1. Physical Activity: the best route to population health
Ashley Cooper

2. Outline What is physical activity?
A brief history of physical activity and health
Two possible approaches to improving health

3. Physical inactivity is the fourth leading cause of death worldwide
The pandemic of physical inactivity should be a public health priority

4. What is Physical Activity?

5. Physical activity is….. Exercise is….. Fitness is…..
Any bodily movement produced by skeletal muscles that results in energy expenditure
Exercise is…..
Planned, structured and repetitive bodily movement done to improve or maintain physical fitness
Fitness is…..
The ability of circulation and respiration to supply oxygen during sustained physical activity

6. A Brief History of Physical Activity and Health

7. Occupational physical activity and heart attacks
Jerry Morris – compared heart attack incidence in drivers vs conductors
Morris et al (1953) "Coronary heart-disease and physical activity of work". Lancet 265 (6795): 1053–7

8. The Harvard Alumni Study
16,936 men who entered Harvard University between
Questionnaires: specific physician diagnosed disease; socio-demographic characteristics including physical activity
1962/66
Baseline
1977
Follow-up 1
1985
Follow-up 2

9. Physical activity measures
Flights of stairs climbed (1 flight = 70 stairs = 28 kcal)
City blocks walked (6 blocks = 0.5 miles = 50 kcal)
Type and amount of sport (light 5 kcal/min; vigorous 10 kcal/min; mixed 7.5 kcal/min)
Physical activity index computed as an indicator of energy expenditure

10. Harvard alumni: physical activity and all-cause mortality
A relatively small increase in energy expenditure (equivalent to approx 30 minutes of walking per day) is associated with ~30% reduced risk of early death
Paffenbarger et al (1986, 1993)

11. MVPA and prevention of chronic disease

12. UK activity guidelines (2011)

13. Physical activity in the UK
Inactive population
35% of men and 45% of women do not meet physical activity guidelines
Only 21% of boys and 16% of girls aged 5-15 meet guidelines for youth
People in the least prosperous areas are twice as likely to be inactive than those in the most prosperous
Disabled people are half as likely to be active compared to non-disabled people

14. Health impact of physical inactivity in the UK (BHF 2013)
10.5% of CHD cases
18.7% of colon cancer cases
17.9% of breast cancer cases
13.0% of type 2 diabetes cases
16.9%of premature all-cause mortality

15. Cost of physical inactivity in the UK
2009/10 estimated cost to PCTs in England >£940 million
Reducing physical inactivity by just one per cent a year over a five-year period would save the UK economy just under £1.2bn (UK Active 2014)
“If every local authority was able to reduce inactivity levels by 1% each year over five-years, they would save local taxpayers £44 per household” (UK Active 2014)
(£17,000 a minute)

16. Possible Approaches to Improving Health: Reducing Sedentary Behaviour

17. The new science of sedentary behaviour
Research over the past 30 years has focussed on establishing the association between MVPA and health
Sedentary behaviours (e.g. sitting in a car, watching TV, using the computer) are ubiquitous
Up to 60% of adult waking time is spent in sedentary behaviours

18. Sitting time and all-cause mortality
17,013 Canadians, 18-90yrs; 12 year follow up; 1,823 deaths
Daily sitting time (5 categories) and leisure time physical activity assessed at baseline
Higher risk of mortality across higher levels of sitting time from all-causes and CVD
Katzmarzyk (2009) MSSE 41:

19. Possible Approaches to Improving Health: Increasing Walking by Active Travel

20. Contribution of walking to work to daily physical activity
Measure
Car
Walk p
MVPA (mins/day)
50 (25)
79 (24)
<0.001
Sed (mins/day)
599 (61)
580 (76)
0.206
Audrey et al (2014). IJBNPA 11:37

21. Physical activity and the school journey
Children who walk to school are more active than car travellers
Walking to school contributes about one-third of adolescent MVPA
Adoption of car travel to school reduces daily MVPA

22. Summary
There is a huge amount of evidence showing the health impacts of physical activity/inactivity
There are major health and societal gains from increasing population levels of physical activity, even by a small amount
There is strong evidence to support active travel for all, and outdoors play for children, as important approaches to increasing physical activity

23. Thank you! Outdoors & Active:
Delivering public health outcomes by increasing
Children’s outdoor play and active travel
Thank you!