Promotion of physical activity in Finland

Transcription

1 Promotion of physical activity in Finland Katja Borodulin, Senior Researcher, Adj.Prof

2 Causal chain for ischaemic heart disease WHO: Global Health Risks Report,

3 Risk of impaired glucose tolerance and type 2 diabetes Risk of impaired glucose tolerance and type 2 diabetes in men and women (national FINRISK Study 2002) 7 6 6,17 5 4, ,89 3,95 Physically active 2 1 1,00 1,37 Physically inactive 0 1st 2nd 3rd WHR tertiles (n=1276) Adjusted for age, family history of diabetes, systolic blood pressure, alcohol consumption, and smoking. Borodulin et al. 2006, Diabetic Medicine, 23:

4 Risk of overweight or obesity (BMI >=25) in women aged years Risk of overweight or obesity 1,8 1,74 1,6 1,61 1,4 1,2 1 1,29 1 1,02 1,01 Active Inactive 0,8 0,6 Low sitting Medium sitting High sitting FINRISK 2002-study, adjusted for age and education Borodulin ym

5 Triglycerides Aerobic fitness and waist-to-hip ratio associates with triglycerides in Finnish men (National FINRISK 2002 Study, n=1787) Finnish men in National FINRISK 2002 Study (n=1713). Controlled for age, smoking, and alcohol use. P(interaction)=0.001 Borodulin et al. 2005, Eur J Cardiovasc Prev Rehabil 12: low middle Fitness (p<0.001) high 3rd tertile 2nd tertile WHR (p<0.001) 1st tertile

6 Aerobic fitness and waist-to-hip ratio associates with C-reactive protein levels CRP 1 0,8 0,6 0,4 Finnish men in National FINRISK 2002 Study (n=1713). Controlled for age, smoking, alcohol use. p-value for interaction term=0.001 Borodulin et al. 2006, Atherosclerosis, 185: ,2 0 Matala Keski Arvioitu aerobinen kunto (p<0.001) Korkea Vyötärö-lantiosuhteen tertiilit (p<0.001)

7 Associations of different types of PA with heart disease mortality in Finnish women (National FINRISK Study ) Adjusted for age, study year, education, alcohol consumption, smoking status, body mass index, systolic blood pressure, cholesterol, and history of diabetes, and separately for other types of physical activity. Gang et al., Circulation, 2007,194:

8 % Time trends in leisure time, occupational, and commuting physical activity (FINRISK Study) LTPA, men LTPA, women OPA, men OPA, women COMPA, men COMPA, women Year Lähde: Borodulin et al. 2008, EurJPublicH

9 Leisure time physical activity frequency, in men Daily 2-3x/wk Once a week Inactive Borodulin 2005, unpublished

10 Leisure time physical activity frequency, in women Daily 2-3x/wk Once a week Inactive Borodulin 2005, unpublished

11 What explains the changes in PA? Technological innovations, motorized transportation Washing machine, TV, internet, computer, elevator Urbanization Increased leisure time; exercise is fashionable, health club memberships etc. Daily PA and active transportation are decreasing Polarization of the society

12 Prevalence of physical activity during leisure time in the European Union. Martinez-Gonzalez et al. MSSE, 2001 medians (25th and 75th percentiles) of MET-h wk-1 in leisure time

13 Kävely työmatkalla Pyöräily työmatkalla Juoksu Hiihto Kävely Pyöräily Uinti, vesivoimistelu Aerobic Pallo- ja mailapelit Kuntosaliharjoittelu Metsästys, marjastus, kalastus Pihatyöt Remontointi Metsätyöt, halonhakkuu Kotityöt, siivoaminen LIIKUNNAN MÄÄRÄ (METh/v) Leisure-time physical activity among Finns Household chores, cleaning mies Men nainen Women Cross-country skiing Walking Beneficial activities (non-conditioning exercise) Lähde: Borodulin ym. 2006, L&T

14 PA Recommendations Based on scientific evidence on the dose-response relationship CDC, ACSM/AHA, WHO Separately for children, adults and older adults ADULTS Moderate Vigorous Combination of Weight training (3-6 METs) (over 6 METs) Mod-Vig Frequency Most days of 3 per wk - 2 per wk wk Duration 30 min/daily Min. 20 min. - - Energy expenditure MET min per wk

15 Recommendation of PA in Finland Current Care guidelines by Finnish Medical Society Duodecim: weekly: moderate 2h 30 min OR vigorous 1h 15min AND weight training UKK institute for health promotion: PA pie

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17 Actors in health-enhancing PA in Finland Central government Ministry of education and culture NGOs National sport & health/public health organizations Private sector Sport & exercise services Ministry of Health Other ministries Local government Municipalities (336) Regional sport & health organizations Local sport & health organizations Physical activity for occupational settings Citizens

18 PA promotion playgrounds Organized PA Non-organized PA Daily PA Role of facilities & physical environment Roles of local authorities, sport clubs, work places, schools, private companies Role of personal motivation to PA Difficult to make one PA program that fits all

19 Examples of national initiatives and programs Fit for life program (adults 40+) Schools on move (children) Trip around the world (children) Strength to aging (older persons) Small daily decision (total population) the Adventures of a Finn-Man, Meter-Man (overweight men)

20 Non-built environment Nature has a special meaning in Finland Every man s right

21 Built environment and facilities Most facilities owned by local authorities (PA sector), but also increasingly by private sector Bike and pedestrian lanes (transport sector) Parks and recreational areas (park sector) Expensive to build and maintain Subsidized entrance fees if not free of charge

22 Bike and pedestrian ways The most popular PA facility in Finland An enabler to PA Maintained year around Safety, lights, cross-roads

23 Summary Many Finns are not physically active enough Multisectorial collaboration is needed PA programs should be targeted and tailored in detail Infrastructure for PA makes a difference