People in the UK are less active than ever before. In fact, children today are are believed to be the least active generation ever, as modern life tightens its grip on families’ ability to take the steps that would help them avoid obesity and health-related conditions.
Recent research shows that one in five children are overweight or obese by the time they start school, and this rises to one in three by the time they start secondary school. Just 23 per cent of boys and 20 per cent of girls meet the national recommended level of activity overall. In addition to this, just 20 per cent of eight- to 11-yearolds do organised leisure activities every day and just 39 per cent do so once or twice a week. Low activity levels also affect younger children, with just one in 10 preschool children currently meeting recommended physical activity guidelines.
Not only are overall activity levels falling, but recent research shows that young people’s activity levels drop off as they get older, and this is thought to lead to low levels of activity in adulthood. Public Health England (PHE) recently revealed that the number of children achieving the recommended hour a day of exercise drops by 40 per cent between the ages of five and 12, a worrying fact that has short- and long-term consequences.
The drop in activity levels is highly problematic, not only for physical health but for mental health too. A PHE survey of 2,000 people found that four in five parents say their children feel happier when they are physically active, and more than nine out of 10 children say they like being active.
According to the survey results, the rate of self-reported happiness follows the same trend as activity levels. These levels fell from 64 per cent of five- and six-year-olds who said they always feel happy, to just 48 per cent of 11-year-olds, showing that wellbeing falls as activity levels do.
Quite often, wellbeing, body image and activity can be intimately linked, explains UKActive public affairs and policy manager Geremy Sagoe. “The drop offs we see as children get older is particularly pronounced in young girls and teenage girls,” he explains.
This is particularly problematic as it could be a contributory factor in the low levels of activity seen in adult women in the UK. Campaigns such as “This Girl Can” by Sport England are aiming to reduce the gap that saw two million fewer women being active than men in 2015.
There have been a number of campaigns aimed at improving activity levels in young people (see “10 Minute Shake Up” box below). While these are having some positive results, there are still barriers to improving physical activity among children.
Technology is a distraction that previous generations may not have had to contend with, admits Geremy, but he argues that we should look at ways to utilise it rather than just complain about it. “Pokémon Go, which we saw a few months back now, got a lot of traction, so gamification is something we should be looking at. If children are using technology in that kind of way then let’s think of ways that we can use that to get them moving more,” he says.
While PE lessons in school are important, one of the best ways to identify how to boost activity levels in children is to take a look at the whole day, says Geremy. This means thinking about how children get to school and back. Do they walk or do they cycle? Do they do any after school activities? It also involves looking at the level of activity that children do in lessons other than PE.
The basic World Health Organization (WHO) guidelines for physical activity in adults (defined as those aged 18-64) recommend at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity each week.
Aerobic activity should always be done in bouts of at least 10 minutes, but there are a myriad of ways that people can get their total amount of activity, such as doing moderate exercise for 30 minutes a day five times a week for example, or in fewer, longer chunks.
Adults should also do muscle strengthening exercises at least twice a week. Although some people may need to make adjustments to allow them to exercise, such as those with chronic conditions, the guidelines still apply to them. However, people who are pregnant, have just had a baby or who have had cardiac problems, should make sure they get medical advice before exercising.
Exercise that counts towards the recommended total could include:
Although there are many schemes to boost activity levels among young people, barriers still exist for many people. The Social Mobility Commission published a study last year that showed that 34 per cent of children from low socioeconomic status backgrounds did sport less than once a week compared with just 13 per cent of children from higher socioeconomic groups. These barriers could cause some of the long-term health inequalities that pharmacy, and the rest of the health service, has to deal with on a daily basis. With an increasing strain on resources, it is more important than ever to take preventative approaches now.
Another barrier is injury, but there is a lot that can be done to prevent and treat injuries so people can keep as active as possible.
What: Exercise can trigger acid reflux (heartburn) if the lower oesophageal sphincter is weak or too relaxed. This is particularly common when eating too close to a period of activity because a full stomach puts extra pressure on the oesophageal sphincter.
Prevent: Customers can be advised to:
Treat: Heartburn treatments can help to reduce symptoms. Proton pump inhibitors (PPIs) can be particularly effective as a first line treatment as they tackle heartburn at its source by blocking acid production in the stomach.
What: This happens when ligaments are stretched, twisted or torn. The most common area to sprain is the ankle.
