We all know physical activity is the magic pill, age-defying elixir or miracle drug. Yet our attempts to increase the population's physical activity have been a failure. There's a global decline in physical activity, and as few as 3% of the population (measured by accelerometer) hit the government weekly guidelines. 

We all know this. We all see more information online, in magazines or at the doctor's office telling us to do more. Individually, as medics, as the government and as exercise providers (PT:s, gyms, sports clubs etc.). But what if we've all been doing it wrong? 

The problem with exercise today is twofold: current guidelines assume we're all identical, and we ignore our emotional response before, during, and after exercise. 

Let's unpack these two problems, and then I will offer a way to think about a solution.

Current guidelines assume we’re all identical

International health and exercise governing bodies (WHO, ACSM, CDC, CSEP, UK CMO etc.) set guidelines for physical activity for different age groups and populations. The guidelines are typically evidence-based, simple and clear. Below are some examples from the UK:

• Children and Young People (5 to 18 years): moderate-to-vigorous intensity for at least 60 minutes per day across the week. 

• Adults (19 to 64 years): resistance exercise at least twice weekly and an accumulation of 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity. 

• Older adults (65 years and over): activities that improve or maintain muscle strength at least two days per week and an accumulation of 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity. 

Again, simple and clear…but wrong. Yes, if the UK population met these guidelines, then, as a population, the UK would be healthier. However, most don't meet these guidelines, and if they did, the variation in response would be considerable. Evidence shows large individual variations in cardio-respiratory fitness to a standardised training program - some will get fitter, some will stay the same, and some may get worse. And these numbers can be significant: non-responders and negative responders at a rate of 45% and 52% in one study. 

Why would we assume the same dose applies to everyone if we consider exercising a drug? I'm an 80kg 40-odd-year-old male, and I definitely don't want my doctor to give me the same dose of ketamine as a 20-year-old 50kg female. Do you feel my pain?

Emotional response to exercise is individual

Humans have been aptly described as 'Feeling Machines that think'. How we feel about things drives our behaviour. And this can drive our attitude before, during and after exercise. 

Experiences in school gym class can affect feelings about starting to exercise throughout our life: shame, embarrassment, and lack of self-belief all combine to label us as someone who doesn't like exercise. 

A life event, a significant birthday, the death of a friend or family member or some scary medical news can spur us to try and change this. We join a class, signup for an event or download a training app. The first few sessions are scary beforehand. Can I do it? Will people be looking at me? They're unpleasant during. No pain, no gain, we tell ourselves. Euphoric immediately afterwards. Phew, I'm finished. And then anxiety-inducing long afterwards. I should do this again, but I'm dreading it. Most then stop. Studies show north of 50% of adults who begin a new physical activity drop out within the first six months. 

But there's a solution that can address both these problems, which lies in a combination of exercise physiology and exercise psychology. 

Exercise physiology is a basic and applied science that describes, explains, and uses the body's responses to exercise and its adaptation to training.

Exercise psychology is the scientific study of the psychological factors associated with participation and performance in sports, exercise and other types of physical activity.

Fixing the issues that we're not all identical and the emotional response to exercise/physical activity is paramount for governments, healthcare, exercise providers, and us as individuals.  

In part 2, I’ll cover how we can fix these two problems.

Go to part 2