Academic journal article Central European Journal of Public Health

Physical Activity and Exercise as a Basic Preventive Measure (Primary Prevention, Prevention after Renal Transplantation)

Academic journal article Central European Journal of Public Health

Physical Activity and Exercise as a Basic Preventive Measure (Primary Prevention, Prevention after Renal Transplantation)

Article excerpt


The life expectancy at birth is now 69 years, that is 6 years more than 20 years ago (1). The most common chronic diseases worldwide are cardiovascular diseases followed by malignancies, type-2 diabetes mellitus, respiratory diseases, and osteoarthritis. The prevalence of these diseases rises with increasing age. The most important modifiable risk factor is a lifestyle and physical activity in particular.

Prehistoric times and archaeological findings suggest that our predecessors had not faced the problem of overweight. On the contrary, excavations have indicated considerable "wear-and-tear" of the musculoskeletal system of man due to strenuous physical activity. On the other hand, our current lifestyle is associated with a host of adverse implications of low levels of physical activity in our industrialized society.

Cardiovascular disease is the the most common global cause of death of adults although it is preventable, with modifiable risk factors implicated in more than 90% of the risk of incident myocardial infarction (2).

In an effort to improve prevention and treatment of chronic diseases, the American College of Sports Medicine issued, as early as 1996, recommendations for everyday cumulative exercise for at least 30 minutes, resulting in an activity equivalent from 3-6 metabolic equivalents (METs), as the basis for a population-based strategy of preventive measures (3).

Throughout the history of mankind physical activity has been a natural and inseparable part of everyday life. Only the richest could have afforded to pursue physical activity also for pleasure (horse riding, falconry, just to mention a few). Physical fitness was also tantamount to prestige. Thus, physical activity was not perceived as a sport the way it is today but, rather, fitted the cultural pattern of behaviour within particular society.

For example, mortality from cardiovascular diseases within the Austro-Hungarian Empire in the early 20th century was just about 4%.

The lack of physical activity is associated with risks that may essentially increase the incidence of serious conditions.

Topping the list is overweight or obesity. Despite many objections and criticisms, the most frequent measure to diagnose this condition remains body mass index (kg/m2).

The Institute for European Food Studies (IEFS) conducted a study designed to assess any potential relations between body weight, physical activity and health status. The study involved 15,339 individuals (about 1,000 from each member state). The study showed that the perception of the importance of physical activity varies among nations. While Finns rated physical activity as the most critical modifiable factor related to health (pursuit of sports self-reported by 92% of the population), Greeks ranked it seventh (with 60% of individuals practicing any sports) (4).

According to the World Health Organization, up to 66% of boys are satisfied with their body weight whereas up to 50% of girls would like to reduce their body weight (regardless of whether they are or not overweight).

The situation in the Czech Republic is not much different, with up to 66% of 15 year old girls intent to start a slimming diet. While the situation is better with boys of the same age, still 22% of them plan to lose weight (again with no need). However, no data are available suggesting an increase in the physical activity of these adolescents (5).

Further information has been published about research into the effect of body weight on the incidence of cardiovascular events, with data obtained in the Health Professionals Follow-up Study (HPFS) (42,351 men aged 39-75 years) and the Nurses' Health Study (NHS) (76,703 women aged 39-65 years). During 16 years of follow-up a total of 2,771 events in men and 2,359 events in women were documented. The relative risk (RR) of cardiovascular disease (CVD) in individuals with a body mass index (BMI) ≥ 30 kg/m2, as compared with individuals with a BMI of 18. …

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