Richard Bailey, Manager “Sport and Health”, International Council of Sport Science and Physical Education (ICSSPE)

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Something like 95% of human biology was naturally selected during the Late Palaeolithic era. For a great deal of this period, humans lived as “hunter­gatherers”, using skilfully crafted stone tools, often travelling enormous distances in the pursuit of food and safe places to live. We now spend most of our days sitting in offices or school classrooms, driving or driven from place to place, and consuming hours and hours of TV and computer games. This is not the life for which our bodies and our brains have been adapted, and we are paying the price.

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Globally, the major cause of death and disability are non­communicable diseases, such as obesity, heart disease, some cancers, chronic respiratory disease, stroke and Type 2 diabetes. These conditions are, in large part, diseases of civilisation; pathological conditions caused by our rapidly changing physical, social and cultural landscapes, and our bodies’ inability to keep up. From the point of view of health living, we live WEIRD lives. This is not just a reference to my home town of Berlin (surely one of the weirdest cities in Europe!). I refer to the useful acronym by the Harvard anthropology Joseph Henrich. He described the lives of those of us in Western, Educated, Industrialised, Rich and Democratic societies.

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Viewed from the perspective of human evolutionary history, the lives of those of us in the so­called modern world are “weird”, as they barely resemble the environment in which we are adapted to operate. Physical activity was a necessary part of ancestral environment, most directly because humans were required to travel, hunt and gather food. In this context, physical activity was just as much a core requirement for survival as food, water and sex. Humans were designed to move.

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We do not move now. Well, we do not move enough. Very few humans now need to hunt, travel large distances on foot, or physically gather food from the local environment for survival. Most individuals no longer have to use manual labour to procure food or shelter. This creates a potential tension or mismatch between the convenience of modern living, and bodies and brains that are still adapted for a different era. The mismatch between our evolved bodies and brains and the modern world is the ultimate cause of the risks associated with the current “pandemic of physical inactivity”.

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For many people, evidence about children and young people is particularly concerning. Aside from any natural anxiety for the well-being of the young, the issue of non­communicable diseases during childhood is of great public health importance, since many of these conditions have been found to track from childhood through to adulthood, which strongly suggests that the roots of adult ill-health and early death lie in childhood. In that light, some research findings give cause for alarm. Only 34% of European adolescents are active enough to meet the current recommendations. This contributes to rising rates of overweight and obesity among children in Europe, particularly among children from low socioeconomic backgrounds. Data show that, in some countries, almost 50% of eight-year-old boys are overweight. It has also been found that more than 86% of 15-year-old girls are considered physically inactive. Low levels of physical activity have also been reported for adults and older people from disadvantaged backgrounds, as well as some minority ethnic groups and people with disabilities.

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Numerous solutions have been proposed to address these challenges, and among the most plausible is the idea of active cities. I understand active cities to be urban spaces designed for movement by everyone. It prioritises active transport; parks and play spaces are the norm. And there is assertive action to increase normal levels of activity in schools and workplaces. Active cities are an attractive compliment to standard physical activity promotion because they make moving easy. In active cities, we can be active merely by making our way around them. Walking, cycling and active leisure are safe, suitable, and accessible by everyone, and minimise the need for motivation, materials, and money

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Available evidence suggests that active cities can significantly increase daily physical activity. And they work most effectively the different aspects of cities – roads, parks, schools, workplaces – working together to maximise opportunities to be active. In a way, active cities work because they help recreate the environments for which our bodies and minds were adapted, where activity is a norm and necessary part of daily life. WEIRD environments squeeze physical activity from people’s lives and replace it with cars and computers and TVs. The active cities concept is an exciting, practical, cost-effective strategy for reversing the trend.

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The WHO estimates the annual worldwide tally to be 35 million people per year dying of diseases associated with physical inactivity, which is double the number dying from all combined infectious diseases, like HIV/AIDS and malaria. Aside from the human cost, there is a huge financial loss: in 2005 alone, the estimated losses in national income from heart disease, stroke and diabetes were $18 billion in China, $11 billion in the Russian Federation, $9 billion in India, and $3 billion in Brazil. Most data on the costs of inactivity focus solely on physical ill-­health. But this is just the most visible expression of a much more complex predicament. It is impossible, with existing figures, to speak accurately about the real cost of inactivity. However, we can guess the amount will increase still further.