Comparing Different Exercise Guidelines

Wondering what different guidelines say about physical activity (PA) recommendations? The table below shows what different health organizations recommend helping people get and stay active. While the exact advice may vary (like how much PA to aim for or how often to do strength training), there are many things they all agree on.

Most recommend:

Regular moderate to vigorous PA (like brisk walking, biking, or dancing)
Strength or resistance exercises a couple of days a week
Sitting less and moving more throughout the day

Even more important, all the experts agree on this: any PA is better than none. You don’t have to make big changes all at once. Small steps like taking short walks, standing up more often, eating a balanced diet, and can make a big difference, especially when you're managing diabetes. Keep reading to learn more!

American Diabetes Association (ADA)†

Guidelines for Children:

Toddlers⁶: 30+ mins of PA per day with no more than 60 mins of sitting at a time will help promote motor skills and muscular development

Preschoolers⁶: At least 60 mins of PA per day

Youth with T1D or T2D⁵: Moderate to Vigorous Physical Activity (MVPA) 60 mins per day or more, with muscle and bone strengthening activities at least 3 days per week

Guidelines for Adults:

Adults with T1D and T2D⁵: Moderate- to vigorous-intensity physical activity (MVPA) 150+ mins per week, spread over at least 3 days per week, with no more than 2 consecutive days without PA AND resistance exercise 2–3 sessions per week on non-consecutive days.

Physically fit individuals⁵: Vigorous-intensity or interval training. Shorter durations (minimum 75 mins per week) may be sufficient.

Older Adults with Diabetes⁵: Flexibility training and balance training 2–3 times per week. Plus: Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance

International Society for Pediatric and Adolescent Diabetes (ISPAD)*

Guidelines for Children and Adolescents:

All children and adolescents (6-18 yrs)⁸: 60 mins or more of PA per day, which should include:

Moderate to vigorous aerobic activity (MVPA)
Muscle strengthening activities
Bone-strengthening activities

MVPA: Constitutes the main portion of the 60 mins per day
Higher intensity (vigorous) PA: At least 3 days per week
Muscle and bone strengthening PA: At least 3 days per week

World Health Organization (WHO)**

Guidelines for Infants and Children:

Infants (<1 yr)¹²:

Be physically active several times per day in a variety of ways, particularly through interactive floor-based play; more is better
For those not yet mobile, this includes at least 30 mins in prone position (tummy time) spread throughout the day while awake

Children (1-2 yrs)¹²:

Spend at least 180 mins in a variety of types of PA at any intensity, including MVPA, spread throughout the day; more is better.

Children (3-4 yrs)¹²:

Spend at least 180 mins per day of various types of PA; more is better

Children (5-17 yrs)¹¹:

MVPA, mostly aerobic: 60 mins per day
Vigorous-intensity aerobic PA, as well as those that strengthen muscle and bone: At least 3 days per week

Guidelines for Adults:

Adults (18-64 yrs)¹¹:

MVPA: at least 150–300 mins per week, OR
Vigorous intensity aerobic PA: at least 75–150 mins per week, OR
An equivalent combination of moderate and vigorous intensity PA throughout the week, for substantial health benefits

PLUS: Muscle strengthening activities at moderate or greater intensity that involve all major muscle groups: 2+ days per week

Older Adults (65+ yrs)¹¹:

MVPA: at least 150–300 mins per week, OR
Vigorous intensity aerobic PA: at least 75–150 mins per week, OR
An equivalent combination of moderate and vigorous intensity PA throughout the week, for substantial health benefits

PLUS: Muscle strengthening activities at moderate or greater intensity that involve all major muscle groups: 2+ days per week

PLUS: Varied multicomponent PA that emphasizes functional balance and strength training at moderate or greater intensity: 3+ days per week

American College of Sports Medicine (ACSM)**

Guidelines for Infants and Children:

Preschool-Aged Children (3-5 yrs)¹⁴:

PA throughout the day to enhance growth and development. Adult caregivers of preschool-aged children should encourage active play that incorporates a variety of activities.

