This lecture proposes to integrate the Olympic ideas plus our knowledge of the science of physical activity and health Supercourse: www.pitt.edu/~super1/ Prepared by Dr. Soni Dodani
The Olympic Games are associated with the development of a country, it will give Beijing a chance to show that its wealth is not only its past, but that it has a creative, modern profile as well.
A pattern of physical activity is regular if activities are performed most days of the week, preferably daily,5 or more days of the week if moderate-intensity activities are chosen or 3 or more days of the week if vigorous-intensity activities are chosen.
The Spectrum of Activity ranges from those with several impaired activity of the disabled, which often represents 20% of a countries population. This ranged upward to sedentary white color workers. The physical fitness branch include those whose fitness is increased due to activity, but also those whose fitness is primarily the result of genetics. There are also many very physically active individuals who are not fit, for example, postal carriers, waitresses, or even mothers with young children. When we are examining physical activity and health, we need to evaluate the physical activity spectrum.
It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness—cardio Exercise causes respiratory fitness, muscular strength, muscular endurance, flexibility, and body composition
The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis.
Despite the proven benefits of physical activity, more than 50% of American adults do not get enough physical activity to provide health benefits. 25% of adults are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education. Furthermore, there are racial and ethnic differences in physical activity rates, particularly among women
Blair SN: Cin J Sport Med. 2003 Sep;13(5):319-320 According to a study conducted by Steve Blair of Cooper Institute, Texas, Hazard ratios were higher for cardiovascular mortality (1.39 [P > 0.10], 1.53 [P < 0.05], 1.95 [P < 0.05] for the categories). Similar hazard ratios for the same comparisons were found for men for all-cause mortality (hazard ratios, 1.25, 1.44, and 1.49 [P < 0.05 for each]) and cardiovascular mortality (hazard ratios, 1.39 [P < 0.06], 1.55 [P < 0.06], 1.67 [P < 0.05]). Physical activity did not predict mortality.
Blair SN: Cin J Sport Med. 2003 Sep;13(5):319-320 Fatness and lack of fitness are associated with all-cause and cardiovascular mortality. Compared with fit/not fat women, adjusted Cox proportional hazard ratios for all-cause mortality are higher for fit/fat (1.32 [P < 0.05]), unfit/not fat (1.30 [P < 0.05]), and unfit/fat women (1.57 [P < 0.05]).
Dempsey T J Okla State Med Assoc. 2004 Mar;97(3):119-21 One of the major reasons is the lack of physical activity due to time spent watching television or using computers. This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others. Physicians can help reduce this trend.
The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis. (CDC Report 1997)
A sedentary lifestyle is detrimental to health. Many of the leading causes of disease and disability in our society, such as Coronary Heart Disease (CHD), strokes, obesity, type II diabetes, hypertension, colorectal cancer, stress, anxiety, osteoarthritis, osteoporosis and low back pain, are associated with physical inactivity. 1
The good news about regular physical activity is that everyone can benefit from it (USDHHS, 1996).
FACT : CVD is the number one killer of Americans. Over one million will suffer a heart attack this year; 30% will not survive the acute episode, and 10% more will die during the following year. About 500,000 will suffer a stroke , 40% will be left with a significant disability, and 30% will die within the following year.
Colon Cancer : Physical activity speeds movement of food through the gastrointestinal tract, reducing the risk of colon cancer For e.g. Breast Cancer : High levels of circulating estrogens influence the development of cancers of the female reproductive system; exercise reduces levels of circulating estrogen, thus reducing risk.
Increase insulin sensitivity Exercise has been shown to increase the ability of the body to use insulin, which improves how the body uses sugar Control blood glucose Exercise removes come glucose directly from the blood to use for energy during and after activity Control Weight/Lower body fat 4 out of 5 people with diabetes are overweight Studies show that when diabetics lose weight, their condition improves Reduce risk of cardiovascular disease People with diabetes are at increased risk for CVD
18 million people suffer from depression each year in the US. (CDC report 1997). Everyone under stress, including persons experiencing anxiety or depression can benefit. Regular physical activity improves one's mood, helps relieve depression, and increases feelings of well-being.
