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Physical Inactivity: Summary of the Evidence

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The document discusses physical inactivity and its health consequences. It defines terms like physical activity, exercise, and intensity. The Canadian recommendation of 150 minutes of moderate physical activity per week is presented. Both aerobic and resistance training are discussed as ways to achieve health benefits, and increasing daily physical activity through simple actions is recommended. The evidence shows that physical inactivity is a major risk factor for disease and that even small increases in activity provide health gains.

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Physical Inactivity UBC Students for Science Based Medicine
THEN http://www.drdavidgeier.com/wp-content/uploads/2011/03/Kids-playing- outside.jpg NOW… http://evidencebasedliving.human.cornell.edu/wp- content/uploads/2011/01/children-video-game.jpg
How much exercise is enough? http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg Let’s look at the evidence relating physical activity with health…
Outline • Defining terms • Physical activity vs. exercise • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://amyfreundbodytalk.com/yahoo_site_admin/assets/images/physical_bod y.326120151_std.jpg Question – fact or fiction: Does physical activity provide benefits to only the physical body?
http://www.kaiserquotes.com/blog/wp- content/uploads/2012/01/Mental-Health- Insurance_XL.jpg The Mayo clinic suggests that mechanistically speaking physical activity is able to improve mental health three ways: 1. brain chemicals (endorphins & neurotransmitters) 2. immune system markers 3. body temperature FICTION! Physical activity does not just promote physical fitness but mental wellness as well.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Physical Activity “Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase over resting energy expenditure.” - ACSM
What does that mean? http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg Skeletal Muscle – attaches to and moves your bones Resting Energy Expenditure - estimated value of how much energy your body requires in a day at rest http://img.ehowcdn.com/article-new/ds- photo/getty/article/78/104/86500437_XS.jpg
Our definition of Physical Activity Becomes… • Any movement you make using your muscles that requires more energy than your body would need to lie on a couch http://tsh.to/img/Raking.jpg http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the- dog.jpg
What comes to mind when you hear exercise? http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
Exercise “A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness.” - ASCM
Our Definition of Exercise Becomes… • A planned or organized workout you do in order improve aspects of fitness such as flexibility or cardiovascular endurance http://www.faqs.org/photos/physical-fitness-2476.jpg http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line- image.jpg
Physical Inactivity “A lack of physical activity…currently the 4th leading risk factor for mortality worldwide.” - WHO
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Canadian Recommendations “All healthy adults aged 18-65 need moderate intensity physical activity for a minimum of 30 minutes five days per week” *Or a total of 150 minutes/week http://media.coreperformance.com/images/411*308/people-who-take-the-stairs- are-fitter-and-more-productive.jpg
Intensity • Moderate intensity exercise for 150 minutes a week Intensity Example Activity Affect on breathing Affect on body temperature Sitting Watching TV Normal Normal Very light Effort Dusting Normal Normal Light Effort Light Gardening Slight Increase Start to Feel Warm Moderate Effort Brisk Walking Greater Increase Warmer Vigorous Effort Jogging More out of breath Quite Warm Very Hard Effort Fast Run Greater Increase Hot/Sweating Maximal Effort All-Out Sprint Completely Out of Breath Sweating/Very Hot *Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
The Dose-Response CurveDeathRate http://ars.els-cdn.com/content/image/1-s2.0-S0140673697123558-gr1.gif (The Lancet, 1998) Doing something is better than doing nothing!
http://www.triradar.com/files/2010/09/RulesOfRunning pg Question - Fact or fiction? Is aerobic training – the classic running, walking, or biking the only way to achieve health benefits from exercise?
http://armstrongpodnsportshealth.files.wordpress.com/2 010/12/evelyn_musclepose1.jpg FICTION! Resistance also known as strength training has recently been proven to show important health benefits that are not gained from aerobic training. A study conducted by researchers from the Centre for Hip Health and Mobility (Vancouver), recently found that women that did strength training showed lasting improved cognitive function and functional brain plasticity, while the women doing other forms of exercise did not.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://summertomato.com/wp-content/uploads/2009/12/jump1.jpg 5 Ways to Increase Daily Physical Activity
#1 Choose the parking space farthest away http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
#2 Take the stairs instead of the elevator http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
#3 Grocery shop with a basket instead of a buggy http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store- shopping-Basket-with-food.jpg
#4 Go for a walk – with friends, colleagues, or a pet! http://blog.northernhealth.ca/nhblog/wp- content/uploads/2012/09/walkingmeeting500x350.jpg
http://www.chicagonow.com/katalin-fitness-health- driven/files/2011/07/948c6_exercise-ball-in-office.jpg #5 Sit on an exercise ball instead of a chair
http://www.modernmom.com/sites/default/files/featured/article/03/blood_type-exercise_article.jpg Question - Fact or fiction? Do you have to engage in organized exercise for 150 minutes a week to be considered physically active?
