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Fact sheet

Physical activity in Norway - fact sheet

Physical activity prevents type 2 diabetes, cardiovascular disease, musculoskeletal disorders and some forms of cancer. Approximately 1 in 5 adults reaches the Norwegian Directorate of Health’s minimum recommendation of at least 30 minutes physical activity per day on average.

Foto: Colourbox.com
Foto: Colourbox.com

Most of our daily physical activity involves light activities, such as when we sit and work, stand, walk around the office and home, prepare food and go shopping. Here are the definitions of commonly used terms.

Table 1: Intensity and type of activity

Intensity

Activity, exercise, training

Light
Light activity that has little impact on breathing and heart rate (pulse).

Physical activity
Any activity where you use your muscles / body, increasing energy consumption.

Moderate
Breathing increases and the heart rate is 60-75 per cent of the maximum.

Exercise 
Activity and body movements to improve health. Exercise is good prevention and treatment for a wide variety of diseases.

High
Involves rapid breathing and heart rate increases to 80 per cent of the maximum.

Training
Physical activity that is planned, and repeated regularly to improve or maintain physical fitness. You can train condition, strength, speed, balance and mobility.

Physical activity and health

Health benefits can be achieved with a dose of moderate physical activity in addition to daily life in light activity. Studies have shown the following: 

Cardiovascular disease: Those who are in poor physical shape have twice the risk of dying from cancer and cardiovascular disease compared with those who are moderately active (Ministry of Health and Care Services 2005; Blair 1989).

Physical activity reduces blood pressure and the risk of type 2 diabetes, which in turn reduces the risk of cardiovascular disease. 

Type 2 diabetes, adults: Good dietary habits combined with 30 minutes of daily physical activity can halve the risk of developing type 2 diabetes according to studies of high-risk individuals in Norway, Finland and the USA. Moderate physical activity seemed to be preventive by itself, independent of weight loss and dietary changes. Fitness training with high intensity has a greater effect than activity of moderate intensity. Weight training also has a preventive effect (Andersen SA, Knowler WC, Tuomilehto J, Laaksonen DE). 

Type 2 diabetes, children and adolescents: Children and adolescents may need 90 minutes of daily moderate physical activity to acquire normal blood sugar regulation and prevent type 2 diabetes. (Ekelund U, Andersen LB).

Cancer: Regular physical activity helps prevent colon cancer, and probably breast cancer and uterine cancer too. The more activity, the stronger the preventive effect. In addition, studies show that increased physical activity prevents cancer of the lungs and pancreas. Moderate physical activity will also indirectly prevent cancers where obesity is a risk factor. (WCRF / AICR 2007: Expert Report).

Between 30 and 60 minutes of moderate and intensive activity per day can reduce the risk of cancer of the colon and probably also breast by 40-50 per cent and 20-40 per cent respectively. (Thune 2000; WHO 2004; IARC 2002). 

Skeleton: Weight-bearing physical activity (walking, running, jumping, etc.) in childhood and adolescence can contribute to a stronger skeleton. Among middle-aged and elderly people, regular exercise can reduce the natural loss of bone mass and prevent a fall because balance, coordination and muscle strength also improve. Muscle strength in the legs is particularly important. 

Overweight and obesity: physical activity of moderate and high intensity prevents weight gain and obesity, weight regain after dieting, and weight gain associated with quitting smoking. It takes probably 60-90 minutes daily activity of moderate intensity, equivalent to brisk walking, for exercise alone to affect weight (HUNT / Drøyvold, Ehrlichman).

In the population, the most physically active have had the least weight gain since 1985, according to results from the health studies in Nord-Trøndelag. 

Other: Physical activity improves pulmonary function, muscle strength, balance and motor skills, helps prevent back problems and strengthens bowel function.

Physical activity and mental health

For people with good mental health, regular exercise enhances well-being, improves the ability to handle stress, provides more energy and encourages better sleep. For people with a mild to moderate depression or chronic fatigue syndrome, physical activity is a well-proven treatment option. 

