tag:theconversation.com,2011:/fr/topics/lack-of-exercise-27550/articlesLack of exercise – The Conversation2020-03-25T18:43:34Ztag:theconversation.com,2011:article/1340442020-03-25T18:43:34Z2020-03-25T18:43:34ZHow to stay fit and active at home during the coronavirus self-isolation<figure><img src="https://images.theconversation.com/files/322822/original/file-20200325-181239-14axs9g.jpg?ixlib=rb-1.1.0&rect=44%2C0%2C4947%2C2357&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Unspash/ayo ogunseinde</span></span></figcaption></figure><p>The extensive social distancing policies put in place to limit the spread of COVID-19 mean most people will have to spend much, if not all, their time at home.</p>
<p>Self-isolation means far fewer opportunities to be physically active if you are used to walking or cycling for transportation and doing leisure time sports.</p>
<p>But equally worryingly, the home environment also offers abundant opportunity to be sedentary (sitting or reclining).</p>
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<p>While self-isolation measures are necessary, our bodies and minds still need exercise to function well, prevent weight gain and <a href="https://www.health.harvard.edu/mind-and-mood/more-evidence-that-exercise-can-boost-mood">keep the spirits up</a> during these challenging times.</p>
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Read more:
<a href="https://theconversation.com/why-are-we-calling-it-social-distancing-right-now-we-need-social-connections-more-than-ever-134249">Why are we calling it 'social distancing'? Right now, we need social connections more than ever</a>
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<p>Exercise can help keep our immune system become strong, <a href="https://bjsm.bmj.com/content/45/12/987" title="Upper respiratory tract infection is reduced in physically fit and active adults">less susceptible to infections</a> and their most <a href="https://www.sciencedirect.com/science/article/pii/S0091743519300775?via%3Dihub" title="Lifestyle risk factors, obesity and infectious disease mortality in the general population: Linkage study of 97,844 adults from England and Scotland">severe consequences</a>, and better able to recover from them. </p>
<p>Even before the restrictive conditions were announced, physical inactivity cost <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61031-9/fulltext" title="Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy">5.3 million</a> lives a year globally.</p>
<p>So we should consider ways to limit the effects of the impact of the COVID-19 crisis, as well as its wider impact of contributing to the long-term chronic disease crisis.</p>
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<a href="https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=385&fit=crop&dpr=1 600w, https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=385&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=385&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=484&fit=crop&dpr=1 754w, https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=484&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/322823/original/file-20200325-181225-9iso0v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=484&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Don’t just sit there in front of the screen.</span>
<span class="attribution"><span class="source">Unsplash</span></span>
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<h2>How much physical activity?</h2>
<p>Global recommendations are for all <a href="https://www.who.int/dietphysicalactivity/factsheet_adults/en/" title="Physical Activity and Adults">adults</a> to accumulate at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, as well as muscle-strengthening activities on two or more days a week.</p>
<p>Any activity is better than none, and more activity provides more physical and mental health benefits.</p>
<p>As several countries are <a href="https://www.euronews.com/2020/03/19/coronavirus-which-countries-are-under-lockdown-and-who-s-next">already under lockdown</a>, it is uncertain for how long you can go outside for a walk, run or cycle. The key question is how can people meet these guidelines when restricted to the home environment?</p>
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<img alt="" src="https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1126&fit=crop&dpr=1 600w, https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1126&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1126&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1415&fit=crop&dpr=1 754w, https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1415&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/322771/original/file-20200325-194478-1716gw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1415&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<h2>Sitting, standing and movement</h2>
<p>Take <a href="https://www.heartandstroke.ca/articles/5-simple-ways-to-reduce-sedentary-time">regular breaks</a> from continuous sitting in front of your computer, tablet, or smartphone every 20 to 30 minutes.</p>
