Physical activity crisis? Why not be more like Uganda and Mozambique?

A new study on “Worldwide trends in insufficient physical activity” has been published in a journal. It continues to confirm what many of us understand already, high income countries tend to have high rates of physical inactivity. Low income countries tend to have low rates of inactivity.

This BBC article pointed out that two of the most active countries are Uganda and Mozambique. Another BBC article explored the Uganda situation in a bit more detail. It asked “So what is Uganda getting right? … People in rural Uganda, where most of the population lives, are very active on their farms, says the BBC’s Patience Atuhaire. But, she says, in urban areas people are becoming more sedentary, especially as they get wealthier.” Evocative imagery accompanies the news item:

farmerbikes road

All of this leads me to ask three awkward, but necessary questions:

  1. Why have I never seen these countries used as positive templates for physical activity?
  2. Might it be something to do with current life expectancy in these countries? Uganda’s average life span is about 59 years. Mozambique’s current average is close to 55 years. [To contrast, Monaco is about 89.5 years, Japan is about 85 years, and Sweden is about 82.5 years].
  3. So, to increase life expectancy, would it be reasonable to encourage highly urbanized living, even if it means decreasing population PA rates in these areas?

 

Joe Piggin

PS: The political nature of this issue (how people should be organised in society and what they should do), does remind me  of something I wrote 11 years ago, available here. I critiqued the strange New Zealand policy of aiming to be “the most active country in the world”. Of course not only did New Zealand never have a chance at the title, but also the goal itself is morally problematic. The implicit rationale of trying to be more active than another country is that you want another country to be less active, and therefore, less “healthy” than your own. This, I argue in academic parlance, is crazy.

Physical activity risks at school. What exactly is cotton wool?

Warnings about risk are moral endeavors. Agendas which aim to minimize risk involve (usually implicit) ideas about human safety, welfare and security. But when people perceive the risk-minimization agenda is being taken too far, such as attempting to minimize risk in school settings, the reaction often contain claims of “nanny state” and “cotton wool”. But a recent Australian news report shows that everything we think about raising “tough”, “resilient” children might be a sham. I recommend reading the link above and then reading the rest of this critique … at your own risk.

The fascinating thing about this article is that despite the “pro-risk narrative” in the title, this narrative is subtly subverted through various disclaimers and imagery. The end result is that far from being a place where children “stare down risk”, the schools presented in the article are places where risk is continuously managed through numerous physical structures and rules. Here are some Socratic questions:

  1. What is the point of the article?
    The article title is: “The anti-cottonwool schools where kids stare down risk in favour of nature play.” Look at the rhetoric here. Schools are positioned as resisting cotton wool and the children are actively staring down risk. Big claims for sure, but they are not necessarily borne out by the evidence.
  2. What activities are now promoted by the schools?
    The article suggests children can now “… race around on rollerblades, fly off ramps in crates and slide down trees.” This sounds fine, but it leads to another question …
  3. Are there any rules at all?
    Yes, actually, there are still plenty of rules:
    Helmets are compulsory
    Signed permission is essential
    Wheeled activities appear to be on a one way track
    Trampolines are fully enclosed with side netting
    No more than 2 children can be on the trampoline at any time
    No stacking milk crates
    No walking on the large wooden spools
    No tying rope to yourself
    Sun hats and shoes appear compulsory
  4. What does the play look like?
    The imagery in the article shows that far from being “free” play, the activities remain regulated with regard to risk reduction. For example, a claim that “Students at West Greenwood Primary School get knocked down, but they get up again” is accompanied by a image of someone falling off a sled onto apparently soft grass. The wheeled activities require helmets and are one way travel.
    sledbikes
    Neither the trampolining nor the “ramp” appear to be particularly places of great risk. If indeed activities such as these have been banned before then I would agree with one of the teachers in the article that things have gone too far if indeed these activities were removed.
    trampramp
  5. What is the result of all this supposed risky play?
    Well, the claim that injury complaints have reduced at one school should really provoke some thoughts. Is it that these children are being injured to the same extent but not complaining? Or impossibly, are they being injured less often despite riskier play? If it is the latter, one might argue this new play is still not risky enough! We don’t learn this from the article but it would be nice to know!

    Joe Piggin

Brasil, football and another reason why junk food in sport should be regulated.

One of the most popular soft/sugar drinks in Brasil is GUARANÁ ANTARCTICA

can black

Guaraná is as popular as Coca Cola is in many other countries. The brand sponsors the Brasilian football team, with national team players often wearing Guaraná branded clothing, and the products often feature player images and the logo of the national governing body, the CBF.


Of course, the product has a very high amount of added sugar. When reading the brand’s own nutritional information, the 20g of added sugar per 200mL is mentioned, yet no daily reference value is mentioned. In fact, the phrase “Valor diário não estabelecido” (“Daily value not established”) appears on the website.

g website

So, when a person consumes an entire 350mL can, and not just a 200mL cup, they would be consuming 35 grams of added sugar. Given what we know about ultra-processed drinks, teeth and overall health, it is astonishing that such an ultra-processed drink is so heavily endorsed by sport celebrities in a country with significant health problems for young children.

