世界衛生組織兒童、青少年及成人之建議身體活動量

實證研究顯示：

• 身體活動對心臟、身體和精神有顯著的健康益處。
• 身體活動有助於預防和管理心血管疾病、癌症和糖尿病等非傳染性疾病。
• 身體活動可減少憂鬱和焦慮的症狀。
• 身體活動可加強思維、學習和判斷能力。
• 身體活動可確保年輕人的健康生長和發育。
• 身體活動可改善整體健康。
• 在全球範圍內，四分之一的成年人沒有達到關於身體活動水準的全球建議。
• 與身體活動充分者相比，身體活動不足者的死亡風險會增加20%至30%。
• 世界上80%以上的青少年身體活動不足。

什麼是身體活動？

根據WHO的定義，身體活動是由骨骼肌肉產生的需要消耗能量的任何身體動作。身體活動是指所有運動，包括閒暇時間的活動，在不同地點之間往返，或作為一個人工作的一部分。中等強度和高強度的身體活動均可增進健康。

盛行的活動方式包括步行、騎自行車、飛輪活動、體育運動、積極的娛樂和遊戲，可以在任何技能級別開展，而且每個人都可以享受。

研究已證實定期的身體活動有助於預防和控制非傳染性疾病，如心臟病、中風、糖尿病和多種癌症。身體活動還有助於預防高血壓，保持健康的體重，並可以改善心理健康、生活品質和幸福感。

建議的身體活動量是多少？

WHO的指南和建議為不同年齡組和特定人口群體提供了關於需要多少身體活動以保持健康的詳細說明。WHO建議：

嬰兒（1歲以下）應：

• 每天以各種方式進行若干次身體活動，特別是通過互動式的地上遊戲，越多越好。對於那些尚不能移動的嬰兒，這包括採取俯卧姿勢，在一天中清醒時累計應達至少30分鐘。
• 每次被束縛的時間不應超過1小時（例如在嬰兒睡籃車/嬰兒座椅車、高腳椅中或綁在照護者背上）。
• 久坐時，鼓勵由照護者為嬰兒讀書和講故事。
• 一天有14-17小時（0-3個月大）或12-16小時（4-11個月大）高品質的睡眠，包括小睡。

1-2歲的兒童應：

• 在一天不同的時間，至少用180分鐘進行任何強度的各類身體活動，包括中等強度至高強度的身體活動，越多越好。
• 每次被束縛的時間不應超過1小時（例如在嬰兒睡籃車/嬰兒座椅車、高腳椅中或綁在照護者背上），也不應長時間坐著。
  • 對於1歲的幼兒，不建議在螢幕前久坐（例如看電視或錄像、玩電腦遊戲）。
  • 對於2歲的幼兒，在螢幕前久坐的時間不應超過1小時，越少越好。
• 久坐時，鼓勵由照護者為兒童讀書和講故事。
• 一天有11-14小時高品質的睡眠，包括小睡，而且睡眠和喚醒時間有規律。

3-4歲的兒童應：

• 在一天不同的時間，至少用180分鐘進行任何強度的各類身體活動，其中至少60分鐘是中等強度至高強度的身體活動，越多越好。
• 每次被束縛的時間不應超過1小時（例如在嬰兒睡籃車/嬰兒座椅車），也不應長時間坐著。
• 一天在螢幕前久坐的時間不應超過1小時，越少越好。
• 久坐時，鼓勵由照護者為兒童讀書和講故事。
• 一天有10-13小時高品質的睡眠，其中可能包括小睡，而且睡眠和喚醒時間有規律。

5-17歲兒童和青少年

• 一週中每天應當至少進行60分鐘中等強度到高強度身體活動，主要是有氧的身體活動每週至少3天應當有高強度的有氧運動，以及加強肌肉和骨骼的活動。應限制久坐不動的時間，尤其是觀看螢幕的娛樂時間。