<p>For example, you could take a few minutes break to walk around the house, take some fresh air on the balcony, in the garden or yard, or play with your dog for a few moments.</p>
<p>Alternate periods of standing while working/studying with sitting by creating your own stand-up desk area.</p>
<h2>Make stairs your best friend</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627027/" title="Associations of self-reported stair climbing with all-cause and cardiovascular mortality: The Harvard Alumni Health Study">Using the stairs</a> is an extremely <a href="https://theconversation.com/dont-have-time-to-exercise-heres-a-regimen-everyone-can-squeeze-in-111600">time-efficient</a> way to maintain fitness. As little as three 20-second fast stair climbs a day <a href="https://nrc-prod.literatumonline.com/doi/10.1139/apnm-2018-0675" title="Do stair climbing exercise 'snacks' improve cardiorespiratory fitness?">can improve fitness</a> in only six weeks.</p>
<p>If you live in an apartment, avoid uncomfortable lift encounters with other self-isolating neighbours by using the staircase for any necessary outdoor journeys. Take care to avoid much contact with handrails. </p>
<p>Internal stairs also offer more stairclimbing and <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/7-quick-stair-exercises-to-do-at-home/art-20390063">strength exercise</a> opportunities. </p>
<h2>Use your own bodyweight</h2>
<p>A <a href="https://academic.oup.com/aje/article/187/5/1102/4582884" title="Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints">2017 British study</a> found home based strength exercises that utilise your own bodyweight – such as press-ups, sit-ups and planks – are <a href="https://theconversation.com/strength-training-can-have-unique-health-benefits-and-it-doesnt-have-to-happen-in-a-gym-84904">as important for health</a> as aerobic exercise.</p>
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<span class="caption">Using your bodyweight.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/26344495@N05/49488914752/">Ivan Radic/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>There are many great resources for such <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/7-quick-stair-exercises-to-do-at-home/art-20390063">indoor</a> bodyweight exercises for <a href="https://www.youtube.com/channel/UCAxW1XT0iEJo0TYlRfn6rYQ">people of all ages</a> <a href="https://www.nhs.uk/live-well/exercise/strength-exercises/">online</a>.</p>
<p>Aim for at least <a href="https://www.who.int/dietphysicalactivity/factsheet_adults/en/">a couple of own bodyweight sessions per week</a>, with <a href="https://insights.ovid.com/pubmed?pmid=21694556" title="Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise">each session involving</a> two to four sets of eight to 15 repetitions of each strength-promoting exercise. Make sure you take a two to three minutes rest between sets.</p>
<h2>Dance the COVID-19 blues away!</h2>
<p>An increasing number of live <a href="https://www.billboard.com/articles/columns/pop/9335531/coronavirus-quarantine-music-events-online-streams">concerts</a> are streamed online. Use the <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2019.1627897" title="Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses">stress-releasing</a> magic of music and dance at home like nobody’s watching (which is not unlikely). </p>
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<figcaption><span class="caption">Dance alone like no one is watching.</span></figcaption>
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<p>Dancing is an excellent way to <a href="https://www.ajpmonline.org/article/S0749-3797(16)00030-1/abstract" title="Dancing Participation and Cardiovascular Disease Mortality">protect the heart</a> and maintain fitness as it can reach <a href="https://journals.lww.com/acsm-msse/Fulltext/2000/09001/Compendium_of_Physical_Activities__an_update_of.9.aspx" title="Compendium of Physical Activities: an update of activity codes and MET intensities">moderate and vigorous intensity</a> and can even imitate high-intensity interval training.</p>
<p>Dancing also has established <a href="https://www.sciencedirect.com/science/article/abs/pii/S0197455613001676" title="Effects of dance movement therapy and dance on health-related psychological outcomes: A meta-analysis">mental health</a> benefits to help us cope with the coronavirus-imposed solitude.</p>
<p>Whether it’s electronic beats, rock or traditional Irish music that floats your boat, it will not be difficult to turn up the volume of your stereo a little higher and turn your lounge or kitchen into a little dance hall every now and again.</p>
<h2>Give them the play time they’ve always wanted</h2>
<p>Social-distancing is a good opportunity to bond more with the little two and four legged members of your family through active play. Both children and dogs will love you replacing some of your online media and sitting time with playing in and around the house with them.</p>
