Second Opinion: Physical activity is a health priority in its own right

Exercise should be promoted for its own sake as empowering, enjoyable and great for psychological health and not just something obese people should do

It doesn’t matter how old or thin we are, everyone needs to exercise. Photograph: Thinkstock

It doesn’t matter how old or thin we are, everyone needs to exercise. Photograph: Thinkstock

 

Today is World Physiotherapy Day and the Irish Society of Chartered Physiotherapists is highlighting the benefits of exercise to human health.

A national survey of 1,000 adults, carried out by the society, found that 97 per cent know that physical activity helps prevent weight gain over time and 89 per cent know that regular exercise can help prevent chronic diseases such as cancer and heart disease.

While this level of knowledge is good news, why is physical activity always coupled with obesity and disease? Can we please stop making this link? It is not helpful and actually decreases exercise levels. Health messages framed in terms of negative outcomes do not bring about behaviour change. Thin people think they do not have to bother being physically active; fat people just feel stigmatised.

A new report from the House of Commons Health Committee, Impact of physical activity and diet on health; Sixth Report of Session 2014-2015, and the UK government response published in July, argue that for too long physical activity has been seen merely in the light of its benefits in tackling obesity. “Physical activity in its own right has huge health benefits totally independent of a person’s weight, and it is vital that the importance of physical activity for all the population – regardless of their weight, age, health, and other factors – is clearly understood and articulated.”

In fact, according to the report, “increasing physical activity could have a greater impact on reducing mortality than reducing weight”.

Uncoupling

This is not the first time an expert group has recommended uncoupling physical activity from obesity and ill health. In 2013 the World Health Organization (WHO) asked the question, “Why are we failing to promote physical activity globally?”

The organisation’s June 2013 bulletin noted that health campaigns for improving levels of physical activity had centred almost exclusively on the message that physical inactivity and a sedentary lifestyle are harmful to health. “Since health-based models have failed to promote physical activity, we must shift the argument from the finality or utility of physical activity (ie promoting health) to what a person experiences when physically active. Under this new approach regular exercise would be presented as a challenging and potentially interesting activity with the flexibility of being adaptable to a person’s circumstances (rather than vice-versa).”

Large numbers of Irish people are not meeting even the minimum levels of physical activity recommended by the WHO and the national physical activity guidelines. Children and young people aged 2-18 should be moderately or vigorously active for at least 60 minutes a day and adults need to be moderately active for 30 minutes, on five days of the week. Only 19 per cent of primary and 12 per cent of post-primary school children are getting enough exercise and these rates have not changed since 2004 despite many health promotion campaigns. Just under a third of Irish adults are meeting the guidelines.

The Central Statistics Office national travel survey for 2014 found that almost half of those surveyed (10,382) used the car for journeys of 2km or less (a short walk of 15-20 minutes) and two-thirds drove for journeys of 2-4km (a 35-minute walk). Irish people love their cars and are just not active enough. A new approach is needed.

Health problems

Thanks to programmes such as RTÉ’s Operation Transformation, physical activity has become inextricably linked to obesity and chronic health problems. The programme does not feature unfit, thin people. Physical activity is presented as a solution to obesity when it is, in fact, a very inefficient way to lose weight.

An average 11-stone person would need to walk at a brisk pace for 12 hours, jog for eight, or cycle for four to lose one pound. Even the recommended national physical activity guidelines and their almost mandatory nature are of questionable value in terms of influencing health behaviour.

If someone cannot manage the necessary hour or half-hour, they give up.

The best guideline for most people might be that some activity, no matter how little, is better than none. A new national activity plan is imminent as part of Healthy Ireland, the national framework for health and wellbeing.

Let’s hope that obesity and chronic disease are barely mentioned.

It is time for physical activity to be promoted for its own sake as empowering, enjoyable, self-efficacious and great for psychological health. The key message from expert witnesses to the House of Commons health committee was “just do more”. I wholeheartedly agree.

drjackyjones@gmail.com

Dr Jacky Jones is a former HSE regional manager of health promotion and a member of the Health Ireland Council.