Exercise in Adults

The UK and WHO guidance agree on the core message and differ mainly in emphasis. Both recommend that adults accumulate at least 150 minutes of moderate intensity activity a week, such as brisk walking or cycling, or at least 75 minutes of vigorous activity such as running, or a combination, along with muscle strengthening on at least 2 days a week. The key difference is that the UK sets 150 minutes as a floor and says simply that more is better, whereas WHO frames it as a range of 150 to 300 minutes of moderate activity, or 75 to 150 minutes of vigorous activity, with further benefit above that. Both now accept that activity can be accumulated in bouts of any length, so the old rule that a bout had to last at least 10 minutes has gone, and both stress that some activity is always better than none.

Muscle strengthening is often the forgotten half of the guidance, yet it carries its own benefits for health and function and should be treated as being as important as the aerobic target. Working all the major muscle groups on at least 2 days a week, using body weight, free weights, resistance bands or machines, or everyday tasks such as carrying shopping or climbing stairs when these sufficiently challenge the major muscle groups, helps maintain muscle mass and bone density, which begin to decline from around the age of 50. The 2026 guidance particularly emphasises strengthening for people taking or recently taking glucagon-like peptide-1 (GLP-1) agonist weight management drugs, where both fat and muscle are lost. The evidence here is still emerging, and resistance activity together with adequate protein and appropriate nutritional support helps to preserve lean muscle mass.

Separately, prolonged sitting is an independent risk to health, associated with higher all-cause and cardiovascular mortality even in people who meet the activity target. There is no agreed cut-off, but adults should minimise sedentary time and break up long periods of sitting with at least light activity.

The benefits of activity build steeply from doing nothing to doing something, and then more gradually beyond about 150 minutes a week, which is why the greatest gains are seen in the least active people taking their first steps.

The protective effect is substantial and dose related. Regular activity lowers the risk of cardiovascular disease, and for high blood pressure the evidence suggests that 150 minutes a week reduces the risk of hypertension by around 6 per cent, with further reductions for each additional 150 minutes. It reduces the risk of type 2 diabetes and of several cancers, improves mental health, and supports weight maintenance after weight loss. Diet remains the main driver of weight itself, but people who are overweight gain cardiovascular and metabolic benefit from being active whatever happens to their weight.

The most effective activity is the kind that fits a person's life and that they will keep doing, so walking, wheeling, cycling for transport, dancing, sport and active hobbies all count, and building activity into daily routines such as taking the stairs or walking to the shops makes it sustainable. For inactive adults the message some is good, more is better matters more than hitting a target that can feel out of reach, and a short specific goal such as a 10 minute walk is a good place to start.

Activity is safe for the great majority of adults, including most people with long term conditions, and the benefits far outweigh the risks. The safest way to progress from inactivity is to start at a low intensity and duration and build up gradually as the body adapts. Musculoskeletal injury is more likely with high impact activity and in those unaccustomed to exercise, and serious cardiac events are rare. Routine pre-exercise medical screening is not needed for most people starting moderate activity, but a person with significant cardiac symptoms such as chest pain or blackouts, or a specific concern, should be assessed first.

• •At least 150 minutes moderate or 75 minutes vigorous activity a week, plus strengthening on at least 2 days.
• •UK gives 150 minutes as a floor; WHO gives a 150 to 300 minute range, both saying more is better.
• •Any bout length counts; the 10 minute minimum bout has been dropped.
• •Strengthening preserves muscle and bone and matters especially for people on GLP-1 weight management drugs.
• •Prolonged sitting is an independent risk even in active people; break it up with light activity.
• •Most adults need no pre-exercise screening; build up gradually and assess those with cardiac symptoms first.