can CDC, 2011 FICTION! Remember, physical activity DOES NOT have to be organized exercise
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://www.caresearch.com.au/Caresearch/Portals/0/Nurses%20Hub/Evidence%20Based%20Practice.jpg Let’s look at some facts from the evidence
#1 About one-third to one-half of the world’s adult population is insufficiently physically active (WHO) http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr eview.jpg http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of- adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a- year.jpg
#2 Physical inactivity is a major contributor to death and disability from non-communicable diseases (NCDs) worldwide Warburton, Health benefits of PA: the evidence. CMAJ 2006
#3 Many Canadian deaths are attributed to physical inactivity (CMAJ, 2000) The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
#4 Musculoskeletal fitness is shown to reduce the risk of falling Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
#5 Physical activity has been proven to slow the early memory decline in Alzheimer’s Disease http://www.alz.org/braintour/images/alzheimer_brain.jpg
Are There Risks? • More is not always better • Overuse injuries • Most gains are in the first bout of exercise • Acute risks of exercise • Risk of training: •Men 1 SD per 1.51 million episodes of exertion • Always consult your doctor before beginning an exercise program
Question - fact or fiction: Does getting enough physical activity automatically mean you will get the body of your dreams?
http://jesscw.files.wordpress.com/2012/05/body-types.jpg FICTION! Of course not. Our bodies depend on how we treat them – things like what we eat, how much we exercise and how much we sleep – and our genetics. Every person is coded to have a different body type.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Physical Activity – A Prescription? • Pedometer based study • Showed a decrease in blood pressure & increase in walking time • Exercise… • If your doctor says so • Physical activity is preventative medicine
Take Away Messages • This presentation is not intended to promote or discredit a specific mode of exercise • Activity doesn’t have to been organized exercise programs • In terms of activity something is better than nothing • Inactivity is associated with a higher rate of mortality & morbidity
“Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it” - Plato http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
References 1. American College of Sports Medicine, Guide to Personal Training 2. British Journal of Cancer, 2009 3. Journal of Alzheimer’s Disease, 2013 4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in Canada, CMAJ, 163(11):1435-40 5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12, 2012 May-Jun. 6. Mayo Clinic, Website 7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117:912-8. 8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323 9. The Lancet, Physical Activity Series Working Group (5 papers), 2012 10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608 11. Warburton, Health benefits of PA: the evidence. CMAJ 2006 12. World Health Organisation, website 13. *URLs of all photo references are pasted on specific slides
THEN http://www.drdavidgeier.com/wp-content/uploads/2011/03/Kids-playing- outside.jpg NOW… http://evidencebasedliving.human.cornell.edu/wp- content/uploads/2011/01/children-video-game.jpg
How much exercise is enough? http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg Let’s look at the evidence relating physical activity with health…
Outline • Defining terms • Physical activity vs. exercise • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://amyfreundbodytalk.com/yahoo_site_admin/assets/images/physical_bod y.326120151_std.jpg Question – fact or fiction: Does physical activity provide benefits to only the physical body?
http://www.kaiserquotes.com/blog/wp- content/uploads/2012/01/Mental-Health- Insurance_XL.jpg The Mayo clinic suggests that mechanistically speaking physical activity is able to improve mental health three ways: 1. brain chemicals (endorphins & neurotransmitters) 2. immune system markers 3. body temperature FICTION! Physical activity does not just promote physical fitness but mental wellness as well.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Physical Activity “Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase over resting energy expenditure.” - ACSM
What does that mean? http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg Skeletal Muscle – attaches to and moves your bones Resting Energy Expenditure - estimated value of how much energy your body requires in a day at rest http://img.ehowcdn.com/article-new/ds- photo/getty/article/78/104/86500437_XS.jpg
Our definition of Physical Activity Becomes… • Any movement you make using your muscles that requires more energy than your body would need to lie on a couch http://tsh.to/img/Raking.jpg http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the- dog.jpg
What comes to mind when you hear exercise? http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
Exercise “A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness.” - ASCM
Our Definition of Exercise Becomes… • A planned or organized workout you do in order improve aspects of fitness such as flexibility or cardiovascular endurance http://www.faqs.org/photos/physical-fitness-2476.jpg http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line- image.jpg
Physical Inactivity “A lack of physical activity…currently the 4th leading risk factor for mortality worldwide.” - WHO
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Canadian Recommendations “All healthy adults aged 18-65 need moderate intensity physical activity for a minimum of 30 minutes five days per week” *Or a total of 150 minutes/week http://media.coreperformance.com/images/411*308/people-who-take-the-stairs- are-fitter-and-more-productive.jpg
Intensity • Moderate intensity exercise for 150 minutes a week Intensity Example Activity Affect on breathing Affect on body temperature Sitting Watching TV Normal Normal Very light Effort Dusting Normal Normal Light Effort Light Gardening Slight Increase Start to Feel Warm Moderate Effort Brisk Walking Greater Increase Warmer Vigorous Effort Jogging More out of breath Quite Warm Very Hard Effort Fast Run Greater Increase Hot/Sweating Maximal Effort All-Out Sprint Completely Out of Breath Sweating/Very Hot *Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
The Dose-Response CurveDeathRate http://ars.els-cdn.com/content/image/1-s2.0-S0140673697123558-gr1.gif (The Lancet, 1998) Doing something is better than doing nothing!
http://www.triradar.com/files/2010/09/RulesOfRunning pg Question - Fact or fiction? Is aerobic training – the classic running, walking, or biking the only way to achieve health benefits from exercise?
http://armstrongpodnsportshealth.files.wordpress.com/2 010/12/evelyn_musclepose1.jpg FICTION! Resistance also known as strength training has recently been proven to show important health benefits that are not gained from aerobic training. A study conducted by researchers from the Centre for Hip Health and Mobility (Vancouver), recently found that women that did strength training showed lasting improved cognitive function and functional brain plasticity, while the women doing other forms of exercise did not.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://summertomato.com/wp-content/uploads/2009/12/jump1.jpg 5 Ways to Increase Daily Physical Activity
#1 Choose the parking space farthest away http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
#2 Take the stairs instead of the elevator http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
#3 Grocery shop with a basket instead of a buggy http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store- shopping-Basket-with-food.jpg
#4 Go for a walk – with friends, colleagues, or a pet! http://blog.northernhealth.ca/nhblog/wp- content/uploads/2012/09/walkingmeeting500x350.jpg
http://www.chicagonow.com/katalin-fitness-health- driven/files/2011/07/948c6_exercise-ball-in-office.jpg #5 Sit on an exercise ball instead of a chair
http://www.modernmom.com/sites/default/files/featured/article/03/blood_type-exercise_article.jpg Question - Fact or fiction? Do you have to engage in organized exercise for 150 minutes a week to be considered physically active?
can CDC, 2011 FICTION! Remember, physical activity DOES NOT have to be organized exercise
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
http://www.caresearch.com.au/Caresearch/Portals/0/Nurses%20Hub/Evidence%20Based%20Practice.jpg Let’s look at some facts from the evidence
#1 About one-third to one-half of the world’s adult population is insufficiently physically active (WHO) http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr eview.jpg http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of- adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a- year.jpg
#2 Physical inactivity is a major contributor to death and disability from non-communicable diseases (NCDs) worldwide Warburton, Health benefits of PA: the evidence. CMAJ 2006
#3 Many Canadian deaths are attributed to physical inactivity (CMAJ, 2000) The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
#4 Musculoskeletal fitness is shown to reduce the risk of falling Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
#5 Physical activity has been proven to slow the early memory decline in Alzheimer’s Disease http://www.alz.org/braintour/images/alzheimer_brain.jpg
Are There Risks? • More is not always better • Overuse injuries • Most gains are in the first bout of exercise • Acute risks of exercise • Risk of training: •Men 1 SD per 1.51 million episodes of exertion • Always consult your doctor before beginning an exercise program
Question - fact or fiction: Does getting enough physical activity automatically mean you will get the body of your dreams?
http://jesscw.files.wordpress.com/2012/05/body-types.jpg FICTION! Of course not. Our bodies depend on how we treat them – things like what we eat, how much we exercise and how much we sleep – and our genetics. Every person is coded to have a different body type.
Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
Physical Activity – A Prescription? • Pedometer based study • Showed a decrease in blood pressure & increase in walking time • Exercise… • If your doctor says so • Physical activity is preventative medicine
Take Away Messages • This presentation is not intended to promote or discredit a specific mode of exercise • Activity doesn’t have to been organized exercise programs • In terms of activity something is better than nothing • Inactivity is associated with a higher rate of mortality & morbidity
“Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it” - Plato http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
References 1. American College of Sports Medicine, Guide to Personal Training 2. British Journal of Cancer, 2009 3. Journal of Alzheimer’s Disease, 2013 4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in Canada, CMAJ, 163(11):1435-40 5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12, 2012 May-Jun. 6. Mayo Clinic, Website 7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117:912-8. 8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323 9. The Lancet, Physical Activity Series Working Group (5 papers), 2012 10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608 11. Warburton, Health benefits of PA: the evidence. CMAJ 2006 12. World Health Organisation, website 13. *URLs of all photo references are pasted on specific slides

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Physical Inactivity: Summary of the Evidence

  • 1. Physical Inactivity UBC Students for Science Based Medicine
  • 3. How much exercise is enough? http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg Let’s look at the evidence relating physical activity with health…
  • 4. Outline • Defining terms • Physical activity vs. exercise • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 6. http://www.kaiserquotes.com/blog/wp- content/uploads/2012/01/Mental-Health- Insurance_XL.jpg The Mayo clinic suggests that mechanistically speaking physical activity is able to improve mental health three ways: 1. brain chemicals (endorphins & neurotransmitters) 2. immune system markers 3. body temperature FICTION! Physical activity does not just promote physical fitness but mental wellness as well.
  • 7. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 8. Physical Activity “Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase over resting energy expenditure.” - ACSM
  • 9. What does that mean? http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg Skeletal Muscle – attaches to and moves your bones Resting Energy Expenditure - estimated value of how much energy your body requires in a day at rest http://img.ehowcdn.com/article-new/ds- photo/getty/article/78/104/86500437_XS.jpg
  • 10. Our definition of Physical Activity Becomes… • Any movement you make using your muscles that requires more energy than your body would need to lie on a couch http://tsh.to/img/Raking.jpg http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the- dog.jpg
  • 11. What comes to mind when you hear exercise? http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
  • 12. Exercise “A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness.” - ASCM
  • 13. Our Definition of Exercise Becomes… • A planned or organized workout you do in order improve aspects of fitness such as flexibility or cardiovascular endurance http://www.faqs.org/photos/physical-fitness-2476.jpg http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line- image.jpg
  • 14. Physical Inactivity “A lack of physical activity…currently the 4th leading risk factor for mortality worldwide.” - WHO
  • 15. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 16. Canadian Recommendations “All healthy adults aged 18-65 need moderate intensity physical activity for a minimum of 30 minutes five days per week” *Or a total of 150 minutes/week http://media.coreperformance.com/images/411*308/people-who-take-the-stairs- are-fitter-and-more-productive.jpg
  • 17. Intensity • Moderate intensity exercise for 150 minutes a week Intensity Example Activity Affect on breathing Affect on body temperature Sitting Watching TV Normal Normal Very light Effort Dusting Normal Normal Light Effort Light Gardening Slight Increase Start to Feel Warm Moderate Effort Brisk Walking Greater Increase Warmer Vigorous Effort Jogging More out of breath Quite Warm Very Hard Effort Fast Run Greater Increase Hot/Sweating Maximal Effort All-Out Sprint Completely Out of Breath Sweating/Very Hot *Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
  • 19. http://www.triradar.com/files/2010/09/RulesOfRunning pg Question - Fact or fiction? Is aerobic training – the classic running, walking, or biking the only way to achieve health benefits from exercise?
  • 20. http://armstrongpodnsportshealth.files.wordpress.com/2 010/12/evelyn_musclepose1.jpg FICTION! Resistance also known as strength training has recently been proven to show important health benefits that are not gained from aerobic training. A study conducted by researchers from the Centre for Hip Health and Mobility (Vancouver), recently found that women that did strength training showed lasting improved cognitive function and functional brain plasticity, while the women doing other forms of exercise did not.
  • 21. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 23. #1 Choose the parking space farthest away http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
  • 24. #2 Take the stairs instead of the elevator http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
  • 25. #3 Grocery shop with a basket instead of a buggy http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store- shopping-Basket-with-food.jpg
  • 26. #4 Go for a walk – with friends, colleagues, or a pet! http://blog.northernhealth.ca/nhblog/wp- content/uploads/2012/09/walkingmeeting500x350.jpg
  • 28. http://www.modernmom.com/sites/default/files/featured/article/03/blood_type-exercise_article.jpg Question - Fact or fiction? Do you have to engage in organized exercise for 150 minutes a week to be considered physically active?
  • 29. can CDC, 2011 FICTION! Remember, physical activity DOES NOT have to be organized exercise
  • 30. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 32. #1 About one-third to one-half of the world’s adult population is insufficiently physically active (WHO) http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr eview.jpg http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of- adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a- year.jpg
  • 33. #2 Physical inactivity is a major contributor to death and disability from non-communicable diseases (NCDs) worldwide Warburton, Health benefits of PA: the evidence. CMAJ 2006
  • 34. #3 Many Canadian deaths are attributed to physical inactivity (CMAJ, 2000) The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
  • 35. #4 Musculoskeletal fitness is shown to reduce the risk of falling Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
  • 36. #5 Physical activity has been proven to slow the early memory decline in Alzheimer’s Disease http://www.alz.org/braintour/images/alzheimer_brain.jpg
  • 37. Are There Risks? • More is not always better • Overuse injuries • Most gains are in the first bout of exercise • Acute risks of exercise • Risk of training: •Men 1 SD per 1.51 million episodes of exertion • Always consult your doctor before beginning an exercise program
  • 38. Question - fact or fiction: Does getting enough physical activity automatically mean you will get the body of your dreams?
  • 39. http://jesscw.files.wordpress.com/2012/05/body-types.jpg FICTION! Of course not. Our bodies depend on how we treat them – things like what we eat, how much we exercise and how much we sleep – and our genetics. Every person is coded to have a different body type.
  • 40. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 41. Physical Activity – A Prescription? • Pedometer based study • Showed a decrease in blood pressure & increase in walking time • Exercise… • If your doctor says so • Physical activity is preventative medicine
  • 42. Take Away Messages • This presentation is not intended to promote or discredit a specific mode of exercise • Activity doesn’t have to been organized exercise programs • In terms of activity something is better than nothing • Inactivity is associated with a higher rate of mortality & morbidity
  • 43. “Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it” - Plato http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
  • 44. References 1. American College of Sports Medicine, Guide to Personal Training 2. British Journal of Cancer, 2009 3. Journal of Alzheimer’s Disease, 2013 4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in Canada, CMAJ, 163(11):1435-40 5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12, 2012 May-Jun. 6. Mayo Clinic, Website 7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117:912-8. 8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323 9. The Lancet, Physical Activity Series Working Group (5 papers), 2012 10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608 11. Warburton, Health benefits of PA: the evidence. CMAJ 2006 12. World Health Organisation, website 13. *URLs of all photo references are pasted on specific slides
  • 46. How much exercise is enough? http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg Let’s look at the evidence relating physical activity with health…
  • 47. Outline • Defining terms • Physical activity vs. exercise • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 49. http://www.kaiserquotes.com/blog/wp- content/uploads/2012/01/Mental-Health- Insurance_XL.jpg The Mayo clinic suggests that mechanistically speaking physical activity is able to improve mental health three ways: 1. brain chemicals (endorphins & neurotransmitters) 2. immune system markers 3. body temperature FICTION! Physical activity does not just promote physical fitness but mental wellness as well.
  • 50. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 51. Physical Activity “Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase over resting energy expenditure.” - ACSM
  • 52. What does that mean? http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg Skeletal Muscle – attaches to and moves your bones Resting Energy Expenditure - estimated value of how much energy your body requires in a day at rest http://img.ehowcdn.com/article-new/ds- photo/getty/article/78/104/86500437_XS.jpg
  • 53. Our definition of Physical Activity Becomes… • Any movement you make using your muscles that requires more energy than your body would need to lie on a couch http://tsh.to/img/Raking.jpg http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the- dog.jpg
  • 54. What comes to mind when you hear exercise? http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
  • 55. Exercise “A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness.” - ASCM
  • 56. Our Definition of Exercise Becomes… • A planned or organized workout you do in order improve aspects of fitness such as flexibility or cardiovascular endurance http://www.faqs.org/photos/physical-fitness-2476.jpg http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line- image.jpg
  • 57. Physical Inactivity “A lack of physical activity…currently the 4th leading risk factor for mortality worldwide.” - WHO
  • 58. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 59. Canadian Recommendations “All healthy adults aged 18-65 need moderate intensity physical activity for a minimum of 30 minutes five days per week” *Or a total of 150 minutes/week http://media.coreperformance.com/images/411*308/people-who-take-the-stairs- are-fitter-and-more-productive.jpg
  • 60. Intensity • Moderate intensity exercise for 150 minutes a week Intensity Example Activity Affect on breathing Affect on body temperature Sitting Watching TV Normal Normal Very light Effort Dusting Normal Normal Light Effort Light Gardening Slight Increase Start to Feel Warm Moderate Effort Brisk Walking Greater Increase Warmer Vigorous Effort Jogging More out of breath Quite Warm Very Hard Effort Fast Run Greater Increase Hot/Sweating Maximal Effort All-Out Sprint Completely Out of Breath Sweating/Very Hot *Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
  • 62. http://www.triradar.com/files/2010/09/RulesOfRunning pg Question - Fact or fiction? Is aerobic training – the classic running, walking, or biking the only way to achieve health benefits from exercise?
