For more information, visit http://www.nhlbi.nih.gov/health/health-topics/topics/phys/

Types of Physical Activity

The four main types of physical activity are aerobic, muscle-strengthening, bone-strengthening, and stretching. Aerobic activity benefits your heart and lungs the most.

Aerobic Activity

Aerobic activity moves your large muscles, such as those in your arms and legs. Running, swimming, walking, biking, dancing, and doing jumping jacks are examples of aerobic activity. Aerobic activity also is called endurance activity.

Aerobic activity makes your heart beat faster than usual. You also breathe harder during this type of activity. Over time, regular aerobic activity makes your heart and lungs stronger and able to work better.

Other Types of Physical Activity

The other types of physical activity—muscle-strengthening, bone strengthening, and stretching—benefit your body in other ways.

Muscle-strengthening activities improve the strength, power, and endurance of your muscles. Doing pushups and situps, lifting weights, climbing stairs, and digging in the garden are examples of muscle-strengthening activities.

With bone-strengthening activities, your feet, legs, or arms support your body's weight, and your muscles push against your bones. This helps make your bones strong. Running, walking, jumping rope, and lifting weights are examples of bone-strengthening activities.

Muscle-strengthening and bone-strengthening activities also can be aerobic. Whether they are depends on whether they make your heart and lungs work harder than usual. For example, running is an aerobic activity and a bone-strengthening activity.

Stretching helps improve your flexibility and your ability to fully move your joints. Touching your toes, doing side stretches, and doing yoga exercises are examples of stretching.

Levels of Intensity in Aerobic Activity

You can do aerobic activity with light, moderate, or vigorous intensity. Moderate- and vigorous-intensity aerobic activity is better for your heart than light-intensity activity. However, even light-intensity activity is better than no activity at all.

The level of intensity depends on how hard you have to work to do the activity. People who are less fit usually have to work harder to do an activity than people who are more fit. Thus, what is light-intensity activity for one person may be moderate-intensity for another.

Light- and Moderate-Intensity Activities

Light-intensity activities are common daily tasks that don't require much effort. Moderate-intensity activities make your heart, lungs, and muscles work harder than usual.

On a scale of 0 to 10, moderate-intensity activity is a 5 or 6. It causes noticeable increases in breathing and heart rate. A person doing moderate-intensity activity can talk but not sing.

Vigorous-Intensity Activities

Vigorous-intensity activities make your heart, lungs, and muscles work hard. On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8. A person doing vigorous-intensity activity can't say more than a few words without stopping for a breath.

Examples of Aerobic Activities

Below are examples of aerobic activities. Depending on your level of fitness, they can be light, moderate, or vigorous in intensity:

• Gardening, such as digging or hoeing that causes your heart rate to go up
• Walking, hiking, jogging, and running
• Water aerobics or swimming laps
• Biking, skateboarding, rollerblading, and jumping rope
• Ballroom dancing and aerobic dancing
• Tennis, soccer, hockey, and basketball

Benefits of Physical Activity

Physical activity has many health benefits. These benefits apply to people of all ages and races and both sexes.

For example, physical activity helps you maintain a healthy weight and makes it easier to do daily tasks, such as climbing stairs and shopping.

Physically active adults are at lower risk for depression and declines in cognitive function as they get older. (Cognitive function includes thinking, learning, and judgment skills.) Physically active children and teens may have fewer symptoms of depression than their peers.

Physical activity also lowers your risk for many diseases, such as coronary heart disease (CHD), diabetes, and cancer.

Many studies have shown the clear benefits of physical activity for your heart and lungs.

Physical Activity Strengthens Your Heart and Improves Lung Function

When done regularly, moderate- and vigorous-intensity physical activity strengthens your heart muscle. This improves your heart's ability to pump blood to your lungs and throughout your body. As a result, more blood flows to your muscles, and oxygen levels in your blood rise.

Capillaries, your body's tiny blood vessels, also widen. This allows them to deliver more oxygen to your body and carry away waste products.

