What Is High-Intensity Incidental Physical Activity (HIIPA)?

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“I take the elevator 'going down,' but never use it 'going up'!” was the mantra of my hardy and spirited elderly upstairs neighbor (who lived on the 12th floor) of our “Stuy Town” apartment building in the East Village of Manhattan for what seemed like an eternity. Her name was Rose. Practically every time I bumped into Rose when the “going down” elevator stopped to pick me up on the third floor, she’d share some insights about her lifelong secrets to staying young at heart.

Rose knew I was a fitness enthusiast who spent a lot of time working out at our local gym and wrote The Athlete’s Way. Therefore, whenever we met face-to-face, she'd drive home the point that people could stay fit “incidentally” by making choices throughout the day that got their blood pumping.

Rose gave me detailed examples of her mindset and daily habits: “I hate working out inside a gym but make sure that I 'huff and puff' a few times every day ... I'd never take the crosstown “L” train to Union Square and make a habit of getting off the downtown Second Avenue bus at 23rd street instead of sitting to 14th street, so I can walk the 'long way' home ... I always use the subway stairs to get back up to street level and hike up twelve flights of stairs to my apartment at least once a day.”

My upstairs neighbor shared these anecdotal examples of her gym-free approach to getting regular exercise with the hope that I'd pass on her "sage advice" to readers. Full disclosure: I haven't dedicated a full post to the underappreciated benefits of "incidental" exercise until now.

Although I've always encouraged people to incorporate multiple forms of daily activity into their lives (e.g., biking to work), until now, I mistakenly undervalued Rose's timeless wisdom about the importance of seamlessly weaving incidental high-intensity exercise into your daily routine.

Years ago, when I regularly crossed paths with Rose, my prescriptive advice reflected the "old school" CDC exercise guidelines, which were updated last year (Piercy et al., 2018). These are the current Physical Activity Guidelines for Americans:

"Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week."

As a coach, I agree with the new guidelines. Ideally, adults should structure a weekly aerobic exercise regimen that includes an accumulation of 75-300 minutes of moderate-to-vigorous physical activity (MVPA)—these activities can be broken down into any increment of time (even if it's less than 10 minutes in duration)—along with at least two weekly high-intensity interval training (HIIT) sessions, and biweekly strength training.

Recently, a team of exercise physiologists and public health advocates got together and coined a new acronym called "HIIPA." This acronym serves as an umbrella term to describe any type of relatively intense physical exertion that occurs episodically as someone goes through the motions of daily life. HIIPA stands for "High-Intensity Incidental Physical Activity" and is precisely what my upstairs neighbor, Rose, advocated eons ago.

Last week, an editorial by an international consortium of authors, "Short and Sporadic Bouts in the 2018 US Physical Activity Guidelines: Is High-Intensity Incidental Physical Activity (HIIPA) the New HIIT?" was published in the British Journal of Sports Medicine.

A typical day of HIIPA activities would consist of 3 to 5 short (0.5–2.0 minute) sporadic bouts of relatively high-intensity physical activity (e.g., climbing stairs, walking briskly, shoveling snow) spread out across the entire day.

"Regular incidental activity that gets you huffing and puffing even for a few seconds has great promise for health," first author Emmanuel Stamatakis, who is a professor of Physical Activity, Lifestyle, and Population Health at the University of Sydney's Centre and School of Public Health, said in a statement.

The authors of this editorial posit that much like someone might perform a series of short bursts of high-intensity cardio-respiratory exertion followed by a period of recovery during a HIIT workout, cobbling together a handful of short bursts of high-intensity effort throughout the day can have similar psychological and physical health benefits.

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In their paper, the authors write, "Building a daily routine that incorporates brief, sporadic bouts of high-intensity incidental physical activity has numerous practical and health advantages. On top of ‘move as often as possible and sit less’ [1], public health and clinical practice could emphasize simple messages analogous to ‘huff and puff regularly.’"

What makes HIIPA unique as an exercise-related terminology is that it puts the spotlight on daily activities most of us living in a modern world—that is structured around convenience, getting somewhere quickly, and not breaking a sweat—tend to avoid automatically. For example, when given a simple choice to hop on the escalator or climb a long flight of stairs, most of us instinctively avoid “huffing and puffing” our way up the stairs.

This "path of least resistance" aspect of our human nature is exactly why it's important to raise awareness about the health benefits of consciously making daily choices that cause someone to get the blood pumping for a few seconds and tag these activities with an easy-to-remember acronym.

In a perfect world, we'd all have the time, motivation, resources, and physical ability to make a daily 30-60 minute MVPA aerobic workout a part of our routine. We'd also be sure that HIIT training was a part of our weekly exercise regimen. But none of us live in a perfect world, and sticking to this type of daily exercise routine is unrealistic and infeasible for many people.

That said, HIIPA offers tremendous bang for the buck and is readily accessible 24/7. HIIPA can easily become a part of most people's daily lifestyle choices. This is great news!

Remember: There are now three key acronyms you can use to describe different elements of your weekly aerobic exercise program: MVPA, HIIT, and HIIPA.

As always: Please use common sense and consult with your primary care physician before beginning any new physical activity or kickstarting a vigorous exercise regimen—especially if you have not done any high-intensity physical activity recently.