Workshop1 f racioppi


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  • Not all benefits found have been quantified, ie. Refer back to the overview of health effects first (e.g. risk reduction for overweight not quantified) Or e.g.: Does Physical Activity Protect Against the Onset of Depression Disorders or Depression Symptoms? Conclusions Population-based, prospective cohort studies provide substantial evidence that regular physical activity protects against the onset of depression symptoms and major depressive disorder. Does Physical Activity Reduce Symptoms of Depression? Conclusions The results of RCTs indicate that participation in physical activity programs reduces depression symptoms in people diagnosed as depressed, healthy adults, and medical patients without psychiatric disorders. All from US guidelines committee report, 2008
  • Please note that 63+38=101% -> they have not rounded to 100% in the Global Health Risk Report unfortunately Say that you will explain in a moment what “ the minimum recommended level of physical activity” means Definitions WHO global risk report: Based on: Danaei G, Ding E, Taylor B, Mozaffarian D, Rehm J, Murray CJL et al. Mortality effects of lifestyle, dietary, and metabolic risk factors in the United States: comparative risk assessment. PLoS Medicine, 2009, 6(4):e1000058. Categories of PA were defined using responses regarding PA during the past 30 Days: Inactive : no moderate or vigorous PA Low-active: <2.5h/wk of moderate activity or <600 MET mins/week Moderately active: either >= 2.5h/wk of moderate or >= 1 h of vigorous activity and >= 600 MET mins /week Highly active: >= 1 h/wk of vigorous activity and >= 1.600 MET mins/week According to WHO (and US) reocmmendations: BUT YOU WILL GET TO THAT Moderately active is 150 minutes to 300 (5 hours) minutes of moderate-intensity activity a week (or 75 to 150 minutes of vigorous-intensity physical activity a week). In scientific terms, this range is approximately equivalent to 500 to 1,000 metabolic equivalent (MET) minutes a week. A range is necessary because the amount of physical activity necessary to produce health benefits cannot yet be identified with a high degree of precision; this amount varies somewhat by the health benefit. For example, activity of 500 MET-minutes a week results in a substantial reduction in the risk of premature death, but activity of more than 500 MET-minutes a week is necessary to achieve a substantial reduction in the risk of breast cancer.
  • Insert HEPA and THE PEP logos, CEHAPE
  • Workshop1 f racioppi

    1. 1. Have "PHAN!“ Promoting networking and action on healthy and equitable environments for physical activity Presenter: Francesca RACIOPPI 1 Contributors: C. SCHWEIZER 1 , M. BRAUBACH 1 , L. NEMER 1 , A. TSOUROS 1 , S. KAHLMEIER 2 1 WHO Regional Office for Europe 2 University of Zurich This project is co-funded by the European Union in the framework of the Health Programme 2008-2013.
    2. 2. In this presentation <ul><li>The challenge </li></ul><ul><li>The project </li></ul><ul><li>The modules and achievements </li></ul><ul><li>The partners </li></ul><ul><ul><li>HEPA Europe </li></ul></ul>
    3. 3. Disability adjusted life years lost due to risk factors in EURO, 2004 Source: Global Health Risks. . Geneva, World Health Organization, 2009 ( / ). Physical inactivity is a leading risk factor for health in Europe, associated with nearly 1 million deaths/year The challenge
    4. 4. What do we know about physical activity and health Source:Physical Activity Guidelines Advisory Committee Report, US Department for Health and Human Services, 2008   Strong evidence  Moderate evidence   Coronary heart disease   High blood pressure   Stroke   Diabetes II   Metabolic syndrome   Colon cancer   Breast cancer <ul><li>  Life expectancy </li></ul><ul><li> Body composition / healthy BMI </li></ul><ul><li>  Fitness </li></ul><ul><li>  Functional health in old age </li></ul><ul><li>  Good biomarker profile incl. for osteoporosis </li></ul><ul><li> Sleep quality </li></ul><ul><li> Health related quality of life </li></ul>
    5. 5. Physical inactivity estimated to cause: 21–25% of breast and colon cancer burden 27% of diabetes burden 30% of ischaemic heart disease burden <ul><li>Risk reductions for: </li></ul><ul><ul><li>20-30% for CHD and CVD morbidity and mortality </li></ul></ul><ul><ul><li>Cancer risks: </li></ul></ul><ul><ul><ul><li>30% for colon cancer </li></ul></ul></ul><ul><ul><ul><li>20% - 40% for breast cancer </li></ul></ul></ul><ul><ul><ul><li>20% for lung cancer </li></ul></ul></ul><ul><ul><ul><li>30% for endometrial cancer </li></ul></ul></ul><ul><ul><ul><li>20% for ovarian cancer </li></ul></ul></ul><ul><ul><li>30% for developing functional limitations </li></ul></ul><ul><ul><li>30% for premature all-cause mortality </li></ul></ul>Magnitude of benefits from reaching minimum recommendations for physical activity Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC: U.S. Department of Health and Human Services, 2008.
