Promotion of physical activity in Finland

Transcription

1 Promotion of physical activity in Finland Tommi Vasankari Prof., MD, PhD UKK Institute for Health Promotion Research National Institute for Health and Welfare Prevention of noncommunicable diseases seminar Helsinki, Finland

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3 Steps to advance HEPA in Finland»Policy»Programmes / Funding»Current situation (Finland)»Guidelines»Evidence

4 Acknowledgments Fogelholm M, Paronen O & Miettinen M. Physical activity a possibility for welfare policy: The state and development of health-enhancing physical activity in Finland. Helsinki (Reports of the Ministry of Social Affairs and Health, ISSN ; 2007:1) Pekka Oja, former Research Director of UKK Institute UKK Institute, Mrs. Riitta Pasanen

5 HEPA development in Finland Sport Committee: PA for all UKK Institute Finland on the Move Social Significance of Sport 1 Fit for Life 1 New Sport Act. Social Significanc e of Sport 2 Local HEPA Guidelines Fit for Life 2 HEPA Committee Report On Foot Programme HEPA Advisory Board 1 Min Health funding for HEPA Government Resolution on HEPA Min Edu funding for HEPA Strength to Aging National PA programme Fit for Life 3 HEPA Advisory Board /

6 State funding and major actions for HEPA promotion: milj. euros Strength to ageing/ray HEPA/Min Edu HEPA/Min Health Youth pa/min Edu FFL programme/min Health FFL programme/min Edu Finland on the Move/Min Edu Liikuntakomitea: Hyvinvointia liikunnasta liikuntaa kaikille 1991 Liikunta-Suomi -projekti 1994 LYP 1995 KKI 1999 Liikuntalain uudistus Lipposen II hallitusohjelma LYP II 2000 TELI paikalliset suositukset OPM:n lasten ja nuorten liikuntaohjelma LiikuntapaikkarakmietintöTELI tukea neuv.- komitea- lähiliikunta-jaloipaikkoihin kunta -ohjelma KKI II 2001 Terveys 2015 TELI 2002 VN:n periaatepäätös 2003 Vanhasen hallitusohjelma STM:n TELIraha 2004 OPM:n TELIraha Voimaa vanh. -ohjelma 2005 KKI III RAY:n tuki Voimaa vanh. -ohjelmalle TELI neuv.kunnan II kausi 2006 Kansall. liikuntaohjelma alkaa OPM:n ja STM:n tilastot

7 Physical activity at different age

8 Sufficiency of LTPA among youth: y Girls Boys 18-y % insufficient sufficient % % insufficient sufficient % insufficient sufficient insufficient sufficient Nuorten terveystapatutkimukset (Tay ym.)

9 LTPA among y old women and men: (%). Women Men % % >2 times per week >2 times per week >4 times per week 4 times per week year year Suomalaisen aikuisväestön terveyskäyttäytyminen ja terveys (AVTK) (KTL)

10 Daily walking and cycling to work among y old women and men: (%). women men % % >15 min per day 20 >15 min per day >30 min per day >30 min per day year year 0 Suomalaisen aikuisväestön terveyskäyttäytyminen ja terveys (AVTK) (KTL)

11 Daily PA among y old: % Men, walking Women, walking Men, other pa Women, other pa Eläkeikäisen väestön terveyskäyttäytyminen (EVTK) (KTL)

12 Physical fitness

13 Results (%) of Cooper-test and muscle fitness test among Finnish conscripts: % Cooper running test excellent(>3000 m) good satisfactory poor (<2200 m) % Muscle fitness test excellent good satisfactory poor year year No data from 1994 Pääesikunnan tilastot ja VARTTI -tietokannan tilastot

14 Overweight and obesity

15 Percent of overweight GIRLS at youth: % years 14-years 16-years 18-years Year Lähde: Susanna Kautiainen 2008, Nuorten terveystapatutkimus

16 Percent of overweight BOYS at youth: % years 18-years 14-years 16-years Year Lähde: Susanna Kautiainen 2008, Nuorten terveystapatutkimus

17 Overweight and obesity in adults

18 Guidelines for PA

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21 Evidence health benefits of PA How to promote PA

