Eat Right… <br />Feel Right<br />Exercise??<br />Mark Stoutenberg, Ph.D.Research Assistant Professor<br />Department of Ep...
What if there was <br />one prescription <br />that could <br />prevent and treat<br />dozens of diseases, <br />such as d...
We know adequate amounts of Physical Activity:<br />Reduces blood pressure<br />Reduces cholesterol<br />Reduces risk of d...
Evolutionary Paradox<br />We won the war on against physical work <br />but are losing to disease!!<br />  As evolution in...
Brain size increased
Increased ability to rationalize and solve-problems
Led to tool development, industrialization and, ultimately </li></ul>Physical <br />Inactivity!<br />
Energy Balance<br />
Thermic Effect of Exercise<br />Jeukendrup and Gleeson. Sport Nutrition: An Introduction to Energy Production and Performa...
Daily Energy Balance<br />Jeukendrup and Gleeson. Sport Nutrition: An Introduction to Energy Production and Performance, 1...
What is Physical Activity? <br />Physical Activity (PA) <br /> 	- any movement of the body that results                   ...
Physical Activity<br />Occupational & Lifestyle PA<br />Leisure-Time Physical Activity<br />Physical Transportation<br />E...
Who is the Most Active?<br />A person who moves around all day but does not do any formal exercise<br />A person who has a...
PA Intensity<br /><ul><li>Low Intensity  (MET < 3.0)
Does not substantially raise heart rate
Light daily activities that include:
Shopping
Cooking
Doing the laundry
Moderate Intensity  (MET = 3.0 – 6.0)
Raises heart rate and hard enough that it causes break a sweat
Examples include:
Brisk walking
Water aerobics
Bike riding
Pushing a lawn mower
Raking leaves</li></li></ul><li>PA Intensity<br /><ul><li>Vigorous Intensity  (MET > 6.0)
Results in a hard, fast breathing rate and an elevated HR
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Staying Active - Dr. Stoutenberg

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Dr. Mark Stoutenberg of University of Miami Health System discussed the importance of physical activity and exercise at the 2011 WellBeingWell Conference.

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  • Performance = Speed, Power, Balance, Agility, SpeedHealth = Cardiovascular Fitness, Flexibility, Body Composition, Muscular Strength, Muscular Endurance
  • HINTS: developed by NCI to describe cancer-related knowledge, beliefs, attitudes and behaviors
  • Exercise is slower than SSRI’s
  • Staying Active - Dr. Stoutenberg

