Recommendations

  1. Children aged 0–5 years 1
    • Should not be sedentary, restrained, or kept inactive, for more than 1 hour at a time, with the exception of sleeping
    • Infants aged 0–1 year should be encouraged to do > 30 mins. floor-based play in a safe and supervised environment
    • Toddlers and preschoolers aged 1–5 years should be physically active > 3 hours/day
  2. Children aged 5–17 years 2
    • Accumulate > 60 mins. of moderate to vigorous physical activity every day
    • Include a variety of aerobic activities, including light physical activity
    • Engage in activities that strengthen muscle and bone > 3 days/week
    • Additional health benefits are achieved with more hours of activity per day
  3. Adults aged 18–64 years 3
    • Doing any physical activity is better than doing none
    • Each week accumulate:
      • 150–300 mins. (2.5–5 hours) of moderate physical activity or
      • 75–150 mins. of vigorous physical activity
    • Be active on most, preferably all days every week
    • Do muscle strengthening activities on at least 2 days each week
  4. During pregnancy 4
    • As per adults aged 18–64
    • Aim to do pelvic floor exercises every day, while pregnant, then for life
    • If planning to be very active during pregnancy seek medical advice
    • As pregnancy progresses modify physical activity to avoid:
      • high falls or collision risk
      • heavy lifting
      • pain or discomfort
    • A gradual return to recommended activity levels after 6-week postnatal health check
  5. Adults > 65 years 5
    • Accumulate > 30 mins. of moderate physical activity on most, preferably all days
    • Do any form of physical activity, regardless of age, weight, health problems or abilities
    • Be active daily in as many ways as possible, doing a range of physical
      activities that incorporate fitness, strength, balance and flexibility
    • Start any new physical activity at an easily manageable level and gradually increasing the amount, type and frequency
    • Those with a lifetime of vigorous physical activity, continue at a level suited to their capability

1. The facts 7–9

  • Australians are less likely to meet physical activity recommendations as they age:
    • from 61% of 2–5 year olds decreasing to 8% of 13–17 year olds
    • from 48% of 18–64 year olds decreasing to 25% of those aged > 65 years
  • < 35% of children under 17 years meet the sedentary screen-based activity recommendations, particularly adolescent boys
  • 30% of pregnant women meet guideline recommendations versus 47% of non-pregnant women in the same age group
  • High socioeconomic groups are more likely to meet guideline recommendations compared to low socioeconomic groups
  • Aboriginal and Torres Straight Islander:
    • children are more likely to meet guideline recommendations compared with non-Indigenous children
    • adults are less likely to meet guideline recommendations compared with non-Indigenous adults

2. Sedentary behaviour

  1. Children aged 0–5 years 1
    • Avoid restraining for > 1 hour at a time e.g. stroller, car seat or high chair
    • Screen time is not recommended. From 2–5 years limit to < 1 hour daily
    • Engage infants with physical play, reading, singing, puzzles and storytelling
  2. Children aged 5–17 years 2,3,10
    • Children in this age bracket:
      • spend more daily time engaged in screen-based activity (1½ hours) than being physically active (2 hours), increasing risk of backpain and headache
      • are more likely to avoid smoking, drugs and alcohol if they meet physical activity recommendations
      • with > 1 screen-based item in their bedrooms, spend 2 hours/week more sedentary than those without such items in their bedroom
    • Minimise sedentary behaviours by:
      • limiting screen-based activities to < 2 hours//day
      • breaking up long periods of sitting as often as possible
  3. Adults aged 18–64 years and pregnant women 3,9
    • Sedentary occupations and screen-based recreation are the greatest causes of inactivity in this group; 22 hours and 13 hours/week respectively
    • Minimise the time spent sitting. Move as frequently as possible
  4. Adults > 65 years 5
  • < 50% meet national recommendations
  • Mortality risk is > 74% in sedentary older people compared to active individuals

3. Benefits of activity

  • Provide Resource 1. to improve participation in physical activity
  • See Table 1. for definitions of physical activity
  1. Children and young people 1,2,11
    • Doing moderate to vigorous activity > 3 days/week:
      • for 40–70 mins. significantly improves cardiorespiratory fitness
      • improves skeletal health with high impact activities
      • for > 30 mins. improves muscle strength and flexibility
      • for > 60 mins. improves self-esteem, reduces anger and stress
    • Any regular physical activity lowers risk of Overweight and obesity (child), Depression, Anxiety disorders while improving cognitive ability, executive function and intelligence
  2. Adults 3
    • Doing moderate to vigorous activity for > 60 mins. > 3 days/week:
      • reduces the risk of Coronary heart disease, Heart failure, and Stroke and transient ischaemic attack by 20–30%
      • reduces the risk of Diabetes by improving glucose regulation and insulin resistance
      • reduces risk of Hypertension, Dyslipidaemia, and Overweight and obesity (adult)
      • can reduce the risk of colon cancer by 30% and breast cancer by 20%
    • Weight bearing and resistance and muscle strengthening activities help protect against Osteoarthritis bone mineral density, functional status, and falls and fracture risk
  3. During pregnancy 9
    • The physical activity benefits for adults apply to women during pregnancy, plus reduced risk for:
      • excessive weight gain
      • gestational diabetes
      • pre-eclampsia
      • pre-term birth
      • varicose veins
      • deep vein thrombosis
    • Healthy women with an uncomplicated pregnancy can exercise safely, but may not due to fears of harm to their unborn child
  4. Older people 5
  • Physical activity offers an effective, non-pharmacological intervention for improving and maintaining quality of life
  • The benefits of physical activity for < 65 years extend to those > 65 years primarily by preventing Coronary heart disease and Diabetes
  • Both strengthening and aerobic exercises can reduce pain and improve function and health status in those with Osteoarthritis

