Accelerating Progress in Obesity Prevention Solving the Weight of the Nation (2012) / Chapter Skim
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5 Physical Activity Environments
5 Physical Activity Environments
Pages 127-152
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From page 127... ...
Communities, organizations, community planners, and public health professionals should encourage physical activity by enhancing the physical and built environment, rethinking community design, and ensuring access to places for such activity. Potential actions include • communities, urban planners, architects, developers, and public health professionals developing and implementing sustainable strategies for improving the physical environment of communities that are as large as several square miles or more or as small as a few blocks in size in ways that encourage and support physical activity; and 1 Note that physical education and opportunities for physical activity in schools are covered in Recommendation 5, on school environments.
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From page 128... ...
Potential actions include • requiring each licensed child care site to provide opportunities for physi cal activity, including free play and outdoor play, at a rate of 15 minutes per hour of care; as a minimum, immediate first step, each site providing at least 30 minutes of physical activity per day for half-day programs and 1 hour for full-day programs. Accelerating Progress in Obesity Prevention 128
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From page 129... ...
; and • all federal government agencies with relevant interests developing priority strategies to promote and support the National Physical Activity Plan, a trans-sector strategy for increasing physical activity among Americans. For state and local health departments, potential actions include • developing plans and strategies for making promotion of physical activity a health priority at the state and local levels.
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For children and adolescents, evidence indicates that 60 minutes of physical activity (including aerobic and bone- and muscle-strengthening activity) every day Accelerating Progress in Obesity Prevention 130
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leads to important health benefits, including positive impacts on physical fitness, body fatness, cardiovascular and metabolic risks, bone health, and depression and anxiety (Physical Activity Guidelines Advisory Committee, 2008)
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should be minimized. The amount of physical activity required to accelerate progress in obesity pre vention requires understanding several concepts, including the volume, duration, intensity, and frequency of physical activity and volume of sedentary time: Accelerating Progress in Obesity Prevention 132
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(Physical Activity Guidelines Advisory Committee, 2008)
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. More work is needed to understand the effectiveness of reducing sedentary behavior and its role in pro moting energy expenditure for obesity prevention.
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Potential actions include • communities, urban planners, architects, developers, and public health pro fessionals developing and implementing sustainable strategies for improving the physical environment of communities that are as large as several square miles or more or as small as a few blocks in size in ways that encourage and support physical activity; and • communities and organizations developing and maintaining sustainable strategies to create and/or enhance access to places and programs where people can be physically active in a safe and enjoyable way. Context This strategy focuses on the environmental determinants of physical activity.
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From page 136... ...
These strategies often are combined with informational outreach activities to enhance their effectiveness. Creating or enhancing access to places for physical activity -- such as through community-scale and street-scale urban design and land use Accelerating Progress in Obesity Prevention 136
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suggests scientific support for environmental walkability, traffic speed/volume, access/proximity to recreation facilities, land use mix, and residential density as key environmental correlates of physical activity, specifically for children and adolescents. If coupled with restriction of energy intake, successful implementation of these strategies should accelerate progress toward obesity prevention.
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Indicators for Assessing Progress in Obesity Prevention for Strategy 1-1 Primary Indicator • Increase in the proportion of children, adolescents, and adults meeting the 2008 Physical Activity Guidelines for Americans. Sources for measuring indicator: BRFSS, NHANES, NHIS, YRBSS Process Indicators • Increase in the proportion of states and municipalities that adopt policies and supports for policies designed to promote enhancements to the physical and built environment that are supportive of increased physical activity.
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From page 139... ...
NOTES: BRFSS = Behavioral Risk Factor Surveillance System; NHANES = National Health and Nutrition Examination Survey; NHIS = National Health Interview Survey; YRBSS = Youth Risk Behavior Surveillance System. Strategy 1-2: Provide and Support Community Programs Designed to Increase Physical Activity Communities and organizations should encourage physical activity by providing and supporting programs designed to increase such activity.
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. Accelerating Progress in Obesity Prevention 140
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Such programs are designed to teach behavioral skills needed to make successful behavior adaptations to increase participation in physical activity. Social support strategies focus on building, strengthening, and maintaining social networks that provide supportive relationships for behavior change related to physical activity (e.g., setting up a buddy system, making contracts between people to complete specified levels of physical activity, establishing walking or other groups to provide friendship and support)
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From page 142... ...
Strategy 1-3: Adopt Physical Activity Requirements for Licensed Child Care Providers State and local child care and early childhood education regulators should establish requirements for each program to improve its current physical activity standards. Potential actions include • requiring each licensed child care site to provide opportunities for physi cal activity, including free play, and outdoor play, at a rate of 15 minutes per hour of care; as a minimum, immediate first step, each site providing at least 30 minutes of physical activity per day for half-day programs, and 1 hour for full-day programs.
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From page 143... ...
report Early Childhood Obesity Prevention Policies notes that very little research has been conducted on the relationship between physical activity and health in infants, and that limited research has been undertaken on the relationship between physical activity and body weight in toddlers and preschoolers. Nonetheless, the prevalence of overweight and obesity clearly has increased in children within these age groups over the past 30 years (Ogden et al., 2010)
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Implementation After fully considering the available evidence, the committee that developed the 2011 IOM report formulated goals for increasing physical activity in young children. The report recommends asking child care regulatory agencies to "require child care providers and early childhood educators to provide infants, toddlers, and preschool children with opportunities to be physically active throughout the day," and to "require child care providers and early childhood educators to allow infants, toddlers, and preschoolers to move freely by limiting the use of equipment that restricts infants' movement and by implementing appropriate strategies to ensure that the amount of time toddlers and preschoolers spend sitting or stand ing still is limited." The report also provides potential actions for achieving these goals.
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From page 145... ...
For federal-level government agencies, potential actions include • the Department of Health and Human Services establishing processes for the regular and routine communication of scientific advances in under standing the health benefits of physical activity, particularly with respect to obesity prevention (these processes could include, but are not limited to, regularly scheduled updates of the Physical Activity Guidelines for Americans and reports of the U.S. Surgeon General)
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The substantive increases in physical activity necessary to accelerate progress on obesity prevention will be difficult to achieve unless government agencies make this a scientific and public health priority. This strategy focuses on making physical activity a priority at the national, state, and local levels by advancing the science and practice of physical activity promotion.
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Such efforts must be supported and maintained if physical activity is to become a national health priority. Indicators for Assessing Progress in Obesity Prevention for Strategy 1-4 Process Indicator • Increase in the prevalence of state and local public health planning efforts specifically designed to promote physical activity.
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, these strategies, when coupled with appropriate energy intake, have the potential to substantially acceler ate progress toward obesity prevention by helping all people meet the minimal physical activity guidelines set forth in the 2008 Physical Activity Guidelines for Americans (HHS, 2008)
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2003. Health and community design: The impact of the built environment on physical activity.
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:67-72. Accelerating Progress in Obesity Prevention 150
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:88-103. West Virginia Physical Activity Plan.
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