身体活动（WHO） - Physical activity-华东公共卫生-

重要事实

缺乏身体活动是全球第四大死亡风险因素。
每年约有320万人因缺乏身体活动而死亡。
缺乏身体活动是心血管疾病、癌症和糖尿病等非传染性疾病的一个主要风险因素。
身体活动对健康有着显著好处，并有助于预防非传染性疾病。
全球三分之一的成年人缺乏身体活动。
世卫组织56%的会员国实行了关于缺乏身体活动问题的政策。
世卫组织会员国商定到2025年将身体活动不足流行率减少10%。

什么是身体活动？

根据世卫组织的定义，身体活动系指由骨骼肌肉产生的需要消耗能量的任何身体动作，其中包括工作期间的活动、游戏、家务、出行和休闲娱乐活动。

“身体活动”不应与“锻炼”混为一谈。锻炼是身体活动的一部分，涉及有计划、有条理和反复的动作，目的在于增进或维持身体素质的一个或多个方面。中等强度和高强度的身体活动有益于健康。

不同类型身体活动的强度因人而异。就各种活动而言，为有利于心肺健康，每次应至少持续活动10分钟。世卫组织建议：

儿童和青少年：每天60分钟的中等强度到高强度的身体活动；
成年人（18周岁以上）：每周150分钟中等强度的身体活动。

身体活动的益处
散步、骑自行车或体育运动等有规律的中等强度身体活动明显有益于健康。在各年龄段，身体活动的益处大于意外事故等可能造成的危害。多少开展一些身体活动总比一点也不做要好。只要全天抽空做一些相对简单的身体活动，就可轻易达到推荐的活动水平。

经常和适当的身体活动水平能够：

改善肌肉和心肺功能；
改善骨骼和功能性健康；
降低高血压、冠心病、猝中、糖尿病、乳腺癌和结肠癌以及抑郁症的风险；
降低跌倒以及髋部或脊椎骨折的风险；以及
对能量平衡和体重控制具有极端重要的作用。

缺乏身体活动的风险

缺乏身体活动是全球第四大死亡风险因素，造成6%的死亡，仅次于高血压（13%）和烟草使用（9%），其风险水平与高血糖（6%）相同。每年约有320万人因缺乏身体活动而死亡。

在许多国家，缺乏身体活动呈上升趋势，这加剧了非传染性疾病负担，并影响全球总体健康。与一周四天以上每天从事至少30分钟中等强度身体活动的人相比，缺乏身体活动的人死亡风险增加20%至30%。

缺乏身体活动是造成以下疾病的主要病因：

约21%-25%的乳腺癌和结肠癌；
约27%的糖尿病；
约30%的缺血性心脏病。

缺乏身体活动的原因
在全球各地，缺乏身体活动水平上升。2008年，全球约有31%的15岁以上青少年和成年人身体活动不足（男性28%，女性34%）。在高收入国家，41%的男性和48%的女性身体活动不足，而在低收入国家，18%的男性和21%的女性身体活动不足。国民生产总值较高或上升，身体活动水平往往较低或下降。身体活动下降的部分原因是，空闲时身体活动不足，并在工作场所和家中久坐不动。同样，人们较多使用“被动”交通方式，也导致身体活动不足。

与城市化有关的一些外部因素也会导致人们不愿从事身体活动，例如：

担心在室外遇到暴力和犯罪行为；
交通密集；
空气质量差和污染；
缺少公园、人行道和体育/娱乐设施。

如何增加身体活动？
个人乃至整个社会都可采取行动，增加身体活动。2013年，世卫组织会员国在《2013-2020年预防和控制非传染性疾病全球行动计划》中同意将身体活动不足流行率减少10%。

世卫组织约80%的会员国针对身体活动不足问题制定了政策和计划，但仅有56%的国家付诸实施。国家和地方当局也在一系列部门落实有关政策，推动和促进身体活动。

增加身体活动的政策意在确保：

所有人都能安全地步行、骑自行车和使用其它形式的主动交通工具；
劳动和工作场所实行鼓励身体活动的政策；
学校拥有供学生积极度过空闲时间的安全地点和设施；
通过高质量体育课程，支持儿童接受有益健康的行为模式，使其能够终生积极从事身体活动；
体育和娱乐设施为大众提供体育活动的机会。

世卫组织的应对

世界卫生大会于2004年通过了《饮食、身体活动与健康全球战略》，其中阐述了为在全世界增加身体活动而需采取的行动。该战略敦促各利益攸关方在全球、区域和地方各级采取行动增加身体活动。

世卫组织在2010年发表的“关于身体活动有益健康的全球建议”中，集中论述了通过身体活动大力预防非传染性疾病问题。它提出了为在全球各地达到所推荐的身体活动水平而可选用的政策方案，例如：

国家制定和实施有益健康的身体活动指南；
将身体活动纳入其它相关政策领域，确保各项政策和行动计划的一致性和互补性；
利用大众媒体提高对身体活动益处的认识；
监督和监测旨在促进身体活动的各项行动。

为衡量身体活动，世卫组织编写了全球身体活动调查问卷（ GPAQ ）。这一调查问卷有助于各国作为非传染性疾病的一项主要风险因素监测缺乏身体活动问题。

2013年世界卫生大会商定了一套全球自愿目标，其中包括到2025年将非传染性疾病导致的过早死亡率减少25%，将身体活动不足流行率减少10%。《2013-2020年预防和控制非传染性疾病全球行动计划》指导各会员国、世卫组织以及联合国其它机构如何切实达到这些目标。

