WHO presser on physical activity guidelines 24 November 2020

Thank you very much for joining this WHO press conference regarding the launch of our new guidelines on a physical activity.

First, I would really like to thank our colleagues from UN Information Service for facilitating this, this press briefing.

We understand that there are a number of things going on and there is a, there's a competition on, on the attention of journalists, especially around around Afghanistan and, and, and we are very aware that that may not be here with us today because of that, but we are, we are happy to have those who are online.

Before I introduce the topic, we have sent to you the executive summary of the report and guidelines.

We have also sent to you press release.

Both of these documents as well as this press briefing is under embargo until tomorrow evening, midnight, Geneva time, so, so 0000, tomorrow night, Geneva time.

We have equally sent to those outside journalists who wanted to have executive summary and press release also under embargo.

So we expect that that this topic will be covered because it's very important.

But just to tell you that for you who are at at at at ballet, we offer this exclusive pre briefing where you can get more information and prepare your stories on this on this topic.

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We are launching new recommendation on how to stay active and healthy and this guidance also, as we mentioned in our media advisory, include guidance for specific groups like women during their pregnancy, people with disabilities, elderly people and people living with certain conditions like diabetes and hypertension.

We have with us Doctor Ruger Crack, who is the Director for Health promotion.

We have also Doctor Fiona Bull who is the UNIT Head of physical Activity and we have Juana Wilmsen who is a technical officer at the unit of physical activity.

You have remember all of them from from maybe a year and a half ago when we launched guidance on, on physical activity for children under 5.

It's, it seems like currently right now, but but you, you know our guess.

So I will give a floor immediately to Doctor Rudiger Crack to introduce us to this new guidance.

And then we will hear, hear also from Doctor Wu and from Guana.

And then hopefully we will have a, some discussion around this topic.

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Undertaking physical activity is one of the single most important ways we can prevent a host of diseases and conditions which result in over 5 million deaths per year worldwide.

Furthermore, physical inactivity has an economic cost to society.

In 2016, estimates highlighted that inactivity costs the health system about 54 billion U.S.

dollars in healthcare and costs another fourteen U.S.

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dollars in lost productivity.

The old adage prevention is better than cure really applies here.

Increasing physical physical activity not only helps prevent and manage heart disease, type 2 diabetes and cancer, it also reduces symptoms of depression and anxiety, reduces cognitive decline, including Alzheimer's, and improves memory.

For the first time, WHO presents recommendations on sedentary behaviour as well as physical activity.

By doing physical activity of any type, you can counteract the harm done by sitting for too long.

WHO urges everyone to continue to stay active through the COVID-19 pandemic.

If we do not remain active, we run the risk of creating another pandemic of ill health as a result of sedentary behaviour.

But we know that one in four adults and a staggering 80% of adolescents don't do enough physical activity.

Women and girls generally do less than men and boys.

This trend is widening inequalities.

Older adults and people living with disabilities are also less likely to be active and miss out on the physical and mental health benefits.

These new guidelines make recommendations for everyone pregnant women, people living with chronic conditions and disabilities, and older adults.

The guidelines emphasise that any duration of physical activity is beneficial, but more is always better.

It is only by political will, investing in the promotion of physical activity and by investing in environments that encourage all groups, ages and abilities to move more, that we can reduce diseases and conditions which cut our lives short.

Many cities have begun to invest in more walking and cycling infrastructure, which can benefit everyone, creating healthier, cleaner environments.

These guidelines will support the creation of policy at a national scale to improve people's health and reach WH OS goal of 1 billion more people leading healthier lives by 2023.

As we face the challenges and constraints of the global COVID pandemic, the importance of maintaining and increasing levels of physical activity has never been more important.

The guidelines highlight the benefits of activities you can do every day as part of your everyday life, whether at home, in transit, or at work.

They prove that everyone can benefit every day, everywhere.

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Thank you very much, Doctor, Doctor.

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So let's go to to Doctor Fiona Bull, who will tell us more specific points of the of the of this guidance.

Dr Doctor Bull, please.

Thank you very much and a very good afternoon and good morning.

Good evening to everyone joining us today.

Let me expand on that introduction by highlighting some of the new findings and the details of these new guidelines on physical activity and sedentary behaviour.

The headline message here is it's physical activity is good for health and that's all levels of physical activity.

Even at the very low ends, doing more activity starting and doing more activity is good for health.

And we've captured that with the Every Moves counts message.

Now why is that?

