Physical activity for health: framework

Why we need to improve levels of physical activity in Scotland

Professor Sir Gregor Smith – Chief Medical Officer for Scotland

In our joint UK Chief Medical Officers review of the latest evidence for the importance of physical activity for health in 2019 we commented that ^[2]

"If physical activity were a drug, we would refer to it as a miracle cure, due to the great many illnesses it can prevent and help treat.”

This view was supported by an extensive review of the increasing global evidence of the health benefits of regular physical activity for all groups.

It is important to be clear that ‘physical activity’ means any bodily movement produced by skeletal muscles that requires energy expenditure. There are many ways we can be active. In our guidelines we recommend optimal levels of activity for health benefit but, while we recommend that all individuals work towards achieving these guidelines, there are no absolute thresholds: benefits are achieved at levels both below and above the guideline levels. We have also produced specific guidelines for individual groups including disabled young people^[3].

The impact of inactivity on health is significant. Globally, WHO estimate that nearly 1.8 billion adults are at risk of disease from not doing enough physical activity^[4]. Recent analysis commissioned by Public Health Scotland found is that there are an estimated 3,000 deaths in Scotland each year attributable to low physical activity within the population.

Non Communicable Diseases (NCD) remain the most common cause of deaths globally and account for more than two thirds of deaths within Scotland.^[5] The role of physical activity in preventing NCD morbidity and mortality is clearly recognised in the World Health Organization 5x5 Non Communicable Diseases agenda^[6] which includes insufficient physical activity as one of the main NCD risk factors.

In this context, it is important to note that physical inactivity is an independent risk factor for NCD and the benefits of being active are not limited to playing a role in the maintenance of healthy weight.

There is also strong evidence that being active can have a positive effect on psychological well-being. A recent summary suggested that:

Physical activity is a ‘stellar’ example of a positive psychology intervention because it helps produce positive emotions, engagement and accomplishment as well as preventing and reducing more negative experiences and states (e.g. stress, depression)^[7]

Physical activity can also play a major role in improving outcomes and tackling inequalities across many different aspects of our lives and society, supporting educational attainment, reducing reoffending; promoting sustainable forms of transport; and enabling people to connect with the natural environment.

Access to the nature-rich outdoors is a key mechanism by which people are physically active. Participating in green health activities has proven benefits for physical and mental health. People who spend more time in nature are more likely to exhibit pro-environmental behaviours and care for their environment. There are therefore clear synergies between the actions required to realise Scotland’s physical activity and health goals, and those required to realise Scotland’s environmental goals.

Physical activity also plays an important role in addressing social isolation and loneliness and can improve resilience, confidence and positive perception of aging.^[8] It provides opportunities for people to connect with their communities and come together in shared activities which inspire and motivate.

The pandemic heightened public appreciation of the importance of being active for health and wellbeing.^[9] It is essential that we do all that we can collectively to sustain that appreciation while ensuring that we have removed barriers which prevent people from movement. Everyone must have the opportunity to gain the benefits which come from being more active, more often.