Fitness
MAHA Commission promotes fitness as a vital sign for children. What does that mean?
Nobody’s against fitness for children. But health secretary Robert F. Kennedy Jr.’s proposal to make physical activity a “vital sign” akin to blood pressure or growth is raising questions among physiology experts.
Physical fitness for all and children’s health are two tentpoles of Kennedy’s Make America Healthy Again mission, articulated in the MAHA Commission’s initial meeting in May, outlined in a draft Make Our Children Healthy Again report in August, and solidified in the full report Tuesday. The report promotes “physical activity as a vital sign,” a concept that usually defines a healthy level as 150 minutes of movement per week.
The commission, though, urges states to establish specific metrics of fitness, for example, a “predicted VO₂ Max” as a baseline for evaluating Medicaid managed care organizations on how much they were improving health. Other factors would include sleep, nutrition, and potentially “select high-quality supplements.”
And decades after President John F. Kennedy introduced it, the Presidential Fitness Test will return to gauge the speed and strength of America’s schoolchildren, the report says.
When the test was introduced in the 1960s, people worried that kids were spending too much time indoors, sitting around and watching television. To jump-start their fitness, physical activity at school was encouraged with routines from running to rope climbing, culminating in an annual test.
STAT has requested comment from the Department of Health and Human Services, which directed inquiries to the White House, asking about the basis for these ideas and what might come next.
What is VO₂ max, anyway?
Experts told STAT they were puzzled by the mention of VO₂ max as a metric. VO₂ max stands for the maximum volume of oxygen the body can take in and use in a single minute during intense physical activity. It’s determined by a standard exercise stress test that measures breathing with a mask to calculate oxygen consumption to define fitness.
As a measure of cardiorespiratory fitness, higher is better. It’s less clear whether it makes sense to apply an adult athlete’s numbers, aka VO₂ max, to children at play.
“It’s a really great test. It’s not really something you can do in someone under 9, 10 years old in a really good way,” Jared Hershenson, a pediatric cardiologist who directs cardiac exercise and rehabilitation at Children’s National Hospital, told STAT. “If you’re talking about trying to measure someone’s fitness who’s younger than that, there really is not any objective test that can do that, or quantitative test that can be done.”
VO₂ max is difficult to measure, even for adults, I-Min Lee, a professor of epidemiology at the Harvard T.H. Chan School of Public Health who studies the role of physical activity in preventing chronic diseases, also told STAT. You need lab equipment and you need participants to exercise to the point of exhaustion. Picture people on an exercise bike or a treadmill, going full out while wearing a mask to track their oxygen levels. Many people won’t or can’t do that, she said.
There are predictive equations that do not rely on lab tests, but instead use age, sex, body mass index, or other numbers. With varying degrees of accuracy, they are more feasible in large numbers of people to advance health.
Lee underscored that physical fitness and physical activity are related, but not identical constructs. Activity is something we do; fitness is a physiological construct.
There’s this catch: Fitness can be improved by regular activity, but it’s also partially genetically determined, she said. “I could exercise to death, but I will never be as fit as Lance Armstrong, since I don’t have his genes.”
Outside the lab, VO₂ max is familiar to weekend warriors who upload their runs, swims, rides, and hikes to sports/social media sites like Strava to track training and add up kudos from their friends. That less-than-lab-quality number is derived from heart rate and other data collected by the watches on their wrists, made by Garmin or Apple or Coros, among others in the burgeoning market for wearables.
In June, Kennedy predicted wearables for all in the next four years, but later pulled back, saying in a statement to Axios that “they are not for everyone because of concerns like cost and personal privacy.”
Eric Topol, a cardiologist and geneticist at Scripps Research Institute, scoffed at measuring VO₂ max in kids when for adults, studies have shown there are more practical ways to measure fitness that don’t involve lab testing or expensive wearables.
“To do that in children? Are you kidding me?” he said in an interview. “That is just absurd. But that’s just the anti-science movement that keeps spewing out things that are not substantiated or possible or likely.”
Topol himself gets his VO₂ max data on his iPhone, but acknowledges its limits compared to a physiology lab. For children, it would make more sense to give them a wristband with a pedometer to measure activity. “Let’s go with something simple and cheap like that, that everybody could have,” he said.