It's because by increasing your level of physical activity, we can reduce the risks of non communicable diseases, things like heart disease, diabetes, hypertension, but we can also improve our health and well-being.

And there are benefits shown by the extensive evidence that were reviewed for these guidelines in in and some of this very new evidence of improvements in cognitive functioning, memory.

These are very important for adults as we're ageing and very important for children learning and developing.

A second area of the guidelines that is very important is the muscle strengthening activity.

It's good for everyone at all ages, again, for youth in terms of developing healthy bones and development and of course in older adults and particularly in preventing falls.

Let me hand to Juana for some more details of the guidelines.

Thank you, Fiona.

So the recommendations this that we're launching actually also include specific recommendations for sub population groups.

These are important groups that weren't covered necessarily in our previous guidelines and these include pregnant and postpartum women.

Previously, there had been some concern that physical activity during pregnancy in the postpartum period might not be safe.

But having reviewed the evidence, we've concluded that for women during pregnancy and postpartum, there are health benefits not only for the mother but also for the baby.

For example, there's a 30% reduction in gestational diabetes amongst women who are physically active during pregnancy, and we recommend that women engage in 150 minutes of physical activity per week during this important stage of their life.

We also reviewed the evidence for people living with chronic conditions and there we focused on the four chronic conditions that Fiona has mentioned, the three key NCDS, so people who are cancer survivors, people living with hypertension and people living with type 2 diabetes.

But in addition, we also reviewed evidence for people living with HIV, which today is an important chronic long term health condition in many parts of the world.

And having looked at the direct groups, we saw that the recommended range of physical activity for health benefits for people living with these conditions were actually very similar to those being recommended for the general adult population, namely 150 to 300 minutes of physical activity per week and the muscle strengthening and the balance enhancing activities in particular for older adults.

The third and last special group are children, adolescents and adults living with disability.

And for this group, physical activity will enhance general health, but is also seen to have specific benefits, in particular for quality of life and for some of the specific impairments that people may have.

Unfortunately, research in this area is quite limited and so we were only able to look at some specific impairments, but feel that the recommendations can be broadly applied to people that they can fulfil them to the best of their abilities.

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So in addition to the guidelines on physical activity for youth, for adults, for the special populations Juana has introduced, another new dimension of these guidelines is the inclusion of sedentary behaviour.

This is an area of rapid scientific development in the last 10 years since the 2010 guidelines.

And the evidence shows that doing a lot of sedentary behaviour, often considered for example like sitting, is detrimental to your health.

It can increase your risk of non communicable disease like cardiovascular disease.

And then another new dimension to these recommendations is the sciences showing that there is an interplay between sedentary behaviours and physical activity.

And the evidence shows that if we are more active we can counteract the detrimental effects of too much sedentary.

So we have two guidelines for adults, older adults that is limit sedentary time and do more activity to offset sedentary time, particularly for those who do long hours of sedentary, which includes a lot of people who've got office based work environments.

For children, we also recommend they limit sedentary time, particularly screen time.

So in summary, physical activity is good for health.

Every move counts, more is better because the benefits continue to increase.

It's good for everyone of all age and all ability.

And we advise and recommend everyone to reduce sedentary time.

Thank you very much.

Thank you very much, Fiona and and Juana.

So those who would like to ask questions, can you just click raise hand?

So I'm not seeing right now anyone raising hand.

I'm sure that will come.

But just listening, maybe I will start with obvious question like how this how we can implement these guidelines and how government can put them in place during this time where so many societies are being told to stay at home.

Well, thank you for that question, Tarek.

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But these guidelines, I think emphasise what many are experiencing during the COVID restrictions that are applied around the world.

And that is that being active everyday is good for our, not only our bodies and physical health, but also our mental health.

It can, uh, rejuvenate, it can reduce stress and anxiety.

And of course it's important to, to move now.

The challenge is how do we do that when there are, um, restrictions perhaps to stay at home?

And we invite and have been recommending through our communications that people find innovative ways to be active in the home, in their garden, using the stairs, using pieces of furniture as their own gym equipment.

And most importantly, for those that can, looking online, there has been a tremendous growth of opportunities, whether they're often free by all sorts of civil society and stakeholders providing us opportunities.

Phone a friend and do classes online together, help your family members do it as a family and when you can get outside.

So I think there are lots of ways we can.

It might feel a little harder, but it is also even more important now during these times.

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I'm still not having any, any questions here.

