Physical activity and health: how much exercise do you need?

Why movement matters so much

Physical activity benefits almost every system in the body. It lowers blood pressure, improves cholesterol and insulin sensitivity, helps maintain a healthy weight, strengthens muscles and bones, and improves sleep and mood. The World Health Organization (WHO) identifies physical inactivity as a leading risk factor for death from non-communicable diseases, and a large share of adults worldwide do not move enough.

Regular activity lowers the risk of:

• cardiovascular disease, including heart attacks, and stroke;
• high blood pressure and type 2 diabetes;
• certain cancers, such as bowel cancer and breast cancer – see cancer prevention;
• depression and anxiety;
• osteoporosis, falls and fractures in later life;
• dementia and cognitive decline.

How much activity does the WHO recommend?

People with long-term conditions and disabilities benefit too – the amount and type of activity are adapted to their abilities, ideally with medical advice.

How to judge intensity

• Moderate activity – you breathe faster and your heart rate rises, but you can still talk, though not sing. Examples: brisk walking, cycling at a steady pace, swimming, gardening, dancing.
• Vigorous activity – you breathe hard and can only say a few words without pausing. Examples: running, fast cycling, aerobics, football, basketball, hill walking.

As a rough guide, one minute of vigorous activity counts for about two minutes of moderate activity.

Types of activity – and why you need them all

• Aerobic (endurance) activity – walking, running, cycling, swimming. It trains the heart and lungs and is the foundation of cardiovascular health.
• Muscle-strengthening exercise – body-weight exercises (squats, lunges, press-ups), resistance bands, weights or gym machines. These preserve muscle mass, which declines with age, and support metabolism and joint stability.
• Balance and flexibility – yoga, Pilates, tai chi and stretching. Particularly important after 65 to help prevent falls.

Everyday movement counts too: taking the stairs, walking to work or the shops, housework and gardening all add up.

Sitting: a separate risk factor

Long hours of sitting – at a desk, in the car or in front of a screen – are linked to a higher risk of heart disease, diabetes and early death, even in people who exercise. The WHO advises limiting sedentary time and replacing it with any activity, even light activity.

Practical ideas:

• get up and move for a few minutes every 30–60 minutes;
• stand or walk while on the phone;
• take the stairs rather than the lift;
• get off the bus or tram one stop early;
• take a short walk after meals – it also helps blood sugar.

How to start safely

1. Start where you are. If you have been inactive for a long time, ten minutes of walking a day is a good beginning. Add a few minutes each week.
2. Choose something you enjoy. The best activity is the one you will keep doing.
3. Plan it. Put specific days and times in your diary like any other appointment.
4. Warm up and cool down. Five to ten minutes of gentle movement at the start and end.
5. Listen to your body. Mild muscle tiredness is normal; chest pain, severe breathlessness or dizziness are not.
6. Wear suitable shoes and clothing, and drink water in warm weather.
7. Move with others. Walking with a friend, a group or a club helps motivation.

A step counter or phone app can help you track progress. The popular 10,000-step target is not essential – research shows benefits at lower step counts too, especially in older adults.

Exercising with a long-term condition

Physical activity is part of the treatment for many long-term conditions, but it needs to be adapted:

• After a heart attack, stent or bypass surgery – supervised cardiac rehabilitation is strongly recommended and lowers the risk of further events.
• With rhythm disorders or valve disease – your cardiologist will advise on type and intensity; with some conditions very strenuous exertion should be avoided.
• With high blood pressure – regular aerobic activity lowers it; very heavy lifting while holding your breath may not suit uncontrolled blood pressure.
• With diabetes – activity improves blood sugar control; watch for hypos if you take insulin or certain tablets.
• With obesity – start with joint-friendly options such as walking, swimming or cycling.
• With joint or back pain – the right exercises often reduce pain; see orthopaedics and traumatology.
• During and after cancer treatment – moderate activity reduces fatigue and improves quality of life, as advised by your oncology team.

When to check with a doctor

Most people can start light to moderate activity such as walking without a medical check. Speak to your GP or a cardiologist before starting vigorous exercise if:

• you have heart disease, high blood pressure, diabetes or kidney disease;
• you get chest pain, breathlessness, palpitations or dizziness on exertion;
• you have ever fainted during exercise;
• there is a family history of sudden death at a young age or inherited heart disease;
• you are over 40–50, have been inactive for a long time and want to take up intense sport.

Stop immediately and call 112 if during exercise you develop severe chest pain, marked breathlessness, collapse or sudden weakness on one side of the body.

A health check-up with blood pressure, an ECG and basic blood tests is a sensible starting point, particularly if you plan big changes. Combine activity with heart-healthy eating for the best results.