Encouraging physical activity
As London counts down to the 2012 Olympics, millions of us will spend the next few weeks watching elite athletes as they compete for gold from the comfort of our homes.
It is hoped, however, that the presence of the biggest sporting event in the world on our shores will encourage people to get off the sofa and take up sport, or even just to increase their daily levels of physical activity.
While the Olympics will undoubtedly attract people to new sports, it is far from clear that it will actually help in increasing levels of physical activity across England.
Instead, a population approach, incorporating government, education and town planning as well as health, is needed to encourage people to do more physical activity.
That's the message from a group of leading experts who have come together to write a series of papers on physical activity in The Lancet.
A new pandemic
They warn, for the first time, that the global impact of physical inactivity on the world's major non-communicable diseases, such as cancer and heart disease, is similar to that of smoking or obesity.
This means that the pandemic of physical inactivity now causes around 1 in 10 deaths worldwide.
A third of adults and 4 out of 5 adolescents are at high risk of disease from failing to do recommended amounts of physical activity.
The Department of Health currently recommends that under fives do at least 3 hours of physical activity a day, children and young people do 60 minutes and up to several hours every day of moderate to vigorous intensity physical activity, and adults and older people (65+) should do150mins - two and half hours - each week of moderate to vigorous intensity physical activity.
So what can be done to encourage people to meet these targets?
Harold Kohl, from the University of Texas Health School of Public Health and an author of one of the Lancet papers, believes that “much work needs to be done to address physical inactivity as a true public health issue”.
“Traditional public health approaches, where responsibility for change has resided with the health sector will not be sufficient.
“Physical inactivity is an issue that crosses many sectors and will require collaboration, coordination and communication with multiple partners,” he says.
Professor Gregory Heath from the University of Tennessee agrees and in his paper sets out to identify the most effective interventions to promote physical activity.
After analysing 100 reviews of clinical and community-based physical activity interventions published between 2001 and 2011, Professor Heath and colleagues identified a number of effective ways of promoting exercise in people of different ages, social groups, and countries worldwide.
The findings echo a number of recommendations from NICE to encourage physical activity, such as using decision prompts and signage to motivate people to use stairs instead of lifts.
This is recommended in NICE's guidance on promoting physical activity in the workplace which also suggests that employees are encouraged to walk, cycle or use other modes of transport involving physical activity to travel to and from work and as part of their working day.
Professor Heath's study recommends creating environments conducive to walking or biking, improving access to sport and recreational activities, as well as shaping polices for community and neighborhood design, land use and travel choice.
NICE has been championing this since January 2008 when it published guidance on physical activity and the environment.
Professor Heath concludes: “Overall, our findings showed the interventions to have consistent and significant effects on physical activity behaviours. Even though in some instances the effect sizes of these interventions were rather modest, they were large enough to translate into real population-level benefits if rolled out on a larger scale.”
NICE local government briefings
So this latest study shows that following NICE's advice can help to increase levels of physical activity in the population by building exercise into daily routines.
But putting this guidance into practice is easier said than done. NICE understands this and will publish a local government briefing on physical activity next week.
The briefing is based on 10 pieces of NICE guidance published up to July 2012 about physical activity, and was written with advice from NICE's Local Government Reference Group, and using feedback from council officers and elected members.
It will offer local government advice on key issues including; incorporate walking, cycling and other modes of active travel into the development or maintenance of roads, creating cycle paths, particularly in urban areas, providing green spaces and play areas that stimulate children and safely challenge them, designing new developments to encourage physical activity, and introducing work-based physical activity programmes.
Encouraging local government to adopt these recommendations could be key to combating the pandemic of physical inactivity and creating a positive Olympic legacy for future generations.
18 July 2012