Prevent: Good quality footwear that is suitable for the activity should be worn, and stretches and strength building exercises for the ankles and legs should be practised if these areas are particularly problematic.
Treat: The normal PRICE protocol (outlined below) should be followed, and customers should also avoid HARM, which stands for:
Heat – such as hot baths, saunas or heat packs
Alcohol – which could increase bleeding
Running – or any other form of exercise
Massage – which can worsen bleeding and swelling.
What: Pain in both shins that appears shortly after starting to run. It’s not understood exactly what causes shin splints, but it is thought to be an inflammation of the muscle around the shin bone.
Prevent: People are at risk of shin splints if they have flat feet, tight calf muscles or are overweight. Suitable footwear, running on softer ground and increasing activity levels gradually can help to prevent the problem.
Treat: Sufferers should rest and reduce their activity levels until the problem has gone away, or switch to lower impact exercise such as yoga or swimming. Paracetamol and ibuprofen can be used for the pain.
What: Tennis elbow causes pain around the outside of the elbow, and occurs as a result of overuse.
Prevent: Customers should avoid putting stress or strain on the elbow. If they play tennis or squash, advice on improving technique should be sought. Lightweight racquets with larger grips are also helpful.
Treat: This is a self-limiting condition that will eventually get better on its own, but patients can use paracetamol, ibuprofen and ice to deal with symptoms in the meantime. They should rest the elbow and stop doing the activity that caused it in the first place.
What: Chafing, blisters and sunburn.
Prevent: Chafing and blisters can be prevented with properly fitting shoes and clothes. Some runners use petroleum jelly on areas that chafe. To prevent sunburn, customers should use a high factor, waterproof sun cream, reapplied frequently.
Treat: Specialist blister plasters can be used as appropriate, and petroleum jelly can also soothe chafed skin. A cooling aftersun moisturiser will help with sunburn.
There are two types of sports injuries that can occur: traumatic injuries such as broken bones and dislocations, which will need referral to A&E, and overuse injuries such as sprains or strains. Many overuse injuries can be treated using self care advice and over-the-counter products.
The best way to avoid overuse injuries is to increase physical activity slowly. Michael McCluskey, a teaching fellow in physiotherapy at Keele University, says that he can usually pin overuse injuries on someone increasing their activity level too quickly or by more than 10 per cent a week. “If you are a new runner, rather than training off the bat to run a half marathon or even a full marathon, you should instead be aiming to do a five kilometre run first in a local park run, and then aiming to do a 10 kilometre run, and then a half marathon and then, finally a marathon,” he explains.
Michael recommends the NHS app “Couch to 5K” for beginners. It‘s free and can be downloaded to a smartphone.
If customers suffer an overuse injury, they should follow the PRICE protocol. This stands for:
“I would advise all my patients who have acquired an injury to take paracetamol to control the pain. The reason is that some people think ‘Oh, it’s just a little bit of pain, ‘I’ll be fine’, but if you take paracetamol and it reduces your pain or completely removes it, that allows you to move and movement is a really important part of joint recovery,” says Michael. Customers can also use anti-inflammatory creams or hot and cold therapy to ease pain and inflammation and to aid recovery of the joint or muscle.
Public Health England’s Change4Life “10 Minute Shake Up” campaign provides children with fun and easy ways to engage in 10 minutes of moderate to vigorous exercise through play. The activities provided as part of the campaign include familiar Disney characters to encourage children to take part.
Examples of activities, which can be accessed via the Change4Life website, include a Beauty and the Beast snowball fight and a Frozen-themed Elsa and Anna tag game. They are updated frequently and include ball games, chasing games, dancing and other physical activities. The variety is designed to help children find something they like, in the hope that they will pursue it further, increasing the chance that they will continue it into adolescence and adulthood in one form or another.
The activities have already been a significant success, with more than 700,000 children taking part in the Shake Up scheme in 2015, rising to over one million in 2016. It is also incredibly popular with parents, with more than 84 per cent of those surveyed saying it made physical activity more fun.
Speaking on behalf of Public Health England, Simone Saidel explains that the scheme was developed to increase the amount of exercise young people take part in. “Parents tend to overestimate how active their kids are and struggle to find ideas to keep them active and entertained,” she says. “To help increase physical activity levels, the Change4Life 10 Minute Shake Ups with Disney campaign aims to help children across England get their 60 minutes of moderate to vigorous physical activity each day with fun 10-minute games inspired by their favourite Disney characters and stories.”
Children today are believed to be the least active generation ever