Physical Activity and Health - Facts and Figures

Definition

Physical activity is defined as "any force exerted by skeletal muscle that results in energy expenditure above resting level" and includes "the full range of human movement, from competitive sport and exercise to active hobbies, walking and cycling or activities of daily living"(1).

Targets

Boy walking with family The Recommended Daily Amount (RDA) of physical activity for adults is 30 minutes on five or more days of the week, for children it's one hour. The Government has set a target in England and Wales for 70% of the population (in Wales, people up to the age of 65) to be "reasonably active" by 2020 while in Scotland the target is for 50% of adults to achieve the minimum levels by 2022(2, 3, 4).

A report by the Chief Medical Officer (CMO) for England suggests "shorter bouts of physical activity, of 10 minutes or more, interspersed throughout the day are as effective as longer sessions of activity"(1). According to the Welsh Assembly Government's Strategy for Physical Activity and Sport, Climbing Higher, physical activity “can be broken down during the course of the day, because moderate physical activity, even if accumulated in short bouts, can achieve health-related benefit"(3).

The CMO for England has stated that the target, 30 minutes of moderate intensity activity such as brisk walking on at least 5 days per week, will only be achieved by helping people to build activity into their daily lives. His 2004 report on physical activity says, “for most people, the easiest and most acceptable forms of physical activity are those that can be incorporated into everyday life. Examples include walking or cycling instead of driving”(1).

The CMO also reports that “the benefits of physical activity can be gained from activities that can be incorporated into everyday life such as regular brisk walking, using stairs and cycling. Physical activity does not have to be vigorous to confer protection”(1).

Current levels

Physical activity levels are low in the UK: only 40% of men and 28% of women meet the minimum recommendations for physical activity in adults(7)

In Scotland, “72% of women and 59% of men are not active enough for health”, making physical inactivity the most common risk factor for CHD, more than obesity and smoking(4)

The average level of inactivity in Wales is amongst the highest in the UK(6). Only 36% of men and 22% of women meet the recommended levels of activity(18)

Physical activity levels decline rapidly with increasing age. In England only 17% of men and 13% of women aged 65-74 are physically active(5)

Scale of the physical inactivity problem

Legs cycling Physical inactivity is one of the leading causes of death in developed countries, responsible for an estimated 22-23% of CHD, 16-17% of colon cancer, 15% of diabetes, 12-13% of strokes and 11% of breast cancer(8)

The cost of physical inactivity in England – including direct costs of treatment for the major lifestyle-related diseases, and the indirect costs caused through sickness absence – has been estimated at £8.2 billion a year. This does not include the contribution of inactivity to obesity which itself has been estimated at £2.5 billion annually(1)

2,447 people in Scotland die prematurely each year due to physical inactivity. This is made up of 2,162 deaths from CHD (42% of total CHD deaths), 168 deaths from stroke (25% of total stroke deaths), and 117 deaths from colon cancer (25% of total colon cancer deaths)(4)

In Wales, the indirect costs of inactivity in terms of lost output and sickness absence, in addition to the direct costs of health care for entirely avoidable illness, comes to at least £500m per annum, equating to around £200 for each person in Wales – every year(6)

“A 10% increase in physical activity combined with a better diet could, conservatively, prevent 300 premature deaths each year and save the health service in Wales more than £25m annually, with wider economic benefits in excess of £100m annually"(3)

“Increasing activity levels will contribute to the prevention and management of over 20 conditions and diseases including CHD, diabetes, cancer, positive mental health and weight management”(9)

Physically active people have a 20-30% reduced risk of premature death and up to 50% reduced risk of major chronic disease such as CHD, stroke and cancer(1)

3% of all disease burden in developed countries is caused by physical inactivity, and over 20% of CHD and 10% of stroke in developed countries is due to physical inactivity(8)

Physical activity & health inequalities

Girl walking along

In the UK there are significant inequalities in levels of physical activity in relation to age, gender, ethnicity and disability, and corresponding inequalities in health.

In 2003-5, in comparison with average life expectancy in England, life expectancy in areas with the worst health and deprivation was 2.0 fewer years for men, and 1.6 fewer years for women(10)

Compared with the general population in England, Indian, Pakistani, Bangladeshi and Chinese men and women are less likely to meet physical activity recommendations. Only 26% of Bangladeshi men and 11% of Bangladeshi women meet the recommended levels(11)

Life expectancy at birth for men living in the most disadvantaged areas in Scotland is 69.5 years, compared with 78.4 years in affluent areas; for women, it's 77.3 years, compared with 82.3 years in the most affluent areas(12)

In Wales 33% of people in routine and manual occupations meet the current physical activity guidelines compared to 28% in professional and manual occupations(31)

In the most deprived areas of Wales people are twice as unlikely to take exercise. Obesity in these communities is one and a half times greater than in better off areas(32)

The government has a PSA target to reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth. Other PSA targets include reducing the inequalities gap by at least 40% for CVD and by at least 6% for cancer, and halting the rise in obesity among children under 11 by 2010(13)