18-64歲成人

• 每週應進行至少150-300分鐘的中等強度有氧身體活動。或至少75-150分鐘的高強度有氧身體活動；或中等強度和高強度活動綜合起來達到等量的身體活動。
• 還應做涉及所有主要肌肉群的中等或更強程度增強肌肉的活動，每週2天或以上，因為可以有額外的健康益處。
• 為獲得額外的健康效益，在一週中可將中等強度有氧身體活動增加至300分鐘以上；或做150分鐘以上的高強度有氧身體活動；或中等強度和高強度活動綜合起來達到等量的身體活動。
• 應限制久坐不動的時間。用任何強度（包括低強度）的身體活動取代久坐時間，對健康有益。
• 為了幫助減少高程度久坐行為對健康的有害影響，所有成年人和老年人應力求超過建議的中等強度至高強度身體活動水平。

身體活動和久坐行為的好處和風險

步行、騎自行車、飛輪活動、體育運動或積極的娛樂等定期的身體活動，明顯有益於健康。多少開展一些身體活動總比一點也不做要好。一天中只要以相對簡單的方式增加一些身體活動，就可輕易達到推薦的活動水準。

缺乏身體活動是非傳染性疾病死亡的主要危險因素之一。與身體活動充分者相比，身體活動不足者的死亡風險會增加20%至30%。

定期進行身體活動可以：

• 改善肌肉和心肺功能
• 改善骨骼和功能性健康
• 降低高血壓、冠心病、中風、糖尿病、包括乳腺癌和結腸癌在內的多種癌症以及憂鬱症的風險
• 降低跌倒以及髖部或脊椎骨折的風險
• 有助於保持健康的體重。

在兒童和青少年中，身體活動可以改善：

• 體能（心肺和肌肉健康）
• 心臟代謝健康（血壓、血脂異常、葡萄糖和胰島素抵抗）
• 骨骼健康
• 認知結果（學習成績、執行功能）
• 心理健康（減少憂鬱症狀）
• 減少肥胖症

在成人和老年人中，較高的身體活動水平可以改善：

• 全因死亡風險
• 心血管疾病死亡風險
• 突發性高血壓
• 部位特異性突發癌症（膀胱癌、乳腺癌、結腸癌、子宮內膜癌、食管腺癌、胃癌和腎癌）
• 突發2型糖尿病
• 防止跌倒
• 心理健康（減少焦慮和憂鬱症狀）
• 認知健康
• 睡眠
• 還可改善肥胖症程度

久坐行為的健康風險

通過使用機動交通工具和更多地使用螢幕進行工作、教育和娛樂，生活中久坐不動的時間變得越來越多。證據表明，久坐行為的增長會造成以下不良健康結果：

兒童和青少年：

• 肥胖症增多（體重增加）
• 較差的心臟代謝健康、健壯程度、行為能力/利他行為
• 縮短睡眠時間

成年人：

• 全因死亡率、心血管疾病死亡率和癌症死亡率
• 心血管疾病、癌症和2型糖尿病的發病率

全球身體活動水準

• 世界上超過四分之一的成年人（14億成年人）身體活動不夠。
• 全世界大約三分之一的女性和四分之一的男性沒有進行足夠的身體活動以保持健康。
• 與低收入國家相比，高收入國家缺乏身體活動的程度要高一倍。
• 自2001年以來，全球身體活動水平沒有改善。
• 2001年至2016年，高收入國家中活動不夠的水平增加了5%（從31.6%增至36.8%）。
• 缺乏身體活動的水平上升，對衛生系統、環境、經濟發展、社區福祉和生活質量產生了負面影響。

2016年，全球18歲及以上的成年人中，28%身體活動不夠（男性23%，女性32%）。這意味著他們不能達到每週至少150分鐘中等強度或75分鐘高強度身體活動的全球建議。

在高收入國家，26%的男性和35%的女性身體活動不夠，而低收入國家中男性和女性的比率分別為12%和24%。身體活動水平低下或下降，常常與國民生產總值較高或上升相對應。

身體活動減少的部分原因是在閒暇時間的不作為，以及工作時和在家裡的久坐行為。同樣，更多地使用「被動」的交通方式，也造成了身體活動不夠。

2016年，全球11-17歲的青少年中，有81%身體活動不夠。青春期少女比男孩的身體活動程度更低，分別有85%和78%的人不能達到WHO組織關於每天至少60分鐘中等強度至高強度身體活動的建議。

如何增加身體活動？

國家和社區必須採取行動，使每個人有更多的機會動起來，以便增加身體活動。這需要國家和地方的不同部門和學科共同做出努力，執行適合本國文化和社會環境的政策和解決辦法，以促進、支援和鼓勵身體活動。

