Physical Activity and Women


Introduction

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Social inequality, poverty and inequitable access to resources, including health care, result in a high burden of noncommunicable diseases (NCDs) among women worldwide. Although women generally tend to live longer with NCDs than men, they are often in poor health. [1] Women remain at a higher risk of non-communicable diseases especially during pregnancy and postmenopausal period. Gestational diabetes, gestational hypertension, breast cancer, cervical cancer, hormonal changes, among others are specific to women[2].

Regular physical activity is vital for good physical and mental health. It helps improve overall health and fitness, maintain a healthy weight, reduce the risk for many chronic diseases and promote good mental health. Australia's Physical Activity and Sedentary Behaviour Guidelines recommend that at least 30 minutes of moderate-intensity physical activity on most, preferably all days is required for good health. This is the same for women and men. However, only 54 per cent of Australian women meet these guidelines[3].

There are, however, large differences in women's level of physical activity in different countries, for instance, most women in Uganda are active during domestic work or house chores, farming, tending shops or small businesses, active transport to church, markets and gardens[4]. Some of the barriers to physical exercise that women face include family responsibilities, as well as cultural or social beliefs, Economic or employment status and level of education. [5]

Benefits of Physical Activity for Women

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Regular physical activity can improve women's health and help prevent many of the diseases and conditions that are major causes of death and disability for women around the world. Many women suffer from disease processes that are associated with inadequate participation in physical activity:[6]
  • Cardiovascular diseases account for one-third of deaths among women around the world and half of all deaths in women over 50 years old in developing countries.
  • Diabetes affects more than 70 million women in the world and its prevalence is projected to double by 2025.
  • Osteoporosis is a disease in which bones become fragile and more likely to break and is most prevalent in post-menopausal women.
  • Breast cancer is the mostly commonly diagnosed cancer in women.Women who engage in regular exercise have been shown to have a reduced risk of breast cancer.[7]

In a study of the elderly, it was found that those participants who reported walking 120 or more minutes per week were “associated with a lower risk of emergency room visits and hospital stays in the subsequent year.”[8] Another study compared a group of women who were self-selected to participate in an exercise regimen versus a sedentary group. Results show that “the moderate-intensity physical activity program experienced potentially valuable health and social cognitive improvements relative to those who did not participate.”

According to the American College of Obstetrics and Gynecology, physical activity not only improves cardiovascular health, but also helps to keep blood pressure, weight, and cholesterol in control. The American College of Obstetrics and Gynecology educational bulletin recommends that both premenopausal and menopausal women exercise in order to prevent osteoporosis.In 2003, the Journal of Cardiopulmonary Rehabilitation reported that even small amounts of physical activity done routinely are found to improve quality of life and mood.[8]

The benefits of physical activity include lowering blood pressure and cholesterol and maintenance of a healthy weight. Other benefits include improved mental health and wellbeing[9], social engagement, enhanced sleep[10] and reduced risk of fractures. Physical Activity has also been associated with improved psychological health by reducing levels of stress, anxiety and depression. This is particularly important for women who demonstrate an incidence of depression that is reported to be almost double that of men in both developed and developing countries. It has also been suggested that physical activity can contribute to building self-esteem and confidence and can provide a vehicle for social integration and equality for women in society[1].

Barriers to Physical Activity 

Common exercise barriers for women include[5]:

  • lack of time
  • lack of motivation
  • parenting demands
  • lack of energy
  • health conditions
  • lack of money/resources
  • gender stereotyping

Physical inactivity is generally more prevalent among girls and women than their male counterparts. Many factors hinder the participation of women in physical activity and their access to health care:[5] The income of women is often lower than that of men and therefore the costs of access to physical activity facilities may be a barrier. Agreement may be required from senior members of the household who control household resources before a woman can engage in physical activity. Women often have a workload in the home and care-giving roles for other family members which may limit the time available for them to engage in physical activity.

According to a review of the research, the presence of children appears to have a strong negative effect on the physical activity levels among women[11] In addition, parents who experienced a decrease in physical activity after having a child are less likely to restore their physical activity to previous levels[11]. Women who have limited mobility may be unable to travel to health centres or physical activity facilities.
Cultural expectations may restrict the participation of women in certain forms of physical activity.

