Lifestyle choices and modifiable behaviours are responsible for a substantial number of premature deaths worldwide and years lived with  disability or disease, as measured by disability adjusted life years (DALYs).

The 2010 Global Burden of Disease study reported that the top three risks to health and wellbeing were:

• High blood pressure (7% DALYs);
• Smoking (6.3% DALYs); and
• Alcohol use (5.5% DALYs).

Dietary risk factors and physical inactivity jointly contributed a further 10% of DALYs. Hence the promotion of positive lifestyle change could improve a person’s health, and the fitness is a key setting for this work.

Changing behaviour is challenging and complex. Evidence regarding interventions to promote physical activity is limited, and there is an evidence gap about the impact of interventions to change multiple behaviours.

Nevertheless, behaviours often co-occur in a positive (for example, physical activity and healthy eating) or detrimental way (for example, smoking and alcohol use). From a practitioner perspective it therefore makes good sense to tackle these problems in a joined up way.

Source: BMJ 2013;346:f1763.

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