WHO recommended Physical activity

Physical activity

WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits.
The term “physical activity” should not be confused with “exercise”, which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Beyond exercise, any other physical activity that is done during leisure time, for transport to get to and from places, or as part of a person’s work, has a health benefit. Further, both moderate- and vigorous-intensity physical activity improve health.

Key facts

• Insufficient physical activity is one of the leading risk factors for death worldwide.
• Insufficient physical activity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.
• Physical activity has significant health benefits and contributes to prevent NCDs.
• Globally, 1 in 4 adults is not active enough.
• More than 80% of the world’s adolescent population is insufficiently physically active.
• Policies to address insufficient physical activity are operational in 56% of WHO Member States.
• WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.

WHO recommends:

Children and adolescents aged 5-17years

• Should do at least 60 minutes of moderate to vigorous-intensity physical activity daily.
• Physical activity of amounts greater than 60 minutes daily will provide additional health benefits.
• Should include activities that strengthen muscle and bone, at least 3 times per week.

Adults aged 18–64 years

• Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
• For additional health benefits, adults should increase their moderate-intensity physical activity to 300 minutes per week, or equivalent.
• Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

Adults aged 65 years and above

• Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
• For additional health benefits, they should increase moderate-intensity physical activity to 300 minutes per week, or equivalent.
• Those with poor mobility should perform physical activity to enhance balance and prevent falls, 3 or more days per week.
• Muscle-strengthening activities should be done involving major muscle groups, 2 or more days a week.

The intensity of different forms of physical activity varies between people. In order to be beneficial for cardiorespiratory health, all activity should be performed in bouts of at least 10 minutes duration.

WHO FACESHEET

Individualized, supportive care key to positive childbirth experience, says WHO

15 FEBRUARY 2018 | GENEVA – WHO has issued new recommendations to establish global care standards for healthy pregnant women and reduce unnecessary medical interventions.
Worldwide, an estimated 140 million births take place every year. Most of these occur without complications for women and their babies. Yet, over the past 20 years, practitioners have increased the use of interventions that were previously only used to avoid risks or treat complications, such as oxytocin infusion to speed up labour or caesarean sections.
“We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities. However, the increasing medicalization of normal childbirth processes are undermining a woman’s own capability to give birth and negatively impacting her birth experience,” says Dr Princess Nothemba Simelela, WHO Assistant Director-General for Family, Women, Children and Adolescents.
“If labour is progressing normally, and the woman and her baby are in good condition, they do not need to receive additional interventions to accelerate labour,” she says.
Childbirth is a normal physiological process that can be accomplished without complications for the majority of women and babies. However, studies show a substantial proportion of healthy pregnant women undergo at least one clinical intervention during labour and birth. They are also often subjected to needless and potentially harmful routine interventions.
The new WHO guideline includes 56 evidence-based recommendations on what care is needed throughout labour and immediately after for the woman and her baby. These include having a companion of choice during labour and childbirth; ensuring respectful care and good communication between women and health providers; maintaining privacy and confidentiality; and allowing women to make decisions about their pain management, labour and birth positions and natural urge to push, among others.

Every labour is unique and progresses at different rates

The new WHO guideline recognizes that every labour and childbirth is unique and that the duration of the active first stage of labour varies from one woman to another. In a first labour, it usually does not extend beyond 12 hours. In subsequent labours it usually does not extend beyond 10 hours.
To reduce unnecessary medical interventions, the WHO guideline states that the previous benchmark for cervical dilation rate at 1 cm/hr during the active first stage of labour (as assessed by a partograph or chart used to document the course of a normal labour) may be unrealistic for some women and is inaccurate in identifying women at risk of adverse birth outcomes. The guideline emphasizes that a slower cervical dilation rate alone should not be a routine indication for intervention to accelerate labour or expedite birth.
“Many women want a natural birth and prefer to rely on their bodies to give birth to their baby without the aid of medical intervention,” says Ian Askew, WHO Director, Department of Reproductive Health and Research. “Even when a medical intervention is wanted or needed, the inclusion of women in making decisions about the care they receive is important to ensure that they meet their goal of a positive childbirth experience.”