    6. 6. Physical inactivity status in the European Region <ul><li>WHO estimates that in adults : </li></ul><ul><ul><li>63% are not reaching the minimum recommended level of physical activity </li></ul></ul><ul><ul><li>20% of those are rated as “inactive” </li></ul></ul><ul><ul><li>38% are sufficiently/highly active </li></ul></ul><ul><li>40% of EU citizens say that they play sport at least once a week </li></ul><ul><li>Citizens of Mediterranean and central European countries tend to exercise less </li></ul><ul><li>22% of 11-year old girls and 30% of boys report at least one hour of daily moderate to vigorous PA (MVPA) </li></ul>Global Health Risk Report, World Health Organization, 2009 Eurobarometer 72.3. Special Eurobarometer 334: Sport and PA Health Behaviour in School Aged Children 2005/06 Survey
    7. 7. How much physical activity do we need? New WHO Global Recommendations <ul><li>Providing guidance on dose response relation between frequency, duration, type and total amount of PA needed for prevention of NCD’s </li></ul><ul><li>Three age-groups </li></ul><ul><ul><li>5 – 17 year olds </li></ul></ul><ul><ul><li>18 – 64 year olds </li></ul></ul><ul><ul><li>65+ </li></ul></ul><ul><li>Main target audience; national and local policy makers </li></ul>
    8. 8. Adults aged 18-64 <ul><li>At least 150 minutes of Moderate intensity PA spread throughout the week </li></ul><ul><li>OR </li></ul><ul><li>at least 75 minutes of Vigorous PA spread throughout the week </li></ul><ul><li>OR </li></ul><ul><li>an equivalent combination of those two </li></ul><ul><li>Bouts of at least 10 minutes . </li></ul>
    9. 9. Environmental interventions to meet the recommendations for healthier life <ul><li>The case for active transport </li></ul><ul><li>Do not require making a time slot available for that </li></ul><ul><ul><li>“ I have no time for physical activity” </li></ul></ul><ul><li>Equitable and accessible options </li></ul><ul><li>Feasible </li></ul><ul><ul><li>10% of trips made in car in Europe cover distances of less than 1 km </li></ul></ul><ul><ul><li>more than 30% less than 3 km and 50% of less than 5 km </li></ul></ul><ul><li>Most people can do it </li></ul><ul><li>Is enjoyable!!!! </li></ul>Photo courtesy of Harry Rutter
    10. 10. “ Whole of government approach” in practice: different sectors need to achieve their own goals Goals Interest <ul><li>Reduce emissions of: </li></ul><ul><ul><li>air pollutants; </li></ul></ul><ul><ul><li>greenhouse gases; </li></ul></ul><ul><ul><li>noise </li></ul></ul>Environment Health Reduce congestion Transport Reduce road traffic injuries Transport , Health Reduce investments in infrastructure for more cars Transport Improve accessibility and quality of urban life Transport , Health Complement improvements to vehicles and fuels Transport Increase physical activity Health Promote tourism Tourism and leisure industry Creation of new jobs Economy, welfare, labour
    11. 11. The project <ul><li>Promotion of networking and action on healthy and equitable urban environments for physical activity , with a particular focus on children and disadvantaged groups. </li></ul><ul><li>Aims: </li></ul><ul><ul><li>Supporting Member States in creating and improving strong collaboration among experts and relevant sectors (such as urban planning, health, transport, education, tourism, sport and leisure) </li></ul></ul><ul><ul><li>Providing Member States with intelligence , guidance , examples of good practices and exchange platforms on physical activity promotion in different local and regional environments. </li></ul></ul><ul><li>February 2010 to October 2012 </li></ul>
    12. 12. Cross-cutting: creating supportive environments for physical activity work/school transportation Domains of activity How often? How long? How much in total? Intensity of activity moderate vigorous household recreation and sports Type of activity Aerobic Strength Balance Flexibility
    13. 13. Cross-cutting: networking
    14. 14. The project at a glance WP1: Coordination WP2: Dissemination WP3: Evaluation WP7: Strengthen networking through HEPA Europe WP6: Exchange experience on tools to integrate PA into urban planning WP7: Develop and refine tools to integrate PA into urban planning WP4: Guidance to promote PA in socially disadvantaged groups WP5: Guidance to promote PA in youth
    15. 15. The modules and achievements <ul><li>Inequalities : guidance on how to promote physical activity in disadvantaged groups (WP4) </li></ul><ul><ul><li>Project group established and convened in April 2011 </li></ul></ul><ul><ul><li>Review of evidence </li></ul></ul><ul><ul><li>Collection and analysis of strategies, initiatives and programmes </li></ul></ul>
    16. 16. The modules and achievements <ul><li>Youth : engage youth in developing guidance on successful approaches in the promotion of physical activity in their everyday lives (WP5) </li></ul><ul><ul><li>Project group established and convened at Parma Conference in March 2010 </li></ul></ul><ul><ul><li>Blueprint for engaging youth in physical activity (70% completed) </li></ul></ul>
    17. 17. <ul><li>Tools : exchange of experience on and improvement of tools for integrating physical activity into city planning and economic assessments (WP6 and 7) </li></ul><ul><ul><li>Project groups established (experts and cities): Kuopio (Finland), Brighton-and-Hove (United Kingdom), Pärnu (Estonia), Coimbra (Portugal) </li></ul></ul><ul><ul><li>Work on Health Economic Assessment Tool (HEAT) completed </li></ul></ul><ul><ul><li>Support provided to cities in applying HEAT </li></ul></ul><ul><ul><li>Work plan for use of HEAT in project cities developed </li></ul></ul>The modules and achievements
    18. 18. Making new tools available <ul><li>How much is reduced mortality from regular walking and cycling worth? </li></ul>
    19. 19. The modules and achievements <ul><li>HEPA Europe : strengthen networking and exchange on physical activity promotion through the European network for the promotion of health-enhancing physical activity (HEPA Europe) (WP8) </li></ul><ul><ul><li>HEPA Annual meetings </li></ul></ul><ul><ul><ul><li>November 2010, Olomouc (Czech Republic) </li></ul></ul></ul><ul><ul><ul><li>October 2011, Amsterdam (The Netherlands) </li></ul></ul></ul><ul><ul><ul><li>2012 TBD </li></ul></ul></ul>
    20. 20. The partners <ul><li>C o-funded by the European Union in the framework of the Health Programme 2008-2013. </li></ul><ul><li>The main partners </li></ul><ul><ul><li>Transport, Health and Environment Pan-European Programme (THE PEP) </li></ul></ul><ul><ul><li>European network for the promotion of health-enhancing physical activity (HEPA Europe) </li></ul></ul><ul><ul><li>CEHAPE Youth Network </li></ul></ul><ul><ul><li>WHO Healthy Cities Network. </li></ul></ul>
    21. 21. HEPA Europe <ul><li>A network of organizations and institutions active at the international, national or sub-national level sharing a common vision and contributing to the goals and objectives of HEPA Europe. </li></ul><ul><li>Vision </li></ul><ul><ul><li>to achieve better health through physical activity among all people in Europe. </li></ul></ul><ul><li>Goal </li></ul><ul><ul><li>to strengthen and support efforts and actions that increase participation and improve the conditions favorable to a healthy lifestyle, in particular to health-enhancing physical activity (HEPA) </li></ul></ul>
    22. 22. HEPA Europe – selected activities <ul><li>Networking and cooperation </li></ul><ul><ul><li>Annual meetings and scientific conferences </li></ul></ul><ul><ul><li>Co-sponsorship of other meetings </li></ul></ul><ul><ul><li>Cooperation with other European bodies on physical activity promotion </li></ul></ul><ul><li>Information dissemination </li></ul><ul><ul><li> </li></ul></ul><ul><ul><li> </li></ul></ul><ul><li>Projects, reports and publications </li></ul><ul><ul><li>Health economic assessment tool (HEAT) for walking and cycling </li></ul></ul><ul><ul><li>Guidelines for health-enhancing physical activity promotion programmes </li></ul></ul><ul><ul><li>Working groups on specific topics, such as </li></ul></ul><ul><ul><ul><li>HEPA in primary care settings </li></ul></ul></ul><ul><ul><ul><li>HEPA in socially disadvantaged groups </li></ul></ul></ul><ul><ul><ul><li>Monitoring and surveillance of physical activity </li></ul></ul></ul><ul><ul><ul><li>occupational HEPA </li></ul></ul></ul><ul><ul><ul><li>physical activity promotion and injury prevention </li></ul></ul></ul>
    23. 23. Thanks