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public health

Get moving!

A growing number big city dwellers are taking up moderate physical activity

Every day, almost 1,000 residents of the São Paulo Metropolitan Region – the urban sprawl formed by the capital and the 37 neighboring municipalities, with 17 million inhabitants – begin to walk or to practice some kind of physical activity regularly. In the São Paulo ABC region ( the industrial suburbs of Santo André, São Bernado and São Caetano), there are almost 40 persons a day who decide to wake up early and adopt the habit of walking on the street or in the nearest park, according to the Study Center of the São Caetano do Sul Physical Fitness Laboratory (Celafiscs), the same that attested the by no means negligible growth of 2% a year in the contingent of São Paulo citizens who have added physical activities to their routine.

But let’s not be parochial: adopting regular and moderate physical activities to combat obesity and immobility is making headway in other capitals as well. Curitiba, looked on for years as being an example of urban planning, is now emerging as a good city for physical activities, on the basis of a study carried out involving interviews with 2,000 persons in 30 municipalities of São Paulo, including the city of São Paulo, and with 400 in the capital of Paraná. Amongst the citizens of Curitiba, 31% knew of the exclusive paths for cycles in their city, recalled by 19.6% of the people of São Paulo, on average. Amongst the residents in Curitiba, 35% know the free leisure spaces where people can walk and practice sports, compared with 25% of those from São Paulo.

When comparing the level of physical activity between the two city groups, the author of this study, orthopedic doctor Victor Matsudo, the president of Celafiscs, noted equivalent results: about 60% of the inhabitants, both of the capital of Paraná and of the São Paulo cities, carry out moderate activities. “We may interpret these figures as a sign that the message of the Shake Up São Paulo program is bearing fruit, and that people are more aware of the importance of exercising themselves”, comments Matsudo, the organizer of the 26th International Symposium on Sports Sciences, which takes place from October 23 to 25 in the capital of São Paulo.

Shake Up São Paulo, one of the highlights of this meeting, at which the presentation of 900 scientific works is expected, is a project that since 1996 has been publicizing the idea that it is not necessary to practice sports or join a health club to exercise oneself efficiently. On the contrary: weekend sportsmen and compulsive fitness buffs run risks by demanding too much of their own body. Shake Up São Paulo pontificates: it is better to incorporate into your daily routine healthy habits that do not even look like physical education, like walking upstairs instead of taking the elevator, taking the dog for a walk, and getting off the bus one stop before your destination. A walk of 30 minutes a day – which can be in three blocks of 10 minutes – is enough to chase away obesity and immobility, responsible for 15% to 20% of the cases of cancer, heart diseases and diabetes.

Shake Up São Paulo is the result of a partnership between Celafiscs and the São Paulo State Secretariat for Health, proposed by the then Secretary for Health, José da Silva Guedes. “There was a time when health problems would be solved with sanitation works, and we would depend on engineers to promote health”, comments Guedes, the professor of Preventive Medicine at the School of Medicine of the São Paulo Charity Hospital (Santa Casa) and scientific consultant for Shake Up São Paulo. Next, it was the turn of vaccines and medicines – that is, health in the hands of doctors and nurses. “Today, when immobility is a risk factor for a series of health problems”, says Guedes, “we can count on a PE coach to give guidance on exercise, or a group of neighbors who decide to go on walks.”

Guedes was Matsudo’s professor at the Charity Hospital, and since the 70’s he has been accompanying his work. When they got back in touch, this led to the creation of a nongovernmental organization, also called Shake Up São Paulo, made up of the secretariat and Celafiscs. This model was decisive: if had been just a private program, it would not perhaps have the resources to grow, and had it been just public, it would be subject to the political impacts. That was what happened with one of the fruits of Shake Up São Paulo, Shake Up Brazil, created in 2000 by the Ministry of Health, but interrupted with the change of government.

“At the beginning , we were much criticized, as nobody believed that moderate exercise was sufficient”, recalls physical education teacher Luis Carlos de Oliveira, from Celafiscs. Little by little, Shake Up São Paulo created activities for specific publics – the young, the elderly and the workers. The most wide-ranging is Shake Up World, part of a world-wide network of walks in commemoration of World Health Day, celebrated on April 7.

On the streets and in the subway
Supported today by the current Secretary for Health, Luiz Roberto Barradas Barata, the Shake Up program is also stimulating municipal governments to build pedestrian precincts and cycle paths and to carry out campaigns in public places. “When there are suitable environments and information, people start walking regularly”, notes Oliveira. In railroad and subway stations, the program put up posters suggesting the use of the stair instead of the escalator. Next year, the program is going to be integrated with the efforts of the World Health Organization, which has chosen 2004 to launch its global strategy for combating obesity and immobility. The message will be the same: 30 minutes a day of physical activity suffice to prevent diseases and guarantee quality of life.

Among the foreign guests at the symposium, there are three Americans. Barry Franklin, from Wayne State University, is going to give a lecture on the benefits of walking. Steven Blair, from the Cooper Institute, is going to present a study carried out on 16,878 men between 40 and 87 years old that established a statistical relationship between poor cardiorespiratory conditioning and the occurrence of cerebrovascular accidents. Mike Pratt, from the Centers for Disease Control and Prevention (CDC), will recount the experience of the Healthy People 2000 campaign, a pioneer in the dissemination of an active life style.