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Striking a Balance... Weigh in with Knowledge, Research,
Practice Symposium, Canadian Diabetes Association
Ottawa, Septemb...
No Conflicts of Interest to Declare
The Issue for today’s session
Sedentary living is real…
….but is it a Unique Public Health Problem?
Slide courtesy David Dunstan
Slide courtesy David Dunstan
Physical Activity

Sedentary
A Typical Canadian Day?

Slide courtesy David Dunstan
Accelerometer

‘Actigraph’
Physical Activity of Canadian Adults: Accelerometer Results
from the 2007-2009 Canadian Health Measures Survey
Colley et a...
Accelerometer Data for a Single Day

Moderate/vigorous-intensity Activity

Light-intensity Activity

Sedentary

Time of Da...
Accelerometer Data for a Single Day

Moderate/vigorous-intensity Activity

95% of waking hours

Light-intensity Activity

...
The Other 23 1/2 Hours in the Day –
Beyond Physical Activity
Two Questions:
Is Sedentary time associated with
health outco...
A 2-week reduction of ambulatory activity (walking) is associated with
a 17% reduction in Insulin sensitivity in 10 health...
Key Point
2-hr glucose (mmol/l)

Sedentary

LPA

Sedentary time (A) by accelerometers was
detrimentally associated with 2-...
Age-adjusted All-cause Mortality

Sitting time and Mortality from All Causes, Cardiovascular
Disease, and Cancer in 17,013...
Television Watching in Relation to Risk of Obesity
Association between TV watching,
and Type 2 Diabetes in Women

Obesity ...
Associations between TV time and Sitting time
With Metabolic Syndrome in 1,958 Older Adults
Gardiner PA., et al. JAGS 59:7...
Does Minimal Intensity Exercise Improve Insulin
Sensitivity in 18 Young (21 yr) Sedentary Subjects?
Duvivier et al. PLoS O...
Does minimal intensity exercise intensity lower
Insulin Sensitivity in Sedentary Subjects?

Duvivier et al. PLoS One 8(2):...
High levels of MVPA are
Associated with reduced Cardiometabolic in
Children Regardless of Sedentary Time.
Type of Sedentar...
Excess TV viewing: a special component
of sedentary time?
Moderate to Vigorous Physical Activity and Sedentary Time
and Cardiometabolic Risk factors in Children and Adolescents
Eke...
SUMMARY
Sedentary Lifestyle:
the Smoking of the 21st Century?
Prevalence

Hazard ratio*

Population
Attributable Risk

Global Deat...
150 minutes per week of
moderate (brisk walking) in
bouts of 10 minutes or more.
Cardiorespiratory Fitness

Increase physical activity = Increase in cardiorespiratory fitness

~20%

Before
~5 times - 30 ...
Effect of Fatness (BMI) and Fitness on
Cardiovascular Disease (CVD) Mortality

RR of CVD Mortality

Wei M et al. JAMA 1999...
Association of CRF and PA with Risk of
Developing Hypertension (HTN) in Men
HR

PA

High

Middle

Low

Sport

WJR

Sedenta...
Effect of Acute Exercise on Insulin Sensitivity in
Men and Women
Perseghin et al. N Eng J Med. 335: 1996.

Insulin Sensiti...
A Typical Canadian Day?

Slide courtesy David Dunstan
Excess TV viewing: a special component
of sedentary time?
www.csep.ca
How much Daily Recreational Screen Time?

2 Hours….or less!
The Issue of today’s lecture
Sedentarism is real…
….but is it a Unique Public Health Problem?
Increasing physical activity behavior in today’s
environment poses a challenge…
Importance of Self-Monitoring – Role for Pedometers
Accumulate 15-30 minutes per day
2000 extra steps / day

Goal: 10,000 ...
Is Exercise the same as Physical Activity?

Exercise is a subset of physical activity
Exercise = ‘structured’ or leisure t...
Walking, Walking Pace and Risk of CHD in Women
Lee et al. JAMA 285(11): 1447, 2001.

