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State Physical Activity Plans – Expanding Roadmaps for Change

By Kate Olscamp, Communications Coordinator with the National Physical Activity Plan AllianceExternal Link: You are leaving health.gov

The National Physical Activity Plan (NPAP) acts as a comprehensive roadmap facilitating widespread achievement of the Physical Activity Guidelines. The vision of the NPAPExternal Link: You are leaving health.gov is that “one day, all Americans will be physically active, and they will live, work, and play in environments that encourage and support regular physical activity.” The realization of this vision will require a groundswell of public support and involve a unified effort at the community, state, and national level.

Connecting with States – A Developing Project of the NPAPA

The latest versionExternal Link: You are leaving health.gov of the NPAP, updated in 2016External Link: You are leaving health.gov, includes overarching priorities which serve to guide the direction of the plan, and the field, moving forward.  One of these overarching priorities is to support the development and implementation of comprehensive physical activity strategic plans at state, regional, and community levels. State initiatives are particularly critical since a great deal of public health policy development occurs at the state level. Establishing physical activity as a statewide priority can help to guide the funding and resource allocation necessary to implement the strategies and tactics within the national and state level physical activity plans. To support this goal the NPAPA is launching a new state-focused initiative. The project, led by Bill Kohl, PhD, MSPH and Eloise Elliot, PhD, will catalogue plans in use throughout the country in an effort to understand the current state-level landscape. The team supporting this effort will examine state-level physical activity plans, as well as broader chronic disease or obesity plans that contain physical activity strategies. This project expands upon research completedExternal Link: You are leaving health.gov earlier in the history of the planExternal Link: You are leaving health.gov, and serves as the first step in the achievement of a crucial NPAP overarching priority.

Lessons Learned from a Plan in Action

One of the plans to be included within the newest cataloguing initiative is the West Virginia Physical Activity PlanExternal Link: You are leaving health.gov. Released in early 2012, the West Virginia Physical Activity Plan is modeled after the NPAP and includes eight sectors relevant to the West Virginia community.  The plan is built around 5 priority areas including:

  1. School Based Programs (through the implementation of ActiveWV Schools)
  2. Public Awareness and Marketing (through the “Be Wild. Be Wonderful. Be Active.” Campaign)
  3. Community Engagement and Environment
  4. Institutional and Organizational Support (focusing on the ActiveWV Health Care program)
  5. Policy

A recent assessment examined the ability for evaluation within the West Virginia plan. Results highlighted the need for an entity in charge of implementation and the simplification of the plan into sector specific logic models. Authors suggest these changes will foster continued application of the plan into the communities it aims to impact.

The Role of States in the National Physical Activity Plan

The focus on the state level within the NPAP extends beyond a single overarching priority and new initiative. In total six sectors, two strategies, and over twenty-five tactics include content specific to state-level activities. Tactics at the state level include:

  • From Community Recreation, Fitness and Parks: Advocate for strong governor advisory panels on physical activity to ensure development of state-level physical activity policies and partnerships between government, community based organizations, and the private sector.
  • From Transportation, Land Use and Community Design: Encourage state governments to provide incentives for local jurisdictions to adopt mixed-use zoning laws.
  • From the Public Health Sector: Support the creation of a physical activity and health unit in state health departments that functions as part of an integrated and coordinated approach to chronic disease prevention.

Outside the plan itself, the National Physical Activity Plan Alliance (NPAPA) has developed a State Liaison NetworkExternal Link: You are leaving health.gov designed to enhance the impact of the NPAP at the state level. Liaisons work in varying capacities including positions within state health departments, community organizations, and academic institutions. Participating individuals serve as representatives for the plan within their states, and are in turn able to share innovative projects and initiatives going on in their area with the national group. The network ensures continued connection with the state level, helping the NPAPA maintain a pulse on the local activities.

To learn more about the NPAP, the State Liaison Network, or ways that you can support this state physical activity plan initiative, visit the NPAP websiteExternal Link: You are leaving health.gov or connect with the NPAP Alliance on social media through FacebookExternal Link: You are leaving health.gov or TwitterExternal Link: You are leaving health.gov.

