Physical Activity & Health This lecture has been dedicated to Olympics games in Athens, Greece Aug 13-29, 2004 By Supercourse Team 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 Athens 2004 Numbers · · · · · · · Population 4,000,000 Visitors 2-2.5,000,000 Athletes 18,000 Helpers 5,000 Referees 2,500 Volunteers 6,000 Journalists 15,000 Place – city of Athens + 4 other sites 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 “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 Spectrum of Physical Activity and Health Physically Fit Physically disabled Physically Active LaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17 Differences between Exercise and Sport Exercise 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  Why Exercise ??? 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 7 6 5 4 Fit Unfit 3 2 1 0 Lean Normal Obese 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 0.8 0.6 0.4 0.2 0 Fit Unfit lean <16% Normal 16-24% Obese >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 Inactivity Leading causes of disease and disability associated with physical inactivity Coronary Heart Disease (CHD) 2. Stroke 3. Obesity 4. Type II Diabetes 5. Hypertension 6. Colorectal cancer 7. Stress and Anxiety 8. Osteo-arthritis 9. Osteoporosis 10.Low back pain 1. 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 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 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 Exercise and Diabetes Increase insulin sensitivity Control blood glucose Control Weight/Lower body fat Reduce risk of cardiovascular disease WHO 2002 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 selfesteem WHO 2002 Exercise and Your Mind  Short-term benefits:  Boost alertness (possibly by 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 time  The 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 / 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!  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 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 Types of Aerobic Exercise Outdoor Activities  Walking  Treadmill  Jogging/running  Bicycling  Swimming  Basketball  Soccer  Jumping Indoor Activities Rope machine  Stair climbing machine  Stationary bike  Elliptical trainer  Rowing machine  Aerobics, boxing... 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) 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…. 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 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?  It is 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 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.  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 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 exercise regularly  gradually increase intensity  rest between sessions  warm-up and cool down  stay flexible  don’t exercise when sick  don’t exercise when muscles are fatigued and straining  know proper form for any activity you do   Caring for Injuries       Rest: stop immediately Ice: apply immediately and repeat every few hours for 15-20 minutes Compress: wrap injured area with elastic bandage Elevation: raise injured area above heart After 2 days, apply heat if there is no swelling Gradually ease back 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