Sport and Public Health Campaigns

In 2002, the World Health Organisation deemed ‘Physical Activity’ the theme of World Health Day. Since that time, April 6th is celebrated as the World Day for Physical Activity. This is an excellent example of a global initiative aimed at promoting health through physical activity across populations.

To reduce the burden of disease world-wide, the World Health Organisation introduced a global strategy in 2004. The Global Strategy on Diet, Physical Activity and Health is a large-scale initiative aimed at promoting health enhancing physical activity and supporting policy development and research.

Collaborative efforts between organisations focusing on sport or health are necessary in ensuring that sport-for-health initiatives are more likely to achieve success. For example, UNICEF has used sport to raise awareness on immunisation and organised sports events for vaccination campaigns in Zambia against measles. Renowned sports stars in various sports promoted the health campaign through which approximately 5 million children were vaccinated in 2003.

Similarly, during the 2003 Cricket World Cup, the cricket teams from India and Pakistan together promoted the national polio eradication campaign in television commercials, competitions and events in the weeks leading up to the tournament.

In 2004, UNAIDS and the International Olympic Committee (IOC) began to collaborate to use sport as a tool for HIV/AIDS prevention. They jointly produced the toolkit on HIV/AIDS Prevention for the sports community and established an intensive communication and awareness campaign on HIV/AIDS prevention through sport during the 2004 Olympic Games in Athens.
  
Right to Play (an international Sport & Development organisation) has partnered with a number of multilateral agencies and inter-agency programmes for vaccination and immunisation. Right to Play worked with the Global Alliance for Vaccination and Immunisation (GAVI) in 2001 in order to advocate for vaccination. To raise awareness about HIV/AIDS as a preventative method of combating the disease, there are hopes to expand activities for social mobilisation in the 74 countries identified by GAVI. Right to Play also collaborates with the WHO for health and vaccination campaigns in the field as well as the celebration of international events such as World Health Day and World AIDS Day.

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Practical Implications of Sport-for-Health Programming

The optimal combination of type, frequency and intensity of physical activity for different populations in not known, yet there is a clear consensus that regular physical activity of at least 30 minutes of moderate intensity is recommended for a healthy lifestyle. It is also important to select activities with cultural relevance for individuals.

In at-risk populations, careful consideration needs to be given to the prescription of physical activity to ensure that the conditions to promote positive health benefits are optimised. Physical fitness, physiological factors (heart and respiratory rates, blood sugar), diet and nutrition, hydration and the type and intensity of activity are factors that impact on the provision of physical activity and sport, particularly for people at risk of chronic non-communicable diseases. For example, walking, light cycling and swimming and other low-impact activities are often selected for people with cardiovascular disease, obesity and diabetes.

There are a number of considerations for sport and physical activity programming that targets HIV/AIDS prevention across various settings:

Active learning models

Participatory game-based learning methods are increasingly being recognised as particularly useful in transmitting HIV/AIDS prevention messages and encouraging changes in attitudes towards HIV/AIDS and sexual health. In sports programmes, this approach towards HIV prevention has been favoured over ‘classroom-style’ teaching such as in school settings and workshop-based methods.

Overcoming barriers to delivering sensitive information

Active learning methods have proved useful in approaching the sensitive topics of HIV/AIDS and sex in ways that allow both mentors and young people to feel more at ease. Interactive games allow participants to address the subject of HIV/AIDS in an indirect way, with learning taking place in a more relaxed atmosphere.

Building capacity among youth leaders

The role of trusted adults in mentoring youth in order to develop youth peer leaders and youth mentors for younger children is increasingly being recognised as an important strategy in HIV prevention. Positive social networks (such as sports teams and after-school clubs) can be used as sites to identify, train and support mentors who can provide support to youth on how to mitigate social pressures that negatively influence behaviour.

Collaboration with health services and specialists

When present, existing HIV prevention services must work alongside sport programmes. The strengths in sport programmes lie in the delivery of information through facilitated means and the role of mentors in providing psychosocial support to young people at risk. In addition, HIV prevention services such as Voluntary Counselling and Testing (VCT), Sexually Transmitted Infection (STI) treatment and condom provision are crucial to maintaining the effectiveness of an HIV prevention programme.

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Tackling HIV/AIDS and Other Communicable Diseases through Sport

The World Bank states that communicable diseases are the largest causes of child deaths in the world and are significant causes of preventable deaths among adults in the developing world. Together they claim more than an estimated 15 million lives a year, with over 80% of these deaths occurring in developing countries.

