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What is physical activity, and
how do "physical activity,""exercise," and
Physical activity is any bodily movement produced by skeletal muscles that results in energy expenditure. Exercise is structured activity and tends to have fitness as its goal. Physical fitness is something you acquire--a characteristic or an attribute one can achieve by being physically active. We now know that all types of physical activity can produce significant health benefits. One does not have to achieve a high fitness level to achieve health benefits. Therefore, the focus of this manual is on physical activity and how to promote it through the community.
What is the connection between physical activity and CVD?
Regular physical activity or cardiorespiratory fitness decreases the risk of cardiovascular disease mortality in general and of coronary heart disease mortality in particular. Existing data are not conclusive regarding a relationship between physical activity and stroke. The extent of decreased risk of coronary heart disease attributable to regular physical activity is similar to that of other lifestyle factors, such as abstaining from tobacco use. Regular physical activity prevents or delays the development of high blood pressure, and exercise reduces blood pressure in people with hypertension. Physical activity can also lower blood cholesterol levels which then decrease the risk of developing CVD.
What are the benefits of physical activity?
Is physical inactivity a public health problem?
Yes. Physical activity is a widely achievable means to a healthier life. According to the 1994 Behavioral Risk Factor Surveillance System (BRFSS) survey, 68% of the adult population reported little or no leisure-time physical activity. Since 1984, there has been a general upward trend in inactivity from 61%. Physical activity levels vary by age, education, and income level. At least half of adults in every age, education, and income group were sedentary in 1994. Fewer adults with higher incomes and educations are sedentary. Lower levels of sedentary lifestyle were associated with increased income and, especially, increased education. West Virginia ranked 4th worst among 50 BRFSS participants in sedentary lifestyles. National data suggest that physical inactivity accounts for approximately 25% of all deaths from chronic diseases in the United States.
How much physical activity is enough to prevent disease and promote good health?
Current recommendations focus on a lifestyle approach to increasing physical activity. In 1995, the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine recommended, "Every American adult should accumulate 30 minutes or more of moderate-intensity physical activity over the course of most days of the week." Moderate physical activity would include brisk walking, climbing stairs, expending more energy in house and garden activities, and engaging in active recreational pursuits.
Previously, recommendations specified guidelines regarding frequency, intensity, and duration of activity. Examples of these activities include fast walking, running, cycling, swimming, or aerobic classes. Recent physical activity recommendations include both the structured and lifestyle approaches to increasing physical activity. Either approach is beneficial for an inactive person, and individual interests and opportunities should determine which is used. Additional health and functional benefits of physical activity can be achieved by adding more time in moderate-intensity activity, or substituting more vigorous activity.
Who should consult a physician before starting a physical activity program?
The health risks associated with a sedentary lifestyle far outweigh the risks associated with being active. Most adults of any age may begin a program of moderate activity, such as walking, without medical evaluation. Only those with known cardiovascular disease, or those who have had a major cardiovascular event such as a heart attack, stroke, or heart surgery, will require an evaluation by their physician before engaging in a moderate physical activity program.
Previously inactive men over the age of 40, women over the age of 50, and people at high risk for CVD should first consult a physician before embarking on a program of vigorous physical activity to which they are unaccustomed. Other individuals who should consult with a physician before engaging in strenuous activities are those who use tobacco or have two or more risk factors for cardiovascular disease (including high blood pressure, high blood cholesterol, family history of heart disease, or diabetes). It would be prudent for individuals with degenerative bone conditions, or for middle-aged and older persons who plan to embark upon a program of vigorous physical activity, to obtain a physician's evaluation as well.
Why are so few West Virginians physically active?
In the fall of 1995, a study of the "barriers to leisure-time physical activity in West Virginia" was implemented via the West Virginia University Survey Research Center, the West Virginia University Prevention Research Center, and the West Virginia Bureau for Public Health. The sample was drawn from a population of noninstitutionalized adults (18+ years of age) with household telephones who lived in West Virginia during the survey period. The main reasons respondents did not currently exercise regularly were: time constraints, health problems, work responsibilities, and poor motivation. Additional reasons included child care issues, feeling too tired, family responsibilities, already active at work, already active at home, and being too old. Respondents most frequently listed walking as the activity they would like to begin. Most respondents (81%) stated they would prefer physical activities that their family could do together. However, 54% said they would use exercise facilities or attend classes if they were available near their homes or worksites.
Recommendations to increase physical activity by health care providers influences 64% to participate in regular exercise. However, only about one third (32%) of respondents stated that their health care provider recommended that they participate in regular physical activity. Social support for increasing physical activity was not perceived as a problem for most respondents.
Additional barriers to participating in physical activity could be: neighborhood safety, lack of access to parks and recreational areas and the inability to afford a gym or health club membership.
Since time seems to be the main barrier to an active lifestyle, physical activity needs to be a part of our everyday environment (at the worksite, at home, and part of family activities). We can restructure our worksites by: parking farther away, utilizing steps, encouraging walking/activity breaks, advocating for reduced insurance premiums for physically active lifestyles, etc. We can promote more family role models, family-structured activities, and incentives for family participation wherever physical activities are provided. We can work with our own local communities to structure sidewalks, rezone walkways and bikeways, restrict traffic in playground areas, and promote open play areas.
Published July 1997
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