Spread the Word! Share this post with your social network using this sample message: Check out how @NationalPAPlanExternal Link: You are leaving health.gov is engaging with state level #PhysicalActivity plans to increase activity nationwide! http://bit.ly/2ns3Cz0External Link: You are leaving health.gov

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Home neighborhood motivates older people to physical activity

A recent study conducted at the Gerontology Research Center of the University of Jyväskylä shows that walk-friendly environmental design may provide opportunities for physical activity in old age. However, especially when mobility function starts to decline, it is important that older adults are aware of attractive environmental factors in their neighborhood.

Physical activity helps to maintain health and function. In old age, physical activity takes place mostly in the home neighborhood. Thus it is important to know if there are attractive environmental features in the neighborhood to motivate older adults to physical activity also when they experience physical limitations, Senior Researcher Erja Portegijs explains.

The results of this study show that physical activity was higher in participants living in a neighborhood with higher walkability. The walkability index reflects opportunities to walk to different destinations, e.g. for shopping and meeting people. The walkability index is an objective measure that can be calculated from open-source geographical information (maps).

The results also show that participants reporting higher numbers of environmental facilitators for outdoor mobility also reported higher levels of physical activity than those perceiving fewer environmental facilitators in their neighborhood. For example, nearby shops, nature and suitable walkways motivated participants to outdoor mobility. The relationship was especially strong for those with limited physical function.

It seems that perceiving attractive factors in the environment becomes especially important for physical activity when mobility function starts to decline and people may need to choose more carefully how to use their energy during the day, Portegijs concludes.

In total 839 inhabitants of Jyväskylä and Muurame in Central Finland participated in this study. The study participants were 75–90 years old and were interviewed at home. Participants were grouped according to the score obtained from a mobility test. Physical activity was assessed by a self-report questionnaire and with an accelerometer that was worn for one week.

All participants were asked about environmental factors that motivated them to go outdoors. By mapping the home address and studying the area up to 1 km from home, the researchers calculated an objective walkability index for their home neighborhood. The index is based on land use mix, population density and road network connectivity in the area.

Explore further: Out-of-home activities may promote older persons’ physical activity

More information: Erja Portegijs et al. Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland, International Journal of Environmental Research and Public Health (2017). DOI: 10.3390/ijerph14030333

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Physical activity important for adults with CVD

(HealthDay News) — Cardiac rehabilitation and the importance of physical function should be emphasized among older adults with cardiovascular disease, according to an American Heart Association scientific statement published online March 23 in Circulation.

Daniel E. Forman, MD, from the University of Pittsburgh Medical Center, and colleagues address the importance of functional capacity both for the perspective it provides on aggregate health and as a goal of care among older adults with cardiovascular disease.

The researchers note that optimal management of these patients requires an understanding of the importance and complexities of measuring and modifying functional capacity. In older adults, the consequences of functional impairment include increased morbidity and mortality, and reduced ability to perform activities of daily living, remain independent, and delay disability. Clinical management of older patients with cardiovascular disease should include periodic assessment of function. Exercise intervention programs should be designed to increase maximal functional capacity and to target the capacity to perform activities of daily living, maintain independence, and optimize quality of life. Older adults respond to exercise training programs, and these should be designed specifically for older patients. Current standards of evidence-based medications often manifest greater functional risks than benefits.

“When treating cardiac patients in their 70s, 80s, and 90s, health care providers often stress medications and procedures without considering the importance of getting patients back on their feet, which is exactly what cardiac rehabilitation programs are designed to do,” Forman said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

  1. Forman DE, Arena R, Boxer R, et al. Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease. Circulation. 23 March 2017. doi.org/10.1161/CIR.0000000000000483

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Physical activity vital for bone strength in adolescence

March 22 (UPI) — A report by the University of British Columbia suggests physical activity has significant effects on bone mass in adolescence.

The study of 309 adolescent boys and girls showed those who participated in moderate to intense physical activity during their growing years had greater bone mass in areas that contribute to superior bone strength.

Researchers analyzed 14 intervention and 23 observational studies for the report, finding that weight-bearing physical activity was more effective at increasing bone strength when compared to non-weight-bearing physical activity. Adolescents who participated in more vigorous weight-bearing activity had the greatest bone strength benefit.

Some sports, such as gymnastics, elicit extreme loads that can exceed 10 times body weight, while other such as running produces about three times body weight load.

“Our findings utilized advanced imaging to extend a convincing body of evidence that physical activity is key to developing a strong and healthy skeleton,” Professor Heather McKay, a researcher at the University of British Columbia, said in a press release. “It’s important for children and youth to step away from their screens, get up from the sofa and move.”