Sport and physical education have shown that they can play an effective role in the fight against HIV/AIDS by providing a popular site for preventative education. There is also evidence indicating that involvement in sport may help to slow down the disease in individuals who are HIV positive.

In Africa, there is an overwhelming majority of sport programmes addressing health concerns with a particular focus on HIV/AIDS. Most of the sport-for-HIV prevention programmes centre their activities on sharing information and using sport and games to raise awareness about HIV/AIDS prevention measures to minimise the risk of contracting the virus. None of the sport-based programmes provide direct treatment such as ARVs (anti-retroviral treatment) for HIV positive individuals as part of their activities but rather focus on using sport as a method of mobilising youth, women and at-risk target groups for health promotion, prevention and education.

HIV/AIDS is usually considered a taboo subject and the creation of safe and informal spaces to discuss HIV/AIDS through sport and games allows young people to learn about steps they can take to protect themselves from this disease and to avoid risky behaviour. A study conducted by MercyCorps on two of their programmes in Liberia and south Sudan has shown that HIV/AIDS knowledge and protective attitude levels of the participants were higher after being involved in their programmes.

The role of sports coaches as role models and mentors has proved a vital component of HIV/AIDS prevention programmes using sport. These coaches can also be peers to other young people of a similar age, with whom building relationships of trust can be easier. The programmes that have proven to be most successful in HIV/AIDS prevention have been those that emphasise developing strong leaders and coaches who offer support and guidance.

59% of HIV positive individuals in sub-Saharan Africa are women. A number of actors have attempted to address the impact of this gender bias in HIV/AIDS affected groups through sport. For example, the Go Sisters project in Zambia seeks to provide sports opportunities to girls and young women and to provide factual information pertaining to sexual and reproductive health. The health elements of the Go Sisters ‘message’ goes hand-in-hand with the promotion of young women as peer leaders and coaches for other girls and young women.

The use of sport in addressing HIV/AIDS does not only focus on the epidemiological aspects but the social impact of the disease on individuals and communities as well. The EduSport Foundation was created from the ‘bottom-up’ by individuals directly affected by HIV/AIDS, who not only prioritise providing young people in affected communities with life-saving information on preventative and protective measures but also actively promote the social integration of HIV positive individuals into the community through sport and physical activity.

Sport and other communicable diseases

A number of sports programmes target other communicable diseases in addition to HIV/AIDS. Programmes in countries affected by malaria and tuberculosis, for instance, have also used sport to raise awareness about prevention from these diseases. The Right to Play project called Thailand Migrant SportWorks Project focuses on using sport as a didactical tool to teach children about infectious disease prevention. Experience shows that programmes which aim to show how infection spreads, along with its causes and symptoms are also effective when physical activities and games are used to communicate these ideas. Partnerships between national health agencies and sport-focused organisations have attempted to provide children and young people with ‘active learning’ models in which to better retain and then discuss abstract health concepts.

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Sport, Physical Activity and Risk Factors for Major Diseases

  An understanding of the most prevalent diseases and associated risk factors is crucial to conceptualise the role of sport in health prevention and promotion. In developing countries, sport is widely used as a tool to educate individuals and communities on the risk factors associated with HIV/AIDS. Whilst HIV/AIDS and other communicable diseases continue to affect millions of people around the world, there is a significant increase in the global burden of non-communicable diseases related to lifestyle changes in physical inactivity, unhealthy diets and tobacco use.

Cardiovascular diseases

Cardiovascular diseases include coronary heart disease and stroke and are the leading causes of death globally. Causes of cardiovascular disease are unhealthy diets, physical inactivity and tobacco use. Physical activity reduces the risk of cardiovascular disease by improving glucose metabolism, reducing body fat and lowering blood pressure.

Diabetes

Diabetes is a disease which occurs when the body does not produce or properly use insulin and this may result in Type I or Type II diabetes. Diabetes may be prevented, or at least delayed, by weight loss, a healthy lifestyle, in particular, regular physical activity. Diet, drug therapy and physical activity are also major components of the treatment of diabetes.

Obesity

Obesity is an abnormal accumulation of fat that may impair health and unlike other diseases, social and environmental factors play a significant role in defining obesity. The incidence of obesity is a growing concern internationally with an estimated 400 million obese people in 2005.  The global rise in the incidence of obesity is related to a shift in diet and decreased physical activity levels.

Cancer

Cancer is not a single disease with a single type of treatment and in fact, there are over 200 types of cancer involving abnormal growth of cells in different parts of the body. It has been estimated that 40% of all cancers may be prevented by a healthy diet, physical activity and no tobacco use.

