Metabolic

The Lancet: Experts call for urgent action to improve physical activity around the world

Not enough progress has been made to tackle physical inactivity around the world. Adolescents and people with disabilities (PLWD) are among the population groups least likely to receive the support they need to meet World Health Organization (WHO) guidelines for physical activity. Global efforts to improve physical activity have stalled, with the total number of physical activity deaths still exceeding 5 million people a year. [1]

Physical inactivity is linked to an increased risk of noncommunicable diseases (NCDs) such as heart disease, diabetes, and some cancers, and costs at least $ 54 billion annually in direct health costs, of which $ 31 billion is borne by the public sector. Slow progress in improving physical activity around the world has been exacerbated by the COVID-19 pandemic, with bans likely being linked to less overall physical activity around the world. Additionally, inactive people and those with NCDs are more likely to be hospitalized or die if they develop COVID-19.

These results come from a new three-part series published in The Lancet and published ahead of the 2020 Tokyo Olympics, Japan. The authors call for immediate and urgent action to prioritize research and public health efforts to improve physical activity around the world and ensure that physical activity is integrated into daily life.

Further progress needed to improve physical activity in adolescents (Paper 1)

Despite the growing number of young people diagnosed with noncommunicable diseases (NCDs), including cardiometabolic and mental disorders, the authors note that research into physical activity in adolescents is limited.

A global analysis shows that 80% of adolescents who go to school are not following WHO’s recommended guidelines of 60 minutes of physical activity per day, with little progress since 2012. In addition, 40% of teens never go to school and 25% do not sit for more than 3 hours a day in addition to sitting at school and doing homework.

The researchers also looked at the screen time of teens in 38 European countries and found that 60% of boys and 56% of girls spent two hours or more a day in front of the TV. In addition, 51% of boys and 33% of girls spent two or more hours a day playing video games. Little is known, however, about how this affects their cardiometabolic and mental health.

The article’s lead author, Dr. Esther van Sluijs of the University of Cambridge, UK, says: “We urgently need to investigate both the short and long-term effects of physical inactivity on adolescents and find effective ways to encourage increased physical activity”, particularly in light of the COVID-19 pandemic. Virtual schooling and social distancing have drastically reduced physical activity and increased screen usage, and the effects of these changes could last a lifetime. ” [2]

She adds, “Teenagers make up almost a quarter of the world’s population, and by making sure they grow up in a social and physical environment that encourages physical activity, we’re helping to change their health now, to improve their future health and have a positive impact on the health of the next generation. ” [2]

More needs to be done to strengthen the rights of people with disabilities to exercise (Paper 2)

Physical activity can provide a number of physical and mental health benefits to the 1.5 billion people worldwide who live with a physical, mental, sensory, or intellectual disability. However, researchers found that people with people with chronic illness were 16-62% less likely to adhere to physical activity guidelines and were at higher risk of serious inactivity-related health problems such as cardiovascular disease, diabetes, and obesity.

The proportion of adults with disabilities living in high-income countries who meet physical activity guidelines is between 21 and 60%, while the estimates for adults without disabilities are between 54 and 91%. The extent of physical activity inequalities in PLWD varies by type of disability and is greatest among people with multiple disabilities.

In addition, the researchers found that any amount of physical activity, even if it was less than the WHO recommended 150 minutes per week, benefited PLWD. Benefits included improvements in cardiovascular health, muscle strength, functional ability, and mental health.

The study’s authors call for physical activity action plans around the world to be adequately resourced, monitored and implemented to genuinely promote the fundamental rights of people with disabilities to fully participate in physical activity.

“Interest in disabled sports continues to grow and could be an important factor in promoting more self-determination, participation and inclusion for people with disabilities. But we also need more research focused on people with disabilities, as well as coherent, targeted measures and guidelines to ensure the rights of people with disabilities are upheld and enable full and effective participation in physical activity, “says Dr. Kathleen Martin Ginis of the University of British Columbia, Canada, and lead author of the article. [2]

The authors point out that 80% of people with disabilities live in low- and middle-income countries. However, in this review, virtually all of the available population data on physical activity of people with disabilities (PLWD) comes from high-income countries in North America and northwestern Europe, suggesting that more research on physical activity in PLWD on a global scale is urgently needed.

Olympics Must Leave a Lasting Legacy for Health (Paper 3)

Major sporting events, including the Olympic Games, provide an opportunity to promote physical activity among the world’s population – including young people and people with disabilities. However, study authors found that the Olympics in the host cities had minimal impact on physical activity and represented a missed opportunity to improve the health of the population.

Researchers found that there was no measurable change in participation in sports either immediately before or after the Olympics [figure 1]. This was true even after the 2001 Olympics launched the Global Impact Project, which suggested that cities should collect indicator data before and after the Olympics, particularly including legacy information on participation in popular sport. These results suggest that more planning and public health efforts are required to get more physical activity after the Olympics or other mass sports events.

“The Olympics and other mass sports events are a missed opportunity to transform health and physical activity at the population level, not just in the host city or country, but around the world. The Olympics provide a global stage to get people interested and excited about physical activity. “The challenge is to translate that enthusiasm into sustainable public health programs that are accessible and enjoyable to the general public,” says the lead author of the article , Prof. Adrian Bauman from the University of Sydney, Australia. [2]

The authors call for pre and post event planning and partnerships between local and national governments and the International Olympic Committee, as well as a thorough physical activity assessment framework for the host cities and countries to build a legacy that leads to increased physical activity and public health improved.

Physical activity: an essential human need beyond and independent of COVID-19.

In a linked editorial, Dr. Pam Das, Senior Executive Editor of The Lancet: “The pandemic is a powerful catalyst for advocating physical activity … Exercise during lockdown has been viewed by many governments around the world as an essential activity – physical activity has been seen to be as important as food, Accommodation and medical care. Early government campaigns during COVID-19 encouraged the public to go out and exercise. Then why can’t governments commit to promoting physical activity as an essential human need beyond and independently of COVID independent? -19?

“The sharp rise in public awareness of health provides an opportunity to focus on the benefits of health rather than dealing with disease. A goal should be to integrate physical activity into the way people lead their daily lives so that the physically active choices, which are often the healthier and greener ones, become the standard. Using public transport, active travel, compulsory physical education in schools, and extracurricular activities are some options. The pandemic has shown how easy it is to walk for 30 minutes.By advocating a level of physical activity that people can reasonably incorporate into their lives, such as walking, expectations can be met. If the bar is set too high, people will do nothing. But with reasonable goals, they can just move around. “

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Peer-reviewed / review / people

NOTES FOR EDITORS

This three-part series did not receive any direct funding. A full list of authors and institutions can be found in the papers.

The labels were added to this press release as part of an Academy of Medical Sciences project to improve evidence communication. Further information can be found at: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf If you have any questions or feedback, please contact The Lancet -Press office pressoffice@lancet.com

[1] The results come from the Lancet Physical Activity Series 2016 https://www.thelancet.com/series/physical-activity-2016

[2] Quote directly from the author and not in the text of the article.

[3] World Health Organization COVID-19 Dashboard https://covid19.who.int/

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