Relative Risk
Do Not Walk
Easy
< 3.2 ...
FREE GYM!
Thank You
Merci

rossr@queensu.ca
The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross
The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross
The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross
The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross
The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross
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The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross

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Presentation by Dr. Bob Ross at the Striking a Balance . . . Weigh in with Knowledge, Research, Practice - Symposium

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The Other 23 1/2 Hours in the Day - Beyond Physical Activity - Dr. Bob Ross

  1. 1. Striking a Balance... Weigh in with Knowledge, Research, Practice Symposium, Canadian Diabetes Association Ottawa, September 30th, 2013. The Other 23 1/2 Hours in the Day – Beyond Physical Activity Robert Ross PhD, FACSM, FAHA School of Kinesiology and Health Studies Medicine, Division of Endocrinology and Metabolism Queen’s University Kingston, Ontario, Canada
  2. 2. No Conflicts of Interest to Declare
  3. 3. The Issue for today’s session Sedentary living is real… ….but is it a Unique Public Health Problem?
  4. 4. Slide courtesy David Dunstan
  5. 5. Slide courtesy David Dunstan
  6. 6. Physical Activity Sedentary
  7. 7. A Typical Canadian Day? Slide courtesy David Dunstan
  8. 8. Accelerometer ‘Actigraph’
  9. 9. Physical Activity of Canadian Adults: Accelerometer Results from the 2007-2009 Canadian Health Measures Survey Colley et al Health Reports 22 (1) March 2011
  10. 10. Accelerometer Data for a Single Day Moderate/vigorous-intensity Activity Light-intensity Activity Sedentary Time of Day
  11. 11. Accelerometer Data for a Single Day Moderate/vigorous-intensity Activity 95% of waking hours Light-intensity Activity Sedentary Time of Day
  12. 12. The Other 23 1/2 Hours in the Day – Beyond Physical Activity Two Questions: Is Sedentary time associated with health outcomes? Is Sedentary time associated with health outcomes independent of physical activity?
  13. 13. A 2-week reduction of ambulatory activity (walking) is associated with a 17% reduction in Insulin sensitivity in 10 healthy young men. Krogh-Madsen et al J Appl Physiol 108: 1034-1040, 2010. Explored whether a decrease in daily steps from ~10,000 to 1,300 was associated with a decrease in insulin sensitivity in young men. 17%
  14. 14. Key Point 2-hr glucose (mmol/l) Sedentary LPA Sedentary time (A) by accelerometers was detrimentally associated with 2-hr glucose independent of moderate-to-vigorous-intensity activity. MVPA Healy et al. Diabetes Care
  15. 15. Age-adjusted All-cause Mortality Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer in 17,013 Canadians (18-90 yr) followed for an average of 12 yrs Katzmarzyck P., et al. Med Sci Sport Exerc 41:998,2009.
  16. 16. Television Watching in Relation to Risk of Obesity Association between TV watching, and Type 2 Diabetes in Women Obesity and Type 2 Diabetes in Women Independent of exercise watching TV was associated with significantly elevated risk of obesity and type 2 diabetes, whereas light to moderate activity was associated with substantially lower risk. Hu F. et al. JAMA 289:1785-1791, 2003.
  17. 17. Associations between TV time and Sitting time With Metabolic Syndrome in 1,958 Older Adults Gardiner PA., et al. JAGS 59:788-796, 2011. 3.00 h/d 2.00 h/d 1.14 h/d Take home Message? 1. Decrease sitting time 2. Increase physical activity time 6.65 h/d 3.43 h/d 4.99 h/d
