![]() Independent of BMI, the most physically active people reduce their risk of developing CVD by 40%, compared with the most sedentary. Studies indicate continuous periods of sedentariness pose more potent health risks than obesity. Screen time is positively associated with obesity, CVD and mortality. A child born in 2012 will accrue three years of screen time by age 18. 14 Young adolescents spend an average of 6.1 hours each day watching television, using a computer or other smart technology, referred to as screen time. The adolescent playing sport for an hour three times per week is still likely to lead a ‘sedentary’ lifestyle relative to their peers 50 years ago. This cluster of behaviours, characterised by very low energy expenditure, is highly prevalent in modern society. Sedentary behaviour is an independent cause of chronic disease and one in six deaths in the UK. Public Health England (PHE) advise that all children and young people should minimise sedentary time. Sedentary lifestyles and adolescent health 12 The inactive adolescent with normal BMI is at heightened risk of chronic disease relative to an overweight, active peer. Current guideline PA levels for adolescents 4 remain insufficient to offset weight gain associated with today's sedentary lifestyles, highlighting the need for promotion of an active lifestyle and healthy diet. The challenging reality is the common co-presentation of PIA and obesity. 10 It is therefore imperative to increase both PA and CRF levels to offset the adverse effects of inactivity, sedentary time and associated obesity. If everyone had a ‘moderate’ level of CRF, overall mortality would be reduced by about 17%, whereas if no one were obese, the risk reduction would be only 2–3%. Furthermore, active overweight and obese people have around 50% lower non-communicable disease risk compared with unfit normal weight counterparts. However, within groups with similar fitness, the risk is higher for inactive individuals compared with those meeting PA guidelines. 1 PA plays a key role in developing healthy cardiorespiratory fitness (CRF), which in turn correlates inversely with morbidity and mortality. PIA is the fourth leading cause of global mortality. Key initial targets include getting everyone to reduce their sedentary behaviour and be more active, with even a little being more beneficial than none at all. Every encounter represents an opportunity to ask about physical activity, provide advice, or signpost to appropriate pathways or opportunities. ![]() Healthcare professionals caring for adolescents and young adults are ideally placed and suited to deliver powerful messages promoting physical activity and behaviour change. ![]() Worrying trends in adverse physical activity behaviours necessitate urgent and concerted action. Physical inactivity, sedentary behaviour and low cardiorespiratory fitness are strong risk factors for the development of chronic diseases with resulting morbidity and mortality, as well as economic burden to wider society from health and social care provision, and reduced occupational productivity. Adolescence represents a critical period of development during which personal lifestyle choices and behaviour patterns establish, including the choice to be physically active.
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