Thailand’s physical activity drive is improving health by addressing NCDs
Dancing to increase her physical activity has been, for Thai dressmaker Umpun Sangprasert, just what the doctor ordered to improve her heart health.
In 2011, when she was 64, Umpun, from Thailand’s northern Angthong Municipality, was diagnosed with high levels of cholesterol and the dietary fat triglyceride. This raised the threat of suffering from a cardiovascular disease, Thailand’s – and the world’s – leading cause of death, including of people aged under 70.
“My doctor advised me to start physical activity and change my diet, and after I started exercising I later found that my triglycerides and cholesterol level had decreased,” says Umpun, now 70 and a village health volunteer. “I enjoyed very much this physical activity and I felt much stronger and healthier so I continue with it.”
So much so she joined a government-led drive to help fellow Thais increase levels of physical activity to curb the threat of heart and other noncommunicable diseases (NCDs), which combined are responsible for 7 in 10 deaths in Thailand.
Government strategies to increase physical activity
New cycle paths have been installed around the country. Popular media, from SMS and social media campaigns, to promotions in cinemas and rock concerts, are calling for an increase in physical activity, like 10 kilometre runs in the capital, Bangkok, and 20 other locations around the country. Public parks are becoming beacons for health, with tai chi, yoga, dancing and other healthy programmes the norm.
Globally, cardiovascular diseases, like stroke and heart attacks, killed an estimated 17.7 million people annually, and almost half of the worldwide death toll associated with NCDs. The other main NCDs are cancers, chronic respiratory diseases and diabetes.
Each shares four common, modifiable risk factors – physical inactivity, unhealthy diet, tobacco and harmful use of alcohol. Combined, they are responsible for 40 million annual deaths, including 15 million people aged between 30 and 70.
“NCDs kill more Thais than anything else – this is why they are a major priority for WHO’s work with government,” says Dr Daniel Kertesz, WHO Representative to Thailand. “We support Thailand’s local and global leadership to reduce physical inactivity and tackle other important risk factors for NCDs.”
Dr Pairoj Saonuam, of Thai Health, says promoting physical activity requires action from many sides, including political support, a social movement, and economic investment. “We need to change the paradigm: exercise is not just activity you do in your free time,” says Dr Saonuam. “We can be physically active during our daily routines, by walking to work, cycling to school and using less motorized transport.”
Global push to increase physical activity by WHO
Also, WHO is leading a global push to increase physical activity, as one in four adults and eight in 10 adolescents are not active enough. WHO is developing a new global action plan to promote physical activity, a key focus being to promote better environments and more opportunities for people of all ages and abilities to be more physically active.
WHO’s new plan will support a target, approved by governments, to cut the global prevalence of insufficient physical activity by 10% by 2025. This is one step in a broader push to reduce premature NCD deaths by one-third by 2030 in line with the Sustainable Development Goals.
WHO recommends adults aged 18 and over do at least 75 minutes of vigorous - or 150 minutes of moderate intensity - physical activity per week. Children and adolescents aged 5-17 years should do at least 60 minutes of daily moderate to vigorous intensity physical activity.
Thailand’s physical activity movement has been gaining momentum, championed by the country’s prime minister, Gen. Prayuth Chan-o-cha, who launched a weekly programme, each Wednesday, for civil servants to take one hour to be physically active at work. In 2016, Thailand hosted the 6th congress of the International Society for Physical Activity and Public Health.
Dr Fiona Bull, who leads WHO’s unit on physical activity and healthy diets, says Thailand is showing regional leadership by developing a national physical activity action plan and leading similar initiatives to prompt countries to scale up action.
“Like other countries in the region, and around the world, rapid changes in Thailand in how people travel, work and play are leading to less active lifestyles,” says Dr Bull. “Thailand is focusing on changing how we think about physical activity and how we can, and should, make it part of our everyday lives.”
Angthong Municipality is doing just that. Programmes for various age groups, including 0-5, 6-17 and 18-59, and over 60 year-olds are helping thousands be more physically active. Community and religious leaders are promoting these activities among local communities.
Rungtiwa Makim, director of Angthong Municipality’s division of public health and environment, says left untreated, the NCD challenge will escalate and affect families and communities, adding to higher national expenditure on healthcare along with economic, social and mental problems for patients and their caretakers.
“In Angthong, it has been easy for people to increase physical activity in their daily routines,” says Ms Makim. “By walking or cycling to work, or buying groceries and running errands, it makes a big difference to your health.”