Common colleagues, this is the opportunity to speak about this important topic.

But in the meantime, maybe do you make a distinction here between what individuals should do and what health authorities should do?

How, how, how governments can help implement these guidance?

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There are multiple audiences for these guidelines.

Of course, WHO provides guidance to member states, and we now invite and will support countries to adopt these guidelines.

It's a real opportunity for countries to review the guidelines they have.

And there are only 78 countries in our most recent survey that have national guidelines on physical activity.

We therefore encourage countries without national guidelines to use these new 2020 guidelines as the basis for fast tracking their policy development.

But in addition, it's not just governments, health professionals and societies.

Medical associations, physiotherapy associations and much more can use them and adopt them and align their policy positions.

There's implications for practise in the healthcare service and of course, for individuals.

These guidelines are for everyone.

The message is clear about what we can do individually, but they're absolutely a policy tool now for accelerating our work to achieve the global action plans ambition of a 15% increase in physical activity by 2030.

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Thank you, Fiona.

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Nina from AFP has a question, please.

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Thank you for taking my question.

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I was wondering first of all, in connection with the pandemic and the restrictions, I think there was a mention that we could be facing another pandemic if we don't move.

Have have you seen any indication of sort of how this is has been impacting physical activity or you know, how concerned are you about a drop in physical activity for starters?

And then also I was wondering on your, your take on how useful you think physical activity trackers like Fitbit's or other things are at a time like this to to help spur people to move more.

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Thank you for your question.

Both very important.

The first question about the impact of COVID is particularly important.

Many countries are able to make some assessment of the impact on population levels through surveys.

They've continued to run.

However, unfortunately in other countries those surveys have actually been put on hold.

So we haven't got a global picture on whether people are less active or in fact in the changes are finding more time and the need to be active in home or outside.

So in fact there is no clear answer on whether overall we are as a population less or more.

However, we do know from examples in specific countries that some people have increased their level of physical activity more time.

Perhaps they're not commuting to work, they're making a break at lunchtime, getting out in the morning, doing some physical activity.

However, to contrast, there are clearly many who are also less active.

So your question is really important, but the answers are not clear.

And what we do know vary vary by country, vary by the population group within countries and the context in which they're living.

And Doctor Luga Kresh introduced the growth of pop up cycle lanes, the increased sort of opportunity in parks where they're open.

So there's promising signs that in fact, maybe there's an agenda to make sure more walking, more cycling, more public open space is available.

To your second question, which asked about the physical activity trackers, These have been very popular in recent years as the technology becomes more affordable and more accessible.

And whether it's in a watch or a device that you wear on your wrist or your, your, uh, hip monitoring how active you are is very good feedback for the individual.

It gives you a daily feedback on whether you are or are not active.

That's important because we tend to think we might be more active.

We tend to underestimate how much time we spend sedentary.

So we at WHO are looking very much for how this technology in its different forms.

Can become more available, more accessible, more affordable and used because we definitely think there's advantages and we'd like to make those available and encourage people to use them.

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Thank you, Fiona.

So just to remind journalists that so this is all on the embargo until tomorrow, midnight Geneva time.

We have possibility for you if you want to do one-on-one interviews on this topic in different languages, English, Spanish, German, French and Russian as well.

I'm just looking do we have, we don't have anyone, but I just wanted to go back maybe to what Juana was saying on different groups.

So what do you think Juana, what groups are particularly vulnerable to any decrease of physical activities during during this this time?

Thanks, Eric.

You've raised a really important issue and I think we're all aware that people living with disabilities and with impairments are generally at a disadvantage in accessing physical activity opportunities.

And I think here it's important to emphasise that when we talk about physical activity, it's not just being part of a Sports Club or a team or going to a gym.

These are activities that we can incorporate into our everyday life, whether it's walking and cycling for transport, it's doing household chores, it's playing games with your friends in the park.

And people living with disability generally have a much, many more barriers to accessing those opportunities or to accessing any sport and exercise opportunities that that are made available.

And so I think both now when we're looking at restrictions on people's movement and maybe restrictions for people living with disability to be supported and accessing some of those opportunities.

We also need to think ahead to the post confinement and lockdown situation and see what we can do to improve both the offering of physical activity opportunities and improve access particularly for these groups.

Another very vulnerable group are people of low socio economic status.

Urban design and cities tend to not be particularly friendly to walking and cycling, particularly in low socio economic areas.

And so there people are facing additional barriers in having access to safe spaces in which they can be physically active as part of their everyday life.

