Question 1

How much physical activity does WHO recommend for adults?

Accepted Answer

WHO guidelines recommend that adults do at least 150-300 minutes of moderate-intensity aerobic physical activity, or 75-150 minutes of vigorous-intensity activity (or an equivalent combination), throughout the week. Additionally, muscle-strengthening activities involving major muscle groups should be done on 2 or more days per week. More activity beyond these minimums provides additional health benefits. Even small amounts of activity are beneficial — any movement is better than none.

Question 2

What diseases can physical activity prevent?

Accepted Answer

Regular physical activity substantially reduces the risk of: cardiovascular disease (35% risk reduction); type 2 diabetes (40%); colon and breast cancers (20-30%); depression and anxiety (30%); dementia (20-30%); and hypertension. It also reduces the risk of falls in older adults, improves bone health, helps manage weight and promotes wellbeing. Physical activity is the closest thing to a miracle drug in preventive medicine.

Question 3

Why is physical inactivity increasing globally?

Accepted Answer

Physical inactivity is rising because modern environments, work and transport systems are built to minimise physical effort. Sedentary jobs, car-dependent cities, passive entertainment and urbanisation all reduce the requirement for physical activity. These are systemic changes that cannot be addressed by telling individuals to "exercise more" — they require policy interventions in urban planning, transport, workplaces and schools. High-income countries and women have the highest inactivity rates.

Question 4

What is the cost of physical inactivity?

Accepted Answer

Physical inactivity is estimated to cost health systems approximately $27 billion per year in direct medical costs (Ding et al., Lancet 2016). Additional indirect costs from lost productivity add $13.7 billion. Individuals who are physically active use healthcare services less — making activity promotion one of the most cost-effective investments in preventive public health.

Question 5

What is the WHO GAPPA?

Accepted Answer

The WHO Global Action Plan on Physical Activity (GAPPA) 2018-2030 targets a 15% relative reduction in the global prevalence of physical inactivity — approximately 500 million people becoming more active by 2030. It is built around four strategic objectives: Active Societies (creating cultures that value physical activity); Active Environments (building safe, walkable cities and cycling infrastructure); Active People (programmes for individuals); and Active Systems (integrated governance and data systems).

Question 6

Can physical activity treat depression?

Accepted Answer

Yes — with an effect comparable to antidepressants in mild-to-moderate depression. A 2023 BMJ meta-analysis of over 1,000 randomised trials found that exercise (walking, jogging, yoga, strength training) was more effective than active control conditions for depression, with jogging and yoga showing the strongest effects. Exercise is now recommended by NICE (UK) and many international guidelines as a first-line treatment for mild-to-moderate depression, and as adjunctive therapy for more severe depression.

Question 7

What physical activity is best for older adults?

Accepted Answer

WHO guidelines for adults over 65 are the same as for younger adults (150+ min/week moderate aerobic, 2+ days muscle-strengthening) with two additions: multi-component physical activity emphasising functional balance and strength training 3+ days per week to prevent falls; and more sedentary time should be replaced with physical activity — any amount. Swimming, walking, tai chi, yoga and resistance training are all appropriate. Falls prevention is a particular priority — exercise can reduce fall incidence by 23%.

Question 8

What is sedentary behaviour and is it different from inactivity?

Accepted Answer

Sedentary behaviour is time spent in low-energy sitting or reclining while awake — desk work, screen time, driving. Physical inactivity is insufficient physical activity (not meeting WHO guidelines). They are related but distinct: someone can meet WHO activity guidelines (e.g. a daily walk) but still be sedentary for most of the day (e.g. a desk worker). Evidence suggests that prolonged sitting has independent health risks beyond those explained by overall activity levels — breaking up sitting time is beneficial even in otherwise active people.

Question 9

How does physical activity relate to mental health?

Accepted Answer

Regular physical activity is a powerful mental health intervention. It reduces symptoms of depression and anxiety, improves sleep quality, reduces stress, builds self-esteem and improves cognitive function. Exercise causes measurable changes in brain structure (increased hippocampal volume) and function (increased BDNF, neuroplasticity). It is beneficial across the life course — from reducing childhood ADHD symptoms to preventing dementia in older adults.

Question 10

What does exercise do for cancer survivors?

Accepted Answer

Physical activity during and after cancer treatment is now recommended by ASCO, ESMO and ACSM. Evidence from hundreds of trials shows that appropriate exercise during treatment: reduces fatigue, nausea and anxiety; improves fitness and functional capacity; and in some cancers (breast, colon) is associated with reduced recurrence risk and improved survival. ACSM guidelines recommend moving as much as possible and avoiding inactivity — even modest amounts of activity benefit cancer survivors.

Question 11

How does walkability of cities affect population health?

Accepted Answer

Urban design is a major determinant of population physical activity. Walkable cities — with mixed land use, pedestrian-friendly streets, safe cycling infrastructure and access to public green space — generate substantially higher rates of walking and cycling than car-dependent sprawl. Studies consistently show that residents of walkable neighbourhoods have lower rates of obesity, diabetes and cardiovascular disease. Built environment interventions are among the most cost-effective population-level physical activity strategies.

Question 12

How does GMJ News cover physical activity?

Accepted Answer

GMJ News tracks WHO GAPPA implementation, inactivity prevalence data (Lancet Global Health annual estimates), exercise and NCD research, and the urban design and active transport policy dimensions. Georgia's rapidly urbanising cities face the challenge of designing for physical activity — a direct public health concern for PHIG and the Georgian Medical Journal.

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