Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence

A narrative review of global and national physical activity and sedentary behaviour guidelines development processes - The GUidelines Standards (GUS) project

BACKGROUND

Clinical and public health guidelines serve to direct clinical practice and policy, based on the best available evidence. The World Health Organization (WHO) and national health bodies of many countries have released physical activity and sedentary behaviour guidelines. Despite significant overlap in the body of evidence reviewed, the guidelines differ across jurisdictions. This study aimed to review the processes used to develop global and national physical activity and sedentary behaviour guidelines and examine the extent to which they conform with a recommended methodological standard for the development of guidelines.

METHODS

We extracted data on nine sets of guidelines from seven jurisdictions (WHO, Australia, Canada, Japan, the Netherlands, United Kingdom, and United States). We rated each set of guidelines as high, medium, or low quality on criteria related to the rigour of the development process.

RESULTS

We observed variation in the quality of guidelines development processes across jurisdictions and across different criteria. Guidelines received the strongest overall ratings for criteria on clearly describing the evidence selected and stating an explicit link between the recommendations and the supporting evidence. Guidelines received the weakest overall ratings for criteria related to clearly describing the methods used to formulate the recommendations and reporting external review by experts prior to publication. Evaluated against the selected criteria, the strongest processes were undertaken by the WHO and Canada.

CONCLUSIONS

Reaching agreement on acceptable guideline development processes, as well as the inclusion and appraisal procedures of different types of evidence, would help to strengthen and align future guidelines.

The frequency and performance trends of European countries in the U18 and U20 rankings for 1500 m and 3000 m between 2009-2020

We purpose to determine the nationality of the European middle-distance athletes under 18 years (U18) and under 20 years (U20) during the last decade, to verify the participation trend for each country, and to assess whether the place of competition can be associated with the athletes ranking position. The sample comprised 902 European male runners, ranked among the best finishers from 2009 to 2020. The athletes were divided into two categories (nU18 ​= ​266; and nU20 ​= ​636) of two distances (n1 500 ​m ​= ​397; n3 000 ​m ​= ​505). The Mantel test was used for participation trend and the Chi-square test (χ2) was used to verify differences between the ranking position and the place of competition. For both distances, the highest number of athletes were from Spain (n = 127), followed by Turkey (n = 62) and Great Britain (n = 50). No significant trends were shown for most of the countries, in both distances. A positive trend was shown for Slovenia (i.e., 3000 ​m) over the years. A non-significant association was verified between the countries and the ranking position, as non-significant differences were proved for the place of competition. This information may be useful to guide athlete development programs in each country.

Estimating Worldwide Impact of Low Physical Activity on Risk of Developing Ischemic Heart Disease-Related Disability: An Updated Search in the 2019 Global Health Data Exchange (GHDx)

We provide here updated analysis of the impact of physical inactivity on risk of developing ischemic heart disease (IHD)-related disability along with the latest 10-year progression. We collected data through an electronic search in the 2019 Global Health Data Exchange (GHDx) database using the keywords "low physical activity", complemented with the additional epidemiologic variables "disability-adjusted life years" (DALYs; number); "ischemic heart disease"; "socio-demographic index" (SDI); "age"; "sex" and "year", for calculating volume of DALYs lost due to physical activity (PA)-related disability after IHD (LPA-IHD impairment). Based on this search, the overall LPA-IHD impairment was estimated at 7.6 million DALYs in 2019 (3.9 and 3.7 million DALYs in males and females, respectively), thus representing nearly 50% of all PA-related disabilities. The highest impact of LPA-IHD impairment was observed in middle SDI countries, being the lowest in low SDI countries. The LPA-IHD DALYs increased by 17.5% in both sexes during the past 10 years (19.2% in males, and 15.8% in females, respectively), though this trend was dissimilar among different SDI areas, especially during the past two years. In high and high-middle SDI countries, the LPA-IHD grew during the past 2 years, whilst the trend remained stable or declined in other regions. In conclusion, LPA-IHD impairment remains substantial worldwide, leading the way to reinforce current policies aimed at increasing PA volume in the population.

