La Physical inactivity has become a true silent pandemicWe spend many hours sitting down, we use the car even for short journeys, and screens occupy a large part of our leisure time. Although we know that Moving more improves health and extends life, yet more than half of the population still does not reach the minimum activity levels recommended by international organizations.
Before this panorama, Public health policies have a key role to play in turning this situation around.It is not just about encouraging people to do sports, but about designing well-thought-out strategies that facilitate an active life at all stages of life, in all environments (school, work, neighborhood, health centers…) and for all social groups, paying special attention to the most vulnerable people.
Why physical activity is a public health priority
The scientific evidence is overwhelming: Staying physically active reduces the risk of chronic diseases such as ischemic heart disease, strokes, the diabetes type 2Some types of cancer and many disorders associated with overweight and obesity are also reduced by regular physical activity. Furthermore, regular physical activity helps control blood pressure, improves lipid profile, and contributes to maintaining a healthy weight.
Beyond the physical, Exercise has a very powerful effect on mental health and emotional well-being.It is associated with fewer symptoms of anxiety and depression, better sleep quality, a greater sense of energy, and improved cognitive function, especially in older peopleIn this group, multi-component work (strength, balance and endurance) helps prevent falls, improves autonomy and delays dependence.
From a metabolic perspective, Physical activity acts as a broad-spectrum “medicine”.It improves insulin sensitivity, helps regulate blood glucose in people with diabetes or at risk of developing it, promotes the maintenance of muscle and bone mass, and contributes to better obesity management. It is no coincidence that scientific societies such as the Spanish Society of Endocrinology and Nutrition emphasize "directed physical activity" as a central element in the prevention and treatment of chronic degenerative diseases.
There are also social and environmental benefits: More active societies use less fossil fuel and create more livable cities.When walking, cycling or using public transport are encouraged, pollution is reducedRoads are decongested and road safety is improved. These changes align perfectly with the Sustainable Development Goals of the 2030 Agenda and with the concept of healthy and sustainable cities.
International and national recommendations on physical activity
The current guidelines from the World Health Organization (WHO) are clear: Adults should engage in 150 to 300 minutes of moderate physical activity per week.or between 75 and 150 minutes of vigorous activity, or an equivalent combination of both. In addition, strength training is recommended at least two days per week, and for older adults, balance, coordination, and flexibility activities are also recommended.
Studies show that Even small changes, maintained over time, have a real impact on healthA very illustrative example is a study published in The Lancet, which suggests that walking just five more minutes a day at a moderate pace (around 5 km/h) can be associated with an approximate 10% reduction in the risk of death from any cause. You don't need to start running marathons: any increase in activity, well-planned and realistic, makes a difference.
In Spain, they have been developed Specific recommendations for Physical Activity for Health and Reduction of Sedentary Behavior Aimed at the general population and based on international evidence, these guidelines, initially published in 2015 and updated in 2022, detail the amount, intensity, frequency, and duration of exercise recommended for different age groups and include guidance on how to reduce screen time and sedentary behavior in daily life.
These national recommendations are accompanied by Supporting materials, such as full documents and infographicsThese tools facilitate understanding of the key messages. For example, they include tables with physical activities classified by intensity for children, adolescents, and adults, which help translate general guidelines into concrete actions: brisk walking, cycling, swimming, dancing, doing demanding household chores, or participating in structured sports.
Even so, studies analyzing the perceptions of policymakers, academic staff, and key health professionals point to a worrying gap: Although the evidence on the dangers of sedentary lifestyles is very strong, policies to combat it still do not occupy a priority position. on many public agendas. Unlike what happens with other risk factors such as tobacco, where there are clear regulations and intensive campaigns, the promotion of physical activity is progressing more slowly and unevenly.
National strategies against sedentary lifestyles and physical inactivity
In recent years, various nationwide strategies have been promoted in Spain that They seek to place physical activity at the center of public policiesOne of the most outstanding is the National Strategy for the Promotion of Sport against Sedentary Lifestyle and Physical Inactivity, integrated into the Recovery, Transformation and Resilience Plan through one of its structural reforms.
This strategy is based on a simple but powerful idea: Regular physical activity is a driver of social, cultural and economic development.It's not just a health issue. Incorporating movement into daily life helps prevent non-communicable diseases, improves mental health and quality of life, and at the same time creates cleaner, safer, and more livable urban environments. The goal is for physical activity to be the norm, not the exception, in Spain.
The context driving this National Strategy includes several key elements. On the one hand, The experience of the COVID-19 pandemic highlighted the importance of leading an active life.On the other hand, international organizations are asking States to approve specific plans against sedentary lifestyles; and the period of the previous “Comprehensive Plan for Physical Activity and Sport (Plan A+D)” has ended, which opened the door to a new framework for action.
