Introduction: There is strong evidence demonstrating the direct and indirect pathways by which physical activity prevents many of the major non communicable diseases (NCD) responsible for premature death and disability1. Physical inactivity was identified as the 4th leading risk factor for the prevention of NCD2, preceded only by tobacco use, hypertension and high blood glucose levels, and accounting for over 3 million preventable deaths globally in 2010.3 Despite these facts, and being identified nearly 20 years ago as the “best buy in public health’4 the level of global and national public health action on physical activity does not match the evidence of the importance and risk posed by physical inactivity. Why?

We commend WHO for developing the Political Declaration on the Prevention and Control of NCDs, adopted at the UN High Level Meeting in September 2011 and Member States on their support for the Political Declaration. Halting the NCD epidemic requires timely implementation of the commitments in the Political Declaration and taking clear decisions at the 65th World Health Assembly this May.

Abstract: MATSUDO, V. K. R., S. M. MATSUDO, T. L. ARAUJO, D. R. ANDRADE, L. C. OLIVEIRA, and P. C. HALLAL. Time Trends in Physical Activity in the State of do Paulo, Brazil: 2002-2008. Med. Sci. Sports Exerc., Vol. 42, No. 12, pp. 2231-2236, 2010. Purpose: To document time trends in physical activity in the state of São Paulo, Brazil (2002-2008). In addition, we discuss the role of Agita São Paulo at explaining such trends. Methods: Cross-sectional surveys were carried out in 2002, 2003, 2006, and 2008 in the state of São Paulo, Brazil, using comparable sampling approaches and similar sample sizes. In all surveys, physical activity was measured using the short version of the International Physical Activity Questionnaire. Separate weekly scores of walking and moderate-and vigorousintensity physical activities were generated; cutoff points of 0 and 150 min.wk-1 were used. Also, we created a total physical activity score by summing these three types of activity. We used logistic regression models for adjusting time trends for the different sociodemographic compositions of the samples. Results: The prevalence of no physical activity decreased from 9.6% in 2002 to 2.7% in 2008, whereas the proportion of subjects below the 150-min threshold decreased from 43.7% in 2002 to 11.6% in 2008. These trends were mainly explained by increases in walking and moderate-intensity physical activity. Increases in physical activity were slightly greater among females than among males. Logistic regression models confirmed that these trends were not due to the different compositions of the samples. Conclusions: Physical activity levels are increasing in the state of São Paulo, Brazil. Considering that the few data available in Brazil using the same instrument indicate exactly the opposite trend and that Agita São Paulo primarily incentives the involvement in moderate-intensity physical activity and walking, it seems that at least part of the trends described here are explained by the Agita São Paulo program.

Abstract: In 1998 the mayor’s office and the District Institute for Sports and Recreation created Muévete Bogotá, a physical activity and health promotion programme for the capital city of Colombia. Muévete means to move or to be active, and this campaign to promote physical activity was designed to improve the health and quality of life of the citizens of Bogotá through regular physical activity. The programme is based on the 1995 recommendations on physical activity of the U.S. Centers for Disease Control and Prevention and the American College of Sports Medicine (Pate el al., 1995), and was developed in close consultation with the  Agita São Paulo programme in Brazil (Matsudo el al., 2003). Muévete Bogotá couples a mass media campaign with programmes targeted to change physical activity behaviour. The interventions, which are conducted at work sites, schools, health care centers and in community settings rely on partnerships created among professionals in areas of education and health, business officials and personnel, and community members, to deliver the programmes in each of these settings and populations.

We commend WHO for the inclusion of a target and indicator addressing physical inactivity in the latest Discussion Paper released on March 21 2012 as part of the comprehensive global monitoring framework under development by WHO in response to paragraphs 61 and 62 of the Political Declaration of the General Assembly on the Prevention and Control of Non communicable Diseases (resolution 66/2).

ABSTRACT One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost–benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara in México, and San Francisco in the USA. The data of the four programs were obtained from program directors and local surveys. The annual cost per capita of the programs was: US $6.0 for Bogotá, US $23.4 for Medellín, US $6.5 for Guadalajara, and US
$70.5 for San Francisco. The cost–benefit ratio for health benefit from physical activity was 3.23–4.26 for Bogotá, 1.83 for Medellín, 1.02–1.23 for Guadalajara, and 2.32 for San Francisco.

Background: Community programs have been suggested to be an important and promising strategy for physical activity (PA) promotion. Limited evidence is available regarding knowledge of and participation in these programs in Latin America. Objective: To describe participation in and knowledge of community PA programs and to explore associations with leisure-time PA in the city of Curitiba, Brazil. Methods: A cross sectional telephone survey was conducted among adults in Curitiba, Brazil (n = 2097). The International Physical Activity Questionnaire was used to determine levels of PA, and specific questions were used to evaluate the extent to which respondents knew about or participated in the programs conducted by the municipality. Logistic regression was used to assess the meeting of PA recommendations in leisure time based on program knowledge and participation. Results: Knowledge of PA programs was high (91.6%) and 5.6% of population participated in the programs. After adjusting for individual characteristics, exposure to Curitiba’s PA community programs was associated with leisure-time PA (POR = 2.9, 95% CI = 2.9–3.0) and walking for leisure (POR = 2.4; 95% CI = 2.3–2.4). The associations were stronger among men than among women. Conclusions: Knowledge and participation in Curitiba’s community PA programs were associated with meeting recommended levels of PA in leisure time.