增加身體活動的政策意在確保：

• 所有人都能安全地步行、騎自行車和使用其它形式的主動非機動化交通工具
• 勞動和工作場所的政策鼓勵上下班時採用促進身體活動的交通方式，並在一天的工作期間提供身體活動的機會
• 托兒所、學校和高等教育機構為所有學生提供支援性和安全的空間及設施，使他們能積極利用空閒時間
• 中小學提供高質量的體育課程，支援兒童接受有益健康的行為模式，使他們能夠終生積極進行身體活動
• 社區和學校的體育規劃為所有年齡和能力的人提供適當的機會
• 體育和娛樂設施為每個人提供機會，讓他們接觸和參與各種不同的體育活動、舞蹈、鍛煉運動和積極的娛樂活動
• 衛生保健提供者建議和支援病患定期進行身體活動。

節錄自：
Physical activity（WHO，2022）
https://www.who.int/news-room/fact-sheets/detail/physical-activity#:~:text=For%201%20year%20olds%2C%20sedentary,1%20hour%3B%20less%20is%20better.

Physical activity
Key facts

• Physical activity has significant health benefits for hearts, bodies and minds
• Physical activity contributes to preventing and managing noncommunicable diseases such as cardiovascular diseases, cancer and diabetes
• Physical activity reduces symptoms of depression and anxiety
• Physical activity enhances thinking, learning, and judgment skills
• Physical activity ensures healthy growth and development in young people
• Physical activity improves overall well-being
• Globally, 1 in 4 adults do not meet the global recommended levels of physical activity
• People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active
• More than 80% of the world's adolescent population is insufficiently physically active

What is physical activity?
WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work. Both moderate- and vigorous-intensity physical activity improve health.

Popular ways to be active include walking, cycling, wheeling, sports, active recreation and play, and can be done at any level of skill and for enjoyment by everybody.

Regular physical activity is proven to help prevent and manage noncommunicable diseases such as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain healthy body weight and can improve mental health, quality of life and well-being.

How much of physical activity is recommended?
WHO guidelines and recommendations provide details for different age groups and specific population groups on how much physical activity is needed for good health.

WHO recommends:
For children under 5 years of age

In a 24-hour day, infants (less than 1 year) should:

• be physically active several times a day in a variety of ways, particularly through interactive floor-based play; more is better. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake;
• not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver’s back);
• Screen time is not recommended.
• When sedentary, engaging in reading and storytelling with a caregiver is encouraged; and
• have 14-17h (0-3 months of age) or 12-16h (4-11 months of age) of good quality sleep, including naps.

In a 24-hour day, children 1-2 years of age should:

• spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate- to vigorous-intensity physical activity, spread throughout the day; more is better;
• not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time.
  • For 1 year olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended.
  • For those aged 2 years, sedentary screen time should be no more than 1 hour; less is better.
• When sedentary, engaging in reading and storytelling with a caregiver is encouraged; and
• have 11-14h of good quality sleep, including naps, with regular sleep and wake-up times.

In a 24-hour day, children 3-4 years of age should:

• spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate- to vigorous-intensity physical activity, spread throughout the day; more is better;
• not be restrained for more than 1 hour at a time (e.g., prams/strollers) or sit for extended periods of time.
• Sedentary screen time should be no more than 1 hour; less is better.
• When sedentary, engaging in reading and storytelling with a caregiver is); encourage; and
• have 10-13h of good quality sleep, which may include a nap, with regular sleep and wake-up times.
• For more information World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age.

Children and adolescents aged 5-17 years

• should do at least an average of 60 minutes per day of moderate-to-vigorous intensity, mostly aerobic, physical activity, across the week.
• should incorporate vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone, at least 3 days a week.
• should limit the amount of time spent being sedentary, particularly the amount of recreational screen time.

Adults aged 18–64 years

• should do at least 150–300 minutes of moderate-intensity aerobic physical activity;
• or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week
• should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits.
• may increase moderate-intensity aerobic physical activity to more than 300 minutes; or do more than 150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week for additional health benefits.
• should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits, and
• to help reduce the detrimental effects of high levels of sedentary behaviour on health, all adults and older adults should aim to do more than the recommended levels of moderate- to vigorous-intensity physical activity

Benefits and risks of physical activity and sedentary behavior

Regular physical activity, such as walking, cycling, wheeling, doing sports or active recreation, provides significant benefits for health. Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can easily achieve the recommended activity levels.

