Conclusions of the Physical Activity Working Group

Dr Godfrey Xuereb Team Leader Population-based Prevention Department of Chronic Diseases and Health Promotion [email protected]

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Physical inactivity - 4 th leading risk factor for global mortality

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1.5 billion adults

are insufficiently active

Percentage of insufficient physical activity comparable country estimates, 2008

Age standardized; by WHO Region and World Bank income group, men and women Source: Global Status Report on NCDs, WHO, 2001 3 |

Prevalence of insufficient physical activity*, ages 15+ age standardized Males, 2008

Source: Global Status Report on NCDs, WHO, 2001 4 |

Prevalence of insufficient physical activity*, ages 15+ age standardized Females, 2008

Source: Global Status Report on NCDs, WHO, 2001 5 |

Being inactive costs the country and the individual • New study* just released on the health care costs of physical inactivity in Canadian adults shows that the estimated direct, indirect and total health care costs in 2009 were: Direct: 2.4 billion C$ (3.8% of overall health care costs) Indirect: 4.3 billion C$ Total Costs: 6.8 billion C$ (3.7% of overall health care costs) • Other studies** have shown that 19% of the coronary artery disease cases in Canadian men are due to physical inactivity * Janssen, 2012, Appl. Physiol. Nutr. Metab.

** Katzmarzyk and Janssen, 2004 Can.J. Appl. Physiol.

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Global recommendations on PA for Health • • • 5-17 yrs old • At least 60 minutes of moderate to vigorous intensity PA daily. +18 yrs old: • At least 150 minutes of moderate-intensity aerobic PA spread throughout the week or • At least 75 minutes of vigorous-intensity aerobic PA spread throughout the week or an equivalent combination. 65yrs old & above: • Should perform PA to enhance balance and prevent falls on 3 or more days/ week. • When they cannot do the recommended amounts of PA due to health conditions, they should be as physically active as their abilities and conditions allow.

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National strategies on diet and physical activity

 Multisectoral collaboration:  Coordinating mechanism headed or chaired by ministry of health.  Multisectoral collaboration containing representation from all key sectors.

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Recommended actions for Member States

1. Primary Care Settings

 Primary care settings involve, in one way or another, primary care professionals providing advice and direction on physical activity to patients.  The effective interventions include providing patients with advice and counselling on physical activity and access to, or provision of, additional resources (e.g., health education, group activities, local community links) with the aim to increase physical activity.

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Recommended actions for Member States

 Potential barriers to implementation include:  insufficient knowledge and training on physical activity in primary health care professionals;  insufficient staff to integrate physical activity counseling into the routine practice in busy primary care settings without sufficient resources;  limited provision of and access to community based facilities or programs on physical activity and limited resources and capacity to deliver the ongoing patient support in person, by phone, email or other communication methods.

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Recommended actions for Member States

2. Mass Media Campaigns

 There is strong evidence that mass media campaigns that aim to raise community awareness, inform and change attitudes towards being active are effective.  One major barrier to these interventions is the cost component of developing and executing campaigns in the most popular media at the most popular coverage time.

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"Best buys" interventions to address NCDs

Population based interventions addressing NCD risk factors

Tobacco use Harmful use of alcohol Unhealthy diet and physical inactivity

Individual based interventions addressing NCDs in primary care

Cancer Cardiovascular disease and diabetes    Excise tax increases Smoke-free indoor workplaces and public places Health information and warnings about tobacco Bans on advertising and promotion Excise tax increases on alcoholic beverages Comprehensive restrictions and bans on alcohol marketing Restrictions on the availability of retailed alcohol Salt reduction through mass media campaigns and reduced salt content in processed foods Replacement of trans-fats with polyunsaturated fats Public awareness programme about diet and physical activity Prevention of liver cancer through hepatitis B immunization Prevention of cervical cancer through screening (visual inspection with acetic acid [VIA]) and treatment of pre cancerous lesions Multi-drug therapy (including glycaemic control for diabetes mellitus) for individuals who have had a heart attack or stroke, and to persons at high risk (> 30%) of a cardiovascular event within 10 years Providing aspirin to people having an acute heart attack

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 Interventions include changes to the school curriculum to increase PE classes, printed education materials, modified PE and or additional physical activity sessions, after school activities based within the school context and travel to school.   Increasing physical activity through strategies aimed at ‘active school transport’ (AST), which includes walking and cycling to school are becoming more popular. Safe Routes to School interventions need to have the involvement of teachers, parents and the community, as well as safety, environmental, and structural improvements, such as sidewalk and signage enhancements.

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14 | CARICOM supports Physical Education Standards for all Caribbean States – Feb 2011, Port of Spain.

Recommended actions for Member States

 Improve sports, recreation and leisure facilities

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Recommended actions for Member States

 Increase the number of safe spaces available for active play

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Recommended actions for Member States

4, Active Transport

 Introduce transport policies that promote active and safe methods of travelling to and from schools, such as walking or cycling;  Ensure that walking, cycling and other forms of physical activity are accessible to and safe for all;

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Recommended actions for Member States

 Barriers include the necessary supportive infrastructure (e.g. bike lanes, cycle tracks, bike boxes, traffic signals, parking and storage) and either existing or improvements being made simultaneously as part of a more comprehensive approach to cycling promotion.

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Recommended actions for Member States

Urban Planning 19 |

The Floor is Yours !

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http://www.who.int/dietphysicalactivity/en/