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Physical inactivity is the fourth leading cause of death worldwide. We summarise present global efforts to counteract this problem and point the way forward to address the pandemic of physical inactivity. Although evidence for the benefits of physical activity for health has been available since the 1950s, promotion to improve the health of populations has lagged in relation to the available evidence and has only recently developed an identifiable infrastructure, including efforts in planning, policy, leadership and advocacy, workforce training and development, and monitoring and surveillance. The reasons for this late start are myriad, multifactorial, and complex. This infrastructure should continue to be formed, intersectoral approaches are essential to advance, and advocacy remains a key pillar. Although there is a need to build global capacity based on the present foundations, a systems approach that focuses on populations and the complex interactions among the correlates of physical inactivity, rather than solely a behavioural science approach focusing on individuals, is the way forward to increase physical activity worldwide.

Background: No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity., Methods and Results: We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men., Conclusions: These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."

Objectives. We examined the association between time spent in physical education and academic achievement in a longitudinal study of students in kindergarten through fifth grade. Methods. We used data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998 to 1999, which employed a multistage probability design to select a nationally representative sample of students in kindergarten (analytic sample=5316). Time spent in physical education (minutes per week) was collected from classroom teachers, and academic achievement (mathematics and reading) was scored on an item response theory scale. Results. A small but significant benefit for academic achievement in mathematics and reading was observed for girls enrolled in higher amounts (70-300 minutes per week) of physical education (referent: 0-35 minutes per week). Higher amounts of physical education were not positively or negatively associated with academic achievement among boys. Conclusions. Among girls, higher amounts of physical education may be associated with an academic benefit. Physical education did not appear to negatively affect academic achievement in elementary school students. Concerns about adverse effects on achievement may not be legitimate reasons to limit physical education programs. (Am J Public Health. 2008;98:721-727. doi:10.2105/AJPH.2007.117176)

Background: The work of The Global Observatory for Physical Activity-GoPA! is the first global effort to compile standardized country-level surveillance, policy and research data for physical activity in order to better understand how countries and regions address promoting physical activity. GoPA! developed standardized country-specific physical activity profiles (“Country Cards”) to summarize country-level data through 2013. The aim of this study was to assess use of the Country Cards, identify the factors associated with their use, and develop recommendations for supporting country-level physical activity promotion. Methods: Cross sectional internet-based survey conducted between August–October 2016. Target study participants were national physical activity leaders and advocates in academia, government and practice from the GoPA! countries, and members of the International Society of Physical Activity and Health. A Country Card use composite score was created based on the diversity and frequency of use. Statistical analyses on the associations between the composite score and respondent characteristics, country characteristics, barriers and opinions were conducted (including descriptive analyses and a logistic regression with robust standard errors). Results: One hundred forty three participants from 68 countries completed the survey. Use of the Country Cards was associated with being part of the GoPA! network, knowing about the Country Cards, and on the stage of country capacity for physical activity promotion. Country Card knowledge varied by country income group, region and the country specific context. More diverse and frequent use of the cards (highest tertile of the composite score for use) was associated with: 1. Being a country contact vs general participant (OR 18.32–95% CI 5.63–59.55, p = 0.002), and 2. Collaborating with a government representative working in NCDs on a monthly or more frequent contact vs less frequent contact (OR 3.39–95% CI 1.00–11.54, P < 0.05). Conclusions: For the Country Cards to have a broader impact, GoPA! will need to widen its reach beyond the academic sector. With further refinement of the cards, and training in their implementation, they could be an important tool for advancing country capacity for contextually-relevant strategies, actions and timelines for PA promotion. Electronic supplementary material The online version of this article (10.1186/s12966-018-0663-7) contains supplementary material, which is available to authorized users.