Cross-country collaboration for physical activity promotion: experiences from the European Union Physical Activity Focal Points Network

Background

An analysis of currently existing partnerships and cross-country collaboration for physical activity (PA) promotion is valuable for understanding how such partnerships operate, and how they impact national PA promotion efforts. This study aimed to outline the formation and development of the European Union’s (EU) Physical Activity Focal Points Network, to evaluate its outputs and benefits and to describe its potential and challenges.

Methods

A mixed methods approach were employed, including document analysis, semi-structured interviews with key officials and an online evaluation survey with the focal points.

Results

The network was founded in 2014. Its main task is to coordinate the national collection of information for the EU’s Health-Enhancing Physical Activity (HEPA) Monitoring Framework. Besides collecting data, focal points usually meet twice a year to share best practices and plan activities for the promotion of PA within the EU. The results of the evaluation survey show that participation in the network helped members specify goals for PA promotion, gain more knowledge regarding how to promote PA, identify more opportunities to promote PA in their country and to join a collaborative project with other countries.

Conclusions

The study shows that the EU Physical Activity Focal Points Network may serve as an example of successful cross-country collaboration in PA promotion. The network has been able to make a contribution to monitoring the implementation of the EU Council Recommendation on HEPA across sectors in particular and of PA promotion in the EU in general.

Monitoring of physical activity promotion in children and adolescents in the EU: current status and future perspectives

BACKGROUND

Policy action is required to address physical inactivity in boys and girls. This action can be supported by international data collection, comparisons and sharing of good practices. Thus, this study aims to present and discuss the ongoing monitoring of physical activity (PA) indicators in children and adolescents in the 28 EU Member States.

METHODS

Data on PA recommendations, PA prevalence, physical education (PE) and PA promotion programs for children and adolescents were provided by governments in a joint EU/WHO survey on the implementation status of the EU Council Recommendation on Health-Enhancing Physical Activity (HEPA) across Sectors.

RESULTS

In 23 countries, national recommendations on PA are available. Detailed PA prevalence data among children and adolescents was available in 27 countries, in most cases separately for sex/gender and age groups. The total amount of PE lessons in schools differed greatly between countries and lessons were predominantly mandatory. After-school HEPA promotion programs were mostly implemented in EU Member States (78.6%), followed by active school breaks (57.1%), active travel to school (57.1%) and active breaks during school lessons (53.6%).

CONCLUSIONS

This study summarizes the monitoring of PA indicators among children and adolescents in all EU Member States by providing a comprehensive overview of the status of PA promotion and monitoring across the region. Based on our findings, it could be concluded that the current EU monitoring system on PA promotion should be adapted to provide evidence that can inform future policy development.

Physical Activity for Health and Fitness: Past, Present and Future

It’s a saying “The early we start, the early we attain good health”. Health is a state of complete physical, mental and social well-being and not merely absence of disease Fitness is an ability to execute daily functional activities with optimal performance, endurance, and strength to manage minimalist of disease, fatigue, stress and reduced sedentary behavior. In the modern era with advancement in technology, erosion of physical activity has drastically led to retardation in health and fitness. Hoods of luxurious and competition among students for scores/grades and professionals for promotions/incentives/benefits have deviated people from concentrating towards their health and putting it secondary. In 2016, across the globe, prevalence of physical inactivity was estimated at 27.5%, among adult population. To support further, in June 2018, WHO reported, 1 in five adults, and 4 of five adolescents to pose reduced physical activity. In the current ongoing pandemic era this scenario has been further negatively impacting the society to suffer from psychosocial, financial and economic loss, contributing to lack of physical activity. Health benefits of physical activity are not limited only to improved cardiorespiratory and muscular fitness, bone and cardiometabolic health, and positive effects on weight status, but it also boosts mental health and social health. Acknowledging the significance and urgency of decreasing insufficient physical activity globally, WHO endorsed a Global Action Plan on Physical Activity (GAPPA) at the World Health Assembly in 2018, wherein the member countries agreed to reach a new target of 15% relative reduction in insufficient physical activity among adolescents by 2030.