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Let's go now to Lionel from Kyodo news agency.

Lionel, we're sorry Talic preserve to I, I haven't had time to check the embargoed material, so sorry for that.

But do do you have a breakdown of the, the prevalence of sedentary around the world by region, Which region is more affected by sedentary behaviours, which one is more active these kind of things?

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Thank you for the question.

If I could take the physical activity part of it first because there's been a lot of work done by many countries to commence and now to start tracking levels of physical activity.

This has been measured through in adolescents and adults and do give us the global estimates that were mentioned at the outset Introduction.

Today we have estimates that one in four adults are not meeting the recommendations that we're introducing and are consistent with the 2010 and 80% of adolescents.

So that's 27.5% of adults don't meet the 150 minimum aerobic activity and 81% of adolescents do not meet the 60 minutes of physical activity per day.

These data show they have not changed over the last 15 odd years.

And we can direct you to a publication which gives this information and shows we're making little progress on changing those levels of physical activity, which is why these guidelines are very much a catalyst and a call for more action on promoting physical activity.

You asked about measuring sedentary behaviour.

And because these guidelines are new, there has not actually been so much data collected.

Some countries have, and you may find for countries of interest, national data which are being reported on, uh, sedentary time.

Individual studies which formed part of the evidence space for these guidelines do indicate that there are populations spending 8910 hours a day or more sedentary.

There's only 24 hours in a day and we all sleep, so that's a very large proportion of time of the day being sedentary.

I go back to one of the main messages of the guidelines and that is that if you do have a lot of sedentary behaviour, then it's important, beneficial to do more physical activity to offset those detriments.

So I hope one of the audiences of these guidelines is that we now need to commence surveillance and monitoring of sedentary behaviour globally.

We'll need research and to standardise that methodology.

And hopefully in forthcoming years, we'll have good trend and tracking of sedentary behaviour now as well as physical activity.

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Thank you, Fiona.

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Peter yes, And I'm just wondering about the urban rural divide or the divide between very built up cities and smaller cities.

Is there a difference in the way people exercise in huge cities or small towns?

You know, you've spoken about the socio economic detriments to physical activity, but is there a, an an urban rural divide in this aspect?

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If I could start and invite colleagues to add any comments.

There are patterns by geographic location, by economic status, and they vary by country and the economic and stage of development of those countries.

So let me give examples, firstly from perhaps some **** income and Western context and cities.

And we see in those contexts that in fact you're more likely to be more active in the cities and less active in the rural, perhaps because indeed you've got more opportunities to be active in the city.

In the urban centres, however, it's almost reversed when you go to a different context, if I may give an example, if we go to India, where indeed in the rural those populations can be more active, again, perhaps explained largely by their occupation.

The work demands more physical activity by their transport patterns, which may still include a large amount of walking and cycling.

And yet both of those change when we go into the urban centres of, for example, India.

And so the pattern is different, but there are patterns and associations.

And then you can layer in economic status, whether you have opportunities to live in better areas which have more supportive parks, safety, cycleways, green areas or not.

And of course, then paying in terms of being able to access the facilities like swimming pools, gyms, clubs.

So the determinants of physical activity are complicated and confounded by all of those factors interacting.

And it's certainly a lot of data there and it varies by country.

I hope that's helped and happy to take any follow up question.

I think one thing I might just add to that, another layer which we maybe haven't mentioned yet is actually gender.

We do see that girls and women are generally less active than boys and men, particularly girls and and women, for example, in Latin America.

And it may be issues around perceptions of safety for them to be physically active.

But it may also be cultural barriers in certain settings that that mean that they don't feel that they can engage in physical activity, whether it's through organised sport or just being physically active with, with friends as part of their everyday life.

So I think that's another important aspect to consider.

And if I just may add 11 more aspect, which is actually the, the way you're constructing your public transport, right?

So if you have a city where public transport is, is not very well developed and you go much more by car of obviously you're actually less physically active.

Those cities around the world that have invested heavily in their public transport systems, we see that in cities people are using it and are, as Fiona and Juana also said, more physically active.

But one thing just to complement what Juana was just saying, I'm really very concerned to see that especially girls are less and are really less active than their boys than boys.

There's this widening inequality and that is something where I think politicians and and other partners need to need to react.

Straightforward.

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Thank you to all three of you.

I'm just getting a message that Stephanie from Reuters wants to ask a question.

And then I saw that Nina had her hand up for follow up.

