1) Physical inactivity has reached pandemic proportions and poses major health risks similar to smoking. 2) Inactivity is responsible for a significant percentage of worldwide deaths from diseases like heart disease and cancer. 3) Public health guidelines recommend at least 150 minutes of moderate physical activity per week, including strength exercises twice a week, but many adults do not meet these minimum recommendations. 4) Goals are outlined to improve physical activity levels in Scotland by increasing physical activity training for medical professionals, assessing activity levels in hospitals, and improving active infrastructure.

1. Be active against cancer!
Wednesday, 4th of February
2015 (World Cancer Day)
Everday actions
Professor Nanette Mutrie
Physical Activity for Health Research Centre
University of Edinburgh
4/02/2015

2. • Physical
inactivity has
reached
‘Pandemic’
proportions
• Inactivity is as
risky as smoking
• July 2012
4/02/2015

3. How does the risk of inactivity
compare with smoking?
0
1
2
3
4
5
6
7
8
9
10
PAF% deaths caused in millions
smoking
inactivity
Lee et al. , Lancet, July 2012
4/02/2015

4. Percentage of worldwide
burden of disease caused by
inactivity
0 1 2 3 4 5 6 7 8 9 10
CHD
Breast cancer
Type 2 Diabetes
Colon Cancer
Prem mortality
Percentage
Lee et al. , Lancet, July 20124/02/2015

5. 4/02/2015

6. Public health guidelines on
Physical Activity
CMOs 2011 ‘start active stay active’
150 mins of moderate activity/week
– or 75 mins vigorous intensity per week
– or combination
Strength exercise at least two days/week
Older adults all of above plus
– balance and co-ordination 2/days/week
Limit sedentary behaviour
4/02/2015

7. % adults achieving minimum
recommendations [SHeS 2013]
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey/Publications/Trendtables134/02/2015

8. Academy of Medical Royal
Colleges press release 29/1/15
‘Major NHS action needed to tackle
physical inactivity – say Scottish
medical leaders’
4/02/2015

9. Goals
By the end of 2016, every GP in Scotland should have the training
and mechanisms to give their patients advice and interventions for
physical inactivity, in the same manner as is currently delivered for
smoking and alcohol
By mid 2016, all hospital assessments will include questions about
physical activity levels and diet alongside questions about smoking
and alcohol
By the end of 2016, every person entering the care system will have
their physical activity levels assessed
By the end of 2015, all medical schools in Scotland will include
educational sessions on physical activity and health behaviour
change
By the end of 2015, all Scottish hospitals will have clearly defined
walking routes from the hospital to enable staff, patients and visitors
to exercise
4/02/2015

10. Business Employmen
t
Research
and
Innovation
Young
People
Early Years Healthier Inequalities
Tackled
Life
Chances
Safe from
Crime
Sustainable
Places
Resilient
Communitie
s
Environmen
t Valued
National
Identity
Impact on
Environmen
t
Older
People
Supported
Public
Services
We encourage and enable the
inactive to be more active
We encourage and enable the
active to stay active throughout
life
We develop physical
confidence and competence
from the earliest age
VISION – A MORE ACTIVE SCOTLAND
Physical activity is about getting people moving. Daily walking, playing in a park, going to a gym,
training with a team or aspiring to win a gold medal- it doesn’t really matter how people get active, it
just matters that we do.
Being physically active contributes to our personal, community and national wellbeing.
Our vision is of a Scotland where more people are more active more often.
We improve our active
infrastructure – people and
places
We support wellbeing and
resilience in communities
through physical activity and
sport
We improve opportunities to
progress and achieve in sport
4/02/2015

11. What is sedentary behaviour?
– Cluster of individual behaviours where sitting or lying
is the dominant mode of posture
– Energy expenditure is very low
– Screen-time (TV viewing, computer
use), motorised transport,
sitting to read, talk, or listen to music

12. Odds of Metabolic Syndrome in Women –
TV Viewing and Physical Activity
Physical activity time
(hrs/wk)
TV viewing
time
(hrs/wk)
*
*
*
* P < 0.05 vs ref.
Courtesy
Neville Owen
Dunstan et al.
(2005).
Diabetologia
48, 2254-2261.
4/02/2015

