Who is still in need of physical activity promotion after the revision of the WHO guidelines?

Abstract Background In 2020, the World Health Organization (WHO) revised their physical activity (PA) guidelines. In contrast to the previous guidelines, moderate-to-vigorous-intensity aerobic PA (MVPA) no longer needs to be accumulated in bouts of at least ten minutes. Since the minimum recommended MVPA amount remained the same, this change was expected to increase MVPA guideline adherence. As such, the revised guidelines may help identify population groups most in need of PA promotion, as they still do not meet the revised MVPA guideline. Methods We utilized 7-day, hip-worn accelerometry data from the baseline examination of the German National Cohort (NAKO). Participants were considered to meet the MVPA guideline if they accumulated the equivalent of ≥ 150 minutes of moderate-intensity aerobic PA per week. Analyses applying (= previous guideline) vs. removing (= revised guideline) the 10-minute bout requirement were performed. Using ANOVA, equality of proportions, and post-hoc tests, we compared the demographic and health characteristics of three groups: 1) Participants meeting the previous guideline; 2) those meeting only the revised guideline; and 3) those meeting neither guideline. Results Of > 60,000 participants (mean age: 50.1 ± 12.6 years, 52.1% women), >95% met the revised MVPA guideline, whereas <40% met the previous guideline. Demographic and health factors varied significantly across groups. For example, participants who met neither MVPA guideline were, on average, 12.1 years (95% confidence interval [CI]: 10.9-13.3) older and had a 5.5 kg/m2 (95% CI: 5.0-5.9) higher body mass index than those meeting the previous guideline. Conclusions In this large, population-based sample, removal of the 10-minute bout requirement for MVPA substantially increased guideline adherence. A small minority (<5%) failed to meet the revised guideline and exhibited distinct demographic and health profiles. These individuals should be prioritized in future PA promotion interventions. Key messages • Using accelerometry data, the removal of the 10-minute bout requirement for MVPA substantially increased guideline adherence in a large population-based sample from Germany. • Only a small fraction of the sample failed to meet the MVPA guidelines without the 10-minute bout requirement, and should be the main target of PA promotion interventions.