Mental health

One in four patients visiting a health service has at least one mental, neurological or behavioural disorder (such as depression, anxiety or mood disorders) that may not be diagnosed or treated. There is evidence to suggest that physical activity can reduce the symptoms of depression and can also be help to ameliorate mental well-being through improved mood and self-perception.

Physical Activity, Chronic Disease and Communicable Diseases

Global trends in physical inactivity claim that more than 60% of adults do not participate in sufficient levels of physical activity and physical inactivity is more prevalent among women, older adults, people from low socio-economic groups and people with disabilities.
In 2005 it was estimated that 80% of cardiovascular disease deaths occurred in low- and middle-income countries. The prevalence of those suffering from overweight and obesity is increasing in developing countries and even in low-income groups in richer countries. The rise of chronic disease, coupled with the existing burden of communicable diseases such as HIV/AIDS, malaria and tuberculosis, produces a ‘double burden of disease’ on low- and middle-income countries.
There are a range of methodologies utilised around the world to deliver health promotion and prevention strategies and an interesting example is the emergence of internet-based health information for developing countries. Sport and physical activity, however, remains an attractive low-cost strategy to promote healthy behaviours and lifestyles throughout the lifespan and reduce the burden of chronic diseases on public health systems.

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The Health Benefits of Sport and Physical Activity

Although research interest on physical activity and health dates back to the 1950s, the breakthrough in the scientific evidence on health benefits of physical activity largely took place during the 1980s and 1990s. There is an overwhelming amount of scientific evidence on the positive effects of sport and physical activity as part of a healthy lifestyle. The positive, direct effects of engaging in regular physical activity are particularly apparent in the prevention of several chronic diseases, including: cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis.

The Report from the United Nations Inter-Agency Task Force on Sport for Development and Peace states that young people can benefit from physical activity as it contributes to developing healthy bones, efficient heart and lung function as well as improved motor skills and cognitive function. Physical activity can help to prevent hip fractures among women and reduce the effects of osteoporosis. Remaining physically active can enhance functional capacity among older people, and can help to maintain quality of life and independence.

Physical activity and psychosocial health

The WHO has estimated that “one in four patients visiting a health service has at least one mental, neurological or behavioural disorder, but most of these disorders are neither diagnosed nor treated”. A number of studies have shown that exercise may play a therapeutic role in addressing a number of psychological disorders. Studies also show that exercise has a positive influence on depression. Physical self-worth and physical self-perception, including body image, has been linked to improved self-esteem. The evidence relating to health benefits of physical activity predominantly focuses on intra-personal factors such as physiological, cognitive and affective benefits, however, that does not exclude the social and inter-personal benefits of sport and physical activity which can also produce positive health effects in individuals and communities.

Sport and Physical Activity as part of a Healthy Lifestyle

A number of factors influence the way in which sport and physical activity impacts on health in different populations. Sport and physical activity in itself may not directly lead to benefits but, in combination with other factors, can promote healthy lifestyles. There is evidence to suggest that changes in the environment can have a significant impact on opportunities for participation and in addition, the conditions under which the activity is taking place can heavily impact on health outcomes. Elements that may be determinants on health include nutrition, intensity and type of physical activity, appropriate footwear and clothing, climate, injury, stress levels and sleep patterns.

Sport and physical activity can make a substantial contribution to the well-being of people in developing countries. Exercise, physical activity and sport have long been used in the treatment and rehabilitation of communicable and non-communicable diseases. Physical activity for individuals is a strong means for the prevention of diseases and for nations is a cost-effective method to improve public health across populations.

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Sport and Health

This section provides an overview of the related areas between sport and health. An introduction to the role of sport in enhancing physical and mental well-being is provided.

A number of key themes related to sport and health are then explored in more detail:

• The health benefits of sport and physical activity
• Sport, physical activity and risk factors for major diseases
• Tackling HIV/AIDS and other communicable diseases through sport
• Practical implications for sport for HIV prevention programmes
• Sport and public health campaigns.

Each sub-section contains a list of recommended reading for those who wish to delve deeper into the topic and these publications are available to download.

A downloadable bibliography of recommended readings and further resources is also included of sources that are not available online but may be accessed through your local library.

Health, Sport and Well-being

There are a variety of ways in which health is understood, especially as a part of developing individuals and communities. A common understanding of health is needed to grasp the ways in which sport can play a role in achieving health objectives and the benefits of physical activity and sport on various body functions...

