Linking Sport and Health through Purposeful Activity Len Almond Loughborough University

My Task today: Raise the priority and significance of Purposeful Activity and Health on your agenda. Identify priorities Propose what we can do?

Sport and Health:we share the same aspirations Sedentary population Insufficiently active Productive/purposeful use of leisure-time

Is there any evidence that Health and Sport need to work together?

Physical Activity levels among children Physical Activity levels among children Health Survey for England 1995-1997 It is recommended that all children and young people aged 5 –18 years participate in physical activity of at least moderate intensity for one hour a day. In England, 55% of boys aged 2 –15 and 39% of girls are active at this recommended level on five or more days a week. But, participation rates decline with age after around 8-10 years, with the decline steepest in girls. By the age of 15, only 18% of girls reach the recommended level of activity.

Physical Activity levels among children Physical Activity levels among children Health Survey for England 1995-1997 Recommended that young people (5-18) accumulate one hour - moderate intensity physical activity/day HEA 1998 55% boys & 39% girls aged 2 –15 years Participation declines around age 8 -10, steepest decline in girls By 15, only 18% girls & 48% boys reach rec. level It is recommended that all children and young people aged 5 –18 years participate in physical activity of at least moderate intensity for one hour a day. In England, 55% of boys aged 2 –15 and 39% of girls are active at this recommended level on five or more days a week. But, participation rates decline with age after around 8-10 years, with the decline steepest in girls. By the age of 15, only 18% of girls reach the recommended level of activity.

No activity reported in previous 4 weeks: Health Survey for England Age M 1994 M 1998 W 1994 W 1998 16-24 7 9 11 18 25-34 8 10 14 35-44 45-54 15 21 12 19 55-64 24 34 28 65-74 29 36 33 45 75+ 53 57 62 71

People who are NOT participating in enough activity to benefit their health. Health Survey for England 1998. Men Women 16-24 years 42% 68% 25-34 years 52% 69% 35-44 years 57% 45-54 years 64% 70% 55-64 years 79% 65-74 years 83% 88%

Percentage of people not able to walk a mile in 20 minutes: ADNFS Men Women 16-24 4 25-34 14 35-44 10 20 45-54 12 40 55-64 30 50 65+ 45 80

Percentage of people not able to walk a mile in 20 minutes on a 5% slope Men Women 16-24 3 36 25-34 10 50 35-44 23 70 45-54 44 80 55-64 75 90 65-74 84 90+

Overweight and Obese Men Health Survey for England (HSE) 1998 1994 (%) 1998 (%) 16-24 years 30.6 27.9 25-34 years 49.7 56.3 35-44 years 61.7 64.7 45-54 years 67.9 73.2 55-64 years 69.2 75.5 65-74 years 71 76.5 Physical activity levels are low in the UK: While 58% of men and 32% of women aged 16-24 years are physically activity for 30 minutes or more at least five days a week this level declines rapidly with age. The majority of the adult population in England are NOT participating in enough physical activity to benefit their health, that is they do not meet current government guidelines of 30 minutes of accumulated moderate intensity physical activity on five or more days of the week.

Overweight and Obese Women Health Survey for England (HSE) 1998 1994 (%) 1998 (%) 16-24 years 28.2 27.3 25-34 years 37.6 43.4 35-44 years 44.8 50.6 45-54 years 54.2 60 55-64 years 64.2 67.8 65-74 years 66 70.3 Physical activity levels are low in the UK: While 58% of men and 32% of women aged 16-24 years are physically activity for 30 minutes or more at least five days a week this level declines rapidly with age. The majority of the adult population in England are NOT participating in enough physical activity to benefit their health, that is they do not meet current government guidelines of 30 minutes of accumulated moderate intensity physical activity on five or more days of the week.

Overweight and Obese Men and Women: HSE 1998 Age Obese Men Obese Women 16-24 years 5.2 10.7 25-34 years 15.9 16.3 35-44 years 16.8 20.5 45-54 years 21.2 23.9 55-64 years 23.3 28.6 65-74 years 29 75+ 20.7

Comparison of BMIs (DTI 2002) Country Weight Height BMI UK M 79.8 W 66.7 M 1.755 W 1.620 M 25.9 W 25.4 USA M 82.1 W 69.4 M 1.760 W 1.626 M 26.5 W 26.2 Holland M 76 W 65 M 1.795 W 1.650 M 23.6 W 23.9

Waist Circumference (DTI 2002) Country Waist Circumference UK M 98.46 cm W 84.06 cm USA M 101.14 cm W 87.40 cm Japan M 78.06 cm W 71.94 cm China M 75.02 cm W 69.18 cm

The Good News In terms of health risk it is better to be overweight and active than the right weight and inactive! (Blair, 1999)

Added Complication for Post 40s By this age most people who are sedentary or insufficiently active will start to lose muscle mass and their strength thus reducing functional decline is also a priority.