The Strategy document delves deeper into the importance of promoting an active life in the current contextIt reviews the international legislative and regulatory framework and defines the vision, mission, and values that should guide all actions. Following this conceptual foundation, strategic lines, intervention areas, and specific measures are developed to facilitate access to quality, safe, and more equitable physical activity and sport.
The ultimate goal is that The entire population, regardless of age, sex, social status or place of residence, can access real opportunities to move moreTo achieve this, actions are planned in coordination with regional and local governments, the education system, health services, the sports sector, and other stakeholders. The goal is not only to increase exercise time, but also to transform the environment so that movement becomes the easiest and most natural choice.
The Strategy for Promoting a Healthy Life in Andalusia
At the regional level, some communities have developed very comprehensive frameworks. One example is the Strategy for the Promotion of a Healthy Life in Andalusia (EPVSA), approved by the Andalusian Governing Council in April 2024. This document, promoted by the General Directorate of Public Health and Pharmaceutical Regulation, aims to improve the health and well-being of the Andalusian population through comprehensive and sustained interventions.
EPVSA starts from a compelling fact: Chronic non-communicable diseases cause approximately 71% of deaths worldwide.According to the WHO, many of the factors that cause these diseases are preventable. Investing in health promotion policies is more efficient and less costly than focusing solely on medical treatment once problems have already arisen.
This Andalusian strategy proposes a comprehensive approach based on “all policies and all settings”In other words, it seeks to incorporate a health perspective at the local level, in the places where people live, study, work, and interact, while remaining mindful of the social determinants that generate inequalities. It also aims to strengthen existing personal and community assets by leveraging the population's resources, networks, and capabilities.
EPVSA is organized around several groups of positive habits that are interrelated and that, together, build a healthier life: healthy nutritionPhysical activity, restorative sleep, emotional well-being, responsible sexuality, and positive use of technology (TRIC) are all addressed. Not only are risks considered, but also behaviors that promote health throughout the lifespan.
Within this framework, Physical activity occupies a central placeThe strategy promotes movement levels in line with WHO recommendations, emphasizing that any increase in activity is better than inactivity and that simple activities like walking or cycling can make a difference. It focuses on creating environments (urban, work, educational, and community-based) that make it easier to choose active transportation and leisure activities over sedentary lifestyles.
Areas of intervention and programs in the Andalusian Strategy
To move from theory to practice, EPVSA is deploying a broad set of sectoral programs geared towards different environments and population groups. Many of them are linked to the Local Action Network on Health (RELAS), which promotes initiatives to encourage healthy habits and community support networks in municipalities and neighborhoods.
Among the most relevant programs are actions in mobility and transport to facilitate active travel, projects promoting healthy habits in healthcare centers and mental health facilities, interventions in schools and university students, as well as specific actions in social services centers, juvenile justice centers, prisons or temporary reception centers for immigrants.
Another important group consists of the alliances with economic operators The plan focuses on the food, restaurant, sports, and leisure sectors to promote healthier and more accessible options. It also includes campaigns to disseminate reliable health information and measures to curb advertising of harmful products and activities, as well as promoting training, research, and innovation in healthy habits.
The package of measures includes initiatives such as The Guide to recommendations on healthy habits in primary careThis proposal outlines a healthcare model within the Andalusian Public Health System focused on promoting physical activity and balanced nutrition through routine consultations. It also includes projects such as the Healthy Andalusia Network, which brings together professionals involved in health promotion, and innovative programs implemented in specific neighborhoods and schools.
The Andalusian Strategy also incorporates, structured monitoring and evaluation mechanismsThe preparation of periodic reports by the Technical Monitoring and Evaluation Office, provincial technical workshops, strategic and program indicators, and dissemination spaces to share results, learn from experiences and adjust actions when necessary are planned.
The Physical Activity and Health Plan of Aragon
In Aragon, a Physical Activity and Health Plan conceived as a framework for governance and inter-administrative collaborationThis plan is jointly promoted by the Departments of Education, Culture and Sport, and Health, through their General Directorates of Sport and Public Health, with the aim of coherently integrating physical activity and health policies.
The main purpose is to lay the foundations for promoting physical activity as an essential element of public healthimproving the quality of life of the Aragonese population. To this end, the process of developing the Plan has been divided into several stages, beginning with the creation of a drafting group with representatives from the health and sports administration, the Aragonese Health Service, and the region's universities.
In the first phase, the work methodology was defined and carried out a comprehensive review of regional, national, European and international plansThis allowed for the identification of best practices, successful experiences, and lessons learned that could be adapted to the Aragonese context. From there, the mission, vision, and values that would guide the Plan were defined.
The mission includes two key axes: Improve governance and create environments conducive to well-being through innovative, cross-sectoral and sustainable strategiesand to raise awareness among the population about the benefits of physical activity throughout all stages of life, with special attention to vulnerable groups. The vision is for a more active and healthy Aragonese society, where exercise is naturally integrated into lifestyle and all stakeholders cooperate based on principles of equity.
