Optimizing Guidelines Toward Optimal Health Outcomes

In a recently published perspective paper, the author argues that the UK’s official health guidelines on physical activity and protein intake should be revised to recommend levels necessary to achieve optimal health, rather than the bare minimum currently recommended [1].

From bare minimum to optimizing for healthspan

Current government guidelines on nutrition and physical activity are designed to prevent nutrient deficiencies; however, preventing deficiencies is only the bare minimum in regard to health outcomes. In a recently published paper, the author makes a clear distinction between these ‘bare minimum’ guidelines and what the recent scientific literature teaches us about the protein intake and physical activity thresholds required to maintain good health.

“Public health advice often focuses on the minimum people need to avoid problems,” said the paper’s author, Chris Macdonald, a lab director at Lucy Cavendish College, University of Cambridge. “But many people want to know what they should do to remain strong, independent, and mentally sharp throughout life.”

The more the merrier

Physical activity is a well-known lifestyle factor necessary for maintaining good health, but there is no perfect amount to achieve benefits. Researchers have observed that as little as 15 minutes of physical activity per day is associated with reduced all-cause mortality [2]. That is not to say this is enough for optimal health, but even a small amount can make a difference. When this number was increased up to multiple hours per day, the researchers observed that mortality steadily declined [2, 3], suggesting that, to a certain point, more movement is associated with better health.

The kind and intensity of activity also matter. Both muscle-strengthening and aerobic activities, such as walking, cycling, and running, are important, and including both in an exercise routine appears essential. Muscle strengthening is important because muscle loss is one of the most common conditions in older populations, increasing the risks of falls and fractures, frailty, disability, and loss of independence and quality of life.

One of the most striking statistics highlighting the importance of improving muscle strength was the comparison between the least- and most-active study participants. In this case, low muscular strength was associated with a roughly 200% increase in all-cause mortality risk compared with the high-strength group [4]. Similarly, another study showed that having “very low cardiorespiratory fitness is associated with a ~ 400% higher mortality risk compared with high cardiorespiratory fitness” [5]. In comparison, smoking is associated with a 50% increase in mortality risk [6]. Additionally, more vigorous activity yields a greater return on time invested in exercise than less vigorous activity does.

The author summarized that the evidence is clear: to achieve optimal health, “more is better: more variation, more time, and more intensity.” This is not reflected in the current government recommendations, which, the author believes, also lack sufficient explanation of the health benefits of exercise. Additionally, public messaging often links exercise to something that should be done by those who struggle with maintaining a healthy weight. Such framing overlooks the greater importance of exercise as an intervention whose primary goal is to improve health and help people stay more independent as they age. Health-focused framing presents exercise as a lifestyle choice that benefits everyone, regardless of their weight and age.

The protein gap

The author also believes that the UK’s protein intake recommendation is insufficient. It currently sits at 0.34 grams of protein per pound of body weight per day (g/lb/day), originally calculated as a minimum maintenance level for a sedentary person.

Higher protein intake is often associated with people engaging in physical exercise, especially resistance training, which makes sense as those people need it in higher amounts. Some research suggests that 1 g/lb/day of protein is associated with optimal health outcomes for people engaged in resistance training [7]. Of course, if someone followed this paper’s recommendation of more physical activity, that person would also need a higher protein intake for that reason.

However, the author also mentions other groups who have been found to benefit from higher protein intake, regardless of physical activity: the elderly and pregnant women. The elderly, due to their age, are prone to sarcopenia (loss of strength and function). One way to address it is to increase protein intake. Research has found improved muscle mass composition and function in elderly people who consume twice the UK’s recommended amount [8-10]. Doubling the UK’s recommended protein amount is also beneficial for fetal growth and is associated with better pregnancy outcomes [11-13]. Beyond those two groups, there are also benefits for a wider population, especially people struggling to maintain a healthy weight, as research suggests that high-protein diets might facilitate fat loss by increasing satiety.

Following the science

Given all this evidence, the author recommends that the government commission a review of exercise and protein intake guidelines and update them to reflect the most recent data for optimal health outcomes. However, he also recognized that there is a scarcity of reliable data in this field, and the available studies have many limitations, especially on nutrition, which often relies on self-reported data. Therefore, he calls for future studies that would include larger sample size and broader variation in doses.