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<span class="caption">Let your pets take you away from that screen for some exercise play.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ret0dd/4382972221/">Flickr/Todd Dwyer</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>Dogs thrive on human attention and, given the opportunity, they would keep you on your feet 24/7. Take advantage of the extra time you will be in and around the house. There are many <a href="https://www.puppyleaks.com/easy-ways-to-keep-your-dog-busy-indoors/">great indoor games</a> to keep you active and improve your dog’s well-being.</p>
<p>No matter <a href="https://activeforlife.com/49-fun-physical-activities-to-do-with-kids-aged-2-to-4/">how young or how old your children</a> are, there are <a href="https://www.nhs.uk/change4life/activities">many fun activities</a> you can do together indoors and in the garden. </p>
<h2>Just do something!</h2>
<p>Left unattended, the self-isolation imposed by COVID-19 will likely skyrocket sedentary time and will drastically reduce the physical activity levels for many. Our suggestions are only a few examples of ideas that need no special equipment and can be done within limited space.</p>
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Read more:
<a href="https://theconversation.com/coronavirus-distancing-measures-are-confusing-here-are-3-things-to-ask-yourself-before-you-see-someone-134394">Coronavirus distancing measures are confusing. Here are 3 things to ask yourself before you see someone</a>
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<p>For more ideas take a look at the online resources of reputable organisations such as the <a href="http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance/stay-physically-active-during-self-quarantine/_recache">World Health Organisation</a>, the <a href="https://www.exerciseismedicine.org/support_page.php/stories/?b=892">American College of Sports Medicine</a>, <a href="https://www.sportengland.org/news/how-stay-active-while-youre-home">Sport England</a> and the <a href="https://www.heart.org/en/healthy-living/fitness/getting-active/25-ways-to-get-moving-at-home-infographic">American Heart Association</a>.</p>
<p>The end goal during self-isolation is to prevent long term physical and mental health damage by sitting less, moving as often as possible, and aiming to maintain fitness by huffing and puffing a few times a day.</p>
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<a href="https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/322827/original/file-20200325-181211-1p6jbgu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Remember to have a good stretch after any exercise.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/adammcguffie/34789086373/">Flickr/Adam McGuffie</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p class="fine-print"><em><span>Emmanuel Stamatakis receives funding from the National Health and Medical Research Council and PAL Technologies (Scotland) for research projects related to physical activity and health. He is affiliated with the BMJ as Editor-in Chief of BMJ Open Sports & Exercise Medicine, and Editor of the British Journal of Sports Medicine. </span></em></p><p class="fine-print"><em><span>Andrew Murray is a Sports and Exercise Consultant with the University of Edinburgh, NHS Inform, the European Tour Golf and Scottish Rugby. He previously worked for the Scottish Government in Physical Activity/ Sport policy. </span></em></p><p class="fine-print"><em><span>Fiona Bull is Head of unit on physical activity at the World Health Organisation Head Quarters in Geneva, Professor (on leave) at the University of Western Australia and Honorary Professor at the University of Edinburgh. She has previously received funding from government research funding agencies in Australia, UK, and Europe and from not for profit funding health related foundations. No research funding from private sector organizations. </span></em></p><p class="fine-print"><em><span>Kate Edwards is an Associate Professor at the University of Sydney, her research includes work on the interactions between exercise and vaccination responses for which has received funding from the Bill and Melinda Gates Foundation, the Ramaciotti Foundation and the Financial Markets Foundation for Children.</span></em></p>Don’t just sit there. It’s easy to get some exercise in your daily routine if you’re stuck at home.Emmanuel Stamatakis, Professor of Physical Activity, Lifestyle, and Population Health, University of SydneyAndrew Murray, Consultant, Sports and Exercise Medicine, The University of EdinburghFiona Bull, Professor, School of Human Sciences, The University of Western AustraliaKate Edwards, Associate Professor, Sydney School of Health Sciences, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1064562018-11-08T10:57:27Z2018-11-08T10:57:27ZIn tackling our physical inactivity pandemic, we risk ignoring those who need the most help<figure><img src="https://images.theconversation.com/files/244335/original/file-20181107-74769-siu6ia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pearing back. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/wafers-blueberry-souffle-form-sofa-pear-1090136375?src=-8U2rruU226GdGSNo3n_0Q-3-57">13Smile</a></span></figcaption></figure><p>The longest living humans on Earth <a href="https://www.ncbi.nlm.nih.gov/pubmed/15489066">report</a> engaging in daily physical activity as the secret of their longevity. For those who don’t live such long lives, we know that spending too much time being inactive is a major cause of early death. Incredibly, <a href="https://www.ncbi.nlm.nih.gov/pubmed/22818936">it kills</a> more people in the world than tobacco smoking each year. </p>
<p>Physical inactivity is now <a href="https://www.ncbi.nlm.nih.gov/pubmed/22818941">sometimes</a> referred to as a “pandemic” – a word normally used to describe diseases such as the plague, which can wipe out a large proportion of a population. At present, few of us are sufficiently active on a daily basis, though the world is slowly waking up to the problem. </p>
<p>The World Health Organisation (WHO) <a href="https://www.who.int/nmh/events/ncd_action_plan/en/">has set</a> a target of reducing the proportion of inactive individuals by 10% by 2025. Yet according to data <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30357-7/fulltext">recently published</a> by the WHO in the Lancet Global Health Journal, we are far from likely to achieve this target. Roughly one third of the world population is still not engaging in enough daily physical activity to remain healthy. </p>
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<a href="https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/244337/original/file-20181107-74787-11xmq7x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Hup!</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/invisible-sad-fat-man-standing-create-1157367085?src=6qMPQMuAiYfPqYJmvRE0-A-1-83">radFX</a></span>
</figcaption>
</figure>
<p>The situation seems worse in rich countries, where twice as many people reported being inactive compared to those in low or middle-income countries (with the exception of Latin America and the Caribbean, where people are also too inactive). In rich countries, the proportion of people who are inactive is also increasing over time. In most other areas of the world, it remains stable. </p>
<p>The authors of the Lancet Global Health article called on affected governments to act urgently to address this problem, by prioritising policies that increase the amount of physical activity that people are doing each day. They referred to increasing cycling and walking infrastructure; improving road safety; and making it easier to take exercise in public spaces, parks and in the workplace. Yet before anyone starts implementing these ideas, there are a couple of major caveats that need taken into account. </p>
<h2>Inactivity up close</h2>
<p>At face value, the idea that physical inactivity is mainly a “first world” problem makes perfect sense. As countries become richer, people have more spending power and better access to technology. They therefore have less need to be active – whether at work, doing household chores or moving from A to B. Yet this overlooks certain realities about inactivity. In the “first world”, for instance, poorer people <a href="https://www.ncbi.nlm.nih.gov/pubmed/26385563">are more</a> at risk from physical inactivity and <a href="http://www.annclinlabsci.org/content/42/3/320.full">associated diseases</a> such as heart problems, diabetes and certain cancers. </p>
<p>One <a href="https://www.sciencedirect.com/science/article/pii/S0264275117312271">recent study</a> looked at physical activity in 24 European countries among 51,820 participants. It found that when economic development (GDP per capita) increased in a region, there were also increases in physical activity – but only among higher-educated adults. </p>
<p>So even in Europe, one of the <a href="https://www.theguardian.com/inequality/datablog/2017/apr/26/inequality-index-where-are-the-worlds-most-unequal-countries">least unequal</a> parts of the world, there are social inequalities in physical activity which are actually increased by economic growth. We suspect that the increasing inactivity in wealthier countries <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30357-7/fulltext">reported by</a> the WHO is related to the fact that the gap between rich and poor in these countries <a href="https://wir2018.wid.world">is growing</a> steadily wider. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=683&fit=crop&dpr=1 600w, https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=683&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=683&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=858&fit=crop&dpr=1 754w, https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=858&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/244336/original/file-20181107-74766-166ejkv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=858&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Girl down.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/tired-exhausted-sleepy-woman-bed-covering-1005621067?src=YyTI-rq-F5j0QuY0Otd7vA-1-14">Pewara Nicropithak</a></span>
