Healthy Body, Healthy Mind John Spinks

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Healthy Body, Healthy Mind John Spinks

  1. 1. Healthy Body, Healthy Mind John Spinks & Ali McManus
  2. 2. Dr. McManus
  3. 4. EXERCISE
  4. 5. THE VALUE OF EXERCISE <ul><li>What do the general public see as the value of exercise? </li></ul><ul><li>What does the Surgeon-General think? </li></ul><ul><li>What do magazines and other sources say? </li></ul>
  5. 6. (from website: www.medinfosource.com/resource/fitnexer.html) Life Advice About Fitness and Exercise Today, there is a growing emphasis on looking good, feeling good and living longer. Increasingly, scientific evidence tells us that one of the keys to achieving these ideals is fitness and exercise. But if you spend your days at a sedentary job and pass your evenings as a &quot;couch potato,&quot; it may require some determination and commitment to make regular activity a part of your daily routine. Equal Opportunity Benefits Exercise is not just for Olympic hopefuls or supermodels. In fact, you're never too unfit, too young or too old to get started. Regardless of your age, gender or role in life, you can benefit from regular physical activity. If you're committed, exercise in combination with a sensible diet can help provide an overall sense of well-being and can even help prevent chronic illness, disability and premature death. Some of the benefits of increased activity are:
  6. 7. <ul><li>Improved Health </li></ul><ul><li>increased efficiency of heart and lungs </li></ul><ul><li>reduced cholesterol levels </li></ul><ul><li>increased muscle strength </li></ul><ul><li>reduced blood pressure </li></ul><ul><li>reduced risk of major illnesses such as diabetes and heart disease </li></ul><ul><li>weight loss </li></ul><ul><li>Improved Sense of Well-Being </li></ul><ul><li>more energy </li></ul><ul><li>less stress </li></ul><ul><li>improved quality of sleep </li></ul><ul><li>improved ability to cope with stress </li></ul><ul><li>increased mental acuity </li></ul><ul><li>Improved Appearance </li></ul><ul><li>weight loss </li></ul><ul><li>toned muscles </li></ul><ul><li>improved posture </li></ul><ul><li>Enhanced Social Life </li></ul><ul><li>improved self-image </li></ul><ul><li>increased opportunities to make new friends </li></ul><ul><li>increased opportunities to share an activity with friends or family members </li></ul><ul><li>Increased Stamina </li></ul><ul><li>increased productivity </li></ul><ul><li>increased physical capabilities </li></ul><ul><li>less frequent injuries </li></ul><ul><li>improved immunity to minor illnesses </li></ul>
  7. 8. Effects of exercise in other areas! Learning ability Aging Substance abuse Better sleep
  8. 9. Greenough…1 <ul><li>Group 1: free access to exercise </li></ul><ul><li>Group 2: treadmill one hour/day </li></ul><ul><li>Group 3: no exercise </li></ul><ul><li>After 30 days, gp1 and gp2 had substantial increase in capillary densities in cerebellum </li></ul>
  9. 10. Greenough…2 <ul><li>Both previous study and this one on rats! </li></ul><ul><li>Taught rats to run through obstacle maze </li></ul><ul><li>Increased number of connections between neurons in cerebellum </li></ul><ul><li>Learning not movement </li></ul>