Table 1. Definitions of activity 2–4

Activity

Meaning

Physical

  • Any movement produced by skeletal muscles that expends energy

Sedentary

  • Activity that involves sitting or lying down, with little energy expenditure e.g. office or vehicle based work, screen-based and electronic media activities or reading

Light

  • Day to day home, workplace or community based activity e.g. standing up, moving around, cleaning or cooking

Moderate

  • An intensity that requires some effort but still allows a conversation to be had e.g. brisk walking, gentle swimming, lawn mowing or tennis

Vigorous

  • Makes you breathe hard or breathless e.g. aerobics, jogging, cycling or competitive sports

Muscle
strengthening

  • Improves strength, power, endurance and size of skeletal muscles by resistance exercises e.g. push-ups, chin-ups, weights or dumbbells

Weight bearing

  • Carrying shopping, lifting weights

Aerobic

  • Requires adequate oxygen supply
  • Involves large muscle groups moving at pace for > few mins.
  • Improves the transport and uptake of oxygen by the cardiorespiratory and metabolic systems, to provide energy for working muscles e.g. walking, swimming, cycling, dancing or competitive sports

Anaerobic

  • Does not require regular supply of oxygen to working muscles
  • Very short term activities before becoming aerobic e.g. sprinting or lifting heavy weights

4. Sleep hygiene 6,12–16

  • Many factors can affect sleep including:
    • medications
    • OSA
    • normal aging
    • neurocognitive disorders
    • pain
    • night-time toileting (nocturia)
    • stress, anxiety and depression
  • People > 45 years that sleep < 5 hours/night have a 30% higher risk of developing multiple chronic conditions. Risk increases to 40% for > 70 year olds
  • OSA related mortality is higher in Aboriginal and Torres Straight Islander populations
  • Risk of insomnia increases with comorbid conditions which in turn interrupts sleep
  • Insomnia contributes to higher rates of depression and overlapping symptoms. See Table 2.
  • Sleep disorders affect women more commonly than men

Table 2. Overlapping symptoms of insomnia and depression 14–16

Mood

Physical

  • Feelings of hopelessness or helplessness
  • Lack of motivation
  • Loss of self-worth
  • Worries about being a burden, a sense of worthlessness or self-loathing
  • Fixation on death or thoughts of suicide
  • Social isolation
  • Fatigue and memory difficulties
  • Daytime sleepiness and poor functioning
  • Impaired reasoning, and problem solving
  • Decreased concentration
  • Unexplained or aggravated aches and pains
  • Weight loss or loss of appetite
  • Neglecting personal care
  • Skipping meals, forgetting medications or disregarding personal hygiene
  1. Improving sleep 14–16
    • Key strategies include:
      • cease smoking and do regular physical exercise
      • get daily light exposure
      • do not nap throughout day
      • reserve the bed for sleep only, not wakeful activities e.g. screen time
      • avoid or cease sleep-interfering substances e.g. alcohol, marijuana, caffeine
      • have a light dinner and avoid middle-of-the-night eating
      • avoid screen time for a half hour before sleep
      • optimise environment e.g. limit light, noise, and extremes in temperature
      • do not go to bed until sleepy and keep a regular sleep schedule
      • leave bed if not tired and return when they are
      • get up each morning at the same time, irrespective of sleep quality
    • Assess a patient’s daytime sleepiness and OSA risk by using a validated tool. If they score highly refer to a sleep specialist. See Resource 2.
  2. Behavioural Therapy: A Proven First-Line Intervention 12–14
    • Cognitive behavioural therapy for insomnia (CBT-I) is standard first-line treatment for insomnia
    • Insomnia is hard to treat with medicines. Long-term use can cause further sleep issues, addiction and cognitive impairment
    • A free mobile phone app, CBT-i Coach, provides different tools to establish improved sleep habits, as well as to identify potential factors that may be causing insomnia. See Resource 3.

5. References

6. Resources

  1. A variety of Nationally developed physical activity resources
  2. The Epworth Sleepiness Scale and STOP-Bang questionnaire
  3. CBT-i Coach for Android or CBT-i Coach for Apple

Last updated: November 2024

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