The Brasilian Ministry of Health argues that ultra-processed drink should be avoided. It is surely time for the CBF to end it’s sponsorship with Guaraná.

Joe Piggin

England, the World Cup and childhood obesity

I hope England wins the World Cup, but whatever happens, children’s health is certainly losing. The entire football “pyramid” in England is riddled with junk food companies.

Football food pyramid jpeg
The English Football Food Pyramid

Through their love of football, children in England are bombarded with marketing for ultra-processed food and drink. It continues through their early years and into adulthood. And it’s not sneaky, ambush marketing. It comes from official football organisations, events, venues, teams, and role models. While sport marketers talk about the successful “reach” of sponsorship, public health promoters focus on the potentially disastrous effects these sponsors can have on children.

But it could all end very soon. The food charity Sustain has told the government what action is needed in sport settings: “Campaigns are currently calling on sports associations to disassociate themselves from junk food brands, but if sports associations will not act, the Government must step in.”

And now a Health Committee in the UK Parliament has formally recommended it is time to end these partnerships:

“The next round of the Government’s childhood obesity plan … should also include a commitment to end sponsorship by brands overwhelmingly associated with high fat, sugar and salt products of sports clubs, venues, youth leagues and tournaments.”

THIS IS MASSIVE NEWS. Sponsorship of children’s sport by junk food companies is pervasive and predatory. It includes organisations such as the FA and FIFA, competitions such as the Premier league and Carabao Cup, venues such as Wembley, and programmes such as McDonald’s national youth sponsorship.

To keep the momentum and pressure on the government to make these changes you can state your support with Sustain here: https://www.sustainweb.org/poll/sugar/

For the health of children, this English football food pyramid needs to come tumbling down.

Joe Piggin

PS: This problem is not confined to England either. It’s global. I plan to track other countries soon. See this recent research in the USA about the pervasiveness of junk food advertising in USA sport.

Ego and physical activity advice

Academic work can be rough on egos. Particularly in the social sciences, where ideas matter. We cultivate our reputations over years, but confidence is a brittle thing – just one chastening book review or article rejection away from frustration, anger or anxiety. In a sense, absorbing criticism is inherent to an ideal university structure. As Stuart Hall said, “The university is a critical institution or it is nothing”. Still, it is often difficult to be either the giver or recipient of a scathing critique.

Being on the receiving end of criticism recently really brought this home to me. I co-signed a letter calling for tackling in rugby to be removed from schools (thereby protecting the bodies of school children from one of the most injurious sports), but there was widespread opposition to the idea. That was understandable, but what irked was that the opposition was often coupled with criticism of the letters signers, with claims that we in our ivory towers didn’t know what we were talking about. The idea to remove tackling was labelled ridiculous, as were the letter writers. It was no fun to have my expertise questioned, much less lambasted.

I am also conscious the egos of others might have been caught up in my own critiques of policy ideas. For example, in journals, presentations and on the blog, I have rejected the claims of scholars regarding the corporate influence of companies such as Coke and Nike on physical activity scholarship. More subtly, I have critiqued the ideas of physical activity scholars who have been trying to advance the discipline and promotion of physical activity. While I would not detract from honest academic labour, I do suspect that there have been times where other academics could have taken my analyses personally. So while the ideas are the target of critique, it is impossible to completely disentangle an idea from the person who espouses it. This potential for ego damage is an inherent condition of academic work. That is unfortunate. Where I have less sympathy is when corporate interests are directing the ideas that are generated. Happily and uncritically toeing the line of a company is simply academic dishonesty. You become a shill, not a critical voice in society.

Academics also put themselves up for ridicule in opinion pieces in the press. Consider this recent opinion article in The Times.

After an Oxford professor suggested people pay at the pump of petrol stations rather than entering a service station shop to be surrounded by sugar, the commentator in The Times wrote:

“Who the hell are you saying this to, Professor Jebb? I thought Oxford lectures unlocked the secrets of the physical universe or proposed new ways to unpick Sumerian orthography. But now it’s, “Don’t go into sweet shops, boys and girls, or you’re gonna get fat”? …
Seriously, though? Your answer to Britain’s greatest health calamity since the Black Death is to gently direct people away from places where sweeties are sold? …
That’s a pretty damning view of humanity, isn’t it? That’s what leads some cultures to veil their women from head to toe, because if men can see their lovely faces, like yummy sweeties on a checkout shelf, they cannot be trusted not to have sex with them right there on the street.”

I’m not quite British enough yet to understand the extent of playful sarcasm or liberal distain for the Professor here. Whatever the case, the writer severely misrepresents what Professor Jebb was saying. I wonder if public shaming like this chips away at the enthusiasm of academics to convey their voices in public. Or worse, if it means some health promotion ideas never see the light of day because of a fear of ridicule. But this opinion piece also raises some concerns for how physical activity and health academics portray their work. And it highlights the problem of trying to gain and maintain legitimacy in an area where many structures seem unbudge-able, so academic advice becomes directed at individuals who are more nudgeable. A health promoter’s job is to give practical advice about healthy living, and resisting unhealthy choice architecture (at petrol stations and elsewhere) is one aspect of the job. But there is a risk of academics in physical activity and health being limited to repeating common sense clichés about how to live healthy lives.

