Introduction
Physical activity is an important determinant of health. Its fundamental role in energy balance and weight control and in decreasing the risks of coronary heart disease, stroke, hypertension, diabetes, colon cancer, breast cancer, and depression is widely known. But in this fast paced life, people hardly incorporate physical activity in their daily routine. Non communicable diseases have, as a result been on the rise across the world.
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Even Mauritius have not been spared from this growing concern on diseases. Undeniably, compared to the past, the health of Mauritians has bettered given that now more facilities are available to combat once mortal diseases. Lifespan has increased as a result and the trend is there are more people as from 65 years old with the balance tipping in favour of the female population. The main problem that Mauritius faces nowadays is in terms of non communicable diseases. The new life trend now leads to other complications like diabetes, hypertension, kidney failure, heart problems, smoke and alcohol related problems.
Literature review
Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure.(WHO,2013)
Regular moderate intensity physical activity is beneficial to health. For instance, it can reduce the risk of cardiovascular diseases, diabetes, colon and breast cancer, and depression. Other benefits include low risk of hip and vertebral fracture and weight control.
Types of Physical Activity
Aerobic, muscle-strengthening, bone-strengthening, and stretching are the four main types of physical activity.
- Aerobic Activity
Aerobic activity benefits the heart and lungs. Large muscles, such as those in your arms and legs are used the most. Running, swimming, walking, biking, dancing, and doing jumping jacks are examples of aerobic activity. Aerobic activity also is also known as endurance activity.
Aerobic activity increases heart rate. The person also breathes harder during this type of activity. Over time, regular aerobic activity makes the heart and lungs stronger and able to work better.
- Muscle-strengthening activity
Muscle-strengthening activities improve the strength, power, and endurance of muscles. Performing pushups and situps, lifting weights, climbing stairs, and digging in the garden are examples of muscle-strengthening activities.
During bone-strengthening activities, muscles push against the bones as the feet, legs, or arms support the body’s weight. This helps to strengthen the bones. Running, walking, jumping rope, and lifting weights are examples of bone-strengthening activities.
Muscle-strengthening and bone-strengthening activities also can be aerobic if they make the heart and lungs work harder than usual. For example, running is both an aerobic and a bone-strengthening activity.
Stretching improves flexibility and ability to fully move the joints. Touching one’s toes, doing side stretches and yoga exercises are examples of stretching. (AHA,2013)
Levels of Intensity in Aerobic Activity
Aerobic activity can be performed with light, moderate, or vigorous intensity. Moderate- and vigorous-intensity aerobic activity is better for the heart than light-intensity activity. However, even light-intensity activity is better than no activity at all.
The level of intensity depends on how hard you have to work to do the activity. People who are less fit usually have to work harder to do an activity than people who are more fit. Therefore, what is light-intensity activity for one person may be moderate-intensity for another.
- Light- and Moderate-Intensity Activities
Light-intensity activities are common daily tasks that do not require much effort. Moderate-intensity activities make the heart, lungs, and muscles work harder than usual.
On a scale of 0 to 10, moderate-intensity activity is given a score of 5 or 6. It causes noticeable increases in breathing and heart rate.
- Vigorous-Intensity Activities
On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8. A person doing vigorous-intensity activity can’t say more than a few words without stopping for a breath.
Examples of Aerobic Activities
Below are examples of aerobic activities. Depending on your level of fitness, they can be light, moderate, or vigorous in intensity:
- Gardening, such as digging or hoeing that causes your heart rate to go up
- Walking, hiking, jogging, and running
- Water aerobics or swimming laps
- Biking, skateboarding, rollerblading, and jumping rope
- Ballroom dancing and aerobic dancing
- Tennis, soccer, hockey, and basketball
In the present era, many technological advances and conveniences have made our life easier and less active. But there are other factors that affect participation in physical exercise. For instance, transportation, social capital, and time barriers independently contribute to low levels of physical activity. (Zlot et al., 2006). Physical activity is highly recommended among adults and those aged 18–64 years old should do at least 150 minutes of moderately intense physical activity throughout the week or at least 75 minutes of vigorous- activity throughout the week or an equivalent combination of moderate- and vigorous activity.(WHO,2013).
