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HEALTH

The north-south exercise divide

A new EU report shows that almost half of Spaniards do no kind of sporting activity Scandanavians are the most active, with southern Europeans lagging far behind Experts pin the blame on a “hostile urban environment” and call for better infrastructure

A sedentary lifestyle is the fourth biggest cause of death in the world.
A sedentary lifestyle is the fourth biggest cause of death in the world.HERIK SORENSEN (Getty Images)

There are many things that set the Spanish apart from the Scandinavians. For example, the amount of sport they do. Or don’t. A recent survey published by the European Commission shows a north-south exercise divide: less than 10 percent of Swedes say they practice no sport at all; in Finland it’s 15 percent, and in Denmark, 14 percent; in Spain the figure is 44 percent.

That said, there are lazier countries: 60 percent of Romanians and Italians never exercise, neither do 64 percent of Poles, while only 25 percent of the Maltese ever do sport. In fact, the European average for idleness is 42 percent: 37 percent for men and 47 percent for women.

Responding to the survey, European Sports Commissioner Androulla Vassilou says, “it confirms the need to take measures to encourage more people to make sport part of their lives. This is crucial, not just in terms of individual health and wellbeing, but also in terms of the economic costs of lack of exercise.”

The medical community is particularly concerned about our lack of exercise. They point out that inactivity is the fourth most serious factor in the world, and is responsible for six percent of deaths, according to the World Health Organization (WHO). It is also responsible for between 21 and 25 percent of breast and colon cancers, 27 percent of diabetes cases, and 30 percent of heart problems.

60 percent of Italians never exercise, neither do 64 percent of Poles

“We are very worried about this,” says Leandro Plaza, president of the Spanish Heart Foundation. Cardiologists believe that exercise is a key ally in the fight against risk factors such as heart problems and high blood pressure. Plaza points out that regular exercise helps boost HDL cholesterol levels (the so-called good cholesterol), and prevents high blood pressure. He points to a report published in the American Journal of Public Health that surveyed the physical activity of 4,000 adults aged between 18 and 30 showing that practicing exercise five times a week, consuming around 300 calories each time, reduced the risk of high blood pressure by 17 percent. Sport can also help reduce the risk of diabetes by consuming glucose in our muscles and reducing our blood sugar levels.

Endocrinologists are also concerned about how sedentary we are becoming. Javier Salvador, president of the Spanish Society of Endocrinology and Nutrition, says this is a key factor in explaining rising levels of obesity in the West, a condition that “now affects 23 percent of Spaniards.” He also mentions an article published last year in British medical journal The Lancet that argues that obesity is behind six percent of Type 2 diabetes in the world, and up to 10.8 percent of cases in Spain.

“We now have access to pharmaceuticals such as statins, which control cholesterol, or tablets to reduce blood pressure, but we also have to do our bit as well. And physical exercise and a balanced diet are part of that,” says Plaza.

Not that just any old type of exercise will do; neither is it necessary to start practicing for a marathon. An hour’s walk one day a week, “something all of us can do, and that will use up 300 calories,” is a good start, says Plaza. “What doesn’t make sense is to do nothing all week, and then punish yourself for three hours on Sunday morning; if you are looking for health benefits, occasional bouts of heavy exercise won’t do you any good,” he says.

We now have access to drugs that control cholesterol, but we have to do our bit as well”

“One can start out at a rate of four or five kilometers an hour, and then as you get fitter, increase the amount of time you walk, or speed things up,” says Miguel Tobal, director of the School of Physical Education and Sport at Madrid’s Complutense University. He says that running for 30 to 35 minutes three or four times a week over a soft surface “to reduce impact on the joints” is a good way to begin a proper exercise routine, and that the length of each run can be extended to up to an hour, alternating with sessions using “small weights.”

But the recent European Commission report highlights a paradox in our societies. Why is it that countries where the climate is milder, allowing for greater time outside, tend to produce the worst results in terms of the amount of physical activity their inhabitants do?

“In Spain, there is no tradition of sport. It is considered something that professionals do, and as a way of exercising, it is relatively new here,” says Miguel Tobal.

Ildefonso Hernández, president of the Spanish Society of Public Health and Hospital Care (Sespas), says government has a role to play in encouraging us to do more exercise. “It’s not just about telling people to exercise, but about providing the facilities, about helping us all find ways to look after ourselves better, and about encouraging us to take part in different sports and activities,” he says.

