Tuesday, 4 August 2015

Initial Research


Physical activity
Fact sheet N°385
Updated January 2015


Key facts
·        Insufficient physical activity is 1 of the 10 leading risk factors for death worldwide.
·        Insufficient physical activity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.
·        Physical activity has significant health benefits and contributes to prevent NCDs.
·        Globally, 1 in 4 adults is not active enough.
·        More than 80% of the world's adolescent population is insufficiently physically active.
·        Policies to address insufficient physical activity are operational in 56% of WHO Member States.
·        WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.


What is physical activity?
WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits.
The term "physical activity" should not be confused with "exercise", which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Both, moderate and vigorous intensity physical activity brings health benefits.


How much of physical activity is recommended?
WHO recommends:
Children and adolescents aged 5-17years
·        Should do at least 60 minutes of moderate to vigorous-intensity physical activity daily.
·        Physical activity of amounts greater than 60 minutes daily will provide additional health benefits.
·        Should include activities that strengthen muscle and bone, at least 3 times per week.

Adults aged 18–64 years
·        Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
·        For additional health benefits, adults should increase their moderate-intensity physical activity to 300 minutes per week, or equivalent.
·        Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

Adults aged 65 years and above
·        Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
·        For additional health benefits, they should increase moderate intensity physical activity to 300 minutes per week, or equivalent.
·        Those with poor mobility should perform physical activity to enhance balance and prevent falls, 3 or more days per week.
·        Muscle-strengthening activities should be done involving major muscle groups, 2 or more days a week.
The intensity of different forms of physical activity varies between people. In order to be beneficial for cardiorespiratory health, all activity should be performed in bouts of at least 10 minutes duration.


Benefits of physical activity and risk of insufficient physical activity
Regular physical activity of moderate intensity – such as walking, cycling, or doing sports – has significant benefits for health. At all ages, the benefits of being physically active outweigh potential harm, for example through accidents. Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can quite easily achieve the recommended activity levels.
Regular and adequate levels of physical activity:

·        improve muscular and cardiorespiratory fitness;
·        improve bone and functional health;
·        reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer and depression;
·        reduce the risk of falls as well as hip or vertebral fractures; and
·        are fundamental to energy balance and weight control.

Insufficient physical activity is 1 of the 10 leading risk factors for global mortality and is on the rise in many countries, adding to the burden of NCDs and affecting general health worldwide. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active.


Levels of insufficient physical activity
Globally, around 23% of adults aged 18 and over were not active enough in 2010 (men 20% and women 27%). In high-income countries, 26% of men and 35% of women were insufficiently physically active, as compared to 12% of men and 24% of women in low-income countries. Low or decreasing physical activity levels often correspond with a high or rising gross national product. The drop in physical activity is partly due to inaction during leisure time and sedentary behaviour on the job and at home. Likewise, an increase in the use of "passive" modes of transportation also contributes to insufficient physical activity.
Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in 2010. Adolescent girls were less active than adolescent boys, with 84% vs. 78% not meeting WHO recommendations.
Several environmental factors which are linked to urbanization can discourage people from becoming more active, such as:

·        fear of violence and crime in outdoor areas
·        high-density traffic
·        low air quality, pollution
·        lack of parks, sidewalks and sports/recreation facilities.


How to increase physical activity?
Both, society in general and individuals can take action to increase physical activity. In 2013, WHO Member States agreed to a target of reducing insufficient physical activity by 10% by 2025 and included strategies to achieve such in the "Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020".

Policies to increase physical activity aim to ensure that:
·        in cooperation with relevant sectors physical activity is promoted through activities of daily living;
·        walking, cycling and other forms of active transportation are accessible and safe for all;
·        labour and workplace policies encourage physical activity;
·        schools have safe spaces and facilities for students to spend their free time actively;
·        quality physical education supports children to develop behaviour patterns that will keep them physically active throughout their lives; and
·        sports and recreation facilities provide opportunities for everyone to do sports.

