Walking and cycling should become the norm for short journeys and should be encouraged throughout local communities says NICE, in new guidance published today (28 November). Local authorities, schools and workplaces should introduce ways to enable their communities to be more physically active and change their behaviours.

Regular physical activity is crucial to achieving and maintaining a healthy lifestyle. It can help to reduce the risk of coronary heart disease, stroke and type 2 diabetes by up to 50%ⁱ, and is also important for good mental health.

At present, we are not active enough as a nation - around two-thirds (61%) of men and nearly three-quarters (71%) of women aged 16 and over are not physically active enoughⁱⁱ. Just over half of boys aged two to 10 years old and a third of girls in the same age group achieve the recommended level of daily physical activity. Physical inactivity is the fourth leading risk factor for global mortality (accounting for 6% of deaths globally)ⁱⁱⁱ.

Walking is the most common recreational and sporting activity undertaken by adults in Britain, with cycling the fourth most common^iv. The majority (85.8%) of adults claim that they can ride a bicycle, yet the average time spent travelling on foot or by bicycle has decreased; from 12.9 minutes per day in 1995/97 to 11 minutes per day in 2007^v. Cycle use is lower in Britain than it is in other European Union countries; bicycles are used in around 2% of journeys in Britain compared with about 26% of journeys in the Netherlands, 19% in Denmark and 5% in France^vi.

This is the first time that NICE has published guidance for organisations and institutions, such as schools, workplaces and local authorities that have a responsibility or influence over local communities, to encourage them to promote physical activity specifically through walking and cycling. NICE recommends coordinated action to identify and address the barriers that may be discouraging people from walking and cycling more often or at all. These include:

• Implement town-wide programmes to promote cycling for both transport and recreational purposes. These could include cycle hire schemes, car-free events or days, providing information such as maps and route signing, activities and campaigns that emphasise the benefits of cycling, fun rides, and others.
• Ensure walking routes are integrated with accessible public transport links to support longer journeys. Signage should give details of the distance and/or walking time, in both directions, between public transport facilities and key destinations.
• Develop and implement school travel plans that encourage children to walk or cycle all or part of the way to school, including children with limited mobility. Pupils should be involved in the development and implementation of these plans.
• Ensure walking and cycling are considered alongside other interventions, when working to achieve specific health outcomes in relation to the local population (such as a reduction in the risk of cardiovascular disease, cancer, obesity and diabetes, or the promotion of mental wellbeing).

The guidance emphasises that encouraging and enabling people to walk or cycle requires action on many fronts, and from a range of different sectors. An integrated approach is needed to achieve the potential public health benefits.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE said: “As a nation, we are not physically active enough and this can contribute to a wide range of health problems. It is important that there is comprehensive, evidence-based guidance in place that can help address these issues. We want to encourage and enable people to walk and cycle more and weave these forms of travel into everyday life. This guidance is aimed at making it easier for people to do this, as well as explaining the benefits and helping to address some of the safety fears that some people may have.”

Local Transport Minister Norman Baker said: “I welcome NICE's guidance on walking and cycling and its recognition that encouraging more people to travel actively is a great way to improve public health. From April, the responsibility for public health will return to local authorities and we want transport, planning and health professionals to work together to help people change the way they travel.

“We want to see more people walking and cycling and this new guidance will play a valuable role in making sure that the funding we are providing translates into local measures that help more people to get more active.”

Dr Harry Rutter, Chair of the Programme Development Group and Strategic and Scientific Advisor to the National Obesity Observatory said: “We face a wide range of problems in England's towns and cities; most people do not get enough physical activity, our roads are congested and polluted, and we need to reduce our carbon emissions. This guidance addresses ways to increase walking and cycling for transport and recreation. If implemented, it has the potential to improve the quality of life for large numbers of people, now and in the future.”

Professor Nanette Mutrie, PDG member and Chair of Physical Activity for Health at the University of Edinburgh said: “We are currently facing a glut of physical inactivity in England, so this guidance is very timely. It provides practical recommendations on incorporating walking and cycling into people's lives. The guidance focuses on a range of options that can collectively make it easier for people to travel by foot or by bike.”

Mr Ralph Bagge, PDG community member and management consultant said: “We all lead such busy lives these days, it's often hard to find the time to exercise as much as we would like. This new guidance focuses on community-level activities to help people to overcome these barriers by promoting walking and cycling as forms of travel or recreation. The answer is on your doorstep - if you have a coat and shoes, you can be active!”

Philip Insall, Director of Health for Sustrans said: “Inactive lifestyles are now causing as many early deaths as smoking - if a virus was this deadly it would fill the front pages and dominate debates in parliament.

“Walking and cycling are among the easiest ways to get active but many people are understandably put off by traffic, safety fears and lack of experience.

“It is now critical to make our roads safer and help everyone to feel confident on a bike or on foot. We need government and local authorities to implement these recommendations immediately to improve people's lives now and save the NHS billions in the long run.”

Ends

Notes to Editors

References

i. The British Heart Foundation.

ii. Craig R, Mindell J, Hirani V (2009). Health survey for England 2008. London: The Health and Social Care Information Centre.

iii. Chief Medical Officers of England, Scotland, Wales and Northern Ireland (2011) Start active, stay active: a report on physical activity from the four home countries´ Chief Medical Officers.

iv. Swimming is the second most common recreational and sporting activity undertaken by adults in Britain, with keep-fit the third most common. Sport and leisure module of the 2002 General Household Survey.

v. Department for Transport, 2010.

vi. Ministry of Transport, Public Works and Water Management, The Netherlands, 2009

About the guidance

1. The guidance will be available on the NICE website from Wednesday 28 November.
2. Although NICE public health guidance is not statutory, the NHS, local authorities and the wider public, private, voluntary and community sectors are expected to follow it.
3. Adults (19-64 years) should be doing at least 150 minutes of moderate intensity activity over the week, in bouts of 10 minutes or more. Activities could include brisk walking or cycling. Older adults (65 years +) should aim to be active daily. Over a week, activity should add up to at least 150 minutes of moderate intensity activity in bouts of ten minutes or more. Children and young people (5-18 years) should engage in moderate to vigorous intensity physical activity for at least 60 minutes and up to several hours every day. (Department of Health, July 2011).The full UK physical activity guidelines can be found on the DH website.

About NICE

1. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

2. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

3. NICE produces standards for patient care:

• quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients.

4. NICEprovides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.