Children and Adolescents (5-17 yrs)¹⁴:

60 mins or more of MVPA daily, including:

Aerobic: Most of the 60+ mins per day should be either moderate or vigorous intensity aerobic PA and should include vigorous intensity PA at least 3 days per week

Muscle-strengthening: As part of their 60+ mins of daily PA, should include muscle-strengthening PA on at least 3 days per week

Bone-strengthening: As part of their 60+ mins of daily PA, should include bone-strengthening PA at least 3 days per week

Guidelines for Adults:

Adults (18+)¹⁴:

Moderate intensity: at least 150-300 minutes per week OR
Vigorous intensity aerobic physical activity: 75 minutes to 150 minutes per week OR
An equivalent combination of moderate and vigorous intensity aerobic activity

In addition:

Adults (18-65 yrs)¹³:

Moderate-intensity aerobic PA for a minimum of 30 mins on 5 days per week, OR
Vigorous-intensity aerobic PA for minimum of 20 mins on 3 days per week, AND

Activities that maintain or increase muscular strength and endurance for minimum of 2 days per week

Older Adults¹⁴:

In addition to key guidelines for adults, as part of weekly PA:

PA that includes balance training as well as aerobic and muscle strengthening activities

Canadian Society for Exercise Physiology (CSEP)***

Infants (<1 yr)¹⁶:

Being physically active several times in a variety of ways, particularly through interactive floor-based play; more is better.
For those not yet mobile, this includes at least 30 mins of tummy time spread throughout the day while awake

Toddlers (1-2 yrs)¹⁶:

At least 180 mins spent in a variety of PA at any intensity, including energetic play, spread throughout the day; more is better

Preschoolers (3-4 yrs)¹⁶:

At least 180 mins spent in a variety of PA spread throughout the day, of which at least 60 mins is energetic play; more is better

Children (5-17 yrs)¹⁶:

MVPA: Accumulation of at least 60 mins per day of MVPA involving a variety of aerobic activities
Vigorous-intensity PA: At least 3 days per week
Muscle and bone strengthening activities: At least 3 days per week
Light-intensity PA: Several hours of a variety of structured and unstructured light PA

† ADA standards of care do not provide specific age categories for Toddlers, Preschoolers, Youth, Adult, or Older Adults.

*Additional guidelines are available for individuals during pregnancy and postpartum, adults and older adults with chronic health conditions, and children and adults living with disability.

**Additional guidelines are available for individuals during pregnancy and postpartum and adults with chronic health conditions and disabilities.

***Additional guidelines are available for individuals during pregnancy and postpartum, individuals with spinal cord injuries, and individuals with Multiple Sclerosis.

References:

1. Get Active! | Exercise & Diabetes | ADA. Accessed May 29, 2025. https://diabetes.org/health-wellness/fitness

2. Volume 48 Issue Supplement_1 | Diabetes Care | American Diabetes Association. Accessed May 29, 2025. https://diabetesjournals.org/care/issue/48/Supplement_1

3. American Diabetes Association Professional Practice Committee. 13. Older Adults: Standards of Care in Diabetes—2025. Diabetes Care. 2024;48(Supplement_1):S266-S282. doi:2337/dc25-S013

4. American Diabetes Association Professional Practice Committee. 13. Older Adults: Standards of Care in Diabetes—2025. Diabetes Care. 2024;48(Supplement_1):S266-S282. doi:2337/dc25-S013

5. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association | Diabetes Care | American Diabetes Association. Accessed May 29, 2025. https://diabetesjournals.org/care/article/39/11/2065/37249/Physical-Activity-Exercise-and-Diabetes-A-Position

6. Exercise & Type 1 | ADA. Accessed May 29, 2025. https://diabetes.org/health-wellness/fitness/exercise-and-type-1

7. ISPAD Clinical Practice Consensus Guidelines. Accessed May 29, 2025. https://www.ispad.org/resources/ispad-clinical-practice-consensus-guidelines.html

8. Chapter 14: Exercise in children and adolescents with diabetes. Accessed May 29, 2025. https://www.ispad.org/resource/ispad-guidelines2018-14-pdf.html

9. Physical activity. Accessed May 29, 2025. https://www.who.int/news-room/fact-sheets/detail/physical-activity

10. Physical activity. Accessed May 29, 2025. https://www.who.int/health-topics/physical-activity

11. WHO Guidelines on Physical Activity and Sedentary Behaviour. 1st ed. World Health Organization; 2020.

12. World Health Organization. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age. World Health Organization; 2019. Accessed May 29, 2025. https://iris.who.int/handle/10665/311664

13. Physical Activity Guidelines. ACSM. Accessed May 29, 2025. https://acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines/

14. Current Guidelines | odphp.health.gov. Accessed May 29, 2025. https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines

15. Downloads – 24-Hour Movement Guidelines. Accessed May 29, 2025. https://csepguidelines.ca/downloads/

16. 24-Hour Movement Guidelines – Canadian 24-Hour Movement Guidelines. Accessed May 29, 2025. https://csepguidelines.ca/

Comparing Different Exercise Guidelines

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