Moderate Intensity Aerobic Exercise Guidelines

Definition and Relative Intensity Measures

Moderate-intensity aerobic exercise is defined as activity performed at 40-59% of VO2 max or heart rate reserve, corresponding to 55-69% of maximum heart rate, with a rating of perceived exertion (RPE) of 12-13 on the Borg scale, and an absolute energy expenditure of 4.8-7.1 METs in young adults, as recommended by the American Heart Association 1, 2
The American College of Cardiology suggests that moderate intensity should be defined in relative terms based on individual fitness level, with 40-59% of VO2 max or heart rate reserve 1, 3, 4
The European Society of Cardiology recommends an RPE of 12-13 on the 6-20 Borg scale (or 5-6 on the CR10 scale) for moderate-intensity exercise 1, 3
The "talk test" can be used to determine moderate intensity, where you can talk but not sing during the activity, as suggested by the British Journal of Sports Medicine 5

The American College of Sports Medicine states that absolute intensity varies by age group due to declining fitness with age, with young adults requiring 4.8-7.1 METs for moderate-intensity exercise 1, 3, 2
The European Society of Cardiology recommends the following METs for moderate-intensity exercise: 4.0-5.9 METs for middle-aged adults, 3.2-4.7 METs for older adults, and 2.0-2.9 METs for very old adults 3, 4
One MET equals 3.5 mL O2/kg/min, representing resting energy expenditure, as defined by the European Heart Journal 7, 8

Brisk walking at 3-4 mph is an example of moderate-intensity aerobic exercise, as recommended by the American Heart Association 1, 5
Water aerobics, stationary cycling (moderate effort), and resistance training with moderate loads are also examples of moderate-intensity activities, as suggested by the British Journal of Sports Medicine 5
Household activities such as gardening, washing windows, and raking lawn can be considered moderate-intensity exercise, as recommended by the American College of Cardiology 1, 3

The World Health Organization recommends that adults accumulate at least 150 minutes per week of moderate-intensity aerobic activity, distributed over most days of the week, with a minimum of 150 minutes/week (2.5 hours) 3, 7
The American College of Sports Medicine suggests that the optimal range for substantial health benefits is 150-300 minutes/week, with activities accumulated in bouts of ≥10 minutes 6, 3, 7
The European Society of Cardiology recommends at least 3-5 days per week, preferably daily, for moderate-intensity exercise 5, 7

The American College of Sports Medicine states that moderate-intensity exercise can be substituted with vigorous-intensity activity at approximately a 2:1 ratio, with 150 minutes of moderate activity equivalent to 75 minutes of vigorous activity 6
Combinations of both intensities can be used to meet recommendations, as suggested by the European Heart Journal 7

The American Heart Association recommends using RPE or talk test rather than heart rate targets for individuals taking medications affecting heart rate (e.g., beta-blockers) 7
The European Society of Cardiology suggests that fitness level matters, with less fit individuals requiring higher relative effort to perform the same absolute activity 8
A progressive approach is recommended, with individuals unable to meet 150 minutes starting with any amount and gradually increasing, as suggested by the European Heart Journal 7