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Those who are the most physically active are about 30% less likely to die prematurely compared to the least active, 16 as visualised in Figure 1. 6, 14, 15 Overall, there is a clear dose response relationship between the amount of physical activity and its health benefits the more active you are in terms of frequency, intensity or duration of activity, the greater the benefits to health.

This has been collated and thoroughly reviewed by a number of health authorities. Recommendations (for physical activity) must be underpinned by science and much of the research effort in this field has focused on the amount and type of physical activity needed to remain healthy. 7 Physical inactivity is identified as a common modifiable risk factor for these diseases alongside smoking, an unhealthy diet, and alcohol misuse. The main focus of the WHO global action plan for the prevention and control of non-communicable diseases is on prevention and treatment of heart disease, cancer, respiratory disease and diabetes the main causes of poor health and early death in Europe and worldwide. Physical activity recommendations 2.1 Background 1, 10, 11, 12, 13 See also section 5 on physical activity and health. As such, physical activity has both a preventive and therapeutic effect across several diseases and conditions and contributes to quality of life in many ways. Moreover, the human body is built to move, and major systems, including the skeletal, muscular, metabolic, circulatory, digestive and endocrine systems, do not develop and function properly unless stimulated by frequent physical activity. See Annex 1 and 2 on definitions and the classification of physical activities with further details and examples. lawn mowing, slow cycling) and vigorous intensity activity (e.g. food shopping, slow walking) moderate intensity (e.g. desk work, watching television), light intensity (e.g. 9These metabolic equivalents (METs) are used to classify activities as sedentary behaviour (e.g. The Compendium of Physical Activities is used to estimate the metabolic intensity of an activity compared to a resting state. Examples of such activities are lifting, carrying, walking, cycling, climbing stairs, housework, shopping, dancing, and gardening 1. This includes activities undertaken while working, playing, carrying out household chores, travelling and engaging in recreational pursuits. Physical activity is defined as any bodily movement, produced by skeletal muscles, that requires energy. 7, 8 In this light, this EUFIC review will define physical activity, address how it relates to health, present recommendations and current physical activity levels, and touch upon economic and other aspects of the global inactivity trend. 6Physical activity is therefore considered a health promotion priority.

In Europe, it has been estimated that physical inactivity costs between €150-300 per citizen per year. 1 On top of that, the burden of disease caused by physical inactivity not only causes suffering for the victims, their families and friends, but also puts a huge strain on health care systems and leads to a loss of productivity due to sickness from work. Our better understanding of the impact of inactivity to health, 5has led to the recognition that physical inactivity is now the fourth leading risk factor for global mortality, after high blood pressure, tobacco use, and high blood glucose, and before overweight and obesity. 2 The WHO estimates that 35% of Europeans do not meet the recommended minimum level of activity for good health, 2, 4and this is predicted to increase not only in Europe, but in many countries worldwide. 2, 3 Research shows stark decline in overall physical activity levels in high income countries over the last 40 years, with medium income and even low income countries set to follow the trend. Vehicles, machines and technology now complete the tasks that once required physical effort. This is largely due to the reduced requirement to be active in daily life. However, only relatively recently a lack of physical activity has become a public health concern. The current World Health Organization (WHO) guidelines show that Plato’s notion has not lost its importance, by encouraging everyone, regardless age or ability, to engage in regular physical activity, ensuring proper physical development and maintenance of physical and mental health throughout the lifespan. The ancient philosopher Plato noted: “Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it”. The contribution of physical activity to good health and quality of life has been known for centuries.