Stage one

The first stage of the recommendation encourages realistic and achievable exercise prescription for the majority of the population. An active lifestyle does not require a structured exercise programme, but it encourages an increase in daily activity where activity is accumulated over a day (Pate, et al., 1995). This proved a change in philosophy; previously the health message invoked a strenuous, more formal type of training. The message behind the first stage encourages moderate intensity exercise, accumulating 30 minutes or more per day on most, preferably all, days of the week (Pate, et al., 1995). The activity can be accumulated in multiple small bouts of activity, for example three ten-minute bouts of walking.

Stage one targets adults who are currently inactive or who are not regularly active, and aims to encourage an accumulation of moderate intensity activity on most days of the week. This stage encourages active living, using the stairs instead of the escalator, walking the children to school instead of driving, etc. Despite the intensity being too low to gain significant improvements in aerobic fitness Franklin (1993),ACSM (2001) and Blair and Church (2004) have shown that activity at this lower intensity will offer substantial benefits across a broad range of health outcomes. These benefits include:

• improved bone density;

• improved glucose tolerance;

• reduced total cholesterol and triglycerides;

• reduced risk of developing high blood pressure;

• psychosocial well being.

In addition, when subjects become more active by accumulated activity they may start to consider participation in more structured activity, as in stage two. All CR patient groups and sedentary individuals should be encouraged to be more active as well as take part in structured activity.

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