We’re not there yet for children’s wearables, Hershenson said, while acknowledging its potential if government and private sector entities work together. There are no reliable fitness data from wearables in pediatric patients, for the children Hershenson’s center sees who have significant challenges or for healthier kids. Companies on their own might have variations in how they measure fitness.
“In any of the technology, as far as I know, nothing’s been correlated with exercise tests. You’d have to have some sort of standard testing to compare it to,” he said. “I think it’s going to have to be some sort of surrogate,” maybe heart rate recovery, which tracks how fast the heart rate returns to its normal resting state after exercise.
Presidential Fitness Test, redux
Then there’s the metric President Trump wants to bring back to life: The Presidential Fitness Test. Started in the 1960s by President Kennedy and modified decades later by President Obama, it sent schoolchildren racing the mile and doing situps, pushups, pullups, and rope climbs. The new report says HHS and the Department of Education will partner with the President’s Council on Sports, Fitness, and Nutrition to help states and schools reintroduce it.
Hershenson isn’t sure measuring how many pullups a child can do is going to help gauge fitness, strength, or flexibility as they pertain to future health.
“I think it’s useful to have some sort of baseline. But you need to know what to do with that,” he said. “We’re not just gonna throw a ball around. Let’s find ways that we can improve this person’s strength and this person’s fitness by doing stuff that’s fun.”
That also means thinking about barriers to exercise.
“To me the best approach is always treating each person individually to figure out how I can help them be the best version of themselves,” Hershenson said. “That’s extraordinarily difficult when you’re making massive public policy for however many millions of people, but I think it’s going to be different for everybody.”
“Is it a questionnaire? Is it measuring heart rate recovery? Is it measuring how many steps you take?” he asked. “It’s probably not going to be perfect.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
Fitness
Jogging 101: Benefits for Your Body and Mind
Walking and running share a number of benefits — but what about that sweet middle ground between the two?
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“Jogging is about creating a steady pace,” says sports and exercise medicine specialist Leonardo Oliveira, MD. “Instead of focusing on speed, you’re focused more on endurance with good, quality steps.”
Before your next jaunt, Dr. Oliveira shares the many benefits of jogging and how it can help improve your overall health and wellness.
9 benefits of jogging
Unlike running, where you’re focused on targeting different heart rate zones, jogging involves keeping a more stable and persistent pace. If you’re jogging at a moderate intensity, for example, your target heart rate will usually fall into zone 2, at 60% to 70% of your max heart rate.
“When you’re jogging, you should be able to carry on a conversation as you breathe through your nose,” says Dr. Oliveira. “If you’re doing just 15 minutes of jogging three times a week, you’re already going to notice the benefits.”
Here’s how you can benefit from jogging.
1. Reduces stress
Jogging, like other exercises, can help decrease your stress levels. As an aerobic exercise, it helps release endorphins, which can boost your mood and create feelings of euphoria or satisfaction. Not only does it provide an outlet for pent-up energy, but jogging outside also allows you to spend more time in nature, which provides even more mental health benefits.
“Research shows exercise can be as effective as medication when treating depression because of its wide-ranging benefits,” says Dr. Oliveira.
2. Burns calories
Jogging is a full-body exercise that offers a higher calorie burn than some other aerobic exercises. According to the widely used Compendium of Physical Activities, jogging burns about 7.5 calories per kilogram of body weight each hour. That means you can burn about:
- 8 times as many calories as sitting quietly
- 4 times as many calories as walking
- 2.6 times as many calories as stationary cycling
“Jogging will burn more calories in a shorter period of time than cycling, especially if you’re not used to exercising,” reports Dr. Oliveira.
3. Improves insulin resistance and boosts metabolism
Insulin resistance is one of the biggest barriers to having a healthy metabolism. Insulin helps your body break down glucose for energy. But if your body can’t do that, your metabolism slows down, leading to:
- Lower energy levels
- Weight gain
- An inability to burn fat
“Exercising at higher intensities helps increase metabolism and insulin resistance,” says Dr. Oliveira. “But researchers have also found that even lower-intensity exercises, like jogging, for longer periods of time can have the same effect.”
4. Strengthens your heart
Jogging also has positive impacts on your heart and its ability to pump blood to the rest of your body. That’s because it contributes to hypertrophy, or the strengthening of your heart’s muscle tissues.
“As you develop endurance, the amount of blood in one pump increases,” explains Dr. Oliveira. “When your heart gets stronger, it contracts more efficiently, which decreases your resting heart rate.”
