Physical Activity and Your Heart

Physical activity is any body movement that works your muscles and uses more energy than you use when you're resting. Walking, running, dancing, swimming, yoga, and gardening are examples of physical activity.

What Is Physical Activity?

According to the Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans," physical activity generally refers to bodily movement that enhances health.

Exercise is a type of physical activity that's planned and structured. Lifting weights, taking an aerobics class, and playing on a sports team are examples of exercise.

Physical activity is good for many parts of your body. This article focuses on the benefits of physical activity for your heart and lungs. The article also provides tips for getting started and staying active, and it discusses physical activity as part of a heart healthy lifestyle.

According to the new Physical Activity Guidelines for Americans, adults gain substantial health benefits from from two and a half hours a week of moderate aerobic physical activity, and children benefit from an hour or more of physical activity.


Outlook Being physically active, along with following a healthy diet and not smoking, is one of the most important things you can do to keep your heart and lungs healthy. Many Americans are not active enough. The good news, though, is that even modest amounts of physical activity are good for your health. The more active you are, the more you will benefit.

Types of Physical Activity

The four main types of physical activity are aerobic, muscle-strengthening, bone-strengthening, and stretching. Aerobic activity is the type that 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, bicycling, 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, depending on whether they make your heart and lungs work harder than usual. For example, running is both 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 activities are better for your heart than light-intensity activities. However, even light-intensity activities are better than no activity at all.

The level of intensity depends on how hard you have to work to do the activity. To do the same activity, people who are less fit usually have to work harder than people who are more fit. So, for example, 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 activities that don’t require much effort.

Moderate-intensity activities make your heart, lungs, and muscles work harder than light-intensity activities do.

On a scale of 0 to 10, moderate-intensity activity is a 5 or 6 and produces 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:

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

Benefits of Physical Activity

Physical activity, especially aerobic activity, is good for your heart and lungs in many ways. The benefits of physical activity apply to people of all ages and races and both sexes.

Physical Activity Strengthens Your Heart and Improves Lung Function

Moderate- and vigorous-intensity physical activity done regularly strengthens your heart muscle. This improves your heart muscle'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, such as carbon dioxide and lactic acid.

Physical Activity Reduces Coronary Heart Disease Risk Factors

Moderate- and vigorous-intensity aerobic activity done regularly can lower your risk for coronary heart disease (CHD), also called coronary artery disease. CHD is a condition in which a fatty material called plaque (plak) builds up inside your coronary arteries. These arteries supply oxygen-rich blood to your heart.

Plaque narrows the coronary arteries and reduces blood flow to the heart. It also makes it more likely that blood clots will form in your arteries. Blood clots can partly or completely block blood flow. This can lead to 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.
• Helps improve and manage levels of cholesterol and other fats in the blood. Physical activity can lower triglyceride levels. Triglycerides are a type of fat. Physical activity also can raise high-density lipoprotein (HDL), or "good," cholesterol levels.
• Improves your body's ability to manage blood sugar and insulin levels. This 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 raise your risk for CHD.
• Helps reduce overweight and obesity when combined with reduced calorie intake. Physical activity also helps you maintain a healthy weight over time.
• May help people 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 like high blood cholesterol, high blood pressure, and smoking, inactivity is a major risk factor for CHD.

Physical Activity Reduces the Risk of Heart Attack In 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 a heart attack.

Vigorous aerobic activity may not be safe for people who have CHD. Talk to your doctor about what type of activity is 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, such as arrhythmia (ah-RITH-me-ah), sudden cardiac arrest, or heart attack, occur during physical activity. These events generally happen to people who already have heart conditions.

In youth and young adults, the risk for heart problems due to physical activity is higher in people who have underlying congenital (kon-JEN-i-tal) heart problems. These are heart problems that have been present since birth.

Congenital heart problems include hypertrophic cardiomyopathy (KAR-de-o-mi-OP-a-the), congenital heart defects, and myocarditis (MI-o-KAR-di-tis; inflammation of the heart muscle). People who have these conditions should talk to their doctors about which physical activities are safe for them.

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

The risk for 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 doesn't do physical activity regularly is at higher risk for heart attack during vigorous activity than a person who is physically fit and regularly active.

If you have a heart problem or chronic (ongoing) disease, such as heart disease, diabetes, or high blood pressure, talk to your doctor about what types of physical activity are safe for you. You also should talk to 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, see "Getting Started and Staying Active.")

Recommendations for Physical Activity

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

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

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

The information below is based on the new guidelines from DHHS.

Guidelines for Children and Youth

For children and youth, the guidelines advise that:

• They do 60 minutes or more of physical activity every day. These 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 climbing trees, 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

For adults, the guidelines advise that:

• Some physical activity is better than none. Inactive adults should gradually increase their level of activity. People gain some 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.
• When doing aerobic activity, do it for at least 10 minutes at a time. Spread the activity throughout the week.
• For 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). More physical activity will increase your health benefits.
• Muscle-strengthening activities that are moderate or high 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, doing situps and pushups, doing yoga, and doing heavy gardening.

Guidelines for Older Adults

For older adults, the guidelines advise that:

• All older adults should avoid inactivity. 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.
• You should follow the guidelines for adults, if possible. Older adults should 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, talk to your doctor about whether you can do physical activity. Ask your doctor which activities are safe for you.

