WHO Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity ( 19) recommend multimodal exercises to prevent falls, and exercises for older adults with declining mobility. Recent WHO guidance in Risk reduction of cognitive decline and dementia ( 18) states that physical activity should be recommended to adults with normal cognition (strong recommendation) and those with mild cognitive impairment (conditional recommendation) to reduce the risk of cognitive decline. The WHO Package of essential noncommunicable disease interventions for primary health care in low-resource settings ( 17) provides a protocol for the clinical management of hypertension, type-2 diabetes, raised cardiovascular risk, asthma, and chronic obstructive pulmonary disease, and includes counselling to progressively increase physical activity to moderate levels (such as brisk walking) and at least 150 minutes per week, in line with the 2010 global recommendations. The importance of physical activity for health is recognized in other WHO guidelines. They will form part of the overall set of global recommendations on physical activity and sedentary behaviour. The 2020 WHO Guidelines on physical activity and sedentary behaviour, replace the 2010 guidelines and are based on the most recent advances in the evidence for the selected behaviours and associated health consequences. The guidelines were called for by the Commission on Ending Childhood Obesity (recommendation 4.12) ( 16), and address the omission of this younger age group in the 2010 Global recommendations on physical activity for health ( 1). In 2019, WHO published Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age ( 15). In 2018, the World Health Assembly, in resolution WHA71.6, 1 called for WHO to update the 2010 recommendations. In 2010, WHO published the Global recommendations on physical activity for health ( 1), the first population-based public health guidelines for children and adolescents, adults and older adults. The Global action plan on physical activity 2018–2030 ( 14) sets out 4 strategic objectives and 20 policy actions to achieve a 15% relative reduction in the global prevalence of physical inactivity in adults and adolescents by 2030. These differences can be explained by inequities in access to opportunities to be physically active, further amplifying inequalities in health.Ĭurrently, there are no global estimates of sedentary behaviour, but technological innovation and the transition towards more sedentary occupations and recreation, and the increasing use of personal motorized transportation are contributing to changing patterns of physical activity and increased sedentary behaviour across the world. The data also highlight that women are less active than men in most countries and that there are significant differences in levels of physical activity within and between countries and regions. Global estimates of physical inactivity indicate that in 2016, 27.5% of adults ( 12) and 81% of adolescents ( 13) did not meet the 2010 WHO recommendations ( 1), and trend data show limited global improvement during the past decade. It is estimated that between four and five million deaths per year could be averted if the global population was more active ( 2, 11). Physical inactivity is defined as not meeting the 2010 Global recommendations on physical activity for health ( 1) and is a leading contributor to global mortality. Emerging new evidence indicates that high levels of sedentary behaviour are associated with cardiovascular disease and type-2 diabetes as well as cardiovascular, cancer and all-cause mortality ( 8– 10). At the low end of the intensity range, sedentary behaviour is defined as any waking behaviour while in a sitting, reclining or lying posture with low energy expenditure ( 7). Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure ( 1) and can be performed at a variety of intensities, as part of work, domestic chores, transportation or during leisure time, or when participating in exercise or sports activities. Physical activity also has benefits for mental health ( 4), delays the onset of dementia ( 5), and can contribute to the maintenance of healthy weight ( 1) and general well-being ( 6). Regular physical activity is a known protective factor for the prevention and management of noncommunicable diseases such as cardiovascular disease, type-2 diabetes, breast and colon cancer ( 1– 3).
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