Overcoming Barriers

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Lack of time – many women juggle child-rearing, household duties and paid work, and don't find time for themselves. Three 10-minute bouts of physical activity over the day have the same health benefits as a continuous 30-minute session. Exercise DVDs are a good way to slot some physical activity into a busy day. Also building in activity with children, such as walking to the shops or playing in the park helps women to stay active[5].
Parenting demands – many women fulfil multiple care-giving responsibilities, for example for children and older relatives, and take responsibility for meal preparation and cleaning.
Lack of energy – fatigue is a by-product of a busy lifestyle. Mothers are often tired.
Health problems – older women are more likely to have a chronic health condition (for example, arthritis) that limits their participation in some forms of exercise. In most cases, physical limitations don’t rule out all activities. For example, exercise in water (such as aquarobics) is an enjoyable option for many people with arthritis[5].
Lack of money – women on low incomes are less likely to exercise regularly. Exercise doesn’t require expensive clothes or a gym membership. One of the most beneficial forms of exercise is free – brisk walking. Most community centres offer a range of physical activity classes and childcare at modest prices.

Socio-cultural beliefs - including being self-conscious about body size or general appearance[12] and gender stereotyping can have an effect; in some cultures women who believe that child rearing and domestic chores are ‘women’s work’ are thought to be less likely to take time to exercise.

Physical Activity for Women During Pregnancy and the Postpartum Period

Physical activity during pregnancy benefits a woman's overall health. For example, moderate-intensity physical activity by healthy women during pregnancy maintains or increases cardiorespiratory fitness.[13]

Strong scientific evidence shows that the risks of moderate-intensity activity done by healthy women during pregnancy are very low, and do not increase risk of low birth weight, preterm delivery, or early pregnancy loss. Some evidence suggests that physical activity reduces the risk of pregnancy complications, such as preeclampsia and gestational diabetes[14], antenatal depression[15] and reduces the length of labor, but this evidence is not conclusive.

During a normal postpartum period, regular physical activity continues to benefit a woman's overall health. Studies show that moderate-intensity physical activity during the period following the birth of a child increases a woman's cardiorespiratory fitness and improves her mood. Such activity does not appear to have adverse effects on breast milk volume, breast milk composition, or infant growth. Physical activity also helps women achieve and maintain a healthy weight during the postpartum period, and when combined with caloric restriction, helps promote weight loss.

For further information on PA during pregnancy, including specific guidelines, please see the Physical Activity and Pregnancy page.

Reference

  1. 1.0 1.1 World Health Organization. Global strategy on diet, physical activity and healt 2006. Available at:http://apps.who.int/gb/archive/pdf_files/WHA59/A59_23-en.pdf?ua=1
  2. Alliance NC 2011. Putting non-communicable diseases on the global agenda.
  3. Australian Government Department of Health. Australia's physical activity and sedentary behaviour guidelines. Dep Heal Website. 2014 Jun.
  4. Kirunda BE. Body weight and physical activity of adults in rural Uganda 2017.
  5. 5.0 5.1 5.2 5.3 5.4 Victoria State Government. Better Health Channel. https://www.betterhealth.vic.gov.au/health/healthyliving/physical-activity-for-women
  6. World Health Organization. Physical Activity Factsheet. http://www.who.int/dietphysicalactivity/factsheet_women/en/
  7. McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, Woods N, Ockene J. Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. Jama. 2003 Sep 10;290(10):1331-6.
  8. 8.0 8.1 Lucy K., Cantor L., Stein T. ,Benefits of Exercise for Women. UM Medical School.
  9. Craft LL, Freund KM, Culpepper L, Perna FM. Intervention study of exercise for depressive symptoms in women. Journal of Women's Health. 2007;16(10):1499-509
  10. Guimaraes LH, de Carvalho LB, Yanaguibashi G, do Prado GF. Physically active elderly women sleep more and better than sedentary women. Sleep Medicine. 2008 Jul 1;9(5):488-93.
  11. 11.0 11.1 Hull EE, Rofey DL, Robertson RJ, Nagle EF, Otto AD, Aaron DJ. Influence of marriage and parenthood on physical activity: a 2-year prospective analysis. Journal of Physical Activity and Health. 2010 Sep;7(5):577-83.
  12. Moreno JP, Johnston CA. Barriers to physical activity in women. American Journal of Lifestyle Medicine. 2014 May;8(3):164-6.
  13. Office of Disease Prevention and Health Promotion. DPHP. 2008 Physical Activity Guidelines for Americans.
  14. Bain E, Crane M, Tieu J, Han S, Crowther C, Middleton P. Diet and exercise interventions for preventing gestational diabetes mellitus (2015).
  15. Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, Ward R. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 2015 Jan 1;122(1):57-62.