Policies and plans to address physical inactivity have been developed in about 80% of WHO Member States, though these were operational in only 56% of the countries in 2013. National and local authorities are also adopting policies in a range of sectors to promote and facilitate physical activity.


Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical inactivity (lack of physical activity) has been identified as the fourth leading risk factor for global mortality (6% of deaths globally). Moreover, physical inactivity is estimated to be the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and approximately 30% of ischaemic heart disease burden.

Regular and adequate levels of physical activity in adults:
·        reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer, depression and the risk of falls;
·        improve bone and functional health; and
·        are a key determinant of energy expenditure, and thus fundamental to energy balance and weight control.

The term "physical activity" should not be mistaken with "exercise". Exercise, is a subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective. Physical activity includes exercise as well as other activities which involve bodily movement and are done as part of playing, working, active transportation, house chores and recreational activities.
Increasing physical activity is a societal, not just an individual problem. Therefore it demands a population-based, multi-sectoral, multi-disciplinary, and culturally relevant approach.



Physical Inactivity: A Global Public Health Problem
Physical inactivity
Globally, around 31% of adults aged 15 and over were insufficiently active in 2008 (men 28% and women 34%). Approximately 3.2 million deaths each year are attributable to insufficient physical activity.
In 2008, prevalence of insufficient physical activity was highest in the WHO Region of the Americas and the Eastern Mediterranean Region. In both these regions, almost 50% of women were insufficiently active, while the prevalence for men was 40% in the Americas and 36% in Eastern Mediterranean. The South East Asian Region showed the lowest percentages (15% for men and 19% for women). In all WHO Regions, men were more active than women, with the biggest difference in prevalence between the two sexes in Eastern Mediterranean. This was also the case in nearly every country.


Reasons for physical inactivity
The current levels of physical inactivity are partly due to insufficient participation in physical activity during leisure time and an increase in sedentary behaviour during occupational and domestic activities. Likewise, an increase in the use of "passive" modes of transport has also been associated with declining physical activity levels.
Increased urbanization has resulted in several environmental factors which may discourage participation in physical activity such as:

·        violence
·        high-density traffic
·        low air quality, pollution
·        lack of parks, sidewalks and sports/recreation facilities.

Population-based, multi-sectoral, multi-disciplinary, and culturally relevant policies need to be implemented to increase physical activity levels globally.
The WHO Member States in WHA 66.10 have agreed on a voluntary global NCD target for a reduction of 10% in physical inactivity by 2025.

http://www.who.int/features/factfiles/physical_activity/en/

Physical inactivity is the fourth leading risk factor for global mortality

Globally, 6% of deaths are attributed to physical inactivity. This follows high blood pressure (13%), tobacco use (9%) and is equal to high blood glucose (6%).
Moreover, physical inactivity is the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and 30% of ischaemic heart disease burden.
Regular physical activity helps to maintain a healthy body
Physically active persons:
  • improve their muscular and cardio-respiratory fitness;
  • improve their bone and functional health;
  • have lower rates of: coronary heart disease, high blood pressure, stroke, diabetes, colon and breast cancer, and depression;
  • have a lower risk of falling and of hip or vertebral fractures;
  • are more likely to maintain their weight.

Physical activity should not be mistaken for sport

Physical activity is any bodily movement produced by the skeletal muscles that uses energy. This includes sports, exercise and other activities such as playing, walking, doing household chores, gardening, and dancing.

Both moderate and vigorous intensity physical activity bring health benefits

Intensity refers to the rate at which the activity is being performed. It can be thought of as "how hard a person works to do the activity".
The intensity of different forms of physical activity varies between people. Depending on an individual's relative level of fitness, examples of moderate physical activity could include: brisk walking, dancing or household chores. Examples of vigorous physical activity could be: running, fast cycling, fast swimming or moving heavy loads.

5-17 years old

People aged 5–17 should accumulate at least 60 minutes of moderate to vigorous physical activity daily. Amounts of physical activity greater than 60 minutes provide additional health benefits.

