In 1996, the Surgeon General of the United States released a report that served as a wake-up call about the general state of health and wellness of people in the U.S. The Surgeon General’s Report on Physical Activity and Health outlined serious issues in two areas. First, the report identified a disturbing, wide-ranging, population-level prevalence of obesity. Second, the report indicated that on average, the lifestyle of the typical U.S. citizen was too sedentary – and trends showed that people in the U.S. were becoming more sedentary with each passing year.

In response to this report – and in the best interests of the health and welfare of the general public – officials from the U.S. Department of Health and Human Services (HHS) created the Physical Activity Guidelines Steering Committee, which initiated a ten-year process that culminated in the Centers for Disease Control (CDC) publication, the 2008 Physical Activity Guidelines for Americans. Like the 1996 report from the Surgeon General, the guidelines were a landmark development in public health policy in the U.S.

In 2019, the CDC released a new report that includes the latest scientific evidence on the health and wellness benefits of exercise. It also includes revised recommendations about the amount and type of exercise people should engage in on a daily and weekly basis to maximize the benefits of exercise and activity. Before we talk about the new report – and in order to give that report context – we’ll offer a brief summary of the initial 2008 publication.

The 2008 Guidelines: An Overview

According to HHS Secretary Michael O. Leavitt, these recommendations were “the first comprehensive guidelines on physical activity ever to be issued by the Federal government.” The report emphasized key facts about the positive effects of exercise. Public health officials made it clear that a consistent exercise routine and an active lifestyle can help:

• Reduce illness
• Reduce disease
• Decrease risk of developing:
  • Heart disease
  • Type 2 diabetes
  • Hypertension
  • Colon cancer
• Reduce symptoms of anxiety and depression
• Develop and maintain healthy bones, muscles, and joints
• Control weight

The report established the amount of time individuals should spend, per day and per week, engaging in moderate and vigorous aerobic activity, weight training, and various forms of intense physical activity to experience the health benefits listed above. The short version: to get the most out of their exercise time, people should spend about two and a half hours a week engaging in moderate intensity aerobic activity, about an hour a week engaging in vigorous aerobic activity, and include higher intensity, muscle- and bone-strengthening activities at least twice a week.

To learn more about how exercise directly supports health, wellness, and recovery in the adolescent population, please read our article “Exercise and Recovery: The Foundation of Total Health.”

Now let’s look at this new CDC report.

The 2019 Guidelines: Key Facts and Findings

The  Physical Activity Guidelines for Americans, 2^nd Edition reiterates the core information from the first set of guidelines and includes new research about the additional health benefits of exercise. The new findings in the report show that a regular exercise and activity routine can lead to:

1. Improved cognitive function for youth ages 6 to 13 years.
2. Reduced risk of cancer at newly identified cancer-risk sites.
3. Improved brain health, healthier sleep patterns, and improved overall quality of life.

In addition, the new guidelines indicate that for pregnant women, exercise and activity help reduce the risk of excessive weight gain, gestational diabetes, and postpartum depression. For people with various chronic medical conditions, the new guidelines indicate a regular exercise and activity routine helps reduce the risk of all-cause and disease-specific mortality, improves physical function, and improves overall quality of life.

The guidelines present revised recommendations for adults, older adults, people with disabilities, and various special populations with specific needs – but we’ll let you read those yourself. Please click the link above to access the full report.

The rest of this article will focus on what the report recommends for children and adolescents. First, we’ll walk through the general recommendations.

CDC 2019: Key Exercise and Activity Guidelines for Adolescents

• Children and adolescents age 6 to 17 years should participate in at least 60 minutes of moderate-to-vigorous physical activity every day.
• The activity should include a mix of aerobic, muscle-strengthening, and bone-strengthening activities:
  • Aerobic: Most of the daily exercise/activity should be performed at either a moderate- or vigorous level of intensity. Adolescents should include vigorous-intensity physical activity at least 3 days a week.
  • Muscle-strengthening: Adolescents should participate in muscle-strengthening physical activities at least 3 days a week.
  • Bone-strengthening: Adolescents should participate in bone-strengthening physical activities at least 3 days a week.
• Adults should provide adolescents opportunities and encouragement to participate in physical activities appropriate for their age and developmental level.
• Activities should be fun and as diverse as possible. Variety helps.