Regular moderate physical activity, including walking and cycling, can help prevent and reduce the risk of:

Cardiovascular disease (CVD)
Cancer
Obesity
Diabetes
Stroke
Mental Health Problems
High Blood Pressure
Musculoskeletal health – osteoporosis and osteoarthritis

Cardiovascular disease (CVD)

In the UK around 36% of people die from CVD – the main forms are Coronary Heart Disease (CHD) (half of all CVD deaths) and stroke (around a quarter)(11)
CHD is the leading cause of death in the UK, causing 101,000 deaths a year. One in five men and one in six women die from the disease. Almost 1 million people living in the UK have had a heart attack(11)
“CVD, including heart disease and stroke, and cancer are the major causes of death in England, together accounting for almost 60% of premature deaths”(9)
Death rates from CHD in the UK are highest in Scotland and the North of England and lowest in the South of England(11)
An estimated 4.2% of males and 3.0% of females in Scotland have CHD(15)
CVD is estimated to cost the UK economy just under £26 billion a year and CHD over £7.9 billion a year(11)
Inactive and unfit people have almost double the risk of dying from CHD compared with more active and fit people(1)

Cancer

"People who are physically active tend to have a lower risk of cancer…the higher the level of physical activity or fitness, the lower the overall risk of cancer. Moderate to vigorous intensity activity appears to be most beneficial. Frequency is also a factor: more frequent physical activity has been associated with greater risk reductions”(1)
Cancer and CVD are responsible for around 60% of preventable deaths in England(9)
137 people per 100,000 die from cancer in deprived areas in England compared to the England average of 119 people per 100,000(10)
It is estimated that 25% of all deaths from colon cancer in Scotland are attributable to physical inactivity(16)
Physical activity is associated with a reduced risk of breast cancer in women after the menopause. Women with higher levels of physical activity have about a 30% lower risk of breast cancer than the least active(16)
Inactive people have a 3.6% higher risk of colon cancer(5)
Physical activity has a clear protective effect on colon cancer. The most active individuals have, on average, a 40-50% lower risk than the least active(16)
“Physical activity can have an indirect effect through its role in the prevention of obesity which, in the USA, has been estimated to result in 10% of all-cause cancer”(1)

Obesity and overweight

Obesity “doubles the risk of all-cause mortality, coronary heart disease, stroke and type 2 diabetes, and increases the risk of some cancers, musculoskeletal problems and loss of function, and carries negative psychological consequences”(1)
“Obesity reduces life expectancy on average by nine years”(20)
In England, the proportion of adults categorised as obese (BMI over 30) increased from 13.2% of men in 1993 to 23.7% in 2006 and from 16.4% of women in 1993 to 24.2% in 2006. Around 44% of men and 35% of women in England are overweight(7)
More than two-thirds of women and three-quarters of men aged 55-74 in England, are overweight or obese(1)
The prevalence of obesity in 2-10 year olds increased from 9.6% to 17.1% among boys, and from 10.3% to 13.2% among girls between 1995 and 2006(7)
In Wales, 37% of adults are overweight and 18% of adults are obese(18)
In Scotland around 22% of men and 24% of women are obese. 64% of men and 57% of women are overweight(19)
Overweight and obesity are increasing rapidly. In England the percentage of adults aged 16-64 who are obese has doubled in the past decade(11)
“It is likely that for many people, 45–60 minutes of moderate-intensity physical activity a day is necessary to prevent obesity”(9)
Rates of obesity are estimated to rise, by 2035, to 47% and 36% for adult men and women respectively. By 2050, 60% males and 50% females could be obese(30)
“Physical activity that can be incorporated into everyday life – such as walking and cycling – appears to be as effective for weight loss as supervised exercise programmes”(1)
The total annual cost to the NHS of overweight and obesity (i.e. the treatment of obesity and its consequences) is estimated at £2 billion, and the total impact on employment may be as much as £10 billion(30)
By 2050, the NHS cost of overweight and obesity could rise to £9.7 billion, with the wider cost to society being £49.9 billion (at today's prices)(30)

Diabetes

Diabetes mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot use it properly. There are two types of diabetes, Type 1 (insulin dependent) which accounts for 5% to 10% of the diagnoses and Type 2 (non insulin dependent) which is much more prevalent and accounts for 90% to 95% of cases. Type 2 is closely linked to obesity.