18-64 years old

Adults aged 18–64 should do at least 150 minutes of moderately intense physical activity throughout the week or at least 75 minutes of vigorous activity throughout the week or an equivalent combination of moderate and vigorous activity. In order to be beneficial for cardio-respiratory health, all activity should be performed in bouts of at least 10 minutes duration.

Adults aged 65 and above

The main recommendations for adults and older adults are the same. In addition, older adults with poor mobility should do physical activity to enhance balance and prevent falls 3 or more days per week. When older adults cannot do the recommended amount of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

These recommendations are relevant to all healthy adults

Unless specific medical conditions indicate the contrary, these recommendations apply to all people, irrespective of gender, race, ethnicity or income level. They also apply to individuals with chronic noncommunicable conditions, not related to mobility, such as hypertension or diabetes. These recommendations can be valid for adults with disabilities as well.

Doing some physical activity is better than doing none

Inactive people should start with small amounts of physical activity and gradually increase duration, frequency and intensity over time. Inactive adults, older adults and those with disease limitations will have added health benefits when they become more active.
Pregnant, postpartum women and persons with cardiac events may need to take extra precautions and seek medical advice before striving to achieve the recommended levels of physical activity.
Supportive environments and communities may help people to be more physically active
Urban and environmental policies can have huge potential to increase the physical activity levels in the population. Examples of these policies include ensuring that:
  • walking, cycling and other forms of active transportation are accessible and safe for all;
  • labour and workplace policies encourage physical activity;
  • schools have safe spaces and facilities for students to spend their free time actively;
  • sports and recreation facilities provide opportunities for everyone to be physically active.

Physical Activity and Adults
Recommended levels of physical activity for adults aged 18 - 64 years
In adults aged 18–64, physical activity includes leisure time physical activity (for example: walking, dancing, gardening, hiking, swimming), transportation (e.g. walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities. In order to improve cardiorespiratory and muscular fitness, bone health, reduce the risk of NCDs and depression:

1.      Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
2.      Aerobic activity should be performed in bouts of at least 10 minutes duration.
3.      For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.
4.      Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.
For further information click below and download the complete document "Global Recommendations on Physical Activity for Health" available in:


Physical activity for all
These recommendations are relevant to all healthy adults aged 18–64 years unless specific medical conditions indicate to the contrary. They are applicable for all adults irrespective of gender, race, ethnicity or income level. They also apply to individuals in this age range with chronic noncommunicable conditions not related to mobility such as hypertension or diabetes.
These recommendations can be valid for adults with disabilities. However adjustments for each individual based on their exercise capacity and specific health risks or limitations may be needed.
There are multiple ways of accumulating the total of 150 minutes per week. The concept of accumulation refers to meeting the goal of 150 minutes per week by performing activities in multiple shorter bouts, of at least 10 minutes each, spread throughout the week then adding together the time spent during each of these bouts: e.g. 30 minutes of moderate-intensity activity 5 times per week.
Pregnant, postpartum women and persons with cardiac events may need to take extra precautions and seek medical advice before striving to achieve the recommended levels of physical activity for this age group.
Inactive adults or adults with disease limitations will have added health benefits if moving from the category of “no activity” to “some levels” of activity. Adults who currently do not meet the recommendations for physical activity should aim to increase duration, frequency and finally intensity as a target to achieving them.


Benefits of physical activity for adults
Overall, strong evidence demonstrates that compared to less active adult men and women, individuals who are more active:

·        have lower rates of all-cause mortality, coronary heart disease, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, colon and breast cancer, and depression;
·        are likely to have less risk of a hip or vertebral fracture;
·        exhibit a higher level of cardiorespiratory and muscular fitness; and
·        are more likely to achieve weight maintenance, have a healthier body mass and composition.


Recommended levels of physical activity for children aged 5 - 17 years
For children and young people, physical activity includes play, games, sports, transportation, chores, recreation, physical education, or planned exercise, in the context of family, school, and community activities.
In order to improve cardiorespiratory and muscular fitness, bone health, and cardiovascular and metabolic health biomarkers:
1.      Children and youth aged 5–17 should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.
2.      Amounts of physical activity greater than 60 minutes provide additional health benefits.
3.      Most of the daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone*, at least 3 times per week.