For parents who want to make sure their teens meet these guidelines, the first step is understanding what all the terms and phrases in the guidelines mean. People who exercise regularly and have participated in sports since childhood know what they mean, for the most part, but people who don’t exercise regularly and didn’t or don’t participate in sports may not know what some of the important terms mean in the context of exercise and activity.

For instance, while everyone knows what the words moderate and vigorous mean, some people may not know precisely what they mean with regards to aerobic, muscle-strengthening, or bone-strengthening activity.

We’ll explain what all those terms mean and offer specific, teen-appropriate examples for each one.

But first, we’ll break down the basics of exercise and fitness, as defined by the CDC:

The Components of Physical Fitness

• Cardiovascular fitness refers to the ability to perform large-muscle, whole-body exercise at moderate-to-vigorous intensities for extended periods of time.
• Musculoskeletal fitness refers to the integration of muscular strength, endurance, and power.
• Flexibility describes the range of motion an individual has in their joints.
• Balance refers to the ability to maintain equilibrium while stationary or in motion.
• Speed refers to the ability to move quickly.

General Guidelines for Exercise and Activity:

• Aerobic activity works best when spread throughout the week, not all loaded on one or two days.
• Exercising more than the recommended 5 hours per week yields additional health benefits. People who are already healthy and strong should consult a trainer, coach, or physician when training more than 10-12 hours a week.
• At least twice a week, all people should do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups.

Now we’ll get into the specifics of what the CDC means when they say aerobic, moderate, vigorous, muscle-strengthening, and bone-strengthening. We’ll also include the CDC’s list of recommended activities for those levels of intensity and types of exercise.

Aerobic Exercise

Aerobic exercises and activities are those during which an individual uses their large muscle groups for a period of twenty minutes or more. Running, hopping, skipping, jumping rope, swimming, dancing, and bicycling are aerobic activities. Aerobic exercise improves cardiovascular fitness.

Moderate- and Vigorous Intensity

As a general rule, an individual engaging in moderate aerobic activity can carry on a conversation – but it’s not easy to speak in long sentences. It’s possible, but not easy. An individual engaging in vigorous activity, on the other hand, may be able to speak or converse in short bursts, but it’s definitely not easy. During vigorous activity, it’s possible to speak in short sentences, but we’ll say it again: it’s not easy.

Rules of thumb:

1. If you can easily engage in long conversations and speak longer sentences, you’re taking it easy. You’re below the moderate level of activity.
2. When you can carry on a conversation, but it’s a little challenging, you’re in the moderate zone.
3. When you can form a sentence, but just barely, you’re in the vigorous zone. If you spend more than a minute or two in the vigorous zone, your speech will probably be more like grunting than talking.
4. If it’s not hard to form full sentences, then you’re below the vigorous zone.
5. Conversation while in the vigorous zone is more like grunting than actual conversation.

Moderate intensity aerobic activities appropriate for teens include:

• Fast or brisk walking
• Cycling at a fairly easy pace
• Recreational activities such as kayaking, hiking, and swimming
• Games that require catching and throwing, such as baseball and softball
• Housework and yardwork

Vigorous intensity aerobic activities appropriate for teens include:

• Running
• Cycling at a brisk pace
• Swimming at a fast pace
• Games that involve running and chasing
• Jumping rope
• Cross-country skiing
• Sports that involve running and jumping, such as soccer, basketball, and tennis
• Martial arts

Now let’s move on to the next type of CDC-recommended exercise: muscle-strengthening activities.

Muscle-Strengthening Activities

These include any activity that make muscles do more work than in typical daily life. For younger adolescents, muscle-strengthening activities can be part of play – think of things like climbing trees and playing tug-of-war. For individuals in mid- or late-adolescence, muscle strengthening activities include things like lifting weights, doing pushups or sit-ups, or working with resistance bands.

Muscle-strengthening activities for teens include:

• Games like tug of war or anything similar
• Body weight exercises such as pushups or triceps dips
• Resistance exercises using weight machines or handheld weights (free weights, kettlebells, etc.)
• Yoga

Next up: bone strengthening activities.

Bone-Strengthening Activities

These include any activity that creates force on the bones. Think light impact, commonly produced by the feet striking the ground. Light impact for the arms and upper body can include punching a bag or striking pad in a cardio-kickboxing class, for instance. Running, jumping rope, playing basketball, and tennis are all bone-strengthening activities.