</figcaption>
</figure>
<p>Neither is wealth the only predictor of physical inactivity. Gender is also very relevant in this context, with women tending to be more inactive than men across the globe. Last year, a <a href="https://www.nature.com/articles/nature23018">Nature article</a> suggested that gender inequality might even be driving the rising global obesity numbers. </p>
<p>It’s not well understood why some groups of people are more inactive than others. It is possible to come up with a tentative answer based on the things that people most often report as being barriers to physical activity: money, time, culture and peer pressure. </p>
<p>At any rate, policies which are blind to these inequalities risk exacerbating them. The problem with the recommendations in the Lancet Global Health paper is who benefits from them. In practice, we <a href="https://www.sciencedirect.com/science/article/pii/S0169204616300846">know that</a>
policies to encourage people to be more active tend to improve resources in wealthier areas. There’s a big risk of helping the wrong groups of people – further widening <a href="http://apps.who.int/iris/bitstream/handle/10665/78335/9789241505178_eng.pdf;jsessionid=04979F67390AC75ACC6998B3314D7FD3?sequence=1">the gap</a> in health equality in the process. </p>
<p>Instead, we should be developing policies against inactivity that specifically target those most in need. The question of what this should look like is something that needs more consideration. But as a starting point, policies like improving access to green spaces and adding new cycling and walking infrastructure need to be aimed at those who need them most. </p>
<p>It’s good news that the world’s inactivity problem is at last on the agenda. But unless we get the prescription right, we could be increasing health inequalities and shoring up an even bigger problem for generations to come.</p><img src="https://counter.theconversation.com/content/106456/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sebastien Chastin receives funding from the Medical Research Council, Chief Scientist Office and the DataLab.</span></em></p><p class="fine-print"><em><span>Bart De Clercq receives funding from the Government of Flanders. </span></em></p><p class="fine-print"><em><span>Jelle Van Cauwenberg receives funding from the Research Foundation Flanders (FWO).</span></em></p>Recent findings say that sitting around is a ‘first world’ problem. In reality, it’s a bit more complicated than that.Sebastien Chastin, Reader, Behaviour Dynamics, Glasgow Caledonian UniversityBart De Clercq, Economist, Ghent UniversityJelle Van Cauwenberg, Doctoral Researcher, Public Health, Ghent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/761672017-07-05T12:07:45Z2017-07-05T12:07:45ZExercise can be punishing – but here’s how to stop thinking of it as a punishment<figure><img src="https://images.theconversation.com/files/174054/original/file-20170615-23528-1esuc1q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/silhouette-jogger-sunsetvintage-color-522073195?src=sgiTygjvKQ_qPU9iq6bF1Q-1-56">shutterstock/oranzyphotography</a></span></figcaption></figure><p>The fitness industry is said to be worth <a href="http://www.leisuredb.com/blog/2016/5/11/press-release-2016-state-of-the-uk-fitness-industry-report">£4.4 billion</a> in the UK alone. But, despite medical research telling us that exercise will help us live longer, the majority of people do not engage with health and fitness. Could it be that exercise is still considered a punishment – as it was in Victorian prisons? Or do we just need to increase the fun and social aspect to exercise to get more of us working up a sweat?</p>
<p>Medical research suggests exercise is good for our health and will help us all live <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001335">longer</a>. But a report by the British Heart Foundation indicates that <a href="http://www.bbc.co.uk/news/health-39457993">20m</a> people living in the UK are physically inactive. To be considered active, the UK department of health recommends adults should accumulate at least 150 minutes of moderate intensity activity per <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213740/dh_128145.pdf">week</a>. So it begs the question, why do close to a third of the country’s population struggle to meet this recommended amount of exercise, when doing so could prolong their life? </p>
<p>A reason why inactive people may not engage in enough exercise is because it is <a href="https://www.bhf.org.uk/news-from-the-bhf/news-archive/2016/january/one-in-ten-brits-admit-to-doing-no-physical-activity-in-the-last-ten-years">not perceived</a> to be a fulfilling or satisfying leisure pursuit. Other competing pastimes of a more sedentary nature, such as watching TV, reading and gaming, are seen by some as being more enjoyable. </p>
<h2>Exercise as punishment</h2>