Physical Activity Reduces Coronary Heart Disease Risk Factors

When done regularly, moderate- and vigorous-intensity aerobic activity can lower your risk for CHD. CHD is a condition in which a waxy substance called plaque (plak) builds up inside your coronary arteries. These arteries supply your heart muscle with oxygen-rich blood.

Plaque narrows the arteries and reduces blood flow to your heart muscle. Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque.

If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. Blocked blood flow to the heart muscle causes a heart attack.

Certain traits, conditions, or habits may raise your risk for CHD. Physical activity can help control some of these risk factors because it:

• Can lower blood pressure and triglyceride (tri-GLIS-er-ide) levels. Triglycerides are a type of fat in the blood.
• Can raise HDL cholesterol levels. HDL sometimes is called “good” cholesterol.
• Helps your body manage blood sugar and insulin levels, which lowers your risk for type 2 diabetes.
• Reduces levels of C-reactive protein (CRP) in your body. This protein is a sign of inflammation. High levels of CRP may suggest an increased risk for CHD.
• Helps reduce overweight and obesity when combined with a reduced-calorie diet. Physical activity also helps you maintain a healthy weight over time once you have lost weight.
• May help you quit smoking. Smoking is a major risk factor for CHD.

Inactive people are nearly twice as likely to develop CHD as people who are physically active. Studies suggest that inactivity is a major risk factor for CHD, just like high blood pressure, high blood cholesterol, and smoking.

Physical Activity Reduces Heart Attack Risk

For people who have CHD, aerobic activity done regularly helps the heart work better. It also may reduce the risk of a second heart attack in people who already have had heart attacks.

Vigorous aerobic activity may not be safe for people who have CHD. Ask your doctor what types of activity are safe for you.

Risks of Physical Activity

In general, the benefits of regular physical activity far outweigh risks to the heart and lungs.

Rarely, heart problems occur as a result of physical activity. Examples of these problems include arrhythmias (ah-RITH-me-ahs), sudden cardiac arrest, and heart attack. These events generally happen to people who already have heart conditions.

The risk of heart problems due to physical activity is higher for youth and young adults who have congenital (kon-JEN-ih-tal) heart problems. The term “congenital” means the heart problem has been present since birth.

Congenital heart problems include hypertrophic cardiomyopathy (KAR-de-o-mi-OP-ah-thee), congenital heart defects, and myocarditis (MI-o-KAR-di-tis). People who have these conditions should ask their doctors what types of physical activity are safe for them.

For middle-aged and older adults, the risk of heart problems due to physical activity is related to coronary heart disease (CHD). People who have CHD are more likely to have a heart attack when they're exercising vigorously than when they're not.

The risk of heart problems due to physical activity is related to your fitness level and the intensity of the activity you're doing. For example, someone who isn't physically fit is at higher risk for a heart attack during vigorous activity than a person who is physically fit.

If you have a heart problem or chronic (ongoing) disease—such as heart disease, diabetes, or high blood pressure—ask your doctor what types of physical activity are safe for you. You also should talk with your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.

Discuss ways that you can slowly and safely build physical activity into your daily routine. (For more information, go to "Getting Started and Staying Active.")

Recommendations for Physical Activity

The U.S. Department of Health and Human Services (HHS) has released physical activity guidelines for all Americans aged 6 and older.

The "2008 Physical Activity Guidelines for Americans" explain that regular physical activity improves health. They encourage people to be as active as possible.

The guidelines recommend the types and amounts of physical activity that children, adults, older adults, and other groups should do. The guidelines also provide tips for how to fit physical activity into your daily life.

The information below is based on the HHS guidelines.

Guidelines for Children and Youth

The guidelines advise that:

• Children and youth do 60 minutes or more of physical activity every day. Activities should vary and be a good fit for their age and physical development. Children are naturally active, especially when they're involved in unstructured play (like recess). Any type of activity counts toward the advised 60 minutes or more.
• Most physical activity should be moderate-intensity aerobic activity. Examples include walking, running, skipping, playing on the playground, playing basketball, and biking.
• Vigorous-intensity aerobic activity should be included at least 3 days a week. Examples include running, doing jumping jacks, and fast swimming.
• Muscle-strengthening activities should be included at least 3 days a week. Examples include playing on playground equipment, playing tug-of-war, and doing pushups and pullups.
• Bone-strengthening activities should be included at least 3 days a week. Examples include hopping, skipping, doing jumping jacks, playing volleyball, and working with resistance bands.

