Regular physical activity provides significant benefits for the treatment of persons with chronic disease and disabilities. Research has shown that regular physical activity can prevent the development of cardiovascular disease, colon cancer, high blood pressure (U.S. Dept. of Health and Human Services, 1996), diabetes (Diabetes Prevention Program Research Group, 2002) and osteoporosis (U.S. Dept. of Health and Human Services, 2004). Regular physical activity also helps treat a variety of common illnesses, including arthritis (CDC, 1999), diabetes (American Diabetes Association, 2004) and cardiovascular disease (NIH, 2002), reducing the need for medications and improving overall quality of life. Physical inactivity and unhealthy eating are significant factors leading to overweight and obesity in children and adults. An estimated 365,000 deaths each year are attributed to these behaviors (Mokdad, 2005).
Current public health recommendations for physical activity call for adults to get at least 30 minutes per day of moderate-intensity physical activity on most (preferably all) days of the week. These recommendations were intended to reduce the risk of chronic diseases (U.S. Dietary Guidelines, 2005). Recent research has shown that achieving this level of habitual physical activity can significantly reduce the risk of numerous chronic diseases among people who are overweight or obese, even if they don't lose weight (President's Council on Physical Fitness, 2000). In 2001, less than half of all adults (45% in the U.S. and 40% in NYS) met the minimum physical activity recommendation of 30 minutes per day on most days of the week (CDC, 2003c; IOM, 2004). Healthy People 2010 calls for at least 30% of adults to engage in vigorous physical activity, which is higher than current rates in the U.S. (25.8%) or NYS (24.3%) (Figure 19).
Figure 19:Proportion of adults who engage in vigorous physical activity that promotes the development and maintenance of cardio-respiratory fitness three or more days per week for 20 or more minutes per occasion. (HP Objective 22-3)
Source: BRFSS 2003, age-adjusted to the 2000 U.S. population
Twenty-six percent of U.S. adults and 27% of adults in NYS engaged in no leisure time physical activity; rates that exceed the Healthy People 2010 target of 20% (Figure 20).
Figure 20:Proportion of adults aged 18 and older who engage in no leisure-time physical activity. (HP Objective 22-1)
Source: BRFSS 2003, age-adjusted to the 2000 U.S. population
Rates of no leisure-time physical activity are higher among women, older adults and those with lower educational attainment, and ethnic minority populations, including Blacks and Hispanics.
Energy expenditure through physical activity is a key component in the prevention and treatment of overweight and obesity (NIH, 1998). Recently released U.S. Dietary Guidelines recommend approximately 60 minutes of moderate-to-vigorous-intensity physical activity on most days of the week without exceeding caloric intake requirements to manage weight and prevent gradual weight gain in adulthood. For adults to sustain weight loss, 60-90 minutes of moderate-intensity activity daily without exceeding caloric intake requirements is recommended (U.S. Department of Agriculture, 2005).
The American College of Sports Medicine makes the following recommendation for physical activity to assist in weight loss: "It is recommended that overweight and obese individuals progressively increase to a minimum of 150 minutes of moderate intensity physical activity per week. However, for long-term weight loss, overweight and obese adults should eventually progress to higher amounts of exercise (e.g., 200-300 minutes per week or more than 2000 kcal per week of leisure-time physical activity)" (Jakicic et al., 2001). This recommendation is based on a reduction in total daily caloric intake as well.
There has not been enough research to establish the specific amount and type of physical activity needed for children and adolescents to achieve and maintain a healthy weight. Recent physical activity recommendations for promoting overall health and well being among children and establishing life-long physical activity habits have been issued. Children (ages 5 through 12 years) should accumulate at least 60 minutes, and up to several hours, of age-appropriate physical activity on all, or most, days of the week. Children should also avoid extended periods of physical inactivity during the daytime hours (National Association for Sport and Physical Education, 2004).
Among U.S. youth, physical activity data are limited, though what data are available indicate declines. By self-report, daily physical education among U.S. high school students has declined from 42% in 1991 to 28% in 2002 (YRBS; DHHS, 1996; IOM, 2004). In NYS, only 18.5% of teens report participating in daily physical education at school, which is about half the Healthy People 2010 target of 50% (Figure 21).