<p>The treadmill was devised as a form of punishment for convicted criminals in the <a href="https://gloscrimehistory.wordpress.com/2014/04/03/on-the-treadmill-hard-labour-at-gloucester-prison/">Victorian era</a>. At this time, prisoners had to undertake long hours of hard labour by walking on treadmills to grind flour. This form of punishment was abolished in the late 19th century for being too cruel. </p>
<p>Exercise also has a long history of being used as a form of <a href="https://theconversation.com/punishing-students-with-exercise-is-reckless-political-posturing-23495?sa=pg1&sq=exercise+punishment&sr=2">correctional behaviour in schools</a>. Indeed in 2014 the then Conservative education secretary, Nicky Morgan, proposed to ban exercise being used in schools as <a href="http://www.dailymail.co.uk/news/article-2752761/Schools-barred-making-pupils-run-laps-punishment-Education-Secretary-orders-U-turn-using-exercise-disciplinary-measure.html">a form of punishment </a> for fear that it would put children off being active.</p>
<p>Given that exercise has a lengthy historical association with the use of discipline for the purpose of punishment and obedience, can 21st-century society ever be truly accepting of exercise as a leisure pursuit that can have personal fulfilment? At present, the high volume of inactivity levels in the UK suggests a large amount of people are not motivated to take exercise. Getting people to be more active, therefore, would require a shift in people exercising because they want to rather than having to. </p>
<h2>Making it social</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/176905/original/file-20170705-6062-g92sgi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A group training session.</span>
<span class="attribution"><span class="source">Daxiao Productions/Shutterstock</span></span>
</figcaption>
</figure>
<p><a href="https://www.edgehill.ac.uk/events/2017/06/21/festival-ideas-workshop/">My research</a> explores the role of social psychology for the development of interventions that make physical activity a fulfilling pursuit for long-term condition sufferers. This is because social psychological science has consistently demonstrated that people are motivated to seek social connections in order to fulfil their psychological needs as human beings. For example, “<a href="http://psycnet.apa.org/psycinfo/1995-29052-001">the belongingness hypothesis</a>” states that people have a basic need to feel closely connected to others.</p>
<p>So it is important people have positive social exercise experiences which enrich their quality of life and in doing so make the pursuit of exercise a more satisfying and worthwhile activity. This can be achieved by creating exercise environments that provide individuals with a shared sense of social connectedness, creating opportunities for people to form friendships, meaningful attachments and mutually supportive relationships. </p>
<p>For example, <a href="http://www.bbc.co.uk/news/av/health-27545191/overweight-football-fans-train-at-top-clubs">the EuroFit programme</a> takes a unique approach for improving men’s health and fitness by allowing fans to train in the environment of a professional football club they support. <a href="https://www.letsride.co.uk/city-ride">City Ride events</a> are another example, where families and friends of all ages and abilities can enjoy cycling together through the streets of a vibrant traffic-free environment. Similarly, <a href="https://www.saga.co.uk/magazine/health-wellbeing/exercise-fitness/walking-sports">walking sports</a> offer a social atmosphere of fun, laughter and camaraderie for those who may have difficulty participating in high impact activities. </p>
<p>Connecting people in dynamic and socially rewarding exercise environments has the potential to offset the drudgery often associated with exercise and make it a leisure pursuit worth doing.</p><img src="https://counter.theconversation.com/content/76167/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andy Levy does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Try thinking of exercise as fun and something to enjoy with friends.Andy Levy, Reader in Psychology, Edge Hill UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/592962016-05-17T15:40:47Z2016-05-17T15:40:47ZHypertension: why the approach to tackle the silent killer has changed<figure><img src="https://images.theconversation.com/files/122862/original/image-20160517-9471-1vwcbny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Traditionally, someone who suffered from hypertension – or high blood pressure – would only receive treatment when his or her blood pressure was measured and the reading was found be higher than normal. But this meant that the condition was often picked up only when the person had a stroke or a heart attack – and in many instances this was too late. </p>
<p>As a result of this, the thinking on when to treat hypertension has changed in the past few years. Research has shown that hypertension should not only be diagnosed on the basis of one blood pressure reading, as this reading could vary and be raised by other triggers such as stress.</p>