Guidelines for Women During Pregnancy and Soon After Delivery

For pregnant women and women who have recently given birth, the guidelines advise that:

• You should talk to your doctor about safe physical activities to do during pregnancy and after delivery.
• If you're healthy but not already very 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 very active, you can continue being active as long as you stay healthy and talk to 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 guidelines also have recommendations for other groups, including people who have disabilities and people who have certain chronic conditions, such as osteoarthritis, diabetes, and cancer.

For more information, see the DHHS "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 to your doctor if you have a chronic (ongoing) health condition.

For more information on starting and staying active, see 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 become a marathon runner to get all of the benefits of 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 low and build slow. Many people like to start with walking and slowly increase their time and distance. You also can take other steps 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. Identify which physical activity benefits you value. This will help you personalize the benefits of physical activity.

Be Active With Friends and Family

Friends and family can help you stay active. For example, go for a hike 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 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 a pedometer (a small device that counts your 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 too.

• Be active on a regular basis to raise your fitness level.
• Do activities that fit your health goals and fitness level. Start low and slowly increase your activity level over time. As your fitness improves, you will be able to do physical activities for longer periods and with more intensity.
• Spread out your activity over the week and vary the types of activity you do.
• Use the right gear and equipment to protect yourself. For example, use bicycle 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 to Your Doctor if Needed

Healthy people who don't have heart problems don't need to check with a doctor before beginning moderate-intensity activities.

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

You also should talk to 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. In addition to physical activity, a healthy lifestyle involves staying at a healthy weight, following a healthy diet, and not smoking.

Stay at 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's important.

It's possible to balance energy IN and energy OUT with diet or physical activity alone. However, research shows that doing physical activity 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 and those who are trying to keep a lot of weight off once it has been lost need a large amount of physical activity unless they also reduce their calorie intake.

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

A healthy diet is an important part of a heart healthy lifestyle. Choose a variety of fruits, vegetables, and grains; half of your grains should come from whole-grain products.

Choose foods that are low in saturated fat, trans fat, and cholesterol. Healthy choices include lean meats, poultry without skin, fish, beans, and fat-free or low-fat milk and milk products.

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

Choose foods and beverages that are low in added sugar. If you drink alcoholic beverages, do so in moderation.

For more information about following a healthy diet, see the National Heart, Lung, and Blood Institute's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these 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 for 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.

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

Key Points

• Physical activity is any body movement that works your muscles and uses more energy than you use when you're resting. Walking, running, dancing, swimming, yoga, and gardening are examples of physical activity.
• Exercise is a type of physical activity that's planned and structured. Lifting weights, taking an aerobics class, and playing on a sports team are examples of exercise.
• Being physically active, along with following a healthy diet and not smoking, is one of the most important things you can do to keep your heart and lungs healthy.
• The four main types of physical activity are aerobic, muscle-strengthening, bone strengthening, and stretching. Aerobic activity is the type that benefits your heart and lungs the most.
• 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. Examples of aerobic activities include walking, running, swimming, and bicycling.
• Muscle-strengthening activities improve the strength, power, and endurance of your muscles. Doing pushups and situps and lifting weights 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. Walking and jumping rope are examples of bone-strengthening activities.
• Stretching helps improve your flexibility and your ability to fully move your joints. Touching your toes and doing yoga are examples of stretching.
• You can do physical activity with light, moderate, or vigorous intensity, depending on how hard you work. Light-intensity activities are common daily activities that don't require much effort. Moderate-intensity activities make your heart, lungs, and muscles work harder than light-intensity activities. Vigorous-intensity activities make your heart, lungs, and muscles work hard. On a scale of 1 to 10, moderate-intensity activity is a 5 or 6 and vigorous-intensity activity is a 7 or 8.
• Physical activity benefits all parts of your body. Even modest amounts of activity are good for your health. The more active you are, the more you will benefit.
• Aerobic activity strengthens your heart and improves lung function, reduces coronary heart disease (CHD) risk factors, and reduces the risk for heart attack.
• In general, the benefits of physical activity far outweigh the risks to the heart and lungs. Rarely, heart problems, such as arrhythmia, sudden cardiac arrest, or heart attack, occur during physical activity. These events generally happen to people who already have heart conditions.
• In youth and young adults, the risk for heart problems due to physical activity is higher in people who have underlying congenital heart problems. In middle-aged and older adults, the risk for heart problems due to physical activity is related to CHD.
• If you have a heart problem or chronic (ongoing) disease, such as heart disease, diabetes, or high blood pressure, talk to your doctor about what types of physical activity are safe for you. You also should talk to your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.
• The U.S. Department of Health and Human Services has released the "2008 Physical Activity Guidelines for Americans." The guidelines explain that regular physical activity improves health, and they encourage people to be as active as possible. The guidelines also contain specific recommendations for children, adults, older adults, and other groups.
• 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 to your doctor if you have a chronic health condition.
• In addition to physical activity, a heart healthy lifestyle involves staying at a healthy weight, following a healthy diet, and not smoking.

Links to Other Information About Physical Activity and Your Heart

NHLBI Resources

• "Aim for a Healthy Weight" Patient Booklet
• Coronary Heart Disease/Coronary Artery Disease (Diseases and Conditions Index)
• Portion Distortion Web Pages
• Overweight and Obesity (Diseases and Conditions Index)
• We Can! Web Pages
• "We Can! Families Finding 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)
• Physical Activity (Centers for Disease Control and Prevention)
• Weight Control Information Network (National Institute of Diabetes and Digestive and Kidney Diseases)

Clinical Trials

• Current Research (ClinicalTrials.gov)
• NHLBI Pediatric Clinical Trials