Attacking the pandemic of physical inactivity: what is holding us back?

Physical inactivity was characterised as a global pandemic in the 2012 Lancet series on physical activity and health.1 The extent of the pandemic, causes and potential solutions were further explored in other papers in the 2012 and 2016 series, and recommendations derived from these papers and an associated workshop are summarised by Ding et al. 2 This paper builds on these syntheses of global knowledge and assesses progress or the lack thereof in addressing the global pandemic of physical inactivity. Ding et al noted the substantial growth of research on physical activity and public health, progress in integrating physical activity into public health policy and practice and make recommendations for closing still important gaps in knowledge. However, population level advances in public health programmes and policies lag behind those seen in equivalently important areas of public health such as HIV prevention, maternal mortality and tobacco control. Clearly, one of the reasons for lack of progress is that physical inactivity, much like diet, obesity and diabetes, is a complex problem requiring solutions across many sectors and at many levels. There is no silver bullet for physical activity promotion. In the current editorial, we examine whether we are failing to implement proven strategies or do not yet truly understand what works to increase population levels of physical activity and close with recommendations for researchers and policymakers. Physical activity is now widely accepted as a global public health issue with many countries including it within national public health plans. Unfortunately, physical activity is often treated as a secondary factor hidden in broad non-communicable disease planning efforts. The 2018 WHO Global Action Plan for Physical Activity (GAPPA) may be the best manifestation of physical activity joining the mainstream of public health.3 It is well elucidated, evidence-based and engages multiple sectors, strategies and …