Dr Mike Evans: 23 and 1⁄2 hours
These are extracts from an editorial comment in the leading medical journal “The Lancet”, July 2012.
Stressing harms of physical inactivity to promote exercise
Exercise has been called a miracle drug that can benefit every part of the body and substantially extend lifespan. Yet it receives little respect from doctors or society. Socially, being inactive is perceived as normal, and in fact doctors order patients to remain on bed rest far more often than they encourage exercise. This passive attitude towards inactivity, where exercise is viewed as a personal choice, is anachronistic, and is reminiscent of the battles still being fought over smoking.
Physical inactivity burdens society through the hidden and growing cost of medical care and loss of productivity. Getting the public to exercise is a public health priority because inactive people are contributing to a mortality burden as large as tobacco smoking. To individuals, the failure to spend 15—30 min a day in brisk walking increases the risk of cancer, heart disease, stroke, and diabetes by 20—30%, and shortens lifespan by 3—5 years. Although the benefits of exercise and the harms of inactivity might seem like two sides of a coin, the benefits message emphasised so far has not worked well for most of the population. In tobacco control, doctors did not emphasise the benefits of non-smoking, but the harms of smoking. Similarly, armed with credible global and national data, we should emphasise the harms of inactivity and not merely the benefits of exercise.
Smoking and physical inactivity are the two major risk factors for non-communicable diseases around the globe. Of the 36 million deaths each year from non-communicable diseases, physical inactivity and smoking each contribute about 5 million. …
Governmental programmes to move people from sedentary living to meeting recommended levels of exercise are very limited, in both developed and developing countries. Where available, these programmes are viewed as useful but not as essential as, say, anti-smoking programmes, partly owing to a failure to emphasise the colossal harms of inactivity. Furthermore, treatment of physical inactivity is not a reimbursable item under most health insurance programmes, and few financial incentives exist for health-care providers to spend time discussing exercise during medical visits.
There is much to learn from tobacco control strategies to reduce the harms of inactivity. WHO introduced the MPOWER measures to assist in reducing smoking harms at the country level. MPOWER includes monitoring behaviour, protecting people from smoke, offering treatment, warning of harms, enforcing the law, and raising the price. Applying MPOWER to physical inactivity, we will need to monitor inactivity prevalence and factors behind it; protect the safety of the exercisers and their built environment; offer services to the inactive to gain skills for sustainable and enjoyable exercise; warn the public of the hazards of inactivity through repeated campaigns; ensure that the medical community fulfils its responsibility to reduce inactivity; and, finally, raise money or provide funding to encourage physical activity and discourage inactivity…
Read the full editorial from the Lancet 18 July 2012