  10. 11. Kramer, Nature, 1999 <ul><li>60-75 year olds </li></ul><ul><li>Inactive individuals </li></ul><ul><li>Test (psychological and physical) </li></ul><ul><li>Long walks three times a week for 6m. </li></ul><ul><li>5% - 7% increase in cardio-respiratory fitness </li></ul><ul><li>Up to 15% improvement in mental tests </li></ul><ul><li>Comparison group did stretching and toning exercises using weights </li></ul><ul><li>Therefore, it’s the TYPE of exercise you do </li></ul><ul><li>Argues that effects are due to increasing blood flow in the brain </li></ul>
  11. 12. Smoking cessation <ul><li>281 smokers, randomly divided into control and experimental groups… </li></ul><ul><li>E…12 sessions of smoking cessation + 3 exercise sessions + 3 health lectures/week </li></ul><ul><li>C…12 sessions of smoking cessation </li></ul><ul><li>E twice as likely to be successful in giving up, and staying off (12% after 60 weeks, cf 5% from C) </li></ul><ul><li>E quitters gained less weight than C quitters </li></ul><ul><li>May not be that strong (see other reviews) </li></ul>
  12. 13. Sleep better? <ul><li>Review of 722 subjects…”regular exercise is associated with a reduction in the prevalence and risk of symptoms of disturbed sleep” </li></ul><ul><li>If walked >6 blocks  33% drop in sleep disturbances </li></ul><ul><li>If walked briskly,  50% drop </li></ul><ul><li>If engaged in regular exercise at least once a week  37% </li></ul>
  13. 14. EXCEPT… <ul><li>Females exercising regularly and vigorously at weekends  50% increase in sleep disturbances </li></ul><ul><li>Why? </li></ul>
  14. 17. U.S. Surgeon General’s Report on Physical Activity and Health <ul><li>THE BENEFITS OF REGULAR PHYSICAL ACTIVITY: </li></ul><ul><li>Regular physical activity that is performed on most days of the week reduces the risk of developing or dying from some of the leading causes of illness and death in the United States. Regular physical activity improves health in the following ways: </li></ul><ul><li>Reduces the risk of dying prematurely. </li></ul><ul><li>Reduces the risk of dying from heart disease. </li></ul><ul><li>Reduces the risk of developing diabetes. </li></ul><ul><li>Reduces the risk of developing high blood pressure. </li></ul><ul><li>Helps reduce blood pressure in people who already have high blood pressure. </li></ul><ul><li>Reduces the risk of developing colon cancer. </li></ul><ul><li>Reduces feelings of depression and anxiety. </li></ul><ul><li>Helps control weight. </li></ul><ul><li>Helps build and maintain healthy bones, muscles, and joints. </li></ul><ul><li>Helps older adults become stronger and better able to move about without falling. </li></ul><ul><li>Promotes psychological well-being. </li></ul>
  15. 18. U.S. Surgeon General’s Report on Physical Activity and Health <ul><li>…… </li></ul><ul><li>Mental Health </li></ul><ul><li>Physical activity appears to relieve symptoms of depression and anxiety and improve mood. </li></ul><ul><li>Regular physical activity may reduce the risk of developing depression, although further research is required on this topic. </li></ul><ul><li>Health-Related Quality of Life </li></ul><ul><li>Physical activity appears to improve health-related quality of life by enhancing psychological well-being and by improving physical functioning in persons compromised by poor health. </li></ul><ul><li>…… </li></ul>
  16. 19. Recent headlines (BBC in the U.K.)
  17. 20. Recent headlines (BBC in the U.K.)
  18. 21. Recent headlines (BBC in the U.K.)
  19. 22. Recent headlines (BBC in the U.K.)
  20. 23. Recent headlines (BBC in the U.K.)
  21. 24. Recent headlines (BBC in the U.K.)