The study was published in the Journal of Bone and Mineral Research.

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Federal Agencies Partner to Motivate Americans to Be Healthy and Active

Today, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) announced that USDA’s free online tool, SuperTracker, has incorporated the President’s Council on Fitness, Sports & Nutrition’s (PCFSN) Presidential Champions program as an additional incentive to motivate Americans to be more physically active. Gamification, the application of points and achievements to non-game contexts, has been shown to inspire both youth and adults to engage in physical activity and to monitor progress toward their own health goals. Now, anyone who has a SuperTracker account can participate in the Presidential Champions program by simply logging into their SuperTracker account and recording their daily physical activity.

Since 2003, the Presidential Champions program has motivated Americans ages six and older to become physically active and live a healthier lifestyle. Based on the Dietary Guidelines for Americans, SuperTracker empowers people to improve eating habits, manage weight, and reduce risk of chronic disease. Users can determine what and how much to eat; track their food intake, physical activity, and weight; and personalize their SuperTracker experience by setting individual goals, journaling, and receiving virtual coaching. With the addition of the Presidential Champions program, SuperTracker’s millions of users can now also be recognized with awards. Through SuperTracker, Presidential Champions participants can now sync their Fitbit accounts and easily track their activity without manually entering data to accumulate points.

“The partnership between these two agencies is truly a win for all involved. We know that the Presidential Champions program has dedicated participants who will benefit from the incredible suite of tools available in the SuperTracker application,” said Angie Tagtow, Executive Director for the USDA’s Center for Nutrition Policy and Promotion, which created and manages SuperTracker. “We now have yet another way for existing SuperTracker users to stay motivated to make positive choices every day on their path to a healthier lifestyle.”

“We are excited for our long-time Presidential Champions participants to continue earning awards for achieving their healthy goals, while gaining access to the personalized physical activity and nutrition features of SuperTracker,” said Dr. Don Wright, Acting Executive Director of PCFSN. “This partnership encompasses the core theme of the Council’s 60th anniversary #0to60 Campaign Exit Disclaimer – inspiring all Americans to accelerate their journey to living healthy.”

About the President’s Council on Fitness, Sports & Nutrition: The President’s Council on Fitness, Sports & Nutrition educates, engages and empowers all Americans to adopt a healthy lifestyle that includes regular physical activity and healthy eating. The President’s Council is a committee of volunteer citizens appointed by the President who serve in an advisory capacity through the Secretary of Health and Human Services. Through cross sector partnerships, the President’s Council promotes healthy lifestyles through evidence based programs and initiatives for Americans of all ages, backgrounds and abilities. For more information about the President’s Council, visit: www.fitness.gov.

About the United States Department of Agriculture, Center for Nutrition Policy and Promotion: Established in 1994 within the U.S. Department of Agriculture, the Center for Nutrition Policy and Promotion works to improve the health and well-being of Americans by developing and promoting dietary guidance that links the best, evidence-based, scientific research to the nutrition needs of consumers.

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GoNoodle program promotes physical activity, mindfulness

— First-grade students at A.A. Nelson Elementary School closed their books and quickly spread out around the classroom recently when their teacher gave the word.

It was GoNoodle time, a time when talking and moving around is not just allowed, but encouraged.

GoNoodle is an international program that promotes physical activity and mindfulness in the classroom. Children’s Miracle Network has funded GoNoodle in Calcasieu Parish schools for 3 1/2 years. It also began funding the program at Jeff Davis Parish schools this fall and hopes to expand to all five parishes.

“I want every one of them to have GoNoodle — that’s my mission,” said Children’s Miracle Network Director Cara Wyland.

Since students don’t have recess every day any more, they have to sit in place for hours at a time if they don’t have a program like GoNoodle, Wyland said.
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Is more physical education at school linked to higher student math scores?

The amount of time students spend doing physical activity in school appears to be linked to higher standardized math scores in D.C. schools, according to a new American University study that examined the success of the city’s Healthy Schools Act and found that schools offering more physical activity had significantly better math success.

The law, passed in 2010, requires D.C. public and public charter schools to adhere to requirements for what food must be served and how much physical activity should be built into each school week. The schools received funding as part of the legislation and were required to report how they implemented the program.

“This finding demonstrates that students’ academic performance improves when there’s a balance between time spent on physical education and time spent on learning,” said Stacey Snelling, dean of American University’s School of Education.

