We are experiencing a planetary tipping point with global warming, environmental degradation, and losses in biodiversity. The burdens of these changes fall disproportionately on poor and marginalized populations. Physical activity promotion strategies need to be aligned with climate action commitments, incorporating the Intergovernmental Panel on Climate Change scenarios in physical activity action plans. The promotion strategies must consider equity a core value and promote physical activity to the most vulnerable populations so that they are protected from the ill-health impacts of a changing climate.
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What the Physical Activity Community Can Do for Climate Action and Planetary Health?
Rodrigo Reis, Ruth F. Hunter, Leandro Garcia, and Deborah Salvo
A Conceptual Primer on the Potential of Adaptive Policies to Reduce Physical Inactivity
Karen Milton, Harry Rutter, Harriet Koorts, and Leandro Garcia
Background: Despite the existence of physical activity policies across many countries, insufficient physical activity remains a major global public health problem. Physical inactivity is an emergent feature of complex systems; it results from a wide range of factors at multiple levels that interact to influence behavior. Traditional approaches to public policy often fail within complex systems, largely due to unpredictability in how the system will respond. Adaptive policies, which are designed to allow for uncertainty about future system behavior and to change over time, may offer a promising solution. In this paper, we introduce the concept of adaptive policies and illustrate how this innovative approach to policy making may be beneficial for reducing physical inactivity. Design: Drawing on existing literature and guiding principles for policy making, we provide 3 examples to illustrate how the concept of adaptive policies can be applied to address physical inactivity. Discussion: The examples illustrate how changes to the way policies and interventions are developed, implemented, and evaluated could help to overcome some of the limitations in existing practices. A key challenge will be engaging policymakers to take a broader perspective of the physical activity system, develop policies that are designed to be adaptable across a range of different future scenarios, and embrace uncertainty and long-term adaptability. Conclusion: Adaptive policies may support decision makers globally to achieve the widespread and sustained changes necessary to increase population levels of physical activity.
Sedentary Behaviors, Leisure-Time Physical Inactivity, and Chronic Diseases in Brazilian Workers: A Cross Sectional Study
Leandro Martin Totaro Garcia, Kelly Samara da Silva, Giovâni F. Del Duca, Filipe Ferreira da Costa, and Markus Vinicius Nahas
Background:
Our purpose was to examine the association of television viewing (hours/day), sedentary work (predominantly sitting at work), passive transportation to work (car or motorcycle), and the clustering of these behaviors (“sedentary lifestyle”), as well as leisure-time physical inactivity (LTPI), with chronic diseases (hypertension, hypercholesterolemia, type 2 diabetes, obesity, and clustering of chronic diseases) in Brazilian workers.
Methods:
Cross-sectional study conducted from 2006 to 2008 in 24 Brazilian federal units (n = 47,477). A questionnaire was applied. Descriptive statistics, binary and multinomial logistic regressions were used.
Results:
Magnitude of association with chronic diseases varied greatly across domains and gender. Sedentariness at work was the most consistent behavior associated with chronic diseases, especially in men (ORhypertension = 1.10, 95% CI: 1.01–1.20; ORhypercholesterolemia = 1.34, 95% CI: 1.21–1.48; ORobesity = 1.27, 95% CI: 1.15–1.41; OR1chronic disease = 1.17, 95% CI: 1.09–1.26; OR≥2chronic diseases = 1.61, 95% CI: 1.46–1.78) compared with women (ORhypercholesterolemia = 1.15, 95% CI: 1.01–1.31; ORobesity = 1.24, 95% CI: 1.04–1.48). LTPI was associated with all diseases in men (except type 2 diabetes), but only with obesity in women.
Conclusion:
Adverse health consequences may be differently associated according to behavior domain and gender. Sedentary work and LTPI were consistently associated with chronic disease in Brazilian workers, especially in men.
Physical Activity Promotion and the United Nations Sustainable Development Goals: Building Synergies to Maximize Impact
Deborah Salvo, Leandro Garcia, Rodrigo S. Reis, Ivana Stankov, Rahul Goel, Jasper Schipperijn, Pedro C. Hallal, Ding Ding, and Michael Pratt
Background: Many of the known solutions to the physical inactivity pandemic operate across sectors relevant to the United Nations Sustainable Development Goals (SDGs). Methods: The authors examined the contribution of physical activity promotion strategies toward achieving the SDGs through a conceptual linkage exercise, a scoping review, and an agent-based model. Results: Possible benefits of physical activity promotion were identified for 15 of the 17 SDGs, with more robust evidence supporting benefits for SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions). Current evidence supports prioritizing at-scale physical activity-promoting transport and urban design strategies and community-based programs. Expected physical activity gains are greater for low-and middle-income countries. In high-income countries with high car dependency, physical activity promotion strategies may help reduce air pollution and traffic-related deaths, but shifts toward more active forms of travel and recreation, and climate change mitigation, may require complementary policies that disincentivize driving. Conclusions: The authors call for a synergistic approach to physical activity promotion and SDG achievement, involving multiple sectors beyond health around their goals and values, using physical activity promotion as a lever for a healthier planet.