So Stephanie or Nina, do you still have something?

Yes, please, if I may from Reuters.

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I remember the guidance about last year for the children, but how long has it been since you've issued these overall this, you know, sort of overall guidance And in addition to the sedentary behaviour aspect, which is new, is there anything else you'd like to flag?

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These guidelines update the 2010 global recommendations, which were for youth, adults and older adults.

So it's been 10 years since new global policy on the importance and recommendations of physical activity.

And as mentioned, the Sedentary edition is now brand new for the first global guidance on sedentary behaviour.

In terms of some other new areas, let me perhaps bring out the interesting difference and it really underpins our every move counts.

Previously and many other national guidelines have identified that it was necessary to do physical activity in bouts of 10 minutes, accumulating these to the 150 minimum recommendation for adults.

New science shows science that's actually developed wearing those wearables using the devices.

So every part of the movement can be captured and and analysed.

And it has shown that in fact that 10 minute minimum is not so important and every move counts.

So being active, adding up and it's the total amount we all achieve reaching 150 and extending.

So at one end it's all movement counts and at the other end it's more and more activity is better.

So that was a second particularly important shift from specifying 10 minutes, which is now removed from those guidelines.

I think another, if I may invite Juana to speak to the important new recommendation for older adults and multi component activity.

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So previously, older adults were were recommended to do activities to enhance balance and prevent falls if they were already frail.

Whereas now it's clear that it's important for older adults before they become frail, before they have any issues about balance and **** risk of falls, to incorporate these activities as part of their weekly physical activity to prevent falls and prevent fall related injuries, which are so important.

I think that that is a really key recommendation and it's for adults from age 65 onwards.

So they're starting to build some of that functional capacity and function and physical function well in advance of any particular danger of falls in in later old age.

Thank you so much, Fiona and Juana.

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And Nina, did you have something or you are OK now?

Sorry.

Yeah, Sorry.

I was going to ask about women and girls, but you addressed it, so I took my hand down.

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I don't see any other other questions, so I'll just maybe ask our guests if they have some, some other key messages to, to repeat or just to, to mention before we, we, we conclude today's press briefing.

Perhaps I'll go 1st and we could then complete with with Doctor Rudiger.

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Our main message from these new guidelines is these.

The guidelines emphasise the importance of everyone being active and that all activity counts towards improving health.

And there's substantial and significant benefits, both physical and mental for being active.

They clearly call for us to reduce the amount of sedentary time that we are undertake and to balance sedentary time with being more active.

The benefits are for everyone of all age and all ability.

And indeed we can have substantial health and well-being benefits by incorporating this into our everyday call upon governments to implement and adopt these guidelines to help their populations get these benefits.

And benefits will then accrue to improved economies, improved environments and reduction of burden on healthcare systems.

So perhaps I'll hand to Juana for any concluding remarks before Rudiger.

I think that the inclusion of these special populations and particularly the inclusion of people living with disability has been a key part of these new guidelines.

I think we're we're really looking at a very inclusive approach to physical activity, which we hope will advance that agenda considerably.

And so for me, that's a really key element that that is has LED us through this work and has been an element that's that's been reflected in the discussion that the guideline development group and that the experts that we brought around the table to review the evidence really carried through to the recommendations.

Yeah, Perhaps just to say that I'm really congratulating all the scientists, the experts around the world that have reviewed this sound evidence that appears there now.

And this solid work is very encouraging and gives very good messages.

That every step counts means that, you know, between, you know, work meetings or between, you know, time at home and and time go to work.

All this counts for my own health.

So to take responsibility and control over our own health, which is health promotion, actually helps us with that sort of knowledge that every step, every physical activity that we do is good for our health and prevents especially non communicable diseases.

Thank you, Thank you very much, doctor.

Thank you, Fiona.

Thank you Juana for, for being with us this afternoon.

So the the guidelines will be officially posted on our website tomorrow night, midnight Geneva time.

So this is also the embargoed time a journalist who were with us and would like to follow up more.

Just just don't hesitate to, to, to contact us and we will, we will try to, to provide more information or to organise one-on-one interviews.

There will be also a video and audio file from this briefing that we may share with some other journalists who, who were sending us messages saying that, oh, why we were not invited for this briefing.

But, but the point is that the, the, the, the, this guidelines are extremely important and and we hope that especially in these difficult times, people will find time and courage to exercise.

With that.

I wish everyone a very nice day and and we stay in touch.