<p>Instead, doctors make use of a <a href="http://cvdrisk.nhlbi.nih.gov/">risk assessment tool</a> that measures the overall cardiovascular risk of a patient. The tool estimates the risk that a person faces over the next ten years of having a heart attack. </p>
<p>They do this by looking at the risk factors patients are exposed to: what is their age and gender? Do they smoke? Are they overweight or obese and do they have high cholesterol levels or diabetes? The tool determines a patient’s risk of developing cardiovascular disease in the next ten years and guides doctors on whether or not they should prescribe high blood pressure treatment to reduce the patient’s risk.</p>
<p>This is because hypertension rates and associated risky lifestyle behaviours are on the rise – especially in the developing world. </p>
<p>Globally about <a href="http://gamapserver.who.int/gho/interactive_charts/ncd/risk_factors/blood_pressure_prevalence/atlas.html">22%</a> of adults over the age of 18 suffer from hypertension, according to statistics from the World Health Organisation in 2014. But in Africa, this figure is higher and sits at 30%.</p>
<p>In South Africa, <a href="http://gamapserver.who.int/gho/interactive_charts/ncd/risk_factors/blood_pressure_prevalence/atlas.html">28% of the adult population</a> suffers from hypertension compared with 23% in Brazil and 25% in China. And among adults older than 50 the rate of hypertension is as high as 70%. </p>
<p>Hypertension is one of the leading causes of cardiovascular diseases such as stroke, heart attacks, heart failure, peripheral vascular disease and kidney disease. </p>
<h2>Why treatment methods have changed</h2>
<p>The challenge with hypertension is that there are usually no warning signs or symptoms for someone suffering from hypertension. Hypertension is often referred to as the “silent killer”, as a heart attack or a stroke may be the first warning sign. </p>
<p>But patients do classically have a combination of other risk factors. These include having an unhealthy diet, not exercising, and smoking and drinking too much. And it is the effects of these behavioural risk factors that may show up in patients as hypertension, raised blood glucose, raised cholesterol, and being overweight and obese.</p>
<p>As a result, it is estimated that in South Africa only 26% of men and 51% of women <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721893/">are aware</a> that they suffer from hypertension.</p>
<p>The <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721893/">research</a> shows that in South Africa hypertension is the leading reason that people seek help from primary care facilities such as clinics. It is also the most common diagnosis in primary care in the country. </p>
<h2>Changing your lifestyle can help</h2>
<p>Treating hypertension is not only about taking tablets. Someone with raised blood pressure can also reduce it by changing their behaviour. There are several guidelines that should be followed:</p>
<ul>
<li><p>Reduce salt intake as it raises blood pressure. The South African government has recently <a href="https://theconversation.com/south-africas-bold-move-on-salt-gets-off-to-a-shaky-start-42256">legislated</a> salt intake, ruling that salt content in common foods such as bread should be reduced. As an extra measure, people should not add extra salt to their food and avoid very salty processed foods such as packet soups, stock cubes or gravies. </p></li>
<li><p>Lose weight. People who are overweight or obese have a higher risk of suffering from hypertension. The key is to eat healthily, exercise and reduce meal portions. Instead of large amounts of starchy food, fruit and vegetable intake must be increased and fatty foods and sugar reduced. </p></li>
<li><p>Drink less. Alcohol also increases blood pressure so it is important to only drink in moderation. Men should not exceed two drinks a day and women one drink a day. </p></li>
<li><p>Exercise more. At least 150 minutes of exercise a week translates into 30 minutes a day, which raises the heart rate. </p></li>
<li><p>Smoke less. A person who smokes can reduce their cardiovascular risk further by cutting down or stopping smoking altogether. </p></li>
</ul>
<p>Even when patients are on treatment for hypertension it is still important for them to try to change their behaviour as this reduces the amount of medication they need to control their blood pressure. </p>
<p>But most importantly, diagnosis is important. Many people are unaware of their cardiovascular risk and raised blood pressure. People should check their blood pressure at least once every five years to ensure that it is normal. This can be done at a clinic or even a pharmacy.</p><img src="https://counter.theconversation.com/content/59296/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Hypertension is one of the leading causes of cardiovascular diseases such as stroke, heart attacks, heart failure and peripheral vascular disease. And in the developing world, it is on the rise.Bob Mash, Division of Family Medicine and Primary Care, Stellenbosch UniversityZelra Malan, Senior Lecturer, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.