In 2014, Public Health England said there needs to be a revolution in physical activity. Revolutions are only possible by upsetting the status quo. And so academics need to be not only willing to do this, but also be prepared for the critiques of those with different agendas. We can rest assured that when giving controversial advice, or advice which negatively affects corporate interests, there is actually no need for our ego at all. We embody one of the seven principles of UK public life – selflessness.

McDonald’s sponsorship of children’s sport

I, and others, have written about how problematic it is that companies which sell ultra-processed food also heavily target young people in their advertising. Even worse is when companies make children do the advertising themselves. See below this from Nottingham in the UK, March 2018: (photo credit: David O’B)

28944971_712869012193362_351359090_o

Many sport organisations have safeguarding policies, but this does not seem to extend to protecting children from exploitation by companies selling all manner of ultra-processed food.

What is physical activity? A definition

The definition offered below differs from recent policy definitions of physical activity. It attempts to capture physical activity by acknowledging the variety of meanings that we attribute to it. I humbly accept that what follows is only a partial definition, and encourage the reader to link these possible aspects of physical activity with their own experiences.

Physical activity might be :

Political
Spiritual
Hysterical
Historic

Exhaustive
Excruciating
Uninteresting
Protesting

Sensual
Sexual
Risqué
Risky

Arresting
Disarming
Investing
Resisting

Painful
Painless
Subtle
Grand

Curtailing
Surveilling
Obsessive
Compulsive

Dialogical
Diabolical
Expensive
Discursive

Ambient
Ambulant
Connecting
Correcting

Wondrous
Wonderful
Unbearable
Uncomfortable

Cathartic
Chaotic
Instructive
Destructive

Balletic
Bathetic
Compulsory
Derisory

Beneficial
Sacrificial
Moving
Reinforcing

Instinctive
Artistic
Repulsive
Oppressive.
J Piggin, 2018

For more on this issue, please see:

Piggin, J. & Hart, L. (2017). Physical activity advocacy in the UK: A multiple streams analysis of a hybrid policy issue, Leisure Studies. 36, 5. 708-720.

http://www.tandfonline.com/doi/abs/10.1080/02614367.2017.1285957

Piggin, J & Bairner, A (2016) The global physical inactivity pandemic: An analysis of knowledge production. Sport, Education and Society. 21, 2. 131-147.

 

The Routledge Handbook of Physical Activity Policy and Practice

I am immensely happy to have been a co-editor of the above book. With Dr Louise Mansfield and Prof Mike Weed, we have attempted to bring together the enormous diversity of scholarly thinking about PA policy and practice.

Rather than solely focusing on physical activity as a means for making populations “healthier” (as judged by traditional health markers), we have included a wide range of chapters to encourage academics, policy makers, practitioners and students to question some of the assumptions about physical activity that have become established in recent years. 75 contributing authors provide contemporary and evocative chapters which frame physical activity in:

  • different ways for …
  • different groups who have …
  • different motivations for achieving …
  • different outcomes.

Therefore, interventions that policy makers deploy must be informed not only by good evidence but also by a sympathy for people whose lives are complex and often constrained by unbudgable (and un-nudgable) forces. Being physically active might not only be a healthy choice … it might also be deeply political.

More detail on the book, including the full table of contents can be found here.

Joe Piggin

Handbook

An urgent call for clarity regarding England Rugby’s injury claims – update

A couple of weeks ago, Prof Alan Bairner and I wrote an analysis of England Rugby’s false and misleading injury rate claims. Here is the link:

http://idrottsforum.org/feature-piggin-bairner170523/

I can now report that England Rugby responded. Here is the initial response – with names redacted:

Dear Joe, 

Thank you very much for your email and for bringing this to attention.

The RFU takes player safety extremely seriously. I would like to take the opportunity to respond to your email and to you and Professor Bairner on your editorial (An urgent call for clarity regarding England Rugby’s injury claims). 

We acknowledge that an editing error was made in the wording used as part of our Rugby Safe booklet, which was published two years ago. It should have read: There is no evidence to show that rugby poses a specifically greater risk of catastrophic injury than other sports and other activities to align with the graphic used directly after it on page eight (screengrab attached). This was a mistake as part of the publishing process.

We want to ensure all our resources include accurate information, so will be undertaking the following:

  • Amending the 2015 Rugby Safe booklet to remove the inaccurate wording with immediate effect (the 2015 document has already been removed from our website)
  • Publishing an updated Rugby Safe booklet next season using the latest research and findings

The RFU has apologised to Colin Fuller for the error. It was not our intention to mislead. We will continue our ongoing commitment and work to ensure player welfare is central to all that we do.
Yours sincerely,

###### #####

RFU 

##### ####

For more see:

Piggin, J. & Bairner, A. (2017) An urgent call for clarity regarding England Rugby’s injury claims. Nordic Sport Science Forum http://idrottsforum.org/feature-piggin-bairner170523/