  18. 18. Does Minimal Intensity Exercise Improve Insulin Sensitivity in 18 Young (21 yr) Sedentary Subjects? Duvivier et al. PLoS One 8(2): e55542, 2013. 6 hrs 14 hrs 13.5 hrs 8 hrs Duration of each condition = 4 days 30 min
  19. 19. Does minimal intensity exercise intensity lower Insulin Sensitivity in Sedentary Subjects? Duvivier et al. PLoS One 8(2): e55542, 2013.
  20. 20. High levels of MVPA are Associated with reduced Cardiometabolic in Children Regardless of Sedentary Time. Type of Sedentary time (eg screen time) may Be more important that overall Sedentary Time. Appl Physiol Nutr Metab 38: 477-483, 2013.
  21. 21. Excess TV viewing: a special component of sedentary time?
  22. 22. Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk factors in Children and Adolescents Ekelund U. et al. JAMA 307(7):704-712,2012 14 studies ; 20,871 ; 4-18 yr Higher MVPA time in children and adolescents is Associated with lower Cardiometabolic Risk Factors Regardless of Sedentary Time
  23. 23. SUMMARY
  24. 24. Sedentary Lifestyle: the Smoking of the 21st Century? Prevalence Hazard ratio* Population Attributable Risk Global Deaths per Year 5,3 million 5,1 million 35% 26% Smoking 8,7% 1,57 9,0 % 1,28 Inactivity Smoking Inactivity Smoking Inactivity Smoking Inactivity Comparison of global burden between smoking and physical inactivity (*from meta-analyses). Adapted from Wen CP, Wu X The Lancet 2012;380:192-3
  25. 25. 150 minutes per week of moderate (brisk walking) in bouts of 10 minutes or more.
  26. 26. Cardiorespiratory Fitness Increase physical activity = Increase in cardiorespiratory fitness ~20% Before ~5 times - 30 min/day 150 minutes /week After ~4 Weeks
  27. 27. Effect of Fatness (BMI) and Fitness on Cardiovascular Disease (CVD) Mortality RR of CVD Mortality Wei M et al. JAMA 1999; 282:1547-53 4.5 3 Fit Unfit 1.5 0 Normal Weight Overweight Obese “Fit” – top 80 percent – 30 minutes per day of physical activity
  28. 28. Association of CRF and PA with Risk of Developing Hypertension (HTN) in Men HR PA High Middle Low Sport WJR Sedentary WJR = walker/jogger/runner Sport = other activities (such as cycling, swimming, racquet and ball sports) CRF Chase et al. Am J Hypertension 2009; 22(4): 417
  29. 29. Effect of Acute Exercise on Insulin Sensitivity in Men and Women Perseghin et al. N Eng J Med. 335: 1996. Insulin Sensitivity (mg/kg, FFM) 18 * 14 20% 10 6 2 0 Baseline Acute ( 1 Day ) * Acute > Baseline
  30. 30. A Typical Canadian Day? Slide courtesy David Dunstan
  31. 31. Excess TV viewing: a special component of sedentary time?
  32. 32. www.csep.ca
  33. 33. How much Daily Recreational Screen Time? 2 Hours….or less!
  34. 34. The Issue of today’s lecture Sedentarism is real… ….but is it a Unique Public Health Problem?
  35. 35. Increasing physical activity behavior in today’s environment poses a challenge…
  36. 36. Importance of Self-Monitoring – Role for Pedometers Accumulate 15-30 minutes per day 2000 extra steps / day Goal: 10,000 steps / day
  37. 37. Is Exercise the same as Physical Activity? Exercise is a subset of physical activity Exercise = ‘structured’ or leisure time activity Physical activity = ‘unstructured’ leisure and non-leisure activity
  38. 38. Walking, Walking Pace and Risk of CHD in Women Lee et al. JAMA 285(11): 1447, 2001. Relative Risk Do Not Walk Easy < 3.2 km / hr 50% Reduction Normal 3.2 – 4.8 km / hr Brisk > 4.8 km / hr Total Walking Time Do Not Walk 1 to 59 min / wk 1.0 to 1.5 hr / wk > 2 hr / wk Walking Pace
  39. 39. FREE GYM!
  40. 40. Thank You Merci rossr@queensu.ca

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