“People with diabetes have a higher chance of developing certain serious health problems, including heart disease, stroke, high blood pressure, circulation problems, nerve damage, and damage to the kidneys and eyes. The risk is particularly high for people with diabetes who are also very overweight, who smoke or who are not physically active.” Regular physical activity helps reduce the risk of developing any of these complications(21)
5.6% of men and 4.2% of women in England have diagnosed diabetes – type 2 accounts for most cases(7)
3% of men and 0.7% of women are likely to have undiagnosed diabetes(7)
In total there are likely to be 2.5m adults in the UK with diabetes(11)
5% of adults in Wales reported being treated for diabetes(18)
It is estimated that 161,000 people in Scotland are affected by Type 2 diabetes (3.2% of the population)(16)
The prevalence of diagnosed diabetes has more than doubled in men, and increased by 85% in women since 1991(11)
Prevalence of diabetes in England almost doubled between 1994 and 2003(7)
The number of people with diabetes is set to almost double over the next 20 years(22)
“Physically active people have a 33-50% lower risk of developing type 2 diabetes compared to inactive people”(1)
Regular physical activity can reduce the risk of developing type 2 diabetes by up to 64% in those at high risk of developing the disease(23)

Stroke

Stroke is the term used to describe the effects of an interruption of the blood supply to a localised area of the brain. If part of the brain is deprived of blood, brain cells are damaged or die. This causes a number of different effects, depending on the part of the brain affected and the amount of damage to brain tissue.

Stroke is the third most common cause of death in England and Wales after heart disease and cancer and the leading cause of disability in the UK (24)
Around 100,000 people in England and Wales have a first stroke each year - one every five minutes(24)
At least 300,000 people are living with moderate to severe disabilities as a result of a stroke(24)
It is estimated that 26% of all deaths from stroke in Scotland are attributable to physical inactivity(16)
Stroke costs the UK economy £7 billion a year in health and social costs(11)
In England the prevalence of stroke in women increased from 1.6% in 1994 to 2.2% in 2006; similarly, the overall rate of stroke in men has risen from 1.8% to 2.4%(7)
“The majority of studies report that those who do regular to light to moderate activity have a lower incidence of stroke compared with those who are inactive, and some data suggest that vigorous activity confers no additional benefit”(1)

Further facts and figures are available from the Stroke Association(24)

Mental Health Problems

“1 in 4 people will experience some kind of mental health problem in the course of a year”(25)
“One in four of us will experience a mental health problem at some point in our lives. Each year more than 250,000 people are admitted to psychiatric hospitals”(26)
Regular physical activity improves mood, helps relieve depression, and increases feelings of well-being. A survey carried out by the charity Mind found that 83% of people with mental health problems looked to physical activity to help lift their mood(27)
“Physical activity is effective in the treatment of clinical depression and can be as successful as psychotherapy or medication, particularly in the longer term”(1)
“Physical activity can be considered for its therapeutic effects on mental illness, and also for its impact on mental health in the general population”(1)
Physical activity can help reduce physiological reactions to stress, improve sleep, reduce anxiety(1)
Rhythmic aerobic forms of exercise – including brisk walking and cycling, appear to be most consistently effective(1)
“Regular physical activity reduces the risk of depression and has positive benefits for mental health including reduced anxiety, and enhanced mood and self-esteem”(9)
Physical activity may improve at least some aspects of cognitive function that are important for tasks of daily living, and is also associated with a reduced risk of developing problems of cognitive impairment in old age(16)

High Blood Pressure

Blood pressure is the pressure of blood in your arteries. The higher your blood pressure the greater your risk of developing narrowed arteries which can lead to heart problems and strokes. Exercising helps lower blood pressure.

In England 33.5% of men and 28.8% of women have hypertension(7)
42% of women aged 55-64 in the UK have high blood pressure, and two thirds of women aged 65-74(11)
Among adults in Wales, 16% of males and 20% of females reported being treated for high blood pressure with the greatest proportion being over 65 years of age(18)
People with a history of high blood pressure have almost twice the risk of a heart attack compared to those with no history of high blood pressure(11)
Participating in physical activity helps lower blood pressure(28)
“High blood pressure can be both prevented and treated by physical activity”(1)
Regular physical activity prevents high blood pressure and reduces blood pressure in people with hypertension(23)

Musculoskeletal health – osteoporosis and osteoarthritis

The loss of bony tissue, resulting in bones that are weak and brittle and liable to fracture. This occurs most commonly in old people, particularly women, but it can also result from longer-term steroid therapy, infection or injury.

The health and social care costs of osteoporosis in the UK amount to £1.7-£1.8 billion a year(16)
“Physical activity can increase bone mineral density in adolescents, maintain it in young adults, and slow its decline in old age”(1)
Physical activity can prevent up to 25% of falls by regulating the production and circulation of hormones, improving balance and developing muscle power(1)
Moderate daily general physical activity, especially walking, may be associated with a lower risk of subsequent osteoarthritis, especially in women(1)
Increasing activity levels has beneficial effects on musculoskeletal health, reducing the risk of osteoporosis, back pain and osteoarthritis(8)
Physical activity can help prevent osteoporosis; daily physical activity, especially walking, may be associated with a lower risk of subsequent osteoarthritis, especially among women(16)
Physical activity can help reduce the risk of falling, and therefore fractures, among older people(16)
A broad range of physical activities can reduce pain, stiffness and disability, and increase general mobility, gait, function, aerobic fitness and muscle strength in older adults with osteoarthritis(16)