  • 63. http://armstrongpodnsportshealth.files.wordpress.com/2 010/12/evelyn_musclepose1.jpg FICTION! Resistance also known as strength training has recently been proven to show important health benefits that are not gained from aerobic training. A study conducted by researchers from the Centre for Hip Health and Mobility (Vancouver), recently found that women that did strength training showed lasting improved cognitive function and functional brain plasticity, while the women doing other forms of exercise did not.
  • 64. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 66. #1 Choose the parking space farthest away http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
  • 67. #2 Take the stairs instead of the elevator http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
  • 68. #3 Grocery shop with a basket instead of a buggy http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store- shopping-Basket-with-food.jpg
  • 69. #4 Go for a walk – with friends, colleagues, or a pet! http://blog.northernhealth.ca/nhblog/wp- content/uploads/2012/09/walkingmeeting500x350.jpg
  • 71. http://www.modernmom.com/sites/default/files/featured/article/03/blood_type-exercise_article.jpg Question - Fact or fiction? Do you have to engage in organized exercise for 150 minutes a week to be considered physically active?
  • 72. can CDC, 2011 FICTION! Remember, physical activity DOES NOT have to be organized exercise
  • 73. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 75. #1 About one-third to one-half of the world’s adult population is insufficiently physically active (WHO) http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr eview.jpg http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of- adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a- year.jpg
  • 76. #2 Physical inactivity is a major contributor to death and disability from non-communicable diseases (NCDs) worldwide Warburton, Health benefits of PA: the evidence. CMAJ 2006
  • 77. #3 Many Canadian deaths are attributed to physical inactivity (CMAJ, 2000) The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
  • 78. #4 Musculoskeletal fitness is shown to reduce the risk of falling Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
  • 79. #5 Physical activity has been proven to slow the early memory decline in Alzheimer’s Disease http://www.alz.org/braintour/images/alzheimer_brain.jpg
  • 80. Are There Risks? • More is not always better • Overuse injuries • Most gains are in the first bout of exercise • Acute risks of exercise • Risk of training: •Men 1 SD per 1.51 million episodes of exertion • Always consult your doctor before beginning an exercise program
  • 81. Question - fact or fiction: Does getting enough physical activity automatically mean you will get the body of your dreams?
  • 82. http://jesscw.files.wordpress.com/2012/05/body-types.jpg FICTION! Of course not. Our bodies depend on how we treat them – things like what we eat, how much we exercise and how much we sleep – and our genetics. Every person is coded to have a different body type.
  • 83. Outline • Defining terms • Physical activity & exercise vs. inactivity • Canadian recommendations for physical activity • How can we achieve these guidelines • Consequences of inactivity – the evidence • The future of prescribed exercise
  • 84. Physical Activity – A Prescription? • Pedometer based study • Showed a decrease in blood pressure & increase in walking time • Exercise… • If your doctor says so • Physical activity is preventative medicine
  • 85. Take Away Messages • This presentation is not intended to promote or discredit a specific mode of exercise • Activity doesn’t have to been organized exercise programs • In terms of activity something is better than nothing • Inactivity is associated with a higher rate of mortality & morbidity
  • 86. “Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it” - Plato http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
  • 87. References 1. American College of Sports Medicine, Guide to Personal Training 2. British Journal of Cancer, 2009 3. Journal of Alzheimer’s Disease, 2013 4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in Canada, CMAJ, 163(11):1435-40 5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12, 2012 May-Jun. 6. Mayo Clinic, Website 7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117:912-8. 8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323 9. The Lancet, Physical Activity Series Working Group (5 papers), 2012 10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608 11. Warburton, Health benefits of PA: the evidence. CMAJ 2006 12. World Health Organisation, website 13. *URLs of all photo references are pasted on specific slides