Children and youth who have disabilities should work with their doctors to find out what types and amounts of physical activity are safe for them. When possible, these children should meet the recommendations in the guidelines.

Some experts also advise that children and youth reduce screen time because it limits time for physical activity. They recommend that children aged 2 and older should spend no more than 2 hours a day watching television or using a computer (except for school work).

Guidelines for Adults

The guidelines advise that:

• Some physical activity is better than none. Inactive adults should gradually increase their level of activity. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week.
• For major health benefits, do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity or 75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity each week. Another option is to do a combination of both. A general rule is that 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity.
• For even more health benefits, do 300 minutes (5 hours) of moderate-intensity aerobic activity or 150 minutes (2 hours and 30 minutes) of vigorous-intensity activity each week (or a combination of both). The more active you are, the more you will benefit.
• When doing aerobic activity, do it for at least 10 minutes at a time. Spread the activity throughout the week. Muscle-strengthening activities that are moderate or vigorous intensity should be included 2 or more days a week. These activities should work all of the major muscle groups (legs, hips, back, chest, abdomen, shoulders, and arms). Examples include lifting weights, working with resistance bands, and doing situps and pushups, yoga, and heavy gardening.

Guidelines for Adults Aged 65 or Older

The guidelines advise that:

• Older adults should be physically active. Older adults who do any amount of physical activity gain some health benefits. If inactive, older adults should gradually increase their activity levels and avoid vigorous activity at first.
• Older adults should follow the guidelines for adults, if possible. Do a variety of activities, including walking. Walking has been shown to provide health benefits and a low risk of injury.
• If you can't do 150 minutes (2 hours and 30 minutes) of activity each week, be as physically active as your abilities and condition allow.
• You should do balance exercises if you're at risk for falls. Examples include walking backward or sideways, standing on one leg, and standing from a sitting position several times in a row.
• If you have a chronic (ongoing) condition—such as heart disease, lung disease, or diabetes—ask your doctor what types and amounts of activity are safe for you.

Guidelines for Women During Pregnancy and Soon After Delivery

The guidelines advise that:

• You should ask your doctor what physical activities are safe to do during pregnancy and after delivery.
• If you're healthy but not already active, do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week. If possible, spread this activity across the week.
• If you're already active, you can continue being active as long as you stay healthy and talk with your doctor about your activity level throughout your pregnancy.
• After the first 3 months of pregnancy, you shouldn't do exercises that involve lying on your back.
• You shouldn't do activities in which you might fall or hurt yourself, such as horseback riding, downhill skiing, soccer, and basketball.

Guidelines for Other Groups

The HHS guidelines also have recommendations for other groups, including people who have disabilities and people who have chronic conditions, such as osteoarthritis, diabetes, and cancer.

For more information, go to the HHS "2008 Physical Activity Guidelines for Americans."

Getting Started and Staying Active

Physical activity is an important part of a heart healthy lifestyle. To get started and stay active, make physical activity part of your daily routine, keep track of your progress, be active and safe, and talk with your doctor if you have a chronic (ongoing) health condition.

For more information about getting starting and staying active, go to the Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans." The National Heart, Lung, and Blood Institute's "Your Guide to Physical Activity and Your Heart" also has helpful information.

Make Physical Activity Part of Your Daily Routine

You don't have to be a marathon runner to benefit from physical activity. Do activities that you enjoy, and make them part of your daily routine.

If you haven't been active for a while, start slowly and build up your level of activity. Many people like to start with walking and slowly increase their time and distance. You also can take other steps, such as those described below, to make physical activity part of your routine.