13. Sedentary behaviour
[SHS 2012]
0
1
2
3
4
5
6
7
8
16-24 25-34 35-44 45-54 55-64 65-74 75+
Hours
Age
Men Weekday
Women Weekday

14. Sedentary behaviour
[SHS 2012]
0
1
2
3
4
5
6
7
8
16-24 25-34 35-44 45-54 55-64 65-74 75+
Hours
Age
Men Weekend
Women Weekend

15. How adults and children typically allocate their time spent sedentary, in light-intensity
physical activity and moderate-to-vigorous intensity physical activity (based on population
data from the 2003–2006 NHANES survey).58.
Owen N et al. Br J Sports Med 2014;48:174-177
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.

16. Why is sitting bad for us?
• More time spent sedentary, less time
spent in light intensity activity
• Energy expenditure decreases
– Increased likelihood of overweight/obesity
– Increases the risk of diseases like cancer
4/02/2015

17. Why is sitting bad for us?
• Lack of muscle contraction during sitting
has been shown to supress activity of an
enzyme (lipoprotein lipase)
– reduces the ability of the body to remove
harmful fats from the bloodstream
– significantly decreases ‘good’ HDL cholesterol
Hamilton, Hamilton, Zderic
4/02/2015

18. Why is sitting bad for us
LPP1 expression
• LPP1 regulates blood clotting and controls inflammation
• Suppression of LPP1 gene expression by over 50 %
after 12 hours of sitting in humans
• Exercise was relatively ineffective at counteracting this
effect
Zderic T, Hamilton M: Lipids in Health and
Disease 2012, 11(1):137.
4/02/2015

19. Why is sitting bad for us
• Deep venous thrombosis
– Blood clots develop deep within the veins for
idle leg muscles
– Specific molecular responses within the legs
to inactivity which increases the risk of DVT
– Light, intermittent and frequent local muscle
contractions of the legs can prevent it
4/02/2015

20. Biwas et al (2015)
Annals of Internal Medicine
162, 126-132
4/02/2015

21. Cancer incidence predicted from self-
reported sedentary time and controlling for
physical activity
4/02/2015

22. Every day actions for you and your clients
Sit less
Walk more
4/02/2015

23. The ABC of Physical Activity for Health:
A consensus statement from the
British Association of Sport and Exercise Sciences
BASES Journal of Sport Sciences 2010
• A- all adults; B- beginners; C-conditioned
• Beginners
– Something is better than nothing
– Set achievable goals
– Find enjoyment
– Seek support
4/02/2015

24. Stand up and discuss with
neighbour
•When and how could you
find ways to sit less at work
or at home?
4/02/2015

25. Sit less at work and at home
• Stand up and stretch
at least once an hour
• Stand to answer
phone
• Walk and talk
meetings
• Short activity breaks
• Communal printer
• Standing desks
• Re-learn how to use
the buttons on the TV!
4/02/2015

26. Take mini activity breaks
4/02/2015

27. Take mini activity breaks
4/02/2015

28. For almost everyone the best place
to start is to increase walking
1) Walking is the easiest mode of activity
for inactive people :
 to get started with
 to sustain
1) Confers all the major benefits of
activity
4/02/2015

29. Stand up and discuss with
neighbour
• When and how could you
find ways to walk more at
work or at home?
4/02/2015

30. Walk more
• Take public transport
• Park 10 min walk
away
• Lunch time walks
• Use a pedometer
• Walk and talk
meetings
• Take the stairs
• Take part in step
count challenges
• Walk the dog further
4/02/2015

32. Find out more:
www.pathsforall.org.uk
Find a Health Walk near you:
www.pathsforall.org.uk/findahealthwalk
4/02/2015

33. Community Pedometer Pack
4/02/2015

34. Paths for All
Strength & Balance Programme
10 simple exercises that will improve strength and balance and reduce the risk
of falls in older adults
4/02/2015

35. Dr Mike Evans 23 ½ hours
https://www.youtube.com/watch?
v=aUaInS6HIGo
4/02/2015