1. The Built Environment
Dr Mike Loosemore
Consultant Sport and exercise Medicine. ISEH. UCLH.
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
2. Health benefits of physical activity
Regular physical activity at the correct intensity:
•Reduces the risk of heart disease by 40%
•Lowers the risk of stroke by 27%
•Reduces the incidence of diabetes by almost 50%
•Reduces the incidence of high blood pressure, by almost 50%
•Can reduce mortality and the risk of recurrent breast cancer by almost 50%
•Can lower the risk of colon cancer by over 60%
•Can reduce the risk of developing of Alzheimer’s disease by one-third
•Can decrease depression as effectively as Prozac or behavioural therapy
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
3. A frightening effect
Obesity
Smoker
Hyper-
tension
High Cholesterol
Diabetes
Low Fitness
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
4. The perils of inactivity
Active Movement
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
5. Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
6.
7.
8. Inactivity
Effect of physical inactivity on major non-communicable
diseases worldwide: an analysis of
burden of disease and life expectancy
The Lancet, Volume 380, Issue 9838, Pages 219 - 229, 21 July 2012
doi:10.1016/S0140-6736(12)61031-9
I-Min Lee Eric J Shiroma Felipe Lobelo Pekka Puska Steven N Blair Peter T Katzmarzyk, for the
Lancet Physical Activity Series Working Group†
Faculty of Sport and Exercise Medicine UK
Health through Sport and Exercise
9. Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
12. Are we less physically active?
•Compared to 1980:
–the UK now travels 25% less on foot and by bicycle
–watches twice as much television
–half as many young people play extra-curricular sport
–half as many work in physically active employment
–daily life also involves a range of labour saving devices, including washing machines, dishwashers, lifts, car-washes and ride-on lawnmowers.
Foresight Obesity Report, 2007
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
13. Trends in manual & non-manual occupations among
E nglish adults . The Health S urvey for E ngland
35
45
55
65
1 991 1 993 1 994 1 997 1 998 1 999 2003 2004
Per cent
Manual Jobs Non-Manual Jobs
Faculty of Sport and Exercise Medicine UK
Health through Sport and Exercise
14. Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
15. The genetic paradox
Endurance v Energy conservation
Active Movement
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
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22. Non-Vigorous PA and Mortality Risk
All Cause Mortality Relative Risk
Non-Vigorous Physical Activity, MET-Hrs/week
Woodcock Int J Epi; 2010
2.5 hours/wk decreased mortality by 19%
7 hours/wk decreased mortality by 24%
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
23. Breaking the Geriatric Curve
NEJM, April 1998
Age
High-Risk Lifestyle (inactivity, smoking, obesity)
‘Deficient
Survival’
Our ultimate goal
Active Movement
Low-Risk Lifestyle (active, non-smoker)
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
24. Br J Sports Med2012;46:709-712 doi:10.1136/bjsm.2012.091485
Review
NON COMMUNICABLE DISEASE PREVENTION
Investments that Work for Physical Activity
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
25. 1.‘Whole-of-school’ programs
2. Active Transport
3. Urban Design
4. Integration into Primary Care
5. Public education
6.Whole-of- community
7.Sport for all
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
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3. Urban Design
31. Effect of increasing active travel in urban England and Wales on costs to the National Health Service
•James Jarrett, James Woodcock, Ulla K Griffi ths, Zaid Chalabi, Phil Edwards, Ian Roberts, Andy Haines
•Lancet 2012; 379: 2198–205
Within 20 years, reductions in the prevalences of type 2 diabetes, dementia, ischaemic heart disease, cerebrovascular disease, and cancer because of increased physical activity would lead to savings of roughly UK£17 billion (in 2010 prices)
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
32. 4. Integration into Primary Care
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
33. 5. Public education
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
35. 7. Sport for all
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
36. 7. Sport for all
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
37. Inactivity
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
38. Inactivity
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
39. Conclusion
• Physical inactivity is the major risk factor for morbidity and mortality.
–There is a linear relationship between physical activity and health status.
–Changing the Built Environment is crucial.
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
40. Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise
41. Thank You
@doctorloosemore
Mikmike.loosemore@eis2win.co.uk
mike@activemovement.co.uk
Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise