Link Between Physical Inactivity and Obesity Queried - Literature review Example

? Link Between Physical Inactivity and Obesity Queried (Word Count 2240) goes here> Number> Submitted> ABSTRACT The objective of this study is to review current literature, United Kingdom government health policies, and World Health Organization viewpoints on physical activity and the issue of obesity. The study covers UK-based literature, studies and government health policies on physical activity and obesity. The standpoint and recommendations of the WHO on obesity and physical activity is also compared with current UK health policy. The evaluation revealed that the UK government is keeping in line with the WHO focus on lifestyle modification as a means of preventing obesity. However, several other factors and theories on obesity are needed to be considered in developing an effective obesity prevention strategy. Therefore, future UK health policies on obesity for all age levels should take a more holistic approach. Furthermore, it is recommended that further research should be conducted regarding the relationship of physical inactivity and obesity using data collected from current and future obesity prevention and treatment interventions. TABLE OF CONTENTS Page Abstract 2 1.0 Introduction 4 1.1 Background 4 1.2 Scope of the Report 5 1.3 Definition of Key Terms 6 2.0 Review of Related Literature and Studies 6 3.0 UK Health Policy Concerning Obesity 8 4.0 The World Health Organization: On Obesity 9 5.0 Analysis 10 6.0 Conclusion 11 7.0 Recommendation 11 8.0 References 13 1.0. Introduction A recent study by Metcalfe, et al. (2010) sparked an on-going debate as to the direction of causality between obesity and physical inactivity among children. As reported in Brimelow (2010), the Metcalfe, et al. study which was not even directly named, although the allusion provided the research journal which published the study and specific details of the findings - “challenged the assumption that a lack of exercise causes children to put on weight” (para. 1). An apparent gap in knowledge prompted an academic debate which needs to be resolved, not with a war of words, but with a critical analysis of readily available evidence. The necessity of an analytic inquiry to shed light on this gap, therefore, served as the main motivation and the primary purpose of writing this paper. 1.1. Background The World Health Organization (WHO) classifies human weight status in terms of an individual’s body mass index (BMI), which is the ratio of a person’s weight in kilograms divided by the square of the height in metres. A person may be underweight, normal, overweight, or obese depending on his or her BMI. Individuals with a BMI below 20 are considered underweight. Normal individuals have a BMI of 20 to 25.9 while overweight people have 25 to 29.9. On the other hand, obese individuals have a BMI of 30 or more (Shaw, Gennat, O’Rourke & Del Mar 2006). Obesity is a cause for public concern because obesity affects more than one billion adults worldwide, with complications ranging from type 2 diabetes, cardiovascular disease, hypertension, stroke, and cancer. (Shaw, Gennat, O’Rourke & Del Mar 2006). Table 1 shows the prevalence of overweight and obesity in the United Kingdom for the years 2002, 2005, and 2010. Table 1: Prevalence of Overweight and Obesity in the United Kingdom (2002, 2005, 2010) Year Overweight (%) Obese (%) Male Female Male Female 2002 62.5 58.8 18.7 21.3 2005 65.7 61.9 21.6 24.2 2010 67.8 63.8 23.7 26.3 As reflected in Table 1, there is a steady increase in the number of individuals who are becoming overweight and obese from 2002 until 2010. As of 2010, 67.8% of the male UK population 15 years old and above are overweight, and 23.7% are obese. On the other hand, 63.8% of females are overweight while 26.3% suffer from obesity (Allender, Peto, Scarborough, Boxer & Rayner 2006). 1.2. Scope of the Report A concise background of the issue at hand is provided. The link between physical activity and obesity will are explored using a combination of desktop research and archival analysis of existing literature and studies. As much as possible only UK-based studies are considered. Key terms are defined to provide a clearer understanding of important concepts used in the study. In addition, a review of related literature and studies are provided covering obesity and other risk factors. The United Kingdom policy on obesity is discussed, followed by the WHO standpoint and recommendation regarding obesity. Moreover a critical analysis of how U.K. policies on obesity meet WHO directives and recommendations are included. Furthermore, conclusions and recommendations based on the analysis are provided to culminate the study. 