Physical Activity & Health Review this power point and answer the questions on the last slide! Answers can be submitted to Mr. Sharpe’s hand-in folder. Suggestion: copy questions down first and then go through the power point attempting to answer as you go through it! 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

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 that leads to physical fitness 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.

“Physical activity is something you do “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

Differences between 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 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

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 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.

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. 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

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 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.

All of these can be Prevented by Regular Physical Activity !!! http://www.cdc.gov/nccdphp/dnpa/physical/starting/index.htm

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 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)

Health Risk of Physical Inactivity Leading causes of disease and disability associated with physical inactivity Coronary Heart Disease (CHD) Stroke Obesity Type II Diabetes Hypertension Colorectal cancer Stress and Anxiety Osteo-arthritis Osteoporosis Low back pain 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

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 The good news about regular physical activity is that everyone can benefit from it (USDHHS, 1996).

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 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.

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 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.

Exercise and Diabetes Increase insulin sensitivity Control blood glucose Control Weight/Lower body fat Reduce risk of cardiovascular disease WHO 2002 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

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 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.

Exercise and Your Mind Short-term benefits: Long-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 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 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 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

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? 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

Get Moving! Components of an exercise program Cardiovascular Activity Strength Training Endurance training Flexibility Training Use an exercise log to help you plan and keep track of your exercise program 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

Cardiovascular 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 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!

Types of Cardio Exercise Outdoor Activities Walking Jogging/running Bicycling Swimming Basketball Soccer Jumping Rope Indoor Activities Treadmill machine Stair climbing machine Stationary bike Elliptical trainer Rowing machine Aerobics, boxing... Hiking/skiing is also included in Outdoor activities

Strength Training Muscles = 40% of our lean body mass Definition Muscle work against resistance that improves strength and endurance Strength allows us to move with maximum force, 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) 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

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…. 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! Exhale with Exertion 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

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 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

How Much and How Hard? Frequency: 3-5 days per week Cardiovascular exercise: 3-5 days a week are necessary to reach most exercise goals and minimize health benefits Endurance and Strength training: a minimum of 2 to 4 days per week (alt days) Flexibility training: a minimum of 2-7 days per week part of warm-ups and cool-downs Duration Cardio: 20+ minutes of continuous aerobic activity Strength: 1-3 sets of 8-12 repetitions 30-90min Endurance: 1-3 sets of 15-20 reps 30-90 min Stretching: Stretch all muscle groups and hold positions for 10-30 seconds 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/

Timing Questions What time of day is best? Can I eat before exercise? 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 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.

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 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.

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 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.

Injury Prevention Caring for Injuries 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 Davis EK J Okla State Med Assoc. 2004 Jan;97(1):18-21

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!

Questions What is physical fitness and how is it achieved? Why do people exercise? What are some reasons that prevent people from exercising? What has led to childhood obesity? List 5 positive impacts of physical fitness. List 10 diseases associated with inactivity. List 10 ways exercise helps people. How can exercise benefit your mind? What are the physical components that should be part of training programs? How much and how hard must you go to improve the physical fitness components? When is the best time to exercise? What have you learnt from this assignment that you think is most beneficial? Answer Questions and hand in on paper or Mr.Sharpe’s hand-in folder