Interview conducted by April Cashin-Garbutt, BA Hons (Cantab)
Why is it important to encourage people to be physically active?
Our bodies were designed to be active. The human body is not meant to spend long periods of time sitting but that’s what our modern lives have led us to do. The result has been the increase in obesity seen across the world, and up to 20 other conditions including cardiovascular disease and diabetes. Being active is natural; being inactive is not.
What physical activity promotion programmes have you previously been involved in and which do you think were the most successful?
In many ways this is the wrong question: one of the problems with our approach in the past is that it has focussed too much on projects or programmes. These have tended to be short-term programmes targeted at small numbers of people which tend to influence behaviour over very short time periods, but then lead to relapse, and have limited population-level impact.
In contrast, the approaches that seem to be having more potential are those that tackle the problem at a systems level. So for example, a town or city taking a comprehensive approach across the area to build environments that are conducive to activity, combined with promotional programmes. We have had some success with this approach in the UK on cycling, but there are other good examples from around the world.
What have you learnt from your involvement in these programmes?
The most important element is very hard to find and even harder to plan: top-level commitment. It is only when the most senior people in the area – mayors or council leaders in the UK for example – show commitment to an initiative and push it through that it will have an impact.
A good UK example is the London congestion charge which has transformed the city for cycling and walking.
What factors need to be taken into consideration when developing a policy on physical activity?
I think the most important principle is for the policy to be multi-level. By that I mean that it tackles the issue from all possible angles and at multiple levels of influence. So for example a policy on walking should include promotional materials and one to one interventions, but only alongside action with community groups and organisations such as workplaces, and changes to the physical environment to make it more amenable for walking.
Do you think it is important to teach people to be physically active from a young age?
Yes! There is not strong evidence that physical activity itself ‘tracks’ from childhood to adulthood but it does seem important to equip children with the basic skills so that they can enjoy the widest range of possible forms of activity and find ones they like.
For example, if children are not taught to throw and catch a ball, they are unlikely to go on to play any ball sports. Similarly, if children are not exposed to natural risks like climbing trees, they are less likely to continue to develop their activity experience.
You are currently a specialist advisor to the National Obesity Observatory. How prevalent is obesity in the UK, and is it on the rise?
Obesity is on the rise in the UK. The proportion who were categorised as obese (BMI 30kg/m2 or over) increased from 13% of men in 1993 to 25% in 2011 and from 16% of women in 1993 to 26% in 2011.
In addition 9.9% of boys and 9.0% of girls (all children 9.5%) in Reception year (aged 4-5 years) and 20.7% of boys and 17.7% of girls in Year 6 (aged 10-11 years) are also classified as obese. We have developed a strong approach to measuring obesity among children in the UK but like most countries we have not worked out what to do about it yet!
How do you think the future of physical activity levels will develop?
As our society ‘progresses’ we are more and more likely to see physical activity designed out of our lives – more car travel, more labour saving devises and so on. I’d like to think that we will increasingly fight against this, as people realise just how important physical activity is, and how it can be a very positive and enjoyable aspect of life.
Would you like to make any further comments?
I guess one other thing that I’d like to get across is that physical activity should not be seen as a medical issue: it is a normal, enjoyable fun aspect of life! It is running, jumping, skipping, walking, cycling, playing, moving! We shouldn’t make it seem like a pill you have to take…
Where can readers find more information?
They can find further information at:
About Dr Nick Cavill
Nick Cavill PhD MPH MFPH
Nick is a director of an independent public health consultancy, a research associate of the University of Oxford BHF Health Promotion Research Group, and an honorary senior research fellow at the University of Salford. He specialises in the development of policy and programmes on sustainable transport and the links to physical activity.
Nick has been involved in many of the major physical activity promotion programmes in the UK including Walking the Way to Health; Walk to School; the Department of Health’s Local Exercise Action Pilots and the Department for Transport’s Cycling Towns programme. He has been involved with strategic reviews of programmes run by organisations such as the British Heart Foundation; Living Streets; the Ramblers; Sport England; Department of Health and Water UK. He has conducted numerous reviews of ‘what works’ in physical activity promotion for National Institute for Health and Clinical Excellence (NICE) and other agencies and worked on a seminal review of walking interventions published in the British Medical Journal.
He is currently a specialist advisor to the National Obesity Observatory, and a member of the National Institute for Health and Clinical Excellence Programme Development Group on walking and cycling. He was one of the core team for the WHO Health Economic Assessment Tool (HEAT) for walking and cycling; a member of the Dept of Health’s Physical Activity Editorial Group; and a member of the World Cancer Research Fund policy panel. He has worked at both Departments of Health and Transport, and was formerly at the Health Education Authority, where he was head of the physical activity programme from 1994 – 2000. In 2011 Nick completed his PhD at the University of Salford, focusing on national policy approaches to promoting physical activity, and was made a member of the Faculty of Public Health through distinction.