Since the Healthy Schools Act was passed, the District’s schools have been required to incrementally increase the amount of physical education offered to elementary and middle school students each year. In the 2014-2015 school year, elementary school students should have received an average of at least 150 minutes per week, while middle school students should have received an average of at least 225 minutes.

Schools across D.C. struggled to meet those targets for physical education, but those that provided about 90 minutes each week saw higher standardized math scores, according to the report.

The study divided the city’s elementary schools into four groups based on how much physical education they offered: the lower 25 percent, lower-middle 25 percent, upper-middle 25 percent and upper 25 percent.

The researchers then took the average DC CAS math proficiency score from the 2012-2013 school year for each of these four groups and found that schools offering more physical activity posted higher math scores. The upper 25 percent had an average of 151 minutes of physical education and saw an average math proficiency rate of 56.66. The lower 25 percent had an average of 29 minutes of physical education per week and an average math proficiency rate of 47.53. Some of the findings also were published in the academic journal Appetite.

Sarah Irvine Belson, one of the authors of the report, said schools offering the most amount of physical education time are distributed relatively evenly throughout the District and are not clustered in wealthier ­neighborhoods.

Researchers graded each school on how it implemented various aspects of the legislation — including building school gardens, serving healthy lunches and offering ample physical education time — on a 33-point scale. They found that, despite socioeconomic differences, there were no significant variations in how schools performed on the 33-point-scale across the District’s eight wards.

The researchers said there are limitations to the findings: The data is based on schools’ self­-reporting, which leaves room for error, and many schools have opened and closed during the five-year study period, yielding some data inconsistencies.

The D.C. Healthy Schools Act was passed to combat the area’s obesity rate, which varies greatly by ward. In Ward 3 — a wealthier area in the upper northwest part of the District — there was an obesity rate of 11.8 percent in 2012, according to government data. In Ward 7, a poorer ward east of the Anacostia River, the obesity rate was more than 36 percent.

D.C. Council member Mary M. Cheh (D-Ward 3), who authored the original 2010 legislation, applauded the report’s findings Tuesday, adding that although schools effectively provided more nutritious lunches, there is still more room for more physical ­activity.

“When children are fed and they are not hopping all around because their hungry, they’re better learners, and that’s translated throughout,” Cheh. “I was impressed with the findings.”

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Fitness, not physical activity, mitigates negative effects of prolonged sitting

Living a sedentary lifestyle – such as sitting for prolonged periods – has been shown to be a risk factor for cardiovascular disease and other conditions. Physical inactivity raises the risk of developing high blood pressure and coronary heart disease and has been found to increase the risk of certain cancers.

Studies have linked excessive sitting to being overweight and obese, type 2 diabetes, and early death. Lack of physical activity can also lead to feelings of anxiety and depression.

Sitting for long periods has been suggested to slow the metabolism, which affects the body’s ability to regulate blood sugar, blood pressure, and break down body fat.

Regular physical activity is essential for healthy aging, and adults aged 65 years and over gain substantial health benefits from regular exercise. Physical activity guidelines recommend older adults do at least 150 minutes of moderate-intensity aerobic activity per week, such as brisk walking, and muscle-strengthening activities on 2 or more days per week to work all major muscle groups.

Among individuals who meet physical activity recommendations, the risk of cardiovascular disease with high sedentary time remains. However, high levels of cardiorespiratory fitness are associated with reduced levels of cardiovascular risk factors, including high blood pressure, obesity, type 2 diabetes, and dyslipidemia.

Most active participants still spent 12-13 hours per day sedentary

Researchers from the Norwegian University of Science and Technology (NTNU) aimed to determine whether meeting physical activity guidelines or having high age-specific cardiorespiratory fitness would reduce the adverse effect of prolonged sitting on cardiovascular risk factors for seniors.

Cardiorespiratory fitness is the ability of the heart and lungs to provide the working muscles with oxygenated blood for a prolonged period and determine the level of fitness, which goes downhill with age. Cardiorespiratory fitness is an important health indicator that can predict cardiovascular disease mortality and can be improved by increasing both the intensity and amount of exercise.

While the average American adult sits for between 9-11 hours a day, the NTNU research found that the participants who were in the least sedentary third of the study still spent between 12-13 hours per day in sedentary behavior. The most sedentary of all participants were sedentary for up to 15 hours a day.

