Exercise and Physical Activity Recommendations for Exercise and Physical Activity Referenced studies that support recommendations are summarized in Online Data Supplements 6 and 7. COR LOE Recommendations I B-R Adults should be routinely counseled in healthcare visits to optimize a physically I B-NR Adults should engage in at least 150 minutes per week of accumulated moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD IIa B-NR For adults unable to meet the minimum physical activity recommendations (at least 150 minutes per week of accumulated moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity), engaging in some moderate- or vigorous-intensity physical activity, even if less than this recommended amount, can be beneficial to reduce ASCVD risk.S3.2-5,S3.2-6 IIb C-LD Decreasing sedentary behavior in adults may be reasonable to reduce ASCVD Synopsis The numerous health benefits of regular physical activ- ity have been well established,S3.2-12 S3.2-15 and physical activity is a cornerstone of maintaining and improving Nevertheless, approximately half of adults in the United States do not meet the mini- mum physical activity recommendations.S3.2-12 Strategies are needed to increase physical activity at both the indi- vidual and the population levels.S3.2-16,S3.2-17 Extensive observational data from meta-analyses and systematic reviews support recommendations for aerobic physical activity to lower ASCVD risk.S3.2-3 S3.2-8, Resistance exercise should also be en- couraged because of its several health benefits, includ- ing improving physical functioning,S3.2-20 improving glycemic control in individuals with diabetes,S3.2-21 and possibly BP lowering.S3.2-22 Whether resistance exercise lowers ASCVD risk is unclear.S3.2-12 Aerobic physical activity is generally very safe.S3.2-23 However, sedentary individuals starting an exercise program should initiate exercise at a lower inten- sity (eg, slow walking) and duration and progress gradually to recommended levels.S3.2-24 It is uncertain whether an upper limit of habitual exercise, either in amount or intensity, may have adverse cardiovascular But, in discussions with patients, it should be mentioned that these very high levels of physical activity (ie, >10 times the minimum recom- mended amount) pertain to only a small fraction of the Individuals with significant functional impairments may need modifications to and more spe- cific guidance on the type, duration, and intensity of physical activity. 