Non-communicable diseases (NCDs), like cancer, cardiovascular disease, chronic respiratory disease and diabetes, are a serious public health crisis the world over.
Their increasing prevalence is partly blamed on ageing, rapid urbanisation, globalisation and industrialisation, all of which result in changes in dietary patterns, increased alcohol intake, tobacco use and little physical activity.
The NCD burden is likely to rise sharply in the coming years unless immediate and appropriate action is taken to address the risk factors.
And should the trend of the increased burden of NCDs and infectious diseases such as malaria, HIV and tuberculosis (TB) persist, Kenya’s health systems will be strained.
Physical inactivity is a major risk factor for NCDs. Though vital for good health and well-being, physical activities such as walking, jogging and running are normally overlooked.
Those leading a sedentary lifestyle need to make regular physical activity part of their daily routine.
With physical inactivity the fourth leading risk factor for death, the World Health Organisation (WHO) recommends doses of physical activity for various age groups.
For children and youth aged five to17 years, physical activity includes play, sports, walking, running and planned exercise (PE) in the context of family, school and community activities.
They should accumulate at least 60 minutes of moderate to vigorous-intensity physical activity per day, preferably daily.
For the 18-64-year age group, exercise includes walking, jogging, cycling, occupational activities, household chores, sports and PE of at least 150 minutes of moderate-intensity activity throughout the week.
For those aged 65 and above, it includes walking, cycling, jogging, household chores, sports or planned exercise. They should do at least 150 minutes of moderate-intensity physical activity throughout the week.
All need to make physical activity part and parcel of daily routine at home, school, work or in the community.
Children and youth should be encouraged and supported in making physical activity choices that are convenient, sustainable, and compatible with their needs, abilities and interests.
Healthy active living needs to be as high a priority as going for treatment; prevention is better than cure.
There is also a need to enhance the built environment to support the integration of physical activity into daily life. Let us get everyone to move more, eat enough and sit less.
Physical activity and exercise have a major role in achieving the ‘Big Four’, especially UHC, and the Competency-Based Curriculum (CBC), particularly the arts and sports pathway.
Q: What is physical activity?
Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity includes exercise, as well as other activities which involve bodily movement and are done as part of playing, working, active transportation, household chores and recreational activities (1).
Q: What is the intensity of physical activity?
Intensity refers to the rate at which the activity is being performed or the magnitude of the effort required to perform an activity or exercise. The intensity of different forms of physical activity varies between people. The intensity of physical activity depends on an individual’s previous exercise experience and their relative level of fitness.
Moderate intensity requires a moderate amount of effort and noticeably accelerates the heart rate, such as brisk walking, dancing, gardening and housework. While vigorous intensity requires a large amount of effort and causes rapid breathing and substantial increase in heart rate, such as fast cycling, running, aerobics and climbing up a hill (2).
Q: What are WHO-recommended levels of physical activity?
Children and youth aged 5–17 should accumulate at least 60 minutes of moderate-to-vigorous-intensity physical activity daily. This can include play, games, sports, transportation, chores, recreation, physical education, or planned exercise, in the context of family, school, and community activities (3).
Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity. This can include leisure time physical activity (for example: walking, dancing, gardening, hiking, swimming), transportation (e.g. walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities (4).
Older adults aged 65 and above should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity (5).
Q: What are the benefits of daily physical activity?
Being physically active is essential for good health throughout life. Regular and adequate levels of physical activity:
- reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer, depression and the risk of falls;
- improve bone and functional health; and
- are a key determinant of energy expenditure, and thus fundamental to energy balance and weight control.
On the other hand, physical inactivity (lack of physical activity) has been identified as the fourth leading risk factor for global mortality (6% of deaths globally). Moreover, physical inactivity is estimated to be the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and approximately 30% of ischaemic heart disease burden (1).
Q: What are the levels of physical activity in the Region?
In 2010, the Region had the highest prevalence of insufficient physical activity globally, which reached 31%. Women were less active than men, with differences of 10% and greater of prevalence between men and women (Insufficient is defined as attaining less than 150 minutes of moderate-intensity physical activity per week, or less than 75 minutes of vigorous-intensity physical activity per week, or equivalent) (6).
Among children and adolescents, the numbers were striking. Globally 81% of adolescents aged 11–17 were insufficiently physically active in 2010 (insufficient is defined as attaining less than 60 minutes of moderate-intensity daily physical activity). Adolescent girls were less active than adolescent boys.
Q: What is WHO’s role in supporting countries to promote physical activity?
Promoting physical activity through a life-course approach is one of the strategic interventions under the area of prevention and reduction of risk factors in the Regional framework for action (7). In addition, WHO is working within the Global strategy on diet, physical activity and health and closely with governments to meet nine global targets to reduce noncommunicable diseases and give us all a better chance at a longer, healthier life by 2025. The seventh global target aims to halt the rise in diabetes and obesity (6,8).
The Regional Office conducted a high-level forum on physical activity using a life course approach and produced advocacy tools. The Office also supported countries for the development of multisectoral plans of action for physical activity and developed a training course on social marketing and mass media campaign for physical activity with Sydney University, a WHO collaborating centre. Lastly, a regional advisory committee was set up to support implementation of the regional call to action on physical activity and a training package is being developed on mass media and social marketing in regard to physical activity and healthy diet (9).
Prof Vincent Onywera, Department of Physical Education, Exercise and Sports Science, Kenyatta University. [email protected]
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