Studies show that physically fit older people react to normal challenges as quickly as unfit people who are 30 years younger A report of Surgeon general, Physical Activity and health, 1996
Opportunities for people to be physically active exist in four major domains of one’s day-to-day life: At work, for example if a job involves manual labour; For transport, for example walking or cycling to school, work or to the shops; In domestic duties at home, for example housework, gardening or do-it-yourself; In leisure time, for example, in sports, exercise or recreational activities. Despite the numerous opportunities for people to be physically active the majority of the population in the UK do very little or no physical activity in any of these domains. 1
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Examples Health goals I want to lower my blood pressure I want to feel good about my weight and health Fitness goals I want to run in a road race
To improve physical fitness, the body must be challenged by loads greater than normal. For example, when muscles are stressed by a greater load than they are used to, they adapt and their function improves. This principle applies to aerobic activity, strength training, and flexibility
the efficiency of our lungs, heart, and vessels in delivering oxygen to our body tissues Oxygen sustains us…. It is the fuel for metabolic reactions Efficient delivery of oxygen allows our muscles, brain, and other tissues to work their best; aerobic exercise promotes this!
Hiking/skiing is also included in Outdoor activities
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Benefits of increased lean body mass (muscle) Greater ease in performing daily activities Reduce body fat: muscle burns more calories at rest than fat Prevent injuries Prevent and treat lower back pain
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Safety Warm-up your muscles first Know proper use of machines, and use correct form Do not exercise alone when using weights (spotter) Don’t “over train”; know your limits, and increase intensity gradually Breathing Don’t hold your breath! E xhale with E xertion Perform shortening and lengthening phases of each exercise Balance your muscle use Strengthen opposing muscle groups Use both sides of your body for each exercise
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Stretching Regimen Warm-up Move into stretch gently, until you feel tension but NO PAIN Hold pose for 10-30 seconds and BREATHE Move out of stretch gently
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Aerobic : 20-60 minutes of continuous aerobic activity. Note: moderate levels throughout the day have been shown to have significant health benefits Strength : 1-3 sets of 8-12 repetitions, involving 8-10 exercises that condition the major muscle groups Stretching : Stretch all muscle groups and hold positions for 10-30 seconds Intensity Fitness benefits occur when we exercise harder than our normal level of activity. In aerobic activity, the heart rate should rise above normal, and to develop muscular strength a person must lift a heavier weight than normal Two methods to monitor intensity Target Heart Rate: measures in beats/minute (220-age) Rate of perceived exertion: use this scale to “describe” and gauge your effort when exercising; rate how you feel on a scale of 1-10 where 0 is sitting quietly on a bench and walking at a moderate pace would be a 3/
Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt If your symptoms are all above your neck and do not include fever or swollen lymph nodes, light exercise is usually done.
A report of Surgeon General, Physical Activity and health, 1996 The International Paralympics Committee (IPC) is the international representative organization of elite sports for athletes with disabilities. IPC organizes, supervises and co-ordinates the Paralympics Games and other multi-disability competitions on elite sports level, of which the most important are world and regional championships. It is an international non-profit organization formed and run by around 160 National Paralympics Committees and 4 disability specific international sports federations.
A report of Surgeon General, Physical Activity and health, 1996 Ensure that people with disabilities are involved at all stages of planning and implementing community physical activity programs.