22 Physical fitness and all-cause mortality meta-analysis from 33 surveys subjects, deaths 1 MET unit better cardiorespiratory fitness (meaning about 1 km/h running/jogging velocity) indicated 13% decreased mortality (RR 0.87)!!! Subjects with poor fitness (<7.9 METs) had 1.7- times higher mortality compared to subjects with good fitness (>10.9 METs)

23 All-Cause Mortality for Individuals With Low vs High CRF Kodama, S. et al. JAMA 2009;301:

24 Poor cardiorespiratory fitness increases the risk of death Physical fitness is undoubtebly one of the most meaningful risk farctors to all-cause mortality! Howabout physical activity is physical activity also associated with mortality?

25 Increased physical activity and changes in mortality? Byberg L, Melhus H, Gedeborg R, Sundström J, Ahlbom A, Zethelius B, Berglund LG, Wolk A, Michaelsson K. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ 2009;338:b688.

26 Increased physical activity and changes in mortality? Effects of changes in physical activity on allcause mortality investigated in men over 50-y. Effects of changes in physical activity were compared to smoking cessation.

27 Methods 2205 men were studied at age 50-y ( ); new investigations at age 60-y, 70-y, 77-y ja 82- y. Cohort study from Uppsala, Sweden 35 year follow-up! Main outcome: mortality

28 Results Absolute mortality: low physical activity: 27.1 deaths / person-year medium PA: 23.6 deaths / person-year high physical activity: 18.4 deaths / person-year Now we focus to the men who increased threir PA between 50-y and 60-y of age.

29 Results At age 70-y, after 10-y with high level of PA the mortality did not differ any more from those having high PA level all the time (HR 1.10). Increased PA decreased mortality (HR 0.51 compared to those who remained at lower PA level) similarly as did smoking cessation (HR 0.64 compared to those who still smoke).

30 Conclusions Increased LTPA after 50-y age will cause decreased mortality (to the similar level as subjects who were permanently at high PA level). The change was as great than the change seen after smoking cessation. Therefore, it is never too late to increase our level of physical activity.

31 Illnesses, risks and symptoms, in which PA is effective in prevention, treatment or rehabilitation osteoporosis muscle atrophy arthrosis rheumatoid arthritis low back pain coronary artery disease periferal artery disease stroke high blood pressure diabetes 1 and 2 obesity / overweight dyslipidemia metabolic syndrome asthma some cancer (e.g. breast) degenerative problems (e.g. in brain) depression pain sleep problems erection problems

32 Evidence of benefits of PA is consistent!

33 Summary of current PA Sufficiently active population: % of youth sufficiently active, % very inactive, boys more active than girls % (?) of adults sufficiently active, women slightly more active than men. PA and age: PA begins to decrease clearly at adolescense. Among adults the least active are y and over 75 y old, while y old are the most active. Changes in population pa during past decades: Youth PA in sport clubs increased during past 30 y. Adults have increased LTPA but decreased work commuting pa during the past 30 years. Endurance fitness of young adult men has decreased steadily from late 1970 s.

34 Strategy for future cross-sectional collaboration working well on both national and local level, especially sport and health government level commitment to HEPA promotion important HEPA promotion has been evidence-based but funding for research insufficient promotional models and approaches too general to meet needs of different audiences strengthen further and include health stronger in political decision making issue an updated Government Resolution for HEPA promotion increase funding for relevant hepa research and development seek new models to target day care centres, schools, workplaces, primary health care, homes for the elderly

35 Strategy for future PA not systematically included in urban planning and land use create PA-friendly local environments through information and resource guidance to municipalities PA messages to public still somewhat confusing develop and issue evidencebased PA recommendations for different target groups data on population PA behaviour and its determinants fragmentary and unsystematic establish national monitoring system for population HEPA and health-related fitness

36 HEPA Development in Finland Sport Committee: PA for all UKK Institute Finland on the Move Social Significance of Sport 1 Fit for Life 1 New Sport Act. Social Significance of Sport 2 Local HEPA Guidelines Fit for Life 2 HEPA Committee Report On Foot Programme Min Health funding for HEPA Government Resolution on HEPA HEPA Advisory Board 1 Min Edu funding for HEPA Strength to Aging National PA programme Fit for Life 3 HEPA Advisory Board /