"Move for health." This is the slogan for this year's World Health Day (7 April 2002) celebration whose theme, physical activity, emphasizes the importance of physical fitness and an active lifestyle.

Why the choice of this theme at this point in time? The reason, according to WHO Director General, Dr Gro Harlem Brundtland, is to draw the attention of policy makers, the public health community and civil society at large to the epidemiological shift in the global burden of disease and the factors fuelling the change.

What are the facts?

According to current WHO estimates, lack of physical activity leads to more than 2 million deaths annually worldwide. The statistics show that the mortality is due to, among other factors: heart disease and stroke; colon cancer (50% of all deaths); and type 2 diabetes (50% of all occurrences). Other conditions created or exacerbated by the lack of physical activity include: obesity; osteoporosis or loss of calcium in the bones (leading to up to 50% of hip fracture in women); knee and back pain, stress, anxiety and depression. "In Africa, as elsewhere in the developing and developed world, non-communicable diseases have become a major epidemic due, in part, to a rapid transition in lifestyle leading to reduced physical activity, changing diets and tobacco use," says Dr David Nyamwaya, Regional Adviser for Health promotion at the WHO Regional Office for Africa (AFRO).

Dr Nyamwaya adds that although distinct physical activity patterns are not yet discernible in Africa, "there is a clear and unmistakable tendency towards sedentary lifestyle among all age groups." He cites, as proof, the report of a WHO-commissioned survey covering 1999/2000 which showed a general decline in physical activity among school-going children not only in Africa but also in other regions of the world.

It has also been observed that in several African countries sedentary pastimes such as watching television and playing computer games are becoming more popular among the youth; people of working age (late teens to 55-60 years) are threatened by sedentary working conditions; physical activity among older people (over 60 years) tends to decrease with age; …/1 women generally tend to be to be less active than men, and low-income and unemployed people also generally tend to be more physically inactive, mainly because they live in environments which are not conducive to engaging in physical activity.

What kind of physical activities are recommended ?

"Physical activity need not be strenuous to promote health", cautions Dr Mohammed Belhocine, Direcor of the Division for the Prevention of Non-Communicable Diseases at AFRO. "Neither should it be seen as a `new' action but as part of a people's daily life settings and activities. For example walking, the most practiced and most recommended form of physical activity is absolutely free."

Among other countless simple activities recommended by experts are household chores such as sweeping and/or vacuum cleaning; cleaning or dusting windows or furniture; gardening; cycling; riding a stationary bicycle even while watching television; physically getting up and manually operating the television, video cassette recorder and other gadgets rather than using the remote control; rope skating, and, even, dancing.

How about white-collar workers who complain of lack of time for physical activity? Dr Nyamwaya insists that office workers can achieve an active lifestyle and reap numerous health benefits without having to become athletes. For example, they can do simple stretching exercises while seated at their desks; climb and walk down the stairs; perform sit-ups, or stand up while making or receiving telephone calls. "The goal is to be active for at least 30 minutes over the course of the day, or at the very least three days in a week" he says.

What are the benefits of physical activity?

Experts on the subject agree that moderate intensity activities, such as are described above, provide health benefits to all who engage in them. The WHO Regional Director for Africa, Dr Ebrahim M. Samba, explains: "In all ages, it (physical activity) enhances blood circulation, respiration and the digestion and metabolism of food. When linked with improvements in healthy diet, prevention of tobacco and other harmful substance use, physical activity contributes to increased disease prevention and enhances general health and well-being.

"Physical activity (also) reduces the risk of both developing and dying from cardiovascular disease ( CVD - which causes 30% of global deaths), reduces the risk of developing type two diabetes (90 % of global diabetes cases) and colon cancer. It helps reduce/prevent hypertension and osteoporosis, reduces stress, anxiety and feelings of depression and helps with the control of weight."

Challenges

Given the proven benefits of physical activity, what actions should governments, individuals and civil society take? "We should all move very quickly to create supportive environments that would facilitate the design of a new health paradigm which emphasizes physical activity," responds Dr Belhocine.

He identified some of these as:

• political commitment in all its ramifications;

• the intensification of health promotion activities in settings such as schools and workplaces (particularly sensitization to the fact that physical activity could lower high blood pressure in patients with high blood pressure even without medical intervention);

• putting in place physical attributes such as safe pedestrian paths in our towns and cities, safe cycling and walking ways, parks, sports, recreation and playing facilities, and

• public involvement in physical activity by political/community/opinion leaders who should serve as role models to lend credibility to health-friendly policies and programmes by practicing what they preach.

Dr Belhocine is also quick to add: " It is important to facilitate access for all citizens irrespective of socio-econmic and health status to all facilities and infrastructure intended to promote physical activity. To create a supportive culture and to motivate people to live actively, the value of an active lifestyle must be promoted in the minds of all citizens."

He concludes with a `revelation': "Many people are oblivious of the fact that World Health Report 2001 ranked cardiovascular disease, at 9.27%, above malaria, at 9.1%, as one of the leading causes of mortality in Africa. For those who still would not embrace physical activity to promote their health, this is a sobering thought."

Very few will disagree. 

For further information, please contact

Samuel T. Ajibola
Public Information and Communication Unit 
World Health Organization - Regional Office for Africa
P.O. Box 6 Brazzville, Congo. 
E-mail: ajibolas [at] afro.who.int (ajibolas[at]afro[dot]who[dot]int) 
Tel: 1 321 95 39378