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Recommendations Summary

EE: Physical Activity in Healthy and Non-Critically Ill 2014

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    EE: Very Light Intensity Physical Activity in Healthy Adults

    If a healthy adult engages in very light intensity physical activity (e.g., getting dressed, driving, walking less than five minutes, etc.) prior to a resting metabolic rate (RMR) measurement, the registered dietitian nutritionist (RDN) should ensure a 30-minute rest period prior to the RMR measurement. Limited evidence in healthy adults reported that 30 minutes of rest is required for RMR to return to baseline after minimal activity. 

    Rating: Weak
    Conditional

    EE: Light to Vigorous Intensity Physical Activity in Healthy Adults

    If a healthy adult engages in light to vigorous intensity physical activity, the RDN should instruct the individual to refrain from physical activity prior to the RMR measurement for a period of time (e.g., 12 to 48 hours for moderate to vigorous physical activity). Physical activity raises the RMR for an unknown period of time in healthy adults after cessation of physical activity. The elevation of metabolic rate will vary based on intensity, type, duration, level of fitness and other factors. Therefore, the length of time that the individual must refrain from physical activity should be determined based on these factors.

    Rating: Consensus
    Conditional

    • Risks/Harms of Implementing This Recommendation

      There are no potential risks or harms associated with the application of this recommendation.

    • Conditions of Application

      • The recommendation EE: Very Light Intensity Physical Activity in Healthy Adults applies to healthy adults who engage in very light intensity physical activity
      • The recommendation EE: Light to Vigorous Intensity Physical Activity in Healthy Adults applies to healthy adults who engage in light, moderate or vigorous intensity physical activity
      • Clinical judgment should be used in applying these recommendations to healthy children and non-critically ill children and adults, due to no evidence in these populations.

    • Potential Costs Associated with Application

      If an individual engages in physical activity prior to the RMR measurement, additional costs may be incurred because the measurement may require a longer rest period, or may need to be rescheduled.

    • Recommendation Narrative

      EE: Very Light Intensity Physical Activity in Healthy Adults

      • One study of healthy adults provides evidence that 30 minutes of rest is required for RMR to return to baseline after very light intensity physical activity (i.e., less than five minutes of activity)
      • Evidence is based on one randomized controlled trial (Frankenfield and Coleman, 2009).
      EE: Light or Vigorous Intensity Physical Activity in Healthy Adults
      Data from other studies of healthy adults were considered for this consensus recommendation. Three articles provide support for the recommendation.
      • In one study of untrained older men performing a single 90-minute bout of concentric resistance exercise, BMR was elevated by 3% (57kcal) at 48 hours post-exercise (Williamson and Kirwan, 1997)
      • One study found that following 40 minutes of high-intensity aerobic exercise, RMR was significantly elevated (50kcal) at 19 hours and 43 hours; whereas 40 minutes of high-intensity resistance training did not result in an increased RMR at 19 or 43 hours (Hunter et al, 2006)
      • After 60 minutes of moderate-intensity resistance training, RMR was significantly elevated at 10 hours and 24 hours, but not significantly different at 48 hours. However, running for 60 minutes at moderate intensity resulted in a significantly elevated RMR at 48 hours (Jamurtas et al, 2004).

    • Recommendation Strength Rationale

      • Conclusion statement supporting EE: Very Light Intensity Physical Activity in Healthy Adults is grade III.
      • The recommendation EE: Light or Vigorous Intensity Physical Activity in Healthy Adults is based on consensus.

    • Minority Opinions

      None.