5. Improves lung expansion and gas exchange
The more you work on building endurance and stamina, the more likely it is that you’ll improve your overall ability to breathe — both at rest and while jogging.
“Consistent aerobic exercise helps your lungs get stronger and more efficient,” says Dr. Oliveira. “Over time, you won’t need to breathe as often because each breath brings in more oxygen than before.”
6. Activates muscles
Jogging activates major muscle groups, including your:
- Quads
- Hamstrings
- Glutes
- Core
- Back
“Strength training is a good complement to jogging because it can help strengthen all the areas of your body,” says Dr. Oliveira. “This can help you handle longer distances.”
7. Reduces stiffness
“Jogging is one of those activities where once you get going, you start to feel better,” notes Dr. Oliveira. “It’s an exercise that helps warm up your muscles and lubricate your joints, which can help with the overall sense of stiffness that comes with age.”
That said, jogging is still a high-impact exercise because it forces you to bear down weight as your feet hit the pavement. Consider working with a physical therapist or athletic trainer to reduce the risk of further injury if you:
- Have arthritis
- Have an active injury
- Had previous sprains or fractures in your lower body
8. Improves endurance
“The more you jog, the more you’ll increase your functional aerobic capacity,” says Dr. Oliveira. “Someone who jogs regularly will have better physical fitness that will help them last longer on a bike or a walk than someone who’s just getting started.”
Your ability to breathe and move also extends to other daily activities that demand cardiovascular strength and endurance, like climbing stairs.
9. Provides better quality of life and other mental health benefits
Research shows that any amount of jogging — even just once a week — can improve your quality of life and lower your risk of dying from cancer and cardiovascular-related issues.
“Jogging is a great form of exercise, but it’s not the only one,” notes Dr. Oliveira. “The most important thing is to work on being healthy and strong. And for a lot of people, if you’re looking to advance your physical fitness, jogging is a good place to start.”
Fitness
Michelle Yeoh, 63, uses ‘exercise snacking’ to stay fit – here’s why mini workouts have big benefits
As an increasing number of scientific studies are published citing the benefits of ‘exercise snacking’ – short bouts of physical activity sprinkled throughout the day – one celeb has sworn by the practise for several years already. The woman in question? Acting great Michelle Yeoh. Below, we look at the power of mini workouts and why the Oscar-winner’s go-to move is so effective.
Stretching
Michelle revealed to Vogue that she incorporates fitness into her morning routine in a way that’s incredibly time-efficient. ‘Remember, you can do your kicks, you can do your stretches, while you are also waking up,’ she said. Indeed, research has shown that regular stretching can improve flexibility, reduce muscle stiffness and improve blood circulation – all crucial elements of healthy ageing.
And you don’t have to stretch for very long, either. One study found that while static stretching improves flexibility in adults, there was no additional benefit observed beyond four minutes per session or 10 minutes per week. So, it seems that a short stretching sesh (you don’t even have to get out of bed to do it) like Michelle’s is a very worthwhile habit to adopt.
Squats
In her Vogue interview, Michelle also shared that she performs squats most days while doing her skincare routine. Virtually every expert and trainer we speak to here at Women’s Health lists squats as one of the most important moves for women to do as they age. A compound exercise (when multiple muscle groups are used), squats also mirror the vital movement pattern of sitting down and getting back up again.
Numerous studies have highlighted the benefits of this simple exercise for posture, strength and power, and one paper even found that intermittent squat exercises performed during prolonged periods of sitting may boost brain power. Whether you’re squatting mid-moisturise like Michelle or while you’re waiting for the kettle to boil, the science suggests sprinkling squats into your day can be really quite powerful.
The power of habit stacking
As Michelle’s routine shows, adopting a sustainable exercise routine often relies on habit stacking – adding a movement to something you already do every day, like doing your skincare or brushing your teeth.
BRB, we’re just off to do our daily squats.
After years living with endometriosis and undergoing seven rounds of IVF, Radio 4 presenter Emma Barnett turned to training with PT Frankie Holah to rebuild strength and a more positive relationship with her body. Download the Women’s Health UK app to access Frankie’s full training plan.
