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 Other activity states that comprise a 24-hour period for an average individual include sleep, light-intensity physical activity, and sedentary behavior (Figure 1). Sedentary behavior refers to waking behavior with an energy expenditure of 1.5 metabolic equivalents while in a sitting or reclining posture (Table 4).S3.2-12 4. OTHER FACTORS AFFECTING CARDIOVASCULAR RISK 4.1. Adults With Overweight and Obesity Recommendations for Adults With Overweight and Obesity Referenced studies that support recommendations are summarized in Online Data Supplements 8 and 9. COR LOE Recommendations I B-R In individuals with overweight and obesity, weight loss is recommended to improve the ASCVD risk factor profile.S4.1-1 I B-R Counseling and comprehensive lifestyle interventions, including calorie restriction, are recommended for achieving and maintaining weight loss in adults with overweight and obesity.S4.1-1,S4.1-2 I C-EO Calculating body mass index (BMI) is recommended annually or more frequently to identify adults with overweight and obesity for weight loss considerations. 