Figure 21:Proportion of adolescents who participate in daily school physical education. (HP Objective 22-9)
Source: YRBSS 2003
In 1999, 75% of adolescents reported meeting current recommendations for physical activity (i.e., participating in at least 30 minutes of moderate physical activity at least 5 days a week or 20 minutes of vigorous activity at least 3 days a week). Rates are lower among Black and Hispanic adolescents. By self-report, 80% of adolescents in the U.S. and 76% of adolescents in NYS spend at least 50% of physical education class being physically active, exceeding the Healthy People 2010 target of 50% (Figure 22).
Figure 22:Proportion of adolescents who spend at least 50 percent of school physical education class time being physically active. (HP Objective 22-10)
Source: YRBSS 2003
The Task Force on Community Preventive Services (CDC, 2001) has compiled recommendations for interventions that communities, policymakers and public health providers can implement. The Task Force, based on their review of current literature on the effectiveness of a variety of strategies to increase physical activity levels, strongly recommends a number of behavioral and social strategies to increase physical activity, including:
- Informational strategies such as "community-wide" campaigns and "point-of-decision" prompts, designed to increase physical activity by providing information necessary to motivate and enable people to change and maintain behavior over time.
- Behavioral and social approaches, like modifying school-based physical education curricula or developing policies that allow for more time for students to engage in physical activity throughout the day.
- Social support interventions in community settings to promote physical activity through building, strengthening, and maintaining supportive social networks.
- Health behavior change programs designed to increase an individual's readiness for change.
- Environmental and policy approaches to increasing physical activity such as the creation of enhanced access to places for physical activity combined with informational outreach activities have also been shown to be effective.
These approaches are designed to provide environmental opportunities, support and cues to help people develop and maintain healthier behaviors (CDC, 2001).
Recent studies suggest that the way we build our communities and transportation systems have a significant effect on physical activity and obesity levels. Places where people can easily and safely walk, for leisure or to destinations such as work, school, or shopping, promote higher levels of physical activity. A national study of 448 metropolitan counties found that people living in sprawling, low-density counties walk less, weigh more, and are more likely to have high blood pressure than people living in more compact counties (Ewing et al., 2003). Residents in highly walkable neighborhoods spent about 70 minutes more per week being physically active than people living in neighborhoods that were less walkable (Saelens et al., 2003). Walking is the most popular form of physical activity, with 38% of New Yorkers reporting some leisure-time walking. The next most frequently mentioned types of leisure-time activity are: running (7%), weight lifting (6%), gardening (5%) and bicycling (4%).
Changes to the built environment over the past 50 years, such as creation of a subsidized interstate highway system, growth in the automobile industry and a shift from urban areas to suburbs, resulted in changes in transportation. For U.S. adults, commuting by automobile to work increased from an average of 22 minutes in 1990 to 26 minutes in 2000. The percentage of U.S. children, aged 5 to 15 years, walking to school declined from 20.2% in 1977 to 12.5% in 2001 (Sturm, 2005b; IOM, 2004). For children living within 1 mile of school, only 31% walked or biked at least once a week in 1999 (CDC, 2002; IOM, 2004).
The benefits of physical activity are well known. All children and adults can benefit from engaging in more daily physical activity. Opportunities for increased access and availability of places to be more physically active is an important component of a public health approach to increasing physical activity.
Jumping Rope After School to Get the Jump on Preventing Overweight and Obesity
Spear-headed by Connie Herzig, Cooperstown elementary school children have been jumping as part of the Red Hot Ropes for 13 years. An after-school class has 3rd, 4th and 5th grade students, that challenges more than 1/2 of each class plus some 20 parent volunteers to learn at least 15 tricks. Tricks that are fun, yet great exercise.
"Forced Learning": Cooperstown is known for baseball, but it's the jump rope that's "huge" at the school. Besides being fun and great exercise, Coach Connie Herzig says it's a real confidence builder. Children learn if they work hard, they can learn. Learning isn't seeing, it's doing it and practice.
Feeling Good Mileage Class
For 6 weeks in the spring, Cooperstown elementary children are challenged to walk, run, skip around a 1/4 mile track. Each lap is recorded by a paper punch on a card that's filled after accumulating 20 punches or 5 miles. For each 5 miles, children receive a colorful plastic foot to tie on to their sneaker laces. For those who complete 25 or 50 miles, they receive recognition and a plastic number for their sneakers at an award ceremony when everyone also received a certificate listing their mileage.