[Jan] Welcome again to Controversies in Public Health.
This is our module 4 lecture.
Our module 4 topic is Physical Activity: Is Sitting Death.
This is Dr. Carney.
Our learning objectives are to describe
the data and trends in physical activity
and inactivity in the United States and globally,
to identify health risks associated with physical
inactivity generally, and sitting specifically,
to describe the health benefits of physical activity
for children, adolescents, and adults,
to identify barriers to physical activity
in children, adolescents, and adults,
and in different geographic areas and populations,
and to propose evidence-based practices that are effective
in promoting and increasing physical activity
in individuals and entire populations.
So why physical activity matters?
This is from the CDC.
About 50% of all adults live with a chronic disease.
Only 1/2 of adults get the physical activity they need
to help reduce and prevent the risk for chronic diseases.
Physical activity saves lives and protects health.
Getting enough physical activity
could prevent 1 in 10 premature deaths.
It could prevent 1 in 8 cases of breast cancer,
1 in 8 cases of colorectal cancer, 1 in 12 cases
of diabetes, and 1 in 15 cases of heart disease.
There are benefits for children,
adults, and for healthy aging.
And you can see all the benefits for children.
For adults you notice that there is great benefit
for reducing risk for chronic conditions,
improving mental health, improving cognitive function,
and preventing weight gain.
And for healthy aging there are benefits
for sleep, balance, active life, bone health,
and delaying the onset of cognitive decline.
This is the self-reported rate
or prevalence of physical inactivity among US adults.
And this is from the Behavioral Risk Factor
Surveillance System in 2017 to 2020.
And you can see this is for all US adults.
And you can see great variation according to where you live.
And as high as greater than 30%
reporting physical inactivity.
And the definition of that was if an individual responded
no to the question, "During the past month
other than your regular job, did you participate
in any physical activities or exercises such as running,
calisthenics, golf, gardening, or walking?"
One of the things that we also notice in addition
to geographic variation is variation by race, ethnicity,
demographic, other demographic factors.
I think this is really important in terms of our efforts
to promote health equity and health for everyone.
So you can look at self-reported prevalence
of physical inactivity among non-Hispanic Asian adults.
How this is generally lower, but varies geographically.
Look next at physical inactivity among non-Hispanic white
adults and with the highest reported rates
of inactivity in some of the Southern states.
This is self-reported rates of physical inactivity among
non-Hispanic American Indian and Alaska native adults.
And you can see that overall these are much higher.
And this is the same measure among Hispanic adults.
And among non-Hispanic black adults.
So what about health benefits
from regular physical activity?
And this is from a news report of an article
published in the journal Circulation in 2022.
And this study looked at more than
a hundred thousand people over 30 years.
And individuals who got the recommended range of moderate,
150 to 300 minutes per week, of moderate activity,
or vigorous physical activity, had 20 to 21% and 19%
low risk of all-cause mortality.
Individuals who performed two to four times
the amount of recommended physical activity
were observed to have even further reductions.
So what about sitting?
We've learned from the much research over the years
and previous Surgeon General's reports that moderate levels
of physical activity, or physical activity at moderate
levels over most days of the week, has substantial
health benefits and reduces all-cause mortality.
But what about, in addition to fitness,
what about sitting?
So sitting is a risk factor independent
of overall physical activity.
And this has been the focus of more recent studies.
It's also a global challenge,
as you can see from the paper published in JAMA Cardiology.
So what do we learn from all this?
Being more active and also sitting less
may help us have longer lives.
The United States Preventive Services Task Force
has evidence-based recommendations
to improve activity levels in individuals.
And the Community Guide to Preventive Services,
which is the guide to community approaches
to improving activity also has evidence-based guidelines,
specifically the role of the adult environment,
making it easier for people to have places to be active.
We still need, however, new strategies to reduce sitting
during the day in both children and adults.
So in controversies about being active,
and particularly the role of sitting in some
of the more recent literature, these are the factors that
you should pay attention to, specifically
what's causing the controversy here,
and how would we respond to the controversy.
For this question, and in our Yellowdig discussion,
I would ask you to specifically consider
what are the barriers to being physically active?
How aware is the public about the evidence for sedentary
behavior, prolonged sitting, as an independent health risk?
Do you think this is widely known or are there things
we should do to be educating people about this?
And how can the importance of more physical activity
as well as less sitting be better communicated?
Again, if you have any questions at all about the material
in this module, please email me anytime.