Background: The 2010 U.S. National Physical Activity Plan contains a comprehensive set of policies, programs, and initiatives to increase physical activity. Purpose: To determine the early awareness, use, diffusion, and implementation of the plan among members of the National Society of Physical Activity Practitioners in Public Health. Methods: The web-based survey was conducted in 2011 and analyzed in 2011–2012. The survey was guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Diffusion of Innovations theory. Of 492 professional members, 291 responded. Results: Overall, 79% reported awareness of the plan, with higher odds among state practitioners compared to other practitioners and among those with state partnerships to address physical activity compared to those without. Among those who were aware (n=230), 15% reported using the plan ≥6 times, whereas 28% had never used it. For those who referred to the plan at least once in their work (n=165), the most commonly reported uses were for brainstorming and discussion (73%); development and implementation of activities (55%); and state-level goal-setting (34%). Related to diffusion principles, many respondents reported that the plan fit their organization''s goals (85%) and was easy to understand (81%), yet fewer agreed that changes made after the plan were easy to observe (32%); easy to implement (28%); and low-cost (25%). Conclusions: This theory-based evaluation found that the National Physical Activity Plan has been broadly disseminated to physical activity practitioners working in public health. Opportunities exist for public health practitioners and others to more fully integrate the plan into their work. [Copyright &y& Elsevier]

Background: Physical inactivity is associated with the increased risk of many chronic diseases. Such risks decrease with increases in physical activity. This study assessed the cost-effectiveness of population-wide strategies to promote physical activity in adults and followed disease incidence over a lifetime. Methods: A lifetime cost-effectiveness analysis from a societal perspective was conducted to estimate the costs, health gains, and cost-effectiveness (dollars per quality-adjusted life year [QALY] gained, relative to no intervention) of seven public health interventions to promote physical activity in a simulated cohort of healthy U.S. adults stratified by age, gender, and physical activity level. Interventions exemplifying each of four strategies strongly recommended by the Task Force on Community Preventive Services were evaluated: community-wide campaigns, individually adapted health behavior change, community social-support interventions, and the creation of or enhanced access to physical activity information and opportunities. Each intervention was compared to a no-intervention alternative. A systematic review of disease burden by physical activity status was used to assess the relative risk of five diseases (coronary heart disease, ischemic stroke, type 2 diabetes, breast cancer, and colorectal cancer) across a spectrum of physical activity levels. Other data were obtained from clinical trials, population-based surveys, and other published literature. Results: Cost-effectiveness ratios ranged between $14,000 and $69,000 per QALY gained, relative to no intervention. Results were sensitive to intervention-related costs and effect size. Conclusions: All of the evaluated physical activity interventions appeared to reduce disease incidence, to be cost-effective, and—compared with other well-accepted preventive strategies—to offer good value for money. The results support using any of the seven evaluated interventions as part of public health efforts to promote physical activity. [Copyright &y& Elsevier]

Purpose: The aim of the study is to compare national estimates of the incidence of self-reported all-cause and activity-specific injuries in adults with differing leisure-time physical activity levels. Methods: Data were analyzed from the 2000 to 2002 National Health Interview Survey. Leisure-time physical activity levels were categorized as active, insufficiently active, and inactive. Results: Age-adjusted incidences of all-cause injury did not differ by leisure-time physical activity level (active, 89.3/1000; 95% confidence interval [CI], 81.8–96.8; insufficiently active, 81.6/1000; 95% CI, 73.1–90.1; and inactive, 86.3/1000; 95% CI, 78.6–93.9). Active respondents (29.4/1000; 95% CI, 25.2–33.6) had a greater incidence of injury related to sport and leisure-time activities than inactive respondents (15.2/1000; 95% CI, 12.1–18.3), whereas inactive respondents (71.1/1000; 95% CI, 63.9–78.2) had a greater incidence of injury related to nonsport and non–leisure-time activities than active respondents (59.9/1000; 95% CI, 53.6–66.2). Results were unchanged after multivariate control for confounding factors. Conclusions: Although the incidence of sport and leisure-time injuries is associated with participation in leisure-time physical activity, no association was observed between leisure-time physical activity and overall injuries. [Copyright &y& Elsevier]