Sedentary is the new smoking | StreetGames National Conference 2013

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Sedentary is the new smoking | StreetGames National Conference 2013

  1. 1. StreetGamesNational Conference11th April 2013Dr William Bird MRCGP MBE© 2012 Intelligent Health/NHS London
  2. 2. © 2012 Intelligent Health/NHS London
  3. 3. Attributable fractions (%) for all-cause deaths in 40 842 (3333 deaths) men and 12 943 (491deaths) women in the Aerobics Center Longitudinal Study.Blair S N Br J Sports Med 2009;43:1-2Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
  4. 4. Attributable fractions (%) for all-cause deaths in 40 842 (3333 deaths) men and 12 943 (491deaths) women in the Aerobics Center Longitudinal Study.Blair S N Br J Sports Med 2009;43:1-2Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
  5. 5. 80 seconds agoMankind has evolved wellIf we take an hour to equal 1000years then four days is 100,000years; the time from the origin ofmankind to today.4 Days ago10 hours ago 4 hours ago 9 minutes ago4000 yrs civilisation10,000 yrs agoAgricultureTechnology100,000 yrs agoHunter gatherersindustrialisation
  6. 6. PeopleWellbeingPurposePlacePeople
  7. 7. Causes of Stress and Free RadicalsChronic StressPeople Place Purpose
  8. 8. 1. Physical activityplays a key role inthe control of thebody’s response tophysical stress1 andprevents telomereshortening22. Chronic stressreduces levels ofphysical activity3.Physical activityand Stress1 Rimmele et al Level of PA affects adrenal andCardiovascular Reactivity to PsychosocialStress: Psychoneuroendocrinology (2009) 43190-1982 Puterman E, Lin J, Blackburn E, ODonovan A,Adler N, et al. (2010) The Power of Exercise:Buffering the Effect of Chronic Stress onTelomere Length. PLoS ONE 5(5): e10837.doi:10.1371/journal.pone.00108373Vitaliano P et al A Path Model of ChronicStress, The Metabolic Syndrome and CoronaryHeart Disease Pyschosomatic Medicine64:418-435 (2002)
  9. 9. eChronic StressStressHormonesPhysicalInactivity
  10. 10. eChronic StressPhysical Inactivity
  11. 11. PeoplePurpose PlaceChronic StressStress HormonesMitochondrial damagePhysical InactivityAnd other poor healthbehavioursCancers Cardiovascular Diabetes DementiaDepressioneMitochondria as a key componentof the stress response.Manoli et al. Trends inEndocrinology and MetabolismVol 18 No 5 2007
  12. 12. Health Benefits of Physical ActivityDisease Risk reduction Strength ofevidenceDeath 20-35% StrongCHD and Stroke 20-35% StrongType 2 Diabetes 35-50% StrongColon Cancer 30-50% StrongBreast Cancer 20% StrongHip Fracture 36-68% ModerateDepression 20-30% StrongAlzheimer’s Disease 60% ModerateREF: Department of Health, StartActive Stay Active 2011© 2012 Intelligent Health/NHS London
  13. 13. Anti-ageing effect• Increases Reactive Oxidative Species (FreeRadicals)that stimulate the production ofantioxidants in the Mitochondria.• This is a powerful anti-ageing mechanismthat protects the cell from DNA damage.• In fact taking anti-oxidants orally interfereswith this mechanism.© 2012 Intelligent Health/NHS London• Increases Reactive Oxidative Species (FreeRadicals) that stimulate the production ofantioxidants in the Mitochondria.• This is a powerful anti-ageing mechanismthat protects the cell from DNA damage.• In fact taking anti-oxidants orally interfereswith this mechanism
  14. 14. Anti-ageing effect• Increases Reactive Oxidative Species (FreeRadicals)that stimulate the production ofantioxidants in the Mitochondria.• This is a powerful anti-ageing mechanismthat protects the cell from DNA damage.• In fact taking anti-oxidants orally interfereswith this mechanism.© 2012 Intelligent Health/NHS London• Increases Reactive Oxidative Species (FreeRadicals) that stimulate the production ofantioxidants in the Mitochondria.• This is a powerful anti-ageing mechanismthat protects the cell from DNA damage.• In fact taking anti-oxidants orally interfereswith this mechanism
  15. 15. SedentaryMitochondrial DNAReactive OxidativeSpeciesAnti-OxidantsMitochondriaOxidative Phosphorylation
  16. 16. Physically ActiveMitochondrial DNAReactive OxidativeSpeciesOxidative PhosphorylationAnti-oxidantsMitochondria
  17. 17. How Does Physical Activity Work?• All Conditions:– Anti-inflammatory.• Release Cytokines from muscle• Improves endothelial function– Enhances mitochondrial antioxidantproduction– lengthened telomeres• Cardiovascular:– Increases Stroke Volume– Reduces Blood Pressure– Improves Heamostatic function(reduced Fibrinogen etc)– Improves cholesterol ratio– Halts and can reverse plaque formation• Cancer– Reduces sex hormone formation– Increases Insulin sensitivity– Increases production of Natural KillerCells© 2012 Intelligent Health/NHS London
  18. 18. Health Benefits of Physical ActivityDisease Risk reduction Strength ofevidenceDeath 20-35% StrongCHD and Stroke 20-35% StrongType 2 Diabetes 35-50% StrongColon Cancer 30-50% StrongBreast Cancer 20% StrongHip Fracture 36-68% ModerateDepression 20-30% StrongAlzheimer’s Disease 60% ModerateREF: Department of Health, StartActive Stay Active 2011© 2012 Intelligent Health/NHS London