Clustering of Physical Inactivity in Leisure, Work, Commuting, and Household Domains: Data From 47,477 Industrial Workers in Brazil
Giovâni F. Del Duca, Leandro Martin Totaro Garcia, Shana Ginar da Silva, Kelly Samara da Silva, Elusa S. Oliveira, Mauro V. Barros, and Markus V. Nahas
Background:
Physical inactivity in each domain (leisure, work, commuting, and household) is not completely independent. This study aimed to describe the clustering of physical inactivity in different domains and its association with sociodemographic factors among Brazilian industrial workers.
Methods:
This was a cross-sectional, population-based study using data from 23 Brazilian states and the Federal District collected via questionnaires between 2006 and 2008. Physical inactivity in each domain was defined as nonparticipation in specific physical activities. Clustering of physical inactivity was identified using the ratio of the observed (O) and expected (E) percentages of each combination. Multinomial logistic regression was used to identify sociodemographic factors with the outcome.
Results:
Among the 44,477 interviewees, most combinations exceeded expectations, particularly the clustering of physical inactivity in all domains among men (O/E = 1.37; 95% CI: 1.30; 1.44) and women (O/E = 1.47; 95% CI: 1.36; 1.60). Physical inactivity in 2 or more domains was observed more frequently in women, older age groups, individuals living without a partner, and those with higher education and income levels.
Conclusions:
Physical inactivity tends to be observed in clusters regardless of gender. Women and workers with higher income levels were the main factors associated with to be physically inactive in 2 or more domains.
Physical Activity Guidelines for the Brazilian Population: Development and Methods
Maria Cecília Marinho Tenório, Christianne Coelho-Ravagnani, Daniel Umpierre, Douglas Roque Andrade, Roseanne Autran, Mauro Virgilio Gomes de Barros, Tânia R. Bertoldo Benedetti, Fabiana Vieira Santos Azevedo Cavalcante, Edilson Serpeloni Cyrino, Samuel Carvalho Dumith, Alex Antonio Florindo, Leandro Martin Totaro Garcia, Grégore Iven Mielke, Raphael Mendes Ritti-Dias, Lorena Lima Magalhães, Paula Fabricio Sandreschi, Sofia Wolker Manta, Juliana Rezende Melo da Silva, Kelly Samara da Silva, Fernando Carlos Vinholes Siqueira, Pedro Curi Hallal, and on behalf of the Brazilian Physical Activity Guidelines Working Group*
Background: This article describes the process and methods used in the development of the first ever Physical Activity Guidelines for the Brazilian Population. Methods: The steering committee established 8 working groups based on other guidelines and the Brazilian agenda for public health and physical activity (PA) promotion: (1) understanding PA; (2) children up to 5 years; (3) children and youth (6–17 y); (4) adults; (5) older adults (60 years and above); (6) physical education at school; (7) pregnant and postpartum women; and (8) people with disabilities. Working groups were formed to (1) synthesize the literature on each topic; (2) conduct workshops with stakeholders, health professionals, researchers, and the public; and (3) prepare a draft chapter for open online consultation. Results: The document provides guidance for the population on the benefits of being active and recommendations regarding the amount (frequency, intensity, and duration) of PA recommended across all chapters. It also includes information on supporting networks for PA. Conclusions: The PA guidelines are widely accessible in Portuguese, including versions in English, Spanish, audiobook, and Braille, and will assist policy makers and professionals from several sectors to promote PA. The ultimate goal is to increase population levels of PA in Brazil.
Physical Activity Guidelines for the Brazilian Population: Recommendations Report
Daniel Umpierre, Christianne Coelho-Ravagnani, Maria Cecília Tenório, Douglas Roque Andrade, Roseanne Autran, Mauro Virgilio Gomes de Barros, Tânia R. Bertoldo Benedetti, Fabiana Vieira Santos Azevedo Cavalcante, Edilson Serpeloni Cyrino, Samuel Carvalho Dumith, Alex Antonio Florindo, Leandro Martin Totaro Garcia, Sofia Wolker Manta, Grégore Iven Mielke, Raphael Mendes Ritti-Dias, Lorena Lima Magalhães, Paula Fabricio Sandreschi, Juliana Rezende Melo da Silva, Kelly Samara da Silva, Fernando Carlos Vinholes Siqueira, Pedro Curi Hallal, and on behalf of the Brazilian Physical Activity Guidelines Working Group*
Background: This article presents the recommendations from the Physical Activity Guidelines for the Brazilian Population. Methods: A steering committee composed of a chair, 6 experts in physical activity, and representatives from the Ministry of Health/Brazil, Pan American Health Organization, Brazilian Society of Physical Activity and Health designed the guidelines, which was implemented by 8 working groups, as follows: (1) understanding physical activity, (2) children up to 5 years old, (3) children and youth from 6 to 17 years old, (4) adults, (5) older adults (60 years and above), (6) physical education at school, (7) pregnant and postpartum women, and (8) people with disabilities. The methodological steps included evidence syntheses, hearings with key stakeholders, and public consultation. Results: Across 8 chapters, the guidelines provide definitions of physical activity and sedentary behavior, informing target groups on types of physical activity, dosage (frequency, intensity, and duration), benefits, and supporting network for physical activity adoption. The guidelines are openly available in Portuguese, Spanish, English, and Braille and in audio versions, with a supplementary guide for health professionals and decision makers, and a report about the preparation and references. Conclusions: The Physical Activity Guidelines for the Brazilian Population provide evidence-based recommendations, being a public-directed resource to contribute to the physical activity promotion in Brazil.