p.43 抽出テキスト

............................................................................................... mortality, as well as incidence of type 2 DM.371373,383387 The reduction in risk continues across the full range of PA volumes, and the slope of risk decline is steepest for the least active individuals.371374,386,387 More information on PA prescription can be found in a recent ESC Guideline.388

4.3.1.1 Physical activity prescription PA should be individually assessed and prescribed in terms of frequency, intensity, time (duration), type, and progression.389 Recommendations regarding pre-participation screening can be found in previous ESC Guidelines.388 Interventions shown to increase PA level or reduce sedentary behaviour include behaviour theorybased interventions, such as goal-setting, re-evaluation of goals, selfmonitoring, and feedback.372,380,381 Using a wearable activity tracker may help increase PA.382 Most important is to encourage activity that people enjoy and/or can include in their daily routines, as such activities are more likely to be sustainable.

4.3.1.2 Aerobic physical activity Examples of aerobic PA include walking, jogging, cycling, etc.389 Adults are recommended to perform at least 150300 min a week of moderate-intensity PA, or 75150 min of vigorous-intensity PA, or an equivalent combination of both, spread throughout the week.371,372 Additional benefits are gained with even more PA. Practising PA should still be encouraged in individuals unable to meet the minimum. In sedentary individuals, a gradual increase in activity level is recommended. When older adults or individuals with chronic conditions cannot achieve 150 min of moderate-intensity PA a week, they should be as active as their abilities and conditions allow.371375,384,385 PA accumulated in bouts of even <10 min is associated with favourable outcomes, including mortality.371,390 PA can be expressed in absolute or relative terms.389 Absolute intensity is the amount of energy expended per minute of activity, assessed by oxygen uptake per unit of time (mL/min or L/min) or by metabolic equivalent of task (MET). A compendium of the energy cost in MET values for various activities is available.391 An absolute measure does not consider individual factors such as body weight, sex, and fitness level.389 Relative intensity is determined based on an individual’s maximum (peak) effort, e.g. percentage of cardiorespiratory fitness (%VO2 max), percentage of maximum (peak) heart rate (%HRmax) or using rating of perceived exertion according to the Borg scale. Less fit individuals generally require a higher level of effort than fitter people to perform the same activity. A relative intensity measure is necessary to provide an individualized PA prescription.389

Classification for both absolute and relative intensity and examples are presented in Table 7.

4.3.1.3 Resistance exercise Resistance exercise in addition to aerobic PA is associated with lower risks of total CV events and all-cause mortality.378,379,393395 The suggested prescription is one to three sets of 812 repetitions at the intensity of 6080% of the individual’s 1 repetition maximum at a frequency of at least 2 days a week in a variety of 810 different exercises involving each major muscle group. For older adults or deconditioned individuals, it is suggested to start with one set of 1015 repetitions at 4050% of 1 repetition maximum.389 In addition, older adults are recommended to perform multicomponent PA that combines aerobic, muscle-strengthening, and balance exercises to prevent falls.372

4.3.1.4 Sedentary behaviour Sedentary time is associated with greater risk for several major chronic diseases and mortality.371,372,375377,396399 For physically inactive adults, light-intensity PA, even as little as 15 minutes a day, is likely to produce benefits. There is mixed evidence to suggest how activity bouts that interrupt sedentary behaviour are associated with health outcomes.375,398,400

4.3.2 Nutrition and alcohol

................................................................................................................ ................................................................................................

Table 7 Classification of physical activity intensity and examples of absolute and relative intensity levels.

Absolute intensity Relative intensity Intensity METa Examples %HRmax RPE (Borg scale score) Talk test Light 1.12.9 Walking <4.7 km/h, light household work 5763 1011 Moderate 35.9 Walking at moderate or brisk pace (4.16.5 km/h),

slow cycling (15 km/h), painting/decorating, vacuuming, gardening (mowing lawn), golf (pulling clubs in trolley), tennis (doubles), ballroom dancing, water aerobics 6476 1213 Breathing is faster but compatible with

speaking full sentences

Vigorous >_6 Race-walking, jogging, or running, cycling >15 km/h, heavy gardening (continuous digging or hoeing), swim-

ming laps, tennis (singles) 7795 1417 Breathing very hard, incompatible with carrying on a conversation

comfortably

%HRmax = percentage of measured or estimated maximum heart rate (220age); MET = metabolic equivalent of task; RPE = rating of perceived exertion (Borg-scale 620); VO2 = oxygen consumption. aMET is estimated as the energy cost of a given activity divided by resting energy expenditure: 1 MET = 3.5 mL oxygen kg1 min1 VO2. Modified from 392 ESC 2021

Recommendations for nutrition and alcohol

Recommendations Classa Levelb

A healthy diet is recommended as a cornerstone of CVD prevention in all individuals.401,402 I A

Continued .................... Downloaded from academic.oup.com/eurheartj/article/42/34/3227/6358713 by guest on 07 October 2026