Physical and Mental Health Benefits of Sport and Physical Activity

Participation in physical activity and sport, through a number of mechanisms, can have significant impact on the health of individuals and communities. The physical, social, emotional and cognitive benefits of sport and physical activity are well-researched and are linked to the reduction of chronic illness and disease... 

Sport, Physical Activity and Risk Factors for Major Diseases

Inactivity is a major risk factor in a number of chronic diseases that are having immense impact on health status world-wide. Sport and physical activity can promote activity lifestyles, which in combination with other approaches, can reduce the risk of chronic lifestyle diseases such as cardiovascular disease, cancer, diabetes, obesity and mental illness...

Tackling HIV/AIDS and Other Communicable Diseases through Sport

Sport and physical education can serve as alternative platforms to provide crucial information to populations at risk of communicable diseases such as malaria, tuberculosis and HIV/AIDS... 

Practical Implications for Sport-for-Health programming

Sport-for-health programming requires careful consideration to be given to the prescription of physical activity, which must be suited to the target group. Furthermore HIV/AIDS prevention programming using sport must take into account a number of factors...

Sport and Public Health Campaigns

Public health campaigns use sport to motivate communities to consider top priority health concerns. A number of large-scale initiatives and targeted partnership approaches promote the health benefits of participation in sport and physical activity...

Bibliografía seleccionada

La bibliografía incluye libros, artículos de revistas y otros recursos (no libre acceso a través de la web) de interés para el deporte y la salud. Por favor, tenga en cuenta esta lista no pretende ser exhaustiva, sino que ofrece una visión general de las principales fuentes de información sobre este tema. Sugerencias y / o adiciones a la bibliografía se pueden enviar a: healthfeeding@hotmail.com

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Exercise is springboard to recovery for cancer patient

Courtesy of USA TODAY
Shannon Miller's competitive spirit and life-long love for exercise are helping her fight the brave fight again. This time, beating cancer is her mission.

"A friend said to me: 'This cancer diagnosis is like being on the balance beam. You fall off. You get back up.' "

The former Olympic gold-medal gymnast is "back up" after being diagnosed with a germ cell malignancy, a form of ovarian cancer, in December. She started nine weeks of chemotherapy March 9 after doctors removed a baseball-size cyst and an ovary. And she started an exercise program that she follows faithfully, even during treatment.

Experts say she is on the right track: assisting her treatment by exercising. Many of the 12 million cancer survivors in the USA also would benefit, they say.

"There is a growing body of research showing exercise not only helps with the side effects of treatment but also decreases the recurrence risk and improves overall survival," says researcher Melinda Irwin, an associate professor of epidemiology and public health at Yale.

"My prognosis is good," says Miller, 34. She says her doctors have said they're hopeful that she and her husband, John Falconetti, will be able to have more children. Their son, Rocco, is 15 months old. The family lives in Jacksonville near John's parents, who, along with friends, help with Rocco on treatment days.

Miller concedes it isn't easy. She says there are many days she just wants to lie in bed, usually during the first week of a three-week treatment cycle. That's when she has five straight days of chemotherapy for five to six hours a day. The other two weeks, she has chemo one day a week.

Nutrition can be a problem. She says she always has had a tendency to become dehydrated, and at one point, she ended up in the hospital because of dehydration after a round of chemo.

Exercise isn't always possible, but more often than not, she says, she finds time to be on her exercise mat at home.

"I find exercise is really helping me with the nausea and fatigue and helping me regain control of my life," says Miller, who won two gold and seven Olympic medals overall in 1992 and 1996.

She says her physical activity also helps her with "chemo brain," a fogginess that can cause forgetfulness and lead to depression.

A far cry from Olympic workouts

The level and kinds of exercise Miller does are endorsed by the American Cancer Society and the National Cancer Institute.

"People think. 'Oh, she's an Olympian. She's probably doing three-hour workouts.' That's not the case at all," she says.

After getting a green light from her physician, Miller began a routine in which she spends 10 to 15 minutes a day doing yoga, lifting 2- to 3-pound weights and walking or swimming. She says she gets winded and has to listen to her body, "which I got very good at doing as an athlete, learning when to rest and when to push it."

The 2006 American Cancer Society guidelines on nutrition and exercise say patients receiving chemotherapy and radiation therapy who are already on an exercise program may need to exercise at a lower intensity and progress at a slower pace temporarily, but the principal goal should be to maintain physical activity as much as possible.

Epidemiologist Larry Kushi, ACS spokesman, says the organization is in the process of updating the 2006 guide and will expand on the benefits of exercise. He adds that he's unaware of any research showing exercise has a negative impact on cancer treatments.

