Every step counts for health

YESTERDAY was World Physical Activity Day, a global movement to get people to be more physically active. Physical inactivity has become a global public health problem and is the fourth leading risk factor in global mortality.

The statistics of noncommunicable diseases (NCDs) in Malaysia are worrying. The 2019 National Health and Morbidity Survey reported that 50.1% of our adult population were overweight or obese, 30.0% had hypertension and 18.3% had diabetes. Meanwhile, 25.1% of adults were physically inactive, a reduction compared with 2015’s figure of 33.5%.

Regular physical activity protects against obesity and NCDs such as hypertension, diabetes, heart disease, stroke and breast and colon cancer. It is associated with improved mental health, delay in dementia onset and enhanced quality of life.

Physical activity is also an indispensable tool in the prevention and management of diabetes mellitus. Regular physical activity is universally recommended in all clinical guidelines on diabetes management. Regular physical activity can improve ABC control among type 2 diabetes patients.

(A is for the A1C test that reflects blood sugar control over the past three months, B is for blood pressure and C is for cholesterol.) Speci-fically, physical activity increases the HDL-cholesterol (good cholesterol) and reduces triglycerides (the most common fat) in the bloodstream.

Here are some types of physical activities to choose from:

> Aerobic exercise involves repeated and continuous movement of large muscle groups in activities such as walking, jogging, cycling and swimming.

> Resistance or strength training includes activities with body weight, free weights, weight machines or resistance bands.

> Flexibility exercises such as stretching improves the range of motion around joints, while balance training reduces fall risk. Flexibility and balance exercises are important for older adults with diabetes. Physical activities like yoga and tai chi combine flexibility, balance and resistance activities.

Ways to become more physically active:

> Reduce the time spent in daily sedentary behaviour such as prolonged sitting. Too much sitting is an independent health risk and distinct from too little exercise. Interrupt lengthy sitting time with bouts of light activity every 30 minutes.

> Build more activity into your day. Some practical tips include using the stairs instead of the lift or escalator and parking further away from your destination and walking the rest of the way.

> Carry out a structured exercise programme. The universal recommendations are moderate-intensity aerobic activity such as brisk walking for at least 150 minutes per week (ie, 30 minutes a day, five days a week) AND muscle-strengthening activities on two or more days a week, OR vigorous-intensity aerobic activity such as running for at least 75 minutes every week AND muscle-strengthening activities on two or more days a week. We can gain even more health benefits if we go beyond the recommended duration.

> Choose an activity that you like and would be able to maintain for the long-term as a part of your lifestyle. For example, walking is most feasible for most people in terms of time and financial expenditure. If you own a smartphone or activity tracker, you could set a target of walking 10,000 steps a day as a goal.

Individuals with chronic diseases must discuss any physical activity programme with a doctor before embarking on it.

Remember, every step counts!


Department of Public Health,

Universiti Malaya Medical Centre

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