Sa Wu,Yufeng Luo,Xue Qiu,Mingxiao Bao

Sport Social Science Research Center,China Institute of Sport Science,Beijing 100061,China

Letter to the editor

Building a healthy China by enhancing physical activity: Priorities,challenges,and strategies

Sa Wu,Yufeng Luo,Xue Qiu,Mingxiao Bao*

Sport Social Science Research Center,China Institute of Sport Science,Beijing 100061,China

Dear editor,

In 2016,several landmark government initiatives were launched in an effort to build a more healthy China.In March, the National People’s Congress of China adopted the 13th Five-Year Plan,which sets out new objectives,principles,and targets for 2016–2020,1including action plans for enhancing environmental protection and green growth,promoting individual and population health,and improving the health care system and services.In June,the central government launched a strategic plan to implement a program to improve the nation’s physical fitnes and health levels.2In August,in an effort to fulfil China’s commitment to the United Nations 2030 Agenda for Sustainable Development,3the Political Bureau of the Chinese Community Party adopted the“Healthy China 2030”plan as part of a comprehensive strategy to improve the general health of the Chinese people.4

The release of these initiatives,especially the National Fitness Program(NFP),2has notonly established the health ofthe Chinese population as a nationalpriority butalso provided opportunities for addressing some of the urgent public health issues that have resulted from the country’s recent economic reforms and related developments that have led to unprecedented industrialization, urbanization,and environmental pollution.With these dramatic policy transitions taking place,China is now poised to address a major emerging health threat—noncommunicable diseases (NCDs)such as diabetes,heart attacks,stroke,and cancer.5These NCDs are estimated to account for more than 80%of China’s disease burden,5,6and the number of individuals afflicte with NCDs is expected to increase as the population ages over the coming decades.5Unhealthy lifestyles,as reflecte in decreases in physical activity(PA)7,8and increases in poor diet,9represent another area of concern that can lead to increased risk for developing NCDs.

One key target of the NFP is to increase the number of people who participate in PAs,with the goal of 700 million people engaging in exercise at least once a week and 435 million exercising regularly.The NFP also calls for increasing sports expenditures to 0.2 trillion U.S.dollar per year and building enough sports field to have 1.8 m2of space per capita dedicated to that purpose.

Although these goals are laudable from a public health perspective,strategies are needed to successfully implement the NFP and achieve its goals despite the significan challenges it presents.10For example,there is no general consensus among public health authorities as to what constitutes the most benefi cial forms and/or levels of PA.Similarly,there is a lack of evidence-based PA guidelines that can aid policymakers and public health authorities in making specifi recommendations to the Chinese population about proper levels of PA.The health benefit of many traditional outdoor PAs and sports11,12have been reduced owing to worsening ambient air pollution.13Rapid growth in urbanization has also resulted in limited availability of open spaces and community-based public facilities for PAs,and there is a large rural–urban gap in PA levels.Finally, although there are some national-level data available on PA and fitness14,15there are no surveillance systems or mechanisms for monitoring PA trends over time,either locally or nationally.

If key PA goals are to be achieved,a number of steps need to be taken.First,a collaborative,coordinated effort that involves various central and local government authorities(e.g.,those responsible for public health,health care,city planning,transportation,education,and the environment)isneeded to both prioritize the NFP’s activities and develop specifi PA promotion guidelines and policies.Second,the government and public health sectors mustundertake large-scale campaignsaimed at(1)promoting safe and clean environments for physical exercise,(2)increasing the level of PA taking place in multiple settings(e.g.,workplaces, neighborhoods,schools,and rural areas),and(3)making accessible and walkable places and facilities available for PAs.It is alsoimportant to develop a national PA research agenda that includes epidemiologic studies and the use of evidence-based information to guide the developmentofPA initiativesand policiesforincreasing PA in communities.Finally,establishing a surveillance system is necessary to systematically track PA behaviors at the local and national levels,thereby creating dependable tools for assessing energy expenditure and more accurately estimating levels of PA.

Acknowledgment

This work is supported by China Institute of Sport Science (No.16-16,16-53).

Authors’contributions

SW carried out the study,obtained research grants for this study,and drafted the manuscript;MB helped to conceive of the study and helped to draft the manuscript;YL and XQ participated in its information collection and coordination.All authors have read and approved the fina version of the manuscript,and agree with the order of presentation of the authors.

Competing interests

None of the authors declare competing financia interests.

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Received 24 August 2015;revised 17 September 2016;accepted 10 October 2016 Available online 21 October 2016

Peer review under responsibility of Shanghai University of Sport.

*Corresponding author.

E-mail address:baomingxiao@ciss.cn(M.Bao)

http://dx.doi.org/10.1016/j.jshs.2016.10.003

2095-2546/?2017 Production and hosting by Elsevier B.V.on behalf of Shanghai University of Sport.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).