  22. 27. STRESS AND EXERCISE
  23. 31. Quiz on stress and sport… <ul><li>Under high levels of stress, athletes typically have a broad attention span. </li></ul><ul><li>T or F? </li></ul>
  24. 32. <ul><li>The clammy feeling we often get when stressed is caused by our body’s natural defence against bleeding to death </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  25. 33. <ul><li>Elite level performers have fewer nervous reactions to stress than do non-elite level performers. </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  26. 34. <ul><li>High levels of stress make it more difficult to think more clearly. </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  27. 35. <ul><li>Caffeine exaggerates the physical and mental effects of stress. </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  28. 36. <ul><li>The only time stress is good is when there is no stress. </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  29. 37. <ul><li>Sighing when you exhale is more relaxing than not sighing. </li></ul><ul><li>T or F? </li></ul>Quiz on stress and sport…
  30. 38. Stress in Hong Kong <ul><li>Newspaper articles </li></ul><ul><li>How many people in HK suffer from anxiety or stress reactions? </li></ul><ul><li>Estimates are: over 1 million. </li></ul><ul><li>How about HKU students? </li></ul>
  31. 39. Stress <ul><li>The concept of stress </li></ul><ul><ul><li>Distress and eustress </li></ul></ul><ul><li>Approaches to the study of stress </li></ul><ul><ul><li>Stimulus-based approaches </li></ul></ul><ul><ul><li>Response-based approaches </li></ul></ul><ul><ul><li>Other approaches (coping, appraisal) </li></ul></ul>
  32. 40. Stimulus-based approaches <ul><li>Life change events </li></ul><ul><li>Hassles </li></ul><ul><li>Duration </li></ul>
  33. 41. Response-based approaches <ul><li>Selye’s views </li></ul><ul><li>Short-term </li></ul><ul><li>Long-term </li></ul><ul><li>Health </li></ul><ul><li>Type A/B </li></ul>
  34. 44. Type A/Type B <ul><li>Many factors case heart disease, but cannot predict 100% </li></ul><ul><li>1974 Rosenman and Friedman </li></ul><ul><li>Type A characteristics </li></ul><ul><li>Type B characteristics </li></ul><ul><li>Test yourself </li></ul>
  35. 45. Effects of Type A/B <ul><li>50-59 year olds Type As have 1.9 times the risk of heart attack cf Type Bs. </li></ul><ul><li>39-49 year olds Type As have 6.5 times the risk of heart attack cf Type Bs. </li></ul><ul><li>These differences not due to cigarettes, age or heriditary factors </li></ul><ul><li>Recent reviews not so clear </li></ul>
  36. 47. Gender differences <ul><li>Male and female Type Bs lowest risk </li></ul><ul><li>Female Type As higher </li></ul><ul><li>Male Type As highest </li></ul>
  37. 48. Response-based approaches <ul><li>Biochemical and endocrinological (e.g. increased nor-adrenaline) </li></ul><ul><li>Physiological (e.g. muscle tension) </li></ul><ul><li>Autonomic (e.g. high blood pressure) </li></ul><ul><li>Immunological (e.g. NKCA) </li></ul><ul><li>Emotional (e.g. annxiety) </li></ul><ul><li>Cognitive (e.g. challenge) </li></ul><ul><li>Behavioural (e.g. run away) </li></ul><ul><li>Social (e.g. isolate) </li></ul><ul><li>Disease (e.g. ulcers, psychosomatics) </li></ul>
  38. 49. Stress situations <ul><li>Work-related stress </li></ul><ul><li>Examination stress (test anxiety) </li></ul><ul><li>Post-traumatic stress disorder ( video ) </li></ul>
  39. 50. See also video (The Mind #37)
  40. 51. Current views <ul><li>Not just stimuli (stressful events) </li></ul><ul><li>It is the personal appraisal of these events </li></ul><ul><li>Reference to self-evaluation of coping ability (past experience) </li></ul><ul><li>And to support systems </li></ul>
  41. 52. Perceived stress Stressful events Background characteristics of individual Stress hormones Health Immune system Mediators: Supports Self-concept Coping ANS activity A biopsychosocial stress model
  42. 53. Exercise and stress <ul><li>Lowers risk of heart attacks (Paffenbarger’s Harvard alumni studies) </li></ul><ul><li>Continues to decrease risk, up to 20 miles/day </li></ul><ul><li>Has to be aerobic (sustained, increased O 2 consumption),  heart pumps more per beat  lower heart rate </li></ul><ul><li>Stress  HR increase </li></ul><ul><li>Cardiovascular conditioning may counteract its effects </li></ul>