Benefits of Physical Activity for Young People
Appropriate practice of physical activity assists young people to:
·        develop healthy musculoskeletal tissues (i.e. bones, muscles and joints);
·        develop a healthy cardiovascular system (i.e. heart and lungs);
·        develop neuromuscular awareness (i.e. coordination and movement control);
·        maintain a healthy body weight.
Physical activity has also been associated with psychological benefits in young people by improving their control over symptoms of anxiety and depression. Similarly, participation in physical activity can assist in the social development of young people by providing opportunities for self-expression, building self-confidence, social interaction and integration. It has also been suggested that physically active young people more readily adopt other healthy behaviours (e.g. avoidance of tobacco, alcohol and drug use) and demonstrate higher academic performance at school.



Recommended levels of physical activity for adults aged 65 and above

In adults aged 65 years and above, physical activity includes leisure time physical activity (for example: walking, dancing, gardening, hiking, swimming), transportation (e.g. walking or cycling), occupational (if the individual is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone and functional health, reduce the risk of NCDs, depression and cognitive decline:

1.      Older adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
2.      Aerobic activity should be performed in bouts of at least 10 minutes duration.
3.      For additional health benefits, older adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and vigorous-intensity activity.
4.      Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week.
5.      Muscle-strengthening activities, involving major muscle groups, should be done on 2 or more days a week.
6.      When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

Benefits of physical activity for older adults

Overall, strong evidence demonstrates that compared to less active men and women, older adults who are physically active:
·        have lower rates of all-cause mortality, coronary heart disease, high blood pressure, stroke, type 2 diabetes, colon cancer and breast cancer, a higher level of cardiorespiratory and muscular fitness, healthier body mass and composition;
·        have a biomarker profile that is more favourable for the prevention of cardiovascular disease, type 2 diabetes and the enhancement of bone health; and
·        exhibit higher levels of functional health, a lower risk of falling, and better cognitive function; have reduced risk of moderate and severe functional limitations and role limitations.

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/e/exercise-mental-health/

 

Getting started

 - Make time

·        Work out what time you have available
·        Choose something that fits into your busy schedule
·        Alternatively, re-jig commitments to make room for some physical activity

- Be practical

·        Will you need support from friends and family?
·        Will your active lifestyle have an impact on others in your life?
·        Are there any costs involved, if so, what you can do to make it affordable?

- Which activity works for you?

·        Is there a particular part of your body you want to exercise?
·        Do you need to be more physically active at home? 
·        Do you want a change of scene? 
·        Would you like a structured activity that someone else has organised?



Making exercise part of daily life

Adopting a more active lifestyle can be as simple as listening to motivational music while doing the housework, or making small changes to your routine. Here are a few suggestions:

- At home

·        Walk the children or grandchildren to school, then jog home
·        Push the mower with extra vigour
·        Get an exercise DVD – and use it!
·        Speed up the housework – vac harder and faster till you’re warm
·        Put on some music for a ten minute dance
·        Apply some real elbow grease when cleaning the car
·        When you do get a break, go for a swim

- At work

·        Start walking to and from the train station - time it - then go faster
·        Use the stairs for journeys less than four floors up
·        Don’t pick up the phone, walk to see a colleague
·        Take a brisk walk, do an exercise class or go for a swim during your lunch break
·        Take a longer walk or cycle route home and discover new areas
·        Stop at the gym on your way home 

- Out and about

·        Leave the car at home for short journeys
·        Get off the bus a stop earlier, or get on a stop later
·        Park at the far end of the supermarket car park, or walk to the shops
·        Join in with your children’s/grandchildren’s games – be part of the football team
·        Jog and walk the dog – jog ten paces, then walk ten.
·        Join an exercise class at your community centre and meet your neighbours




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