For other disorders, physical activity can also have an effect. In general, people with mental disorders are often inactive and in poorer physical shape than the rest of the population (Martinsen 2000). 

With some mental disorders, the risk of obesity is increased, partly because some medications cause increased appetite and weight gain as an unwanted effect. Physical activity can counter these effects.

Recommendations

The Norwegian Directorate of Health has issued these recommendations: 

  • Adults should be physically active with moderate intensity for a minimum of 30 minutes daily, e.g. quick walking to become warm and have an increased pulse. This is enough to give health benefits for those who previously have had little daily activity. The activity can be split into shorter sessions throughout the day, e.g. 3 x 10 min. 
  • 60 – 90 minutes per day is recommended to prevent overweight. 
  • At least 60 minutes varied daily physical activity with both moderate and high intensity is recommended for children and adolescents. The activity can be split into shorter sessions throughout the day.

An international expert panel has made a recommendation for physical activity in the prevention of cancer: 
To prevent cancer, at least 30 minutes continuous brisk walking or equivalent per day is recommended. This should be increased to 60 minutes per day as physical fitness improves, alternatively 30 minutes daily with intensive physical activity. Sedentary activities such as watching television should be limited (WCRF / AICR 2007: Expert Report).

Measurement of physical activity

Instead of questionnaires, researchers are increasingly using condition tests, activity meters and other measuring methods to register physical activity and fitness. Results from questionnaires often show higher activity than measurements with activity meters.

Physical activity in adults

 
Andelen inaktive, 1997-2003.
Figure 1: Proportion of 40- and 45-year-old men mostly sedentary in their spare time (defined as inactive). Source: Health studies in the Norwegian counties. Troms, Finnmark: 2001-03 (40 and 45 years). Oslo, Hedmark, Oppland: 2000-2001 (40 and 45 years). Other counties: 1997-1999 (40-42 years).

A minority of adults meet the recommendations of the Norwegian Directorate of Health.

In the so-called KAN1 study, measurements were made using activity meters for almost 3,500 people in 2008-2009. They were aged 20 to 85 years. The results show that, on average, 22 per cent of adult women and 18 per cent of adult men met the recommendations of 30 minutes of daily activity (Norwegian Directorate of Health 2009). 

Among men, the percentage who met the recommendations was similar in all age groups. Women aged 30-50 years were slightly less active than other age groups. 

Since most people today have occupations that are mostly sedentary with light activity, leisure time has great significance for the total amount of physical activity and amount of activity with moderate and high intensity. 

Figure 1 shows the proportion of adults who are mostly sedentary in their leisure time. These are figures from studies among 40- and 45-year olds in 14 counties during 1997-2003. This would include watching television or other activity that does not involve being physically active.

See the results from the studies in Graff-Iversen et al 2007 in the reference list.

Social differences

 
Andel fysisk inaktive. Oslo 2000-2001. Etter utdanning..
Figure 2: Proportion of men (blue) and women 40 and 45 years who are mainly inactive in leisure time, by educational level in Oslo 2000-2001. Secondary education - left, further education - middle, tertiary education -right (Grøtvedt L).

In Oslo, more people in the eastern suburbs (30 per cent) do not exercise and are sedentary in their leisure time than in the western suburbs (20 per cent) Among women in the same age group (40 and 45 years), the corresponding figures were approximately 25 and 15 per cent (Grøtvedt, 2002).  

College or university-educated people are more likely to exercise in their leisure time (see figure 2), according to figures from 2000-2001.

Ethnic differences

Samis have a somewhat higher physical activity than ethnic Norwegians, whilst immigrants from Asia and Africa have lower activity levels.

In these immigrant groups, one in two is defined as "inactive", compared to one in five ethnic Norwegians. (Kumar 2008, Hermansen 2002, Grøtvedt 2002).

Children and adolescents

Activity levels increase during childhood, and begin to fall until adulthood, particularly among girls. Health studies among children and adolescents and a study by the Norwegian Directorate of Health confirm this pattern. Table 2 shows the results of a 2011 study where activity was registered. Approximately 50 per cent of 15-year olds achieved the recommended level. (Norwegian Directorate of Health, ungKan, 2012).