世卫组织正与联合国教科文组织一道开发高质量体育教学一揽子政策，以提高全世界体育教学质量，使所有人都能获得高质量体育机会。

Physical activity
Fact sheet N°385
February 2014
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Key facts

Physical inactivity is the fourth leading risk factor for death worldwide.
Approximately 3.2 million people die each year due to physical inactivity.
Physical inactivity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.
Physical activity has significant health benefits and contributes to prevent NCDs.
Globally, one in three adults is not active enough.
Policies to address physical inactivity are operational in 56% of WHO Member States.
WHO Member States have agreed to reduce physical inactivity by 10% by 2025.

WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits.

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What is physical activity?

The term "physical activity" should not be confused with "exercise", which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Both, moderate and vigorous intensity physical activity brings health benefits.

The intensity of different forms of physical activity varies between people. In order to be beneficial for cardiorespiratory health, all activity should be performed in bouts of at least 10 minutes duration. WHO recommends:

for children and adolescents: 60 minutes of moderate to vigorous intensity activity per day;
for adults (18+): 150 minutes of moderate-intensity activity per week.

Benefits of physical activity

Regular physical activity of moderate intensity – such as walking, cycling, or doing sports – has significant benefits for health. At all ages, the benefits of being physically active outweigh potential harm, for example through accidents. Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can quite easily achieve the recommended activity levels.

Regular and adequate levels of physical activity:

improve muscular and cardiorespiratory fitness;
improve bone and functional health;
reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer and depression;
reduce the risk of falls as well as hip or vertebral fractures; and
are fundamental to energy balance and weight control.

Risks of physical inactivity

Physical inactivity is the fourth leading risk factor for global mortality and causes 6% of all deaths. It is only outstripped by high blood pressure (13%) and tobacco use (9%) and carries the same level of risk as high blood glucose (6%). Approximately 3.2 million people die each year because they are not active enough.

Physical inactivity is on the rise in many countries, adding to the burden of noncommunicable diseases and affecting general health worldwide. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who engage in at least 30 minutes of moderate intensity physical activity on most days of the week.

Physical inactivity is the main cause for approximately:

21–25% of breast and colon cancers
27% of diabetes
30% of ischaemic heart disease.

Reasons for physical inactivity
The levels of physical inactivity increased across the globe. Globally, around 31% of adults aged 15 and over were not active enough in 2008 (men 28% and women 34%). In high-income countries, 41% of men and 48% of women were insufficiently physically active, as compared to 18% of men and 21% of women in low-income countries. Low or decreasing physical activity levels often correspond with a high or rising gross national product. The drop in physical activity is partly due to inaction during leisure time and sedentary behaviour on the job and at home. Likewise, an increase in the use of "passive" modes of transportation also contributes to physical inactivity.

Several environmental factors which are linked to urbanization can discourage

people from becoming more active, such as:

fear of violence and crime in outdoor areas
high-density traffic
low air quality, pollution
lack of parks, sidewalks and sports/recreation facilities.

How to increase physical activity?

Both, society in general and individuals can take action to increase physical activity. In 2013, WHO Member States agreed to reduce physical inactivity by 10% in the framework of the "Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020".
Policies and plans to address physical inactivity have been developed in about 80% of WHO Member States, though these are operational in only 56% of the countries. National and local authorities are also adopting policies in a range of sectors to promote and facilitate physical activity.

Policies to increase physical activity aim to ensure that:

walking, cycling and other forms of active transportation are accessible and safe for all;
labour and workplace policies encourage physical activity;
schools have safe spaces and facilities for students to spend their free time actively;
Quality Physical Education (QPE) supports children to develop behaviour patterns that will keep them physically active throughout their lives; and
sports and recreation facilities provide opportunities for everyone to do sports.

WHO response

The “Global Strategy on Diet, Physical Activity and Health”, adopted by the World Health Assembly in 2004, describes the actions needed to increase physical activity worldwide. The Strategy urges stakeholders to take action at global, regional and local levels to increase physical activity.

The "Global Recommendations on Physical Activity for Health", published by WHO in 2010, focus on primary prevention of NCDs through physical activity. It proposes different policy options to reach the recommended levels of physical activity globally, such as:

the development and implementation of national guidelines for health-enhancing physical activity;
the integration of physical activity within other related policy sectors, in order to secure that policies and action plans are coherent and complementary;
the use of mass media to raise awareness of the benefits of being physically active;
the surveillance and monitoring of actions to promote physical activity.

To measure physical activity, WHO has developed the Global Physical Activity Questionnaire (GPAQ). This questionnaire helps countries to monitor physical inactivity as one of the main NCD risk factors.

In 2013, the World Health Assembly agreed on a set of global voluntary targets which include a 25% reduction of premature mortality from NCDs and a 10% decrease in physical inactivity by 2025. The “Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020” guides Member States, WHO and other UN Agencies on how to effectively achieve these targets.

Together with UNESCO, WHO is developing a Quality Physical Education (QPE) policy package. The QPE policy package aims to improve the quality of physical education worldwide and make it available to everyone.