2023” was published [1]. This compilation offers recommendations and reference information regarding physical activity and exercise, marking the first revision of the previous report 10 years ago. In this version, several features can be recognized as follows.
Recommendations for Physical Activity for Each Person:
The current recommendations were indicated according to age, presence of disease, etc. There was an important vision for the previous revision of “Healthy Japan 21 (Third Phase)” [2]. Their perspectives were “health promotion that leaves no one behind (inclusion)” and “promotion of more effective initiatives (implementation).” Accordingly, recommendations were provided for:
a) Some age groups of adults, children, and the elderly,
b) Patients with hypertension, type 2 diabetes (T2D), dyslipidemia, and knee osteoarthritis (OA),
c) People working in the workplace advising beneficial key points for comfortable activity at work [3]. Each guideline was summarized into 2-4 pages, which is easy to use as a teaching tool. One of the themes of this revision was to present recommendations in a compact manner.
Elevated 15 METs Per Week for The Elderly:
In the 2013 edition, the recommended amount of physical activity for the elderly was “10 MET･hrs of physical activity per week regardless of intensity” [4]. However, this time, the requirement has been changed to “physical activity with an intensity of 3 METs or more totaling 15 MET-hours or more per week.” There is evidence for this reason from the results of the Umbrella Review [5]. Elderly individuals with physical activity at >3 METs and >15 MET-hours per week have approximately a 30% lower risk of all-cause mortality and cardiovascular mortality compared to those with little physical activity. This recommendation was announced by considering both these data and the current physical activity situation of the elderly in Japan. Regarding other recommendations for elderly people, the direction of multi-component exercise has been indicated, and some specific examples and scientific basis for these were also presented in the current version.
Recommended 8000 Steps/Day for The Elderly:
For the current guideline, adults are recommended to take at least 8,000 steps a day, and elderly people are recommended to take at least 6,000 steps a day [1]. The unique feature of the guideline is that the amount of physical activity showed a corresponding number of steps, as well as metabolic syndrome (Met-S) levels. In recent years, various studies have shown a relationship between the number of steps taken and diseases, and it has become apparent that walking improves the function of the locomotor itself. In addition, the concept of sedentary behavior was used for the first time for usage of the Japanese language [6]. It was clearly stated that adults and elderly people should be careful not to spend too much time sitting, and even people who have difficulty standing should find ways to move their bodies as much as possible.
Each Subject has their Own Goal:
For the standard level for adults, at least 8,000 steps per day for adults is not the value that can be easily achieved in daily life. It is difficult to achieve this goal unless each person is constantly aware of it [7]. As stated in this guideline, it is necessary to pay attention to individual differences from all backgrounds. Under these circumstances, working on possible matters every day would be important, as well as always being conscious of moving the body as much as possible. From a children’s point of view, the WHO presented in 2020 the Guidelines for Physical Activity and Sedentary Behavior (2020) [8]. We can use several recommended descriptions as a reference. However, circumstances differ depending on the country in the world. When looking at the current state of children’s exercise habits in Japan, there is a polarization between those who are continuing sufficient physical activity and those who are not doing it at all. Therefore, this guideline provides only reference values concerning this matter.
Concrete Exercise Guidance:
The current guideline presented the “key points for safely performing physical activities and exercise” in three steps. These were a) precautions before exercise, b) understanding symptoms and risk classification, and c) evaluation of physical activity status. These can be used in actual instruction and include check sheets that both trainers and trainees can use to take most advantage of them. Just advising for “please exercise” is not enough to make behavioral changes. Instead, by using the current checklist, the trainee can understand and learn what they should do to a certain extent, and what they should be careful of. We hope that everyone can use the guideline as a beneficial reference for actual performance [9]. The main recommended items for adults and the elderly are summarized in Table-1.
Table-1: Main Recommendation Items for Adults and Elderly
In summary, the latest guideline of Physical Activity and Exercise Guide for Health Promotion was presented by the MHLW Japan in January 2024. It described adequate recommendations for age groups, patients, and working people. It can provide trainers and trainees with beneficial comments for smooth understanding and performance. This article becomes a hopefully useful reference for actual physical activity.
Conflict of Interest
The authors have read and approved the final version of the manuscript. The authors have no conflicts of interest to declare.
References
[1] Ministry of Health, Labor and Welfare. Physical Activity and Exercise Guide for Health Promotion 2023. Japan: Ministry of Health, Labor and Welfare; 2024 Jan. Available from: https://www.mhlw.go.jp/content/001194020.pdf
[2] Ministry of Health, Labor and Welfare. The vision of the Health Japan 21 (3rd revision) 2023. Japan: Ministry of Health, Labor and Welfare; 2023 Oct. Available from: https://www.mhlw.go.jp/content/11907000/001153055.pdf
[3] Yamaga Y, Svensson T, Chung UI, Svensson AK. Association between Metabolic Syndrome Status and Daily Physical Activity Measured by a Wearable Device in Japanese Office Workers. Int J Environ Res Public Health. 2023 Feb 28;20(5):4315. [PMID: 36901325]
[4] Komiyama Y. Health Japan 21 (2nd revision). Japan: Minister of Health, Labour and Welfare; 2013. Available from: https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000047330.pdf
[5] Fukushima N, Kikuchi H, Sato H, Sasai H, Kiyohara K, Sawada SS, Machida M, Amagasa S, Inoue S. Dose-Response Relationship of Physical Activity with All-Cause Mortality among Older Adults: An Umbrella Review. J Am Med Dir Assoc. 2024 Mar;25(3):417-30. [PMID: 37925162]
[6] Gao W, Sanna M, Chen YH, Tsai MK, Wen CP. Occupational Sitting Time, Leisure Physical Activity, and All-Cause and Cardiovascular Disease Mortality. JAMA Netw Open. 2024 Jan 2;7(1):e2350680. Erratum in: JAMA Netw Open. 2024 Feb 5;7(2):e242037. [PMID: 38241049]
[7] Stens NA, Bakker EA, Mañas A, Buffart LM, Ortega FB, Lee DC, Thompson PD, Thijssen DHJ, Eijsvogels TMH. Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. J Am Coll Cardiol. 2023 Oct 10;82(15):1483-94. [PMID: 37676198]
[8] WHO. Exercise guideline 2020 by WHO. Geneva: WHO; 2020. Available from: https://www.nibiohn.go.jp/eiken/info/pdf/WHO_undo_guideline2020.pdf
[9] Mizuta R, Maeda N, Tashiro T, Suzuki Y, Kuroda S, Ishida A, Oda S, Watanabe T, Tamura Y, Komiya M, Urabe Y. Effectiveness of Metaverse Space-Based Exercise Video Distribution in Young Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2024 Jan 16;12:e46397. [PMID: 38227355]