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"Lack of activity destroys the good condition of every human being,
while movement and methodical physical activity save and preserve it" - Plato
In Nigeria, the term ‘Waka’ in the pidgin vocabulary means walking or moving. In fact, when you have really “waka’, you are adjudged to have really burnt some calories. Unfortunately, due to urbanization people are no longer ‘wakaing’ globally.
According to the World Health Organisation (WHO), physical inactivity is the fourth largest cause of mortality (death) worldwide and it is estimated that obesity will overtake smoking as the largest preventable cause of cancer in the United Kingdom in few years time.
Therefore, the urgent need to tackle the pandemic of physical inactivity.
Consequently, there has been much advocacy for doctors and other health professionals to include exercise counseling as part of routine clinical practice.
In fact, in some countries such as the United Kingdom and the United State of America, doctors are beginning to prescribe exercise for the management of conditions ranging from mental illnesses to cancer.
While it is often assumed that physical inactivity-related illnesses may not be too much of an issue in low to middle-income nations like Nigeria, this may not be founded on evidence.
In fact, due to rapid urbanization, we are beginning to see more people in these nations being diagnosed with obesity-related illnesses such as stroke, diabetes etc.
Often times, what I hear from my colleagues particularly in Nigeria is the assumption that average Nigeria is physically active because of the day to day hustle and bustle in a city like Lagos. While this may sound logical, it is far from being scientific and thus may be misleading. Therefore, there is an urgent need to begin to address lifestyle issues such a sedentary living if we truly want to prevent and manage non-communicable diseases.
In 2017, I was part of a team of medics that conducted a work based health check for a multinational company in Lagos. In the course of the two days health screening, I noticed that most of the workers in that company were obese and had either a borderline type 2 diabetes mellitus (DM) or recently diagnosed type (DM).
During my consultation, I discovered that most of them were so eager to get a drug prescription for their conditions; unfortunately, they met the ‘wrong doctor’ this time. I noticed that most of them at diagnosis of DM were not told about lifestyle modification such as being physically active which could have been beneficial in normalizing their blood sugars.
So, my consultation was largely behavioral counseling about the immense benefits of being physically active and also telling them how they can go about it.
Furthermore, the other issue is a misconception of what exercise and physical activity are. Basically, physical activity is defined as any bodily movement that involves the contraction of your muscles.
It entails any activity you carry out in the course of the day that will involve movement (walking, gardening, climbing the stairs etc). On the other hand, exercise is a specific form of physical activity which is planned, repetitive and carried out for specific intents such as developing more strength or flexibility.
To achieve the later, the individual may have to register in a gym or have access to sporting equipment. However, how many people can afford to go to the gym?
Though physical activity and exercise have got immense health benefits, emphasis on being physically active from a perspective of swimming, using a treadmill or lifting dumbbells may discourage people particularly those who don’t have the means to access such facilities.
Rather, we should be encouraging individuals to inculcate active lifestyles such as brisk walking and using the stairs into their daily routines.
How much physical activity should be recommended? I am often asked these questions when I talk about physical activity for health. When doctors tell patients they need to be physically active without explaining how they should go about it is like telling a patient to take paracetamol without telling them how and when to use it.
Sadly, this is how must health professionals approach physical activity counseling. What are the recommended physical activity guidelines, how much should be done, how should it be done, are there contraindications and side effects to being physically active? I hope to shed more light on this in my subsequent writings. In the meantime, stay physically active and sit less because movement is indeed medicine. Make sure you waka today!
JIMISAYO OSINAIKE, MD, MSC Sport and Exercise Medicine(Manchester), Level 3 Certified Pre-Hospital Immediate Care in Sport. (England Rugby Union)
Jimi is a medical doctor by training with an interest in sport medicine and physical activity for health.
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