Hallal PC Med Sci Sports Exerc. 2003 Nov;35(11):1894-900 Social environments such as school, work, family and friends can significantly influence an individual's level of physical activity. However, characteristics of our communities such as the accessibility and location of parks, trails, sidewalks, and recreational centers as well as street design, density of housing, and availability of public transit may play and even greater role in promoting or discouraging an individual or family's level of physical activity. There are also significant environmental barriers from water and air pollution to crime and dangerous automobile traffic. CDC 1997
Active Community Environments Initiative project to promote and support the awareness and development of places where people of all ages and abilities can easily enjoy walking, bicycling, and other forms of recreation. There are many opportunities within our environment in developing countries for women that support physical activities. What is required is awareness and will to do. Even malls provide opportunities for fitness walking. Understanding environmental opportunities and barriers that we face in our pursuit for a healthy lifestyle may provide some of the knowledge necessary to promote healthy living.
Davis EK J Okla State Med Assoc. 2004 Jan;97(1):18-21 Although physical activity has numerous health benefits, there are potential adverse effects associated with being physically active, ranging from those that cause minor inconvenience to those that are life threatening. Most musculoskeletal injuries related to physical activity are likely to be preventable by gradually working up to a desired level of activity and by avoiding excessive amount of activity. Although there is no evidence that physical activity itself causes osteoarthritis, injuries sustained during competitive sports have been shown to increase the risk of developing osteoarthritis. Although serious cardiac events can occur with physical exertion, the overall benefit of regular physical activity is lower all-cause mortality.
Davis EK J Okla State Med Assoc. 2004 Jan;97(1):18-21
Physical Activtiy and Heath
Physical Activity & Health This lecture has been dedicated to Olympics games in Beijing, China Aug 08-24, 2008 By Supercourse Team
Physical Activity & HealthLecture Developers (Supercourse Team)Soni Dodani MD, PhDOthers: Ali Ardalan, Eugene Shubnikov, Francios Sauer,Faina Linkov, Mita Lovelaker, Jesse Huang, Nicholas Padilla, Rania Saad, Ron LaPorteQuestions: Super1@pitt.eduHow to join the Supercourse: www.pitt.edu/~super1/
Learning Objectives To encourage students to be physically active To illustrate Exercise and its effect on disease prevention To provide examples of simple, moderate intensity physical activity To encourage regular physical activity in developing countries with focus on women To encourage physical fitness in people with disabilities To build an Olympic Physical activity and health supercourse
The Olympic Games This Year Beijing 2008Numbers · Population 14,000,000· Visitors 2-2.5,000,000· Athletes 18,000· Helpers 5,000· Referees 2,500· Volunteers 6,000· Journalists 15,000
What is Physical Activity Physical activity Bodily movement produced by skeletal muscles that results in an expenditure of energy Physical fitness A measure of a persons ability to perform physical activities that require endurance, strength, or flexibility. Regular physical activity A pattern of physical activity is regular if activities are performed in some order CDC,1997
“Physical activity is something you do. Physical fitness is something youacquire, a characteristic or an attribute one can achieve by being physicallyactive. And exercise is structured andtends to have fitness as its goal" Anonymous
Spectrum of Physical Activity and Health Physically Fit Physically Physically Active disabledLaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17
Differences between ExerciseExercise and Sport It’s a form of physical activity done primarily to improve one’s health and fitness.Sports Is complex, institutionalized, competitive and these very characteristics works against moderate and rhythmical exercise. CDC 1999
Common Reasons Not To Exercise I don’t have the time I don’t like to sweat I’ll look silly It hurts I don’t know what to do It’s not important
Do you know? 13.5 million people have coronary heart disease. 1.5 million people suffer from a heart attack in a given year. 250,000 people suffer from hip fractures each year. Over 60 million people (a third of the population) are overweight. 50 million people have high blood pressure. (WHO, 2003)
Do you Know that…….Adjusted RR for CVD Mortality by Fitness and % Body Fat
Do you Know that……. Adjusted RR for All-Cause Mortality by Fitness and % Body Fat 126.96.36.199.2 1 Fit0.8 Unfit0.60.40.2 0 lean Normal Obese <16% 16-24% >24%
Do you know that …… Childhood obesity has reached epidemic proportions in most part of the world Children are eating more and exercising less. Time spent watching television or using computers This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others
All of these can be Prevented by Regular Physical Activity !!!
