The federal government has just released updated physical activity guidelines for adults and older adults (aged 65+) for the first time in more than a decade.

The Australian government first produced guidelines for adults in 1999, building on decades of strong evidence that physical activity delivers tremendous health benefits.

So, what’s changed with the new guidelines, and will they produce strong health outcomes?

What’s changed?

The guidelines “illustrate what a healthy 24 hours of movement looks like” and “aim to help people improve their health and wellbeing through movement”.

For the first time, Australia has adopted “24 hour movement guidelines” for adults, now including sleep.

Specifically, they recommend 7-9 hours a night of good quality sleep, with consistent bed and wake-up times.

New “practical guidance” on how to meet the recommendations are provided, for example: “for those who are able and track daily steps, aim for 7,000 or more steps per day”.

We commend the new guidelines – they provide evidence-based information on ways to get healthier.

But it is only information.

Without changes to laws, policies and funding, the guidelines tell people to do more – without more.

What’s missing?

The guidelines frame physical activity as your responsibility: they tell you to move your body and get a good night’s rest, regularly.

But making it our responsibility isn’t working at the population level. Since the first guidelines in 1999, national physical activity levels have remained stubbornly low.

Guidelines haven’t and won’t shift the needle on population levels of physical activity. They provide information, not supportive environments that can eliminate barriers to activity, such as lack of time and cost-of-living pressures.

Decades of research show population activity levels and sleep quality are primarily shaped by our physical and social environment, such as where people live, what is close by, what it costs and how much spare time we have.

Creating active neighbourhoods through supportive laws, funding and policies will shift the needle.

Here are four policy ideas that would actually increase Australians’ physical activity.

1. Redirect road funds to walking and cycling

The vast majority of Australians support redirecting road funds to walking and cycling.

Walking and riding deliver strong population health benefits, which translate into economic benefits. For example, for every one kilometre walked, it is estimated the national economy benefits by A$6.30, while every kilometre cycled benefits the economy by $4.10.

Current investment in foot and bike paths is dismal. The per person spend at a federal level is much less than the cost of a coffee.

By comparison, we subsidise driving by $8 billion a year. That is, federal, state and local governments spent $44 billion last year on roads, but collected just $36 billion in road-related revenue.

That makes the subsidy for driving 300 times greater than the investment in walking and cycling.

Redirecting this driving subsidy to an investment in walking and cycling would make economic and health sense.

2. Shift away from ‘just do it’ messaging

Mass media campaigns have largely failed to change population levels of physical activity.

Global evidence is clear: just telling people to move more isn’t working.

Rather, mass media messaging should highlight the many benefits of physical activity, which in turn may build public acceptance for better physical activity policies.

3. Change car traffic and speed limits

The more people have to drive, the worse our health outcomes are.

To boost walking and cycling, streets need to be safe and things people need – such as schools, jobs and shops – need to be close by.

Policies such as congestion charges and removing subsidised parking make it possible to change from car-centric cities to ones that support walking and cycling.

Making streets safer supports more people to move around by foot or bike. One way to do this is through default speed limits in built-up areas.

Currently, the default speed limit in built-up areas, in all jurisdictions, is 50 kilometres per hour. In the 1990s, it used to be 60kmh – and changing it to 50kmh has saved hundreds of lives.

However, global best practice is 30kmh, creating a safer environment.

4. Remove red tape on creating active villages

Why are “local” shops so far away for many of us, or not accessible by foot? Because of several planning related laws that ingrain low-density housing without access to local shops.

Rethinking housing density limits, setback requirements, minimum parking requirements and single-use zoning laws will allow cafes and shops back into new residential areas.

This means more people will be able to walk, ride or scoot to where they need to go.

Lessons from overseas

Some 61 countries have shifted the dial and are on track to meet their national physical activity targets. Australia isn’t one of them.

Many of these countries are in Western Europe and Scandinavia, well known for having laws that create highly walkable environments.

Half of countries globally have a standalone national physical activity policy but Australia doesn’t despite calls to action by non-government organisations.

Policy changes must shift beyond individual motivation to move more – instead we must reshape our environment through laws and funding. We need more population approaches if we are to shift the dial on physical activity.

Matthew Mclaughlin, Adjunct Research Fellow, School of Human Sciences, The University of Western Australia; Jo Salmon, Deakin Distinguished Professor, Faculty of Health, Deakin University, and Peter McCue, PhD Candidate, School of Population Health, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Parkinson’s disease is the fastest growing neurological disorder, with over 10 million cases worldwide. Up to 150,000 Australians currently live with the disease and 50 new cases are diagnosed each day.

The number of people living with Parkison’s is projected to more than triple between 2020 and 2050.

Yet despite the immense impact on those living with Parkinson’s and their loved ones, and the staggering cost to our economy – at least A$10 billion a year – there is still a lot we don’t know about how this disease presents and progresses.