It doesn’t make sense to do nothing all week, then punish yourself on Sunday”

That means wide pavements and walkways, cycle paths, and other sports infrastructure… Because it’s not just about doing sport per se, but about any kind of activity that helps overcome what seems to be our inclination towards a sedentary lifestyle. If towns and cities were designed differently, it would be possible to walk or cycle to work.

Hernández, a former director general of the Public Health Institute under the previous Socialist Party government, says that there is a tendency to blame us for becoming sedentary, when the environment around has much to do with this. “In the Public Health Institute we know that policy making is important. We need programs at the community level. This should be a government priority, because to create a health system that benefits everybody means keeping as many people out of hospital as possible in the first place, and physical activity is key to achieving that; it is one of the factors that most affects mortality.”

Hernández says that a survey he and other academics carried out demonstrates the benefits of physical activity. For the over-65s, doing an extra hour’s exercise a week can reduce that group’s death rate by six in every thousand. And doing two hours a week of exercise to help with balance can reduce chances of a fall by half. These statistics can have a big impact: the Ministry of Health reports that one in three elderly people suffers a serious fall each year. These falls can have serious consequences, and in some cases can lead to fatal illnesses: a report by the Spanish Society of Gerontology says 1,400 elderly people die each year from problems related to falls.

Hernández says the right environment and infrastructure at the local level is particularly important for helping older people get out and walk, run, or cycle. “Older people who live in better housing, in nicer neighborhoods, tend to enjoy better health,” he says. “In Spain, our cities are very aggressive, hostile places, as well as being polluted. We need policies based on synergies: policies to reduce traffic. And if we combine this with doing more exercise, the return on health will be spectacular.”

In Spain, there is no tradition of sport. It is considered something that professionals do”

Physical activity and the habit of practicing sport is slowly catching on in Spain, particularly among younger people. A report by the Sports Council highlights the importance of starting early: “The lack of physical exercise spreads its root in childhood, and consolidates during adolescence. That is why it is very difficult to combat this problem by the time people are adults.”

But Spanish schools still do not take sport seriously, it seems. The European Union and the WHO recommend at least one hour a day of gym or other sports activity as part of the school day, but most Spanish schools limit sports to two hours a week. As a result, Spaniards remain sedentary, and subject to a range of related health problems. Spanish children aged between four and 12 spend an average of two-and-a-half hours a day watching television, more than their French, British or German counterparts. A survey by Eurodata TV Worldwide show that within the EU, only Italian children spend as much time in front of the television as Spanish youngsters do.

Élida Alfaro, a lecturer in Sports Sciences at Madrid’s Politécnica University, says that in Spain, both schools and families put much more emphasis on the acquisition of theoretical knowledge than on developing their sports or athletic skills. “This means that schools provide very few hours of physical education. In this country we do not acquire the habit of practicing sport, or the stamina to be able to include sport as part of our daily lives when we become adults,” she says.

She highlights the need for the country’s educational and sports authorities to raise awareness of the importance of exercise as part of children’s overall education, and that parents need to understand the importance of their children doing physical exercise from an early age: “It is very important to acquire technical and professional knowledge, but if our bodies do not have the resources they need to stay healthy and prevent illness, then our education isn’t going to be much use to us,” she says.

Lack of exercise spreads its root in childhood, and consolidates during adolescence”

Not that practicing sport is just about physical health. Numerous surveys also highlight the link between physical activity and cognitive development in infancy, and even between academic performance.

The last couple of years have seen some progress, however. The Ministry of Health has set up sports programs for children, while the minister responsible, Ana Mato, has said schools will start providing more sports. Recent legislation aimed at improving educational standards specifically mentions the need to “promote” sports during the school day.

Meanwhile, the number of Spaniards who exercise regularly (five days a week) is slowly increasing, rising by three percent to 15 percent of the population since 2009; while 31 percent of the population now do so between one and four times a week, an increase of four percent over the same period.

That figure of 15 percent of Spaniards who exercise regularly, included in the European Commission’s report, puts Spain on a par with Scandinavia. The problem area is the group of people who exercise at least once a week, which is 31 percent in the case of Spain, compared to 55 percent of Swedes and 53 percent of Finns.

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