Physical inactivity is one of the leading risk factors for noncommunicable diseases mortality. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active.

Regular physical activity can:

• improve muscular and cardiorespiratory fitness;
• improve bone and functional health;
• reduce the risk of hypertension, coronary heart disease, stroke, diabetes, various types of cancer (including breast cancer and colon cancer), and depression;
• reduce the risk of falls as well as hip or vertebral fractures; and
• help maintain a healthy body weight.

In children and adolescents, physical activity improves:

• physical fitness (cardiorespiratory and muscular fitness)
• cardiometabolic health (blood pressure, dyslipidaemia, glucose, and insulin resistance)
• bone health
• cognitive outcomes (academic performance, executive function)
• mental health (reduced symptoms of depression)
• reduced adiposity

In adults and older adults, higher levels of physical activity improves:

• risk of all-cause mortality
• risk of cardiovascular disease mortality
• incident hypertension
• incident site-specific cancers (bladder, breast, colon, endometrial, oesophageal adenocarcinoma, gastric and renal cancers)
• incident type-2 diabetes
• prevents of falls
• mental health (reduced symptoms of anxiety and depression)
• cognitive health
• sleep
• measures of adiposity may also improve

Health risks of sedentary behaviour

Lives are becoming increasingly sedentary, through the use of motorized transport and the increased use of screens for work, education and recreation. Evidence shows higher amounts of sedentary behaviour are associated with the following poor health outcomes:

In children and adolescents:

• increased adiposity (weight gain)
• poorer cardiometabolic health, fitness, behavioural conduct/pro-social behaviour
• reduced sleep duration

In adults:

• all-cause mortality, cardiovascular disease mortality and cancer mortality
• incidence of cardiovascular disease, cancer and type-2 diabetes.

Levels of physical activity globally

• More than a quarter of the world’s adult population (1.4 billion adults) are insufficiently active
• Worldwide, around 1 in 3 women and 1 in 4 men do not do enough physical activity to stay healthy.
• Levels of inactivity are twice as high in high-income countries compared to low-income countries,
• There has been no improvement in global levels of physical activity since 2001
• Insufficient activity increased by 5% (from 31.6% to 36.8%) in high-income countries between 2001 and 2016.

Increased levels of physical inactivity have negative impacts on health systems, the environment, economic development, community well-being and quality of life.

Globally, 28% of adults aged 18 and over were not active enough in 2016 (men 23% and women 32%). This means they do not meet the global recommendations of at least 150 minutes of moderate-intensity, or 75 minutes vigorous-intensity physical activity per week.

In high-income countries, 26% of men and 35% of women were insufficiently physically active, as compared to 12% of men and 24% of women in low-income countries. Low or decreasing physical activity levels often correspond with a high or rising gross national product.

The drop in physical activity is partly due to inaction during leisure time and sedentary behaviour on the job and at home. Likewise, an increase in the use of "passive" modes of transportation also contributes to insufficient physical activity.

Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in 2016. Adolescent girls were less active than adolescent boys, with 85% vs. 78% not meeting WHO recommendations of at least 60 minutes of moderate to vigorous intensity physical activity per day.

How to increase physical activity?
Countries and communities must take action to provide everyone with more opportunities to be active, in order to increase physical activity. This requires a collective effort, both national and local, across different sectors and disciplines to implement policy and solutions appropriate to a country’s cultural and social environment to promote, enable and encourage physical activity.

Policies to increase physical activity aim to ensure that:

• walking, cycling and other forms of active non-motorized forms of transport are accessible and safe for all;
• labour and workplace policies encourage active commuting and opportunities for being physically active during the work day;
• childcare, schools and higher education institutions provide supportive and safe spaces and facilities for all students to spend their free time actively;
• primary and secondary schools provide quality physical education that supports children to develop behaviour patterns that will keep them physically active throughout their lives;
• community-based and school-sport programmes provide appropriate opportunities for all ages and abilities;
• sports and recreation facilities provide opportunities for everyone to access and participate in a variety of different sports, dance, exercise and active recreation; and
• health care providers advise and support patients to be regularly active.