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Be Active - Why and How | Professor Nanette Mutrie

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Professor Nanette Mutrie's keynote speech "Be Active - Why and How' at the SCPN's 'Be Active Against Cancer' conference, Tuesday 4th February 2014.

Published in: Government & Nonprofit
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Be Active - Why and How | Professor Nanette Mutrie

  1. 1. Be active against cancer! Tuesday, 4th of February 2014 (World Cancer Day) Be Active – Why and How? Professor Nanette Mutrie Physical Activity for Health Research Centre University of Edinburgh
  2. 2. • Physical inactivity has reached ‘Pandemic’ proportions • Interventions are needed! • July 2012
  3. 3. "Everything that gets worse when you grow older gets better when you exercise."
  4. 4. Regular physical activity reduces risk of: • All-cause mortality • Coronary heart disease • High blood pressure • Stroke • Falling • Metabolic syndrome • Type 2 diabetes • Breast cancer • Colon cancer • Depression Lee et al. , Lancet, July 2012
  5. 5. Strong evidence of the following benefits for adults: – Increased cardiorespiratory and muscular fitness – Healthier body mass and composition – Improved bone health – Increased functional health – Improved cognitive function Lee et al. , Lancet, July 2012
  6. 6. 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 smoking Lee et al. , Lancet, July 2012
  7. 7. 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
  8. 8. 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 2012
  9. 9. 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
  10. 10. Percentage adults achieving Scottish strategy1 recommendations [SHeS,2012] 39 37 39 39 38 0 10 20 30 40 50 strategy recommendations [5x30] 2008 2009 2010 2011 2012 1. Let’s make Scotland more active. 2003
  11. 11. Percentage adults achieving Scottish strategy recommendations and ‘new’ recommendations [SHeS,2012] 0 10 20 30 40 50 60 70 strategy recommendations [5x30] new recommendations [150 mins] 2008 2009 2010 2011 2012
  12. 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.
  13. 13. Independent of level of moderate to vigourous activity, greater sitting time was associated with increased endometrial cancer risk
  14. 14. Physical Activity and Cancer Preventability estimates (PAF%) (UK) (WCRF, 2013) Site PAF% accounted for by low physical activity Breast 12 Colorectum 12 Endometrium 10 http://www.wcrf.org/cancer_statistics/preventability_estimates/preventability_estimates_food.ph Low physical activity will also influence obesity and increased risk for the following cancer sites Oesphagus Breast Pancreas Colorectum Gallbladder Endometrium Kidney
  15. 15. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention 2012 Physical activity may reduce the risk of several types of cancer, including cancers of the breast, colon, and endo- metrium, as well as advanced prostate cancer, and possibly, pancreatic cancer.
  16. 16. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention 2012 • Physical activity may help to prevent certain cancers via: • regulating sex hormones • insulin • prostaglandins • various beneficial effects on the immune system.
  17. 17. Be Active – Why and How? The HOW part
  18. 18. 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
  19. 19. 7 Investments that work for physical activity 1. ‘Whole-of-school’ programs 2. Transport policies and systems that prioritise walking, cycling and public transport 3. Urban design regulations and infrastructure that provides for equitable and safe access for recreational physical activity, and recreational and transport- related walking and cycling across the life course 4. Physical activity and NCD prevention integrated into primary health care systems 5. Public education, including mass media to raise awareness and change social norms on physical activity 6. Community-wide programs involving multiple settings and sectors & that mobilize and integrate community engagement and resources 7. Sports systems and programs that promote ‘sport for all’ and encourage participation across the life span
  20. 20. 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
  21. 21. Why Walking for Health? Social Least affected by SIMD Low to no expenseTRANSFORMATIVE Habit/ routine Non age dependent 1st pathway for the least active/sedentary WHY?
  22. 22. Walking + pedometers? • Pedometers have been identified as the single most effective method of physical activity promotion (Heath et al., 2012).
  23. 23. Understanding behaviour change techniques [BCTs] in relation to walking and cycling • From studies with sig. intervention effects (n=21) the most frequently coded BCTs were: – “Prompt self-monitoring of behavior” – “Prompt intention formation” • In terms of walking – the pedometer offers a perfect tool • Bird EL, Baker G, Mutrie N, Ogilvie D, Sahlqvist S, Powell J. Behavior Change Techniques Used to Promote Walking and Cycling: A Systematic Review. Health Psychol. 2013 Mar 11. PubMed PMID: 23477577.
  24. 24. Pedometers make use of several behaviour change techniques: goal-setting (individuals can set daily step goals) self-monitoring (check out daily steps) self-efficacy (improve confidence in walking ability) problem-solving (adapt walking behaviour to suit weather and setting) motivation (provide instant feedback to individuals on goals) social support (a visual prompt for friends and family)
  25. 25. • Week 1 and 2: – an additional 1,500 steps at least 3 days/week • Week 3 and 4: – increase to 5 days/week • Week 5 and 6: – an additional 3,000 steps on at least 3 days/week • Week 7: – increase to 5 days/week • Week 8-12: – maintain week 7 WWW Walking Goals
  26. 26. 12-week Results step-counts 0 2000 4000 6000 8000 10000 Baseline Week 12 Time-point Mean daily step-counts Intervention Control Steps/day • 65% of intervention group achieved an increase of 15,000 steps/week 154 steps/day *3,175 steps/day • * indicates significant difference between baseline and week 12 at p < .001
  27. 27. Step counts 0 2000 4000 6000 8000 10000 12000 baseline 12 weeks 24 weeks 48 weeks Time point Steps MAX MIN
  28. 28. Cost effectiveness • Shaw, et al. (2011). 'Pedometers cost buttons': Bmc Public Health, 11(1), 200. • Under £100/person to achieve recommended levels of PA
  29. 29. Find out more: www.pathsforall.org.uk Find a Health Walk near you: www.pathsforall.org.uk/findahealthwalk
  30. 30. Community Pedometer Pack
  31. 31. Paths for All Strength & Balance Programme 10 simple exercises that will improve strength and balance and reduce the risk of falls in older adults

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