Those changes should be followed by communication efforts to raise public awareness. Those messages should be communicated in a way that is easy for an average person to understand and implement, such as by using the recommended grams of protein per meal or by creating an easy-to-use calculator that aids meal composition to hit the target protein amount per meal.

Macdonald summarized the benefits behind the changes as follows: “High-intensity exercise and high-protein diets also empower the general population to extend their lifespan and healthspan. Therefore, it is less about having ‘abs’ and a ‘beach body’ and more about being able to lift up, play with, and even remember your grandchildren thanks to a strong and resilient body and mind.”

“When we see a stereotypical image of a hunched-over, slow, fragile person in ill health in their later years, it seems like an inevitable consequence of ‘Father Time.’ However, I propose that in most cases, it is evidence of a non-evidence-based lifestyle. In short, we should not be quick to normalize and accept the consequences of a largely sedentary lifestyle; we should proactively empower people to reclaim their health and their independence. The reduction in unnecessary suffering would be profound.”

Literature

[1] Macdonald C. (2026). Beyond the bare minimum: the case for revised physical activity guidelines and protein intake recommendations that maximise healthspan. Frontiers in nutrition, 13, 1853124.

[2] Wang, F., Wang, Y., Wang, K., Wu, S., Chen, Y., Li, Y., Chen, S., & Gao, X. (2025). Dose‒response relationship between physical activity and all-cause mortality in Chinese adults. Scientific reports, 15(1), 43359.

[3] Samitz, G., Egger, M., & Zwahlen, M. (2011). Domains of physical activity and all-cause mortality: systematic review and dose-response meta-analysis of cohort studies. International journal of epidemiology, 40(5), 1382–1400.

[4] García-Hermoso, A., Cavero-Redondo, I., Ramírez-Vélez, R., Ruiz, J. R., Ortega, F. B., Lee, D. C., & Martínez-Vizcaíno, V. (2018). Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women. Archives of physical medicine and rehabilitation, 99(10), 2100–2113.e5.

[5] Mandsager, K., Harb, S., Cremer, P., Phelan, D., Nissen, S. E., & Jaber, W. (2018). Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA network open, 1(6), e183605.

[6] Aune, D., Schlesinger, S., Norat, T., & Riboli, E. (2018). Tobacco smoking and the risk of sudden cardiac death: a systematic review and meta-analysis of prospective studies. European journal of epidemiology, 33(6), 509–521.

[7] Bosse, J. D., & Dixon, B. M. (2012). Dietary protein to maximize resistance training: a review and examination of protein spread and change theories. Journal of the International Society of Sports Nutrition, 9(1), 42.

[8] Ishaq, I., Noreen, S., Maduabuchi Aja, P., & Atoki, A. V. (2025). Role of protein intake in maintaining muscle mass composition among elderly females suffering from sarcopenia. Frontiers in nutrition, 12, 1547325.

[9] Wu, W., Chen, F., Ma, H., Lu, J., Zhang, Y., Zhou, H., Yang, Y., Nie, S., Wang, R., Yue, W., Li, M., & Yang, X. (2025). Dietary protein requirements of older adults with sarcopenia determined by the indicator amino acid oxidation technology. Frontiers in nutrition, 12, 1486482.

[10] Yuan, W., Ao, P., Ma, Y., Ma, Y., Song, J., Wei, S., & Yuan, L. (2025). Association between dietary intake of protein and amino acids and sarcopenia: a cross-sectional study. PloS one, 20(11), e0337095.

[11] Stephens, T. V., Payne, M., Ball, R. O., Pencharz, P. B., & Elango, R. (2015). Protein requirements of healthy pregnant women during early and late gestation are higher than current recommendations. The Journal of nutrition, 145(1), 73–78.

[12] Yang, J., Chang, Q., Tian, X., Zhang, B., Zeng, L., Yan, H., Dang, S., & Li, Y. H. (2022). Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein. Nutrition & metabolism, 19(1), 43.

[13] Kramer, M. S., & Kakuma, R. (2003). Energy and protein intake in pregnancy. The Cochrane database of systematic reviews, (4), CD000032.