Personalize the Benefits

People value different things. Some people may highly value the health benefits from physical activity. Others want to be active because they enjoy recreational activities or they want to look better or sleep better.

Some people want to be active because it helps them lose weight or it gives them a chance to spend time with friends. Figure out which benefits of physical activity you value, and focus on those.

Be Active With Friends and Family

Friends and family can help you stay active. For example, go hiking with a friend, take dancing lessons with your spouse, or play ball with your child. The possibilities are endless.

Make Everyday Activities More Active

You can make your daily routine more active. For example, take the stairs instead of the elevator. Instead of sending e-mails, walk down the hall to a coworker's office. Rake the leaves in your yard instead of using a leaf blower.

Reward Yourself With Time for Physical Activity

Sometimes going for a bike ride or a long walk relieves stress after a long day. Think of physical activity as a special time to refresh your body and mind.

Keep Track of Your Progress

Consider keeping a log of your activity. A log can help you track your progress. Many people like to wear pedometers (small devices that counts steps) to track how much they walk every day. These tools can help you set goals and stay motivated.

Be Active and Safe

Physical activity is safe for almost everyone. You can take steps to make sure it's safe for you. For example:

• Be active on a regular basis to raise your fitness level.
• Do activities that fit your health goals and fitness level. Start slowly and build up your activity level over time. As your fitness improves, you will be able to increase the length and intensity of your activity.
• Spread out your activity over the week and vary the types of activity you do.
• Use the proper gear and equipment to protect yourself. For example, use bike helmets, elbow and knee pads, and goggles.
• Be active in safe environments. Pick well-lit and well-maintained places that are clearly separated from car traffic.
• Follow safety rules and policies, such as always wearing a helmet when biking.
• Make sensible choices about when, where, and how to be active. Consider weather conditions (such as how hot or cold it is), and change your plans as needed.

Talk With Your Doctor if Needed

Healthy people who don't have heart problems may not need to check with their doctors before starting moderate-intensity physical activities.

If you have a heart problem or chronic disease—such as heart disease, diabetes, or high blood pressure—ask your doctor what types of physical activity are safe for you.

You also should ask your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.

Physical Activity as Part of a Heart Healthy Lifestyle

Physical activity is one part of a heart healthy lifestyle. A healthy lifestyle also involves maintaining a healthy weight, following a healthy diet, and not smoking.

Maintain a Healthy Weight

Being overweight or obese increases your risk for heart disease, even if you have no other risk factors. Overweight or obesity also raises your risk for other diseases that play a role in heart disease, such as diabetes and high blood pressure.

Your weight is the result of a balance between energy IN and energy OUT. Energy IN is the energy, or calories, you take in from food. Energy OUT is the energy you use for things like breathing, digestion, and physical activity.

If you have:

• The same amount of energy IN and energy OUT over time, your weight stays the same
• More energy IN than energy OUT over time, you will gain weight
• More energy OUT than energy IN over time, you will lose weight

To maintain a healthy weight, your energy IN and energy OUT should balance each other. They don't have to be the same every day; it's the balance over time that matters.

Balancing energy IN and energy OUT with diet or physical activity alone is possible. However, research shows that being physically active AND following a healthy diet is a better way to reach and stay at a healthy weight.

People who want to lose more than 5 percent of their body weight need to do a lot of physical activity unless they also reduce their calorie intake. The same is true for people who are trying to keep off a lot of weight that they have lost.

Many people need to do more than 300 minutes (5 hours) of moderate-intensity activity a week to meet their weight-control goals.

Follow a Healthy Diet

Following a healthy diet can help you maintain good health. A healthy diet includes a variety of vegetables and fruits. These foods can be fresh, canned, frozen, or dried. A good rule is to try to fill half of your plate with vegetables and fruits.

A healthy diet also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, poultry without skin, seafood, processed soy products, nuts, seeds, beans, and peas.

Choose and prepare foods with little sodium (salt). Too much salt can raise your risk for high blood pressure. Studies show that following the Dietary Approaches to Stop Hypertension (DASH) eating plan can lower blood pressure.