Making a More Rigorous Case

Inactivity as a major risk factor

Preventable Hazards to Population Health: Disability Adjusted Life Years (DALYS) Occupational hazards Illicit drugs Cholesterol Low fruit/vegetables Obesity Alcohol abuse Hypertension Physical inactivity Smoking Mathers (1999) Burden of Disease and Injury in Australian

Physical Inactivity is a MAJOR Health Risk World Health Organisation (2002) One of the top ten leading causes of death and disability in the world Many of the leading causes of disease and disability in our society such as CHD, strokes, obesity, type 2 diabetes, hypertension, colorectal cancer, stress, anxiety are associated with too little physical activity. Preliminary findings from a World Health Organisation study on health risk factors suggest that a sedentary lifestyle is one of the ten leading causes of death and disability in the world.

Potential Savings for reducing Physical Inactivity: Scotland £85 million saved by increasing physical activity levels by 1% for next 5 years P.A. Strategy for Scotland 2002 UK 9% CHD could be avoided if sedentary/ lightly active became moderately active McPherson, Britton & Causer 2002 Several studies have attempted to estimate the potential saving in human lives, health care costs and industry costs if physical activity was reduced. Limited data are available in the UK however A rough approximation is that inactivity accounts for 15% of US health care budget. If a 30% reduction in occurrences of CAD, stroke and type 2 diabetes was achieved with a minimum of 5 x 30 minutes of brisk walking: would achieve a saving of $119 billion Inactivity contributed to 12.4% of direct costs of arthritis at a cost of $8 billion per year Research Digest Series 3 (16) March 2002

Mathers,C. (1999) Burden of Disease and Injury in Australia Mathers,C. (1999) Burden of Disease and Injury in Australia. Australian Institute of Health and Welfare Physical activity appears to be under recognised in terms of public health importance for priority-based resource allocation Investment in physical activity may be as low as 10% of what it should be given these data on the preventive role of physical activity.

What Should we do?

Public Health Officials Regional Assemblies Local Councils Raise the priority given to promoting Purposeful Activity and Health by: MPs Civil Servants Public Health Officials Regional Assemblies Local Councils

All Sport Bodies Recognise the significance of Health as an added value to Sport as enrichment of our cultural wealth

A Different Perspective Sport needs to accommodate another dimension Rusty Ladies example

All of us need to: Recognise what it is that we need to promote

Sport and Health: INCREASE ACTIVITY LEVELS OF Sedentary population Insufficiently active PROMOTE MORE Productive/purposeful use of leisure-time

THREE KEY AREAS FOR HEALTH GAINS 16-25 Post 35 Post 60

Concerns for All Communities Overweight/obese (all ages) Reduced functional capacity (post 40) Counter mental health problems (all ages)

Health and Sport: Our task Helping People to: Put something active into their lives Learn to love being active Develop a commitment as a result of the satisfactions that sport can generate

East of England Activity Targets Age Range Numbers of people % sedentary 5% increase 15-24 600,556 13.5 81,075 4,054 25-44 1,643,339 13 213,634 10,682 45-64 1,304,844 25.5 332,735 16,637 65-74 458,606 41 188,028 9,401 total 4,007,345 815,472 40,774

Reducing Sedentary Pop. Targets for East of England Total sedentary 40,774 Numbers Target Primary Care Trusts (PCT) 41 994 GP Surgeries per PCT Average number 16 62

Thank You With your help we can put purposeful Physical Activity into everyone’s lives. WE REALLY CAN MAKE A DIFFERENCE

Contact: Len Almond BHF National Centre for Physical Activity and Health Loughborough University Loughborough LE11 3TU Tel. 01509 223329 Fax. 01509 223972 Email: L.Almond@lboro.ac.uk Website: www.bhfactive.org.uk