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[Jan] Welcome again to
Controversies in Public Health.

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This is our module 4 lecture.

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Our module 4 topic is Physical
Activity: Is Sitting Death.

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This is Dr. Carney.

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Our learning objectives are to describe

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the data and trends in physical activity

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and inactivity in the
United States and globally,

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to identify health risks
associated with physical

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inactivity generally,
and sitting specifically,

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to describe the health
benefits of physical activity

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for children, adolescents, and adults,

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to identify barriers to physical activity

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in children, adolescents, and adults,

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and in different geographic
areas and populations,

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and to propose evidence-based
practices that are effective

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in promoting and increasing
physical activity

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in individuals and entire populations.

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So why physical activity matters?

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This is from the CDC.

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About 50% of all adults
live with a chronic disease.

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Only 1/2 of adults get the
physical activity they need

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to help reduce and prevent
the risk for chronic diseases.

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Physical activity saves
lives and protects health.

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Getting enough physical activity

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could prevent 1 in 10 premature deaths.

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It could prevent 1 in 8
cases of breast cancer,

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1 in 8 cases of colorectal
cancer, 1 in 12 cases

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of diabetes, and 1 in 15
cases of heart disease.

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There are benefits for children,

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adults, and for healthy aging.

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And you can see all the
benefits for children.

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For adults you notice that
there is great benefit

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for reducing risk for chronic conditions,

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improving mental health,
improving cognitive function,

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and preventing weight gain.

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And for healthy aging there are benefits

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for sleep, balance,
active life, bone health,

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and delaying the onset
of cognitive decline.

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This is the self-reported rate

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or prevalence of physical
inactivity among US adults.

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And this is from the
Behavioral Risk Factor

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Surveillance System in 2017 to 2020.

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And you can see this is for all US adults.

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And you can see great variation
according to where you live.

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And as high as greater than 30%

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reporting physical inactivity.

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And the definition of that
was if an individual responded

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no to the question, "During the past month

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other than your regular
job, did you participate

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in any physical activities
or exercises such as running,

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calisthenics, golf,
gardening, or walking?"

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One of the things that we
also notice in addition

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to geographic variation is
variation by race, ethnicity,

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demographic, other demographic factors.

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I think this is really important
in terms of our efforts

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to promote health equity
and health for everyone.

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So you can look at
self-reported prevalence

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of physical inactivity among
non-Hispanic Asian adults.

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How this is generally lower,
but varies geographically.

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Look next at physical inactivity
among non-Hispanic white

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adults and with the highest reported rates

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of inactivity in some
of the Southern states.

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This is self-reported rates
of physical inactivity among

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non-Hispanic American Indian
and Alaska native adults.

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And you can see that overall
these are much higher.

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And this is the same measure
among Hispanic adults.

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And among non-Hispanic black adults.

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So what about health benefits

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from regular physical activity?

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And this is from a news
report of an article

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published in the journal
Circulation in 2022.

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And this study looked at more than

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a hundred thousand people over 30 years.

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And individuals who got the
recommended range of moderate,

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150 to 300 minutes per
week, of moderate activity,

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or vigorous physical activity,
had 20 to 21% and 19%

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low risk of all-cause mortality.

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Individuals who performed
two to four times

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the amount of recommended
physical activity

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were observed to have
even further reductions.

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So what about sitting?

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We've learned from the much
research over the years

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and previous Surgeon General's
reports that moderate levels

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of physical activity, or
physical activity at moderate

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levels over most days of
the week, has substantial

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health benefits and reduces
all-cause mortality.

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But what about, in addition to fitness,

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what about sitting?

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So sitting is a risk factor independent

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of overall physical activity.

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And this has been the focus
of more recent studies.

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It's also a global challenge,

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as you can see from the paper
published in JAMA Cardiology.

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So what do we learn from all this?

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Being more active and also sitting less

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may help us have longer lives.

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The United States Preventive
Services Task Force

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has evidence-based recommendations

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to improve activity levels in individuals.

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And the Community Guide
to Preventive Services,

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which is the guide to community approaches

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to improving activity also
has evidence-based guidelines,

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specifically the role of
the adult environment,

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making it easier for people
to have places to be active.

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We still need, however, new
strategies to reduce sitting

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during the day in both
children and adults.

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So in controversies about being active,

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and particularly the
role of sitting in some

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of the more recent literature,
these are the factors that

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you should pay attention to, specifically

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what's causing the controversy here,

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and how would we respond
to the controversy.

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For this question, and in
our Yellowdig discussion,

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I would ask you to specifically consider

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what are the barriers to
being physically active?

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How aware is the public about
the evidence for sedentary

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behavior, prolonged sitting,
as an independent health risk?

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Do you think this is widely
known or are there things

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we should do to be
educating people about this?

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And how can the importance
of more physical activity

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as well as less sitting
be better communicated?

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Again, if you have any questions
at all about the material

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in this module, please email me anytime.