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Physical Activtiy and Heath
1. Physical Activity & Health
This lecture has been dedicated to
Olympics games in Beijing, China
Aug 08-24, 2008
By Supercourse Team
2. Physical Activity & Health
Lecture Developers (Supercourse Team)
Soni Dodani MD, PhD
Others: Ali Ardalan, Eugene Shubnikov, Francios
Sauer,Faina Linkov, Mita Lovelaker, Jesse Huang,
Nicholas Padilla, Rania Saad, Ron LaPorte
Questions: Super1@pitt.edu
How to join the Supercourse: www.pitt.edu/~super1/
3. 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
4. The Olympic Games This Year
Beijing 2008
Numbers
· 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
5. 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 person's 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
6. “Physical activity is something you do.
Physical fitness is something you
acquire, a characteristic or an attribute
one can achieve by being physically
active. And exercise is structured and
tends to have fitness as its goal"
Anonymous
7. Spectrum of Physical Activity
and Health
Physically Fit
Physically
Physically Active
disabled
LaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17
8. Differences between Exercise
Exercise 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
9. 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
11. 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)
12. Do you Know that…….
Adjusted RR for CVD Mortality by Fitness and % Body Fat
13. Do you Know that…….
Adjusted RR for All-Cause Mortality
by Fitness and % Body Fat
2
1.8
1.6
1.4
1.2
1 Fit
0.8
Unfit
0.6
0.4
0.2
0
lean Normal Obese
<16% 16-24% >24%
14. 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
15. All of these can be Prevented by
Regular Physical Activity !!!
16. 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
17. Health Risk of Physical Inactivity
Leading causes of disease and disability
associated with physical inactivity
q Coronary Heart Disease (CHD)
q Stroke
q Obesity
q Type II Diabetes
q Hypertension
q Colorectal cancer
q Stress and Anxiety
q Osteo-arthritis
q Osteoporosis
q Low back pain
18. 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
19. Exercise & Cardiovascular Disease
FACT
Sedentary lifestyle is a risk factor for
CVD, according to the American Heart
Association
Exercise reduces Blood Pressure
High blood pressure (above 140/90)
is the main cause of Heart Attack and
Stroke
Exercise prevents Atherosclerosis
(clogged arteries)
Exercise reduces cholesterol plaques
that clog arteries and can lead to
stroke and heart attack WHO 2002
20. Exercise and Cancer
The 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
21. Exercise and Diabetes
Increase insulin sensitivity
Control blood glucose
Control Weight/Lower body fat
Reduce risk of cardiovascular disease
WHO 2002
22. Exercise and Depression
Exercise can help prevent depression.
In fact, recent studies have shown that
exercise was found to be just as
effective (despite a slower initial
response) as antidepressant
medication 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
23. 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
24. Opportunities for Physical
Activity
At work
For transport
In domestic duties
In leisure time
The majority of people do very little or
no physical activity in any of these
domains
25. 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?
26. 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
27. Fitness Equipment / Safety
Fitness Equipment / Safety
Buy Appropriate SHOES
Wear Comfortable Clothing
TOO HOT! TOO COLD!
Run and Walk with a Friend
More fun, safer, with a physical and
mental support system
Night Time: stay to the well lit areas
Select activities that are fun ………..
To YOU!
28. 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
29. Aerobic Activity
Definition
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
31. Strength Training
Definition
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 mass
Use it or lose it: unused muscle disappears
(atrophy)
32. Types of Strength Training
Free 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 together
Your body, your weight
The most convenient form of resistance
exercise
Pushups, pull-ups,. Lunges, squats….
33. Flexibility Training
Flexibility = The ability to move a joint
through its range of motion
We lose flexibility with disuse and aging
Benefits
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
34. 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
35. 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
36. 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
37. Exercise for people with special needs
"You don't 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.
38. Exercise for Women in developing
countries
There has been several studies which
have shown that less emphasis is
given to exercise especially in women
The reasons are several and most
important one is awareness.
Women sports are not encouraged
in most of developing countries
There is stigma that women should
not be involved in outdoor sports
39. 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
40. 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
41. 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
42. 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!
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