NHS promotes walking over going to the gym

 March 31, 2004-The Guardian

Thirty minutes of moderate exercise a day will cut adults' risk of heart disease in half, reduce their chance of contracting colon cancer by 40% and slash the likelihood of other conditions such as obesity, diabetes and osteoporosis, the NHS's public health advisers in England said yesterday.
Modest increases in activity, from walking to line dancing and gardening, would cut billions off health budgets and improve the country's sense of physical and mental wellbeing, according to the Health Development Agency.

Its robust intervention paves the way for sedentary lifestyles to become the next target for government action, alongside measures to modify drinking, smoking and eating habits.

The five days, 30 minutes a day, message has been used by health professionals for nearly a decade, but exercise advice has had a low priority until now. Political interest has focused on sport and physical activity among schoolchildren, although the major gains in public health would be made by small improvements in getting adults moving, as three in four women and three in five men do not follow the advice.

Experts believe it is better to encourage people to exercise within their daily routine rather than to go to the gym.

The chief medical officer, Professor Sir Liam Donaldson, is expected to spend time outlining the consequences of continuing a couch potato existence in the next few weeks.

Meanwhile, the HDA wants GPs and nurses to speak to patients about their activity levels as routinely as about smoking. This could mean having to increase support services. The emphasis so far has been giving "exercise prescriptions" to a small group of patients, but the agency described this as making "a relatively large effort to intervene with a small number of people".

The government should also consider giving companies financial incentives to encourage employees to exercise. HDA officials are concerned that local experiments, including free swimming lessons and activity programmes providing "exercise buddies" for adults over 50, have not been evaluated nationally.

But they are also keen to ensure that a new emphasis on exercise does not take attention away from the food industry's responsibility to help improve diet and nutrition. They say ministers face a complex balancing act when drawing up white paper proposals on public health this year.

Paul Streets, the agency's chief executive, said: "We're facing a race against time to get more people more active. The evidence shows that the best way to do this is by encouraging activity that is achievable, can easily fit into our everyday lives and importantly, one that we enjoy."

Mr Streets, who cycles around London, said: "This daily 30 minutes can be done in chunks of time - it doesn't have to be in one session. We're seeing unprecedented levels of obesity, but physical activity is part of the answer in tackling this major public health issue in tandem with a healthy diet."

Mike Kelly, the agency's director of evidence and guidance, said people also needed safe places to walk or cycle, as well as accessible and affordable gyms and leisure centres.

"We need service providers - including the government, NHS, workplaces and private companies - to make it easier to be physically active."

The Croydon Active Lifestyle Project, funded by the South London council and the local primary care trust, is one of the examples the HDA thinks others might follow. Patients referred to the scheme pay £5 upfront and £2 for each of 20 activity sessions. Customers who are not referred pay £3 to £4 a session.

Kenneth Simmans, 73, weighed 140kg (22 stone) and had diabetes and asthma, when referred by his GP last September. He attended a weekly class which concentrated on stretching and muscle exercise. Now he is walking regularly and has a more balanced diet.

"I felt like a two-year-old," he said. "I have lost four stone so far and my asthma is now non- existent."

Top 10 tips for getting more active

• Take the stairs or walk up escalators instead of using the lift

• Walk to the next stop before getting on the bus

• Get a pedometer to record how much you are walking each day

• Enlist the support of a friend

• Leave your car at home for short journeys

• Go for a walk at lunch-time at work

• Play active games with your children and walk with them to school instead of driving them

• Get on your bike

• Try taking up a new hobby such as dancing or gardening

• Be more active in the bedroom - that means sex, not dumbbells