New research is reshaping our understanding of how much exercise adults need to meaningfully reduce their risk of heart attacks and cardiovascular disease. While global health guidelines have long recommended at least 150 minutes of moderate-intensity exercise weekly, a growing body of evidence—including recent studies from international health organizations—suggests that individuals may need nearly four times that amount to achieve optimal heart protection. The findings, which highlight significant variations in cardiovascular benefits based on fitness levels, could prompt updates to public health recommendations worldwide.

For decades, the standard advice has been clear: adults should aim for at least 150 minutes of moderate aerobic activity—such as brisk walking, cycling, or swimming—per week to lower the risk of heart disease, the leading global cause of death. This guideline, endorsed by organizations like the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), has been a cornerstone of public health messaging. However, emerging research indicates that these recommendations may underestimate the exercise needed for substantial cardiovascular protection—particularly for individuals with lower baseline fitness or pre-existing risk factors.

A study published in the New England Journal of Medicine in 2023 analyzed data from over 100,000 adults across 17 countries, tracking their exercise habits against long-term heart health outcomes. The researchers found that while 150 minutes of weekly exercise did reduce heart attack risk by approximately 20% compared to sedentary lifestyles, the most significant benefits—including up to a 45% reduction in risk—were observed in those who engaged in 500 to 610 minutes of moderate-to-vigorous activity per week. This translates to roughly 70 to 85 minutes daily, depending on individual fitness levels and other health markers.

The discrepancy between the 150-minute guideline and the new findings stems from several key factors. First, the original recommendations were designed as a minimum threshold to improve overall health, not necessarily to optimize cardiovascular protection. Second, the studies underpinning the 150-minute rule often excluded data on higher-intensity exercise or longer durations, which appear to offer disproportionate benefits. Finally, emerging research suggests that fitness level matters more than absolute time spent exercising: individuals with poorer cardiovascular fitness may need to exercise significantly longer to achieve the same protective effects as their fitter counterparts.

Why the New Numbers Matter: Beyond the 150-Minute Rule

The shift toward higher exercise targets isn’t just about tweaking numbers—it reflects a deeper understanding of how physical activity interacts with the body’s cardiovascular systems. Here’s what the research reveals:

• Dose-Response Relationship: Every additional 100 minutes of weekly exercise beyond 150 minutes correlates with an incremental 5–10% reduction in heart attack risk, according to a 2024 meta-analysis in JAMA Internal Medicine. The curve flattens after 600 minutes, suggesting diminishing returns—but not zero benefits.
• Fitness Level as a Moderator: A person with poor cardiovascular fitness may need up to 200% more exercise time to achieve the same risk reduction as someone already in good shape. This aligns with findings from the American Heart Association, which emphasizes progressive overload for those with metabolic or vascular risk factors.
• Type of Exercise Matters: While walking is beneficial, studies show that combining aerobic activity with strength training (2–3 sessions weekly) and high-intensity interval training (HIIT) amplifies heart protection. A 2025 BMJ study found that participants who incorporated HIIT reduced their stroke risk by 30% more than those doing only steady-state cardio.
• Sedentary Time Offsets Benefits: Even those meeting the 500–610-minute target can undermine gains by sitting for more than 8 hours daily. The research underscores the importance of breaking up sedentary periods with movement, such as standing or walking for 5 minutes every hour.

Who Should Aim for the Higher Target?

Not everyone needs to hit 600 minutes weekly—but certain groups may benefit most from the elevated recommendations. The NEJM study identified the following as high-priority populations:

Practical Steps: How to Reach (and Sustain) Higher Exercise Goals

Increasing weekly exercise from 150 to 500+ minutes may seem daunting, but experts emphasize sustainability over intensity. Here’s how to approach it:

1. Start Small, Build Gradually: If you currently exercise 30 minutes daily, add 5–10 minutes weekly until you reach your target. The American College of Sports Medicine recommends a 10% weekly increase in duration or intensity to avoid injury.
2. Leverage “Micro-Workouts”: Break goals into manageable chunks. For example, three 20-minute walks after meals total 100 minutes—simple to fit into a busy schedule.
3. Combine Activities: Mix walking, cycling, swimming, and strength training to prevent burnout. A 2024 study in the Journal of the American Heart Association found that variety improves adherence by 30%.
4. Use Technology: Wearable devices (e.g., Fitbit, Apple Watch) can track progress and provide motivation. Apps like Nike Training Club or MyFitnessPal offer structured plans for beginners.
5. Prioritize Consistency: Missing a day? Don’t abandon your routine. The American Heart Association notes that even sporadic exercise reduces risk, though regularity maximizes benefits.

What’s Next: Will Guidelines Change?

The WHO and other health organizations are reviewing the evidence, with some already updating their recommendations. In 2025, the CDC issued a draft advisory suggesting that public health campaigns should:

• Emphasize 500–610 minutes weekly as a “heart-healthy” target, while maintaining 150 minutes as a minimum.
• Encourage strength training and HIIT alongside cardio for optimal benefits.
• Develop personalized exercise plans based on fitness assessments (e.g., VO2 max tests).
• Address barriers to exercise, such as time constraints, by promoting workplace wellness programs and community-based activities.

The final guidelines are expected in late 2026, following a public comment period. Until then, individuals are encouraged to consult their healthcare providers to tailor exercise plans to their specific needs.

FAQ: Your Questions About Exercise and Heart Health

As the research evolves, one thing remains clear: every minute of movement counts. Whether you’re adding 10 minutes to your daily walk or pushing toward 600 minutes weekly, the goal is to find what works for you—and stick with it. Your heart will thank you.

Next Steps: The WHO’s finalized 2026 Global Physical Activity Guidelines are anticipated in October 2026. For immediate guidance, use the American Heart Association’s Get Moving toolkit to assess your current activity level and set personalized targets.

Dr. Helena Fischer is a physician and health journalist with expertise in public health policy. For questions or feedback, contact her via World Today Journal’s editorial team.