Bone-strengthening activities for teens include:

• Running
• Martial arts
• Any sport that includes running and jumping

We know that was a lot of information – and if you’re the parent of a sedentary or semi-active kid, you might feel overwhelmed. Don’t worry: you don’t have to change your entire lifestyle overnight.

How to Meet the Guidelines

We understand that every family has its own relationship to exercise and activity. In some families, regular vigorous activity is the family norm, and in others it’s not at all. And it’s not binary. On the active side, some families are casually active, and participate in activities like hiking and camping. Other families are more intense: kids participate in organized sports and parents do everything from playing league tennis to running marathons to racing bicycles. On the more sedentary side, some families may do just enough to meet the guidelines. They take family walks, do some group exercise classes, and try to get their steps in every day. Others may be totally sedentary – and meeting the guidelines might seem like too big of an ask, at first.

Families in the active category are all set and can use the CDC guidelines as a reference for their activity and exercise-rich lifestyle. Families in the sedentary category should not be discouraged, and understand that they can change their lifestyle without changing who they are. It takes time and effort, but it’s worthwhile and possible: families and individuals do it every day. One note the CDC plays again and again in both the 2008 publication and the 2019 publication is that any activity is better than no activity, even if it’s far short of the amount of activity the guidelines recommend.

Three Steps to An Active Lifestyle

For adolescents who lead a sedentary lifestyle and do not meet the guidelines, the CDC advises parents to take a three-step approach:

1. Replace their sedentary behavior with active behavior whenever possible. Teens can walk or ride a bike to school instead of riding the bus or getting a ride with friends or parents.
2. Start low and go slow. This means beginning with low intensity activities and gradually increasing their intensity and duration over time. The health benefits will accrue as the time and intensity of the exercise and activity increases.
3. Keep activities fun and interesting. Find out what interests the teenager and use that as a jumping-off point. Variety is important. It’s also important to find something simple and stick with it. That simple thing varies by the family and the individual, but there’s something out there for everyone.

The last thing the CDC includes in the new report is a set of key guidelines for safe physical activity. To ensure their personal safety and avoid injury, people beginning a new exercise regimen should:

• Match the activity to their level of fitness and their health and wellness goals
• Take a common-sense approach: intensity should increase gradually, over time, and be directed toward specific, achievable fitness goals.
• Protect themselves by using reliable and appropriate athletic or exercise equipment, exercise in safe environments, follow all rules and regulations related to their activity, and make reasonable choices about when and where they engage in activity and exercise
• Know that all physical activity carries some level of risk, but also know that almost everyone can find a way to have fun and exercise safely.

Special Note For Teens With Chronic Health Conditions

Teens with chronic health conditions should consult a physician before beginning a new exercise or activity regimen. Parents and teens can meet with a professional trainer or physical therapist and create a list of activities that are safe, fun, and appropriate for their state of health.

For Parents of Adolescents in Treatment and Recovery

Exercise and activity are important elements of a healthy lifestyle. They’re also core components of almost all treatment and recovery programs for adolescents with mental health and/or alcohol or substance use disorders. When we talk about meeting predetermined guidelines for exercise and activity, it’s helpful to keep perspective: we don’t want to get carried away and imagine we’re all about to change our lives and train like professional athletes. That’s not our message here, nor is it the message the CDC advertises. Their goal is to keep the population healthy and combat the obesity epidemic. Our goal is to help teenagers who have mental health issues or substance use problems. All our exercise and activity advocacy is subordinate to that fundamental objective.

We use exercise in treatment and promote an active lifestyle because it helps our teens be the best people they can be – and we know it’s exactly what some of them need.

If you’re the parent of a teenager in recovery, you know recovery comes first. We’ll restate that: recovery comes first. Any exercise routine needs to support and synchronize seamlessly with the treatment and/or aftercare plan your family creates with your adolescent’s treatment team. The CDC guidelines are a valuable tool to help set goals and give everyone – including teens in treatment – a clear idea of how much activity they need to do to stay healthy and reap the benefits of exercise.

Their simple and reasonable message is this: if you’re active already, that’s great – stay at it. If you know you need to be more active, start where you are and build up gradually. Be consistent, stick with it, and you’ll reach your goals in due time.

We couldn’t agree more.