The pandemic proportions of lethargy

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18 juli 2012 | If you lead a sedentary life at your computer, you might as well start smoking. The one habit seems as least as lethal as the other. On the eve of the Olympics, The Lancet tries to get people moving.

Just as millions of people are installing themselves on thecouch to watch the Olympic Games, The Lancet set out a series ofarticles to scare people into physical activity. “Physicalinactivity burdens society through the hidden and growing cost ofmedical care and loss of productivity. Getting the public toexercise is a public health priority because inactive people arecontributing to a mortality burden as large as tobaccosmoking.”

The true miracle drug

“Exercise has been called a miracle drug that can benefitevery part of the body and substantially extend lifespan”,authors Chi Pang Wen and Xifeng Wu state in the journal. “Yet it receives little respectfrom doctors or society. Socially, being inactive is perceivedas normal, and in fact doctors order patients to remain on bed restfar more often than they encourage exercise. This passive attitudetowards inactivity, where exercise is viewed as a personal choice,is anachronistic, and is reminiscent of the battles still beingfought over smoking.”

The facts should scare any couch potato into action. “Toindividuals, the failure to spend 15-30 min a day in brisk walkingincreases the risk of cancer, heart disease, stroke, and diabetesby 20-30%, and shortens lifespan by 3-5 years. Although thebenefits of exercise and the harms of inactivity might seem liketwo sides of a coin, the benefits message emphasised so far has notworked well for most of the population. In tobacco control, doctorsdid not emphasise the benefits of non-smoking, but the harms ofsmoking. Similarly, armed with credible global and national data,we should emphasise the harms of inactivity and not merely thebenefits of exercise.”

5 million deaths each year

“Smoking and physical inactivity are the two major risk factorsfor non-communicable diseases around the globe. Of the 36 milliondeaths each year from non-communicable diseases, physicalinactivity and smoking each contribute about 5million. Physical inactivity and smoking have similarpopulation attributable risks, although their relativerisks and prevalence are somewhat different.”

“For smoking, intensive and coordinated tobacco control effortshave been organised through WHO’s Framework Convention on TobaccoControl (FCTC), a treaty already ratified by 175 countries. Bycontrast, we have few organised efforts to combat physicalinactivity. Governmental programmes to move people from sedentaryliving to meeting recommended levels of exercise are very limited,in both developed and developing countries. Where available, theseprogrammes are viewed as useful but not as essential as, say,anti-smoking programmes, partly owing to a failure to emphasise thecolossal harms of inactivity. Furthermore, treatment of physicalinactivity is not a reimbursable item under most health insuranceprogrammes, and few financial incentives exist for health-careproviders to spend time discussing exercise during medicalvisits.”