Rapid changes in lifestyle make increased physical activity a priority for the Americas

Abstract

The health benefits of regular participation in sports and aerobic fitness have been well recognized for more than 30 years. However, over the past decade new scientific evidence has shown that physical activity need not be strenu-ous to be beneficial to health. In fact, 30 minutes of moderate-intensity physi-cal activity every day or on most days of the week provides important health benefits. This modest but regular amount of activity can greatly reduce or pre-vent the risk of cardiovascular disease, type 2 diabetes, osteoporosis, colon cancer, and breast cancer. Regular, moderate physical activity, including daily activities such as climbing stairs, brisk walking, and biking, can reduce stress, alleviate depression and anxiety, enhance self-esteem, and increase mental alertness (1). Moreover, school-age children who are regularly active demon-strate enhanced school performance and a better sense of personal and social responsibility than those who are more sedentary (2). Most of those health benefits have been widely publicized and to some extent enjoy popular recognition. Nevertheless, sedentary lifestyles are predominant in most urban areas worldwide. Indeed, inactivity constitutes an important risk factor behind the epidemic rates of noncommunicable diseases (NCDs). In its 2002 World Health Report (3) the World Health Organization (WHO) reported that 76% of all deaths in the Americas in the year 2000 were due to NCDs, a proportion similar to that found in the developed regions of Europe (86%) and the Western Pacific (75%). In that same year in Latin Amer-ica alone there were an estimated 119 000 deaths due to inactive lifestyles. Latin America and the Caribbean have become the most urbanized region in the developing world, with over 60% of the population residing in urban centers. This rapid urban population growth has outpaced the devel-opment of social and physical infrastructure, employment, health services, and housing. Together, these various trends have contributed to inadequate public transportation systems, increased traffic congestion and environmental pollution, decreased activity levels in both work and leisure time, and changes to the physical and social urban landscape. Data from 24 countries in the Region of the Americas indicate that over half the population are inactive, that is, not performing the minimum recommended 30 minutes of moderate-intensity activity on at least 5 days of the week (3). In several of the countries of the Americas the proportion of the population at risk due to inactive lifestyles is close to 60%. This situation may be especially critical among persons 60 and older. These persons make up the fastest growing segment of the population in Latin America and the Ca-ribbean, with a growth rate that is 3.5 times that of the population overall. In addition, these older persons have the highest prevalence of NCDs. For this large and growing population with decreased mobility and other health con-cerns, environments that support a physically active lifestyle and greater access to public transportation are becoming increasingly important. IMPROVED SURVEILLANCE AND MORE DATA ARE URGENTLY NEEDED In most parts of the world little or nothing has been done to monitor trends in physical activity. Just 31 of the 191 WHO Member States had physi-cal activity data that were suitable for use in the recent comparative risk assessment project that formed the basis of the risk factor analyses for the 2002