This article was updated on June 29, 2021.
One of AICR’s 10 Cancer Prevention Recommendations is to be physically active as part of your everyday life. In other words, move more and sit less. More specifically, AICR recommends being physically active at a moderate-vigorous intensity for at least 30 minutes, at least 5 times a week. Even more, activity may be better – and if these benchmarks can’t be reached, some activity is better than none.
Despite this seemingly simple advice, many barriers exist to putting this recommendation into action, and about half of Americans are not getting enough physical activity. Our society has largely engineered physical activity out of our daily lives through technological innovation, making it more difficult for us to meet recommendations. Fortunately, there are actions governments can take to make physical activity easier, such as creating and enhancing parks, sidewalks and bike lanes, and promoting their use. Schools and childcare settings can also be required to provide physical education or a minimum amount of physical activity time before, during and after the school day.
Our sister organization, the World Cancer Research Fund International (WCRF), is currently celebrating the one year anniversary of its MOVING Framework and accompanying policy database, which are designed to help governments identify evidence-based policy options and see where such policies have been implemented globally. With funding provided through the European Union’s Confronting Obesity: Co-creating policy with youth project (CO-CREATE), last year WCRF launched the MOVING framework for physical activity policies to complement the existing NOURISHING framework for diet and nutrition.
As with NOURISHING, the letters of MOVING stand for six policy areas where action is needed to increase physical activity to promote a healthy weight and reduce cancer risk. The six policy areas are grouped into the domains of active societies, active environments and active people. All of the policy areas fall under the heading of active systems, recognizing that factors such as leadership, research funding, financing and policy monitoring and evaluation are important for strong policies across all areas. The policy database contains examples of policies in these six areas that are in effect at the national level in countries around the world, supported by their government and verified by in-country experts. New policies are being added regularly.
In a 2020 launch webinar for the databases, two US-based researchers, Barry Popkin, Ph.D., with the University of North Carolina Gillings School of Global Public Health, and Jim Sallis, Ph.D., with the Department of Family Medicine at the University of California, San Diego, explained how they are using the NOURISHING and MOVING frameworks and databases. More information about MOVING is available on the WCRF blog.
Policies in Action
In the US, policies to increase physical activity have been enacted at all levels of government. For example, consistent with the “M” in MOVING, which stands for “Make programmes, opportunities, and initiatives that promote physical activity a priority,” the US Department of Health and Human Services has issued the Physical Activity Guidelines for Americans. These guidelines provide evidence-based recommendations for how Americans can increase their physical activity to improve their health. The associated Move Your Way campaign provides tools and materials that help people add physical activity into their daily lives. AICR’s Cancer Prevention Recommendations and related materials align closely with the US Physical Activity Guidelines. AICR is advocating for federal legislation, like the Promoting Physical Activity for Americans Act, which would require updated physical activity recommendations to be published at least once per decade. This legislation would ensure that federal physical activity recommendations reflect the current evidence related to physical activity and health and are useful in making physical activity more accessible across generations.
Consistent with the “G” in MOVING, which stands for “Give physical activity education, assessment, and counseling,” AICR is working to increase access to physical activity and lifestyle counseling through behavior change. As a founding member of the Physical Activity Alliance, AICR is working with other nonprofit, professional and industry associations to embed physical activity assessment and prescription in health care delivery and promotion. Over the past year, AICR and PAA have made progress toward integration of physical activity assessments, prescriptions, and referrals into the health care system through identifying billing codes that can be used for physical activity interventions, developing a for creating a standard measure for physical activity in electronic health records. In January 2021, AICR hosted a symposium exploring the importance of evidence-based practices in implementing physical activity interventions across the cancer control continuum with experts Prajakta Adsul, MBBS, PhD, MPH, Karen Basen-Engquist, PhD, MPH, Laura Rogers, MD, MPH and Kathryn Schmitz, PhD, MPH. Additionally, PAA hosted an introductory Physical Activity Congressional Briefing to discuss the importance of federal efforts to increase physical activity in the United States and introduce PAA’s public policy priorities.
Consistent with the “M”, “O”, and “G” in MOVING, AICR is also supportive of the Moving Through Cancer Initiative, led by the American College of Sports Medicine, which is focused on incorporating physical activity within cancer care. Accomplishing this goal will require making physical activity interventions a priority, training health care and exercise professionals, incorporating physical activity assessment and referral into the health care system, and increasing access to and reimbursement for physical activity interventions.