A complementary document to The Toronto Charter for Physical Activity: A Global Call to Action. Physical inactivity is the fourth leading cause of deaths due to non communicable disease (NCDs) worldwide - heart disease, stroke, diabetes and cancers - and each year contributes to over three million preventable deaths .1 Physical inactivity is related (directly and indirectly) to the other leading risk factors for NCDs such as high blood pressure, high cholesterol and high glucose levels; and, to the recent striking increases in childhood and adult obesity, not only in developed countries but also in many developing countries. Substantial scientific evidence supports the importance of physical inactivity as a risk factor for NCD independent of poor diet, smoking and alcohol misuse.

Physical activity promotes wellbeing, physical and mental health, prevents disease, improves social connectedness and quality of life, provides economic benefits and contibutes to environmental sustainability. Communities that support health enhancing physical activity, in a variety of accessible and affordable ways, across different settings and throughout life, can achieve many many of these benefits. The Toronto Charter for Physical Activity outlines four actions based upon nine guiding principles and commitment to support enhancing physical activity for all.

In spite of the growing use of motion sensors, particularly accelerometers, for the measurement of physical activity in high-income countries, virtually all population-based physical activity studies from low- and middle-income countries (LMICs) still rely on selfreport. In addition to the well known financial aspect of this inequality, availability of trained personnel is another challenge in LMICs. Also, less widely known barriers,
such as importation regulations also play a role.

The purpose of this paper is to present key points of an intervention programme (Agita São Paulo Program) to promote physical activity in a developing country. Agita is a multi-level, community-wide intervention designed to increase knowledge about the benefits and the level of physical activity in a mega-population of 34 million inhabitants of Sa˜o Paulo State, Brazil. The main message was taken from the Centers for Disease Control/American College of Sports Medicine (CDC/ACSM) recommendation that: ‘everyone should accumulate at least 30 minutes of physical activity, on most days of the weeks, of moderate intensity, in one single or in multiple sessions’.

Strategic partnership is a logical approach to face some of the public health problems. However, its application is somewhat more complex. In this paper our experience with three networks (Agita São Paulo, Physical Activity Network of Americas, and Agita Mundo Network) was described. In the case of Agita São Paulo even the name was a consequence of a partnership with a marketing company, and is an idiomatic expression that means much more than just to move your body. It also means to move psychologically and socially, with the concept of ‘‘active citizenship’’. Among the important features of that intervention, we highlighted: (a) national and international intellectual partnership; (b) strong institutional partnerships, including government in one hand, and non-governmental and private sector in the other hand, in a so called: ‘‘two-hats approach’’; (c) minimal formalization/maximal flexibility...

In searching for strategies to combat increasing sedentary status of the world’s population, several models have been developed. Among those is the Ecological Model proposed by Sallis and Owen in 1997. This model considers intrapersonal, social environment, and natural and constructed physical environmental factors. Intrapersonal factors comprise: demographic; biological; affective; and behavioural aspects. Social environment components include: social climate; supportive behaviours; culture; policies governing incentives; and resources for physical activity. Weather and geography are among the natural physical environment factors, while among the constructed physical environment components we have: information; urbanisation; architecture; transport; and entertainment and recreation infrastructure. Each of these components have been selected as the intervention focus of many programmes, however, to manage different factors of the model at the same time is quite unusual. Thus, the aim of this article is to present how the Agita Sao Paulo Programme has been trying to managing all of these components in a synchronised way, ising a mobile approach. In this model, when one component is targetted, a system imbalance occurs.

Recommendations for physical activity in the Guide to Community Preventive Services (the Community Guide) have not been systematically examined or applied in developing countries such as those in Latin America. The aim of this systematic review was to assess the current evidence base concerning interventions to increase physical activity in Latin America using a modified Community Guide process and to develop evidence-based recommendations for physical activity interventions.

The evaluation of the Agita Sa˜o Paulo Program, a multi-leveled and a multi-strategy intervention on promoting physical activity (PA) in a mega-community has shown that: (1) evaluation of the processes and impact has been permanent and essential to the decisionmaking process; (2) process evaluation included indicators, instruments and evaluation techniques such as questionnaires, meeting and general reports, documents, letters, interviews, database, organization and impact of mega-events, health indexes, investments and costs charts; (3) impact evaluation included individual changes in knowledge, attitudes, recall of the program, and PA levels, as much as the effects on policies, the environment, investment, costs and organization of the target settings of intervention; (4) community-based partners in the evaluation included stakeholders, program coordinators and external agencies.