At a later stage, the drafting group structured the plan into Three main areas of work: LEADING, DOING, and BUILDING CAPACITYFor each area, coordination groups were formed that defined specific objectives and lines of action, with the participation of key informants from different sectors and always incorporating the perspective of gender, life stages and vulnerable populations.
Areas of LEADING, DOING and BUILDING CAPACITY in Aragon
The area LEADER focuses on the governance of the Physical Activity and Health PlanIt includes actions to establish shared leadership between the health and sports sectors, create coordination structures, establish spaces for dissemination and communication, promote the necessary regulations and develop systems for evaluating and analyzing the level of implementation of the plan.
The area HACER groups together the interventions most directly linked to the practice of physical activity in the population. It is geared towards three main goals: improving or maintaining health status, addressing and controlling risk factors, and promoting adherence to physical activity throughout life (childhood, youth, adulthood, and older adults). It takes into account the different environments in which people move: schools, work, leisure time, community, as well as situations of particular physical, mental, or social vulnerability.
On the other hand, the area BUILDING CAPACITY aims to strengthen knowledge and skills related to physical activityExercise and sport. This translates into research initiatives to generate evidence on health outcomes, training programs for professionals from different sectors, and the development of digital tools and systems that support the monitoring, prescription, and evaluation of physical activity.
In a fifth stage of the process, the objective was to translate the objectives into concrete actionsKey informants were invited to participate, selected for their experience, multi-sectoral representation, and knowledge of specific areas, always maintaining a perspective of equity. This process identified measures tailored to the Aragonese context but aligned with international recommendations.
The result is a plan that It does not simply recommend “going out to do sports”but it proposes changes in the organization of services, the design of environments and the way of working of professionals in health, sports, education and the community, seeking to ensure that physical activity is present in a cross-cutting manner in multiple public policies.
Integrating physical activity into healthcare and daily life
One of the clearest trends in public health is that of to integrate physical activity into clinical care as if it were just another treatmentSpecialists in endocrinology and nutrition emphasize that, despite great pharmacological advances, the best way to address many diseases is still to prevent them from appearing or delay their onset through healthy lifestyles.
Professionals grouped in initiatives such as the SEEN's GENEFSEEN group insist that Exercise is not just for “burning calories”, but it has profound effects on the metabolic, immune, and cognitive systems. In previously sedentary older peopleYear-long resistance training programs have shown significant improvements in aerobic capacity and cognitive performance. In people over 65, combining balance, strength, and endurance exercises reduces the risk of falls and improves functionality.
Furthermore, there is a strong relationship between sedentary lifestyle and increased chronic-degenerative diseasesincluding obesity. Very inactive people often have decreased muscle mass, which predisposes them to chronic pain, loss of strength, and poorer overall health. As age increases, the association between lack of activity and cardiovascular risk becomes practically exponential.
The good news is that Physical activity provides benefits at any ageEstablishing and maintaining a habit is easier if started in childhood or adolescence, but even older adults or those with chronic conditions can experience significant improvements in their blood pressure, weight, blood sugar control, and quality of life. Evidence indicates that exercising in youth is associated years later with better aerobic capacity, greater bone mineral density, lower body fat, and a reduced risk of hypertension and type 2 diabetes.
In parallel, it has been observed that Exercise improves tolerance to certain cancer treatments and can influence their prognosis.That is why targeted physical activity programs now include broader objectives: developing muscle strength, aerobic capacity, flexibility and balance to enhance overall functionality and well-being, beyond mere weight loss.
Keys to effective policies for promoting physical activity
The various strategies reviewed agree that It is not enough to simply send generic messages like "exercise more"For policies to be effective, coordinated actions are required at several levels: regulatory, community, institutional and clinical, with stable resources and continuous evaluation.
Among the elements that make the difference, the following stand out, on the one hand, coordination between administrations and sectors (healthcare, education, sports, urban planning, transport, social services, the world of work). On the other hand, the involvement of the population in the design of the measures, taking advantage of existing community assets and adapting the interventions to the realities of each territory.
It is also essential improve the training of healthcare and sports professionals so they can prescribe and support physical activity in a realistic, personalized, and safe way. This includes practical tools for assessing activity levels, detecting risks, proposing progressive programs, and monitoring progress, integrating movement into routine care in primary care and other settings.
Taken together, all these policies and programs point to a shared idea: to build a society where the easy option is to move and not stay stillTo make walking to work, taking the stairs, playing in the park, joining a sports club, or participating in active community initiatives part of everyday life. And to ensure that the promotion of physical activity is supported by solid, evaluated, and sustainable strategies capable of reducing inequalities and improving the health and well-being of the entire population.