    1. 1. Eat Right… <br />Feel Right<br />Exercise??<br />Mark Stoutenberg, Ph.D.Research Assistant Professor<br />Department of Epidemiology & Public Health<br />University of Miami Miller School of Medicine<br />
    2. 2. What if there was <br />one prescription <br />that could <br />prevent and treat<br />dozens of diseases, <br />such as diabetes, hypertension <br />and obesity? <br />THE MAGIC PILL?<br />
    3. 3. We know adequate amounts of Physical Activity:<br />Reduces blood pressure<br />Reduces cholesterol<br />Reduces risk of diabetes<br />Reduces risk of cancer<br />Reduces excess body fat<br />Reduces risk of osteoporosis<br />Reduces risk of heart attack<br />Reduces anxiety<br />Reduces depression<br />Improves memory<br />Improves functional abilities<br />
    4. 4. Evolutionary Paradox<br />We won the war on against physical work <br />but are losing to disease!!<br /> As evolution increased our ability to:<br /><ul><li>Move and think improved
    5. 5. Brain size increased
    6. 6. Increased ability to rationalize and solve-problems
    7. 7. Led to tool development, industrialization and, ultimately </li></ul>Physical <br />Inactivity!<br />
    8. 8. Energy Balance<br />
    9. 9. Thermic Effect of Exercise<br />Jeukendrup and Gleeson. Sport Nutrition: An Introduction to Energy Production and Performance, 1st Edition.<br />
    10. 10. Daily Energy Balance<br />Jeukendrup and Gleeson. Sport Nutrition: An Introduction to Energy Production and Performance, 1st Edition.<br />
    11. 11. What is Physical Activity? <br />Physical Activity (PA) <br /> - any movement of the body that results in energy expenditure<br />Physical Activity<br />Exercise<br />
    12. 12. Physical Activity<br />Occupational & Lifestyle PA<br />Leisure-Time Physical Activity<br />Physical Transportation<br />Exercise<br />Sport<br />Fitness<br />Health-Related Fitness<br />Performance-Related Fitness<br />
    13. 13. Who is the Most Active?<br />A person who moves around all day but does not do any formal exercise<br />A person who has a desk job and goes to the gym for 1 hour each night<br />
    14. 14. PA Intensity<br /><ul><li>Low Intensity (MET < 3.0)
    15. 15. Does not substantially raise heart rate
    16. 16. Light daily activities that include:
    17. 17. Shopping
    18. 18. Cooking
    19. 19. Doing the laundry
    20. 20. Moderate Intensity (MET = 3.0 – 6.0)
    21. 21. Raises heart rate and hard enough that it causes break a sweat
    22. 22. Examples include:
    23. 23. Brisk walking
    24. 24. Water aerobics
    25. 25. Bike riding
    26. 26. Pushing a lawn mower
    27. 27. Raking leaves</li></li></ul><li>PA Intensity<br /><ul><li>Vigorous Intensity (MET > 6.0)
    28. 28. Results in a hard, fast breathing rate and an elevated HR
    29. 29. Examples:
    30. 30. Jogging or running
    31. 31. Swimming laps
    32. 32. Riding a bike fast or on hills
    33. 33. Playing singles tennis or basketball</li></li></ul><li>Health Benefits of Exercise<br />
    34. 34. Lifetime PA & Breast Cancer<br />Nurses’ Health Study II (2008)<br />64,777 eligible women <br />Length of follow-up = 6 years<br />550 cases of BCa in premenopausal women<br />Total lifetime PA associated with 25% decrease in risk in BCa<br />Higher levels of leisure-time PA during ages 12–22 were extremely important<br />Regardless of PA levels during later years in life<br />Maruti, S.S., et. al. J Natl Cancer Inst. 2008; 100: 728-737.<br />
    35. 35. PA & Cancer Survival<br /><ul><li>Women who decreased their PA levels are at an approximately 4-fold increased risk of death
    36. 36. Pre- to post-diagnosis</li></ul>Irwin, M.L., et. al. J Clin Oncol. 2008; 26: 3958-3964. <br />
    37. 37. Cancer Prevention Strategies<br /><ul><li>Health Information National Trends Survey (HINTS)
    38. 38. Asked respondents, “Can you think of anything people can do to reduce their chances of getting cancer?”
    39. 39. Of the 5,586 respondents, only 25.1% cited exercise as a cancer prevention strategy
    40. 40. Those who cited exercise as a prevention strategy were more likely (65.6%) to report exercising at least once a week</li></ul>Hawkins, N.A., et. al. Health Educ Behav. 2010; 37(4): 490-503.<br />
    41. 41. Exercise & Neurogenesis<br />Exercise may prevent depression related to aging and decreasing levels of neurogenesis<br />Neurogenesis results in higher cognitive function<br />Rats that run 3-8km per night show 2-3 times greater neurogenesis (Fabel et al., 2008)<br />Increase in number & enhanced maturation of newly developing neurons (van Praag et al., 2008)<br />
    42. 42. Exercise & Depression<br />Exercise reduces depressive(Rethorst et al., 2008) and anxiety symptoms (Wipfli et al., 2009)<br />Suggestions that exercise may be equally effective in treating depression as psychotherapy(Klein at al., 1985) and anti-depressant medication(Babyak et al., 2000; Blumenthal et al., 2007)<br />Exercise has been shown to be successful both as a monotherapy and in addition to other treatments<br />Decreased interaction effect with other treatments<br />
    43. 43. Brain Reward Pathway<br /><ul><li>Middle of the brain  “Reward Pathway”
    44. 44. Based on the neurotransmitter called dopamine
    45. 45. Continued surges of dopamine causes the brain to:
    46. 46. Produce less dopamine - or -
    47. 47. Reduce the number of dopamine receptors that receive signals
    48. 48. The ability to experience any pleasure is reduced
    49. 49. More drug is needed to try and bring their dopamine function back up to normal</li></li></ul><li>Exercise “High”<br />Exercise increases plasma dopamine (Van Loon et al., 1979)<br />Chronic wheel running prevents decreases in affinity of dopamine receptors in aging mice (McRae et al., 1987)<br />Dopamine turnover is increased following acute bout of exercise (Hattori et al., 1994)<br />
    50. 50. Exercise & Drug Abuse<br />STimulant Reduction Intervention using Dosed Exercise <br /><ul><li>Addition of exercise to residential drug treatment programs
    51. 51. Cocaine & Methamphetamine abusers
    52. 52. Vigorous intensity walking on a treadmill 3x a week
    53. 53. To compare the difference in % days abstinence between an exercise interventionon stimulant use</li></li></ul><li>Exploratory Goal of STRIDE<br />Individuals who suffer from addiction often have one or more accompanying medical issues including:<br />Lung disease <br />CVD / Stroke <br />Cancer<br />To determine if there are additional healthbenefits to using exercise augmentation inthe treatment of substance use disorders<br />
    54. 54. Your “Exercise” Prescription<br />
    55. 55. Determinants;<br />Risk & Protective <br />Factors<br />Disease Processes<br />Genetic<br />Diabetes<br />Biological <br />(e.g., food & brain, <br />reward system)<br />CVD<br />Physical Activity<br />Positive/<br />Negative<br />Energy <br />Balance<br />Psychological <br />(e.g., stress, depression)<br />Obesity & Undernutrition<br />Cancer<br />Social<br />Ecological / Environmental <br />(e.g., built environment)<br />Infectious Disease<br />Metabolic Syndrome<br />Diet<br />Economic<br />Cultural<br />Policies<br />Disease Processes<br />Determinants;<br />Risk & Protective <br />Factors<br />
    56. 56. Current Recommendations? <br /><ul><li>Moderately intense cardio 30 minutes a day, 5 days a week; </li></ul>Or<br /><ul><li>Vigorously intense cardio 20 minutes a day, 3 days a week; </li></ul>And<br /><ul><li>Do 8 - 10 strength-training exercises, 8 - 12 repetitions of each exercise 2x / week.</li></ul>2008 Physical Activity Guidelines for Americans<br />
    57. 57. Lifestyle Modifications<br />Convenient, less intimidating, less structured <br />Increase likelihood of remaining active over a longer duration<br />Integrating activities into daily life<br />No set patterns of activity or training or dose of exercise<br />Use of behavior modification strategies include:<br />Self-monitoring<br />Problem-solving<br />Self-management<br />Stimulus control<br />
    58. 58. Project Active<br /><ul><li>Lifestyle PA program vs. a structured, gym-based program (24 month program & study)
    59. 59. Primary goal was to increase daily PA
    60. 60. Lifestyle PA:
    61. 61. Significant reduction in BP
    62. 62. Improvement in cardiorespiratory fitness
    63. 63. Reduction in BF%
    64. 64. Changes were maintained over 24 months!
    65. 65. Now called the “Active Living Every Day” program </li></ul>Dunn AL et al. Comparison of Lifestyle and Structured Interventions to Increase Physical Activity and Cardiorespiratory Fitness. JAMA. 1999, 281(4).<br />

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