- Written by CHUKWUMA MUANYA
The recently launched 2013 Nigerian Report Card on Physical Activity for Children and Youth, Nestlé’s Healthy Kids Global Programme and other current studies are unanimous that at least 60 minutes of moderate to vigorous physical activity daily will not only reduce the risk of developing chronic diseases such as obesity, high blood pressure, cancer, diabetes but exposure to bad behaviours such as smoking, unprotected sex and violence. CHUKWUMA MUANYA writes. THE verdict is out: Regular physical activity from childhood and youth has strong positive effects on health throughout life by preventing the onset of chronic and non communicable diseases (NCDs) such as hypertension, diabetes, cancer, and the resultant disabilities and premature deaths.
The 2013 Nigerian Report Card on Physical Activity for Children and Youth, prepared and produced by the Nigerian Heart Foundation (NHF) reads: “Physical activity is important for the health and general development of children and youth, and the attitude of physical inactivity portends a great danger for this population. It has been documented that physical inactivity and low levels of physical activity are predisposing factors to many chronic diseases.
“An increase in the prevalence of cardiovascular diseases among Nigerian adolescents has been previously reported, and the treand of declined usage of active mode of transportation arising from the proliferation of fairly used imported cars, locally known as Tokunbo, and operation of motor bikes, Okada, for commercial purpose has also been documented.
“For health gains, it has been recommended that children and youth should accumulate at least 60 minutes of moderate to vigorous physical activity daily, however, physical activity greater than 60 minutes provides additional health benefits.”
Executive Director NHF, Dr. Kingsley Akinroye, said: “We hope this report card will initiate a thrust for action on the pivotal role of physical activity in the promotion of the health of Nigerians especially in the fight against NCDs.”
Also, Nestlé, the world’s leading nutrition, health and wellness company, is actively addressing the pressing issues of obesity and under-nutrition in Central and West Africa and worldwide.
According to Nestle, in youngsters, a lack of physical activity and bad dietary habits may lead to obesity. At the same time, the absence of vital micronutrients such as vitamin A, zinc, iron or iodine can cause stunting in growth and a lower resistance to infection.
To help tackle these prevalent problems, Nestlé launched its Healthy Kids Global Programme aimed at children aged six to 12 in 2009.
The programme aims to help counteract these widespread trends by promoting nutrition education, good nutritional practices, healthy lifestyles and physical activity amongst schoolchildren.
Its approach is based on worldwide multi-stakeholder partnerships such as national and local governments, non- governmental organizations, nutrition health institutes or sport federations.
Two years after its global launch, Nestlé extended the initiative to the Central and West Africa region, starting with Nigeria and Ghana.
To further develop the physical activity side of the initiative, children are taking part in one physical activity class each week.
Nestlé teamed up with its global partner, the International Association of Athletics Federations (IAAF), in Nigeria in 2013, and the Athletics Federation of Nigeria, to further develop the programme and promote athletics in schools.
The company has also implemented its Kids Athletics Programme through the Ghana Athletics Association, the local entity that is working with the IAAF.
In 2013, Nestlé carried out its first monitoring and evaluation of the Healthy Kids Programme in Nigeria with the Human Nutrition Department at the University of Ibadan.
Results showed that participating schoolchildren significantly improved their eating habits and physical activity behaviour.
The Nestlé Healthy Kids Global Programme is part of the company’s approach to business, which it calls ‘Creating Shared Value’. It is part of Nestlé’s commitment to promote healthy diets and encourage active lifestyles and physical activity.
NHF and Nestle are supported by a research published over the weekend in the British Journal of Sports Medicine, which suggests that, from age 30, physical inactivity has the biggest impact on certain risk factors - such as excess weight, smoking and high blood pressure- in women.
These risk factors are known to increase lifetime risk of developing heart disease in women.
The researchers used data on 32,254 participants in the Australian Longitudinal Study on Women’s Health, which tracks the long-term health of women born in certain spans of time between 1921 and 1978.
Also, a new research published in Diabetologia indicates that brief bursts of intense exercise before meals (termed exercise ‘snacking’ by the study authors) helps control blood sugar in people with insulin resistance more effectively than one daily 30-minute session of moderate exercise.
Diabetologia is the journal of the European Association for the Study of Diabetes.
The research was conducted by exercise science and medicine researchers, including Monique Francois, and Associate Professor James Cotter from the University of Otago, Dunedin, New Zealand.
Get moving: researchers found low levels of physical activity had the greatest impact on women’s heart disease risks. The investigators observed that smoking prevalence fell from 28 per cent in women 22-27 years old to five per cent in those between the ages of 73 and 78.
However, inactivity prevalence and high blood pressure increased across their lifespans, from age 22 to 90, and overweight prevalence increased between the ages of 22 and 64, declining after those ages.
The team then combined prevalence with relative risk data - which reveals the likelihood that a woman with a specific risk factor will develop heart disease, compared with a woman without that risk factor.
After combining this data, the researchers observed that, until the age of 30, smoking had the greatest influence on heart disease risk.
Between the ages of 30 and 90, however, low physical activity levels had the greatest effect on higher levels of population risk, compared with any of the other risk factors, the team found.
The World Health Organization (WHO) recommend that all adults get 150 minutes of moderate intensity physical activity each week, and the researchers say if every woman between 30 and 90 were to reach this recommendation, then more than 2,000 middle-aged and older women’s lives would be saved in Australia each year.