"She's totally doing the right thing," says Yale researcher Irwin, who is a former competitive gymnast herself, "but not nearly as good as Shannon Miller."

The research behind it

Irwin says the verdict is still out on how exercise benefits cancer survivors, but she notes studies in which breast cancer survivors who exercise have lower levels of insulin, and some studies have shown that high levels of insulin strongly increase the risk of breast cancer recurrence and death.

Her National Cancer Institute-funded trial involving 230 sedentary women diagnosed with ovarian cancer is examining the impact of exercise on quality of life, fatigue and survival.

"Our study is the largest exercise trial in cancer survivors," she says. It will provide critical information in understanding the potential mechanisms through which physical activity may affect ovarian cancer risk and prognosis, including what roles estrogens, insulin and insulin-like growth factors might play.

In a 2008 study in which she participated, Irwin says, "we not only showed an improvement in survival from breast cancer, but survival from other causes, such as cardiovascular disease and diabetes, so exercise is really associated with a multitude of benefits."

Miller says she has kept up with the research on exercise and cancer, but that hasn't been the driving factor behind her workouts.

Even before her diagnosis, she had long been an advocate for healthy living. She started her own business, Shannon Miller Lifestyles, after getting a marketing degree from the University of Houston and a law degree from Boston College. The focus is on fitness, health and nutrition, and pregnancy and motherhood.

She is an author and motivational speaker, and she has continued her radio show on SML Radio during her treatments.

Her son 'keeps me going'

Being an avid journal writer has helped Miller lately. She has kept journals for as long as she can remember, she says, but now, outlining her treatments, diet and workouts has helped her feel she has regained control of her life. She's featuring her writings on her website, documenting her journey through chemotherapy.

"I have trouble remembering what works and what doesn't," she says. "I write everything down. That way, when you're having a bad day, you can look back and see what you did that might help you have a good day again.

"Sometimes even looking back and knowing you had a good day is a big boost."

And being a mom has helped as well. By far, walking with her toddler to the park is her favorite way to get her exercise.

"People think it must be tough with a small child," she says. "But he keeps me going. He loves to walk. He holds onto my hand and walks to the park with me. We can't slow him down."

Rocco certainly plays a role in her weight-lifting routine as well, she says.

"Anyone with a toddler knows you have to be able to pick them up and carry them around," she says. "So I need to stay strong.

"Plus, this will get me back on my feet faster once the chemotherapy is over."

chemotherapy. Experts agree that many cancer patients can benefit from following her example.

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'Pediatrics' study disputes energy-drink claims

By Nanci Hellmich, USA TODAY

  Some young people gulp drinks such as Red Bull, Full Throttle and Rockstar to boost their energy, concentration and athletic performance. But the caffeinated energy drinks don't appear to provide the purported benefits and can cause problems, including serious medical complications, says a review of the scientific literature published online today in Pediatrics.

The paper is already drawing criticism from the beverage industry, which says energy drinks have no more caffeine than a cup of coffee and aren't widely used by kids and teens.

Steven Lipshultz, chair of pediatrics at the University of Miami School of Medicine, and colleagues reviewed 121 scientific studies, government reports and media sources on energy drinks — different from sports drinks, vitamin waters and sodas.

Energy drinks usually contain 70 to 80 milligrams of caffeine per 8-oz. serving, more than double many cola drinks. Energy drinks also may contain guarana, a plant that contains caffeine, taurine (an amino acid), vitamins, herbal supplements and sweeteners.

Surveys show that 30% to 50% of teens and young adults consume energy drinks, but "we didn't see evidence that drinks have beneficial effects in improving energy, weight loss, stamina, athletic performance and concentration," Lipshultz says.

And the research shows that children and teens — especially those with cardiovascular, renal or liver disease, seizures, diabetes, mood and behavior disorders and hyperthyroidism — are at a higher risk for health complications from these drinks, says Lipshultz, a pediatric cardiologist.

He encourages pediatricians and parents to talk to kids and teens about whether they should be drinking such beverages.

Maureen Storey of the American Beverage Association, an industry group, said in a statement that "this literature review does nothing more than perpetuate misinformation about energy drinks, their ingredients and the regulatory process."

She says government data indicate that the "caffeine consumed from energy drinks for those under the age of 18 is less than the caffeine derived from all other sources including soft drinks, coffee and teas."

Red Bull said in a statement that the study "largely ignores in its conclusions the genuine, scientifically rigorous examination of energy drinks by reputable national authorities. ... The effects of caffeine are well-known, and as an 8.4-oz. can of Red Bull contains

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