After almost two years of staying at home, sitting at makeshift desks or kitchen tables and talking to everyone through a screen, you may be looking forward to a fresh start this year, planning to get out and move about more.
The word pandemic has become synonymous with the current Covid-19 crisis but there are other, more invisible impacts on our health we should be aware of. University of Edinburgh researchers suggest we are also living through another global health crisis – a pandemic of physical inactivity.
“In the same way that Covid-19 is pandemic – reaching every part of the world – then inactivity is pandemic,” explains Professor Nanette Mutrie, Professor of Physical Activity for Health and Director of the Physical Activity for Health and Research Centre (PAHRC). “All parts of the globe are, on average, less active than the optimal level suggested by the Word Health Organisation; accumulate 150 minutes of moderate intensity activity each week.”
Professor Mutrie has been working with colleagues Dr Paul Kelly, Reader in Physical Activity for Health, and Dr Claire Fitzsimons, Lecturer in Physical Activity for Health, to research and combat the effects of physical inactivity, as well as challenging long-held assumptions to support more people to become more active.
Fortunately, as many of us will have used the New Year as an opportunity to take stock and set some goals for the year ahead, the PAHRC research shows it might not be as hard as we think to be more active in our daily lives, and stick with it.
Bucking the trend
Professor Mutrie explains what sparked their research: “It has recently been established that there has been zero progress in the last few years in increasing physical activity around the world. In fact, western developed countries have decreased levels of population activity.”
When Scotland launched its policy for physical activity, Let’s Make Scotland More Active, in 2003, the team made a surprising discovery: “Scotland has bucked the trend of most other western developed countries and has shown a modest increase in the percentage of the population increasing the minimum recommended level of activity from 2012 to 2019.”
The team began to look more closely at physical activity in Scotland, the UK, and around the world and soon, were able to provide evidence to inform and influence public policy.
Global, national and local impact
When many of us think about becoming more active, we often begin by thinking about the sports we should join and talk ourselves out of activities like walking and cycling, thinking their impact will be minimal.
The PAHRC team actually found that there are big benefits to walking and cycling, and that its activities like these, as well as household tasks, that can help us reach the recommended level far more consistently than sporadic team sports. These findings have helped organisations implement more realistic measures to support people to get active.
In 2014, the World Health Organisation (WHO), used Dr Kelly’s statistical modelling in its Health Economic Assessment Tool (HEAT). The tool is available at a local level and helps transport and urban planners, traffic engineers, health economists and health experts examine how beneficial walking and cycling would be, when considering other factors such as pollution, injury and carbon impact.
In 2017, WHO updated HEAT and introduced Dr Kelly’s new results of the impact of pollution on walking and cycling to refine and better support important economic decisions.
The tool has been adopted across WHO member countries. The Senior Policy and Programme adviser and coordinator of HEAT wrote: “The HEAT has been applied in several countries and continues to inform and impact policy and planning decisions, making the case for better walking and cycling environments. England and Sweden have included the HEAT in their Official National Guidance, and Austrian, Finnish and French governments have promoted the tool for in-country use.”
In 2018, the Scottish Government used PAHRC’s research to change how its Active Scotland Outcomes Framework measures people’s activity levels. The research also played a vital role in the development of the 2019 UK Chief Medical Officer’s Physical Activity Guidelines. These are available to all and encourage and support people to become more physically active.
Professor Mutrie was appointed to chair a working group to communicate these guidelines and measure their effectiveness. The group was made up of leading physical activity researchers and included Dr Kelly. While examining UK guidelines, the working group identified an effective communication strategy to reach as many people as possible.
Professor Mutrie said: “It was a privilege to be appointed to chair the work of the communications expert group and that work is now being complemented by further work from PAHRC on guidance on how we should create messages about physical activity.”
Breaking down barriers
There have been many questions about the efficacy of walking and cycling in the face of health problems caused through pollution, a narrative that created a barrier to this kind of exercise. Dr Kelly’s research showed that no matter your original activity level, the benefits of walking and cycling for a small amount each week can be felt by everyone.
Dr Kelly began by investigating how much, and what kind of, physical activity should be recommended to everyone. He created new statistical models that scrutinised more than 200,000 participants from Europe, the USA, China and Japan. His work confirmed, for the first time, that walking or cycling for just 150 minutes, or two and a half hours a week, can reduce the risk of premature death by 10 per cent, regardless of how active you already are.
Dr Kelly went on to examine the risk of air pollution in relation to 150 minutes of walking or cycling, using his statistical model on a global scale. He found that the benefits far outweigh the risks in 98 per cent of the world’s cities, making this form of activity more accessible to millions of people.
Changing the narrative
Another barrier to physical activity is the belief that lower impact activities are not as effective as more vigorous ones. By examining the Scottish Government’s Scottish Health Survey 2013 data, the PAHRC team found that most people met the suggested quota of activity through more domestic tasks than team sports.
Professor Mutrie explains why this is the case: “Many activities of daily living are easier to build into each person’s day than activities that require special facilities. They can be done in everyday clothing, and are often tasks that need doing anyway, such as gardening.”
So why are fewer people achieving the recommended 150 minutes in more conventional sports activities than in walking and household tasks? Dr Fitzsimons explains: “Sport has more barriers including costs, venues, equipment, skill and previous negative experiences, for example, in PE at school.
“However, those who can do sport will be able to get health benefits,” Dr Fitzsimons continues. “It is just that more people will be able to walk or cycle in their everyday life than will be able to participate in sport – especially if we can consider that activity is a lifelong activity. Very few older adults participate in sport.”
The team suggested that changing the narrative around the recommended 150 minutes of activity each week, with more of a focus on domestic activities than sports, could see a rise in population activity figures.
The dangers of sitting
The team was also able to challenge another long-held assumption. Previous research in Scotland found those in older age experience more sedentary time. However, the PAHRC team found new evidence to suggest otherwise. “Our study investigated the effects of age and gender on weekday (including work) sedentary time for all adults. Instead, only 16- to 24-year-olds reported lower levels than those over 75 years,” explains Dr Fitzsimons.
The reason for this? The PAHRC team included sedentary time spent at work, sitting at a desk. The Covid-19 pandemic has had a big impact on this data. Dr Fitzsimons elaborates: “We do think this is something that requires further exploration, particularly in the current circumstances in relation to working from home as a result of the Covid-19 pandemic and reduced opportunities for movement throughout the working day, for example, reduced transport activity time, moving around the office building for meetings or going out for lunch or coffee.”
The team agree that there’s still work to be done, but the impact of their research has reached people across the globe, influencing and changing physical activity policy, breaking down old barriers and highlighting potential new threats. Ultimately though, the team are certain we can find our way out of this pandemic too.
The team agree that there’s still work to be done, but the impact of their research has reached people across the globe, influencing and changing physical activity policy, breaking down old barriers and highlighting potential new threats. Ultimately though, the team are certain we can find our way out of this pandemic too.
Image credits: Watching tv, Milan Markovic/Getty Images; People cycling through the Meadows, Bob Douglas/Getty Images; Loading washing machine, Stígur Már Karlsson /Heimsmyndir/Getty Images; Stretching at desk, AndreyPopov/Getty Images