  43. 54. Exercise and stress <ul><li>In other words, low levels of exercise  HR increase after exercise or after stress  anxiety  high levels of noradrenaline  more anxiety (vicious cycle)  less exercise (another vicious cycle)… </li></ul><ul><li>Aerobic exercise, on the other hand  low levels of HR increase after exercise or after stress  no heightened anxiety  less perceived stress </li></ul>
  44. 55. Kathleen Light (1999) <ul><li>Men with history of hypertension </li></ul><ul><li>Cardiovascular responsivity to stress predicts risk of hypertension 10 years later </li></ul><ul><li>(Three times greater risk if very responsive) </li></ul>
  45. 56. <ul><li>Effects of exercise on anxiety, moods, tension and depression more pronounced in subjects who are more stressed or physically unfit before study </li></ul>
  46. 57. If you’ve had a heart attack, should you exercise? <ul><li>Experimental group…year long rehabilitation including exercise 3 times per week (Dugmore et al, 1999, UK, 124 pts over 5 years) </li></ul><ul><li>Cardiovascular differences (E-C) shown </li></ul><ul><li>Less depression </li></ul><ul><li>Less anxiety </li></ul><ul><li>Required less drugs </li></ul><ul><li>Less likely to visit doctor </li></ul><ul><li>Returned to work earlier </li></ul><ul><li>More likely to return to work full-time </li></ul>
  47. 58. Cholesterol <ul><li>Stress  arousal  Increase in catecholamines  increase in plasma lipid levels </li></ul><ul><li>Work-related stressors more clearly associated with cholesterol </li></ul><ul><li>Modifying variables, such as diet, smoking and activity levels, appear to be important determinants of cholesterol levels </li></ul><ul><li>How about in adolescents? </li></ul>
  48. 59. Coleman, Friedman & Burright <ul><li>119 NY high school students (14-17) </li></ul><ul><li>Multiple regression… </li></ul><ul><ul><li>Family history | Combined, predicted </li></ul></ul><ul><ul><li>Dietary fat | 4% of variance of </li></ul></ul><ul><ul><li>Age | cholesterol levels </li></ul></ul><ul><ul><li>Daily life events 4% </li></ul></ul><ul><ul><li>Physical activity 3% </li></ul></ul><ul><ul><li>Season 10% </li></ul></ul><ul><ul><li>Sedentary behaviour n.s. </li></ul></ul><ul><ul><li>OVERALL 21% </li></ul></ul>
  49. 60. <ul><li>For females, daily life events  7% </li></ul><ul><li>For males, n.s. </li></ul><ul><li>For major life events, n.s. </li></ul><ul><li>For family life events, n.s. </li></ul>
  50. 61. SO? Does exercise exert its effects on stress through… <ul><li>Feel good factor? </li></ul><ul><li>Endorphin hypothesis? (little evidence) </li></ul><ul><li>Social support? </li></ul><ul><li>Distraction hypothesis? </li></ul><ul><li>Cardiovascular conditioning? </li></ul>
  51. 62. Illness No exercise Exercise High stress Low stress
  52. 63. How about other relationships? <ul><li>Bramwell et al ’75 </li></ul><ul><ul><li>LEs correlated with sports injuries! </li></ul></ul><ul><ul><li>Low LCUs  30% injury rate (U.S. football) </li></ul></ul><ul><ul><li>Med LCUs  50% </li></ul></ul><ul><ul><li>High LCUs  73% </li></ul></ul><ul><ul><li>Why? </li></ul></ul>
  53. 64. Why? <ul><li>Lack of vigilance? </li></ul><ul><li>Attentional focussing? </li></ul><ul><li>Increase in muscle tension? </li></ul>
  54. 65. Smith et al ‘90 <ul><li>Increases in stress only predicted injuries in those athletes who had low social support </li></ul><ul><li>(= coping/mediational factor; LCUs doesn’t look at this) </li></ul>
  55. 66. Physical Exercise Physical well-being Absolute health Direct effect Psychological well-being Social well-being Direct effect Direct effect Indirect effect Indirect effect Indirect effect Altered ??  Cardiorespiratory fitness  Altered body morphology Strength & muscle tone  Co-ordination & skill  Morbidity/mortality <ul><li>Social support </li></ul><ul><li>Opportunity for social integration </li></ul><ul><li>Positive evaluation of self by others </li></ul><ul><li>Cognition </li></ul><ul><li>Adaptive motivational orientation </li></ul><ul><li>Adaptive attributional style </li></ul><ul><li>Self esteem </li></ul><ul><li> Internal LOC </li></ul><ul><li>Affect </li></ul><ul><li>Mood stability </li></ul><ul><li>Depression </li></ul><ul><li> Anxiety </li></ul>From Schomer & Drake (2001)
  56. 67. Some websites for stress http://www.bbc.co.uk/health/mens/stress.shtml http://www.bbc.co.uk/health/mental/coping.shtml

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