High quality care for all women

Unnecessary labour interventions are widespread in low-, middle- and high-income settings, often putting a strain on already scarce resources in some countries, and further widening of the equity gap.
As more women give birth in health facilities with skilled health professionals and timely referrals, they deserve better quality of care. About 830 women die from pregnancy- or childbirth-related complications around the world every day – the majority could be prevented with high-quality care in pregnancy and during childbirth.
Disrespectful and non-dignified care is prevalent in many health facilities, violating human rights and preventing women from accessing care services during childbirth. In many parts of the world, the health provider controls the birthing process, which further exposes healthy pregnant women to unnecessary medical interventions that interfere with the natural childbirth process.
Achieving the best possible physical, emotional, and psychological outcomes for the woman and her baby requires a model of care in which health systems empower all women to access care that focuses on the mother and child.
Health professionals should advise healthy pregnant women that the duration of labour varies greatly from one woman to another. While most women want a natural labour and birth, they also acknowledge that birth can be an unpredictable and risky event and that close monitoring and sometimes medical interventions may be necessary. Even when interventions are needed or wanted, women usually wish to retain a sense of personal achievement and control by being involved in decision making, and by rooming in with their baby after childbirth.

World leaders join new drive to beat noncommunicable diseases

16 FEBRUARY 2018 | GENEVA – WHO is announcing today a new high-level commission, comprised of heads of state and ministers, leaders in health and development and entrepreneurs. The group will propose bold and innovative solutions to accelerate prevention and control of the leading killers on the planet – noncommunicable diseases (NCDs) like heart and lung disease, cancers, and diabetes.
The WHO Independent Global High-level Commission on NCDs is co-chaired by President Tabaré Vázquez of Uruguay; President Maithripala Sirisena of Sri Lanka; President Sauli Niinistö of Finland; Veronika Skvortsova, Minister of Healthcare of the Russian Federation; and Sania Nishtar, former Federal Minister of Pakistan.
Seven in 10 deaths globally every year are from NCDs, the main contributors to which are tobacco use, harmful use of alcohol, unhealthy diets, and physical inactivity. More than 15 million people between the ages of 30 and 70 years die from NCDs annually. Low- and lower-middle income countries are increasingly affected, with half of premature deaths from NCDs occurring in those countries. Many lives can be saved from NCDs through early diagnosis and improved access to quality and affordable treatment, as well as a whole-of-government approach to reduce the main risk factors.
“NCDs are the world’s leading avoidable killers but the world is not doing enough to prevent and control them,” says Dr Vázquez. “We have to ask ourselves if we want to condemn future generations from dying too young, and living lives of ill health and lost opportunity. The answer clearly is ‘no.’ But there is so much we can do to safeguard and care for people, from protecting everyone from tobacco, harmful use of alcohol, and unhealthy foods and sugary drinks, to giving people the health services they need to stop NCDs in their tracks.”
Mr Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Commission member, said: “For the first time in history, more people are dying of noncommunicable diseases, such as heart disease and diabetes, than infectious diseases. This loss of human life spares no one — rich or poor, young or old – and it imposes heavy economic costs on nations. The more public support we can build for government policies that are proven to save lives – as this Commission will work to do – the more progress we’ll be able to make around the world.”
The new Commission was established by WHO Director-General Dr Tedros Adhanom Ghebreyesus and runs until October 2019. It will provide actionable recommendations to contribute to the Third United Nations General Assembly High-level Meeting on NCDs scheduled for the second half of 2018. This will include the submission of its first report to Dr Tedros in early June.
“Everybody deserves the right to a healthy life,” says Dr Tedros. “We can beat the drivers of the NCD epidemic, which are among the world’s main obstacles to health. I am looking to the Commission to show us new ways to unblock the barriers to good health, and identify innovative, bold and practical actions steps to scale up prevention and treatment of NCDs and provide health for all.”
Co-chair Dr Nishtar says the Commission’s establishment has come at an opportune time, as the world prepares for the UN High-level Meeting on NCDs. “This year, governments will be held to account on progress they have made in protecting their citizens from NCDs,” says Dr Nishtar. “While there have been improvements in some countries and regions, the overall rate of progress has been unacceptably slow. This is resulting in too many people suffering and dying needlessly from NCDs, and leaving families, communities and governments to bear the human and economic costs.”
The World Health Assembly has endorsed the set of WHO “best buys” and other cost-effective interventions proven to prevent or delay most premature NCD deaths. Such measures, which can be readily scaled up in countries, target prevention and treatment of, and raising awareness about, NCDs.