The NTNU study was part of a randomized controlled clinical trial with the primary objective of investigating the effect of exercise training on morbidity and mortality in the older adult population.

The team conducted a cross-sectional study of 495 women and 379 men from Norway aged between 70-77 years. Sedentary time and physical activity were assessed by accelerometers, while cardiorespiratory fitness was determined by peak oxygen uptake (VO2 peak) – the measurement of the volume of oxygen that the body can utilize during physical exertion.

Researchers compared different levels of activity with fitness levels and cardiovascular risk factor clusters. A cardiovascular risk factor cluster was defined as the presence of three to five risk factors for heart disease.

These risk factors included: elevated waist circumference, elevated blood triglycerides or reduced “good” cholesterol levels, high blood pressure or treatment for hypertension, and elevated fasting blood sugar levels – combined symptoms commonly referred to as metabolic syndrome.

High cardiorespiratory fitness reduced risk of heart disease

Findings – published in Mayo Clinic Proceedings – showed that when compared with women and men who were the least sedentary, women and men from the most sedentary group were 83 percent and 63 percent more likely to have cardiovascular risk factors from extended time sitting, respectively.

However, when the team took participants’ level of fitness into consideration – measured by having high age-specific cardiorespiratory fitness – they found that the fittest 40 percent had a decreased likelihood of cardiovascular risk factors from prolonged sitting.

This finding held true even though the fittest participants spent between 12-13 hours per day sedentary and did not meet current moderate to vigorous physical activity guidelines.

No decreased risk was observed in older adults who were physically active without being fit. Therefore, say the researchers, meeting physical activity guidelines alone does not eliminate the cardiovascular risks of sedentary behavior if individuals do not have a certain level of cardiorespiratory fitness.

“Our Western lifestyles necessarily involve a lot of sitting, and we spend more and more time sitting on average as we age. But our findings show that being fit plays an important part in successful aging and may lend protection against the negative health effects of being sedentary.”

First author Silvana Sandbakk

Regular physical exercise, even below the recommended guidelines, is beneficial to health and longevity. “However, it seems that fitness makes a difference for this age group and while we wait for more evidence, some physical activity in elders that improves fitness will go a long way,” Sandbakk concludes.

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Type 2 Diabetes and Physical Activity: Being Active Can Lower Disease Risk by 26 Percent, Study Finds

Eating healthy, losing weight, and being more active are known ways to prevent and manage diabetes, and two new studies based out of the United Kingdom suggest that those who walk or cycle for the recommended 150 minutes a week may reduce their risk of Type 2 diabetes by 26 percent.

With diabetes on the rise, (one in three people in the United States will develop Type 2 diabetes in their lifetime, the CDC reports) it’s important to gain a deeper understanding of the disease, as well as find new ways to prevent and treat it. Researchers are getting closer to understanding the specific exercise and diet routines that can help the 29.1 million people in the United States who have the condition.

In one meta-analysis, researchers examined data from more than one million adults without diabetes documented in 23 studies conducted across Europe, Asia, Australia and the US. Around 80,000 participants went on to develop Type 2 diabetes during the studies’ follow-up periods. Researchers looked at the effects of participants’ physical activity, and compared it to other behavioral factors like diet, according to a statement. The participants who exercised moderately 150 minutes a week had a 26 percent reduced risk of developing the condition.

In the second study, 41 adults with Type 2 diabetes between the ages of 18 and 75 were selected. This group was instructed by researchers to keep their diet or lifestyle habits consistent while walking 30 minutes each day over a 14-day period. After a 30-day ‘washout’ period, this was repeated with an alternative walking regimen. Those who walked after meals had significantly lower blood glucose levels than people who walked at other times, according to a statement.

“We already know that physical activity has a major role to play in tackling the growing worldwide epidemic of type 2 diabetes,” said researcher Dr Soren Brage from the University of Cambridge, in a press release.

“These new results add more detail to our understanding of how changes in the levels of physical activity across populations could impact the incidence of disease. They also lend support to policies to increase physical activity at all levels,” Brage explained. “This means building environments that make physical activity part of everyday life.”

Source: Smith A, Brage S, Woodcock J, Mann J, Reynolds A. New Studies Reveal The Importance Of Both The Amount And Timing Of Physical Activity On The Risk Of Developing Type 2 Diabetes, And In Aiding The Management Of The Disease. Springer. 2016.

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