Based on their results, the researchers say the effect of different risk factors on chances of developing heart disease change throughout a woman’s life.
The researchers added: “Our data suggest that national programs for the promotion and maintenance of physical activity, across the adult lifespan, but especially in young adulthood, deserve to be a much higher public health priority for women than they are now.”
Though they note that reducing smoking in young women is important, more focus should be put on keeping physically active; the main focus has been on obesity and BMI, they said.
Meanwhile, the Diabetologia study used a cross-over design, meaning that each participant acts as their own control, and questions can be answered with a much smaller number of participants. Nine individuals (two women, seven men) were recruited. All had blood test results showing insulin resistance, were not on cardiovascular or diabetic medication, were aged 18 to 55 years (mean age 48), and had a mean BMI 36 kg/m2. They included two newly diagnosed type 2 diabetics only detected as part of the screening.
The participants completed three separate exercise interventions in randomised order. Measures were recorded across three days with exercise performed on the middle day, as either: (1) traditional continuous exercise (CONT), comprising one 30 min moderate-intensity (60% of maximal heart rate) session of incline walking before dinner (evening meal) only; (2) exercise snacking (ES), consisting of 6×1 min intense (90 per cent maximal heart rate) incline walking intervals finishing 30 min before breakfast, lunch and dinner, with one minute slow walking recovery time after each minute of intense exercise; or composite exercise snacking (CES), encompassing 6×1 min intervals alternating between walking and resistance-based exercise (with a one-minute slow walking recovery minute after each minute of exercise), again finishing 30 min before breakfast lunch and dinner. ES and CONT were matched for energy usage, whereas ES and CES were matched for time but CES provided a brief workout for all of the body’s major muscle groups across the day. Meal timing and composition were the same for all three exercise interventions, and monitored using diet records, daily verbal discussion, and dietary analysis software.
Female participants completed the trials in the early follicular phase of their menstrual cycle (across three separate cycles), whereas male participants had a minimum of seven days between trials.
The researchers found that the ES and CES routines controlled blood sugar more effectively than the CONT routine, particularly 3-hour post-meal glucose following breakfast (17 per cent reduction compared to no exercise) and dinner (13 per cent reduction compared to CONT). Across the day this represented a 12 per cent reduction in mean post-meal blood glucose concentration. The effect of the pre-lunch ES on blood glucose levels after lunch was unclear. Moreover, the reductions in blood glucose with ES compared to CONT persisted for a further 24 hours across the day following exercise.
While acknowledging that further work is required to determine the clinical significance of their study, the authors say their work adds to the recent interest in ‘accumulating physical activity’ as brief, repetitive bouts of intense exercise (as opposed to a single, prolonged, continuous exercise session) to prevent cardiometabolic disease. Many international guidelines prescribe exercise to maintain health (for example 30 min of moderate exercise 5 times a week), but such regimes still leave many people with prolonged sedentary time or inactivity, which has already been highlighted in previous research as harmful to health. Previous research has also shown more frequent breaks in sedentary time are beneficial for waist circumference, blood glucose control and other metabolic parameters.
Exercise ‘snacking’, whether before meals or not, provides breaks in sedentary time, and thus may be important for public health. In this study, 30 min of moderate-intensity exercise (CONT) did not improve blood sugar control, whereas distributing the same volume of exercise as three brief pre-meal HIT ‘exercise snacks’ resulted in a mean 12% reduction in the average post-meal glucose level (the mean across the three meals), an effect that was also sustained across the subsequent day. Walking-based (ES) and combined-exercise (CES) snacks improved blood sugar control similarly, and both forms of exercise involved similar levels of exertion in the nine patients. In this study ES lowered 24-hour glucose levels relative to the control day, whereas CONT did not. Although compared to the control day ES was more effective than CONT on the day after exercise (subsequent 24 hour), on that day the 24-hour mean glucose for ES was not statistically significantly lower than CONT.
Other research focussing on several weeks of interval training versus continuous exercise has found that interval exercise every second day is just as effective as continuous exercise every day, despite the significantly lower volume of exercise. The current study and others show that if the exercise is intense, it may only need to be performed every second day, further adding to the time efficient nature of this interval exercise.
“The notion of doing small amounts of interval exercise before meals is a unique and very important feature of this study,” says Francois. “Sustained hyperglycaemia following meals is an important feature of insulin resistance. Reducing these post-meal spikes is important for reducing the risk of developing type 2 diabetes and its associated complications.”
She added: “Dosing these small amounts of high intensity exercise before meals (particularly breakfast and dinner) may be a more time efficient way to get exercise into people’s day, rather than devoting a large chunk of the day.”
She concluded: “We found exercise snacking to be a novel and effective approach to improve blood sugar control in individuals with insulin resistance. Brief, intense interval exercise bouts undertaken immediately before breakfast, lunch and dinner had a greater impact on post-meal and subsequent 24 h glucose concentrations than did a single bout of moderate, continuous exercise undertaken before an evening meal. The practical implications of our findings are that, for individuals who are insulin resistant and who experience marked post-meal increases in blood glucose, both the timing and the intensity of exercise should be considered for optimising glucose control.”
The researchers are continuing the work in this area, and are set to publish further studies, including one other acute 24 hour response to high-intensity exercise using different forms of exercise in younger sedentary individuals, and a longer-term training study on other health-related measures. They also plan to study such exercise targeting younger insulin-resistant individuals.
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