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Hannah Bradfield is a Senior Health and Fitness Writer for Women’s Health UK. An NCTJ-accredited journalist, Hannah graduated from Loughborough University with a BA in English and Sport Science and an MA in Media and Cultural Analysis. She has been covering sports, health and fitness for the last five years and has created content for outlets including BBC Sport, BBC Sounds, Runner’s World and Stylist. She especially enjoys interviewing those working within the community to improve access to sport, exercise and wellness. Hannah is a 2024 John Schofield Trust Fellow and was also named a 2022 Rising Star in Journalism by The Printing Charity. A keen runner, Hannah was firmly a sprinter growing up (also dabbling in long jump) but has since transitioned to longer-distance running. While 10K is her favoured race distance, she loves running or volunteering at parkrun every Saturday, followed, of course, by pastries. She’s always looking for fun new runs and races to do and brunch spots to try.
Fitness
I Have a Master’s in Exercise Science. These Are the Only 6 Strength Moves You Need To Build Muscle
Strength training doesn’t have to be complicated. Fitness content on social media may leave you thinking that you should only work out at specific times, use certain weights and incorporate an ever-rotating assortment of moves — but to reap the full benefits of building muscle, you can actually keep things surprisingly simple.
The Physical Activity Guidelines for Americans recommends at least two days of resistance training, aka strength training, for adults each week as part of their workout routines. And those two days need only include six moves, Adrian Chavez, Ph.D., nutrition and health coach, tells TODAY.com.
It’s often the most advanced fitness routines that generate the most buzz online. And while having lots of different strength moves in your arsenal can stave off boredom at the gym, it’s not usually necessary, Chavez explains. Sticking to the basics and staying consistent will give you the most bang for your buck, he adds.
The Most Efficient Strength-Training Moves
The six moves Chavez says are most efficient for improving health and body composition are:
“Those movements cover all of the (major) muscle groups of the body,” Chavez says. “I wouldn’t necessarily say these are the only six movements that you need, but those are the ones that are going to work the largest amount of muscle in each movement.”
Building muscle through strength training can boost longevity, a mood, bone density and more.
It’s also a key factor to improving metabolic health, Chavez points out. Muscle burns calories, even while you’re at rest. So, the more muscle you have, the more calories you’ll burn.
If you’re after efficient results, focusing on these six movements that target the body’s largest muscle groups will get you there since these muscles require the most energy to function.
Which Muscles Does Each Move Target?
The overhead press primarily targets the shoulders, says Chavez. It also works the triceps, the trapezius muscles in your upper back and the core.
Perform a chest press when you’re looking to strengthen your pectoralis muscles, the two largest in the chest. These muscles are responsible for lifting, rotating and pushing.
By including a back row in your strength training routine, you’ll be working your upper back and biceps, says Chavez.
The overhead pull-down or pull-up will strengthen your latissimus dorsi muscles (lats), which extend from the lower back to the armpit. Chavez says you’ll be engaging your biceps, too.
Squats work the quadricep muscles (quads) in the thighs, hamstrings and glutes, says Chavez. They’ll also engage your core, since squats require stability.
Include deadlifts in your routine to challenge your quad muscles in the thigh, hamstrings, glutes and lower back, says Chavez. You can choose between the regular deadlift and the Romanian deadlift, or incorporate both into your workout.
Benefits of a Consistent Strength Training Routine
Studies show that consistency when strength training, rather than the complexity of your workout plan, is what makes the biggest difference for health. Any kind of resistance training compared to none at all improve sstrength, muscle function and endurance regardless of intensity, equipment type and variation, research shows.
These six moves are not the only effective workouts for improving strength and altering body composition, but if you were to stick only to these six, you’d be in great shape, he explains.
Regular strength training will not only improve your physique but also your quality of life. “When you do a deadlift, that’s like picking up your kid,” Chavez says, comparing pull-ups to playing with them on the monkey bars.
“Carrying groceries, moving furniture, all of those things become a lot easier when you build some strength. And … these six movements cover all of the major muscle groups, so that will translate into really changing the way that you experience life,” he adds.
How to Add Variation
Once you’ve committed to a training plan you’ll use again and again, you may also want to mix things up, Chavez says.
To avoid boredom or to add an additional challenge, most of the six moves have variations.
For example, narrow-stance squats isolate the quads. Or you can change the grip during bicep curls to also target the forearms. “Learning slight variations to these primary movements is how you really build out a good routine,” he says.
An ideal workout program includes strength training at least two times a week and additional sessions with a type of cardio you enjoy. Chavez plays basketball, runs and rides his bike in between strength training sessions. He also suggests walking, swimming or rowing.
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