Unfortunately, according to the Mauritius non-communicable diseases survey 2009, only 16.5% of Mauritians (10.9% of women and 23.2%of men) undertook sufficient vigorous or moderate physical activity to meet national guidelines, that is, 150 minutes of activity per week. 56% (65.8% of women and 45.7% of men) reported doing no moderate or vigorous leisure time physical activity at all.
In line with the NCD survey 2009, the prevalence of type 2 diabetes aged 20-74 years was 21.3%: 21.9% in men and 20.6% in women in Mauritius. The prevalence of hypertension was 37.9%: 35.4% for women and 40.5% for men. The age and gender standardised prevalence of obesity was 16.0%: 11.3% in men and 20.5% in women (Mauritian adult population aged 25 -74 years). Comparing those results with the NCD 2004, the preliminary results of the 2004 NCD Survey indicate that the age-standardised prevalence of diabetes in the Mauritian population aged 20-74 years was 15.0% (15.0% among male, 15.1% among female). The prevalence of hypertension in 2004 in participants aged 20-74 years (standardized on the Census year 2000 population) was 24.2% in males, 22.8% in females and 23.1% in both sexes. In 2004, the age-standardised prevalence of obesity in adults aged 20-74 years was 5.6% among males and 13.7% among females, giving an overall prevalence of 10.3%.
On one side, adults do not perform enough physical activity, on the other side, type 2 diabetes; hypertension and obesity are on the rise in Mauritius.
Importance of physical activity
Benefits of physical activity are widely recognised.
Physical activity improves the cardiovascular and respiratory system
On a regular basis, moderate- and vigorous-intensity physical activity strengthens the heart muscle. The heart’s ability to pump blood to lungs and throughout your body is improved. oxygen levels in your blood rise as more blood flows to your muscles.
Capillaries also widen. This allows them to deliver more oxygen to your body and carry away waste products.
Physical Activity Reduces Coronary Heart Disease Risk Factors(CHD)
On a regular basis, moderate- and vigorous-intensity aerobic activity can lower risk for CHD. CHD is a condition in which plaque builds up inside the coronary arteries. These arteries supply heart muscle with oxygen-rich blood.
Plaque narrows the arteries and decreases blood flow to heart muscle. Eventually, an area of plaque can rupture . A blood clot can form on the surface of the plaque.
As the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. A heart attack can result.
Certain traits, conditions, or habits may increase the risk for CHD. Physical activity can help control some of these risk factors because it:
- Can decrease blood pressure and triglyceride levels
- Can raise HDL cholesterol levels.
- Maintain blood glucose and insulin levels, which lowers your risk for type 2 diabetes.
- Decreases levels of C-reactive protein (CRP). This protein is a sign of inflammation. High levels of CRP may suggest an increased risk for CHD.
- Helps reduce overweight and obesity when combined with a reduced-calorie diet. Physical activity also helps in maintaining a healthy weight over time
- Can help people to quit smoking. Smoking is a major risk factor for CHD.
Inactive people are nearly twice as likely to develop CHD as people who are physically active. According to studies, inactivity is a major risk factor for CHD, just like high blood pressure, high blood cholesterol, and smoking.
Physical Activity Reduces Heart Attack Risk
For people who have CHD, aerobic activity done regularly improves the function of the heart. It also decreases the risk of a second heart attack in people who already have had heart attacks.
Vigorous aerobic activity may not be safe for people who have CHD.
Physical activity boosts mental wellness
Tension, anxiety, depression and anger are relieved by performing physical activity
Exercise increases the flow of oxygen which directly affects the brain. Your mental acuity and memory can be improved with physical activity.
Physical activity improves physical wellness.
Stronger immunity
It enhances your immune system and decreases the risk of developing diseases such as cancer and heart disease.
Reduced risk factors
Becoming more active can lower your blood pressure by as much as 4 to 9 mm Hg. That’s the same reduction in blood pressure delivered by some antihypertensive medications. Physical activity can also boost your levels of good cholesterol.
Recommendations of physical activity
AHA Recommendation
At least 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150
OR
At least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75; or a combination of the two
AND
Moderate to high intensity muscle-strengthening activity at least 2 or more days per week for additional health benefits.
Physical inactivity
Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally
Globally, six percent of deaths are attributed to physical inactivity. This follows high blood pressure (13%), tobacco use (9%) and is equal to high blood glucose (6%).
Moreover, physical inactivity is the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and 30% of ischaemic heart disease burden. (WHO)
Physical inactivity
Globally, around 31% of adults aged 15 and over were insufficiently active in 2008 (men 28% and women 34%). Approximately 3.2 million deaths each year are attributable to insufficient physical activity.
In 2008, prevalence of insufficient physical activity was highest in the WHO Region of the Americas and the Eastern Mediterranean Region. In both these regions, almost 50% of women were insufficiently active, while the prevalence for men was 40% in the Americas and 36% in Eastern Mediterranean. The South East Asian Region showed the lowest percentages (15% for men and 19% for women). In all WHO Regions, men were more active than women, with the biggest difference in prevalence between the two sexes in Eastern Mediterranean. This was also the case in nearly every countrhttp://www.who.int/dietphysicalactivity/factsheet_inactivity/en/y.
Physical inactivity and cardiovascular disease
The increasing urbanization and mechanization of the world has reduced our levels of physical activity. The World Health Organization believes that more than 60% of the global population is not sufficiently active.
If you are physically active you will increase your life span, regardless of any adverse inherited factors. Physical activity, at any age, protects against a multitude of chronic health problems including many forms of cardiovascular disease.
Physical activity protects you by regulating your weight and improving your body’s use of insulin. Being active is beneficial for your blood pressure, blood lipid levels, blood glucose levels, blood clotting factors, the health of your blood vessels and inflammation, which is powerful promoter of cardiovascular disease.
Studies show that doing more than 150 minutes (2 hours and 30 minutes) of moderate physical activity or an hour of vigorous physical activity every week will reduce your risk of coronary heart disease by about 30%.
The consequences of physical inactivity are staggering.
More of us are overweight.
Adult (and childhood) obesity/overweight level continues to increase: 68% of all Adults are obese or overweight.
It is more difficult today to create an active lifestyle.
People are less active due to technology and better mass transportation.
Sedentary jobs have increased 83% since 1950; Physically active jobs now make up only about 25% of our workforce. That is 50% less than 1950.
Our average work week is longer. Americans work 47 hours a week – 164 more hours a year than 20 years ago.
Extra weight costs us physically and financially.
Obesity costs American companies $225.8B per year in health-related productivity losses.
The average healthcare cost exceeds $3,000 per person annually. An obese employee costs employer additional $460 to $2,500 in medical costs and sick days per year
There are previous studies that have been carried out to assess the views of high school students towards physical activity. In 2010 according to the study carried out by Lovell among non-exercising female students in the United Kingdom, that the greatest perceived benefit from exercise was physical performance followed by the benefits of psychological outlook, preventive health, life enhancement, and then social interaction. The greatest perceived barrier to exercise was physical exertion, which was rated significantly higher than time expenditure, exercise milieu, and family discouragement barriers.
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Another study was carried by Daskapan in 2006 targetting Turkish university students. Current exercise habits and perceived barriers to physical activity were assessed in the sample. Using a Likert Type scale, participants responded an instrument with 12 items representing barriers to physical activity. Mean scores were computed. External barriers were more important than internal barriers. “Lack of time due to busy lesson schedule”, “My parents give academic success priority over exercise.” and “lack of time due to responsibilities related to the family and social environment” were most cited items for physical activity barriers.
In 1999, Allison carried out a study to assess the perceived barriers to physical activity among high school students in Metropolitan school in Toronto. Results showed that time constraints due to school work, other interests, and family activities were three of the four barriers considered most important. Female students had more perceived barriers than the male students towards physical activity. Two empirically distinct and theoretically meaningful factors emerged from the analysis—perceived internal barriers and perceived external barriers. Perceived internal barriers were predictive of physical activity in overall activity and outside of school activity. Perceived external barriers were predictive of overall physical activity and other school activity, but in the direction opposite of that hypothesized.
It was concluded that perceived barriers may be predictive of physical activity participation among high school students only under specific conditions.
Till date, no study has been carried out in Mauritius among the young population. To combat the rise in non-communicable diseases plaguing Mauritius, it is essential to identify the factors that are preventing young adults, especially the future graduates of our country, from adhering to the national guidelines of 150 minutes physical activity per week. On the same wavelength, the aim of this study is to identify the barriers that influence the students in participating in physical exercise. Findings from the current study will help to investigate the students’ motives for physical exercise and the challenges they face in taking part in regular physical exercise. The findings can assist policy makers, to design effective health strategies in promoting physical exercise at the level of the university.
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