1.3 Definition of Key Terms Causality – the principle or relationship between cause and effect. Disability Adjusted Life Years – the overall disease burden, expressed as the number of years lost due to illness, disability, or early death. Free-living scenario – as used in this paper, a state wherein a person goes about his daily activities in an unstructured, spur of the moment manner. Morbidity – the rate of incidence of a disease. Mortality – the rate of death. Physical activity – as used in this paper, any voluntary movement which involves force. Sedentary lifestyle – a type of lifestyle with no or irregular physical activity. 2.0 Review of Related Literature and Studies Martinez-Gonzales, Martinez, Hu, Gibney & Kearney (1999) investigated the relationship between obesity, physical inactivity, and sedentary lifestyle by analysing data obtained from a survey of 15,239 respondents from European Union states. Data on leisure-time sedentary and non-sedentary activities, BMI, and prevalence of obesity were used in the analysis. Results revealed direct association between obesity and a sedentary lifestyle. Similarly, the rate of physical activity is inversely proportional to the number of people practicing a sedentary lifestyle. The results have been consistent with the perception on sedentary lifestyle and lack of physical activity as key factors in the prevalence of obesity. In contrast, Weinsier et al. (2000) argued that based on their evaluation of physical activity, sedentary lifestyle, and obesity, physical inactivity may be a cause as well as a result of weight gain. This is based on the results that show how people who increased their physical activity were able to reduce their weigh gain. However, baseline data showed no significant relationship between physical inactivity and weight gain. This is further compounded by the difficulty of measuring physical activity in a free-living scenario. In addition, Allender, Foster, Scarborough and Rayner (2007) calculated the impact of physical inactivity in relation to health and economics to determine the financial burden it places on the UK national health system. Mortality and morbidity information obtained from the WHO relating to physical inactivity, Disability Adjusted Life Years (DALY) data, and population-attributable factors on specific diseases were applied to National Health Service cost data to determine the financial cost. The analysis revealed that physical inactivity represents 3% of DALY lost in the UK in 2002 and places a 1.06 billon burden on the UK health service system. Meanwhile, Brown and Summerbell (2008) investigated the link between childhood obesity and physical activity by evaluating 38 studies on controlled trials of school-based lifestyle interventions in relation to diet and physical activity. Fifteen out of thirty-eight studies on physical activity and nine out of twenty combined diet and physical activity interventions revealed significant and positive changes to BMI. The results further show that physical activity may help children maintain a healthy weight. However, the numbers were inconsistent, making long-term benefits doubtful. In contrast, Wong and Leatherdale (2009) evaluated the relationship between physical activity, sedentary lifestyle, BMI, and the risk of obesity in Canadian students. Data obtained from 25,060 students in grades 9 to 12 from 76 secondary schools in Ontario, Canada were analysed in terms of BMI, weight perceptions, social influences, team sports participation, and smoking-behaviour. Respondents were subsequently classified as: high-active / high-sedentary, low-active / low-sedentary and low-active / high- sedentary (Wong and Leatherdale, 2009). The results of the analysis reveal that male students belonging to the low-active / high sedentary group are more likely to be overweight compared to those belonging to the high-active / low sedentary group. Meanwhile, female students belonging to the low-active / high sedentary and high-active / high sedentary group are more likely to be overweight compared to their counterparts in the high-active / low sedentary group. Based on these results, it has been concluded that children with low levels of physical activity combined with high sedentary behaviour have a high probability of being overweight and developing obesity in the long run (Wong and Leatherdale, 2009). 3.0 UK Health Policy Concerning Obesity The UK government acknowledges the growing problem of obesity among its citizens. Aside from its direct impact among affected citizens, obesity places a heavy burden on the country’s health services. It is estimated that expenditures for initiatives on the reduction of obesity amounts to ?4.2 billion annually. Therefore, the government has developed and outlined its health policy on obesity through the Healthy Lives, Healthy People white paper (UK Department of Health 2011). As outlined in the Healthy Lives, Healthy People initiative, the government plans to curb obesity by creating initiatives that will help people change their lifestyles and promote equality in health services. A novel approach proposed the use of social networking to disseminate information regarding obesity. Another program involved employer initiatives in promoting obesity prevention to employees, their families, and the immediate community (Secretary of State for Health 2010). Moreover, another move suggests placing the responsibility of funding and provision of obesity prevention and other health related services to Public Health England. It has been proposed to allow Public Health England to handle issues regarding avoidable illnesses. Thus, the National Health Service will be able to focus on other equally important efforts. For example, by allowing Public Health England to handle obesity initiatives, cases of diabetes and liver disease are expected to go down (Secretary of State for Health 2010). Change4Life is the marketing component of the UK government initiative in obesity prevention. The Change4Life program encourages citizens to adopt proper diet and physical activity as a way of life through their official website hosted by the National Health Service. The Website provides important information on the benefits of proper diet and physical activity and caters to adults and children. The main goal of the program is to help create awareness on the obesity problem in all sectors of society (National Health System 2011). Another obesity prevention initiative is the National Child Measurement Programme wherein children’s height and weight information is recorded once a year. The information collected is used by the National Health Service and local authorities in the development of health-related programs for children. Individual measurements are shared with the child’s parents in order to help parents make important decisions about their child’s health (UK Department of Health 2011). 4.0 The World Health Organization: On Obesity The World Health Organization identified physical inactivity as a leading risk factor of obesity and mortality worldwide. In this regard, the WHO had developed a set of recommendations regarding physical activity. These recommendations focused on preventing non-communicable diseases through the promotion of physical activity by policymakers. For children aged 5 to 17 years old, a total of at least 60 minutes of moderate to vigorous intensity physical activity is recommended. Physical activities should be aerobic in nature and performed at least 3 times a week. Meanwhile, adults should accumulate at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity physical activity per week. Aerobic activities should last for at least 10 minutes and muscle-strengthening activities should be done at least twice a week. On the other hand, older adults should perform at least 150 minutes of physical activity weekly, depending on their physical condition. Activities should be aerobic, with particular focus in enhancing balance and muscle strength (World Health Organization 2011). The WHO strongly recommends governments to take an active role together with other sectors of society in creating a supportive environment wherein citizens are encouraged to adopt measures that help address issues regarding obesity and physical inactivity. This includes health policies focusing on increased physical activity on all age levels (World Health Organization 2004). 5.0 Analysis The concept of physical inactivity as a cause or consequence of obesity places both researchers and policymakers in a quandary since there are several obesity theories in existence. Key theories on obesity present the following attributes as possible causes: genetics, lifestyle, diet, marketing and advertising, psychosocial factors, and environment (Lang and Rayner 2007). According to WHO policy, obesity prevention initiatives should focus on behavioural changes such as proper diet and increased physical activity. However, recent studies claim that health policies focusing solely on behavioural modification only yielded limited effects and moderate success (Gill, Baur and King 2010). Also, Reily et al. (2006) evaluated the effects of physical activity intervention on young children and concluded that despite improvements in the children’s motor skills, there was no significant reduction in body mass index. Moreover, Lobstein, Millstone, Jacobs, Stirling, and Mohebati (2006) argued that a holistic approach on obesity prevention should be pursued. Strategies should be based on: health education; opportunities and incentives for physical activity; availability of reliable information on food, diet, physical activity, fitness, and health; and changing patterns of supply and demand for food and beverages. 6.0 Conclusion Based on these observations, the UK government should focus on the development of holistic policies that will help address the obesity issue by creating an environment where stakeholders have more participation in the shaping of public policy. In addition, since obesity is not caused by physical inactivity alone, policymakers and local authorities should take every facet of obesity theory into consideration in order to create a more comprehensive approach (Lang and Rayner 2007). 7.0 Recommendations After evaluating current literature, UK and WHO policies on obesity, recommendations on the following areas are presented below: Knowledge on obesity and health education. Education and training on obesity and health education should be intensified in schools, healthcare facilities, and the general public. Also, further research should be conducted on obesity prevention and treatments. Opportunities and incentives for physical activity. More physical activity should be incorporated in infrastructure and transportation planning. In addition, schools should consider adding more sports facilities. Availability of reliable food information for consumers. Controls should be implemented regarding advertisements pertaining to food and beverages, placing a priority on products that target young children. Moreover, processed food manufacturers should comply with mandatory nutritional labelling policies. Changing patterns of supply and demand for food and beverages. Controls on the availability and sale of food and beverages high in fat and sugar should be put in place and enforced in public institutions such as schools and hospitals. Since further research is still required to determine the real relationship between physical activity and obesity, the aforementioned measures should be able to provide more information and research opportunities once better obesity prevention and treatment programs are implemented and its effects are measured and validated. 8.0 References Allender, S. Peto, V., Scarborough, P., Boxer, A. & Rayner, M. 2006, Diet, physical activity and obesity statistics, chapter 3. British Heart Foundation, London. Allender, S., Foster, C., Scarborough, P. & Rayner, M. 2007, ‘The burden of physical activity-related ill health in the UK’, Journal of Epidemiology Community Health, vol. 61, no. 4, pp. 344-348. Brimelow, A. 2010, Link between inactivity and obesity queried, British Broadcasting Company, viewed 11 March 2011, < http://www.bbc.co.uk/news/10545542>. Brown, T. & Summerbell, C. 2008, ‘Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence’, Obesity Reviews, vol. 10, no.1, pp. 110-141. Gill, T. P., Baur, L. A., & King, L. A. 2010, ‘Should health policy focus on physical inactivity rather than obesity? No’, British Medical Journal, vol. 340. Lang, T. & Rayner, G. 2007, ‘Overcoming policy cacophony on obesity: an ecological public health framework for policymakers’, Obesity Reviews, vol. 8, no. 1, pp. 165-181. Lobstein, T., Millstone, E., Jacobs, M., Stirling, A. & Mohebati, L. 2006, Policy options for responding to obesity: UK national report of the PorGrow project, University of Sussex, Sussex. Martinez-Gonzales, M. A., Martinez, J. A., Hu, F. B., Gibney, M. J. & Kearney, J. 1999, ‘Physical inactivity, sedentary lifestyle, and obesity in the European Union’, International Journal on Obesity-Related Metabolic Disorders, vol. 23, no. 11, pp. 1192-1201. Metcalfe, B. S., Hosking, J., Jeffery, A. N., Voss, L. D., Henley, W. & Wilkin, T. J. 2010, ‘Fatness leads to inactivity, but inactivity does not lead to fatness: a longitudinal study in children (EarlyBird 45)’, Archives of Diseases in Childhood, viewed 14 March 2011, < http://adc.bmj.com/content/early/2010/06/23/adc.2009.175927.abstract?sid=ef3473da-b793-45e3-8670-cc2ee74d6a73>. National Health System 2011, Change4Life, National Health Service, viewed 16 March 2011, < http://www.nhs.uk/change4life/Pages/change-for-life.aspx> Reilly, J. J., Kelly, L., Montgomery, C., Williamson, A., Fisher, A., McColl, J. H., Conte, R. L., Paton, J. Y. & Grant, S. 2006, ‘Physical activity to prevent obesity in young children: cluster randomised controlled trial’, British Medical Journal, vol. 333. Secretary of State for Health 2010, ‘Healthy lives, healthy people: our strategy for public health in England’, UK Department of Health, viewed 16 March 2011, < http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122347.pdf>. Shaw, K., Gennat, H., O’Rourke, P. and Del Mar, C. 2006, ‘Exercise for overweight or obesity (review)’, Health Science and Medicine, viewed 14 March 2011, < http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1049&context=hsm_pubs>. UK Department of Health 2011, Obesity, UK Department of Health, viewed 16 March 2011, < http://www.dh.gov.uk/en/Publichealth/Obesity/index.htm>. Weinsier, R. L., Hunter, G. R., Zuckerman, P. A., Redden, D. T., Darnell, B. E., Larson, D. E., Newcomer, B. R. & Goran, M. I. 2000, ‘Energy expenditure and free-living physical activity in black and white women: comparison before and after weight loss’, American Journal of Clinical Nutrition, vol. 71, no. 5, pp. 1138-1146. Wong and Leatherdale, 2009, ‘Association between sedentary behaviour, physical activity, and obesity: Inactivity among active kids’, Preventing Chronic Disease, vol. 6, no. 1, pp. A26. World Health Organization 2004, Global strategy on diet, physical activity and health, World Health Organization, Geneva. World Health Organization 2011, Global recommendations on physical activity for health, World Health Organization, viewed 16 March 2011, < http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf> Read More