How Physical Activity Impacts Health Helps control weight. Reduces feelings of depression and anxiety. Helps build and maintain healthy bones, muscles, and joints. Reduces the risk of developing colon cancer. Helps reduce blood pressure in people who already have high blood pressure. Causes the development of new blood vessels in the heart and other muscles. Enlarges the arteries that supply blood to the heart. WHO 2002
Health Risk of Physical InactivityLeading causes of disease and disabilityassociated with physical inactivityq Coronary Heart Disease (CHD)q Strokeq Obesityq Type II Diabetesq Hypertensionq Colorectal cancerq Stress and Anxietyq Osteo-arthritisq Osteoporosisq Low back pain
What Can Exercise do for You? Reduce the risk of the three leading causes of death: Heart Disease, stroke, and cancer Control or prevent development of Disease Enhance Mental Abilities Improve Sleeping Habits and Increase Energy Levels Lift Depression and Help Manage Stress Control Weight, improving self-image, appearance and health
Exercise & Cardiovascular DiseaseFACT Sedentary lifestyle is a risk factor for CVD, according to the American Heart AssociationExercise reduces Blood Pressure High blood pressure (above 140/90) is the main cause of Heart Attack and StrokeExercise prevents Atherosclerosis (clogged arteries) Exercise reduces cholesterol plaques that clog arteries and can lead to stroke and heart attack WHO 2002
Exercise and CancerThe Basics Exercise helps to prevent obesity, a major risk factor for several types of cancer Exercise enhances immune function Exercise activates antioxidant enzymes that protect cells from free radical damage WHO 2002
Exercise and DiabetesIncrease insulin sensitivityControl blood glucoseControl Weight/Lower body fatReduce risk of cardiovascular disease WHO 2002
Exercise and DepressionExercise can help prevent depression.In fact, recent studies have shown thatexercise was found to be just aseffective (despite a slower initialresponse) as antidepressantmedication for treatment of depression. Exercise reduces health problems , making you feel better Exercise helps you sleep better Exercise controls weight, enhancing self- esteem WHO 2002
Exercise and Your Mind Short-term benefits: Boost alertness (possiblyby triggering the release of epinephrine and nor epinephrine) Improve memory Improve intellectual function Spark creativity Long-term benefits: Exercise has been shown to slow and even reverse age-related decline in mental function and loss of short-term memory A report of Surgeon general, Physical Activity and health, 1996
Opportunities for Physical Activity At work For transport In domestic duties In leisure timeThe majority of people do very little or no physical activity in any of these domains
Getting Started….Setting Goals What will motivate you? Think about your reasons for exercising Are your goals important enough to keep you motivated long-term? Think short-term and long-term How will you benefit from your fitness plan day-to-day? In 1 year? In 5 years? In 10 years?
Before You Start... If you are over 40 or have health problems (heart disease, high blood pressure, diabetes, obesity, muscle or joint problems) see a physician before beginning exercise Be informed Learn as much as you can about exercise by reading and talking to other people Learn safety precautions before you do any exercise
Fitness Equipment / SafetyFitness Equipment / Safety Buy Appropriate SHOES Wear Comfortable Clothing TOO HOT! TOO COLD! Run and Walk with a FriendMore fun, safer, with a physical and mental support system Night Time: stay to the well lit areas Select activities that are fun ……….. To YOU!
Get Moving! Components of an exercise program Aerobic Activity Strength Training Flexibility Training Use an exercise log to help you plan and keep track of your exercise program WHO 2002
Aerobic ActivityDefinition Continuous movement that uses big muscle groups and is performed at an intensity that causes your heart, lungs, and vascular system to work harder than at rest Cardio respiratory Fitness is built through aerobic exercise Aerobic exercise conditions and strengthens our heart, respiratory system, muscles, and immune system CDC physical activity report 1999
Strength TrainingDefinition Muscle work against resistance that improves strength and endurance Strength allows us to move, and endurance allows us to perform work over time Muscles = 40% of our lean body massUse it or lose it: unused muscle disappears (atrophy)
Types of Strength TrainingFree Weights use of dumbbells and/or bars with weights on the ends involves balance and coordination; useful for enhancing function in daily activities and recreational sports Bonuses: convenient, cheap, and provides a wide variety of exercises that work several muscle groups togetherYour body, your weight The most convenient form of resistance exercise Pushups, pull-ups,. Lunges, squats….