Try to avoid foods and drinks that are high in added sugars. For example, drink water instead of sugary drinks, like soda.

Also, try to limit the amount of solid fats and refined grains that you eat. Solid fats are saturated fat and trans fatty acids. Refined grains come from processing whole grains, which results in a loss of nutrients (such as dietary fiber).

If you drink alcohol, do so in moderation. Too much alcohol can raise your blood pressure and triglyceride level. (Triglycerides are a type of fat found in the blood.) Alcohol also adds extra calories, which can cause weight gain.

For more information about following a healthy diet, go to the National Heart, Lung, and Blood Institute's (NHLBI's) “Your Guide to Lowering Your Blood Pressure With DASH” and the U.S. Department of Agriculture's ChooseMyPlate.gov Web site. Both resources provide general information about healthy eating.

Don't Smoke

People who smoke are up to six times more likely to have a heart attack than people who don't smoke. The risk of having a heart attack increases with the number of cigarettes smoked each day.

Smoking also raises your risk for stroke and lung diseases, such as COPD (chronic obstructive pulmonary disease) and lung cancer.

Quitting smoking can greatly reduce your risk for heart and lung diseases. Ask your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI's "Your Guide to a Healthy Heart."

Clinical Trials

The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.

NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has shown how lifestyle factors, such as physical activity, can improve health and lower the risk of disease.

The NHLBI continues to support research aimed at learning more about the benefits of physical activity and ways to encourage people to stay active. For example, the NHLBI currently supports research that:

• Evaluates a program aimed at increasing physical activity among Mexican American women, for whom obesity is a growing health concern
• Explores whether improving public park programs and facilities will increase physical activity in certain communities
• Examines whether church-based programs that emphasize physical activity and healthy eating can improve health habits in African American congregations
• Explores whether a self-managed physical activity program is beneficial and cost-effective for people who have COPD (chronic obstructive pulmonary disease)
• Evaluates whether the neighborhoods that teenagers live in affect their quality of life, physical activity levels, and eating habits

Much of this research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions.

For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.

By taking part in a clinical trial, you can gain access to new treatments before they're widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don't directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.

If you volunteer for a clinical trial, the research will be explained to you in detail. You'll learn about treatments and tests you may receive, and the benefits and risks they may pose. You'll also be given a chance to ask questions about the research. This process is called informed consent.

If you agree to take part in the trial, you'll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.

For more information about clinical trials related to healthy lifestyles and disease prevention, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:

• http://clinicalresearch.nih.gov
• www.clinicaltrials.gov
• www.nhlbi.nih.gov/studies/index.htm
• www.researchmatch.org

For more information about clinical trials for children, visit the NHLBI's Children and Clinical Studies Web page.

Links to Other Information About Physical Activity and Your Heart

NHLBI Resources

• Aim for a Healthy Weight
• "Aim for a Healthy Weight" Patient Booklet
• “At-A-Glance: Physical Activity and Your Heart”
• Cardiovascular Information for the Public 
• Coronary Heart Disease (Health Topics)
• Portion Distortion Web Pages
• Overweight and Obesity (Health Topics)
• We Can!^® (Ways to Enhance Children's Activity & Nutrition)
• "We Can! Families Finding the Balance: A Parent Handbook"
• "Your Guide to a Healthy Heart"
• "Your Guide to Physical Activity and Your Heart"

Non-NHLBI Resources

• "2008 Physical Activity Guidelines for Americans" (U.S. Department of Health and Human Services (HHS))
• Physical Activity (Centers for Disease Control and Prevention)
• Weight Control Information Network (National Institute of Diabetes and Digestive and Kidney Diseases)

Clinical Trials

• Children and Clinical Studies
• Clinical Trials (Health Topics)
• Current Research (ClinicalTrials.gov)
• NHLBI Clinical Trials
• NIH Clinical Research Trials and You (National Institutes of Health)
• ResearchMatch (funded by the National Institutes of Health)

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^® We Can! Ways to Enhance Children's Activity & Nutrition, We Can!, and the We Can! logos are registered trademarks of HHS.