Table 2: Percentage of 6-, 9- and 15-year olds who meet the recommendation for 60 minutes of daily moderate physical activity (Norwegian Directorate of Health 2012).
 Age Girls  Boys
 6-year-olds  87 %  96 %
 9-year-olds  70 %  86 %
 15-year-olds  43 %  58 %

 The Norwegian Directorate of Health study showed that: 

  • On average, the activity of 6-year-olds was 20 per cent higher than the activity of 9-year-olds and 70 per cent higher than that of 15-year-olds.
  • Boys were more active than girls. Boys were more active on weekdays than at weekends. 
  • Most of the day is spent at rest or in activity with low intensity. 
  • Non-western immigrants have lower activity levels than immigrants with western backgrounds. 
  • Friends seem to affect the activity level positively, except for 15 year old girls. 
  • Parental support is particularly important for 6-year-old activity. 
  • Self-motivation and sense of enjoyment and achievement was important for increased activity.

Trends over time

The proportion of working adults with sedentary occupations has increased significantly in recent decades. From the 1970s to the 1990s, the percentage increased from 20 to 30-40 per cent among men. Among women, the percentage increased from 10 to 30 per cent. Fewer people have manual occupations. (Graff-Iversen et al 2001).

If physical activity is to increase or be maintained, it needs to happen in leisure time. The proportion that is physically active in leisure time has increased somewhat in the last 20 years, but this is not enough to compensate for work and leisure time becoming more sedentary (SEF, 2001).

Findings from the study by the Norwegian Directorate of Health in 2011 show a similar activity level as in the previous study from 2005-2006.

International

The Nordic countries have common recommendations for diet and physical activity. These recommendations are prepared by an expert committee appointed by the Nordic Council of Ministers. The Norwegian Directorate of Health's recommendations are based on the latest Nordic expert report from 2004. These are under revision (2012). 

In 2004, the World Health Organization presented a global strategy for physical activity, diet and health. 

USA: 

In 2007, an international expert committee issued a report with recommendations for including physical activity in the prevention of cancer. 

References

  • Andersen LB et al. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 2006; 9532: 299-304.
  • Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989; 262: 2395 - 401.
  • Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, et al. (2006) TV Viewing and Physical Activity Are Independently Associated with Metabolic Risk in Children: The European Youth Heart Study. PLoS Med 3(12): e488.
  • Erlichman J, Kerbey AL, James WPT. Physical activity and its impact on health outcomes. Paper 2: Prevention of unhealthy weight gain and obesity by physical activity: an analysis of the evidence. Obesity Reviews 2002, 3: 273-87.
  • Ekelund U, Anderssen S, Andersen LB et al. Prevalence and correlates of the metabolic syndrome in a population-based sample of European youth. Am J Clin Nutr 2009;89 90-96.
  • Graff-Iversen S, Jenum AK, Grøtvedt L, Bakken B, Selmer RM, Søgaard AJ. Risikofaktorer for hjerteinfarkt, hjerneslag og diabetes i Norge. Tidsskr Nor Lægeforen 2007; 127: 2537-41.
  • Graff-Iversen S, Skurtveit S, Nybø A, Ross GB. Utviklingen i kroppsarbeid hos norske 40 - 42-åringer i tiden 1974 - 94 Tidsskr Nor Lægeforen 2001; 121: 2584 - 8.
  • Grøtvedt L. Helseprofil for Oslo, Voksne (PDF). Folkehelseinstituttet 2002.
  • Hermannsen R, Njolstad I, Fonnebo V. Physical activity according to ethnic origin in Finnmark county. Norway. The Finnmark Study. Int J Circumpolar Health. Aug; 61: 189-200, 2002.
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  • HUNT/Kurtze: Kurtze N et al. Selvrapportert fysisk aktivitet i norske befolkningsundersøkelser - et metodeproblem. Norsk Epidemiol 2003;13:163-170.
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