Call for ‘health passports’ for children to reduce disease risk

Ireland should introduce a system of ‘health passports’ for children to support them in keeping physically active in an effort to stave off chronic disease and ill health later in life, according to Prof Niall Moyna, Professor of Clinical Exercise Physiology, Dublin City University. 

During a very well-received presentation at the IOS 2022 Annual Medical Conference, Prof Moyna highlighted the importance of physical activity and a healthy, active lifestyle in maintaining good health and preventing the development of chronic conditions. “There is compelling evidence for the benefits of physical activity in relation to health.” 

Speaking during the questions and answers session, he said that physical activity levels in Irish children are inadequate and below the recommended levels in the majority, and their fitness levels are not monitored or supported (outside of competitive sports and PE). 

However, Prof Moyna suggested that a ‘health passport’ system, where children would be assessed in school on their fitness over regular intervals, in a fun, ‘child-centric way’, using validated scores, would provide an ideal opportunity to intervene early on when needed and would educate children on the importance of physical activity for good health. This would encourage children to remain fit throughout their life and provide important data to help inform policy at a national level. 

“The whole idea would be to identify kids early on who are at risk and, in a very sensitive way, to bring that to the attention of the public health nurse and let them intervene rather than wait until it’s too late,” he said. 

He pointed out that one-third of people over the age of 18 years have a chronic condition, which rises to one-in-two aged over 50 years, “which is quite alarming.” These conditions, including chronic obstructive pulmonary disease, heart disease, and neurological conditions, accounted for 76 per cent of all deaths in Ireland in 2021, and lead to years of ill health, increased risk of hospitalisation, and premature death. 

Prof Moyna quoted a number of studies showing that people with various levels of physical activity have much better health, and are less likely/slower to develop chronic health conditions. 

He quoted supporting data, adding that modern medicine tends to focus far more on medication or surgery rather than lifestyle adjustments, despite the overwhelming evidence on the benefits, which he said needs to be addressed. 

Prof Moyna discussed the findings of a recent major meta-analysis of studies involving over 115,000 people, which showed the positive health benefits of physical activity in reducing various negative health risks and outcomes. 

“If you can increase your function capacity just by one MET [metabolic equivalent of task], you will get a 13 per cent reduction in all-cause mortality, a 15 per cent reduction in cardiovascular events, a 7 per cent decrease in waist circumference, a 5 per cent decrease in systolic blood pressure, and improvements in triglycerides and resting blood pressure…. So every one MET increase we can have between four and 10 METs is hugely important in relation to longevity and risk of death.” 

Prof Moyna also looked at international physical activity guidelines, which advocate a mixture of daily moderate activity and more vigorous activity a couple of times a week. He said that daily walking, even for just 30 minutes, dramatically reduces the risk of developing chronic diseases, as well as aiding bone mineral density. 

Speaking to the Medical Independent after the conference, Prof O’Brien praised Prof Moyna’s presentation and suggestions on improving child fitness. “I agree with Prof Moyna where he states that prevention of diseases should begin in childhood. 

“His idea of having health passports for children would make both logical and financial sense, [and] is something that the Government should look very seriously at investing in. 

“Such an initiative would significantly decrease the long-term financial burden on our already creaking health system. It would also ensure that our younger generations would live healthier lifestyles than previous generations, and they would carry this through to their adulthood and old age. 

“Physical activity should be compulsory in all schools from pre-school right through to when the student finishes school, by which stage physical activity has become a way of life. 

“Personally, I cannot see why our Government would not initiate this type of programme. I am unsure that if we want a healthier Ireland, spending millions on bicycle lanes is the answer. 

“I would also like to add at this point, that I believe we are extremely lucky to have the expertise of such a knowledgeable, health-focused individual working tirelessly for better lifestyles for the next generation and for generations to come in Ireland.”