Flexibility TrainingFlexibility = The ability to move a joint through its range of motion We lose flexibility with disuse and agingBenefits Decreased chance of muscular injury, soreness, and pain Helps prevent and reduce lower back pain Improves joint health (tight muscles stress our joints)Activities stretching, yoga, pilates, tai chi
How Much and How Hard?Frequency: 3-5 days per week Aerobic exercise: a minimum if 3 days a week are necessary to reach most exercise goals and minimize health benefits Strength training: a minimum of 2 days per week Flexibility training: a minimum of 3-5 days per week Duration Aerobic: 20-60 minutes of continuous aerobic activity Strength: 1-3 sets of 8-12 repetitions Stretching: Stretch all muscle groups and hold positions for 10-30 seconds
Timing Questions What time of day is best? Choose the most convenient time for your schedule Choose a regular time--the same time every day Timing may depend on the activity you choose Can I eat before exercise? Itis best not to eat a meal for 2 hours beforehand Be sure to drink plenty of water before and during exercise Should I exercise when I’m sick? No, especially if you have a fever
Exercise for people with special needs People with disabilities are less likely to engage in regular moderate physical activity than people without disabilities, yet they have similar needs to promote their health and prevent unnecessary disease Exercise is for everyone!!!!!!! Individuals who have physical disabilities or chronic, disabling conditions such as arthritis can improve muscle stamina and strength with regular physical activity
Exercise for people with special needs"You dont stop exercising because you grow old.You grow old because you stop exercising." Anonymous People with disabilities should first consult a physician before beginning a program of physical activity to which they are unaccustomed Provide community-based programs to meet the needs of persons with disabilities. Ensure that environments and facilities conducive to being physically active are available and accessible to people with disabilities, such as offering safe, accessible, and attractive trails for bicycling, walking, and wheelchair activities.
Exercise for Women in developing countriesThere has been several studies whichhave shown that less emphasis isgiven to exercise especially in women The reasons are several and mostimportant one is awareness. Women sports are not encouragedin most of developing countries There is stigma that women shouldnot be involved in outdoor sports
Exercise is for everyone There is need for awareness for physical fitness in developing countries Exercise is not only for men but for everyone With commitment, opportunities can be developed. Even shopping malls provide opportunities for fitness walking CDC 1997
Health Risks of Physical Activity Most musculo-skeletal injuries sustained during physical activity are likely to be preventable Injuries sustained during competitive sports have been shown to increase the risk of developing osteoarthritis Serious cardiac events can occur with physical exertion. The overall benefit of regular physical activity is lower all-cause mortality
Injury Prevention Caring for Injuries exercise regularly Rest: stop immediately gradually increase Ice: apply immediately intensity and repeat every few rest between sessions hours for 15-20 warm-up and cool minutes down Compress: wrap stay flexible injured area with elastic bandage don’t exercise when sick Elevation: raise injured area above heart don’t exercise when muscles are fatigued After 2 days, apply heat and straining if there is no swelling know proper form for Gradually ease back any activity you do into activity when pain is gone
Summary Physical inactivity is one of the top 10 leading causes of death and disability in the developed world Exercise improves our body and minds Even moderate exercise has many health benefits It is important to set fitness goals that are realistic and meaningful for you It takes time to make fitness part of a lifestyle, and we will all have ups and downs in following our exercise programs Exercise feels good!
“The first wealth is health." Ralph Waldo Emerson