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Get those patients moving

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Physical activity forms an important part of the energy balance equation and is therefore a significant focus in Australia’s efforts to reduce rates of overweight and obesity.

Physical inactivity is also an independent risk factor for acquiring chronic diseases including diabetes, cardiovascular disease, osteoporosis and depression, which means it warrants attention in its own right.

Recently released data from the Australian Health Survey showed that 43 per cent of adults were sufficiently active (meaning they met the recommended amount of at least 30 minutes of moderate physical activity on most days).

Participation was greatest among 18 to 24-year-olds, with rates generally decreasing with age. Levels of activity were also found to be associated with socioeconomic status, health, Body Mass Index and whether or not a person was a smoker.

Incorporating exercise into travel has been identified as a highly effective way of increasing levels of physical activity.

Earlier this week, the Commonwealth Department of Infrastructure and Transport released the Ministerial Statement Walking, Riding and Access to Public Transport – Supporting active travel in Australian communities.

The Statement sets out how the Australian Government will work to increase the proportion of people walking and riding for short trips. No specific funding was associated with the Statement, but it does highlight that in addition to the obvious public health benefits (including reduced health care costs), active travel increases capacity in the overall transport network, reduces congestion, lessens environmental impacts and improves community well being and social cohesion.

The Statement also made reference to research commissioned by the Queensland Government in 2011 which found that for each person who cycles 20 minutes to and from work, the economy benefited by $21.20, and for each person who walked 20 minutes to work and back, the benefit was $8.48. These calculations took into account injury costs associated with walking and cycling, which were still significantly outweighed by the health benefits gained.

We know that bicycle riding can be encouraged with safe, well connected bicycle pathways and secure cycle storage facilities, and that participation in walking can be increased with convivial streetscapes, access to public transport as well as having local shops, cafes and other desirable locations. These effects of town planning and urban design on physical activity and health were highlighted during a presentation at the AMA’s 2012 National Conference.

As leaders in the community, doctors play an important role in encouraging physical activity and regular planned exercise. They do this by example through their own participation in various sporting and recreational pursuits, and through brief interventions with patients.

It is expected that updated national physical activity recommendations will be released shortly.

If the recently revised Australian Dietary Guidelines are any indication, it is likely they will recommend an increase from 30 minutes to 45 to 60 minutes of moderate physical activity on most days for those wishing to maintain a healthy weight, and 60 to 90 minutes of activity for those wishing to lose weight, or to prevent weight gain in those previously obese. 

While these recommendations would acknowledge the current health impact of overweight and obesity, the risk is that people find the time commitment unrealistic in the context of their daily lives. Any recommendations in relation to the interaction between the duration and intensity of physical activity will also be of interest.

The AMA’s Public Health and Child and Youth Health Committee recently considered the importance of physical activity and agreed that it was timely to update the AMA’s Position Statement Physical Activity – 2006.

The revised policy will include a specific emphasis on the importance of physical activity for brain development during childhood, and a focus on the role of physical activity in the prevention and management of chronic disease.

I know that many AMA members are strong advocates for increasing levels of physical activity, and I welcome your feedback on this important issue.