  19. 19. Anti-InflammatoryTwo possible mechanisms:• the reduction in visceral fat mass;– Visceral fat increases inflammatory agents andreduces anti-inflammatory ones creating apermanent state of Inflammation.• Increased production anti-inflammatorycytokines from contracting muscle.© 2012 Intelligent Health/NHS LondonTwo possible mechanisms:• the reduction in visceral fat mass;– Visceral fat increases inflammatory agents andreduces anti-inflammatory ones creating apermanent state of Inflammation.• Increased production anti-inflammatorycytokines from contracting muscle.
  20. 20. © 2012 Intelligent Health/NHS London
  21. 21. © 2012 Intelligent Health/NHS London
  22. 22. © 2012 Intelligent Health/NHS London
  23. 23. Muscles© 2012 Intelligent Health/NHS London
  24. 24. © 2012 Intelligent Health/NHS London
  25. 25. Natural Killer Cells© 2012 Intelligent Health/NHS London
  26. 26. Fitness and Fat© 2012 Intelligent Health/NHS London
  27. 27. Physical Activity and Weight Loss• To reduce or maintain weightloss between 120mins and250mins of moderate activityare required.• To achieve significant weightloss over 250 mins a week ofmoderate activity is required.American College of Sports Medicine PositionStand. Appropriate physical activity interventionstrategies for weight loss and prevention ofweight regain for adults. Medicine and Science inSports and Exercise [2009, 41(2):459-71© 2012 Intelligent Health/NHS London
  28. 28. Risk of cardiovascular disease mortality by cardiorespiratory fitness and body mass indexcategories, 2316 men with type 2 diabetes at baseline, 179 deaths.Blair S N Br J Sports Med 2009;43:1-2Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved. © 2012 Intelligent Health/NHS London
  29. 29. Risk of cardiovascular disease mortality by cardiorespiratory fitness and body mass indexcategories, 2316 men with type 2 diabetes at baseline, 179 deaths.Blair S N Br J Sports Med 2009;43:1-2Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.Normal Weight andUnfit Fat and Fit© 2012 Intelligent Health/NHS London
  30. 30. Cardiorespiratory Fitness and Body Mass Indexas Predictors of Cardiovascular Disease MortalityAmong Men With DiabetesTimothy S. Church, MD, MPH, PhD; Michael J. LaMonte, PhD; Carolyn E.Barlow, MS; Steven N. Blair, PED Arch Intern Med. 2005;165:2114-2120© 2012 Intelligent Health/NHS London179 CVD deaths during amean (SD) follow-up of 15.9(7.9) years and 36 710“manyears” of exposure.
  31. 31. Cumulative all-cause mortality associated with randomization to dietary weight loss in theTrial of Nonpharmacologic Intervention in the Elderly (TONE). 1Based on Cox proportionalhazards regression.Shea M K et al. Am J Clin Nutr 2011;94:839-846©2011 by American Society for Nutrition
  32. 32. CVD Mortality Risk Factors Modified byPhysical Activity
  33. 33. In Summary© 2012 Intelligent Health/NHS London
  34. 34. NEW WAY OF RECORDING ANDINCENTIVISING SPORT© 2012 Intelligent Health/NHS London
  35. 35. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking Competition
  36. 36. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking Competitionwww.beatthestreet.meThe Beat Boxes wereinstalled around theschool in threecircles. The BeatBoxes in the outercircle had threepoints, the middlecircle, two points andthe inner circle (theschool) one point.
  37. 37. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking CompetitionEach Child has anonline consul to seetheir progress
  38. 38. © Copyright 2012 Intelligent Health | Beat The StreetSCHOOL RANKINGS1st Laura Secord 58% Vancouver2nd Lord Kitchener 56% Vancouver3rd Zenchuan School 42% Shanghai4th Cleeve Park 35% London5th Reading Girls 34% Reading6th Lammas School 29% London6th George Mitchell 28% London7th Langley Park 27% London7th Highdown School 27% Reading10th Hugh Farringdon 18% Reading11th Bow School 17% London12th Bexleyheath Academy 12% London13th Ravensbourne School 7% London
  39. 39. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking Competition2012 London Reading Vancouver ShanghaiHealth MinisterCongratulates thewinning Beat the Streetchildren.Houses of ParliamentOctober 26th 2012
  40. 40. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking CompetitionLondon 2012 CanadianSilver MedallistAndrew Byrne supportsLaura Secord School
  41. 41. Most incentivising components
  42. 42. 2012 London Reading Vancouver ShanghaiThe Global SchoolWalking Competition• Sports providers holdNFC phones (e.g WestHam FC)• Children touch phonewith cards to registerattendanceGet Children into Sportafter Beat The Street
  43. 43. © 2012 Intelligent Health/NHS London
  44. 44. Mile End Park© 2012 Intelligent Health/NHS London
  45. 45. Thank youWilliam.bird@intelligenthealth.co.ukNow GetMoving

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