Sedentary pandemic threatens EU health

The statistics are shocking, but the importance of 'moving more' for people's health has often been overshadowed by the sexier stories relating to diet, junk foods and sugar taxes.

"I am particularly worried about today's children and young people," said EU health commissioner Vytenis Andriukaitis in Estonia in September.

"They spend much time playing with smartphones and tablets, eating snacks and sweets, drinking sugary drinks - and not moving much."

Tartu calling

Andriukaitis was speaking at a healthy lifestyles conference in Tartu, Estonia, where he teamed up with EU commissioner for education, culture, youth and sport, Tibor Navracsics, and EU commissioner for agriculture, Phil Hogan, to launch the "Tartu call for a healthy lifestyle".

This consisted of 15 commitments, bringing together work in a range of fields - such as sport, food, health, innovation and research - in an effort to promote healthy lifestyles.

There will be increased funding for projects promoting physical activity under the sport chapter of the Erasmus+ programme, for instance, as well as further research to determine what drives lifestyle choices.

Physical activity will also become a "priority" for the high-level group of government representatives on nutrition and physical activity.

Many of the commitments lack detail or targets, but the fact that the three EU commissioners have come together gives reason for optimism.

The partnership demonstrates "serious intention", said EuropeActive, which represents the health and fitness sector in Brussels.

Navracsics told EUobserver that it marks a "more coherent approach to healthy lifestyles across relevant policy areas that tackle health, sport and food matters".

"There is no magic bullet," he said.

Tackling obesity requires a number of policy interventions, at the heart of which will be efforts to encourage people to eat more healthily, drink better and move more.

As members of the employment, social policy, health and consumer affairs council (EPSCO) recently suggested, countries must address both the lack of physical activity and unhealthy diets to have any chance of tackling childhood obesity.

The announcement in Tartu, across the commissioners' three directorates, suggests the commission is ready to grasp that nettle, too.

Fighting inactivity

Unhealthy diets and physical inactivity are "at the heart of [the obesity] problem", the commissioners noted in a joint statement.

"They never usually talk to each other, [so] it's a step forward," explained Jean-Claude Coubard, the founder of the European Healthy Lifestyle Alliance (EHLA) and executive director of the International Chair on Cardiometabolic Risk (ICCR), an academic think tank.

Campaigners are delighted the silos between responsible directorates - headed by the three commissioners - have finally been broken, but now they are waiting to see what happens next.

Coubard has written to all three commissioners for details on how they plan to "fight inactivity" and shake policymakers out of their stupor.

Indeed, for too long Europe's leaders have themselves been guilty of doing nothing: not one member state has achieved the recommended levels of activity, for example.

Much of the focus has been on children - and, in particular, the sharp fall in physical activity levels between the ages of 11 and 15.

The "Health at a glance: Europe 2016" report, published by the OECD and European Commission last year, showed that in 2013-14, 20 percent of girls aged 11 exercised to recommended daily levels, but only 10 percent of those aged 15 did.

For boys, the figures were 30 percent for the younger children and 20 percent for the older ones.

Factors playing a part in the low levels of activity included the availability of space and equipment, present health conditions and school curricula.

Evolving habits?

However, daily habits have also "evolved" the authors noted, with TV, the internet and smartphones proving an irresistible distraction for many young people.

As David Morley, professor of youth sport and physical activity at Sheffield Hallam University recently put it: "Opportunities for children to move are in decline - think less time for running around outside and more time inside looking at screens."

This has not only seen children become more sedentary, of course - the time in front of those screens is also an opportunity for advertisers to push unhealthy foods at this vulnerable demographic.

It's not just children that need to move more, said EHLA's Coubard. "Physical inactivity concerns everyone - this problem is huge everywhere."

In the most recent Eurobarometer survey on sport and physical activity, from March 2014, three out of five adults in the EU said they never or seldom play sport or do any exercise.

Research has shown that the common barriers for adults include the "perception of lack of time, feeling too tired and preferring to rest".

Office-based jobs and - once again - smartphones and technology also keep Europeans inside on their sofas rather than outside in the sunshine.

The amount of exercise people do very much depends on where they live: in Sweden, 80 percent of adults hit the 150 minutes of moderate-intensity, aerobic physical activity recommended by the World Health Organisation; whereas, in Romania, it's just 38 percent.

Only six EU countries managed 70 percent or more.

Expensive health

There is also an educational gap - those with a higher level of education do more exercise, the OECD found. As commissioner Andriukaitis noted: "Eating well or practising sports is not something that all Europeans can afford."

But EU member states can't afford to sit on their backsides, either.

Inactivity costs the EU over €80 billion a year, through four non-communicable diseases - coronary heart disease, type II diabetes, colorectal and breast cancer - and the indirect costs of inactivity-related mood and anxiety disorders.

Nevertheless, the commission and member states are notoriously reluctant to spend money on preventative measures, which "appear too expensive", Coubard said. "We need more big campaigns," he explained, though those tend to come with a big price tag.

The pay back could be significant, however.

By 2030, that €80 billion cost of inactivity could be €125 billion, according to a 2015 study by the Centre for Economics and Business Research (CEBR) study, commissioned by the International Sport and Culture Association.

Getting people moving and cutting inactivity levels by a fifth could save 100,000 lives and more than €16 billion a year, the experts estimated.

Countries have run national campaigns on smoking, cancer and diabetes - so why not one on healthy lifestyles?

Taking responsibility

"It's about education and information, and it must be at national level - like a one year promotional campaign," Coubard said.

There are hotspots of progress, including the Jogg programme in the Netherlands, and Ireland's active school flag initiative.

Many cities have also "taken responsibility" to encourage people to walk, cycle, swim and run more.

Whether new campaigns are part of the Tartu Call remains to be seen. Progress against the commitments will be assessed in 2019. By then, the next Eurobarometer survey will have been published (in May 2018).

Navracsics said this will provide a "very useful" indication of the trends, and whether the measures put in place at national and European level to promote physical activity - such as the European Week of Sport - are already producing tangible effects.

CEBR warned that if nothing is done to get people moving and more active in their day to day lives, physical inactivity "could pose a bigger risk to public health in the future than smoking".

The Tartu call is a positive step, but the commissioners now need to prove it's not just puff.