A recent large-scale study of nearly 11,000 Australians living with Parkinson’s disease provides some critical insights into symptoms, risk factors and how these affect men and women differently. Let’s take a look.

First, what is Parkinson’s disease?

Parkinson’s is a progressive disease in which cells that produce the chemical messenger dopamine in a part of the brain called the “substantia nigra” begin to die. This is accompanied by multiple other brain changes.

It is usually considered a movement disorder. Common motor symptoms include a resting tremor, slowed movement (bradykinesia), muscle stiffness and balance issues.

But Parkinson’s also involves a variety of lesser known non-motor symptoms. These may include:

• mood changes
• difficulties with memory and cognition (including slower thinking, challenges with planning or multitasking and difficulty paying attention or concentrating)
• sleep disturbances
• autonomic dysfunction (such as constipation, low blood pressure and urinary problems).

While these are sometimes referred to as the “invisible” symptoms of Parkinson’s, they often have a greater negative impact on quality of life than motor symptoms.

So, what does the new research tell us?

The study used data collected as part of the Australian Parkinson’s Genetics Study led by the QIMR Berghofer Medical Research Institute. After a pilot study in 2020, it was launched as an ongoing, nationwide research project in 2022.

Some 10,929 Australians with Parkinson’s were surveyed and provided saliva samples for genetic analysis. This is the largest Parkinson’s cohort studied in Australia and the largest active cohort worldwide.

There were several key initial findings.

1. Non-motor symptoms are common

The study reinforced how common non-motor symptoms are, with loss of smell (52%), changes in memory (65%), pain (66%) and dizziness (66%) all commonly reported.

Notably, 96% of participants experienced sleep disturbances, such as insomnia and daytime sleepiness.

2. A better picture of risk factors

The study also provided insights into what can influence Parkinson’s risk.

This is important because we don’t completely understand what causes the dopamine producing cells in the substantia nigra to die in the first place.

Age is the primary risk factor for Parkinson’s. The new study found the average age for symptom onset was 64, and for diagnosis, 68.

3. Genes and environment both play a role

In the recent study, one in four people (25%) had a family history of Parkinson’s. But only 10–15% of Parkinson’s cases are caused by – or strongly linked to – mutations in specific genes.

It’s important to remember that families don’t only share genes but often their environment.

Multiple environmental factors, such as pesticide exposure and traumatic brain injury, also increase risk of Parkinson’s.

The majority (85–90%) of cases of Parkinson’s are likely due to complex interaction between genetic and environmental risk factors, and advancing age.

The study showed environmental exposures linked to Parkinson’s risk were common:

• 36% of people reported pesticide exposure
• 16% had a prior history of traumatic brain injury
• 33% had worked in high-risk occupations (such as agriculture, or petrochemicals or metal processing).

These exposures were significantly higher in men than in women.

4. Differences between the sexes

The disease is 1.5 times more common in men. In the new study, 63% of those surveyed were male.

Parkinson’s also presents and progresses differently in males and females.

The study found women were younger than men at time of symptom onset (63.7 versus 64.4 years) and diagnosis (67.6 versus 68.1 years), and more likely than men to experience pain (70% versus 63%) and falls (45% versus 41%).

Men experienced more memory changes than women (67% versus 61%) and impulsive behaviours, particularly sexual behaviour (56% versus 19%) – although most participants exhibited no or only mild impulsivity.

What we still don’t know

The large-scale study and its comprehensive survey shed valuable light on people living with Parkinson’s in Australia.

But it’s still only a sliver of the population. More than 186,000 people with Parkinson’s were invited to participate and just under 11,000 took part – a less than 6% response rate.

Of these participants, 93% had European ancestry. So this sample may not be fully representative of Parkinson’s disease.

The information we have about symptoms also relied on self-reports by the study’s participants, which are subjective and can be biased or less reliable than objective measurements of function. To address this, the researchers are planning to use smartphones and wearable devices to collect more comprehensive data.

Finally, while this provides a snapshot of the current cohort, it’s not clear how participants compare to people of a similar age without Parkinson’s, or how their symptoms may change over time.

These are important areas of future research for this ongoing study.

What all this means

Studies like this provide crucial insights into risk factors linked to Parkinson’s. They also help us better understand the symptoms people experience.

This is important because the way Parkinson’s presents varies from person to person. Not everyone will experience the same symptoms to the same extent.

Similarly, the way the disease progresses over time differs between people.

A better understanding of the factors that influence this can lead to earlier identification of who’s at risk and more personalised ways of managing this disease.

Lyndsey Collins-Praino, Associate Professor, School of Biomedicine, Adelaide University

This article is republished from The Conversation under a Creative Commons license. Read the original article.